WorldWideScience

Sample records for evaluating complementary therapies

  1. Evaluating complementary and alternative therapies for cancer patients.

    Science.gov (United States)

    Cassileth, B R

    1999-01-01

    "Complementary and alternative" therapies are actually a vast collection of disparate, unrelated regimens and products, ranging from adjunctive modalities that effectively enhance quality of life and promising antitumor herbal remedies now under investigation, to bogus therapies that claim to cure cancer and that harm not only directly, but also indirectly by encouraging patients to avoid or postpone effective cancer care. Complementary therapies such as music and massage, herbal teas to aid digestion and relieve nausea, yoga, tai chi, meditation, and the many other well-documented techniques that relieve stress and enhance well-being should be made available to patients to augment and ease the experience of cancer treatment and recovery. Many time-tested herbal and diet-based remedies are now being studied for their abilities to induce or extend remission without toxicity. At the same time, lack of government regulatory authority leaves consumers at the mercy of those who promote unproved remedies, scores of which the grocery store and pharmacy shelves. Many of these over-the-counter products contain harmful ingredients. Herb-drug interactions, only some of which are documented, occur with frequency and are sufficiently problematic to require that patients stop taking herbal remedies prior to surgery (to prevent interactions with anesthetics and anticoagulant effects); before radiation (due to potential for increased photosensitivity); and during courses of chemotherapy (to prevent product-drug interactions). Moreover, both good information and misinformation that appear in printed materials and on the Internet appeal to better educated consumers, who are, in fact, the most likely to try complementary and alternative methods.

  2. Complementary and alternative medical therapies.

    Science.gov (United States)

    Schachter, Steven C

    2008-04-01

    Complementary and alternative medical therapies include herbs, acupuncture, and mind-body therapies. This review highlights the findings of recently published studies of complementary and alternative medical therapies and epilepsy, and provides an update of the US Food and Drug Administration's role in regulating herbal products. Complementary and alternative medical therapies are often tried by patients with epilepsy, frequently without physician knowledge. Many modalities have been evaluated in patients with epilepsy, though methodological issues preclude any firm conclusions of efficacy or safety. Some herbal medicines have been shown experimentally to have mechanisms of action relevant to epilepsy and promising actions in animal models. There is currently a paucity of credible evidence to support the use of complementary and alternative medical therapies in patients with epilepsy. Herbal medicines traditionally used for epilepsy and compounds isolated from them, as well as other herbal medicines and their constituent compounds that have been shown experimentally to have mechanisms of action relevant to epilepsy, should undergo further preclinical evaluation with a view towards clinical development under the new US Food and Drug Administration guidelines. Additional studies of other, nonherbal complementary and alternative medical therapies are also warranted based on anecdotal observations or pilot studies that suggest a favorable risk-benefit ratio.

  3. Pain and Complementary Therapies.

    Science.gov (United States)

    Hamlin, Amy S; Robertson, T Michelle

    2017-12-01

    Treatment of both acute and chronic pain typically involves a combination of pharmacologic and provider-based interventions, which is effective for some patients but not for others. Use of pain medications, especially repeated and frequent usage, involves the risk of adverse reactions, overuse, and dependency. Complementary and alternative therapies (CAT) offer an alternative or adjunctive method to decrease the pain experience and enhance function and quality of life. Various evidence-based CAT methods have been proved to be effective in the management of both acute and chronic pain. Nurses are well placed to implement various CAT modalities. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Culture and complementary therapies.

    Science.gov (United States)

    Engebretson, Joan

    2002-11-01

    Complementary therapies are becoming increasingly popular in cultures dominated by biomedicine. Modalities are often extracted from various healing systems and cultural contexts and integrated into health care, expanding the focus from treatment of disease to the promotion of health. The cultural aspects of biomedicine are presented and compared and contrasted with other healing systems. Three healing systems; traditional Chinese medicine, Yoga, with roots in Ayurvedic medicine and Shamanic healing illustrate these fundamental differences in approaches to healing. A reverse example of isolating one healing intervention from biomedicine and interpreting it through other cultural lenses is presented. Implications are drawn for practice and research.

  5. Complementary and Alternative Therapies for Chronic Constipation

    Directory of Open Access Journals (Sweden)

    Xinjun Wang

    2015-01-01

    Full Text Available Chronic constipation, an ancient disease, is prevalent, and costly in the general population. Complementary and alternative therapies are frequently used for constipation. This review introduces various methods of complementary and alternative therapies, including acupuncture, moxibustion, massage, and herbal medicine. Efficacy, safety, influence factors, sham control design, and mechanisms of these therapies are discussed and evaluated. Acupuncture or electroacupuncture was found to be most commonly used for constipation among these complementary and alternative therapies, followed by herbal medicine. Although only a small number of clinical studies are flawless, our review of the literature seems to suggest that acupuncture or electroacupuncture and herbal medicine are effective in treating constipation, whereas findings on massage and moxibustion are inconclusive. More well-designed clinical trials are needed to improve and prove the efficacy of the complementary and alternative therapies for constipation; mechanistic studies that would lead to wide spread use and improvement of the methods are also discussed in this review.

  6. Developing and evaluating complementary therapy services: Part 1. Establishing service provision through the use of evidence and consensus development.

    Science.gov (United States)

    Richardson, J

    2001-06-01

    The integration of complementary therapies within the British National Health Service (NHS) in the context of limited evidence of effectiveness has been much debated, as has the need for the provision of health services to be more evidence-based. In June 1994, a project was launched within a South-East London NHS Hospital Trust to introduce complementary therapy (acupuncture, homeopathy, and osteopathy), in the context of an evaluation program. This followed approximately 4 years of working toward raising the profile of complementary therapies within the hospital through study days, workshops, and providing a massage and osteopathic service for staff. A survey of local general practitioners highlighted areas of complementary therapy provision and interest in referring patients to a hospital-based service. A steering group was established to draw together a proposal for funding the service. Evidence for the effectiveness of acupuncture, homeopathy, and osteopathy was presented at a multidisciplinary seminar. A consensus development process, using a modified Delphi technique to establish referral indicators followed this. This study provides a useful model of service development in the absence of good quality evidence for the effectiveness of clinical interventions.

  7. Complementary and Integrative Therapies

    Science.gov (United States)

    ... imagery • Meditation and prayer • Qi gong • Reflexology • Reiki • Yoga Whole medical systems use many types of therapies. Examples include: Ayurveda, homeopathic medicine and traditional Chinese medicine. Safety of ...

  8. Complementary therapies for acne vulgaris.

    Science.gov (United States)

    Cao, Huijuan; Yang, Guoyan; Wang, Yuyi; Liu, Jian Ping; Smith, Caroline A; Luo, Hui; Liu, Yueming

    2015-01-19

    Acne is a chronic skin disease characterised by inflamed spots and blackheads on the face, neck, back, and chest. Cysts and scarring can also occur, especially in more severe disease. People with acne often turn to complementary and alternative medicine (CAM), such as herbal medicine, acupuncture, and dietary modifications, because of their concerns about the adverse effects of conventional medicines. However, evidence for CAM therapies has not been systematically assessed. To assess the effects and safety of any complementary therapies in people with acne vulgaris. We searched the following databases from inception up to 22 January 2014: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL; 2014,Issue 1), MEDLINE (from 1946), Embase (from 1974), PsycINFO (from 1806), AMED (from 1985), CINAHL (from 1981), Scopus (from 1966), and a number of other databases listed in the Methods section of the review. The Cochrane CAM Field Specialised Register was searched up to May 2014. We also searched five trials registers and checked the reference lists of articles for further references to relevant trials. We included parallel-group randomised controlled trials (or the first phase data of randomised cross-over trials) of any kind of CAM, compared with no treatment, placebo, or other active therapies, in people with a diagnosis of acne vulgaris. Three authors collected data from each included trial and evaluated the methodological quality independently. They resolved disagreements by discussion and, as needed, arbitration by another author. We included 35 studies, with a total of 3227 participants. We evaluated the majority as having unclear risk of selection, attrition, reporting, detection, and other biases. Because of the clinical heterogeneity between trials and the incomplete data reporting, we could only include four trials in two meta-analyses, with two trials in each meta-analysis. The categories of CAM included

  9. Complementary therapies for acne vulgaris

    Science.gov (United States)

    Cao, Huijuan; Yang, Guoyan; Wang, Yuyi; Liu, Jian Ping; Smith, Caroline A; Luo, Hui; Liu, Yueming

    2015-01-01

    Background Acne is a chronic skin disease characterised by inflamed spots and blackheads on the face, neck, back, and chest. Cysts and scarring can also occur, especially in more severe disease. People with acne often turn to complementary and alternative medicine (CAM), such as herbal medicine, acupuncture, and dietary modifications, because of their concerns about the adverse effects of conventional medicines. However, evidence for CAM therapies has not been systematically assessed. Objectives To assess the effects and safety of any complementary therapies in people with acne vulgaris. Search methods We searched the following databases from inception up to 22 January 2014: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 1), MEDLINE (from 1946), Embase (from 1974), PsycINFO (from 1806), AMED (from 1985), CINAHL (from 1981), Scopus (from 1966), and a number of other databases listed in the Methods section of the review. The Cochrane CAM Field Specialised Register was searched up to May 2014. We also searched five trials registers and checked the reference lists of articles for further references to relevant trials. Selection criteria We included parallel-group randomised controlled trials (or the first phase data of randomised cross-over trials) of any kind of CAM, compared with no treatment, placebo, or other active therapies, in people with a diagnosis of acne vulgaris. Data collection and analysis Three authors collected data from each included trial and evaluated the methodological quality independently. They resolved disagreements by discussion and, as needed, arbitration by another author. Main results We included 35 studies, with a total of 3227 participants. We evaluated the majority as having unclear risk of selection, attrition, reporting, detection, and other biases. Because of the clinical heterogeneity between trials and the incomplete data reporting, we could only include four

  10. The impact of NHS based primary care complementary therapy services on health outcomes and NHS costs: a review of service audits and evaluations

    Directory of Open Access Journals (Sweden)

    Wye Lesley

    2009-03-01

    Full Text Available Abstract Background The aim of this study was to review evaluations and audits of primary care complementary therapy services to determine the impact of these services on improving health outcomes and reducing NHS costs. Our intention is to help service users, service providers, clinicians and NHS commissioners make informed decisions about the potential of NHS based complementary therapy services. Methods We searched for published and unpublished studies of NHS based primary care complementary therapy services located in England and Wales from November 2003 to April 2008. We identified the type of information included in each document and extracted comparable data on health outcomes and NHS costs (e.g. prescriptions and GP consultations. Results Twenty-one documents for 14 services met our inclusion criteria. Overall, the quality of the studies was poor, so few conclusions can be made. One controlled and eleven uncontrolled studies using SF36 or MYMOP indicated that primary care complementary therapy services had moderate to strong impact on health status scores. Data on the impact of primary care complementary therapy services on NHS costs were scarcer and inconclusive. One controlled study of a medical osteopathy service found that service users did not decrease their use of NHS resources. Conclusion To improve the quality of evaluations, we urge those evaluating complementary therapy services to use standardised health outcome tools, calculate confidence intervals and collect NHS cost data from GP medical records. Further discussion is needed on ways to standardise the collection and reporting of NHS cost data in primary care complementary therapy services evaluations.

  11. Complementary and Alternative Therapies for Down Syndrome

    Science.gov (United States)

    Roizen, Nancy J.

    2005-01-01

    In their role as committed advocates, parents of children with Down syndrome have always sought alternative therapies, mainly to enhance cognitive function but also to improve their appearance. Nutritional supplements have been the most frequent type of complementary and alternative therapy used. Cell therapy, plastic surgery, hormonal therapy,…

  12. Evaluating Complementary Therapies for Canine Osteoarthritis—Part II: A Homeopathic Combination Preparation (Zeel®

    Directory of Open Access Journals (Sweden)

    Anna Hielm-Björkman

    2009-01-01

    Full Text Available A homeopathic combination preparation (HCP for canine osteoarthritic pain was evaluated in a randomized, double-controlled and double-blinded clinical trial. Forty-four dogs with osteoarthritis (OA that were randomly allocated into one of three groups completed the study. All dogs were fed test products or placebo for 8 weeks. The dogs were evaluated at the clinic four times, with 4-week intervals. Six different variables were assessed: veterinary-assessed mobility, two force plate variables, an owner-evaluated chronic pain index and pain and locomotion visual analogue scales (VASs. Intake of extra non-steroidal anti-inflammatory drugs was also evaluated. A Chi-squared test and a Mann–Whitney test were used to determine significant improvement between groups. When changed into dichotomous responses of ‘improved’ or ‘not improved’ three out of the six variables showed a significant difference (P = 0.016, P = 0.008, P = 0.039 in improved dogs per group, between the HCP group and the placebo group. The odds ratios were over one for the same variables. As extent of improvement in the variables from start to end of treatment, the HCP product was significantly more improved in four (P = 0.015, P = 0.028, P = 0.049, P = 0.020 of the six variables, compared with the placebo. Our results indicated that the HCP Zeel® was beneficial in alleviating chronic orthopedic pain in dogs although it was not as effective as carprofen.

  13. Qualitative content analysis of complementary topical therapies ...

    African Journals Online (AJOL)

    In order to alleviate diabetic foot problems, patients sometimes seek complementary therapies outside the professional context. This paper describes the use of complementary remedies as a topical treatment for diabetic foot ulcers among Jordanians. Qualitative content analysis was used to analyse written responses of 68 ...

  14. Complementary therapies for cancer-related symptoms.

    Science.gov (United States)

    Deng, Gary; Cassileth, Barrie R; Yeung, K Simon

    2004-01-01

    Relief of cancer-related symptoms is essential in the supportive and palliative care of cancer patients. Complementary therapies such as acupuncture, mind-body techniques, and massage therapy can help when conventional treatment does not bring satisfactory relief or causes undesirable side effects. Controlled clinical trials show that acupuncture and hypnotherapy can reduce pain and nausea. Meditation, relaxation therapy, music therapy, and massage mitigate anxiety and distress. Pilot studies suggest that complementary therapies may treat xerostomia, hot flashes, and fatigue. Botanicals or dietary supplements are popular but often problematic. Concurrent use of herbal products with mainstream medical treatment should be discouraged.

  15. Comparative Evaluation of the Complementary and Alternative Medicine Therapy and Conventional Therapy Use for Musculoskeletal Disorders Management and Its Association with Job Satisfaction among Dentists of West India

    Directory of Open Access Journals (Sweden)

    Devanand Gupta

    2014-10-01

    Full Text Available Musculoskeletal problems have become a significant issue in the profession of dentistry. There are currently no recommended effective disease-preventing and modifying remedies. High prevalence rates for musculoskeletal disorders (MSDs among dentists have been reported in the literature. Complementary and alternative medicine can be helpful in managing and preventing the MSDs. The purpose of this study was to determine if dentists in the western part of India are using complementary and alternative medicine therapies for MSDs, and also to find if those who use complementary and alternative medicine therapies have greater job/career satisfaction compared to conventional therapy (CT users. Dentists of western India registered under the Dental Council of India (N=2166 were recruited for the study. Data were analyzed using univariate and bivariate analyses and logistic regression. A response rate of 73% (n=1581 was obtained, of which 79% (n=1249 was suffering from MSDs. The use of complementary and alternative medicine or CT was reported by 90% (n=1124 of dentists with MSDs. Dentists using complementary and alternative medicine reported greater health (P<0.001 and carrier satisfaction (P<0.001 and were able to work as many hours they wanted (P<0.001 compared to CT users. Complementary and alternative medicine therapies may improve the quality of life and enhance job satisfaction for a dentist who suffers from MSDs.

  16. Comparative Evaluation of the Complementary and Alternative Medicine Therapy and Conventional Therapy Use for Musculoskeletal Disorders Management and Its Association with Job Satisfaction among Dentists of West India.

    Science.gov (United States)

    Gupta, Devanand; Batra, Renu; Mahajan, Shveta; Bhaskar, Dara John; Jain, Ankita; Shiju, Mohammed; Yadav, Ankit; Chaturvedi, Mudita; Gill, Shruti; Verma, Renuka; Dalai, Deepak Ranjan; Gupta, Rajendra Kumar

    2014-10-01

    Musculoskeletal problems have become a significant issue in the profession of dentistry. There are currently no recommended effective disease-preventing and modifying remedies. High prevalence rates for musculoskeletal disorders (MSDs) among dentists have been reported in the literature. Complementary and alternative medicine can be helpful in managing and preventing the MSDs. The purpose of this study was to determine if dentists in the western part of India are using complementary and alternative medicine therapies for MSDs, and also to find if those who use complementary and alternative medicine therapies have greater job/career satisfaction compared to conventional therapy (CT) users. Dentists of western India registered under the Dental Council of India (N = 2166) were recruited for the study. Data were analyzed using univariate and bivariate analyses and logistic regression. A response rate of 73% (n = 1581) was obtained, of which 79% (n = 1249) was suffering from MSDs. The use of complementary and alternative medicine or CT was reported by 90% (n = 1124) of dentists with MSDs. Dentists using complementary and alternative medicine reported greater health (P alternative medicine therapies may improve the quality of life and enhance job satisfaction for a dentist who suffers from MSDs.

  17. Complementary and Alternative Therapies in ALS

    Science.gov (United States)

    Bedlack, Richard S.; Joyce, Nanette; Carter, Gregory T.; Pagononi, Sabrina; Karam, Chafic

    2015-01-01

    Synopsis Given the severity of their illness and lack of effective disease modifying agents, it is not surprising that most patients with ALS consider trying complementary and alternative therapies. Some of the most commonly considered alternative therapies include special diets, nutritional supplements, cannabis, acupuncture, chelation and energy healing. This chapter reviews these in detail. We also describe 3 models by which physicians may frame discussions about alternative therapies: paternalism, autonomy and shared decision making. Finally, we review a program called ALSUntangled which using shared shared decision making to review alternative therapies for ALS. PMID:26515629

  18. Complementary therapy use in HIV/AIDS.

    Science.gov (United States)

    Mulkins, Andrea; Morse, Janice M; Best, Allan

    2002-01-01

    To examine the social psychological aspects of complementary therapy use in HIV/AIDS health care and to identify what happens in a person's illness management process when incorporated into their care for HIV-related symptoms. Grounded theory research method guided sampling, data collection and analysis with 21 males at various AIDS service organizations. A grounded theory model Finding a Way to Live was developed. Participants experienced a six-stage process whereby the HIV served as a precondition for a profound self-transformation; a commitment to and rediscovery of the meaning of life. Complementary therapies, referred to as 'tools' by the participants, were cited as an integral part of how people living with HIV found wellness within their illness. The type of therapy, meanings attached to them, intention for and frequency of use corresponded to where individuals were in the six-stage process. As participants began to experience personal growth, the nature of the therapies shifted from those being highly tangible and focusing on the physical self to those facilitating inner awareness, such as meditation. The process of integration was a complex, ongoing process wherein complementary therapies were an integral part of facilitating learning, self-discovery and ultimately, healing.

  19. Animal-assisted therapy: evaluation and implementation of a complementary therapy to improve the psychological and physiological health of critically ill patients.

    Science.gov (United States)

    DeCourcey, Mary; Russell, Anne C; Keister, Kathy J

    2010-01-01

    Animal-assisted therapy has gained widespread support in a variety of health care settings, including critical care units. This article seeks to review some of the current animal-assisted therapy, define a structured program, and evaluate the potential ability of the therapy to enhance the progress and health of our patients.

  20. Woman to woman. Complementary therapy use in menopause.

    Science.gov (United States)

    Will, Constance I; Fowles, Willa

    2003-12-01

    Many women are turning to herbal, homeopathic, dietary, and other complementary therapies for relief of stressful aspects of menopause. Several questions related to complementary therapy use are not, however, well addressed in current research literature. Why do women seek out complementary therapies? Which therapies do they choose and why? What is the nature of their experiences using complementary therapies? In this qualitative study, 19 Caucasian women, who identified themselves as using or having used complementary therapies during menopause were interviewed in one of four focus groups. Findings revealed a wide variety of therapies, such as vitamin, mineral, and herbal preparations and lifestyle and behavioral initiatives, used to address distressing aspects of menopause. Also identified was lack of family and professional support for women who are seeking complements or alternatives to conventional treatment.

  1. Complementary and Alternative Therapies for Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Natascia Brondino

    2015-01-01

    Full Text Available Background. Complementary and alternative medicine (CAM represents a popular therapeutic option for patients with autism spectrum disorder (ASD. Unfortunately, there is a paucity of data regarding the efficacy of CAM in ASD. The aim of the present systematic review is to investigate trials of CAM in ASD. Material and Methods. We searched the following databases: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, CINAHL, Psychology and Behavioral Sciences Collection, Agricola, and Food Science Source. Results. Our literature search identified 2687 clinical publications. After the title/abstract screening, 139 publications were obtained for detailed evaluation. After detailed evaluation 67 studies were included, from hand search of references we retrieved 13 additional studies for a total of 80. Conclusion. There is no conclusive evidence supporting the efficacy of CAM therapies in ASD. Promising results are reported for music therapy, sensory integration therapy, acupuncture, and massage.

  2. How to implement complementary therapies for laboring women.

    Science.gov (United States)

    Zwelling, Elaine; Johnson, Kitti; Allen, Jonell

    2006-01-01

    Complementary therapies have been a part of nursing practice for centuries and are supported today as a part of nursing practice by many state boards of nursing. Some of these modalities can be used by nurses as a part of their comprehensive plan of labor support for women during the childbirth experience. This article describes five complementary therapies (aromatherapy, massage, use of birth balls, music therapy, and hydrotherapy), and how one large Midwestern hospital system implemented an educational program for nurses that helped them integrate complementary therapies into their nursing care for laboring women.

  3. Optimizing Usability Studies by Complementary Evaluation Methods

    NARCIS (Netherlands)

    Schmettow, Martin; Bach, Cedric; Scapin, Dominique

    2014-01-01

    This paper examines combinations of complementary evaluation methods as a strategy for efficient usability problem discovery. A data set from an earlier study is re-analyzed, involving three evaluation methods applied to two virtual environment applications. Results of a mixed-effects logistic

  4. A pilot evaluation on a stress management programme using a combined approach of cognitive behavioural therapy (CBT) and complementary and alternative medicine (CAM) for elementary school teachers.

    Science.gov (United States)

    Tsang, Hector W H; Cheung, W M; Chan, Alan H L; Fung, Kelvin M T; Leung, Ada Y; Au, Doreen W H

    2015-02-01

    The aim of this study is to explore the efficacy of implementing a stress management programme based on a combined approach using cognitive behavioural therapy and complementary and alternative medicine for elementary school teachers who experienced mild level of stress, anxiety and/or depressive symptoms in Hong Kong. A 12-h programme involving cognitive behavioural therapy, self-management, relaxation techniques (diaphragmatic breathing and progressive muscle relaxation), mindful exercises (qigong and yoga), aromatherapy and acupressure was conducted. A quasi-experimental design was used to compare the intervention groups (n = 47) with the wait-list control groups (n = 46). The primary outcome measures were depression, anxiety and stress. Results indicated that the intervention group had significant reduction in depression [(F = 3.93; degrees of freedom (df) = 2.90; p = 0.023)], anxiety (F = 3.37; df = 2.90; p = 0.039) and stress (F = 3.63; df = 2.89; p = 0.031) when compared with the control group. Participants in both groups demonstrated lowered level of salivary cortisol at the post-assessment. The pilot results provided preliminary support to the multi-component stress management programme in relieving affective symptoms of teachers. The programme may be considered as an initial strategy to empower teachers with the abilities to cope with their affective symptoms. Further evaluation using a better designed randomized study with a larger sample size is warranted. (word: 198; max.: 200). © 2013 John Wiley & Sons, Ltd.

  5. Evaluating Complementary and Alternative Therapies

    Science.gov (United States)

    ... t Work Drug Information Resources Side Effects Dating, Sex, and Reproduction Advanced Cancer For Children For Teens For Young Adults For Older Adults Prevention and Healthy Living Cancer.Net Videos Coping With Cancer Research and Advocacy Survivorship Blog ...

  6. Have complementary therapies demonstrated effectiveness in rheumatoid arthritis?

    Science.gov (United States)

    Fernández-Llanio Comella, Nagore; Fernández Matilla, Meritxell; Castellano Cuesta, Juan Antonio

    2016-01-01

    In recent decades the treatment of rheumatoid arthritis (RA) has improved thanks to the use of highly effective drugs. However, patients usually require long term therapy, which is not free of side effects. Therefore RA patients often demand complementary medicine, they seek additional sources of relief and/or less side effects. In fact 30-60% of rheumatic patients use some form of complementary medicine. Therefore, from conventional medicine, if we want to optimally treat our patients facilitating communication with them we must know the most commonly used complementary medicines. The aim of this review is to assess, based on published scientific research, what complementary therapies commonly used by patients with RA are effective and safe. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  7. Review article: complementary and alternative therapies for inflammatory bowel disease.

    Science.gov (United States)

    Langmead, L; Rampton, D S

    2006-02-01

    Complementary and alternative medicine includes a wide range of practices and therapies outside the realms of conventional western medicine. Despite a lack of scientific data in the form of controlled trials for either efficacy or safety of complementary and alternative medicine, use by patients with inflammatory bowel disease, particularly of herbal therapies, is widespread and increasing. There is limited controlled evidence indicating efficacy of traditional Chinese medicines, aloe vera gel, wheat grass juice, Boswellia serrata and bovine colostrum enemas in ulcerative colitis. Encouraging results have also been reported in small studies of acupuncture for Crohn's disease and ulcerative colitis. Contrary to popular belief, natural therapies are not necessarily safe: fatal hepatic and irreversible renal failure have occurred with some preparations and interactions with conventional drugs are potentially dangerous. There is a need for further controlled clinical trials of the potential efficacy of complementary and alternative approaches in inflammatory bowel disease, together with enhanced legislation to maximize their quality and safety.

  8. Complementary alternative medical therapies for heart surgery patients: feasibility, safety, and impact.

    Science.gov (United States)

    Kshettry, Vibhu R; Carole, Linda Flies; Henly, Susan J; Sendelbach, Sue; Kummer, Barbara

    2006-01-01

    Complementary therapies (touch, music) are used as successful adjuncts in treatment of pain in chronic conditions. Little is known about their effectiveness in care of heart surgery patients. Our objective is to evaluate feasibility, safety, and impact of a complementary alternative medical therapies package for heart surgery patients. One hundred four patients undergoing open heart surgery were prospectively randomized to receive either complementary therapy (preoperative guided imagery training with gentle touch or light massage and postoperative music with gentle touch or light massage and guided imagery) or standard care. Heart rate, systolic and diastolic blood pressure, and pain and tension were measured preoperatively and as pre-tests and post-tests during the postoperative period. Complications were abstracted from the hospital record. Virtually all patients in the complementary therapy group (95%) and 86% in standard care completed the study. Heart rate and blood pressure patterns were similar. Decreases in heart rate and systolic blood pressure in the complementary therapies group were judged within the range of normal values. Complication rates were very low and occurred with similar frequency in both groups. Pretreatment and posttreatment pain and tension scores decreased significantly in the complementary alternative medical therapies group on postoperative days 1 (p < 0.01) and 2 (p < 0.038). The complementary medical therapies protocol was implemented with ease in a busy critical care setting and was acceptable to the vast majority of patients studied. Complementary medical therapy was not associated with safety concerns and appeared to reduce pain and tension during early recovery from open heart surgery.

  9. Complementary Therapies – a spiritual resource in recovery-processes?

    DEFF Research Database (Denmark)

    Lunde, Anita; Dürr, Dorte Wiwe; Johannessen, Helle

    of complementary therapies in residential homes within social psychiatry. Methods: The study includes participant observation, interviews, questionnaires and focus groups in four psychiatric residential home in the regions of Southern Denmark and Mid-Jutland. Data are collected from January 2017 to October 2017......Background: Studies show that spirituality is an important issue for alternative and complementary practitioners and their treatment practice. In social psychiatry in Denmark, several residential homes have implemented various therapies such as massage and ear acupuncture, which along with other...

  10. Complementary and alternative therapies for low back pain

    NARCIS (Netherlands)

    van Tulder, M.; Furlan, A.D.; Gagnier, J.J.

    2005-01-01

    The support for the principles of evidence-based medicine has increased within the field of complementary and alternative medicine (CAM). The objective of this chapter is to determine the effectiveness of CAM therapies compared to placebo, no intervention, or other interventions for acute/subacute

  11. On the front line. Nursing and complementary therapies.

    Science.gov (United States)

    1997-07-01

    Wide-range of complementary therapies are being used by nurses to deal with the health issues encountered in standard nursing practice. The Lamp looks at some hands-on examples-the soothing jets of the hydrobath, the healing power of music, the pain relief given by therapeutic massage and the efficacy of essential oils.

  12. Complementary and alternative therapies for back pain II.

    NARCIS (Netherlands)

    Furlan, Andrea D.; Yazdi, Fatemeh; Tsertsvadze, Alexander; Gross, Anita; Van Tulder, Maurits; Santaguida, Lina; Cherkin, Dan; Gagnier, Joel J.; Ammendolia, Carlo; Ansari, Mohammed T.; Ostermann, Thomas; Dryden, Trish; Doucette, Steve; Skidmore, Becky; Daniel, Raymond; Tsouros, Sophia; Weeks, Laura; Galipeau, James

    2010-01-01

    Back and neck pain are important health problems with serious societal and economic implications. Conventional treatments have been shown to have limited benefit in improving patient outcomes. Complementary and Alternative Medicine (CAM) therapies offer additional options in the management of low

  13. ACUPUNCTURE EFFECTIVENESS AS A COMPLEMENTARY THERAPY IN FUNCTIONAL DYSPEPSIA PATIENTS

    Directory of Open Access Journals (Sweden)

    Flavia Altaf da Rocha LIMA

    2013-09-01

    Full Text Available Context Functional dyspepsia represents a frequent gastrointestinal disorder in clinical practice. According to the Roma III criteria, functional dyspepsia can be classified into two types as the predominant sympton: epigastric pain and postprandial discomfort. Even though the pathophysiology is still uncertain, the functional dyspepsia seems to be related to multiple mechanisms, among them visceral hypersensitivity, changes in the gastroduodenal motility and gastric accommodation and psychological factors. Objective Evaluate the effectiveness of acupuncture as a complementary to conventional treatment in functional dyspepsia patients. Methods Randomized clinical trial in which were enrolled patients with functional dyspepsia patients in according with Rome III criteria. One group was submitted to drug therapy and specific acupuncture (GI and the other to drug therapy and non-specific acupuncture (GII. The gastrointestinal symptoms, presence of psychiatric disorders and quality of life were evaluated, at the end and three months after treatment. Results After 4 weeks of treatment there was improvement of gastrointestinal symptoms in Group I (55 ± 12 vs 29 ± 8.8; P = 0.001 and Group II (50.5 ± 10.2 vs 46 ± 10.5; P = 0.001. Quality of life was significantly better in Group I than group II (93.4 ± 7.3 vs 102.4 ± 5.1; P = 0.001. Anxiety (93.3% vs 0%; P = 0.001 and depression (46.7% vs 0%; P = 0.004 were significantly lower in Group I than group II. When comparing the two groups after 4 weeks of treatment, gastrointestinal symptoms (29 ± 8.8 vs 46 ± 10.5; P<0.001 and quality of life (102.4 ± 5.1 vs 96 ± 6.1; P = 0.021 were significantly better in Group I than group II. Three months after the treatment, gastrointestinal symptoms remained better only in Group I, when compared to the pre-treatment values (38 ± 11.3 vs 55 ± 12; P = 0.001. Conclusion In patients with functional dyspepsia the complementary acupuncture treatment is superior to

  14. Complementary and alternative medicine therapies for the anesthesiologist and pain practitioner: a narrative review.

    Science.gov (United States)

    Woodbury, Anna; Soong, Stephen Neal; Fishman, David; García, Paul S

    2016-01-01

    This narrative review provides an overview of the complementary and alternative medicine (CAM) therapies that anesthesiologists and pain management practitioners commonly encounter along with recommendations for evaluation and implementation. A literature search of PubMed was performed using the comprehensive MeSH term, "Complementary Therapies OR Dietary Supplements", and a search was conducted of the various licensing organizations and books published on the topics of CAM and integrative medicine. In North America, the most commonly encountered CAM therapies include 1) manipulation and procedural therapies; 2) herbs, nutritional supplements (nutraceuticals), and dietary therapies; and 3) mind-body and energy therapies. Controversy exists regarding many of these therapies, particularly those with a higher risk of harm, such as chiropractic manipulation, acupuncture, and nutraceutical use. Several well-conducted studies were analyzed to show how research in CAM can control for placebo responses. Practical considerations are provided for patients and practitioners interested in pursuing or already employing CAM in perioperative and chronic pain management settings. Complementary and alternative medicine therapies in general may provide a useful adjunct in the management of chronic pain. Nevertheless, many patients are not aware of the risks and benefits of individual therapies. In the perioperative setting, the most concerning CAM therapy is the use of herbs and other supplements that may produce physiologic and metabolic derangements and may interact with prescription medications. Resources exist to aid pain specialists, anesthesiologists, and patients in the evidence-based utilization of CAM therapies.

  15. Acupuncture effectiveness as a complementary therapy in functional dyspepsia patients.

    Science.gov (United States)

    Lima, Flávia Altaf da Rocha; Ferreira, Lincoln Eduardo Villela Vieira de Castro; Pace, Fábio Heleno de Lima

    2013-01-01

    Functional dyspepsia represents a frequent gastrointestinal disorder in clinical practice. According to the Roma III criteria, functional dyspepsia can be classified into two types as the predominant symptom: epigastric pain and postprandial discomfort. Even though the pathophysiology is still uncertain, the functional dyspepsia seems to be related to multiple mechanisms, among them visceral hypersensitivity, changes in the gastroduodenal motility and gastric accommodation and psychological factors. Evaluate the effectiveness of acupuncture as a complementary to conventional treatment in functional dyspepsia patients. Randomized clinical trial in which were enrolled patients with functional dyspepsia patients in according with Rome III criteria. One group was submitted to drug therapy and specific acupuncture (GI) and the other to drug therapy and non-specific acupuncture (GII). The gastrointestinal symptoms, presence of psychiatric disorders and quality of life were evaluated, at the end and three months after treatment. After 4 weeks of treatment there was improvement of gastrointestinal symptoms in Group I (55 ± 12 vs 29 ± 8.8; P = 0.001) and Group II (50.5 ± 10.2 vs 46 ± 10.5; P = 0.001). Quality of life was significantly better in Group I than group II (93.4 ± 7.3 vs 102.4 ± 5.1; P = 0.001). Anxiety (93.3% vs 0%; P = 0.001) and depression (46.7% vs 0%; P = 0.004) were significantly lower in Group I than group II. When comparing the two groups after 4 weeks of treatment, gastrointestinal symptoms (29 ± 8.8 vs 46 ± 10.5; Pacupuncture treatment is superior to conventional treatment. Further studies with more patients are needed to confirm these findings.

  16. Personal health budgets: a new way of accessing complementary therapies?

    OpenAIRE

    Rogers, Jim

    2011-01-01

    The popularity and use of complementary and alternative therapies and medicines (CAM) has remained high in the UK and many other countries over at least the last two decades. Access to such modalities via publicly funded health and welfare systems has remained very limited over the same period. Personal health budgets, designed to offer significant control and personal choice over health care, offer a potential mechanism for some individuals to access publicly funded CAM treatments more direc...

  17. Systematic reviews of complementary therapies - an annotated bibliography. Part 2: herbal medicine

    NARCIS (Netherlands)

    Linde, K.; ter Riet, G.; Hondras, M.; Vickers, A.; Saller, R.; Melchart, D.

    2001-01-01

    BACKGROUND: Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with herbal medicine.

  18. Systematic reviews of complementary therapies - an annotated bibliography. Part 3: homeopathy

    NARCIS (Netherlands)

    Linde, K.; Hondras, M.; Vickers, A.; ter Riet, G.; Melchart, D.

    2001-01-01

    BACKGROUND: Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with homeopathy.

  19. Systematic reviews of complementary therapies - an annotated bibliography. Part 1: acupuncture

    NARCIS (Netherlands)

    Linde, K.; Vickers, A.; Hondras, M.; ter Riet, G.; Thormählen, J.; Berman, B.; Melchart, D.

    2001-01-01

    BACKGROUND: Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy). This article is dealing with acupuncture.

  20. Regulation, religious experience, and epilepsy: a lens on complementary therapies.

    Science.gov (United States)

    Cohen, Michael H

    2003-12-01

    Complementary and alternative medical (CAM) therapies include chiropractic, acupuncture and traditional Oriental medicine, massage therapy, and herbal remedies; mind-body therapies (such as meditative practices and visualization); and folk practices and religious healing. Of these, modalities based on spiritual healing create a number of conundrums for the clinician, including legal, regulatory, and ethical issues. Further, the historic relationship between the study of epilepsy and religious experience suggests particular, potential associations between CAM therapies (and especially spiritual healing) and care for epileptic patients. There are at least two dimensions to this exploration: first, the widespread use of spiritual healing for treatment of epilepsy; and second, the hypothesized connection between epileptic seizures and mystical states. A number of legal rules help address potential abuse of authority by health care professionals, and include: (1) medical licensure; (2) scope of practice; (3) professional discipline; (4) malpractice; and (5) fraud. This article offers a preliminary resource for clinicians interested in these topics.

  1. Supplemental and complementary alternatives to hormone replacement therapy.

    Science.gov (United States)

    Keller, C; Fullerton, J; Mobley, C

    1999-05-01

    Tables 1 and 2 offer a summary of information currently available on the sources, dosages, and proposed health benefits of the supplemental and complementary nutritional therapies that can be suggested as alternatives to hormone replacement therapy. These therapies have the additional benefit of being broadly available to women of all socioeconomic strata, and should be acceptable to women of various ethnicities and cultures. Adequate intakes (AI) of vitamins are recommended based on observational or experimentally determined approximations of the average nutrient intake, by a defined population or group, that appears to sustain a defined nutritional state (Food and Nutrition Boar, Institute of Medicine, 1997). Reviewing the empirical evidence concerning the use of vitamin supplements leads to the conclusion that doses higher than AI or recommended daily requirements is not warranted. For those individuals who choose to supplement, counseling should be provided to caution about tolerable upper limits, those maximum levels of nutrient intake judged unlikely to pose a risk for adverse health effects (Food and Nutrition Boar, Institute of Medicine). Supplemental and complementary therapy directed at ameliorating symptoms or reducing the risk of menopause related illness (osteoporosis and CHD) becomes a decision balance of the woman's preferences, risk and health history, and personal and financial resources. There appears to be some protection of morbidity and mortality from CHD with antioxidant dietary intake. Osteoporosis appears to be delayed with calcium supplementation. Menopausal symptoms, CHD risk, and osteoporosis risk appears to be reduced with phytoestrogen supplementation, although doses have not been established. Research concerning the safety and efficacy of these therapies continues. Findings from current clinical trials, such as the Women's Health Initiative may render these and additional alternative therapies to HRT more precise in the near future.

  2. Complementary and alternative therapies for back pain II.

    Science.gov (United States)

    Furlan, Andrea D; Yazdi, Fatemeh; Tsertsvadze, Alexander; Gross, Anita; Van Tulder, Maurits; Santaguida, Lina; Cherkin, Dan; Gagnier, Joel; Ammendolia, Carlo; Ansari, Mohammed T; Ostermann, Thomas; Dryden, Trish; Doucette, Steve; Skidmore, Becky; Daniel, Raymond; Tsouros, Sophia; Weeks, Laura; Galipeau, James

    2010-10-01

    Back and neck pain are important health problems with serious societal and economic implications. Conventional treatments have been shown to have limited benefit in improving patient outcomes. Complementary and Alternative Medicine (CAM) therapies offer additional options in the management of low back and neck pain. Many trials evaluating CAM therapies have poor quality and inconsistent results. To systematically review the efficacy, effectiveness, cost-effectiveness, and harms of acupuncture, spinal manipulation, mobilization, and massage techniques in management of back, neck, and/or thoracic pain. MEDLINE, Cochrane Central, Cochrane Database of Systematic Reviews, CINAHL, and EMBASE were searched up to 2010; unpublished literature and reference lists of relevant articles were also searched. study selection: All records were screened by two independent reviewers. Primary reports of comparative efficacy, effectiveness, harms, and/or economic evaluations from randomized controlled trials (RCTs) of the CAM therapies in adults (age ≥ 18 years) with back, neck, or thoracic pain were eligible. Non-randomized controlled trials and observational studies (case-control, cohort, cross-sectional) comparing harms were also included. Reviews, case reports, editorials, commentaries or letters were excluded. Two independent reviewers using a predefined form extracted data on study, participants, treatments, and outcome characteristics. 265 RCTs and 5 non-RCTs were included. Acupuncture for chronic nonspecific low back pain was associated with significantly lower pain intensity than placebo but only immediately post-treatment (VAS: -0.59, 95 percent CI: -0.93, -0.25). However, acupuncture was not different from placebo in post-treatment disability, pain medication intake, or global improvement in chronic nonspecific low back pain. Acupuncture did not differ from sham-acupuncture in reducing chronic non-specific neck pain immediately after treatment (VAS: 0.24, 95 percent CI: -1

  3. Allopathic and complementary alternatives to hormone replacement therapy.

    Science.gov (United States)

    Eichholz, Amy C; Mahavni, Vikas; Sood, Anil K

    2002-07-01

    Management of the menopause is a rapidly growing concern due to the ageing human population. The overall female lifespan has increased over the last century and up to a third of a woman's life is now spent in menopause. To that end, significant attention has been placed on maximising the quantity and quality of life in the menopausal years. The optimal management strategies are ones that are highly flexible and sensitive to an individual's expectations and concerns. Thus, while traditional oestrogen replacement therapy has been in place for > 20 years, there is now a greater interest in alternatives to this modality for those women who cannot or will not use it. This article reviews some of the alternative therapies that are being incorporated both in the allopathic and complementary medicine arenas.

  4. Complementary Therapies for Symptom Management in Cancer Patients.

    Science.gov (United States)

    Satija, Aanchal; Bhatnagar, Sushma

    2017-01-01

    Cancer patients are often poly-symptomatic which distressingly affects their quality of lives (QOLs). Alhough, conventional management provides adequate symptom control, yet is coupled with some limitations. Complementary therapies (CTs) have shown beneficial effects in cancer patients for symptomatic relief. The aim of this article is to provide evidence-based review of commonly used CTs for symptom management in cancer care. Hypnosis has promising evidence to be used for managing symptoms such as pain, chemotherapy-induced nausea/vomiting, distress, fatigue, and hot flashes. Guided imagery increases comfort and can be used as a psycho-supportive therapy. Meditation substantially improves psychological function, mental health, and QOL. Cognitive behavioral therapies effectively reduce pain, distress, fatigue, anxiety, and depression; and improve subjective sleep outcomes along with mood and QOL. Yoga has short term beneficial effects for anxiety, depression, fatigue, perceived stress, QOL, and well-being. T'ai Chi and qigong are beneficial adjunctive therapies for supportive cancer care, but their role in reducing cancer pain is not well proven. Acupuncture is effective for reducing treatment related side-effects, pain and fatigue. Other therapies such as massage techniques, energy therapies, and spiritual interventions have also demonstrated positive role in managing cancer-related symptoms and improve overall well-being. However, the clinical effectiveness of these therapies for symptom management in cancer patients cannot be concluded due to poor strength of evidence. Nonetheless, these are relatively free from risks and hence can be given along with conventional treatments. Only by tailoring these therapies as per patient's beliefs and preferences, optimal patient-centered holistic care can be provided.

  5. Complementary therapies for symptom management in cancer patients

    Directory of Open Access Journals (Sweden)

    Aanchal Satija

    2017-01-01

    Full Text Available Cancer patients are often poly-symptomatic which distressingly affects their quality of lives (QOLs. Alhough, conventional management provides adequate symptom control, yet is coupled with some limitations. Complementary therapies (CTs have shown beneficial effects in cancer patients for symptomatic relief. The aim of this article is to provide evidence-based review of commonly used CTs for symptom management in cancer care. Hypnosis has promising evidence to be used for managing symptoms such as pain, chemotherapy-induced nausea/vomiting, distress, fatigue, and hot flashes. Guided imagery increases comfort and can be used as a psycho-supportive therapy. Meditation substantially improves psychological function, mental health, and QOL. Cognitive behavioral therapies effectively reduce pain, distress, fatigue, anxiety, and depression; and improve subjective sleep outcomes along with mood and QOL. Yoga has short term beneficial effects for anxiety, depression, fatigue, perceived stress, QOL, and well-being. T'ai Chi and qigong are beneficial adjunctive therapies for supportive cancer care, but their role in reducing cancer pain is not well proven. Acupuncture is effective for reducing treatment related side-effects, pain and fatigue. Other therapies such as massage techniques, energy therapies, and spiritual interventions have also demonstrated positive role in managing cancer-related symptoms and improve overall well-being. However, the clinical effectiveness of these therapies for symptom management in cancer patients cannot be concluded due to poor strength of evidence. Nonetheless, these are relatively free from risks and hence can be given along with conventional treatments. Only by tailoring these therapies as per patient's beliefs and preferences, optimal patient-centered holistic care can be provided.

  6. Shamanism as a healing paradigm for complementary therapy.

    Science.gov (United States)

    Money, M

    2001-08-01

    Any healing process--whether recovery from infection, physical trauma, or psychological distress--must entail the stimulation and direction of the body's own restorative functions. In former times these functions were called the vis mediatrix naturae. Arguably best articulated within traditional Chinese medicine (e.g. Reid 1993), many complementary therapies have identified this principle. The immune system is implicated in the operation of these healing processes, and immune system functions are modulated by both internal and external variables. External variables include the nature of the infection or trauma. Internal variables include the meaning of the illness to the patient or the patient's imagery surrounding the illness. It follows that any modulation of internal variables that increases immune function will therefore be highly beneficial in the healing process. Sometimes such modulation happens spontaneously, when it may be referred to as the placebo effect, or a good bedside manner, or spontaneous remission. Sometimes such modulation may be brought about intentionally either by the patient or by a therapist or healer. One body of technique for such modulation is shamanism, which pays particular attention to bridging the internal world of the patient to the external world where the problem originates. Shamanic practice is specifically focused on this healing task, and has its own toolkit of techniques for the modification of consciousness, the manipulation of imagery and meaning, and the generation of a healing milieu and therapeutic images from its mythic content. Early concerns about the mental health of shamanic practitioners are now thoroughly resolved (e.g. Stephen & Suryani 2000). Indeed, the relevance of shamanism to positive mental health is currently being explored (e.g. Money 1994, Singh 1999). Its relevance to social work (Voss et al. 1999) and to the near death experience (Green 1998) are also subjects of academic inquiry. The shamanic corpus

  7. Patient preferences on the integration of complementary therapy with conventional cancer care.

    Science.gov (United States)

    Savas, Peter; Robertson, Amanda; Beatty, Lisa; Hookings, Emily; McGee, Margaret; Marker, Julie; McCaleb, Belle; Bowen, Joanne; Richards, Alison; Koczwara, Bogda

    2016-06-01

    Complementary therapy use by patients with cancer is highly prevalent, although little is known about the optimal model of integration with conventional care. This study explored patient preferences regarding integration in an Australian context. Cancer patients participated in focus groups conducted by an experienced facilitator. Transcripts of discussions were subjected to thematic analysis. Fourteen female and four male patients took part in eight focus groups. Eleven had received conventional cancer treatment for early-stage disease, and seven for advanced stage. Participants had sound understanding of the distinction between complementary and alternative medicines. There were differing views on whether complementary therapy and conventional cancer services should be colocated. Some participants described colocation as discordant with their reasons for using complementary therapy. Participants valued guidance from oncology health professionals regarding complementary therapy that was tailored to their individual needs. In addition to medical oncologists, nursing staff and affiliated complementary therapists were considered to be appropriate sources for guidance. Additional themes identified in the analysis were also informative: patients achieve autonomy and self-expression through complementary therapies; the knowledge and attitudes of health professionals and limited consultation time are barriers to integration; self-funding of complementary therapies is acceptable to participants. The study findings suggest that while patients have diverse views regarding the optimal integration model, there is no strong preference for geographic colocation of complementary therapy with conventional cancer care. Patients valued personalized information and guidance regarding complementary therapy from health professionals involved in their cancer care. © 2014 Wiley Publishing Asia Pty Ltd.

  8. [Irritable bowel syndrome: diet and complementary medicine therapies?].

    Science.gov (United States)

    Gerkens, A

    2012-09-01

    Irritable bowel syndrome (IBS) is a frequent and invalidating functional bowel disorder with entangled mechanisms. Its therapeutic approach is therefore complex. Classical therapies, prescribed alone or in combination in light of the predominant symptom, consist of antispasmodics, fibers, laxatives, antidiarrheals, and psychotropic agents. Other emerging pharmacological therapies, such as prokinetics, prosecretory or serotoninergic agents, bile acid modulators and antibiotics have been recently studied in clinical trials. Dietary measures can include reduction of short-chain poorly absorbed carbohydrates (FODMAPs) and gluten restriction. Assessment of food allergy can be proposed in a subgroup of IBS patients. Complementary and alternative medicine therapies, that are generally low cost and safe, appear to be appreciated by patients. Probiotics have demonstrated action on the gut microbiote modulation, and may be helpful in a subset of patients. Peppermint oil has an established visceral analgesic effect. Hypnotherapy represents an original, global and effective approach. Finally, education, reassurance and listening to the patient, leading to a solid therapeutic relationship, represents an essential backdrop of remedy or diet effectiveness.

  9. Systematic review: complementary therapies and employee well-being.

    Science.gov (United States)

    Ravalier, J M; Wegrzynek, P; Lawton, S

    2016-08-01

    A variety of workplace-based interventions exist to reduce stress and increase productivity. However, the efficacy of these interventions is sometimes unclear. To determine whether complementary therapies offered in the workplace improve employee well-being. We performed a systematic literature review which involved an electronic search of articles published between January 2000 and July 2015 from the databases Cochrane Central Register of Controlled Trials, PsycINFO, MEDLINE, AMED, CINAHL Plus, EMBASE and PubMed. We also undertook a manual search of all applicable article reference lists to ensure that no relevant studies were missed. We only selected published, full-length, English-language, peer-reviewed journal articles. Articles had to address the research objective using valid and reliable measures. We excluded articles concerning return to work or whose populations had been adversely affected by work resulting in the development of health issues. We included 10 articles in the review from 131 identified. Mindfulness and meditation-based interventions were most effective in improving workplace health and work performance; the latter demonstrating some evidence of maintaining gains up to 3 months later. The evidence for relaxation interventions was inconclusive. Mindfulness and meditation interventions may be helpful in improving both psychosocial workplace health and work performance, but long-term efficacy has yet to be fully determined. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Complementary and alternative drug therapy versus science-oriented medicine

    Science.gov (United States)

    Anlauf, Manfred; Hein, Lutz; Hense, Hans-Werner; Köbberling, Johannes; Lasek, Rainer; Leidl, Reiner; Schöne-Seifert, Bettina

    2015-01-01

    This opinion deals critically with the so-called complementary and alternative medical (CAM) therapy on the basis of current data. From the authors’ perspective, CAM prescriptions and most notably the extensive current endeavours to the “integration” of CAM into conventional patient care is problematic in several respects. Thus, several CAM measures are used, although no specific effects of medicines can be proved in clinical studies. It is extensively explained that the methods used in this regard are those of evidence-based medicine, which is one of the indispensable pillars of science-oriented medicine. This standard of proof of efficacy is fundamentally independent of the requirement of being able to explain efficacy of a therapy in a manner compatible with the insights of the natural sciences, which is also essential for medical progress. Numerous CAM treatments can however never conceivably satisfy this requirement; rather they are justified with pre-scientific or unscientific paradigms. The high attractiveness of CAM measures evidenced in patients and many doctors is based on a combination of positive expectations and experiences, among other things, which are at times unjustified, at times thoroughly justified, from a science-oriented view, but which are non-specific (context effects). With a view to the latter phenomenon, the authors consider the conscious use of CAM as unrevealed therapeutic placebos to be problematic. In addition, they advocate that academic medicine should again systematically endeavour to pay more attention to medical empathy and use context effects in the service of patients to the utmost. The subsequent opinion discusses the following after an introduction to medical history: the definition of CAM; the efficacy of most common CAM procedures; CAM utilisation and costs in Germany; characteristics of science-oriented medicine; awareness of placebo research; pro and contra arguments about the use of CAM, not least of all in terms

  11. Complementary and alternative drug therapy versus science-oriented medicine

    Directory of Open Access Journals (Sweden)

    Anlauf, Manfred

    2015-06-01

    Full Text Available This opinion deals critically with the so-called complementary and alternative medical (CAM therapy on the basis of current data. From the authors’ perspective, CAM prescriptions and most notably the extensive current endeavours to the “integration” of CAM into conventional patient care is problematic in several respects.Thus, several CAM measures are used, although no specific effects of medicines can be proved in clinical studies. It is extensively explained that the methods used in this regard are those of evidence-based medicine, which is one of the indispensable pillars of science-oriented medicine. This standard of proof of efficacy is fundamentally independent of the requirement of being able to explain efficacy of a therapy in a manner compatible with the insights of the natural sciences, which is also essential for medical progress. Numerous CAM treatments can however never conceivably satisfy this requirement; rather they are justified with pre-scientific or unscientific paradigms. The high attractiveness of CAM measures evidenced in patients and many doctors is based on a combination of positive expectations and experiences, among other things, which are at times unjustified, at times thoroughly justified, from a science-oriented view, but which are non-specific (context effects. With a view to the latter phenomenon, the authors consider the conscious use of CAM as unrevealed therapeutic placebos to be problematic. In addition, they advocate that academic medicine should again systematically endeavour to pay more attention to medical empathy and use context effects in the service of patients to the utmost.The subsequent opinion discusses the following after an introduction to medical history: the definition of CAM; the efficacy of most common CAM procedures; CAM utilisation and costs in Germany; characteristics of science-oriented medicine; awareness of placebo research; pro and contra arguments about the use of CAM, not least

  12. Prevalence of complementary and alternative therapy use by cancer patients undergoing radiation therapy.

    Science.gov (United States)

    Edwards, Grace V; Aherne, Noel J; Horsley, Patrick J; Benjamin, Linus C; McLachlan, Craig S; McKay, Michael J; Shakespeare, Thomas P

    2014-12-01

    The use of complementary and alternative therapies (CAT) in oncology patients is increasing in incidence, with calls to routinely screen for their use. We introduced a screening tool as part of clinical care to identify CAT use. We evaluated all patients who attended the radiation oncology outpatient clinic between December 2011 and July 2012, who had filled out the CAT screening tool, and evaluated types of CAT use, reasons for use and predictors of CAT usage. A total of 639 patients completed the CAT screening tool, which was 75% of eligible patients. There were 464 (72.6%) men and 175 (27.4%) women, with a mean age of 69.9 years (range 27-94 years). Prostate cancer was the predominant diagnosis (53.1%), followed by breast cancer (17.5%) and skin cancer (14.7%). Of these, 530 patients (82.9%) had used at least one therapy. Of the 530 patients using CAT, the most quoted reasons for use were to improve quality of life (42.6%), to boost the immune system and general health (33.6%), to increase energy levels (32.6%) and to live longer (28.9%). Of the 530 users, only 112 patients (21.1%) took CAT to help cure their cancer. Women were significantly more likely to use CAT, as were patients with breast cancer. The use of CAT in patients with cancer is prevalent and more frequent in our population than in other published studies. Few patients use CAT to improve their cancer cure, but rather use CAT for other reasons. © 2014 Wiley Publishing Asia Pty Ltd.

  13. Active Theater as a Complementary Therapy for Parkinson's Disease Rehabilitation: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Nicola Modugno

    2010-01-01

    Full Text Available Most medical treatments of Parkinson's disease (PD are aimed at the reduction of motor symptoms. However, even when motor improvements are evident, patients often report a deterioration of their daily lives. Thus, to achieve a global improvement in personal well-being, not only drugs, but also complementary therapies, such as physical exercise, occupational and speech therapy, and active music therapy, have been used. We hypothesized that theater could reduce clinical disability and improve the quality of life of PD patients (primary end points more efficiently than other complementary therapies because (1 in order to impersonate a character, patients are forced to regain the control of their bodies; and (2 while being part of a group, patients have a high degree of social interaction. The need to regain the control of their bodies and their social functioning is very likely to deeply motivate patients. To assess this hypothesis, we ran a randomized, controlled, and single-blinded study that lasted 3 years, on 20 subjects affected by a moderate form of idiopathic PD, in stable treatment with L-dopa and L-dopa agonists, and without severe sensory deficits. Ten patients were randomly assigned to an active theater program (in which patients were required to participate, while the others underwent physiotherapy (control group, the most common nonpharmacological treatment for PD rehabilitation. Patients of both groups were evaluated at the beginning of each year, using five clinical rating scales (Unified ParkinsonParkinson'ss Disease Rating Scale [UPDRS], Schwab and England Scale, ParkinsonParkinson'ss Disease Quality of Life [PDQ39] Scale, Epworth Sleepiness Scale, and Hamilton Depression Rating Scale. The theater patients showed progressive improvements and, at the end of the third year, they showed significant improvements in all clinical scales. Conversely, the control patients did not exhibit significant ameliorations with time. Thus, the

  14. Complementary and alternative therapies for the management of menopause-related symptoms: a systematic evidence review.

    Science.gov (United States)

    Nedrow, Anne; Miller, Jill; Walker, Miranda; Nygren, Peggy; Huffman, Laurie Hoyt; Nelson, Heidi D

    2006-07-24

    Nearly half of adults in the United States use complementary and alternative therapies each year for a variety of reasons. These therapies are increasingly popular among women seeking alternatives to treatment with estrogen for managing menopausal symptoms. The objective of this review was to assess the effectiveness of complementary and alternative therapies in the management of menopausal symptoms. MEDLINE, PsychINFO, Cochrane Library database, MANTIS, and AMED. Full-text, English-language, randomized controlled trials and meta-analyses comparing a complementary or alternative therapy with placebo or control for treatment of menopausal symptoms. All eligible trials were reviewed, abstracted into evidence tables, and rated for quality. Seventy randomized controlled trials met inclusion criteria. Forty-eight studies of phytoestrogens and other biologically based agents showed mixed results. Smaller numbers of studies using mind-body, energy, manipulative, and body-based therapies and whole medical systems showed little benefit in treating menopausal symptoms. Although individual trials suggest benefits from certain therapies, data are insufficient to support the effectiveness of any complementary and alternative therapy in this review for the management of menopausal symptoms. Many of these potential therapies warrant further study in trials with rigorous scientific designs to determine benefit and safety.

  15. Strategies to teach alternative and complementary therapies in nursing: an integrative review

    Directory of Open Access Journals (Sweden)

    Natália Chantal Magalhães da Silva

    2013-12-01

    Full Text Available The lack of discussions that clarify the teaching of alternative and complementary therapies in undergraduate nursing programs shows the need for developing research on this topic. The objective of this study was to identify, in scientific literature, the strategies for teaching alternative and complementary therapies in nursing undergraduate programs. The guiding methodology used was integrative review. The search was performed on SCIENCE DIRECT, LILACS and MEDLINE databases. According to the articles included in this study, the proposals for including these therapies in the program are by: lectures, theoretical courses and discussion groups. However, studies should be conducted to confirm the efficacy of these strategies so these therapeutic methods can be included in the Pedagogical Political Project of the nursing undergraduate program, thus allowing for the consolidation of those practices. Descriptors: Education, Nursing; Education, Higher; Complementary Therapies.

  16. Equine-Assisted Therapies: Complementary Medicine or Not?

    Science.gov (United States)

    Ratcliffe, Katherine T.; Sanekane, Cindy

    2009-01-01

    Equine-assisted therapies are interventions that use the unique qualities of a horse to assist persons with disabilities to improve their gross motor, language, social, and self-help skills. Programs offering these services are varied and operate on all major continents across the world. The effectiveness of equine-assisted therapies is generally…

  17. Examining the evidence: complementary adjunctive therapies for multiple sclerosis.

    Science.gov (United States)

    Namaka, Mike; Crook, Arla; Doupe, Andrea; Kler, Kulwinder; Vasconcelos, Marcus; Klowak, Meghann; Gong, Yuewen; Wojewnik-Smith, Alicja; Melanson, Maria

    2008-09-01

    The purpose of this article is to provide a comprehensive overview of the most frequently encountered non-conventional approaches trialed for use in multiple sclerosis (MS). The efficacy and safety of non-conventional approaches ranging from bee venom therapy (BVT) to an array of vitamins and herbal products were discussed and evaluated. Relevant English-language articles were identified through searches of MEDLINE (1990-2006), PubMed (1999-2006), Cochrane (1995-2006) and Toxnet (2000-2006). Classification of available literature was conducted according to the evidence based guidelines established by the American Academy of Neurology (AAN). However, due to the non-conventional nature of these treatment approaches, most available literature was derived from anecdotal reports and suboptimal clinical studies, lacking the rigor of evidence-based practice. There is presently only marginal supportive evidence for BVT in MS treatment. The inability to identify and quantify the active component of BVT combined with the associated risk of anaphylaxis has deterred its widespread use. The most promising evidence comes from prophylactic daily supplementation with vitamin D. Despite beneficial reports regarding non-herbal supplements such as alpha-lipoic acid (ALA), luteolin, evening primrose oil and vitamins such as B12, the lack of evidence does not support their prophylactic use. Based on available evidence, the prophylactic use of vitamin D is a viable option as an adjunct to conventional medicine. Although there is a lack of conclusive evidence to support the use of other non-conventional treatments, patients are still opting to trial and bare the risks of these products which are accessible without the intervention of a healthcare professional. Controlled, evidence-based trials are essential for healthcare professionals to competently intervene and recommend these products.

  18. Music as a complementary therapy in medical treatment

    OpenAIRE

    Samuel Halim

    2002-01-01

    Music can act not only as a source of enjoyable sound that gives pleasant feeling, but also a source of healing. Music as a therapy has developed, supported by many researches conducted by experts in music, education and medicine. The impact of music therapy can be observed in many case studies, showing the positive effects of music to the betterment of human’s neuro-behavior, emotional and physical states. Some reasons to use music as a therapy are: toget audioanalgesic response, to focus at...

  19. Topics in Integrative, Alternative, and Complementary Therapies (PDQ)

    Science.gov (United States)

    ... Therapy for more information. Glutamine Glutamine is an amino acid that is important for the health of gastrointestinal ( ... naturally contain vitamin D. These foods include fatty fish, fish liver oil, and eggs. See Vitamin D ...

  20. Music as a complementary therapy in medical treatment

    Directory of Open Access Journals (Sweden)

    Samuel Halim

    2002-12-01

    Full Text Available Music can act not only as a source of enjoyable sound that gives pleasant feeling, but also a source of healing. Music as a therapy has developed, supported by many researches conducted by experts in music, education and medicine. The impact of music therapy can be observed in many case studies, showing the positive effects of music to the betterment of human’s neuro-behavior, emotional and physical states. Some reasons to use music as a therapy are: toget audioanalgesic response, to focus attention, to reinforce learning, to enhance interpersonal relationships, and to promote mind-body health in the medical staff. The use of music to help patients with non-infectious diseases such as Alzheimer disease, autism, cancer, headache, heart disease and stroke are described along with experiments and case studies on these diseases. However controversies around music therapy occurred. Therefore, more experiments need to be taken in order to clear the controversies and to use music as a therapy in the present and future medical treatment. (Med J Indones 2002; 11: 250-7.Keywords: therapeutic effect, music therapy, Alzheimer, autism, cancer, stroke

  1. Perception of risk and communication among conventional and complementary health care providers involving cancer patients' use of complementary therapies: a literature review.

    Science.gov (United States)

    Stub, Trine; Quandt, Sara A; Arcury, Thomas A; Sandberg, Joanne C; Kristoffersen, Agnete E; Musial, Frauke; Salamonsen, Anita

    2016-09-08

    Communication between different health care providers (conventional and complementary) and cancer patients about their use of complementary therapies affects the health and safety of the patients. The aim of this study was to examine the qualitative research literature on the perception of and communication about the risk of complementary therapies between different health care providers and cancer patients. Systematic searches in six medical databases covering literature from 2000 to 2015 were performed. The studies were accessed according to the level of evidence and summarized into different risk situations. Qualitative content analysis was used to analyze the text data, and the codes were defined before and during the data analysis. Twenty-nine papers were included in the primary analysis and five main themes were identified and discussed. The main risk situations identified were 1. Differences in treatment concepts and philosophical values among complementary and conventional health care providers. 2. Adverse effects from complementary products and herbs due to their contamination/toxicity and interactions with conventional cancer treatment. 3. Health care physicians and oncologists find it difficult to recommend many complementary modalities due to the lack of scientific evidence for their effect. 4. Lack of knowledge and information about complementary and conventional cancer treatments among different health care providers. The risk of consuming herbs and products containing high level of toxins is a considerable threat to patient safety (direct risk). At the same time, the lack of scientific evidence of effect for many complementary therapies and differences in treatment philosophy among complementary and conventional health care providers potentially hinder effective communication about these threats with mutual patients (indirect risk). As such, indirect risk may pose an additional risk to patients who want to combine complementary therapies with

  2. Complementary and alternative medicine use for vasomotor symptoms among women who have discontinued hormone therapy.

    Science.gov (United States)

    Kupferer, Elizabeth M; Dormire, Sharon L; Becker, Heather

    2009-01-01

    To explore the use and perceived usefulness of complementary and alternative medicine therapies and nonhormonal conventional medicine alternatives to treat vasomotor symptoms occurring after withdrawal from hormone therapy. Retrospective, single cross sectional descriptive study. Study volunteers were recruited via a direct mailed questionnaire sent to a sample of women throughout the United States. Additional respondents were recruited through flyers and postcards advertising the study placed with permission at several health care provider offices and other locations. A sample of 563 menopausal women who had discontinued the use of hormone therapy completed a questionnaire describing their experiences with the use of complementary and alternative medicine. Responses to an investigator developed survey. Nearly half of the women surveyed used complementary and alternative medicine. The most common choices of complementary and alternative medicine were (a) multivitamins and calcium, (b) black cohosh, (c) soy supplements and food, (d) antidepressants, (e) meditation and relaxation, (f) evening primrose oil, (g) antihypertensives, and (h) homeopathy. Of the alternative therapies that were used by at least 5% of the sample, antidepressants were perceived as the most useful. With the increased adoption of complementary and alternative medicine, it is important for health care providers to be familiar with the various methods so they are comfortable discussing the benefits and risks with their patients to assist them in making informed decisions.

  3. Chinese medicine as complementary therapy for female infertility.

    Science.gov (United States)

    Xia, Ju-Feng; Inagaki, Yoshinori; Zhang, Jian-Feng; Wang, Ling; Song, Pei-Pei

    2017-04-01

    Chinese medicine (CM) has been used in clinical treatment for thousands of years in China, Japan, Korea, and other countries. CM is at present attracting many attentions around the world for reproductive health care and disease prevention, including treatment of female infertility. This review focuses on the CM treatment for female infertility patients, and supplies a summary on the efficacy, safety, and mechanism of some Chinese herbal medicines, herbal medicine-derived active compounds, and acupuncture. A large number of researches have reported that CM could alleviate or even cure female infertility by regulating hormone, improving reproductive outcome of in vivo fertilization, affecting embryonic implantation, curing polycystic ovarian syndrome, endometriosis, pelvic inflammatory disease, relieving mental stress, and regulating immune system. Meanwhile, a few studies claimed that there was little adverse reaction of CM in randomized controlled trials. However, up to present there is a lack of adequate evidences with molecular mechanistic researches and randomized controlled trials to prove the CM as an effective and safe treatment for infertility. Thus, utility of CM as a complementary medicine will be a feasible method to improve the outcome of female infertility treatment.

  4. Complementary Therapies for Significant Dysfunction from Tinnitus: Treatment Review and Potential for Integrative Medicine

    Directory of Open Access Journals (Sweden)

    Ruth Q. Wolever

    2015-01-01

    Full Text Available Tinnitus is a prevalent and costly chronic condition; no universally effective treatment exists. Only 20% of patients who report tinnitus actually seek treatment, and when treated, most patients commonly receive sound-based and educational (SBE therapy. Additional treatment options are necessary, however, for nonauditory aspects of tinnitus (e.g., anxiety, depression, and significant interference with daily life and when SBE therapy is inefficacious or inappropriate. This paper provides a comprehensive review of (1 conventional tinnitus treatments and (2 promising complementary therapies that have demonstrated some benefit for severe dysfunction from tinnitus. While there has been no systematic study of the benefits of an Integrative Medicine approach for severe tinnitus, the current paper reviews emerging evidence suggesting that synergistic combinations of complementary therapies provided within a whole-person framework may augment SBE therapy and empower patients to exert control over their tinnitus symptoms without the use of medications, expensive devices, or extended programs.

  5. Evaluation of Inter Therapy

    DEFF Research Database (Denmark)

    Pedersen, Inge Nygaard

    2002-01-01

    This article (revised conference lecture from the 10th World Congress of Music Therapy, Oxford July 2002)) emphasizes the evaluation of the training of Inter Therapy for music therapy students at the MA training at Aalborg University. The students take turns in being client and therapist within...

  6. Formulation and proximate evaluation of complementary diets from ...

    African Journals Online (AJOL)

    Objective: Complementary foods in Nigeria among low-income households are based on staple cereals. Malnutrition among the affected infants could be attributed to unfortified or poorly-fortified cereal-based complementary foods. The present study was conducted to formulate composite blends using locally available but ...

  7. Patient choice and evidence based decisions: The case of complementary therapies

    Science.gov (United States)

    Wye, Lesley; Shaw, Alison; Sharp, Debbie

    2009-01-01

    Abstract Objective  Current government policies simultaneously pursue the development of ‘patient‐led’ and ‘evidence‐based’ approaches to healthcare. The objective of this study was to explore how primary care clinicians and Primary Care Trust (PCT) managers balance these potentially competing tensions when considering popular, controversial treatments, like complementary therapies, in consultations (clinicians) or funding decisions (PCT managers). Setting and participants  We selected two case sites where complementary therapies were offered on NHS premises in England. We interviewed 18 PCT managers and clinicians, conducted an observation of a PCT meeting on complementary therapies and collected documentary data from referral databases and service funding bids. All interviews were taped, transcribed and analysed thematically. Interview, observation and documentary data were used to compare reported beliefs and behaviour to observed and documented behaviour. Results  The majority of clinicians and PCT managers claimed that research evidence guided their decisions; those who did not felt increasingly marginalized. However, discrepancies between reported and observed behaviour suggest that perceptions of research evidence, rather than fact based knowledge, predominated when considering complementary therapies. Conclusion  In the case of NHS complementary therapy service provision, patient preference may be largely insignificant in clinician and PCT managerial decisions, with decisions based mainly on ‘evidence rhetoric’ devised from collectively agreed, unchallenged, tacit perceptions of research literature. If a patient‐led NHS is to become a reality, NHS professionals need to cede the power that they wield with evidence rhetoric and acknowledge the legitimacy of patient preferences, views and alternative sources of evidence. PMID:19656225

  8. The effectiveness of complementary manual therapies for pregnancy-related back and pelvic pain

    Science.gov (United States)

    Hall, Helen; Cramer, Holger; Sundberg, Tobias; Ward, Lesley; Adams, Jon; Moore, Craig; Sibbritt, David; Lauche, Romy

    2016-01-01

    Abstract Background: Low back pain and pelvic girth pain are common in pregnancy and women commonly utilize complementary manual therapies such as massage, spinal manipulation, chiropractic, and osteopathy to manage their symptoms. Objective: The aim of this systematically review was to critically appraise and synthesize the best available evidence regarding the effectiveness of manual therapies for managing pregnancy-related low back and pelvic pain. Methods: Seven databases were searched from their inception until April 2015 for randomized controlled trials. Studies investigating the effectiveness of massage and chiropractic and osteopathic therapies were included. The study population was pregnant women of any age and at any time during the antenatal period. Study selection, data extraction, and assessment of risk of bias were conducted by 2 reviewers independently, using the Cochrane tool. Separate meta-analyses were conducted to compare manual therapies to different control interventions. Results: Out of 348 nonduplicate records, 11 articles reporting on 10 studies on a total of 1198 pregnant women were included in this meta-analysis. The therapeutic interventions predominantly involved massage and osteopathic manipulative therapy. Meta-analyses found positive effects for manual therapy on pain intensity when compared to usual care and relaxation but not when compared to sham interventions. Acceptability did not differ between manual therapy and usual care or sham interventions. Conclusions: There is currently limited evidence to support the use of complementary manual therapies as an option for managing low back and pelvic pain during pregnancy. Considering the lack of effect compared to sham interventions, further high-quality research is needed to determine causal effects, the influence of the therapist on the perceived effectiveness of treatments, and adequate dose–response of complementary manual therapies on low back and pelvic pain outcomes during

  9. Occupational therapy evaluation

    DEFF Research Database (Denmark)

    Nielsen, Kristina Tomra; Wæhrens, Eva Ejlersen

    2015-01-01

    Background: The Occupational Therapy Intervention Process Model (OTIPM) serves to guide occupational therapists in their professional reasoning. The OTIPM prescribes evaluation of task performance based on both self-report and observation. Although this approach seems ideal, many clinicians raise...

  10. Complementary therapy use by patients and parents of children with asthma and the implications for NHS care: a qualitative study

    Directory of Open Access Journals (Sweden)

    Sharp Debbie

    2006-06-01

    Full Text Available Abstract Background Patients are increasingly using complementary therapies, often for chronic conditions. Asthma is the most common chronic condition in the UK. Previous research indicates that some asthma patients experience gaps in their NHS care. However, little attention has been given to how and why patients and parents of children with asthma use complementary therapies and the implications for NHS care. Methods Qualitative study, comprising 50 semi-structured interviews with a purposeful sample of 22 adults and 28 children with asthma (plus a parent, recruited from a range of NHS and non-NHS settings in Bristol, England. Data analysis was thematic, drawing on the principles of constant comparison. Results A range of complementary therapies were being used for asthma, most commonly Buteyko breathing and homeopathy. Most use took place outside of the NHS, comprising either self-treatment or consultation with private complementary therapists. Complementary therapies were usually used alongside not instead of conventional asthma treatment. A spectrum of complementary therapy users emerged, including "committed", "pragmatic" and "last resort" users. Motivating factors for complementary therapy use included concerns about conventional NHS care ("push factors" and attractive aspects of complementary therapies ("pull factors". While participants were often uncertain whether therapies had directly helped their asthma, breathing techniques such as the Buteyko Method were most notably reported to enhance symptom control and enable reduction in medication. Across the range of therapies, the process of seeking and using complementary therapies seemed to help patients in two broad ways: it empowered them to take greater personal control over their condition rather than feel dependant on medication, and enabled exploration of a broader range of possible causes of their asthma than commonly discussed within NHS settings. Conclusion Complementary therapy

  11. Systematic reviews of complementary therapies – an annotated bibliography. Part 3: Homeopathy

    Directory of Open Access Journals (Sweden)

    Vickers Andrew

    2001-07-01

    Full Text Available Abstract Background Complementary therapies are widespread but controversial. We aim to provide a comprehensive collection and a summary of systematic reviews of clinical trials in three major complementary therapies (acupuncture, herbal medicine, homeopathy. This article is dealing with homeopathy. Potentially relevant reviews were searched through the register of the Cochrane Complementary Medicine Field, the Cochrane Library, Medline, and bibliographies of articles and books. To be included articles had to review prospective clinical trials of homeopathy; had to describe review methods explicitly; had to be published; and had to focus on treatment effects. Information on conditions, interventions, methods, results and conclusions was extracted using a pretested form and summarized descriptively. Results Eighteen out of 22 potentially relevant reviews preselected in the screening process met the inclusion criteria. Six reviews addressed the question whether homeopathy is effective across conditions and interventions. The majority of available trials seem to report positive results but the evidence is not convincing. For isopathic nosodes for allergic conditions, oscillococcinum for influenza-like syndromes and galphimia for pollinosis the evidence is promising while in other areas reviewed the results are equivocal. Interpretation Reviews on homeopathy often address general questions. While the evidence is promising for some topics the findings of the available reviews are unlikely to end the controversy on this therapy.

  12. Complementary and alternative therapies for treatment of insomnia in women in postmenopause.

    Science.gov (United States)

    Hachul, H; Monson, C; Kozasa, E H; Oliveira, D S; Goto, V; Afonso, R; Llanas, A C; Tufik, S

    2014-12-01

    Menopause is an important episode in the life of women and, for the great majority of women, occurs in their fifties. The climacteric period, which is often associated with insomnia, represents one of the most important changes in the female reproductive cycle because it marks the end of reproductive capacity. Hormonal therapy has been considered the most useful and standardized method for treating menopause and climacteric-associated symptoms despite its side-effects. The present study is a review of the scientific literature about the efficacy, toxicity and safety of complementary and alternative therapies used as alternatives to hormone therapy to treat insomnia in menopausal women. Mind-body therapies and the use of isoflavonoids have exhibited promise as interventions for treating insomnia in the climacteric at our Walk-In Clinic of Sleep Disturbance at the Universidade Federal de São Paulo. This review will describe the use of complementary and alternative therapies and their effectiveness in treating insomnia in this period of a woman's life.

  13. Complementary and alternative therapies for treating multiple sclerosis symptoms: a systematic review.

    Science.gov (United States)

    Huntley, A; Ernst, E

    2000-06-01

    Multiple sclerosis (MS) is a chronic disease of the central nervous system without a known cure. Thus the role of complementary and alternative therapies (CATs) for the management of symptoms lies in palliative care and this is borne out by the popularity of these treatments amongst MS sufferers. This review is aimed at determining whether this use is supported by evidence of effectiveness from rigorous clinical trials. Database literature searches were performed and papers were extracted in a pre-defined manner. Twelve randomized controlled trials were located that investigated a CAT for MS: nutritional therapy (4), massage (1), Feldenkrais bodywork (1), reflexology (1), magnetic field therapy (2), neural therapy (1) and psychological counselling (2). The evidence is not compelling for any of these therapies, with many trials suffering from significant methodological flaws. There is evidence to suggest some benefit of nutritional therapy for the physical symptoms of MS. Magnetic field therapy and neural therapy appear to have a short-term beneficial effect on the physical symptoms of MS. Massage/bodywork and psychological counselling seem to improve depression, anxiety and self-esteem. The effectiveness for other CATs is unproven at this time. In all the CATs examined further investigations are needed in the form of rigorous large-scale trials.

  14. The Effectiveness of Physiotherapy and Complementary Therapies on Voice Disorders: A Systematic Review of Randomized Controlled Trials

    OpenAIRE

    Cardoso, Ricardo; Meneses,Rute F.; Lumini-Oliveira, José

    2017-01-01

    The treatment of voice disorders includes physiotherapy and complementary therapies. However, research to support these treatments is scarce. Objective: to verify the effectiveness of physiotherapy and complementary therapies on voice disorders. Research on electronic databases PubMed/Medline, SciELO, and LILACS was performed using the combination: voice AND (treatment OR intervention) according to PRISMA guidelines. Only randomized controlled trials (RCTs) were included in the review. Studie...

  15. Complementary therapy use by persons with multiple sclerosis: benefits and research priorities.

    Science.gov (United States)

    Esmonde, Lisa; Long, Andrew F

    2008-08-01

    People with multiple sclerosis (MS) are commonly actively involved in self-care, with many accessing complementary and alternative medicine (CAM) to help in symptom management. To provide increased insight into benefits from CAM use and service user ideas over research priorities, a two-part study, involving a questionnaire and interactive workshop, was undertaken with attendees at a national Congress of the MS Trust in the UK. The six most used therapies were reflexology, massage, yoga, relaxation and meditation, acupuncture and aromatherapy. Each was rated by a quarter to two-fifths as 'extremely helpful'. Insight into the nature of the therapeutic benefit was provided in user comments. Despite the self-selected nature of the sample, the findings point to potential benefits of a set of CAM therapies in helping people with MS. More research on potential benefits of therapies was called for by participants and on the dynamics of the therapeutic effect.

  16. Use of complementary and alternative therapies to promote sleep in critically ill patients.

    Science.gov (United States)

    Richards, Kathy; Nagel, Corey; Markie, Megan; Elwell, Jean; Barone, Claudia

    2003-09-01

    The efficacy of complementary and alternative therapies for sleep promotion in critically ill patients is largely unexamined. We found only seven studies (three on environmental interventions and one each on massage, music therapy, therapeutic touch, and, melatonin) that examined the effect of complementary and alternative therapies. A number of studies, however, have shown that massage, music therapy. and therapeutic touch promote relaxation and comfort in critically ill patients, which likely leads to improved sleep. Massage, music therapy, and therapeutic touch are safe for critically ill patients and should be routinely applied by ICU nurses who have received training on how to administer these specialized interventions. Environmental interventions, such as reducing noise, playing white noise such as ocean sounds, and decreasing interruptions to sleep for care, also are safe and logical interventions that ICU nurses should use to help patients sleep. Progressive muscle relaxation has been extensively studied and shown to be efficacious for improving sleep in persons with insomnia; however, progressive muscle relaxation requires that patients consciously attend to relaxing specific muscle groups and practice these techniques, which may be difficult for critically 11 patients. We do not currently recommend aromatherapy and alternative sedatives, such as valerian and melatonin, for sleep promotion in critically ill patients because the safety of these substances is unclear. In summary, we recommend that ICU nurses implement music therapy, environmental interventions, therapeutic touch, and relaxing massage to promote sleep in critically ill patients. These interventions are safe and may improve patient sleep, although randomized controlled trials are needed to test their efficacy. Aromatherapy and alternative sedatives require further investigation to determine their safety and efficacy.

  17. Tumor therapy evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Blattmann, H. [Paul Scherrer Inst. (PSI), Villigen (Switzerland); Kaser-Hotz, B.; Parvis, A. [Zurich Univ., Zurich (Switzerland)] [and others

    1997-08-01

    The aim of this program is to acquire data in order to evaluate the advantages of the proton spot scan technique compared to other forefront radiotherapy procedures, and to integrate the diagnostic and therapeutic possibilities of the life science department for human cancer therapy by testing it in veterinary radio-oncology. (author) 1 fig., 2 tab., 2 refs.

  18. Terapias complementarias en los cuidados: Humor y risoterapia Complementary therapies in the cares: humour and laugh

    Directory of Open Access Journals (Sweden)

    M. Carmen Ruiz Gómez

    2005-06-01

    Full Text Available Dentro de las terapias complementarias, la utilización de la risoterapia aporta beneficios tanto en la salud como en las situaciones de enfermedad, siendo un "instrumento de cuidados" barato y sin efectos secundarios. La tendencia actual hacia todo lo natural, las corrientes sobre cuidados de salud de las distintas culturas, unidas a las recomendaciones de la OMS a los enfermeros sobre la necesidad de utilizar los "métodos tradicionales y complementarios" para conseguir mejorar la salud de la población, hacen que la risoterapia sea una alternativa como instrumento opcional de cuidados. Planteamos una revisión bibliográfica con el objetivo de conocer la aplicación de la risoterapia en la salud y más concretamente en los cuidados enfermeros. Del análisis de los resultados podemos concretar que la risa se trabaja en diferentes ámbitos profesionales, no sólo en el sanitario. Es en el campo de la comunicación donde más se divulga esta terapia. Hemos encontrado pocas publicaciones de enfermería, pero muy valiosas ya que trabajan en el terreno de la investigación y de la docencia. Sería interesante que los profesionales de enfermería utilizaran esta terapia que mejora la calidad de los cuidados y ofrece un campo independiente propicio para la investigación.Related to complementary therapies, humour and laugh contribute to enhance health status and diminish illness situations. Humour as a therapy is an inexpensive tool in the patient care and it has not secondary effects in most cases. Current tendencies, either about natural ways to health or believes on health care of popular cultures, and who recommendations to patients in the use of traditional and complementary methods to improve population health, make humour and laugh an alternative therapy as an optional care tool. We have reviewed the literature with the aim of recognize the application of humour therapy on health and more specifically on nurse cares.On the basis of the review

  19. Rosemary (Rosmarinus officinalis L.) Extract as a Potential Complementary Agent in Anticancer Therapy.

    Science.gov (United States)

    González-Vallinas, Margarita; Reglero, Guillermo; Ramírez de Molina, Ana

    2015-01-01

    Cancer remains an important cause of mortality nowadays and, therefore, new therapeutic approaches are still needed. Rosemary (Rosmarinus officinalis L.) has been reported to possess antitumor activities both in vitro and in animal studies. Some of these activities were attributed to its major components, such as carnosic acid, carnosol, ursolic acid, and rosmarinic acid. Initially, the antitumor effects of rosemary were attributed to its antioxidant activity. However, in recent years, a lack of correlation between antioxidant and antitumor effects exerted by rosemary was reported, and different molecular mechanisms were related to its tumor inhibitory properties. Moreover, supported by the U.S. Food and Drug Administration and the European Food and Safety Authority, specific compositions of rosemary extract were demonstrated to be safe for human health and used as antioxidant additive in foods, suggesting the potential easy application of this agent as a complementary approach in cancer therapy. In this review, we aim to summarize the reported anticancer effects of rosemary, the demonstrated molecular mechanisms related to these effects and the interactions between rosemary and currently used anticancer agents. The possibility of using rosemary extract as a complementary agent in cancer therapy in comparison with its isolated components is discussed.

  20. Behaviors of providers of traditional korean medicine therapy and complementary and alternative medicine therapy for the treatment of cancer patients.

    Science.gov (United States)

    Yu, Jun-Sang; Kim, Chun-Bae; Kim, Ki-Kyong; Lee, Ji-Eun; Kim, Min-Young

    2015-03-01

    In Korea, cancer is one of the most important causes of death. Cancer patients have sought alternative methods, like complementary and alternative medicine (CAM) together with Western medicine, to treat cancer. Also, there are many kinds of providers of CAM therapy, including providers of Korean oriental medicine therapy. The purpose of this study is to identify the behaviors of Korean oriental medicine therapy and CAM therapy providers who treat cancer patients and to provide background knowledge for establishing a new policy with the management and quality control of CAM. Structured and well organized questionnaires were made, and 350 persons were surveyed concerning the providers of CAM or Korean oriental medicine. The questionnaires were collected and analyzed. The questionnaires (182) were collected. The questionnaires identified a total of 73 known providers, such as medicinal professionals or other providers of CAM suppliers, 35.6% of whom had had experience with treating cancer patients (52.6% vs. 29.6%). The treatment methods were a little different: alternative therapy and nutritional therapy being preferred by medicinal professionals and mind body modulation therapy and alternative therapy being preferred by other CAM providers. Four patients (7.4%) experienced side effects, and 6 patients (12.5%) experienced legal problems. As the method for managing the therapy, CAM providers, medicinal professionals, and other CAM providers had different viewpoints. For example, some CAM providers stated that both legislation and an official education on CAM or a national examination were needed as a first step to establish the provider's qualifications and that as a second step, a license test was needed for quality control. To the contrary, medicinal professionals stated that a license test was needed before legislation. Adequate management and quality control of CAM providers is thought to involve both education and legislation.

  1. Behaviors of Providers of Traditional Korean Medicine Therapy and Complementary and Alternative Medicine Therapy for the Treatment of Cancer Patients

    Directory of Open Access Journals (Sweden)

    Jun-Sang Yu

    2015-03-01

    Full Text Available Objectives: In Korea, cancer is one of the most important causes of death. Cancer patients have sought alternative methods, like complementary and alternative medicine (CAM together with Western medicine, to treat cancer. Also, there are many kinds of providers of CAM therapy, including providers of Korean oriental medicine therapy. The purpose of this study is to identify the behaviors of Korean oriental medicine therapy and CAM therapy providers who treat cancer patients and to provide background knowledge for establishing a new policy with the management and quality control of CAM. Methods: Structured and well organized questionnaires were made, and 350 persons were surveyed concerning the providers of CAM or Korean oriental medicine. The questionnaires were collected and analyzed. Results: The questionnaires (182 were collected. The questionnaires identified a total of 73 known providers, such as medicinal professionals or other providers of CAM suppliers, 35.6% of whom had had experience with treating cancer patients (52.6% vs. 29.6%. The treatment methods were a little different: alternative therapy and nutritional therapy being preferred by medicinal professionals and mind body modulation therapy and alternative therapy being preferred by other CAM providers. Four patients (7.4% experienced side effects, and 6 patients (12.5% experienced legal problems. As the method for managing the therapy, CAM providers, medicinal professionals, and other CAM providers had different viewpoints. For example, some CAM providers stated that both legislation and an official education on CAM or a national examination were needed as a first step to establish the provider’s qualifications and that as a second step, a license test was needed for quality control. To the contrary, medicinal professionals stated that a license test was needed before legislation. Conclusion: Adequate management and quality control of CAM providers is thought to involve both

  2. 'Thinking outside the box': complementary and alternative therapies use in paediatric oncology patients.

    Science.gov (United States)

    Molassiotis, Alexander; Cubbin, Denise

    2004-03-01

    The aim of this study was to determine the prevalence of complementary and alternative medicine (CAM) use among children with cancer who had received or were receiving treatment at a large hospital in the UK, including the identification of the most commonly used therapies and parental motives for doing so. Using a cross-sectional survey design, questionnaires were sent to parents of paediatric patients diagnosed with cancer. Of the 49 respondents, 32.7% reported using some type of CAM. The most commonly used therapies included multivitamins, aromatherapy massage, diets and music as therapy. Most children had used more than one therapy. Many of the factors that motivated parents to use CAM were related to helping or supporting their child's medical treatment. The main benefits identified from using CAM included increased confidence, pain relief and relaxation. The longer the time since diagnosis the more children tended to use CAM. The reasons for parents not using CAM included the child doing well and therefore not seeing the need for CAM use; not being aware of CAM; CAM not being offered and lack of information available. Parents identified a need for more information to be available both at ward level and for information about CAM to be discussed by medical staff, particularly at the start of treatment. The results indicate that CAM is frequently used by children and young people with cancer and that their use plays a substantial role in helping children through their conventional cancer treatment.

  3. The effect of complementary therapy for hospital nurses with high stress

    Directory of Open Access Journals (Sweden)

    Kazuko Onishi

    2016-01-01

    Full Text Available Objective: This study was to examine the effect of complementary therapy (CT for nurses with high stress levels. It was taken before we employ this technique for cancer survivors because cancer patients are a heterogeneous group that requires substantial resources to investigate. Methods: A quasi-experimental design with five groups was employed for this study. The groups were examined whether there were effects for reducing the stress and the differences in effectiveness among four intervention groups and a nonintervention group. Stress relief was measured using pulse rate and blood pressure measurements and the short form of the profile of mood states (POMS-SF. The participants practiced the therapy for 20 min twice per week for 3 weeks. A two-way factorial analysis of variance was used to analyze the data. Results: The study enrolled 98 nurses (92 female and 6 male with a mean age of 37.3 ± 10.5 years (range: 22–60 years. Fifty-nine nurses had 10 or more years of nursing experience. There were significant differences in pulse rate and the POMS-SF scores. All groups were effective for reducing the stress level of high-stress nurses, whereas four intervention CT groups were not more effective than nonintervention group. Conclusions: The complementary therapies were useful for nurses with high stress levels. Thus, they can be used as a self-management tool for such nurses. Afterward, we will use the CT for cancer survivors to determine whether it can improve the quality of life of cancer patients.

  4. Complementary and alternative medical therapy utilization by people with chronic fatiguing illnesses in the United States

    Directory of Open Access Journals (Sweden)

    Jones Ann-Britt

    2007-04-01

    Full Text Available Abstract Background Chronic fatiguing illnesses, including chronic fatigue syndrome (CFS, pose a diagnostic and therapeutic challenge. Previous clinical reports addressed the utilization of health care provided to patients with CFS by a variety of practitioners with other than allopathic training, but did not examine the spectrum of complementary and alternative medicine (CAM therapies used. This study was designed to measure CAM therapy use by persons with fatiguing illnesses in the United States population. Methods During a random-digit dialing survey to estimate the prevalence of CFS-like illness in urban and rural populations from different geographic regions of the United States, we queried the utilization of CAM including manipulation or body-based therapies, alternative medical systems, mind-body, biologically-based, and energy modalities. Results Four hundred forty fatigued and 444 non-fatigued persons from 2,728 households completed screening. Fatigued subjects included 53 persons with prolonged fatigue, 338 with chronic fatigue, and 49 with CFS-like illness. Mind-body therapy (primarily personal prayer and prayer by others was the most frequently used CAM across all groups. Among women, there was a significant trend of increasing overall CAM use across all subgroups (p-trend = 0.003. All categories of CAM use were associated with significantly poorer physical health scores, and all but one (alternative medicine systems were associated with significantly poorer mental health scores. People with CFS-like illness were significantly more likely to use body-based therapy (chiropractic and massage than non-fatigued participants (OR = 2.52, CI = 1.32, 4.82. Use of body-based therapies increased significantly in a linear trend across subgroups of non-fatigued, prolonged fatigued, chronic fatigued, and CFS-like subjects (p-trend = 0.002. People with chronic fatigue were also significantly more likely to use body-based therapy (OR = 1.52, CI = 1

  5. Use and perceived benefits of complementary therapies by cancer patients receiving conventional treatment in Italy.

    Science.gov (United States)

    Bonacchi, Andrea; Fazzi, Lorenzo; Toccafondi, Alessandro; Cantore, Maurizio; Mambrini, Andrea; Muraca, Maria Grazia; Banchelli, Grazia; Panella, Mauro; Focardi, Francesca; Calosi, Roberto; Di Costanzo, Francesco; Rosselli, Massimo; Miccinesi, Guido

    2014-01-01

    In Italy, data regarding the use of complementary therapies (CTs) among patients with cancer are sparse and discordant. The present study aimed to investigate the demographic and psychological characteristics of Italian cancer patients who use CTs and the perceived benefit of users. Eight hundred three patients from six Italian oncology departments were interviewed about CT use and completed two questionnaires to explore psychological distress and the resilience trait called sense of coherence (SOC). Patients included in the study had different primary tumor sites and were in different phases of the disease and care process. At the time of measurement, 37.9% of patients were using one or more types of CTs. The most commonly used CTs were diets and dietary supplements (27.5%), herbs (10.8%), homeopathy (6.4%), and mind-body therapies (5.5%). The Italian context is characterized by a high percentage of patients who informed their physicians about CT use (66.3%) and who experienced benefits (89.6%); 75.2% of the patients had used CTs in the past. Multivariate analysis revealed that young, female patients, who previously used complementary and alternative medicine in the past, appear more likely to use at least one type of CT in the present. Predictors of the use of CTs varied according to the type of CT. Among psychological factors, SOC was positively associated with both past and present CT use. Overall prevalence of CTs among Italian cancer patients is high and is in accordance with the European average. In addition to clinical and sociodemographic factors, the resilience trait SOC also was associated with CT use. Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  6. Compliments for the complementary.

    Science.gov (United States)

    Leigh, Christine

    1994-07-27

    We read with interest the news item 'Complementary therapy first' (June 15) regarding another centre for complementary therapies and research and would like to draw attention to the services offered at The Royal London Homeopathic Hospital NHS Trust. Based in Great Ormond Street, homeopathy and complementary therapies are and have been available on the NHS for many years.

  7. Complementary therapy support in cancer survivorship: a survey of complementary and alternative medicine practitioners' provision and perception of skills.

    Science.gov (United States)

    Samuel, C A; Faithfull, S

    2014-03-01

    This study reviewed the confidence and perceived skills of complementary and alternative medicine (CAM) practitioners in providing care and symptom management for clients post cancer. An e-survey was mailed to approximately 21, 000 CAM practitioners, targeted at those working with clients who were experiencing consequences of cancer and its treatments. Questions were asked about the main symptoms and concerns of clients, the confidence and current skill levels of practitioners and additional training requirements. Six hundred and twelve practitioners responded to the survey, 507 of whom were working with individuals experiencing the consequences of cancer and its treatments. Forty-five per cent (n = 134) had undertaken training in cancer prior to working with cancer patients, 61% (n = 182) had undertaken courses or study days relative to cancer care in the past two years. The most often treated symptoms or concerns of patients were those of a psychosocial nature, pain management and lymphoedema. CAM practitioners with limited knowledge and training are providing support to cancer survivors, particularly in services where the National Health Service has limited provision. CAM practitioners may fulfil a future role in providing long-term support for cancer survivors; however, in order to properly safeguard patients they are in need of further training and development. © 2013 John Wiley & Sons Ltd.

  8. Music therapy as part of the alternative-complementary therapy in cancer patients in hospital

    OpenAIRE

    Efstratios Athanassakis; Savvato Karavassiliadou

    2012-01-01

    Cancer is one of the modern health problems of people living in developed countries. Furthermore, therapeutic approaches to cancer patients is constantly updated with new data. Aim: The aim of the present study was to review the international literature referred to the application of music therapy in the treatment for pediatric and adult patients with cancer. Method and materials: The method of this study included bibliography research from both the review and the research literature on MEDLI...

  9. Complementary analyses in economic evaluation of health care

    NARCIS (Netherlands)

    M.A. Koopmanschap (Marc)

    1994-01-01

    textabstractThe steady increase in health care costs and the continuous emergence of new medical technologies have forced policy makers in health care to reconsider the current resource allocation and to become more selective with investing in new health care programs. Economic evaluations can

  10. The Effectiveness of Physiotherapy and Complementary Therapies on Voice Disorders: A Systematic Review of Randomized Controlled Trials

    Directory of Open Access Journals (Sweden)

    Ricardo Cardoso

    2017-04-01

    Full Text Available The treatment of voice disorders includes physiotherapy and complementary therapies. However, research to support these treatments is scarce. Objective: to verify the effectiveness of physiotherapy and complementary therapies on voice disorders. Research on electronic databases PubMed/Medline, SciELO, and LILACS was performed using the combination: voice AND (treatment OR intervention according to PRISMA guidelines. Only randomized controlled trials (RCTs were included in the review. Studies were analyzed using the physiotherapy evidence database (PEDro scale and the Center for Evidence-Based Medicine’s Levels of Evidence scale. Eight papers met the inclusion criteria. From the RCTs included in this review, six assessed massage, one transcutaneous electrical nerve stimulation (TENS, one refer to spinal manipulative therapy, and one to acupuncture. The literature regarding the effectiveness of physiotherapy and complementary therapies was good in both quality and results, indicating that massage, TENS, and acupuncture seem to be effective treatments to reduce voice complaints and improve voice quality, supporting the inclusion of complementary therapies but mostly physiotherapy interventions in the treatment of patients with voice disorders.

  11. The Effectiveness of Physiotherapy and Complementary Therapies on Voice Disorders: A Systematic Review of Randomized Controlled Trials.

    Science.gov (United States)

    Cardoso, Ricardo; Meneses, Rute F; Lumini-Oliveira, José

    2017-01-01

    The treatment of voice disorders includes physiotherapy and complementary therapies. However, research to support these treatments is scarce. to verify the effectiveness of physiotherapy and complementary therapies on voice disorders. Research on electronic databases PubMed/Medline, SciELO, and LILACS was performed using the combination: voice AND (treatment OR intervention) according to PRISMA guidelines. Only randomized controlled trials (RCTs) were included in the review. Studies were analyzed using the physiotherapy evidence database (PEDro) scale and the Center for Evidence-Based Medicine's Levels of Evidence scale. Eight papers met the inclusion criteria. From the RCTs included in this review, six assessed massage, one transcutaneous electrical nerve stimulation (TENS), one refer to spinal manipulative therapy, and one to acupuncture. The literature regarding the effectiveness of physiotherapy and complementary therapies was good in both quality and results, indicating that massage, TENS, and acupuncture seem to be effective treatments to reduce voice complaints and improve voice quality, supporting the inclusion of complementary therapies but mostly physiotherapy interventions in the treatment of patients with voice disorders.

  12. Complementary and alternative therapies in hospice: The national home and hospice care survey: United States, 2007.

    Science.gov (United States)

    Bercovitz, Anita; Sengupta, Manisha; Jones, Adrienne; Harris-Kojetin, Lauren D

    2011-01-19

    Objective-This report presents national estimates on the provision and use of complementary and alternative therapies (CAT) in hospice. Comparisons of organizational characteristics of hospice care providers are presented by whether the provider offered CAT. Comparisons of selected characteristics of patients discharged from hospice are presented by whether they received care from a provider that offered CAT, and whether they received a CAT service. Methods-Estimates are based on data from the 2007 National Home and Hospice Care Survey (NHHCS), conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics. Results-In 2007, 41.8% of hospice care providers offered CAT services, had a CAT provider on staff or under contract, or both. Among hospice care providers offering CAT, over one-half offered massage (71.7%), supportive group therapy (69.0%), music therapy (62.2%), pet therapy (58.6%), or guided imagery or relaxation (52.7%). Of the hospice care providers that offered CAT, 21.5% had at least one discharged hospice patient who received CAT during hospice care. Overall, 4.9% of all discharged hospice patients received at least one CAT from the hospice care provider. Over one-half of discharged patients (56.5%) received care from a provider that offered CAT, and of those, 8.6% received at least one CAT from the hospice care provider during their stays. There were no differences in demographics, health, functional status, or admission diagnoses between patients discharged from hospice either by whether they received care from a provider that offered CAT or whether they received CAT.

  13. Expectations of patients and parents of children with asthma regarding access to complementary therapy information and services via the NHS: a qualitative study.

    Science.gov (United States)

    Shaw, Alison; Thompson, Elizabeth A; Sharp, Deborah J

    2006-12-01

    To explore the expectations of patients and parents of children with asthma regarding access to complementary therapies via the NHS. Fifty semi-structured interviews with adults and parents of children with asthma, from a range of health-care settings, including users and non-users of complementary therapies. Interviews were recorded, transcribed verbatim and the data were analysed thematically. Thirty-one patients were using complementary therapies for asthma, six were using complementary therapies for other health problems and 13 were non-users. Various therapies were used for asthma, most commonly homeopathy and breathing techniques, predominantly outside the NHS. Two broad themes emerging from the data were expectations about access to information and knowledge about complementary therapies via NHS health professionals, and expectations regarding access to complementary therapy services via the NHS. As a minimum, the majority of participants wanted NHS health professionals to be more 'open' towards and know more about complementary therapies than their patients - perceived as not currently usual. Most were positive about greater NHS access to complementary therapy services, for enhancing patient choice, improving equality in access for less affluent patients and facilitating patients' self-help. Participants who were highly sceptical about complementary therapies argued that lack of scientific evidence of effectiveness prohibited the need for greater complementary therapy knowledge or service provision within the NHS. Alongside their expectations, patients and parents expressed realistic views about facilitators and barriers to greater access. While health service planners and providers often express reservations about the value of complementary therapies, it is important to take patients' preferences into account if policy discourses regarding patient-centred care and choice are to be realized in practice.

  14. Predictors of use of complementary and alternative therapies among patients with cancer.

    Science.gov (United States)

    Fouladbakhsh, Judith M; Stommel, Manfred; Given, Barbara A; Given, Charles W

    2005-11-03

    To determine predictors of use of complementary and alternative medicine (CAM) therapies among patients with cancer. Secondary analysis of two federally funded panel studies. Urban and rural communities in the midwestern United States. Patients with lung, breast, colon, or prostate cancer (N = 968) were interviewed at two points in time. 97% received conventional cancer treatment, and 30% used CAM. The sample was divided evenly between men and women, who ranged in age from 28-98; the majority was older than 60. Data from a patient self-administered questionnaire were used to determine CAM users. Responses indicated use of herbs and vitamins, spiritual healing, relaxation, massage, acupuncture, energy healing, hypnosis, therapeutic spas, lifestyle diets, audio or videotapes, medication wraps, and osteopathic, homeopathic, and chiropractic treatment. Dependent variable for analysis was use or nonuse of any of the identified CAM therapies at time of interviews. Independent variables fell into the following categories: (a) predisposing (e.g., gender, age, race, education, marital status), (b) enabling (e.g., income, health insurance status, caregiver presence, geographic location), and (c) need (e.g., cancer stage, site, symptoms, treatment, perceived health need). Significant predictors of CAM use were gender, marital status, cancer stage, cancer treatment, and number of severe symptoms experienced. Patients with cancer are using CAM while undergoing conventional cancer treatment. Nurses need to assess for CAM use, advocate for protocols and guidelines for routine assessment, increase knowledge of CAM, and examine coordination of services between conventional medicine and CAM to maximize positive patient outcomes.

  15. Natural healers: a review of animal assisted therapy and activities as complementary treatment for chronic conditions.

    Science.gov (United States)

    Reed, Reiley; Ferrer, Lilian; Villegas, Natalia

    2012-01-01

    The primary objective of this review is to synthesize the existing literature on the use of animal-assisted therapy and activity (AAT/A) as complementary treatment among people living with chronic disease and to discuss the possible application of this practice among children living with HIV. Relevant databases were searched between March 10 and April 11, 2011, using the words: animal assisted therapy or treatment and chronic conditions or diseases. Thirty-one articles were found and 18 followed the inclusion and exclusion criteria. Research suggests that AAT/A is effective for different patient profiles, particularly children. Interaction with dogs has been found to increase positive behaviors, such as sensitivity and focus, in children with social disabilities. Decreased levels of pain have also been reported among child patients as a result of AAT/A. More research should be done in the area of children living with chronic diseases that require strict adherence to treatment, such as HIV, and on AAT/A's prospective use as an educational tool to teach children about the importance of self-care for their medical conditions.

  16. Herbal therapy and quality of life in hypertension patients at health facilities providing complementary therapy

    Directory of Open Access Journals (Sweden)

    Nurhayati Nurhayati

    2016-07-01

    -sectional study used a of data from medical records in hypertension subjects health care facilities in provinces of: DKI Jakarta, Central Java, West Java, East Java, Bali, Banten, and South Sumatra which used complementary medicine for treatment patients. The interview and recording of patient medical records was done by 77 medical doctors who practicing herbal medicine. The quality of life based on Short Form 36 WHO questionnaire for getting data quality of life of hypertension patients. Risk factors that related to quality of life in hypertension patients were analyzed using Cox regression. Results: Total patients had been collected were 189 subjects. The proportion of those who had good quality of life were 51.9% (97/187. Dominant risk factors related to quality of life in hypertension patients were level of education and type of treatment. Compared with those who had low education level, those who had middle and high education level had 83% more risk to be good quality of life. Furthermore, in terms of type of treatment, those who had pharmaceutical and herbal/traditional had 29% more risk to be good quality of life. Conclusion: Hypertension subjects who had higher level of education and had pharmaceutical and herbal/traditional had more risk to be good quality of life. Keywords: quality of life, hypertension patients 

  17. Knowledge, Attitudes, and Personal Use of Complementary and Alternative Medicine among Occupational Therapy Educators in the United States.

    Science.gov (United States)

    Bradshaw, Michelle L

    2016-01-01

    The purpose of this study was to establish a baseline description of American occupational therapy educators' knowledge, attitudes, and personal use of complementary and alternative medicine (CAM) as a first step in exploring the larger issue of future occupational therapy practitioners' preparedness for meeting clients' occupational needs in today's evolving healthcare environment. Results of this cross-sectional survey highlighted limitations of occupational therapy educators' knowledge of common CAM concepts and therapies across all demographic variables, varying attitudes towards CAM in general and its inclusion in occupational therapy education, and personal use of common CAM therapies. Without increased occupational therapy educator knowledge about CAM and engagement in the current healthcare practices, occupational therapy practitioners are at risk for having a limited role in integrative healthcare.

  18. Music therapy as specific and complementary training for adults after cochlear implantation: A pilot study.

    Science.gov (United States)

    Hutter, E; Argstatter, H; Grapp, M; Plinkert, P K

    2015-09-01

    Although cochlear implant (CI) users achieve good speech comprehension, they experience difficulty perceiving music and prosody in speech. As the provision of music training in rehabilitation is limited, a novel concept of music therapy for rehabilitation of adult CI users was developed and evaluated in this pilot study. Twelve unilaterally implanted, postlingually deafened CI users attended ten sessions of individualized and standardized training. The training started about 6 weeks after the initial activation of the speech processor. Before and after therapy, psychological and musical tests were applied in order to evaluate the effects of music therapy. CI users completed the musical tests in two conditions: bilateral (CI + contralateral, unimplanted ear) and unilateral (CI only). After therapy, improvements were observed in the subjective sound quality (Hearing Implant Sound Quality Index) and the global score on the self-concept questionnaire (Multidimensional Self-Concept Scales) as well as in the musical subtests for melody recognition and for timbre identification in the unilateral condition. Discussion Preliminary results suggest improvements in subjective hearing and music perception, with an additional increase in global self-concept and enhanced daily listening capacities. The novel concept of individualized music therapy seems to provide an effective treatment option in the rehabilitation of adult CI users. Further investigations are necessary to evaluate effects in the area of prosody perception and to separate therapy effects from general learning effects in CI rehabilitation.

  19. Evaluation of a complementary cyber education program for a pathophysiology class.

    Science.gov (United States)

    Yoo, Ji-Soo; Ryue, Sook-Hee; Lee, Jung Eun; Ahn, Jeong-Ah

    2009-12-01

    The goal of this study was to develop and evaluate a complementary cyber education program for a required pathophysiology class for nursing students. The cyber education program comprised electronic bulletin boards, correspondence material storage, an announcement section, a report submission section, reference sites, and statistics on learning rates. Twelve online lectures complemented five lectures in the classroom. To evaluate the course's educational effectiveness, we performed an online objective questionnaire and an open questionnaire survey anonymously, and compared the complementary cyber education program with traditional classroom education. The complementary cyber education program effected significant improvements in scores for importance with regard to major, clarity of goals and education plans for courses, professor readiness, preciseness and description of lectures, amount and efficiency of assignments, and fairness in appraisal standards compared with the traditional classroom education group. This study indicates that a complementary cyber education program provides nursing students with the flexibility of time and space, the newest information through updated lectures, efficient motivational aids through intimacy between the lecturer and students, and concrete and meaningful tasks. The complementary cyber education course also increased student effort toward studying and student satisfaction with the class.

  20. Care seeking, use of complementary therapies and self management among people with type 2 diabetes and cardiovascular disease

    DEFF Research Database (Denmark)

    Manderson, Lenore; Canaway, Rachel; Unantenne, N.

    2012-01-01

    In a multiphase mixed method interdisciplinary study known as CAMELOT, we explored why people under treatment for type 2 diabetes and/or cardiovascular disease also presented to and used complementary or alternative medicine (CAM) practitioners or therapies in order to establish the relationship...

  1. Using Religious Songs as an Integrative and Complementary Therapy for the Management of Psychological Symptoms Among African American Cancer Survivors.

    Science.gov (United States)

    Hamilton, Jill B; Worthy, Valarie C; Kurtz, Melissa J; Cudjoe, Joycelyn; Johnstone, Peter A

    Acupuncture, acupressure, yoga, meditation, cognitive-behavioral techniques, and, to a lesser extent, music are among those integrative and complementary therapies with known beneficial effects on psychological symptoms. However, noticeably absent from this research is the use of religious song as a type of integrative and complementary therapy. The aim of this study was to explore how religious songs were used to alleviate psychological symptoms associated with a cancer diagnosis among a sample of older African American cancer survivors. Thirty-one older African American cancer survivors residing in the Southeastern US participated in a qualitative descriptive study involving criterion sampling, open-ended semistructured interviews, and qualitative content analysis. Participants used religious songs in response to feeling depressed, low, or sad; feeling weak and seeking strength to endure treatment; and feeling worried, anxious, or fearful. Religious songs were also a source of support and hope. Types of religious songs included instructive, thanksgiving and praise, memory of forefathers, communication with God, and life after death. Religious songs appear to be an important form of religious expression in this population and used to manage psychological symptoms. Integrative and complementary oncology therapy has generally focused on yoga, meditation, acupuncture, and cognitive-behavioral techniques. However, religious songs are an important strategy used among older African American cancer patients. Religious songs can be readily integrated into cancer care. The incorporation of religious songs into spiritually based support groups and other integrative and complementary therapies might enhance health outcomes among this medically underserved cancer population.

  2. The effect of complementary music therapy on the patient's postoperative state anxiety, pain control, and environmental noise satisfaction.

    Science.gov (United States)

    Comeaux, Tressa; Comeaux, Tressa

    2013-01-01

    Postoperative pain is difficult to manage with analgesia alone. Complementary interventions such as music therapy provide a level of distraction, thus promoting comfort. In this study, decreased pain and environmental noise were demonstrated, without diminishing state anxiety, in a group of postoperative patients.

  3. Lymphedema after breast or gynecological cancer: use and effectiveness of mainstream and complementary therapies.

    Science.gov (United States)

    Finnane, Anna; Liu, Yuan; Battistutta, Diana; Janda, Monika; Hayes, Sandra C

    2011-09-01

    The purpose of this study was to describe the use, as well as perceived effectiveness, of mainstream and complementary and alternative medicine (CAM) therapies in the treatment of lymphedema following breast or gynecological cancer. Further, the study assessed the relationship between the characteristics of lymphedema (including type, severity, stability, and duration), and the use of CAM and/or mainstream treatment. This was a cross-sectional study using a convenience sample of women with lymphedema following breast and gynecological cancers. A self-administered questionnaire was sent to 247 potentially eligible women. Of those returned (50%), 23 were ineligible and 6 were excluded due to level of missing data. In the previous 12 months, the majority of women (90%) had used mainstream treatments to treat their lymphedema, with massage being the most commonly used (86%). One (1) in 2 women had used CAM to treat their lymphedema, and 98% of those using CAM were also using mainstream treatments. Over 27 types of CAM were reported, with use of a chi machine, vitamin E supplements, yoga, and meditation being the most commonly reported forms. The perceived effectiveness ratings (1-7 with 7=completely effective) of mainstream (mean±standard deviation (SD): 5.3±1.5) and CAM therapies (mean±SD: 5.2+1.6) were considered high. These results demonstrate that mainstream and CAM treatment use is common, varied, and considered to be effective among women with lymphedema following breast or gynecological cancer. Furthermore, it highlights the immediate need for larger prospective studies assessing the inter-relationship between the use of mainstream and CAM therapies for treatment success.

  4. Evaluation of programs to improve complementary feeding in infants and young children.

    Science.gov (United States)

    Frongillo, Edward A

    2017-10-01

    Evaluation of complementary feeding programs is needed to enhance knowledge on what works, to document responsible use of resources, and for advocacy. Evaluation is done during program conceptualization and design, implementation, and determination of effectiveness. This paper explains the role of evaluation in the advancement of complementary feeding programs, presenting concepts and methods and illustrating them through examples. Planning and investments for evaluations should occur from the beginning of the project life cycle. Essential to evaluation is articulation of a program theory on how change would occur and what program actions are required for change. Analysis of program impact pathways makes explicit the dynamic connections in the program theory and accounts for contextual factors that could influence program effectiveness. Evaluating implementation functioning is done through addressing questions about needs, coverage, provision, and utilization using information obtained from process evaluation, operations research, and monitoring. Evaluating effectiveness is done through assessing impact, efficiency, coverage, process, and causality. Plausibility designs ask whether the program seemed to have an effect above and beyond external influences, often using a nonrandomized control group and baseline and end line measures. Probability designs ask whether there was an effect using a randomized control group. Evaluations may not be able to use randomization, particularly for programs implemented at a large scale. Plausibility designs, innovative designs, or innovative combinations of designs sometimes are best able to provide useful information. Further work is needed to develop practical designs for evaluation of large-scale country programs on complementary feeding. © 2017 John Wiley & Sons Ltd.

  5. Complementary and alternative medical therapies for chronic low back pain: What treatments are patients willing to try?

    Directory of Open Access Journals (Sweden)

    Erro Janet

    2004-07-01

    Full Text Available Abstract Background Although back pain is the most common reason patients use complementary and alternative medical (CAM therapies, little is known about the willingness of primary care back pain patients to try these therapies. As part of an effort to refine recruitment strategies for clinical trials, we sought to determine if back pain patients are willing to try acupuncture, chiropractic, massage, meditation, and t'ai chi and to learn about their knowledge of, experience with, and perceptions about each of these therapies. Methods We identified English-speaking patients with diagnoses consistent with chronic low back pain using automated visit data from one health care organization in Boston and another in Seattle. We were able to confirm the eligibility status (i.e., current low back pain that had lasted at least 3 months of 70% of the patients with such diagnoses and all eligible respondents were interviewed. Results Except for chiropractic, knowledge about these therapies was low. Chiropractic and massage had been used by the largest fractions of respondents (54% and 38%, respectively, mostly for back pain (45% and 24%, respectively. Among prior users of specific CAM therapies for back pain, massage was rated most helpful. Users of chiropractic reported treatment-related "significant discomfort, pain or harm" more often (23% than users of other therapies (5–16%. Respondents expected massage would be most helpful (median of 7 on a 0 to 10 scale and meditation least helpful (median of 3 in relieving their current pain. Most respondents indicated they would be "very likely" to try acupuncture, massage, or chiropractic for their back pain if they did not have to pay out of pocket and their physician thought it was a reasonable treatment option. Conclusions Most patients with chronic back pain in our sample were interested in trying therapeutic options that lie outside the conventional medical spectrum. This highlights the need for additional

  6. Functional relaxation as complementary therapy in irritable bowel syndrome: a randomized, controlled clinical trial.

    Science.gov (United States)

    Lahmann, Claas; Röhricht, Frank; Sauer, Nina; Noll-Hussong, Michael; Ronel, Joram; Henrich, Gerhard; von Arnim, Angela; Loew, Thomas

    2010-01-01

    Irritable bowel syndrome (IBS) is a frequently disabling and almost invariably distressing disease with a high overall prevalence. Numerous trials identified the importance of psychogenic and emotional etiological factors, and this is obvious in clinical practice. Although relaxation techniques are frequently recommended, there is still a lack of evidence for their efficacy in the management of IBS. This study therefore aims to determine the efficacy of functional relaxation (FR) in IBS. The subjects were 80 patients with IBS. Participants were randomly allocated either to FR or to enhanced medical care (EMC: treatment as usual plus two counseling interviews) as control intervention with 2 weekly sessions over the 5-week trial each. Thirty-nine (39) patients completed FR and 39 received EMC. An impairment-severity score (IS) was employed as the primary outcome parameter with assessment at baseline, after treatment, and again after 3-month follow-up. FR was significantly superior to EMC with a standardized effect size of 0.85. The achieved effects through FR remained stable in terms of psychic and bodily impairment after 3-month follow-up. The results of our trial suggest a positive effect of FR training on subjective functional impairment in the IS, if provided in addition to treatment as usual (TAU). There appears to be a clinically relevant long-term benefit of FR as a nonpharmacological and complementary therapy approach in IBS.

  7. Concurrent Complementary and Alternative Medicine CAM and Conventional Rehabilitation Therapy in the Management of Children with Developmental Disorders

    Directory of Open Access Journals (Sweden)

    Soo Yeon Kim

    2013-01-01

    Full Text Available Background. We investigated the concurrent use of conventional rehabilitations and complementary and alternative medicine (CAM therapies for the long-term management of children with developmental disorders (DDs. Methods. The parents or caregivers of 533 children with DDs (age range, 1–19 years who visited the rehabilitation centers were surveyed using in depth face-to-face interviews. Results. Of the 533 patients enrolled, 520 completed the questionnaire (97% response rate. A total of 292 (56% children were receiving multiple therapies, more than two conventional rehabilitations and CAM, at the time of the interview. A total of 249 (48% children reported lifetime CAM use, 23% used CAM at the time of the interview, and 62% of the patients planned to use CAM therapy in the future. Conventional rehabilitation therapies used at the time of the interview included physical therapy (30%, speech therapy (28%, and occupational therapy (19%, and the CAM therapies included herbal medicine (5% and acupuncture or moxibustion (3%. The respondents indicated that in the future they planned to use acupuncture or moxibustion (57%, occupational therapy (18%, cognitive behavioral therapy (16%, speech therapy (10%, and physical therapy (8%. Conclusion. Concurrent management as conventional rehabilitations and CAM therapies is widely used by children with DDs.

  8. A review of the clinical evidence for complementary and alternative therapies in Parkinson's disease.

    Science.gov (United States)

    Bega, Danny; Gonzalez-Latapi, Paulina; Zadikoff, Cindy; Simuni, Tanya

    2014-10-01

    No conventional treatment has been convincingly demonstrated to slow or stop the progression of Parkinson's disease (PD). Dopaminergic therapy is the gold standard for managing the motor disability associated with PD, but it falls short of managing all of the aspects of the disease that contribute to quality of life. Perhaps for this reason, an increasing number of patients are searching for a more holistic approach to healthcare. This is not to say that they are abandoning the standard and effective symptomatic therapies for PD, but rather are complementing them with healthy living, mind-body practices, and natural products that empower patients to be active participants in their healthcare and widen the net under which disease modification might one day be achieved. Despite high rates of utilization of complementary and alternative medicine (CAM) practices, data on efficacy is generally limited, restricting physicians in providing guidance to interested patients. Exercise is now well-established as integral in the management of PD, but mind-body interventions such as Tai Chi that incorporate relaxation and mindfulness with physical activity should be routinely encouraged as well. While no comment can be made about neuroplastic or disease-modifying effects of mind-body interventions, patients should be encouraged to be as active as possible and engage with others in enjoyable and challenging activities such as dance, music therapy, and yoga. Many PD patients also choose to try herbs, vitamins, and neutraceuticals as part of a healthy lifestyle, with the added expectation that these products may lower free radical damage and protect them against further cell death. Evidence for neuroprotection is limited, but patients can be encouraged to maintain a healthy diet rich in "high-power," low-inflammatory foods, while at the same time receiving education that many promising natural products have produced disappointing results in clinical trials. It is vital that the

  9. Developing a patient-centered outcome measure for complementary and alternative medicine therapies I: defining content and format

    Directory of Open Access Journals (Sweden)

    Ritenbaugh Cheryl

    2011-12-01

    Full Text Available Abstract Background Patients receiving complementary and alternative medicine (CAM therapies often report shifts in well-being that go beyond resolution of the original presenting symptoms. We undertook a research program to develop and evaluate a patient-centered outcome measure to assess the multidimensional impacts of CAM therapies, utilizing a novel mixed methods approach that relied upon techniques from the fields of anthropology and psychometrics. This tool would have broad applicability, both for CAM practitioners to measure shifts in patients' states following treatments, and conventional clinical trial researchers needing validated outcome measures. The US Food and Drug Administration has highlighted the importance of valid and reliable measurement of patient-reported outcomes in the evaluation of conventional medical products. Here we describe Phase I of our research program, the iterative process of content identification, item development and refinement, and response format selection. Cognitive interviews and psychometric evaluation are reported separately. Methods From a database of patient interviews (n = 177 from six diverse CAM studies, 150 interviews were identified for secondary analysis in which individuals spontaneously discussed unexpected changes associated with CAM. Using ATLAS.ti, we identified common themes and language to inform questionnaire item content and wording. Respondents' language was often richly textured, but item development required a stripping down of language to extract essential meaning and minimize potential comprehension barriers across populations. Through an evocative card sort interview process, we identified those items most widely applicable and covering standard psychometric domains. We developed, pilot-tested, and refined the format, yielding a questionnaire for cognitive interviews and psychometric evaluation. Results The resulting questionnaire contained 18 items, in visual analog scale format

  10. Developing a patient-centered outcome measure for complementary and alternative medicine therapies I: defining content and format

    Science.gov (United States)

    2011-01-01

    Background Patients receiving complementary and alternative medicine (CAM) therapies often report shifts in well-being that go beyond resolution of the original presenting symptoms. We undertook a research program to develop and evaluate a patient-centered outcome measure to assess the multidimensional impacts of CAM therapies, utilizing a novel mixed methods approach that relied upon techniques from the fields of anthropology and psychometrics. This tool would have broad applicability, both for CAM practitioners to measure shifts in patients' states following treatments, and conventional clinical trial researchers needing validated outcome measures. The US Food and Drug Administration has highlighted the importance of valid and reliable measurement of patient-reported outcomes in the evaluation of conventional medical products. Here we describe Phase I of our research program, the iterative process of content identification, item development and refinement, and response format selection. Cognitive interviews and psychometric evaluation are reported separately. Methods From a database of patient interviews (n = 177) from six diverse CAM studies, 150 interviews were identified for secondary analysis in which individuals spontaneously discussed unexpected changes associated with CAM. Using ATLAS.ti, we identified common themes and language to inform questionnaire item content and wording. Respondents' language was often richly textured, but item development required a stripping down of language to extract essential meaning and minimize potential comprehension barriers across populations. Through an evocative card sort interview process, we identified those items most widely applicable and covering standard psychometric domains. We developed, pilot-tested, and refined the format, yielding a questionnaire for cognitive interviews and psychometric evaluation. Results The resulting questionnaire contained 18 items, in visual analog scale format, in which each line was

  11. Proposal of indicators to evaluate complementary feeding based on World Health Organization indicators.

    Science.gov (United States)

    Saldan, Paula Chuproski; Venancio, Sonia Isoyama; Saldiva, Silvia Regina Dias Medici; de Mello, Débora Falleiros

    2016-09-01

    This study compares complementary feeding World Health Organization (WHO) indicators with those built in accordance with Brazilian recommendations (Ten Steps to Healthy Feeding). A cross-sectional study was carried out during the National Immunization Campaign against Poliomyelitis in Guarapuava-Paraná, Brazil, in 2012. Feeding data from 1,355 children aged 6-23 months were obtained through the 24 h diet recall. Based on five indicators, the proportion of adequacy was evaluated: introduction of solid, semi-solid, or soft foods; minimum dietary diversity; meal frequency; acceptable diet; and consumption of iron-rich foods. Complementary feeding showed adequacy higher than 85% in most WHO indicators, while review by the Ten Steps assessment method showed a less favorable circumstance and a high intake of unhealthy foods. WHO indicators may not reflect the complementary feeding conditions of children in countries with low malnutrition rates and an increased prevalence of overweight/obesity. The use of indicators according to the Ten Steps can be useful to identify problems and redirect actions aimed at promoting complementary feeding. © 2016 John Wiley & Sons Australia, Ltd.

  12. State-trait anxiety inventory (STAI) scores during pregnancy following intervention with complementary therapies.

    Science.gov (United States)

    Newham, James J; Westwood, Melissa; Aplin, John D; Wittkowski, Anja

    2012-12-15

    We review intervention trials that have used the State-Trait Anxiety inventory (STAI) as a measure of maternal anxiety in pregnancy in order to provide ranges in scores before and after participation in complementary therapy-based interventions to highlight the expected ranges of scores in pregnancy and determine whether anxiety in pregnancy is amenable to change when measured by the STAI. Combinations of the key words "STAI", "state anxiety", "pregnancy", "anxiety", "maternal", "stress", "outcome" and "intervention" were used to search publications between January 1970 and January 2011. Studies eligible for inclusion recruited low risk, adult women to a non-pharmacological intervention or a comparator group, and measured anxiety at baseline and post-intervention. Ten studies were eligible. Scores were routinely high compared to expected ranges in non-pregnant populations. Studies examining the immediate effects of an intervention consistently reported significantly lowered STAI scores after a single session. Likewise, studies examining the effect of interventions consisting of multiple sessions over the course of pregnancy found that those in the intervention group were more likely to show an improvement in STAI scores. Heterogeneity in type and duration of intervention prevent drawing conclusions on which were most effective in reducing anxiety. Scores on the STAI appear amenable to change during pregnancy, both after a single session and multiple sessions of interventions designed to reduce maternal anxiety. This review offers a guideline for the expected range of scores for future studies examining the efficacy of interventions in pregnancy when using the STAI. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

  13. Economic Evaluation of Complementary and Alternative Medicine in Oncology: Is There a Difference Compared to Conventional Medicine?

    Science.gov (United States)

    Huebner, Jutta; Prott, Franz J; Muecke, Ralph; Stoll, Christoph; Buentzel, Jens; Muenstedt, Karsten; Micke, Oliver

    2017-01-01

    To analyze the financial burden of complementary and alternative medicine (CAM) in cancer treatment. Based on a systematic search of the literature (Medline and the Cochrane Library, combining the MeSH terms 'complementary therapies', 'neoplasms', 'costs', 'cost analysis', and 'cost-benefit analysis'), an expert panel discussed different types of analyses and their significance for CAM in oncology. Of 755 publications, 43 met our criteria. The types of economic analyses and their parameters discussed for CAM in oncology were cost, cost-benefit, cost-effectiveness, and cost-utility analyses. Only a few articles included arguments in favor of or against these different methods, and only a few arguments were specific for CAM because most CAM methods address a broad range of treatment aim parameters to assess effectiveness and are hard to define. Additionally, the choice of comparative treatments is difficult. To evaluate utility, healthy subjects may not be adequate as patients with a life-threatening disease and may be judged differently, especially with respect to a holistic treatment approach. We did not find any arguments in the literature that were directed at the economic analysis of CAM in oncology. Therefore, a comprehensive approach assessment based on criteria from evidence-based medicine evaluating direct and indirect costs is recommended. The usual approaches to conventional medicine to assess costs, benefits, and effectiveness seem adequate in the field of CAM in oncology. Additionally, a thorough deliberation on the comparator, endpoints, and instruments is mandatory for designing studies. © 2016 S. Karger AG, Basel.

  14. Commercialization strategy of the herbal composition HemoHIM as a complementary drug for anti-cancer therapies

    Energy Technology Data Exchange (ETDEWEB)

    Jo, Sungkee; Jung, Uhee; Park, Haeran

    2013-01-15

    Ο Purpose - Establishment of strategy for the development of HemoHIM as a complementary drug for cancer therapies including non-clinical data preparation, obtainment of a research project grant, base of manufacturing process and raw material standardization Ο Research Results - Examination and confirmation of the essential requirements to develop the complementary drug for anticancer therapies by consulting with Korea FDA, and clinical CRO, and medical experts (animal efficacy study, toxicological safety test, standard analytical method, raw material standardization) - Obtainment of a governmental research project for 3 years from Ministry of Health and Welfare to develop HemoHIM as an complementary herbal drug for anti-cancer therapies - Acquisition of fundamental data on the manufacturing process and the raw material standardization for the optimal efficacy of HemoHIM Ο Expected benefit - Planning to get the approval of IND from Korea FDA by 2015 after completing the non-clinical study through the on-going project from Ministry of Health and Welfare - Planning to commercialize the product by 2017.

  15. Tools to improve planning, implementation, monitoring, and evaluation of complementary feeding programmes.

    Science.gov (United States)

    Untoro, Juliawati; Childs, Rachel; Bose, Indira; Winichagoon, Pattanee; Rudert, Christiane; Hall, Andrew; de Pee, Saskia

    2017-10-01

    Adequate nutrient intake is a prerequisite for achieving good nutrition status. Suboptimal complementary feeding practices are a main risk factor for stunting. The need for systematic and user-friendly tools to guide the planning, implementation, monitoring, and evaluation of dietary interventions for children aged 6-23 months has been recognized. This paper describes five tools, namely, ProPAN, Optifood, Cost of the Diet, Fill the Nutrient Gap, and Monitoring Results for Equity System that can be used in different combinations to improve situation analysis, planning, implementation, monitoring, or evaluation approaches for complementary feeding in a particular context. ProPAN helps with development of strategies and activities designed to change the behaviours of the target population. Optifood provides guidance for developing food-based recommendations. The Cost of the Diet can provide insight on economic barriers to accessing a nutritious and balanced diet. The Fill the Nutrient Gap facilitates formulation of context-specific policies and programmatic approaches to improve nutrient intake, through a multistakeholder process that uses insights from linear programming and secondary data. The Monitoring Results for Equity System helps with analysis of gaps, constraints, and determinants of complementary feeding interventions and adoption of recommended practices especially in the most vulnerable and deprived populations. These tools, and support for their use, are readily available and can be used either alone and/or complementarily throughout the programme cycle to improve infant and young child-feeding programmes at subnational and national levels. © 2017 John Wiley & Sons Ltd.

  16. Acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee: randomised controlled trial

    Science.gov (United States)

    Vas, Jorge; Méndez, Camila; Perea-Milla, Emilio; Vega, Evelia; Panadero, María Dolores; León, José María; Borge, Miguel Ángel; Gaspar, Olga; Sánchez-Rodríguez, Francisco; Aguilar, Inmaculada; Jurado, Rosario

    2004-01-01

    Objectives To analyse the efficacy of acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee, with respect to pain relief, reduction of stiffness, and increased physical function during treatment; modifications in the consumption of diclofenac during treatment; and changes in the patient's quality of life. Design Randomised, controlled, single blind trial, with blinded evaluation and statistical analysis of results. Setting Pain management unit in a public primary care centre in southern Spain, over a period of two years. Participants 97 outpatients presenting with osteoarthritis of the knee. Interventions Patients were randomly separated into two groups, one receiving acupuncture plus diclofenac (n = 48) and the other placebo acupuncture plus diclofenac (n = 49). Main outcome measures The clinical variables examined included intensity of pain as measured by a visual analogue scale; pain, stiffness, and physical function subscales of the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index; dosage of diclofenac taken during treatment; and the profile of quality of life in the chronically ill (PQLC) instrument, evaluated before and after the treatment programme. Results 88 patients completed the trial. In the intention to treat analysis, the WOMAC index presented a greater reduction in the intervention group than in the control group (mean difference 23.9, 95% confidence interval 15.0 to 32.8) The reduction was greater in the subscale of functional activity. The same result was observed in the pain visual analogue scale, with a reduction of 26.6 (18.5 to 34.8). The PQLC results indicate that acupuncture treatment produces significant changes in physical capability (P = 0.021) and psychological functioning (P = 0.046). Three patients reported bruising after the acupuncture sessions. Conclusions Acupuncture plus diclofenac is more effective than placebo acupuncture plus diclofenac for the symptomatic

  17. Qualitative evaluation: a critical and interpretative complementary approach to improve health programs and services.

    Science.gov (United States)

    Tayabas, Luz María Tejada; León, Teresita Castillo; Espino, Joel Monarrez

    2014-01-01

    This short essay aims at commenting on the origin, development, rationale, and main characteristics of qualitative evaluation (QE), emphasizing the value of this methodological tool to evaluate health programs and services. During the past decades, different approaches have come to light proposing complementary alternatives to appraise the performance of public health programs, mainly focusing on the implementation process involved rather than on measuring the impact of such actions. QE is an alternative tool that can be used to illustrate and understand the process faced when executing health programs. It can also lead to useful suggestions to modify its implementation from the stakeholders' perspectives, as it uses a qualitative approach that considers participants as reflective subjects, generators of meanings. This implies that beneficiaries become involved in an active manner in the evaluated phenomena with the aim of improving the health programs or services that they receive. With this work we want to encourage evaluators in the field of public health to consider the use of QE as a complementary tool for program evaluation to be able to identify areas of opportunity to improve programs' implementation processes from the perspective of intended beneficiaries.

  18. Teaching evidence-based medicine at complementary and alternative medicine institutions: strategies, competencies, and evaluation.

    Science.gov (United States)

    Zwickey, Heather; Schiffke, Heather; Fleishman, Susan; Haas, Mitch; Cruser, des Anges; LeFebvre, Ron; Sullivan, Barbara; Taylor, Barry; Gaster, Barak

    2014-12-01

    As evidence-based medicine (EBM) becomes a standard in health care, it is essential that practitioners of complementary and alternative medicine (CAM) become experts in searching and evaluating the research literature. In support of this goal, the National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine (NCCAM) provided R25 funding to nine CAM colleges to develop individual programs focused on teaching EBM. An overarching goal of these research education grants has been to provide CAM faculty and students with the skills they need to apply a rigorous evidence-based perspective to their training and practice. This paper reviews the competencies and teaching strategies developed and implemented to enhance research literacy at all nine R25-funded institutions. While each institution designed approaches suitable for its research culture, the guiding principles were similar: to develop evidence-informed skills and knowledge, thereby helping students and faculty to critically appraise evidence and then use that evidence to guide their clinical practice. Curriculum development and assessment included faculty-driven learning activities and longitudinal curricular initiatives to encourage skill reinforcement and evaluate progress. As the field of integrative medicine matures, the NIH-NCCAM research education grants provide essential training for future clinicians and clinician-researchers. Building this workforce will facilitate multidisciplinary collaborations that address the unique needs for research that informs integrative clinical practice.

  19. Integrating complementary/alternative medicine into primary care: evaluating the evidence and appropriate implementation

    Directory of Open Access Journals (Sweden)

    Wainapel SF

    2015-12-01

    Full Text Available Stanley F Wainapel,1 Stephanie Rand,1 Loren M Fishman,2 Jennifer Halstead-Kenny1 1The Arthur S Abramson Department of Physical Medicine and Rehabilitation, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, 2Department of Rehabilitation and Regenerative Medicine, College of Physicians and Surgeons, Columbia University, New York, NY, USA Abstract: The frequency with which patients utilize treatments encompassed by the term complementary/alternative medicine (CAM is well documented. A number of these therapies are beginning to be integrated into contemporary medical practice. This article examines three of them: osteopathic manipulation, yoga, and acupuncture, with a focus on their physiological effects, efficacy in treating medical conditions commonly encountered by practitioners, precautions or contraindications, and ways in which they can be incorporated into clinical practice. Physicians should routinely obtain information about use of CAM as part of their patient history and should consider their role based on physiological effects and clinical research results. Keywords: integrative medicine, osteopathic manipulation, yoga, acupuncture therapy

  20. The use of complementary and alternative therapies and of psychotherapy by Romanian patients with irritable bowel syndrome.

    Science.gov (United States)

    Dumitraşcu, D L; Nedelcu, L; Pop, Sorina; Blaga-Surdea, Teodora; Dadu, R T; Costin, Simona; Popescu, Manuela; Picos, Alina; David, Liliana

    2013-01-01

    Irritable bowel syndrome (IBS) is an invalidating condition, lacking a perfect therapy. Therefore, many patients use also complementary and alternative therapies (CAT) or psychotherapy (PT). There are no data on the use of CAT and PT in IBS in our area. We looked for this until uncovered aspect of IBS management in Romania. 250 consecutive patients with IBS (142 F/108M, aged 49 +/- 12 years) referred to a tertiary gastroenterological center were questioned about the use of CAT and PT using a structured specially developed questionnaire. All of the patients accepted to answer the questionnaire after careful instruction. 162 out of 250 pts (64%) admitted to have used one or more CAT, usually together with pharmacological prescriptions. Among CAT users, 32 patients (20%) used only CAT and not allopathic drugs. CAT used were: homeopathy 13%, herbal therapy 72%, acupuncture 3%, bioenergetic resonance 11%, others 13%. Probiotics were used by 30%. Users were mainly females of lower educational levels. Psychotherapy was used by 30 pts (12%). 25 (10%) used CBT, 15 (6%) used relaxation therapy. The majority of IBS pts. in our area use CAT usually in association with allopathic therapy. The most frequently used are herbal prescriptions followed by probiotics. PT less frequently used in our IBS patients.

  1. Curricular Inclusion of Complementary and Alternative Medicine Content in Occupational Therapy Education in the United States.

    Science.gov (United States)

    Bradshaw, Michelle L

    2016-10-01

    An exploratory, cross-sectional survey design was used to explore the extent to which CAM was included, what factors impacted its inclusion, topics and student learning outcomes covered, who taught the material, and what sources were used to prepare for delivering course content. While the vast majority of responding occupational therapy educators reported curricular inclusion of CAM, educational experiences for occupational therapy students varied widely. This overview of the curricular inclusion of CAM by faculty in occupational therapy programs in the United States indicated that many occupational therapy educators are responding to the demands of a more integrative healthcare system. Resolving ethical and pragmatic issues, providing faculty development opportunities, and standardizing student learning outcomes would align all stakeholders and mitigate ambiguities that currently exist surrounding the inclusion of CAM in occupational therapy education.

  2. Complementary and alternative medicine therapies as symptom management strategies for the late effects of breast cancer treatment.

    Science.gov (United States)

    Henneghan, Ashley M; Harrison, Tracie

    2015-03-01

    Advancements in breast cancer treatment continue to improve the likelihood of survival. The increase in survival has come at a cost, however; the late effects of breast cancer treatment have remained a constant reminder to women of what they have endured and require holistic nursing's attention. One area of nursing practice that might improve the condition of breast cancer survivors once their treatment has ended is complementary and alternative medicine (CAM) therapies. To provide guidance to nurses working with breast cancer survivors, a focused review of the literature exploring the symptomatology and prevalence of breast cancer's late effects as well as the use of CAM therapies to improve those effects is presented. Evidence suggests that CAM therapies have sometimes been incorporated into symptom management strategies currently employed; however, the evidential claims as a whole have been generally inconclusive, especially for complete resolution of the late effects. Regardless, a number of studies demonstrate a reduction of negative symptoms experienced with few to no side effects of CAM therapies. © The Author(s) 2014.

  3. A Systematic Overview of Reviews for Complementary and Alternative Therapies in the Treatment of the Fibromyalgia Syndrome

    Directory of Open Access Journals (Sweden)

    Romy Lauche

    2015-01-01

    Full Text Available Objectives. This systematic overview of reviews aimed to summarize evidence and methodological quality from systematic reviews of complementary and alternative medicine (CAM for the fibromyalgia syndrome (FMS. Methods. The PubMed/MEDLINE, Cochrane Library, and Scopus databases were screened from their inception to Sept 2013 to identify systematic reviews and meta-analyses of CAM interventions for FMS. Methodological quality of reviews was rated using the AMSTAR instrument. Results. Altogether 25 systematic reviews were found; they investigated the evidence of CAM in general, exercised-based CAM therapies, manipulative therapies, Mind/Body therapies, acupuncture, hydrotherapy, phytotherapy, and homeopathy. Methodological quality of reviews ranged from lowest to highest possible quality. Consistently positive results were found for tai chi, yoga, meditation and mindfulness-based interventions, hypnosis or guided imagery, electromyogram (EMG biofeedback, and balneotherapy/hydrotherapy. Inconsistent results concerned qigong, acupuncture, chiropractic interventions, electroencephalogram (EEG biofeedback, and nutritional supplements. Inconclusive results were found for homeopathy and phytotherapy. Major methodological flaws included missing details on data extraction process, included or excluded studies, study details, and adaption of conclusions based on quality assessment. Conclusions. Despite a growing body of scientific evidence of CAM therapies for the management of FMS systematic reviews still show methodological flaws limiting definite conclusions about their efficacy and safety.

  4. Case study of Bell's palsy applying complementary treatment within an occupational therapy model.

    Science.gov (United States)

    Haltiwanger, Emily; Huber, Theresa; Chang, Joe C; Gonzalez-Stuart, Armando; Gonzales-Stuart, Armando

    2009-01-01

    For 7% of people with Bell's palsy, facial impairment is permanent. The case study patient was a 48-year-old female who had no recovery from paralysis 12 weeks after onset. Goals were to restore facial sensory-motor functions, functional abilities and reduce depression. Facial paralysis was assessed by clinical observations, the Facial Disability Index and Beck Depression Index. Complementary interventions of aromatherapy, reflexology and electro-acupuncture were used with common physical agent modalities in an intensive home activity and exercise programme. The patient had 100% return of function and resolution of depression after 10 days of intervention. The limitation of this study is that it was a retrospective case study and the investigators reconstructed the case from clinical notes. Further research using a prospective approach is recommended to replicate this study. 2009 John Wiley & Sons, Ltd

  5. COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) THERAPIES FOR MANAGEMENT OF PAIN RELATED TO ENDOMETRIOSIS

    OpenAIRE

    Panda Roshni; A Suneetha Susan Cleave; Suresh P.K

    2012-01-01

    Endometriosis is a gynaecological disease with a complex etiology. It is associated with severe pelvic pain, sub fertility and reduced quality of life. Endometriosis has a multifactorial etiology and therefore its management is also multidimensional. The main targets of therapy are controlling of the pain symptoms and increasing fertility where it is desired. Hormonal and surgical therapies are the two major treatment modalities available currently. But they are not without their side effects...

  6. Treatment of obesity as a potential complementary approach to cancer therapy.

    Science.gov (United States)

    Sirin, Olga; Kolonin, Mikhail G

    2013-06-01

    Obesity has long been recognized as a risk factor for diabetes and cardiovascular disease. Recent epidemiological data also associate obesity with cancer risk and progression. For this reason, a combination treatment of obesity along with treatment of the cancer itself may improve patient survival and well-being. As the molecular pathways linking obesity and cancer become better understood, new potential therapy targets are surfacing. In this article, we summarize the mechanisms proposed to account for the obesity-cancer association and discuss approaches to manipulation of adipose tissue as potential interventions aimed at cancer prevention or supplemental therapy. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Parents' attitudes toward the use of complementary therapy by their children with moderate or severe cerebral palsy.

    Science.gov (United States)

    Wray, Jo; Edwards, Vanessa; Wyatt, Katrina; Maddick, Andrew; Logan, Stuart; Franck, Linda

    2014-02-01

    To describe the use of, and attitudes toward, complementary therapy (CT) by parents of children with moderate to severe cerebral palsy. Parents of 32 children with cerebral palsy (age 5-12 years) enrolled in a randomized trial of cranial osteopathy prospectively participated in semi-structured interviews in the home to explore the use of CT and views regarding access to and expectations of these therapies. Interview transcripts were analyzed thematically, and content analysis was used to determine the frequency of use of different therapies. Sixteen children (50%) had received one or more types of CT, although only three were currently receiving any CT. The primary reasons for trying CT were to reduce children's pain and improve physical function. Parents had limited knowledge of the range of, and possible indications for, CT and expressed concerns about CT safety and effectiveness. Practical considerations of time and cost were also identified. Some parents had strong beliefs about the benefits, and, overall, parents indicated a high level of commitment to finding any treatments, conventional or CT, to help their children. Parents of children with cerebral palsy want to help their child, but they need information, guidance, and practical support to facilitate their decision-making regarding the use of CT. A clearer understanding of factors predictive of optimal outcomes will enable resources to be targeted effectively.

  8. Treatment of Fibromyalgia Syndrome: Recommendations of Recent Evidence-Based Interdisciplinary Guidelines with Special Emphasis on Complementary and Alternative Therapies

    Directory of Open Access Journals (Sweden)

    Jacob Ablin

    2013-01-01

    Full Text Available Objective. Current evidence indicates that there is no single ideal treatment for fibromyalgia syndrome (FMS. First choice treatment options remain debatable, especially concerning the importance of complementary and alternative medicine (CAM treatments. Methods. Three evidence-based interdisciplinary guidelines on FMS in Canada, Germany, and Israel were compared for their first choice and CAM-recommendations. Results. All three guidelines emphasized a patient-tailored approach according to the key symptoms. Aerobic exercise, cognitive behavioral therapy, and multicomponent therapy were first choice treatments. The guidelines differed in the grade of recommendation for drug treatment. Anticonvulsants (gabapentin, pregabalin and serotonin noradrenaline reuptake inhibitors (duloxetine, milnacipran were strongly recommended by the Canadian and the Israeli guidelines. These drugs received only a weak recommendation by the German guideline. In consideration of CAM-treatments, acupuncture, hypnosis/guided imagery, and Tai Chi were recommended by the German and Israeli guidelines. The Canadian guidelines did not recommend any CAM therapy. Discussion. Recent evidence-based interdisciplinary guidelines concur on the importance of treatment tailored to the individual patient and further emphasize the need of self-management strategies (exercise, and psychological techniques.

  9. What is the complementary role of ultrasound evaluation in the diagnosis of acute appendicitis after CT?

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Kyung Mi [Department of Radiology, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Lee, Kwanseop [Department of Radiology, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of)], E-mail: kwanseop@hallym.or.kr; Kim, Min-Jeong; Yoon, Hoi Soo; Jeon, Eui Yong; Koh, Sung Hye [Department of Radiology, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Min, Kwangseon [Department of Pathology, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Choi, Dongil [Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (Korea, Republic of)

    2010-04-15

    The objective of our study was to estimate the complementary role of ultrasound evaluation in the diagnosis of acute appendicitis after abdominoplevic CT. A total of 104 patients initially underwent abdominopelvic CT before appendix US due to acute abdominal pain. All CT examinations were evaluated retrospectively for the presence of acute appendicitis. The findings of appendix on CT were classified into five categories (definite appendicitis, probably appendicitis, equivocal CT findings for diagnosis of appendicitis, probably not appendicitis, and normal looking appendix). Appendix US images and their radiologic reports were also evaluated retrospectively. Then, CT and US findings were correlated with clinical or pathologic diagnosis. Three all patients with definite appendicitis initially on CT again showed US findings of appendicitis. In the 32 patients of probably appendicitis on CT, US showed normal looking appendix in seven patients (21.8%, 7 of 32) who improved with medical treatment and discharged. In the 16 patients of equivocal CT findings for diagnosis of appendicitis, US showed appendicitis in seven patients (43.8%, 7 of 16) and normal looking appendix in nine patients. In the 12 patients of probably not appendicitis on CT, US showed acute appendicitis in two patients (16.7%, 2 of 12). In the 41 patients of normal looking appendix on CT, US showed acute appendicitis in five patients (12.2%, 5 of 41). US reevaluation enables us to avoid misdiagnosis of appendicitis on CT and improve diagnostic accuracy of acute appendicitis.

  10. Belief in and use of complementary therapies among family physicians, internists and orthopaedists in Germany - cross-sectional survey.

    Science.gov (United States)

    Linde, Klaus; Alscher, Anna; Friedrichs, Clara; Wagenpfeil, Stefan; Karsch-Völk, Marlies; Schneider, Antonius

    2015-02-01

    Few studies have compared the belief in and the use of complementary and alternative medicine (CAM) across different medical specialties. To investigate to what extent family physicians, internists and orthopaedists working in private practice in Germany (i) belief in the efficacy of CAM therapies; (ii) use these therapies for treating patients and (iii) whether beliefs and use are associated with basic professional attitudes. A four-page questionnaire was sent to nation-wide random samples of the three groups of physicians. Participants were asked to indicate their belief in the efficacy and their use of seven CAM treatments and to rate their agreement to statements on orthodox and heterodox professional views, patient-provider relationship and placebo effects. A total of 935 of 2018 (46%) physicians contacted sent back a questionnaire. The belief in specific effects of CAM therapies varied strongly within and between specialties, but overall many physicians hold positive views. Internists were more skeptic than family physicians and orthopaedists (P family physicians, 6% of internists and 31% of orthopaedists reported to use four or more CAM therapies more often than once a week. Frequent CAM use was strongly associated with being an orthopaedist and a higher overall belief in CAM modalities. Holding orthodox professional views predicted low CAM use. Many physicians (particularly, family physicians and orthopaedists) working in private practice in Germany use CAM therapies frequently and believe in their efficacy. Professional views and the specific working situation seem to influence use and believe strongly. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Challenge and Urgency in Defining Doctoral Education in Marriage and Family Therapy: Valuing Complementary Models

    Science.gov (United States)

    Wampler, Karen S.

    2010-01-01

    In this overview, I comment on the strong theme of the need to define and improve the quality of doctoral education in marriage and family therapy that pervades the three essays. Deficits in research training are the central concern, although the essayists take different perspectives on the nature of the research training needed. The different…

  12. Complementary and alternative medical therapies for children with attention-deficit/hyperactivity disorder (ADHD).

    Science.gov (United States)

    Pellow, Janice; Solomon, Elizabeth M; Barnard, Candice N

    2011-12-01

    Attention-deficit/hyperactivity disorder (ADHD) is a commonly diagnosed childhood disorder characterized by impulsivity, inattention, and hyperactivity. ADHD affects up to 1 in 20 children in the United States. The underlying etiologies of ADHD may be heterogeneous and diverse, and many possible risk factors in the development of ADHD have been identified. Conventional treatment usually consists of behavioral accommodations and medication, with stimulant medication most commonly being prescribed. Parents concerned about the side effects and long-term use of conventional medications are increasingly seeking alternatives to pharmacologic treatment. Complementary and alternative medicine (CAM) offers parents various treatment options for this condition, including dietary modifications, nutritional supplementation, herbal medicine, and homeopathy. CAM appears to be most effective when prescribed holistically and according to each individual's characteristic symptoms. Possible etiologies and risk factors for the condition also need to be considered when developing a treatment plan. This article serves to highlight the latest research regarding the most commonly used CAM for children with ADHD.

  13. Evaluation of complementary-alternative medicine (CAM) questionnaire development for Indonesian clinical psychologists: A pilot study.

    Science.gov (United States)

    Liem, Andrian; Newcombe, Peter A; Pohlman, Annie

    2017-08-01

    This study aimed to evaluate questionnaire development to measure the knowledge of Complementary-Alternative Medicine (CAM), attitudes towards CAM, CAM experiences, and CAM educational needs of clinical psychologists in Indonesia. A 26-item questionnaire was developed through an extensive literature search. Data was obtained from provisional psychologists from the Master of Professional Clinical Psychology programs at two established public universities in urban areas of Indonesia. To validate the questionnaire, panel reviews by executive members of the Indonesian Clinical Psychology Association (ICPA), experts in health psychology, and experts in public health and CAM provided their professional judgements. The self-reporting questionnaire consisted of four scales including: knowledge of CAM (6 items), attitudes towards CAM (10 items), CAM experiences (4 items), and CAM educational needs (6 items). All scales, except CAM Experiences, were assessed on a 7-point Likert scale. Sixty provisional psychologists were eligible to complete the questionnaire with a response rate of 73% (N=44). The results showed that the CAM questionnaire was reliable (Cronbach's coefficient alpha range=0.62-0.96; item-total correlation range=0.14-0.92) and demonstrated content validity. Following further psychometric evaluation, the CAM questionnaire may provide the evidence-based information to inform the education and practice of Indonesian clinical psychologists. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The Use of Videogames as Complementary Therapeutic Tool for Cognitive Behavioral Therapy in Bulimia Nervosa Patients.

    Science.gov (United States)

    Fernandez-Aranda, Fernando; Jimenez-Murcia, Susana; Santamaría, Juan J; Giner-Bartolomé, Cristina; Mestre-Bach, Gemma; Granero, Roser; Sánchez, Isabel; Agüera, Zaida; Moussa, Maher H; Magnenat-Thalmann, Nadia; Konstantas, Dimitri; Lam, Tony; Lucas, Mikkel; Nielsen, Jeppe; Lems, Peter; Tarrega, Salomé; Menchón, José Manuel

    2015-12-01

    Although cognitive behavioral therapy (CBT) has been demonstrated to be the most effective approach for the treatment of bulimia nervosa (BN), there is lack of studies showing whether a combination with a serious video game (SVG) might be useful to enhance patients' emotional regulation capacities and general outcome. The aims of this study were (a) to analyze whether outpatient CBT + SVG, when compared with outpatient CBT - SVG, shows better short-term outcome; (b) to examine whether the CBT + SVG group is more effective in reducing emotional expression and levels of anxiety than CBT - SVG. Thirty-eight patients diagnosed as having BN according to DSM-5 criteria were consecutively assigned to two outpatient group therapy conditions (that lasted for 16 weekly sessions): 20 CBT + SVG versus 18 CBT - SVG. Patients were assessed before and after treatment using not only a food and binging/purging diary and clinical questionnaires in the field of eating disorders but also additional indexes for measuring anger expression and anxiety. Regarding the post-treatment psychometric measures, most of the mean differences (Eating Disorder Inventory-2, Symptom Checklist-Revised, State-Trait Anxiety Index, and partially State-Trait Anger Expression Inventory) achieved moderate to high effect size (d > 0.5), in the sense that CBT + SVG obtained the best results compared with the CBT - SVG group. Regarding therapy outcome (dropout, partial remission, and total remission), CBT + SVG showed better results and a moderate effect size emerged for the comparison of the risk of dropout during the treatment, being higher for CBT - SVG compared with CBT + SVG (44.1 percent versus 20.0 percent, d = 0.54). Although the sample size in our study was low, and consequently results should be considered with caution, we have obtained promising findings suggesting that in the short-term CBT + SVG might be a good option not only for improving

  15. Individualised medicine from the perspectives of patients using complementary therapies: a meta-ethnography approach.

    Science.gov (United States)

    Franzel, Brigitte; Schwiegershausen, Martina; Heusser, Peter; Berger, Bettina

    2013-06-03

    Personalised (or individualised) medicine in the days of genetic research refers to molecular biologic specifications in individuals and not to a response to individual patient needs in the sense of person-centred medicine. Studies suggest that patients often wish for authentically person-centred care and personal physician-patient interactions, and that they therefore choose Complementary and Alternative medicine (CAM) as a possibility to complement standard care and ensure a patient-centred approach. Therefore, to build on the findings documented in these qualitative studies, we investigated the various concepts of individualised medicine inherent in patients' reasons for using CAM. We used the technique of meta-ethnography, following a three-stage approach: (1) A comprehensive systematic literature search of 67 electronic databases and appraisal of eligible qualitative studies related to patients' reasons for seeking CAM was carried out. Eligibility for inclusion was determined using defined criteria. (2) A meta-ethnographic study was conducted according to Noblit and Hare's method for translating key themes in patients' reasons for using CAM. (3) A line-of-argument approach was used to synthesize and interpret key concepts associated with patients' reasoning regarding individualized medicine. (1) Of a total of 9,578 citations screened, 38 studies were appraised with a quality assessment checklist and a total of 30 publications were included in the study. (2) Reasons for CAM use evolved following a reciprocal translation. (3) The line-of-argument interpretations of patients' concepts of individualised medicine that emerged based on the findings of our multidisciplinary research team were "personal growth", "holism", "alliance", "integrative care", "self-activation" and "wellbeing". The results of this meta-ethnographic study demonstrate that patients' notions of individualised medicine differ from the current idea of personalised genetic medicine. Our study

  16. Individualised medicine from the perspectives of patients using complementary therapies: a meta-ethnography approach

    Science.gov (United States)

    2013-01-01

    Background Personalised (or individualised) medicine in the days of genetic research refers to molecular biologic specifications in individuals and not to a response to individual patient needs in the sense of person-centred medicine. Studies suggest that patients often wish for authentically person-centred care and personal physician-patient interactions, and that they therefore choose Complementary and Alternative medicine (CAM) as a possibility to complement standard care and ensure a patient-centred approach. Therefore, to build on the findings documented in these qualitative studies, we investigated the various concepts of individualised medicine inherent in patients’ reasons for using CAM. Methods We used the technique of meta-ethnography, following a three-stage approach: (1) A comprehensive systematic literature search of 67 electronic databases and appraisal of eligible qualitative studies related to patients’ reasons for seeking CAM was carried out. Eligibility for inclusion was determined using defined criteria. (2) A meta-ethnographic study was conducted according to Noblit and Hare's method for translating key themes in patients’ reasons for using CAM. (3) A line-of-argument approach was used to synthesize and interpret key concepts associated with patients’ reasoning regarding individualized medicine. Results (1) Of a total of 9,578 citations screened, 38 studies were appraised with a quality assessment checklist and a total of 30 publications were included in the study. (2) Reasons for CAM use evolved following a reciprocal translation. (3) The line-of-argument interpretations of patients’ concepts of individualised medicine that emerged based on the findings of our multidisciplinary research team were “personal growth”, “holism”, “alliance”, “integrative care”, “self-activation” and “wellbeing”. Conclusions The results of this meta-ethnographic study demonstrate that patients’ notions of individualised medicine

  17. Complementary value of functional capacity evaluation for physicians in assessing the physical work ability of workers with musculoskeletal disorders

    NARCIS (Netherlands)

    Wind, H.; Gouttebarge, V.; Kuijer, P.P.F.M.; Sluiter, J.K.; Frings-Dresen, M.H.W.

    2009-01-01

    OBJECTIVE: To study the complementary value of information from functional capacity evaluation (FCE) for insurance physicians (IPs) who assess the physical work ability of claimants with long-term musculoskeletal disorders (MSD). METHOD: A post-test only design was used in the context of disability

  18. Complementary and alternative medicine use of women with breast cancer : Self-help CAM attracts other women than guided CAM therapies

    NARCIS (Netherlands)

    Lo-Fo-Wong, Deborah N. N.; Ranchor, Adelita V.; de Haes, Hanneke C. J. M.; Sprangers, Mirjam A. G.; Henselmans, Inge

    2012-01-01

    Objective: Examine stability of use of complementary and alternative medicine (CAM) of breast cancer patients, reasons for CAM use, and sociodemographic, clinical, and psychological predictors of CAM use. Methods: CAM use was assessed after adjuvant therapy and six months later. Following the CAM

  19. Complementary and alternative medicine use of women with breast cancer: Self-help CAM attracts other women than guided CAM therapies

    NARCIS (Netherlands)

    Lo-Fo-Wong, Deborah N. N.; Ranchor, Adelita V.; de Haes, Hanneke C. J. M.; Sprangers, Mirjam A. G.; Henselmans, Inge

    2012-01-01

    Objective: Examine stability of use of complementary and alternative medicine (CAM) of breast cancer patients, reasons for CAM use, and sociodemographic, clinical, and psychological predictors of CAM use. Methods: CAM use was assessed after adjuvant therapy and six months later. Following the CAM

  20. Can the Brain Be Trained? Comparing the Literature on the Use of EEG Biofeedback/Neurofeedback as an Alternative or Complementary Therapy for Attention Deficit Hyperactivity Disorder (ADHD)

    Science.gov (United States)

    Stankus, Tony

    2008-01-01

    Psychologists, social workers, and school counselors are increasingly adding neurofeedback (NFT), a controversial alternative or complementary therapy to their treatment plans for patients with Attention Deficit Hyperactivity Disorder. NFT involves training the patient in self-regulation of brain wave patterns, employing a standard diagnostic…

  1. Evaluating complementary networks of restoration plantings for landscape-scale occurrence of temporally dynamic species.

    Science.gov (United States)

    Ikin, Karen; Tulloch, Ayesha; Gibbons, Philip; Ansell, Dean; Seddon, Julian; Lindenmayer, David

    2016-10-01

    Multibillion dollar investments in land restoration make it critical that conservation goals are achieved cost-effectively. Approaches developed for systematic conservation planning offer opportunities to evaluate landscape-scale, temporally dynamic biodiversity outcomes from restoration and improve on traditional approaches that focus on the most species-rich plantings. We investigated whether it is possible to apply a complementarity-based approach to evaluate the extent to which an existing network of restoration plantings meets representation targets. Using a case study of woodland birds of conservation concern in southeastern Australia, we compared complementarity-based selections of plantings based on temporally dynamic species occurrences with selections based on static species occurrences and selections based on ranking plantings by species richness. The dynamic complementarity approach, which incorporated species occurrences over 5 years, resulted in higher species occurrences and proportion of targets met compared with the static complementarity approach, in which species occurrences were taken at a single point in time. For equivalent cost, the dynamic complementarity approach also always resulted in higher average minimum percent occurrence of species maintained through time and a higher proportion of the bird community meeting representation targets compared with the species-richness approach. Plantings selected under the complementarity approaches represented the full range of planting attributes, whereas those selected under the species-richness approach were larger in size. Our results suggest that future restoration policy should not attempt to achieve all conservation goals within individual plantings, but should instead capitalize on restoration opportunities as they arise to achieve collective value of multiple plantings across the landscape. Networks of restoration plantings with complementary attributes of age, size, vegetation structure, and

  2. Complementary and alternative therapies to relieve labor pain: A comparative study between music therapy and Hoku point ice massage.

    Science.gov (United States)

    Dehcheshmeh, Faranak Safdari; Rafiei, Hossein

    2015-11-01

    Pain is a common experience for women during labor. In the present study, we compared the effect of two types of non-pharmacological pain relief methods "music therapy" and "Hoku point ice massage" on the severity of labor pain. This prospective, randomized, controlled trial was conducted in Shahrekord, Iran, from September 2013 to June 2014. We randomly assigned 90 primiparous women who expected a normal childbirth into three groups: group "A" received music therapy, group "B" received Hoku point ice massage, and group "C" received usual labor care. At the beginning of the active phase (4 cm cervical dilation) and before and after each intervention (at dilations 4, 6, and 8 cm), the intensities of labor pain were measured using Visual Analogue Scale (VAS). At the beginning of the active phase, the mean VAS scores were 5.58 ± 1.29, 5.42 ± 1.31, and 6.13 ± 1.37 in the women in groups "A," "B," and "C," respectively (P > 0.05). After the intervention, the mean pain scores were significantly lower at all of the time points in groups "A" and "B" than in group "C" women (P pain scores showed a more decreasing trend after the intervention in group "A" than that in group "B," the difference between the two groups was not statistically significant (P > 0.05). Music therapy and Hoku point ice massage are easily available and inexpensive methods and have a similar effect in relieving labor pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Addressing holistic healthcare needs of oncology patients: Implementation and evaluation of a complementary and alternative medicine (CAM) course within an elective module designed for healthcare professionals.

    Science.gov (United States)

    Klafke, Nadja; Homberg, Angelika; Glassen, Katharina; Mahler, Cornelia

    2016-12-01

    Patients, and especially oncology patients, increasingly demand information and application of complementary therapies to supplement their conventional medical treatment and follow-up care. Due to the widespread interest in holistic treatment opportunities in oncology populations, healthcare professionals need to be prepared in differentiating evidence-based methods of the complementary and alternative medicine (CAM) spectrum and how to consult with patients about it. This paper reports on the implementation and evaluation of a newly designed module "Complementary and Alternative Medicine in oncological healthcare" in the bachelor degree program Interprofessional Health Care (B.Sc.). The study applied a developed evaluation questionnaire to capture students' perspectives on the CAM contents. This assessment instrument was administered pre and post the CAM teaching unit. Interprofessional medical education, University Hospital Heidelberg, Germany. The integration of the CAM elective module was possible and was met by positive response. Students' interest was reflected in an increase of their self-reported knowledge gain and positive CAM attitude. Comparison of pre and post evaluation data demonstrate that, particularly, students' expectations on developing their own opinion about CAM, and getting an overview of the evidence-base of different CAM methods have been met. Evaluation results indicate that the module content was in line with the students' expectations and may have positively impacted on their general CAM attitude. The results support us in continuing to offer this CAM course within the elective module to prepare today's healthcare professionals for patient-oriented healthcare delivery. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Prevention and Treatment of Influenza, Influenza-Like Illness, and Common Cold by Herbal, Complementary, and Natural Therapies.

    Science.gov (United States)

    Mousa, Haider Abdul-Lateef

    2017-01-01

    In recent years viral respiratory tract infections, especially influenza viruses, have had a major impact on communities worldwide as a result of unavailability of effective treatment or vaccine. The frequent alterations in the antigenic structures of respiratory viruses, particularly for RNA viruses, pose difficulties in production of effective vaccines. The unavailability of optimal medication and shortage of effective vaccines suggests the requirement for alternative natural therapies. Several herbal remedies were used for prevention and treatment viral respiratory illnesses. Among those that were found effective included maoto, licorice roots, antiwei, North American ginseng, berries, Echinacea, plants extracted carnosic acid, pomegranate, guava tea, and Bai Shao. There is scientific evidence regarding the effectiveness of several complementary therapies for colds. Oral zinc may reduce the length and severity of a cold. Taking vitamin C supplements on a regular basis only slightly reduces the length and severity of colds. Probiotics were found better than placebo in reducing the number episodes of acute upper respiratory tract infections, the rate of episodes of acute upper respiratory tract infection and reducing antibiotic use. Alkaline diets or drinks might have antiviral properties as in vitro studies demonstrated inactivation effect of alkaline medium on respiratory virus. Earthing might have a natural anti-inflammatory effect for human body. It is now accepted that an overwhelming inflammatory response is the cause of human deaths from avian H5N1 influenza infection. Earthing accelerates immune response following vaccination, as demonstrated by increases of gamma globulin concentration. No in vivo or clinical studies were found that investigate the role of alkalization or earthing on respiratory viral infections. Thus, future studies are recommended to reveal any potential curative effects. © The Author(s) 2016.

  5. The effectiveness of complementary manual therapies for pregnancy-related back and pelvic pain: A systematic review with meta-analysis.

    Science.gov (United States)

    Hall, Helen; Cramer, Holger; Sundberg, Tobias; Ward, Lesley; Adams, Jon; Moore, Craig; Sibbritt, David; Lauche, Romy

    2016-09-01

    Low back pain and pelvic girth pain are common in pregnancy and women commonly utilize complementary manual therapies such as massage, spinal manipulation, chiropractic, and osteopathy to manage their symptoms. The aim of this systematically review was to critically appraise and synthesize the best available evidence regarding the effectiveness of manual therapies for managing pregnancy-related low back and pelvic pain. Seven databases were searched from their inception until April 2015 for randomized controlled trials. Studies investigating the effectiveness of massage and chiropractic and osteopathic therapies were included. The study population was pregnant women of any age and at any time during the antenatal period. Study selection, data extraction, and assessment of risk of bias were conducted by 2 reviewers independently, using the Cochrane tool. Separate meta-analyses were conducted to compare manual therapies to different control interventions. Out of 348 nonduplicate records, 11 articles reporting on 10 studies on a total of 1198 pregnant women were included in this meta-analysis. The therapeutic interventions predominantly involved massage and osteopathic manipulative therapy. Meta-analyses found positive effects for manual therapy on pain intensity when compared to usual care and relaxation but not when compared to sham interventions. Acceptability did not differ between manual therapy and usual care or sham interventions. There is currently limited evidence to support the use of complementary manual therapies as an option for managing low back and pelvic pain during pregnancy. Considering the lack of effect compared to sham interventions, further high-quality research is needed to determine causal effects, the influence of the therapist on the perceived effectiveness of treatments, and adequate dose-response of complementary manual therapies on low back and pelvic pain outcomes during pregnancy.

  6. Randomized clinical trial of the effectiveness of complementary therapies for recurrent aphthous stomatitis.

    Science.gov (United States)

    Rodríguez-Archilla, Alberto; Raissouni, Tarik

    2017-07-21

    Despite the high prevalence of recurrent aphthous stomatitis (RAS), its etiology is not yet completely clear and there is no completely remedial treatment available at present. The objective of this study was to evaluate the clinical efficacy and safety of 4 treatments (silver nitrate, propolis, rhubarb and walnut) for RAS. A randomized clinical trial was conducted with 125 patients with minor aphthae, including 25 patients per group: cauterization with silver nitrate, propolis, rhubarb extract, walnut extract and placebo. No patient reported adverse effects related to the treatment received. There were significant (P<.001) differences in the time elapsed until symptom resolution. The fastest treatment was silver nitrate (1.16 days), followed by the 3 alternative treatments (1.60 days with propolis, 1.84 with rhubarb and 2.00 with walnut; with no differences between them), and finally the placebo (4.64 days). The mean healing time of the lesions was statistically higher (8.96 days) for the placebo than for the 4 treatments: silver nitrate (7.32 days), propolis (6.80), rhubarb (7.72) and walnut (8.00). Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  7. Cold Atmospheric Plasma: A Promising Complementary Therapy for Squamous Head and Neck Cancer.

    Directory of Open Access Journals (Sweden)

    Christian Welz

    Full Text Available Head and neck squamous cell cancer (HNSCC is the 7th most common cancer worldwide. Despite the development of new therapeutic agents such as monoclonal antibodies, prognosis did not change for the last decades. Cold atmospheric plasma (CAP presents the most promising new technology in cancer treatment. In this study the efficacy of a surface micro discharging (SMD plasma device against two head and neck cancer cell lines was proved. Effects on the cell viability, DNA fragmentation and apoptosis induction were evaluated with the MTT assay, alkaline microgel electrophoresis (comet assay and Annexin-V/PI staining. MTT assay revealed that the CAP treatment markedly decreases the cell viability for all tested treatment times (30, 60, 90, 120 and 180 s. IC 50 was reached within maximal 120 seconds of CAP treatment. Comet assay analysis showed a dose dependent high DNA fragmentation being one of the key players in anti-cancer activity of CAP. Annexin-V/PI staining revealed induction of apoptosis in CAP treated HNSCC cell lines but no significant dose dependency was seen. Thus, we confirmed that SMD Plasma technology is definitely a promising new approach on cancer treatment.

  8. Ningdong granule: a complementary and alternative therapy in the treatment of attention deficit/hyperactivity disorder.

    Science.gov (United States)

    Li, Ji-Jun; Li, Zai-Wang; Wang, Shu-Zhen; Qi, Fang-Hua; Zhao, Lin; Lv, Hong; Li, An-Yuan

    2011-08-01

    Attention deficit/hyperactivity disorder (ADHD) is a common neurobehavioral and neuropsychiatric disorder in school-age children, and recent studies provide evidence implicating the metabolic abnormalities of dopamine (DA) for its pathophysiology. Methylphenidate, a kind of psychostimulant, is widely used in the treatment of ADHD, but some patients do not respond to it or cannot bear its side effects. As a traditional Chinese medicine preparation, Ningdong granule (NDG) has been used in the treatment of ADHD for several years in China. However, a systematical pharmacological study on its safety and mechanism still remains obscure. This paper aims to evaluate the efficiency, safety, and possible mechanism of NDG on ADHD children compared to methylphenidate. Seventy-two ADHD children were recruited to perform an 8-week, randomized, methylphenidate-controlled, doubled-blinded trial. The subjects were equally assigned to two groups receiving either NDG 5 mg/kg/day or methylphenidate 1 mg/kg/day for 8 weeks. The efficiency was assessed by the Teacher and Parent ADHD Rating Scales every 2 weeks for a total of 8 weeks. The side effects were recorded during the study. Blood, urine, and stool routine samples, liver and renal function test, and DA and homovanillic acid (HVA) concentration in sera were tested at the beginning and end of the trial. NDG ameliorated ADHD symptoms after an 8-week medication with fewer side effects compared to methylphenidate (P ADHD children as monitored by the blood, urine, and stool analysis and liver and renal function for 8 weeks (P ADHD Rating Scales. Compared to methylphenidate, NDG is effective and safe for ADHD children in the short term, increases the HVA concentration in sera to regulate DA metabolism, and promises to be an alternative medication, safely and effectively.

  9. CLINICAL EFFICACY OF DIETARY MANIPULATION AS COMPLEMENTARY AND ALTERNATIVE MEDICINE THERAPIES ON FEMALE INTERSTITIAL CYSTITIS PATIENTS.

    Science.gov (United States)

    Oh-Oka, Hitoshi

    2016-01-01

    (Objectives) We examined the clinical efficacy of dietary manipulation (DM) for female patients with interstitial cystitis (IC) in stable condition who were followed in our hospital. (Patients and methods) This study included 20 female patients with IC in rather stable condition who were followed at our hospital. In cooperation with the nutrition control team, we created a basic IC diet menu for 1 month (total daily calories, 1,500 kcal; protein, 65 g; fat, 40 g; carbohydrate, 220 g; water, 1,000 ml; salt, 7 g). Data regarding daily food intake and food-related symptoms were collected by detailed interview of each patient conducted by the doctors, nurses, and nutritionists at our hospital. In accordance with the abovementioned nutrition control, we set meal menu to control IC symptoms and advised the patients to reduce the intake of specific food items to the maximum possible extent.The following food items were removed from or restricted in the diet of patients: tomatoes, tomato products, soy, tofu product (seasoning was acceptable), spices (pepper, curry powder, mustard, horseradish, etc.), excessive potassium, citrus, high-acidity-inducing substances (caffeine, carbonate, and citric acid), etc. We evaluated the following factors to determine the efficacy of this diet menu 3 months after the start of the intervention: O'Leary-Sant symptom index (OSSI), O'Leary-Sant problem index (OSPI), urgency visual analogue scale (UVAS) score, (0, no urgency; 10, severe urgency), bladder or pelvic pain VAS (PVAS) score, (0, no pain; 10, worst possible pain), and numerical patient-reported quality of life (QOL) index (0, highly satisfied; 6, highly dissatisfied). (Results) OSSI and OSPI improved from 11.7 to 10.1 (p<0.0001), and from 10.7 to 8.8 (p=0.01), respectively. The UVAS score significantly reduced from 6.4 to 4.8, and the PVAS score significantly improved from 6.5 to 4.8 (p<0.0001). The patient-reported QOL index significantly improved from 5.1 to 3.9 (p<0

  10. A methodological framework for evaluating the evidence for Complementary and Alternative Medicine (CAM) for cancer

    DEFF Research Database (Denmark)

    Zachariae, Robert; Johannesen, Helle

    2011-01-01

    In spite of lacking evidence for effects on cancer progression itself, an increasing number of cancer patients use various types of complementary and alternative medicine (CAM). There is disagreement between CAM practitioners, researchers and clinical oncologists, as to how evidence concerning ef...... to different types of research questions and discussing the relevance of different research methodologies for different types of effects....

  11. Complementary Pancreatitis Therapies

    Science.gov (United States)

    ... improves the overall functioning of the body and quality of life. Exercise can decrease stress, pain, nausea, fatigue, and depression. ... are other ways to exercise (eg, stretching, isometric ... can improve sleep, concentration, and the ability to cope with stress. ...

  12. Atomic force microscopy for biomechanical and structural analysis of human dermis: a complementary tool for medical diagnosis and therapy monitoring.

    Science.gov (United States)

    Peñuela, Leonardo; Negro, Carola; Massa, Michela; Repaci, Erica; Cozzani, Emanuele; Parodi, Aurora; Scaglione, Silvia; Quarto, Rodolfo; Raiteri, Roberto

    2017-11-20

    Skin mechanical properties are usually measured considering the entire skin thickness and very little is known about the mechanical behavior of individual skin layers. We propose atomic force microscopy (AFM) as a tool to quantify nanoscale changes in the biomechanical properties and ultrastructure of human papillary dermis exposed to different mechanical and physical stimuli. Samples from three human skin biopsies were studied: one stretched by obesity, one subjected to a high level of sun-exposure, and normal skin as control. Slices of the papillary dermis layer were harvested at controlled depths from each skin biopsy and 25 μm2 areas of each slice were imaged and D-periodicity of collagen fibers measured by AFM, together with their stiffness. Standard histological analysis was also carried out in order to correlate biochemical properties and their distribution with stiffness and topography. We obtained similar stiffness values between the sample affected by obesity and the control sample at any depth level into the dermis, while the sun-exposed sample presented a significant lower stiffness. Additionally, all samples presented an increase in the stiffness at higher depths into the papillary dermis layer. Collagen fibers close to the epidermis of sample affected either by obesity and sun-exposure- the former even more than the latter - are thicker and present a larger D-period than those in the control sample. Our results open the possibility to use structural and mechanical analysis based on AFM as a complementary tool for medical diagnosis and therapy monitoring. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  13. A feasibility pilot study on the use of complementary therapies delivered via mobile technologies on Icelandic surgical patients? reports of anxiety, pain, and self-efficacy in healing

    OpenAIRE

    Hansen, Margaret M

    2015-01-01

    Background Complementary therapies (CT), such as relaxation technique, massage, guided imagery, and accupuncture have shown to benefit patients undergoing surgery. The aim of this study was to determine the feasibility of using audio relaxation technique (ART), music intervention (MI), nature video application with music (NVAM), and nature video application without music (NVA) delivered via mobile technologies in a clinical setting. Secondary, the effects of ART, MI, NVAM and NVA on patients?...

  14. Mental health evaluations used in occupational therapy.

    Science.gov (United States)

    Hemphill, B J

    1980-11-01

    To each students occupational therapy evaluation techniques (or methods) in psychiatry, evaluations currently being used in the field were identified. Three consecutive surveys were sent to occupational therapy faculty, clinical supervisors, and clinicians to ascertain which evaluation techniques were being taught, those which the students were expected to know about in their fieldwork experiences, and those which were practiced in the field. On an average, occupational therapy schools were teaching four evaluation tools. Affiliating students were expected to know about 3 of 24 evaluation tools listed in the survey, and none of the evaluation techniques were being practiced significantly by occupational therapists. Since 75 percent of the therapists reported that they developed their own evaluation tools, it was suggested that instructors be familiar with the existing evaluation tools and teach students the methodology required for developing their own evaluation tools (or instruments).

  15. Gene therapy using self-complementary Y733F capsid mutant AAV2/8 restores vision in a model of early onset Leber congenital amaurosis.

    Science.gov (United States)

    Ku, Cristy A; Chiodo, Vince A; Boye, Sanford L; Goldberg, Andrew F X; Li, Tiansen; Hauswirth, William W; Ramamurthy, Visvanathan

    2011-12-01

    Defects in the photoreceptor-specific gene aryl hydrocarbon receptor interacting protein-like 1 (Aipl1) are associated with Leber congenital amaurosis (LCA), a childhood blinding disease with early-onset retinal degeneration and vision loss. Furthermore, Aipl1 defects are characterized at the most severe end of the LCA spectrum. The rapid photoreceptor degeneration and vision loss observed in the LCA patient population are mimicked in a mouse model lacking AIPL1. Using this model, we evaluated if gene replacement therapy using recent advancements in adeno-associated viral vectors (AAV) provides advantages in preventing rapid retinal degeneration. Specifically, we demonstrated that the novel self-complementary Y733F capsid mutant AAV2/8 (sc-Y733F-AAV) provided greater preservation of photoreceptors and functional vision in Aipl1 null mice compared with single-stranded AAV2/8. The benefits of sc-Y733F-AAV were evident following viral administration during the active phase of retinal degeneration, where only sc-Y733F-AAV treatment achieved functional vision rescue. This result was likely due to higher and earlier onset of Aipl1 expression. Based on our studies, we conclude that the sc-Y733F-AAV2/8 viral vector, to date, achieves the best rescue for rapid retinal degeneration in Aipl1 null mice. Our results provide important considerations for viral vectors to be used in future gene therapy clinical trials targeting a wider severity spectrum of inherited retinal dystrophies.

  16. Pilot study of the efficacy of empowering patients through coaching as a complementary therapy in attention deficit hyperactivity disorder.

    Science.gov (United States)

    García Ron, A; Serrano Grasa, R; Blanco Lago, R; Huete Hernani, B; Pérez Martinez, D A

    2016-03-01

    Attention deficit hyperactivity disorder (ADHD) is the most frequent neurodevelopmental disorder and must be considered a public health priority because of its functional repercussions in school, family, and social settings. Health empowerment is an innovative model of care for patients with chronic diseases based on self-management education. Our goal is to evaluate the effectiveness of empowerment using coaching within a multimodal treatment plan in paediatric patients with ADHD. Descriptive open prospective study. We included children between 6 and 12 years old belonging to patient association in a suburban area of the Region of Madrid. We evaluated the situation before and after 5 cost-free coaching sessions using the Conners Questionnaire, Dundee difficult times of day scale, and satisfaction scales. We included 49 patients (73.5% males) with an average age of 8.5 years. The ADHD hyperactive-impulsive subtype was present in 63.3% and 77.6% had some type of comorbidity. All were treated with methylphenidate and their clinical course was poor. Clinical improvements were observed in 79.6% with a 34.6% mean reduction in symptoms (SD 11.1), and improvements remained stable at 6 months follow-up after coaching. We reached a satisfaction level of 7.8 out of 10 (SD 1.7), and 95.9% of the participants recommended this treatment to other families. Our results provide information on the potential benefits of coaching as complementary treatment for ADHD. Copyright © 2015 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  17. Complementary Actions

    Directory of Open Access Journals (Sweden)

    Luisa eSartori

    2015-05-01

    Full Text Available Complementary colors are color pairs which, when combined in the right proportions, produce white or black. Complementary actions refer here to forms of social interaction wherein individuals adapt their joint actions according to a common aim. Notably, complementary actions are incongruent actions. But being incongruent is not sufficient to be complementary (i.e., to complete the action of another person. Successful complementary interactions are founded on the abilities: (i to simulate another person’s movements, (ii to predict another person’s future action/s, (iii to produce an appropriate incongruent response which differ, while interacting, with observed ones, and (iv to complete the social interaction by integrating the predicted effects of one’s own action with those of another person. This definition clearly alludes to the functional importance of complementary actions in the perception–action cycle and prompts us to scrutinize what is taking place behind the scenes. Preliminary data on this topic have been provided by recent cutting-edge studies utilizing different research methods. This mini-review aims to provide an up-to-date overview of the processes and the specific activations underlying complementary actions.

  18. Assessments in outcome evaluation in aphasia therapy

    DEFF Research Database (Denmark)

    Isaksen, Jytte; Brouwer, Catherine E.

    2015-01-01

    Abstract Outcomes of aphasia therapy in Denmark are documented in evaluation sessions in which both the person with aphasia and the speech-language therapist take part. The participants negotiate agreements on the results of therapy. By means of conversation analysis, we study how such agreements...... on therapy outcome are reached interactionally. The sequential analysis of 34 video recordings focuses on a recurrent method for reaching agreements in these outcome evaluation sessions. In and through a special sequence of conversational assessment it is claimed that the person with aphasia has certain...

  19. Evaluation of hysteroscopy as a complementary exam in the investigation of chronic pelvic pain.

    Directory of Open Access Journals (Sweden)

    Bruno Hállan Meneses Dias

    2013-09-01

    Full Text Available Introduction: Chronic pelvic pain (CPP is a difficult condition to identify and many disorders are correlated. This study investigates the role of hysteroscopy as a complementary exam in the diagnosis of CPP. Methods: One hundred ninety-one medical records of women with indication to perform a hysteroscopy and presented CPP were reviewed. Results: The analysis showed abnormalities in 99 patients. Of these, more than 70% presented conditions that could cause CPP. Cervical stenosis and findings suggestive of adenomyosis were the most frequent ocurrences. Conclusions: Hysteroscopy is useful to detect pathological conditions of the cervix and uterine cavity that may coexist with chronic pelvic pain.

  20. Evaluating the complementary roles of an SJT and academic assessment for entry into clinical practice.

    Science.gov (United States)

    Cousans, Fran; Patterson, Fiona; Edwards, Helena; Walker, Kim; McLachlan, John C; Good, David

    2017-05-01

    Although there is extensive evidence confirming the predictive validity of situational judgement tests (SJTs) in medical education, there remains a shortage of evidence for their predictive validity for performance of postgraduate trainees in their first role in clinical practice. Moreover, to date few researchers have empirically examined the complementary roles of academic and non-academic selection methods in predicting in-role performance. This is an important area of enquiry as despite it being common practice to use both types of methods within a selection system, there is currently no evidence that this approach translates into increased predictive validity of the selection system as a whole, over that achieved by the use of a single selection method. In this preliminary study, the majority of the range of scores achieved by successful applicants to the UK Foundation Programme provided a unique opportunity to address both of these areas of enquiry. Sampling targeted high (>80th percentile) and low (academic performance scores correlated with supervisor ratings (r = .31 and .28, respectively). The relationship was stronger between the SJT and in-role performance for the low scoring group (r = .33, high scoring group r = .11), and between academic performance and in-role performance for the high scoring group (r = .29, low scoring group r = .11). Trainees with low SJT scores were almost five times more likely to receive remedial action. Results indicate that an SJT for entry into trainee physicians' first role in clinical practice has good predictive validity of supervisor-rated performance and incidence of remedial action. In addition, an SJT and a measure of academic performance appeared to be complementary to each other. These initial findings suggest that SJTs may be more predictive at the lower end of a scoring distribution, and academic attainment more predictive at the higher end.

  1. Learning Experiences of Nurses as Part of a European Union Project on Complementary Therapies: A Multinational Qualitative Study.

    Science.gov (United States)

    Boz, İlkay; Özer, Zeynep; Teskereci, Gamze; Kavradim, Selma Turan

    The objectives of this study were to investigate learning experiences of the nurses who participated in transnational and multinational occupational training. A qualitative descriptive methodology was used. Data are clustered into 3 categories "occupational training," "complementary care," and "intercultural interaction." This research has revealed many insights into the transnational training of nurses.

  2. Uso de terapias complementares por mães em seus filhos: estudo em um hospital universitário Use of complementary therapies by mothers in their children: study at an university hospital

    Directory of Open Access Journals (Sweden)

    Luiza Borges Gentil

    2010-06-01

    Full Text Available O objetivo deste estudo é avaliar a utilização de terapias complementares (TC por mães em seus filhos. Trata-se de um estudo transversal, descritivo. Foram entrevistadas 202 mães de crianças assistidas em um hospital universitário. As variáveis analisadas foram: uso de terapias complementares/motivos para tal, tipos de terapias utilizadas, sua finalidade, seus efeitos, revelação ao médico/motivos para tal e reação do médico. A prevalência de uso de terapias complementares foi 87,6%. De 177 mães que utilizavam TC, muitas mencionaram mais de um tipo, sendo: chás (72,8%, benzimento (41%, simpatias (12,9%, remédios/xaropes caseiros (8,4%, oração/promessa (7,4%, homeopatia (4,0%, tratamento espiritual/parapsicológico (4,0%, mistura de substâncias desconhecidas/garrafada (3%, massagem (2% e reiki/florais (1,5%. As ervas mais utilizadas foram erva-doce (16,7%, camomila (14,8% e hortelã (10,9%; 57,6% das mães não informaram o uso ao médico. Dos 499 tratamentos empregados, houve percepção de melhora em 429 (86% e relato de dois casos de efeitos adversos. A prevalência do uso de terapias complementares foi alta, sendo os chás a terapia mais utilizada e erva-doce, camomila e hortelã as ervas mais usadas. Houve percepção de melhora na maioria das terapias usadas.The objective of this article is to evaluate the use of complementary therapies by mothers in their children. A cross-sectional and descriptive study with 202 mothers of children that attended an University Hospital were interviewed. The variables analyzed were: use of complementary therapies/reasons, therapies used its purpose, effects, doctor's revelation/reasons and doctor's reaction. The prevalence of complementary therapies use was of 87.6%. Among the 177 mothers that used complementary therapies, many mentioned more than one kind, as follow: teas (72.8%, blessings (41%, sympathies (12.9%, homemade remedies/syrups (8.4%, prayer/promises (7.4%, homeopathy (4

  3. A novel and effective acupuncture modality as a complementary therapy to acute pain relief in inpatients with rib fractures

    Directory of Open Access Journals (Sweden)

    Hsin-Yi Ho

    2014-06-01

    Full Text Available Background: Pain control has been emphasized as a priority for both practitioners and inpatients with rib fractures, since analgesia could only offer limited relief from severe pain. A prospective and randomized controlled trial was conducted to analyze the efficacy and efficiency of acupuncture in acute pain relief for inpatients with rib fractures. Methods: A total of 58 inpatients were recruited and allocated to two groups, receiving identical doses of conventional oral analgesics as well as filiform needles as treatment and thumbtack intradermal (TI needles placed upon the skin surface as a control, respectively, via novel acupuncture modality once daily for three consecutive days. The effect of pain relief was evaluated during activities that induce pain, and sustained maximal inspiration (SMI lung volumes and sleep quality were assessed. Results: The patients treated with filiform needles had more effective pain relief than those in the TI needle group during deep breathing, coughing, and turning over the body (p < 0.05, and the effect persisted for at least 6 h in most patients. Sustained maximal inspiration lung volumes and sleep quality did not show improvement through every acupuncture intervention, and they could not respond accurately to pain relief via acupuncture. Conclusion: The active evaluation could provide a more adaptive model for assessing pain intensity due to rib fractures. This novel acupuncture modality in which the needle insertion sites are corresponding to the pain spots can be a safe and viable therapy for relieving pain in inpatients with rib fractures.

  4. A novel and effective acupuncture modality as a complementary therapy to acute pain relief in inpatients with rib fractures.

    Science.gov (United States)

    Ho, Hsin-Yi; Chen, Chao-Wei; Li, Ming-Chieh; Hsu, Yu-Pao; Kang, Shih-Ching; Liu, Erh-Hao; Lee, Ko-Hung

    2014-01-01

    Pain control has been emphasized as a priority for both practitioners and inpatients with rib fractures, since analgesia could only offer limited relief from severe pain. A prospective and randomized controlled trial was conducted to analyze the efficacy and efficiency of acupuncture in acute pain relief for inpatients with rib fractures. A total of 58 inpatients were recruited and allocated to two groups, receiving identical doses of conventional oral analgesics as well as filiform needles as treatment and thumbtack intradermal (TI) needles placed upon the skin surface as a control, respectively, via novel acupuncture modality once daily for three consecutive days. The effect of pain relief was evaluated during activities that induce pain, and sustained maximal inspiration (SMI) lung volumes and sleep quality were assessed. The patients treated with filiform needles had more effective pain relief than those in the TI needle group during deep breathing, coughing, and turning over the body (p acupuncture intervention, and they could not respond accurately to pain relief via acupuncture. The active evaluation could provide a more adaptive model for assessing pain intensity due to rib fractures. This novel acupuncture modality in which the needle insertion sites are corresponding to the pain spots can be a safe and viable therapy for relieving pain in inpatients with rib fractures.

  5. Evaluating complementary and alternative medicine interventions: in search of appropriate patient-centered outcome measures

    Directory of Open Access Journals (Sweden)

    Mallory Devon

    2006-11-01

    Full Text Available Abstract Background Central to the development of a sound evidence base for Complementary and Alternative Medicine (CAM interventions is the need for valid, reliable and relevant outcome measures to assess whether the interventions work. We assessed the specific needs for a database that would cover a wide range of outcomes measures for CAM research and considered a framework for such a database. Methods The study was a survey of CAM researchers, practitioners and students. An online questionnaire was emailed to the members of the Canadian Interdisciplinary Network for CAM Research (IN-CAM and the CAM Education and Research Network of Alberta (CAMera. The majority of survey questions were open-ended and asked about outcome measures currently used, outcome measures' assessment criteria, sources of information, perceived barriers to finding outcome measures and outcome domains of importance. Descriptive quantitative analysis and qualitative content analysis were used. Results One hundred and sixty-four completed surveys were received. Of these, 62 respondents reported using outcome measures in their CAM research and identified 92 different specific outcomes. The most important barriers were the fact that, for many health concepts, outcome measures do not yet exist, as well as issues related to accessibility of instruments. Important outcome domains identified included physical, psychological, social, spiritual, quality of life and holistic measures. Participants also mentioned the importance of individualized measures that assess unique patient-centered outcomes for each research participant, and measures to assess the context of healing and the process of healing. Conclusion We have developed a preliminary framework that includes all components of health-related outcomes. The framework provides a foundation for a larger, comprehensive collection of CAM outcomes. It fits very well in a whole systems perspective, which requires an expanded set of

  6. Complementary and

    African Journals Online (AJOL)

    {Research Paper. ISSN 0189-6016O20Ц6. Afr. J, Traditional,. Complementary and. Alternative Medicines www.africanethnomedicines.net. THE EFFECT OF A LOCAL MINERAL KADOSERO TOWARDS THE ..... Their targets for inhibition include the cytoplasmic membrane, DNA replication, protein synthesis and various.

  7. Safety assessment for a KBS-3H spent nuclear fuel repository at Olkiluoto. Complementary evaluations of safety

    Energy Technology Data Exchange (ETDEWEB)

    Neall, Fiona; Pastina, Barbara; Snellman, Margit; Smith, Paul; Gribi, P.; Johnson, Lawrence

    2008-12-15

    The KBS-3H design is a variant of the more general KBS-3 method for the geological disposal of spent nuclear fuel in Finland and Sweden. In the KBS-3H design, multiple assemblies containing spent fuel are emplaced horizontally in parallel, approximately 300 m long, slightly inclined deposition drifts. The copper canisters, each with a surrounding layer of bentonite clay, are placed in perforated steel shells prior to deposition in the drifts; the assembly is called the 'supercontainer'. The other KBS-3 variant is the KBS-3V design, in which the copper canisters are emplaced vertically in individual deposition holes surrounded by bentonite clay but without steel supercontainer shells. SKB and Posiva have conducted a Research, Development and Demonstration programme over the period 2002-2007 with the overall aim of establishing whether KBS-3H represents a feasible alternative to KBS-3V. As part of this programme, the long-term safety of a KBS-3H repository has been assessed in the KBS-3H safety studies. In order to focus the safety studies, the Olkiluoto site in the municipality of Eurajoki, which is the proposed site for a spent fuel repository in Finland, was used as a hypothetical site for a KBS-3H repository. The present report is part of a portfolio of reports discussing the long-term safety of the KBS-3H repository. The overall outcome of the KBS-3H safety studies is documented in the summary report, 'Safety assessment for a KBS-3H repository for spent nuclear fuel at Olkiluoto'. The purpose and scope of the KBS-3H complementary evaluations of safety report is provided in Posiva's Safety Case Plan, which is based on Regulatory Guide YVL 8.4 and on international guidelines on complementary lines of argument to long-term safety that are considered an important element of a post-closure safety case for geological repositories. Complementary evaluations of safety require the use of evaluations, evidence and qualitative supporting arguments

  8. Health economic evaluation in complementary medicine: development within the last decades concerning local origin and quality.

    Science.gov (United States)

    Ostermann, Thomas; Krummenauer, Frank; Heusser, Peter; Boehm, Katja

    2011-12-01

    This evaluation investigates characteristics of health economics evaluations in CAM. Particular emphasis is paid to differences regarding continental origin and time of publication of investigations. Database searches to identify potential studies were carried out in Medline (via Pubmed), the Cochrane Central Register of Controlled Trials 1st Quarter 2010, the Cochrane Database of Systematic Reviews 2005 to January 2010, the Cochrane Methodology Register 1st Quarter 2010, the Database of Abstracts of Reviews of Effects 1st Quarter 2010, Health Technology Assessment (via OVID) and CAMbase. Data were screened, extracted and the methodological quality of the underlying publications was assessed. Univariate statistical analyses were carried out and Classification and Regression Tree (CART) analysis was performed. One hundred and forty-three studies were included in this review, 43 of which were randomised trials. Of all included studies 56% were carried out in primary care settings and 54% chose the perspective of health care provider/health insurance. When the study characteristics were stratified for the "year of publication" (before versus in/after 2002), locally significant differences were found for study setting (Chi-square p=0.014) and methodological quality (Mann/Whitney p=0.014). Furthermore, studies from America differed from those conducted in Europe with respect to the field of CAM (p<0.001, Chi-square). There were also differences in trial settings as the majority of European studies was carried out in primary care settings (n=54; 70%), whereas American studies had a broader scope with only 24 studies (42%) in the field of primary care. The CART analyses confirmed the findings of the univariate analysis. Differences in healthcare systems were mirrored by the observed differences in CAM related health economic evaluations. Basic requirements for reporting and conducting clinical trials ought to be met in more studies evaluating health economics. Such

  9. An overview of systematic reviews of complementary and alternative therapies for fibromyalgia using both AMSTAR and ROBIS as quality assessment tools.

    Science.gov (United States)

    Perry, Rachel; Leach, Verity; Davies, Philippa; Penfold, Chris; Ness, Andy; Churchill, Rachel

    2017-05-15

    Fibromyalgia (FM) is a chronic, debilitating pain disorder. Dissatisfaction with conventional medicine can lead people with FM to turn to complementary and alternative medicine (CAM). Two previous overviews of systematic reviews of CAM for FM have been published, but they did not assessed for risk of bias in the review process. Five databases Medline, Embase, AMED (via OVID), Web of Science and Central were searched from their inception to December 2015. Reference lists were hand-searched. We had two aims: the first was to provide an up-to-date and rigorously conducted synthesis of systematic reviews of CAM literature on FM; the second was to evaluate the quality of the available systematic review evidence using two different tools: AMSTAR (Shea et al. BMC Med Res Methodol 15; 7:10, 2007) and a more recently developed tool ROBIS (Whiting et al. J Clin Epidemiol 69:225-34, 2016) specifically designed to assess risk of bias in systematic reviews. Any review that assessed one of eight CAM therapies for participants diagnosed with FM was considered. The individual studies had to be randomised controlled trials where the intervention was compared to placebo, treatment as usual or waitlist controls to be included. The primary outcome measure was pain, and the secondary outcome measure was adverse events. We identified 15 reviews that met inclusion criteria. There was low-quality evidence that acupuncture improves pain compared to no treatment or standard treatment, but good evidence that it is no better than sham acupuncture. The evidence for homoeopathy, spinal manipulation and herbal medicine was limited. Overall, five reviews scored 6 or above using the AMSTAR scale and the inter-rater agreement was good (83.6%), whereas seven reviews achieved a low risk of bias rating using ROBIS and the inter-rater agreement was fair (60.0%). No firm conclusions were drawn for efficacy of either spinal manipulation or homoeopathy for FM. There is limited evidence for topical

  10. Evaluation of impact of artificial reefs on artisanal fisheries: need for complementary approaches

    Directory of Open Access Journals (Sweden)

    Barbara Koeck

    2011-01-01

    Full Text Available In a general context of fisheries decline due to overfishing and to other phenomena such as climate change, it appears to be crucial to implement a sustainable management of natural resources by finding a balance between conservation and exploitation purposes. Artificial reefs (ARs have recently become one of the existing management tools, often in combination with fishing quotas or marine protected areas. To evaluate the effectiveness of the studied ARs, different methods have been used: (i visual census by SCUBA diving (AR scale, (ii fisheries landings survey (local scale and (iii external fish tagging (regional scale. Underwater visual census (UVC showed a significantly higher species richness and density in ARs than in the control site. Abundance, biomass and LPUE data (Landings Per Unit Effort issued from artisanal fisheries landings survey were not significantly different around the AR system from other fishing grounds of the French Catalan coast. The tagging experiments on Diplodus sargus suggested that the connectivity of demersal fish populations must be taken into account to evaluate the influence area of ARs and thus their indirect impacts on artisanal fisheries. The present study highlights the interest of combining methods covering different spatial scales in order to evaluate direct and indirect impacts of ARs on artisanal fisheries. Methods for the evaluation of AR efficiency are discussed.Dentro do atual contexto de redução nos estoques de peixes ligados à sobrepesca, e também à outros fenômenos tais como as mudanças climáticas, é indispensável implementar um plano de gestão durável para os recursos pesqueiros, conciliando sua exploração e conservação. Os recifes artificiais (RAs tem surgido nos dias atuais como uma importante ferramenta de gestão, freqüentemente combinada à cotas de pesca ou áreas marinhas protegidas. Com a finalidade de avaliar a eficiência dos recifes artificiais, utilizou-se os seguintes

  11. Complementary and alternative medicine (CAM providers’ views of chronic low back pain patients’ expectations of CAM therapies: a qualitative study

    Directory of Open Access Journals (Sweden)

    Schafer Lisa M

    2012-11-01

    Full Text Available Abstract Background Some researchers think that patients with higher expectations for CAM therapies experience better outcomes and that enthusiastic providers can enhance treatment outcomes. This is in contrast to evidence suggesting conventional medical providers often reorient patient expectations to better match what providers believe to be realistic. However, there is a paucity of research on CAM providers’ views of their patients’ expectations regarding CAM therapy and the role of these expectations in patient outcomes. Methods To better understand how CAM providers view and respond to their patients’ expectations of a particular therapy, we conducted 32 semi-structured, qualitative interviews with acupuncturists, chiropractors, massage therapists and yoga instructors identified through convenience sampling. Interviews were recorded, transcribed and analyzed thematically using Atlas ti version 6.1. Results CAM providers reported that they attempt to ensure that their patients’ expectations are realistic. Providers indicated they manage their patients’ expectations in a number of domains— roles and responsibilities of providers and patients, treatment outcomes, timeframe for improvement, and treatment experience. Providers reported that patients’ expectations change over time and that they need to continually manage these expectations to enhance patient engagement and satisfaction with treatment. Conclusions Providers of four types of CAM therapies viewed patients’ expectations as an important component of their experiences with CAM therapy and indicated that they try to align patient expectations with reality. These findings suggest that CAM providers are similar in this respect to conventional medical providers.

  12. Benzoic acid derivatives: Evaluation of thermochemical properties with complementary experimental and computational methods

    Energy Technology Data Exchange (ETDEWEB)

    Verevkin, Sergey P., E-mail: sergey.verevkin@uni-rostock.de [Department of Physical Chemistry and Department “Science and Technology of Life, Light and Matter”, University of Rostock, D-18059 Rostock (Germany); Department of Physical Chemistry, Kazan Federal University, 420008 Kazan (Russian Federation); Zaitsau, Dzmitry H. [Department of Physical Chemistry, Kazan Federal University, 420008 Kazan (Russian Federation); Emeĺyanenko, Vladimir N. [Department of Physical Chemistry and Department “Science and Technology of Life, Light and Matter”, University of Rostock, D-18059 Rostock (Germany); Stepurko, Elena N. [Chemistry Faculty and Research Institute for Physical Chemical Problems, Belarusian State University, 220030 Minsk (Belarus); Zherikova, Kseniya V. [Nikolaev Institute of Inorganic Chemistry of Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk (Russian Federation)

    2015-12-20

    Highlights: • Vapor pressures of benzoic acid derivatives were measured. • Sublimation enthalpies were derived and compared with the literature. • Thermochemical data tested for consistency using additivity rules and computations. • Contradiction between available enthalpies of sublimation was resolved. • Pairwise interactions of substituents on the benzene ring were derived. - Abstract: Molar sublimation enthalpies of the methyl- and methoxybenzoic acids were derived from the transpiration method, static method, and TGA. Thermochemical data available in the literature were collected, evaluated, and combined with own experimental results. This collection together with the new experimental results reported here has helped to resolve contradictions in the available enthalpy data and to recommend sets of sublimation and formation enthalpies for the benzoic acid derivatives. Gas-phase enthalpies of formation calculated with the G4 quantum-chemical method were in agreement with the experiment. Pairwise interactions of the methyl, methoxy, and carboxyl substituents on the benzene ring were derived and used for the development of simple group-additivity procedures for estimation of the vaporization enthalpies, gas-phase, and liquid-phase enthalpies of formation of substituted benzenes.

  13. Evaluation of complementary diagnostic tools for bovine tuberculosis detection in dairy herds from India.

    Science.gov (United States)

    Thakur, Mukesh Kumar; Sinha, Dharmender Kumar; Singh, Bhoj Raj

    2016-08-01

    A cross-sectional study was undertaken to know the herd prevalence and evaluate the single intradermal tuberculin testing (SITT), culture isolation, and polymerase chain reaction (PCR) analysis for the diagnosis of bovine tuberculosis (TB). A total of 541 cows of three dairy farms of Bareilly and Mukteshwar were screened by SITT followed by collection of pre-scapular lymph node (PSLN) aspirates (71), milk (54), and blood (71) samples from reactor animals. These clinical samples were processed for culture isolation and direct PCR-based identification and species differentiation. Out of 541 cows screened by SITT, 71 (13.12%) animals were found positive. Mycobacteria were isolated from 3 (4.22%) PSLN aspirate but not from any cultured milk and blood samples. 28 (39.43%) PSLN aspirate and 5 (9.25%) milk samples were positive for Mycobacterium TB (MTB) complex (MTC) by PCR amplification for the IS6110 insertion sequence; however, blood samples were found negative. For species differentiation, multiplex-PCR using 12.7 kb primers was conducted. Out of 28 PSLN aspirate, Mycobacterium bovis was detected in 18 (64.28%) and MTB in 8 (28.57%), whereas 2 aspirate samples (7.14%) were positive for both the species. All the five milk positive samples were positive for M. bovis. Direct detection of bovine TB by a molecular-based method in dairy animals after preliminary screening was appeared to be more sensitive and specific compared to the conventional method (i.e., culture isolation). Its application in form of serial testing methodology for the routine diagnosis and thereafter, culling of infected stock may be suggested for the control programs in dairy herds. The PSLN aspirate was found to be the most suitable specimen for culture isolation and PCR-based detection of Mycobacterium spp. among live infected animals.

  14. Evaluation of complementary diagnostic tools for bovine tuberculosis detection in dairy herds from India

    Directory of Open Access Journals (Sweden)

    Mukesh Kumar Thakur

    2016-08-01

    Full Text Available Aim: A cross-sectional study was undertaken to know the herd prevalence and evaluate the single intradermal tuberculin testing (SITT, culture isolation, and polymerase chain reaction (PCR analysis for the diagnosis of bovine tuberculosis (TB. Materials and Methods: A total of 541 cows of three dairy farms of Bareilly and Mukteshwar were screened by SITT followed by collection of pre-scapular lymph node (PSLN aspirates (71, milk (54, and blood (71 samples from reactor animals. These clinical samples were processed for culture isolation and direct PCR-based identification and species differentiation. Results: Out of 541 cows screened by SITT, 71 (13.12% animals were found positive. Mycobacteria were isolated from 3 (4.22% PSLN aspirate but not from any cultured milk and blood samples. 28 (39.43% PSLN aspirate and 5 (9.25% milk samples were positive for Mycobacterium TB (MTB complex (MTC by PCR amplification for the IS6110 insertion sequence; however, blood samples were found negative. For species differentiation, multiplex-PCR using 12.7 kb primers was conducted. Out of 28 PSLN aspirate, Mycobacterium bovis was detected in 18 (64.28% and MTB in 8 (28.57%, whereas 2 aspirate samples (7.14% were positive for both the species. All the five milk positive samples were positive for M. bovis. Conclusion: Direct detection of bovine TB by a molecular-based method in dairy animals after preliminary screening was appeared to be more sensitive and specific compared to the conventional method (i.e., culture isolation. Its application in form of serial testing methodology for the routine diagnosis and thereafter, culling of infected stock may be suggested for the control programs in dairy herds. The PSLN aspirate was found to be the most suitable specimen for culture isolation and PCR-based detection of Mycobacterium spp. among live infected animals.

  15. Evaluation of the aggregation states of monoclonal antibodies by diverse and complementary methods.

    Science.gov (United States)

    Yoshino, Tetsuya; Ishikawa, Tomoyoshi; Ishihara, Takashi; Takeuchi, Yoshimi; Yoshikawa, Hitomi; Yoshida, Hideaki; Yoshida, Hitoshi; Wakamatsu, Kaori

    2011-01-01

    Therapeutic monoclonal antibodies (MAbs) with high specificity and fewer adverse effects are becoming widely used for the treatment of various diseases. MAbs need to be stored and administered at high concentrations in solution, the conditions under which MAbs may aggregate. As aggregated MAbs compromise their safety and efficacy, aggregation should be prevented; thus, it is important to analyze the aggregation states of MAbs in detail. We obtained 2 MAbs against dinitrophenol (DNP) that exhibited different aggregation properties: anti-DNP1 exhibited a much higher aggregate content (dimer or trimer) than anti-DNP2 when analyzed by size-exclusion chromatography (SEC). As anti-DNP1 had a longer complementarity-determining region 3 (CDR3) light chain than anti-DNP2 by 2 amino acid residues, we hypothesized that the increased aggregation of DNP1 was due to these extra residues; therefore, we prepared mutant antibodies with shorter CDR3s to compare their aggregation properties. Anti-DNP1-ΔEI, with the same CDR3 length as anti-DNP2, exhibited no aggregates as expected. Anti-DNP1-ΔI, with 1 additional residue, exhibited a smaller peak than wild-type (WT) in SEC, whereas this mutant exhibited stronger thioflavin T fluorescence than WT, which is indicative of amyloid formation. In addition, the anti-DNP1-ΔI solution (but not others) became opalescent at 4°C and exhibited large visible particles, which are undetectable by SEC. The fragment antigen-binding region of this mutant was found to have lower thermal stability than the others by differential scanning calorimetry. These data suggest that diverse analytical methods should be applied to evaluate MAb aggregation, in addition to the commonly used SEC.

  16. A conceptual framework of stress vulnerability, depression, and health outcomes in women: potential uses in research on complementary therapies for depression.

    Science.gov (United States)

    Kinser, Patricia A; Lyon, Debra E

    2014-09-01

    Depression is a chronic mental health condition that affects millions of individuals worldwide. It is well-established that psychological stress plays an integral role in depression and that depression has numerous negative health outcomes. However, a closer look at components of stress vulnerabilities and depression is required to allow for the development and testing of appropriate interventions. This article describes a conceptual framework about the complex and bidirectional relationship between stress vulnerability, depression, and health outcomes in women. The authors elucidate how the framework can be applied in clinical research about cellular aging and on the mechanisms of complementary and alternative medicine (CAM) for depression, using yoga as an example of a CAM modality. The proposed conceptual framework may be helpful for adding depth to the body of knowledge about the use of mind-body therapies for individuals at high risk of stress vulnerability and/or depression.

  17. Article Withdrawal: "Perceptions of the use of complementary therapy and Siddha medicine among rural patients with HIV/AIDS: a case study from India" by Maria Costanza Torri.

    Science.gov (United States)

    2014-01-01

    The above article from the International Journal of Health Planning and Management, published online in Wiley Online Library on July 4th 2012, has been withdrawn by agreement between the author, the journal Editor-in-Chief and John Wiley & Sons Ltd. The withdrawal has been agreed owing to an error at the publishers and subsequent dual publication in the journal. The journal Editor-in-Chief and John Wiley & Sons Ltd. would like to emphasise that there is no suggestion of a breach of publication ethics by Dr Torri. REFERENCE Torri MC. 2012. Perceptions of the use of complementary therapy and Siddha medicine among rural patients with HIV/AIDS: a case study from India. Int J Health Plann Mgmt. doi: 10.1002/hpm.2242. Copyright © 2013 John Wiley & Sons, Ltd.

  18. Robotic therapy provides a stimulus for upper limb motor recovery after stroke that is complementary to and distinct from conventional therapy.

    Science.gov (United States)

    Brokaw, Elizabeth B; Nichols, Diane; Holley, Rahsaan J; Lum, Peter S

    2014-05-01

    Individuals with chronic stroke often have long-lasting upper extremity impairments that impede function during activities of daily living. Rehabilitation robotics have shown promise in improving arm function, but current systems do not allow realistic training of activities of daily living. We have incorporated the ARMin III and HandSOME device into a novel robotic therapy modality that provides functional training of reach and grasp tasks. To compare the effects of equal doses of robotic and conventional therapy in individuals with chronic stroke. Subjects were randomized to 12 hours of robotic or conventional therapy and then crossed over to the other therapy type after a 1-month washout period. Twelve moderate to severely impaired individuals with chronic stroke were enrolled, and 10 completed the study. Across the 3-month study period, subjects showed significant improvements in the Fugl-Meyer (P = .013) and Box and Blocks tests (P = .028). The robotic intervention produced significantly greater improvements in the Action Research Arm Test than conventional therapy (P = .033). Gains in the Box and Blocks test from conventional therapy were larger than from robotic therapy in subjects who received conventional therapy after robotic therapy (P = .044). Data suggest that robotic therapy can elicit improvements in arm function that are distinct from conventional therapy and supplements conventional methods to improve outcomes. Results from this pilot study should be confirmed in a larger study.

  19. Complementary Chinese Herbal Medicine Therapy Improves Survival of Patients With Pancreatic Cancer in Taiwan: A Nationwide Population-Based Cohort Study.

    Science.gov (United States)

    Kuo, Yi-Ting; Liao, Hou-Hsun; Chiang, Jen-Huai; Wu, Mei-Yao; Chen, Bor-Chyuan; Chang, Ching-Mao; Yeh, Ming-Hsien; Chang, Tung-Ti; Sun, Mao-Feng; Yeh, Chia-Chou; Yen, Hung-Rong

    2017-08-01

    Pancreatic cancer is a difficult-to-treat cancer with a late presentation and poor prognosis. Some patients seek traditional Chinese medicine (TCM) consultation. We aimed to investigate the benefits of complementary Chinese herbal medicine (CHM) among patients with pancreatic cancer in Taiwan. We included all patients with pancreatic cancer who were registered in the Taiwanese Registry for Catastrophic Illness Patients Database between 1997 and 2010. We used 1:1 frequency matching by age, sex, the initial diagnostic year of pancreatic cancer, and index year to enroll 386 CHM users and 386 non-CHM users. A Cox regression model was used to compare the hazard ratios (HRs) of the risk of mortality. The Kaplan-Meier curve was used to compare the difference in survival time. According to the Cox hazard ratio model mutually adjusted for CHM use, age, sex, urbanization level, comorbidity, and treatments, we found that CHM users had a lower hazard ratio of mortality risk (adjusted HR = 0.67, 95% CI = 0.56-0.79). Those who received CHM therapy for more than 90 days had significantly lower hazard ratios of mortality risk than non-CHM users (90- to 180-day group: adjusted HR = 0.56, 95% CI = 0.42-0.75; >180-day group: HR = 0.33, 95% CI = 0.24-0.45). The survival probability was higher for patients in the CHM group. Bai-hua-she-she-cao (Herba Oldenlandiae; Hedyotis diffusa Spreng) and Xiang-sha-liu-jun-zi-tang (Costus and Chinese Amomum Combination) were the most commonly used single herb and Chinese herbal formula, respectively. Complementary Chinese herbal therapy might be associated with reduced mortality among patients with pancreatic cancer. Further prospective clinical trial is warranted.

  20. Apitherapy as a complementary therapeutic alternative for physical therapy in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Raquel Amalia Vélez-Tobar

    2010-03-01

    Full Text Available Introduction: Physical therapy in Reumatoid Arthritis (RA patients seek reduce pain, improve join mobility, avoid muscular atrophy and increase functional activity. Our study introduces Apitherapy (bee venom therapy like acomplementary physical modality in the rehabilitation management of RA patients in acute phase. Apitoxin or bee venom has demonstrated analgesic, anti-inflammatory, and tissue repair proprieties. Materials and methods: We selectfour AR patients, following the ACR yardsticks. They were tree adult woman anda one male who accept to participate like voluntaries in a simple observational study. All patients were full informed about the risk and potential benefit of bevenom therapy. We evaluate all patients with allergy tests and reject sensibility to apitoxin, as well other systemic diseases. All patients were evaluated with HAQ, EVA, AHI, join mobility test, and whit pain body map. The patients received conventional Physical Therapy treatment in the first phase, and them one month later, they received Physical Therapy with Apiteraphy. Outcomes: Tree of four patients (all woman answered best to the Physical Therapy plus Apitherapy that to the Physical Therapy alone. All patients reported decreased of symptoms and greater reduction of RA sings after Physical Therapy plus Apitherapy treatment that Physical Therapy alone. The last patient hasn't changes with Apitherapy. However, none of these findings got statistics significance. Conclusions: Is possible to conjugate Physical Therapy with Apitherapy in the rehabilitation treatment of RA patients and wait positive changes in pain and physical function in some of them that can be best that Physical Therapy alone; although, his durability and long time benefits or secondary effects, must be evaluate in new studies with most patients and mainly control methods.

  1. A critical realist evaluation of a music therapy intervention in palliative care.

    Science.gov (United States)

    Porter, Sam; McConnell, Tracey; Clarke, Mike; Kirkwood, Jenny; Hughes, Naomi; Graham-Wisener, Lisa; Regan, Joan; McKeown, Miriam; McGrillen, Kerry; Reid, Joanne

    2017-12-08

    Music therapy is increasingly used as an adjunct therapy to support symptom management in palliative care. However, studies to date have paid little attention to the processes that lead to changes in patient outcomes. To fill this gap, we examined the processes and experiences involved in the introduction of music therapy as an adjunct complementary therapy to palliative care in a hospice setting in the United Kingdom (UK). Using a realistic evaluation approach, we conducted a qualitative study using a variety of approaches. These consisted of open text answers from patients (n = 16) on how music therapy helped meet their needs within one hospice in Northern Ireland, UK. We also conducted three focus groups with a range of palliative care practitioners (seven physicians, seven nursing staff, two social workers and three allied health professionals) to help understand their perspectives on music therapy's impact on their work setting, and what influences its successful implementation. This was supplemented with an interview with the music therapist delivering the intervention. Music therapy contains multiple mechanisms that can provide physical, psychological, emotional, expressive, existential and social support. There is also evidence that the hospice context, animated by a holistic approach to healthcare, is an important facilitator of the effects of music therapy. Examination of patients' responses helped identify specific benefits for different types of patients. There is a synergy between the therapeutic aims of music therapy and those of palliative care, which appealed to a significant proportion of participants, who perceived it as effective.

  2. Complementary Languages

    DEFF Research Database (Denmark)

    Preisler, Bent

    2009-01-01

    The Danish language debate is dominated by two key concepts: ‘domain loss' and its opposite, ‘parallel languages' (parallelsproglighed). The under­stood reference is to the relationship between Danish and English - i.e. the spread of English at the expense of Danish vs. the coexistence of Danish...... society is everywhere unproblematic. A case in point is Higher Education. I will also argue that the recently proposed solution to ‘domain loss' - Danish and English used ‘in parallel', ‘parallel languages' - because it is unrealistic as well as undesirable as a consistent principle - should be replaced...... by an alternative concept that more adequately describes the realities of what adherents of ‘parallel languages' can hope for. The new concept I have dubbed ‘complementary languages' (komplementær­sproglighed). I will explain this concept in the following and contrast it both with ‘parallel languages...

  3. Use of therapies other than disease-modifying agents, including complementary and alternative medicine, by patients with multiple sclerosis: a survey study.

    Science.gov (United States)

    Stoll, Sharon S; Nieves, Christine; Tabby, David Stuart; Schwartzman, Robert

    2012-01-01

    Many patients with multiple sclerosis use complementary and alternative medicine (CAM) to supplement their traditional treatment. To identify both the prevalence and frequency of use of therapies other than disease-modifying agents (DMAs), including CAM, among patients with multiple sclerosis. The authors administered a 13-question survey regarding patients' current use of non-DMA therapies-including dietary supplements, exercise, and "true" CAM (eg, acupuncture, chiropractic, massage)-and mainstream treatments, including physical therapy and osteopathic manipulative treatment. Patients rated their level of disability on a scale of 1 to 10 (with 10 being most severe). A hospital outpatient clinic in Philadelphia, Pennsylvania. Inclusion criteria were physician-confirmed multiple sclerosis (either relapsing-remitting or progressive), regardless of sex, duration of disease, age at onset, disability level, or type of disease. Patients were excluded if they were younger than 18 years. Patient-reported use of non-DMA therapies and perception of disability. A total of 111 patients with multiple sclerosis completed the survey properly. All respondents used non-DMA therapies. Twenty-three patients (20.7%) used these therapies without concomitantly taking a DMA. A plurality (34.8%) of those patients reported a disability score of 7 or 8. Sixty-two of the 88 participants (70.5 %) who used DMAs reported disability scores of 5 or less. Sixty-five patients (58.6.%) reported exercising on a weekly basis. Among those patients, 47 (72.3%) reported a disability score of 5 or less. Sixty-four patients (57.7%) used such CAM therapies as acupuncture and massage, or such other non-DMA treatments as osteopathic manipulative treatment and psychotherapy. Among those patients, 37 (64.9%) reported a disability score of 5 or less. Many patients with multiple sclerosis are seeking more than traditional medical treatment. Physicians and other health care professionals must be aware of the

  4. A lecture program on complementary and alternative medicine for cancer patients--evaluation of the pilot phase.

    Science.gov (United States)

    Huebner, J; Ebel, M; Muenstedt, K; Micke, O; Prott, F J; Muecke, R; Hoppe, A

    2015-06-01

    About half of all patients with cancer use complementary or alternative medicine (CAM). In 2013, we started a lecture program for patients, followed by evidence-based recommendations on counseling on CAM. These recommendations have been published before by this working group. The aim of the program is to provide scientific facts on the most often used CAM methods in standardized presentations which help patients discuss the topic with their oncologists and support shared decision making. The article presents the evaluation of the pilot phase. Participants received a standardized questionnaire before the start of the lecture. The questionnaire comprises four parts: demographic data, data concerning experience with CAM, satisfaction with the lecture, and needs for further information on CAM. In 2013, seven lectures on CAM were given in cooperation with regional branches of the German Cancer Society in several German states. Four hundred sixty patients and relatives took part (75% females and 16% males). Forty-eight percent formerly had used CAM. Most often named sources of information on CAM were print media (48%) and the Internet (37%). Most participants rated additional written information valuable. About one third would like to have an individual consultation concerning CAM. A standardized presentation of evidence on CAM methods most often used, together with recommendations on the self-management of symptoms, is highly appreciated. The concept of a highly interactive lecture comprising is feasible and if presented in lay terminology, adequate. In order to give additional support on the topic, written information should be provided as the first step.

  5. Complementary role of two evaluation methods in the usability and accessibility evaluation of a non-standard system

    CSIR Research Space (South Africa)

    Adebesin, F

    2010-10-01

    Full Text Available for making time out of their busy schedule to evaluate the DD, as well as the learners who participated in the field usability study. 8. REFERENCES [1] Adebesin, T. F. 2010. Report on the Usability and Accessibility Evaluation of the Digital Doorway...

  6. Reiki and related therapies in the dialysis ward: an evidence-based and ethical discussion to debate if these complementary and alternative medicines are welcomed or banned.

    Science.gov (United States)

    Ferraresi, Martina; Clari, Roberta; Moro, Irene; Banino, Elena; Boero, Enrico; Crosio, Alessandro; Dayne, Romina; Rosset, Lorenzo; Scarpa, Andrea; Serra, Enrica; Surace, Alessandra; Testore, Alessio; Colombi, Nicoletta; Piccoli, Barbara Giorgina

    2013-06-21

    Complementary and Alternative Medicines (CAMs) are increasingly practiced in the general population; it is estimated that over 30% of patients with chronic diseases use CAMs on a regular basis. CAMs are also used in hospital settings, suggesting a growing interest in individualized therapies. One potential field of interest is pain, frequently reported by dialysis patients, and seldom sufficiently relieved by mainstream therapies. Gentle-touch therapies and Reiki (an energy based touch therapy) are widely used in the western population as pain relievers.By integrating evidence based approaches and providing ethical discussion, this debate discusses the pros and cons of CAMs in the dialysis ward, and whether such approaches should be welcomed or banned. In spite of the wide use of CAMs in the general population, few studies deal with the pros and cons of an integration of mainstream medicine and CAMs in dialysis patients; one paper only regarded the use of Reiki and related practices. Widening the search to chronic pain, Reiki and related practices, 419 articles were found on Medline and 6 were selected (1 Cochrane review and 5 RCTs updating the Cochrane review). According to the EBM approach, Reiki allows a statistically significant but very low-grade pain reduction without specific side effects. Gentle-touch therapy and Reiki are thus good examples of approaches in which controversial efficacy has to be balanced against no known side effect, frequent free availability (volunteer non-profit associations) and easy integration with any other pharmacological or non pharmacological therapy. While a classical evidence-based approach, showing low-grade efficacy, is likely to lead to a negative attitude towards the use of Reiki in the dialysis ward, the ethical discussion, analyzing beneficium (efficacy) together with non maleficium (side effects), justice (cost, availability and integration with mainstream therapies) and autonomy (patients' choice) is likely to lead to a

  7. Use of black vulture (Coragyps atratus in complementary and alternative therapies for cancer in Colombia: A qualitative study

    Directory of Open Access Journals (Sweden)

    Sánchez-Pedraza Ricardo

    2012-05-01

    Full Text Available Abstract Background Although Coragyps atratus has been used as a traditional therapy for patients with cancer, the scientific literature does not contain enough information on how this therapy is used or the mechanisms that explain this therapeutic practice. Objectives To understand the methods of use and the reasons given by patients and caregivers for the use of Coragyps atratus in cancer treatment. Methods This study used a qualitative design based on twenty in-depth interviews of patients with cancer or caregivers of patients with the disease. The analysis of the text was based on an inductive thematic approach. Results Resistance to disease and immune enhancement are properties attributed to Coragyps atratus when used for cancer treatment. The most recommended method of use is fresh blood ingestion, and the associated mechanism of action is transfer of immune factors to the individual who consumes it. Conclusions Use of Coragyps atratus as a treatment for cancer is a popular alternative therapy in Colombia. More studies are needed to understand the clinical effects of this intervention in cancer patients. Spanish abstract Introducción Aunque Coragyps atratus se usa tradicionalmente como terapia para pacientes con cáncer, no existe suficiente información en la literatura científica sobre su forma de utilización ni sobre los mecanismos explicativos que subyacen a esta práctica terapéutica. Objetivos Conocer métodos de utilización y mecanismos explicativos dados por los pacientes y cuidadores de pacientes sobre el uso de Coragyps atratus en el tratamiento del cáncer. Materiales y métodos Diseño cualitativo basado en veinte entrevistas en profundidad de pacientes con cáncer o cuidadores de pacientes con esta enfermedad. Análisis de texto basado en enfoque temático inductivo. Resultados Al Coragyps atratus se le atribuyen propiedades de resistencia y fortalecimiento del sistema inmune de personas enfermas de cáncer. La forma de

  8. Use of black vulture (Coragyps atratus) in complementary and alternative therapies for cancer in Colombia: A qualitative study

    Science.gov (United States)

    2012-01-01

    Background Although Coragyps atratus has been used as a traditional therapy for patients with cancer, the scientific literature does not contain enough information on how this therapy is used or the mechanisms that explain this therapeutic practice. Objectives To understand the methods of use and the reasons given by patients and caregivers for the use of Coragyps atratus in cancer treatment. Methods This study used a qualitative design based on twenty in-depth interviews of patients with cancer or caregivers of patients with the disease. The analysis of the text was based on an inductive thematic approach. Results Resistance to disease and immune enhancement are properties attributed to Coragyps atratus when used for cancer treatment. The most recommended method of use is fresh blood ingestion, and the associated mechanism of action is transfer of immune factors to the individual who consumes it. Conclusions Use of Coragyps atratus as a treatment for cancer is a popular alternative therapy in Colombia. More studies are needed to understand the clinical effects of this intervention in cancer patients. Spanish abstract Introducción Aunque Coragyps atratus se usa tradicionalmente como terapia para pacientes con cáncer, no existe suficiente información en la literatura científica sobre su forma de utilización ni sobre los mecanismos explicativos que subyacen a esta práctica terapéutica. Objetivos Conocer métodos de utilización y mecanismos explicativos dados por los pacientes y cuidadores de pacientes sobre el uso de Coragyps atratus en el tratamiento del cáncer. Materiales y métodos Diseño cualitativo basado en veinte entrevistas en profundidad de pacientes con cáncer o cuidadores de pacientes con esta enfermedad. Análisis de texto basado en enfoque temático inductivo. Resultados Al Coragyps atratus se le atribuyen propiedades de resistencia y fortalecimiento del sistema inmune de personas enfermas de cáncer. La forma de utilización mas común es la

  9. Uso da terapia não farmacológica, medicina alternativa e complementar na fibromialgia Non-pharmacological therapy and complementary and alternative medicine in fibromyalgia

    Directory of Open Access Journals (Sweden)

    Alessandra de Sousa Braz

    2011-06-01

    multifactorial pathogenesis, its ideal treatment requires a multidisciplinary approach including the association of pharmacological and non-pharmacological therapies. The pharmacological therapy currently recommended for the syndrome includes antidepressants, calcium-channel modulators, muscle relaxants, and analgesics. In most cases, the non-pharmacological treatment consists of patient education, supervised aerobic physical activity, and cognitive-behavioral therapy. However, many patients do not respond satisfactorily, or have side effects associated with the long-term use of drugs, in addition to reporting difficulties in adhering to a therapy based on exercises and physical medicine. Thus, physicians and patients are increasingly interested in an alternative and complementary therapy for fibromyalgia. This review approaches the different therapeutic modalities used in fibromyalgia, emphasizing the evidence of non-pharmacological therapy and use of alternative and complementary medicine for these patients.

  10. Technology evaluation: cystic fibrosis therapy, Genzyme.

    Science.gov (United States)

    Cockett, M I

    1999-04-01

    Genzyme is developing therapies to replace the defective forms of the cystic fibrosis (CF) transmembrane conductance regulator (CFTR) protein in CF patients. The company is developing a gene therapy, as well as a recombinant production of CFTR for protein replacement therapy. Both approaches have been granted orphan drug status by the FDA [156348]. The results of several clinical trials were discussed at the first annual meeting of the American Society of Gene Therapy in May 1998. A single dose nasal administration was well tolerated by volunteers, but had disappointing efficacy. In a study completed at the Royal Brompton Hospital, London, a single dose aerosol application of GL-67:DOPE was administered to eight patients, while another eight received GL-67:DOPE plus pCF1-CFTR. In the second group, a moderate increase in the potential difference in the lung was observed, with a slight trend towards bacterial adherence normalization in the airway cells. Seven of the patients in the second group, and three patients who received lipid alone, developed, flu-like symptoms within 24 h. A trial at the University of Alabama, using the same formulation, showed that flu-like symptoms developed in six of eight patients by day two, and in all patients by day seven [290120]. In 1995, the company began a clinical safety trial involving delivery of a normal CF gene to the patient's lungs via an adenovirus vector. The administration involves the inhalation of an aerosol containing the vector or, separately, delivery to one lobe of the patient's lung via a bronchoscope [191678]. To evaluate additional delivery methods for the gene, Genzyme has an exclusive research agreement for the use of Vical's cytofectins as non-viral delivery vectors for CFTR. Also under investigation are delivery systems for the nasal epithelium using liposomes or lipid-DNA complexes. These protocols are being developed in collaboration with the National Heart & Lung Institute, London, and an undisclosed

  11. Video games as a complementary therapy tool in mental disorders: PlayMancer, a European multicentre study

    OpenAIRE

    Konstantas, Dimitri; Fernández-Aranda, Fernando; Jiménez-Murcia, Susana; Santamaría, Juan José; Gunnard, Katarina; Soto, Antonio; Kalapanidas, Elías; Bults, Richard; Davarakis, Costas; Ganchev, Todor; Granero, Roser; Kostoulas, Theodoros; Lam, Tony; Lucas, Mikkel; Masuet-Aumatell, Cristina

    2012-01-01

    Background: Previous review studies have suggested that computer games can serve as an alternative or additional form of treatment in several areas (schizophrenia, asthma or motor rehabilitation). Although several naturalistic studies have been conducted showing the usefulness of serious video games in the treatment of some abnormal behaviours, there is a lack of serious games specially designed for treating mental disorders. Aim: The purpose of our project was to develop and evaluate a serio...

  12. Comparative Benefits and Harms of Complementary and Alternative Medicine Therapies for Initial Treatment of Major Depressive Disorder: Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Asher, Gary N; Gartlehner, Gerald; Gaynes, Bradley N; Amick, Halle R; Forneris, Catherine; Morgan, Laura C; Coker-Schwimmer, Emmanuel; Boland, Erin; Lux, Linda J; Gaylord, Susan; Bann, Carla; Pierl, Christiane Barbara; Lohr, Kathleen N

    2017-12-01

    To report the comparative benefits and harms of exercise and complementary and alternative medicine (CAM) treatments with second-generation antidepressants (SGA) for major depressive disorder (MDD). Systematic review and meta-analysis. Outpatient clinics. Adults, aged 18 years and older, with MDD receiving an initial treatment attempt with SGA. Any CAM or exercise intervention compared with an SGA. Treatment response, remission, change in depression rating, adverse events, treatment discontinuation, and treatment discontinuation due to adverse events. We found 22 randomized controlled trials for direct comparisons and 127 trials for network meta-analyses, including trials of acupuncture, omega-3 fatty acids, S-adenosyl methionine, St. John's wort, and exercise. For most treatment comparisons, we found no differences between treatment groups for response and remission. However, the risk of bias of these studies led us to conclude that the strength of evidence for these findings was either low or insufficient. The risk of treatment harms and treatment discontinuation attributed to adverse events was higher for selective serotonin receptor inhibitors than for St. John's wort. Although we found little difference in the comparative efficacy of most CAM therapies or exercise and SGAs, the overall poor quality of the available evidence base tempers any conclusions that we might draw from those trials. Future trials should incorporate patient-oriented outcomes, treatment expectancy, depressive severity, and harms assessments into their designs; antidepressants should be administered over their full dosage ranges; and larger trials using methods to reduce sampling bias are needed.

  13. Testing the efficacy of Yoga as a Complementary Therapy for Smoking Cessation: Design and Methods of the BreathEasy trial

    Science.gov (United States)

    Bock, Beth C; Rosen, Rochelle K.; Fava, Joseph L.; Gaskins, Ronnesia B.; Jennings, Ernestine; Thind, Herpreet; Carmody, James; Dunsiger, Shira I; Gidron, Naama; Becker, Bruce M.; Marcus, Bess H.

    2014-01-01

    Smokers trying to quit encounter many challenges including nicotine withdrawal symptoms, cigarette craving, increased stress and negative mood and concern regarding weight gain. These phenomena make it difficult to successfully quit smoking. Studies in non-smoking populations show that yoga reduces stress and negative mood and improves weight control. By increasing mindfulness we anticipate that yoga may also improve smokers’ ability to cope with the negative symptoms associated with quitting. Yoga may also improve cognitive deliberation which is needed to make effective choices and avoid smoking in tempting situations. The BreathEasy study is a rigorous, randomized controlled clinical trial examining the efficacy of Iyengar yoga as a complementary therapy to cognitive-behavioral therapy for smoking cessation. All participants are given an 8-week program of smoking cessation classes, and are randomized to either twice weekly yoga (Yoga) or twice-weekly health and wellness classes which serve as a control for contact and participant burden (CTL). Assessments are conducted at baseline, 8 weeks, 3, 6, and 12 months follow up. The primary outcome is prolonged abstinence using an intention-to-treat approach. Multiple internal and external audits using blind data collection are employed to ensure treatment fidelity and reliability of study results. To understand why yoga may be more effective than CTL, we will examine mechanisms of action (i.e., mediators) underlying intervention efficacy. We will examine maintenance of yoga practice and smoking status at each follow up. Focus groups and interviews will be used to enrich our understanding of the relationship of yoga practice and smoking abstinence. PMID:24937018

  14. The Use of Placebo and Non-Specific Therapies and Their Relation to Basic Professional Attitudes and the Use of Complementary Therapies among German Physicians – A Cross-Sectional Survey

    Science.gov (United States)

    Linde, Klaus; Friedrichs, Clara; Alscher, Anna; Wagenpfeil, Stefan; Meissner, Karin; Schneider, Antonius

    2014-01-01

    We aimed to investigate the use of placebos (e.g. saline injections) and non-specific treatments (e.g. vitamin supplements in individuals without a relevant deficiency) among physicians working in private practices in Germany, and how such use is associated with the belief in and the use of complementary and alternative treatments, and basic professional attitudes. A four-page questionnaire was sent to nationwide random samples of general practitioners (GP), internists and orthopaedists working in private practices. The response rate was 46% (935 of 2018). 24% of GPs, 44% of internists and 57% of orthopaedists had neither used pure placebos nor non-specific therapies in the previous 12 months. 11% percent of GPs, 12% of internists and 7% of orthopaedists had exclusively used pure placebos; 30%, 33% and 26%, respectively, had exclusively used non-specific therapies; 35%, 12% and 9% had used both. Age, sex and agreement to the statement that physicians should harness placebo effects were not significantly associated with any pattern of use. Exclusive use of pure placebos was associated with being a GP, being an internist, and having unorthodox professional views. In addition to these three factors, a lower use of CAM therapies and a wish for having more time was associated with the exclusive use of non-specific therapies. Among physicians using both pure placebo and non-specific therapies, heterodox views were also somewhat more pronounced. However, associations were particularly strong for being a GP (Odds ratio 11.6 (95%CI 6.41; 21.3)) and having orthodox views (Odds ratio 0.10 (95%CI 0.06; 0.18)) among this group. In conclusion, the use of placebos and non-specific treatments varies strongly between medical specialties and is associated with basic professional attitudes. The findings support the view that the use of placebos and, in particular, of non-specific therapies is primarily a coping behaviour for difficult and uncertain situations. PMID:24695272

  15. The use of placebo and non-specific therapies and their relation to basic professional attitudes and the use of complementary therapies among German physicians--a cross-sectional survey.

    Science.gov (United States)

    Linde, Klaus; Friedrichs, Clara; Alscher, Anna; Wagenpfeil, Stefan; Meissner, Karin; Schneider, Antonius

    2014-01-01

    We aimed to investigate the use of placebos (e.g. saline injections) and non-specific treatments (e.g. vitamin supplements in individuals without a relevant deficiency) among physicians working in private practices in Germany, and how such use is associated with the belief in and the use of complementary and alternative treatments, and basic professional attitudes. A four-page questionnaire was sent to nationwide random samples of general practitioners (GP), internists and orthopaedists working in private practices. The response rate was 46% (935 of 2018). 24% of GPs, 44% of internists and 57% of orthopaedists had neither used pure placebos nor non-specific therapies in the previous 12 months. 11% percent of GPs, 12% of internists and 7% of orthopaedists had exclusively used pure placebos; 30%, 33% and 26%, respectively, had exclusively used non-specific therapies; 35%, 12% and 9% had used both. Age, sex and agreement to the statement that physicians should harness placebo effects were not significantly associated with any pattern of use. Exclusive use of pure placebos was associated with being a GP, being an internist, and having unorthodox professional views. In addition to these three factors, a lower use of CAM therapies and a wish for having more time was associated with the exclusive use of non-specific therapies. Among physicians using both pure placebo and non-specific therapies, heterodox views were also somewhat more pronounced. However, associations were particularly strong for being a GP (Odds ratio 11.6 (95%CI 6.41; 21.3)) and having orthodox views (Odds ratio 0.10 (95%CI 0.06; 0.18)) among this group. In conclusion, the use of placebos and non-specific treatments varies strongly between medical specialties and is associated with basic professional attitudes. The findings support the view that the use of placebos and, in particular, of non-specific therapies is primarily a coping behaviour for difficult and uncertain situations.

  16. Video games as a complementary therapy tool in mental disorders: PlayMancer, a European multicentre study.

    Science.gov (United States)

    Fernández-Aranda, Fernando; Jiménez-Murcia, Susana; Santamaría, Juan J; Gunnard, Katarina; Soto, Antonio; Kalapanidas, Elias; Bults, Richard G A; Davarakis, Costas; Ganchev, Todor; Granero, Roser; Konstantas, Dimitri; Kostoulas, Theodoros P; Lam, Tony; Lucas, Mikkel; Masuet-Aumatell, Cristina; Moussa, Maher H; Nielsen, Jeppe; Penelo, Eva

    2012-08-01

    Previous review studies have suggested that computer games can serve as an alternative or additional form of treatment in several areas (schizophrenia, asthma or motor rehabilitation). Although several naturalistic studies have been conducted showing the usefulness of serious video games in the treatment of some abnormal behaviours, there is a lack of serious games specially designed for treating mental disorders. The purpose of our project was to develop and evaluate a serious video game designed to remediate attitudinal, behavioural and emotional processes of patients with impulse-related disorders. The video game was created and developed within the European research project PlayMancer. It aims to prove potential capacity to change underlying attitudinal, behavioural and emotional processes of patients with impulse-related disorders. New interaction modes were provided by newly developed components, such as emotion recognition from speech, face and physiological reactions, while specific impulsive reactions were elicited. The video game uses biofeedback for helping patients to learn relaxation skills, acquire better self-control strategies and develop new emotional regulation strategies. In this article, we present a description of the video game used, rationale, user requirements, usability and preliminary data, in several mental disorders.

  17. Video games as a complementary therapy tool in mental disorders: PlayMancer, a European multicentre study

    Science.gov (United States)

    Fernández-Aranda, Fernando; Jiménez-Murcia, Susana; Santamaría, Juan J.; Gunnard, Katarina; Soto, Antonio; Kalapanidas, Elias; Bults, Richard G. A.; Davarakis, Costas; Ganchev, Todor; Granero, Roser; Konstantas, Dimitri; Kostoulas, Theodoros P.; Lam, Tony; Lucas, Mikkel; Masuet-Aumatell, Cristina; Moussa, Maher H.; Nielsen, Jeppe; Penelo, Eva

    2012-01-01

    Background: Previous review studies have suggested that computer games can serve as an alternative or additional form of treatment in several areas (schizophrenia, asthma or motor rehabilitation). Although several naturalistic studies have been conducted showing the usefulness of serious video games in the treatment of some abnormal behaviours, there is a lack of serious games specially designed for treating mental disorders. Aim: The purpose of our project was to develop and evaluate a serious video game designed to remediate attitudinal, behavioural and emotional processes of patients with impulse-related disorders. Method and results: The video game was created and developed within the European research project PlayMancer. It aims to prove potential capacity to change underlying attitudinal, behavioural and emotional processes of patients with impulse-related disorders. New interaction modes were provided by newly developed components, such as emotion recognition from speech, face and physiological reactions, while specific impulsive reactions were elicited. The video game uses biofeedback for helping patients to learn relaxation skills, acquire better self-control strategies and develop new emotional regulation strategies. In this article, we present a description of the video game used, rationale, user requirements, usability and preliminary data, in several mental disorders. PMID:22548300

  18. High-frequency electrical stimulation can be a complementary therapy to promote nerve regeneration in diabetic rats.

    Directory of Open Access Journals (Sweden)

    Chia-Hong Kao

    Full Text Available The purpose of this study was to evaluate whether 1 mA of percutaneous electrical stimulation (ES at 0, 2, 20, or 200 Hz augments regeneration between the proximal and distal nerve stumps in streptozotocin diabetic rats. A10-mm gap was made in the diabetic rat sciatic nerve by suturing the stumps into silicone rubber tubes. Normal animals were used as the controls. Starting 1 week after transection, ES was applied between the cathode placed at the distal stump and the anode at the proximal stump every other day for 3 weeks. At 4 weeks after surgery, the normal controls and the groups receiving ES at 20, and 200 Hz had a higher success percentage of regeneration compared to the ES groups at 0 and 2 Hz. In addition, quantitative histology of the successfully regenerated nerves revealed that the groups receiving ES at a higher frequency, especially at 200 Hz, had a more mature structure with more myelinated fibers compared to those in the lower-frequency ES groups. Similarly, electrophysiology in the ES group at 200 Hz showed significantly shorter latency, larger amplitude, larger area of evoked muscle action potentials and faster conduction velocity compared to other groups. Immunohistochemical staining showed that ES at a higher frequency could significantly promote calcitonin gene-related peptide expression in lamina I-II regions in the dorsal horn and recruit a higher number of macrophages in the diabetic distal sciatic nerve. The macrophages were found that they could stimulate the secretion of nerve growth factor, platelet-derived growth factor, and transforming growth factor-β in dissected sciatic nerve segments. The ES at a higher frequency could also increase cutaneous blood flow in the ipsilateral hindpaw to the injury. These results indicated that a high-frequency ES could be necessary to heal severed diabetic peripheral nerve with a long gap to be repaired.

  19. The Effects Of Adding Complementary Treatment And Comparison To Ordinary Physical Therapy In Women With Low Back Pain Due To Osteoarthritis

    Directory of Open Access Journals (Sweden)

    Talebian S

    2005-06-01

    Full Text Available Background: Low back pain (LBP is a one of the most common symptoms of vertebral column diseases. Spinal muscles have a outstanding role in maintaining vertebral column function in daily life. But proper function and motion of hip and knee joints also has an important role in performing smooth, fine and nonstressed movements of lumbar spin. Where as accurate and fine motions of hip and knee joints in cooperate with lumbar spin can improve translation and summation of forces and increase performance of movements. The aim of this research is to indicate the amount of interventions of lower limb joints on lumbar spin function in patients with LBP, and attention to physical treatment (PT of them. Materials and Methods: Fifty females with LBP due to osteoarthritis ( OA of lumbar spin participated in this study and divided in two groups randomly with similar number of cases: a ordinary treatment or control group and b complementary treatment group. Patients in control group treated by routine PT approach ( superficial heat, ultrasound, TENS, forward flexion and back extension exercises and patients in complementary or test group received routine treatment similar to control group and also strength and stretching exercises of hip and knee joint muscles ( latisimous dorsi, gluteous maximus, iliopsoas, quadriceps and hamstring bilaterally. Range of motion (ROM of lumbar, hip and keen joints by valid goniametere and pain of lumbar in motions at all of axis by visual analog scale measured before, after five and ten sessions of treatments in both groups. Results: In control group with non parametric tests there was not significant difference of MMT of muscles and ROMs of hip and knee joints. Lumbar pain in motion after ten sessions of PT in this group reduced significantly ( P< 0.05 . Increase of lumbar motion in all of axis after PT was significant at this patients ( P< 0.05 . In second group that received complementary treatments; ROM of joints, lumbar

  20. Over the Counter & Complementary Therapies

    Science.gov (United States)

    ... 12 months, suggesting there may be a slight benefit. However, additional research is needed particularly to understand the dose effect. Insomnia was slightly increased in the GTP group, suspect this is related to the caffeine content. Caution: Green tea products contain caffeine. Take ...

  1. Use of complementary and alternative medicine by patients with cancer in northern Turkey: analysis of cost and satisfaction.

    Science.gov (United States)

    Aydin Avci, Ilknur; Koç, Zeliha; Sağlam, Zeynep

    2012-03-01

    The aims of this study were to determine (1) the prevalence of complementary and alternative medicine use among patients with cancer, (2) the method of use of the particular therapy, (3) the reasons for using complementary and alternative medicine therapies, (4) the benefits experienced by the use of complementary and alternative medicine, (5) the source of information about complementary and alternative medicine therapies and, (6) the satisfaction and cost of complementary and alternative medicine. Complementary and alternative medicine consists of diverse medical and healthcare systems, practices and products that are not considered at present to be a part of conventional medicine. The majority of patients who use complementary and alternative medicine use more than one method. Complementary and alternative medicine use is more common in cases of advanced disease or poor prognosis. This is a descriptive study of complementary and alternative medicine. This study was conducted in the Chemotherapy Unit at Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey, between 18 March 2008-30 June 2008. Two hundred fifty-three patients with cancer, among 281 patients who applied to the chemotherapy clinic between these dates, agreed to take part in the study with whom contact could be made were included. A questionnaire including descriptive characteristics in collecting data, characteristics about diseases and their treatments, complementary and alternative medicine information and implementation situations and a control list about complementary and alternative medicine implementations were given. The collected data were evaluated by computer using descriptive statistics, the chi-square test and Student's t-test. In this study, 94·1% of the patients were content with medical treatment, 58·9% of them used complementary and alternative medicine treatments, 41·1% did not use any complementary and alternative medicine treatments. The satisfaction level of the

  2. Targeting Activin Receptor-Like Kinase 1 (ALK1) Inhibits Angiogenesis and Tumorigenesis Through a Mechanism of Action Complementary to Anti-VEGF Therapies

    Science.gov (United States)

    Hu-Lowe, Dana D.; Chen, Enhong; Zhang, Lianglin; Watson, Katherine D.; Mancuso, Patrizia; Lappin, Patrick; Wickman, Grant; Chen, Jeffrey H.; Wang, Jianying; Jiang, Xin; Amundson, Karin; Simon, Ronald; Erbersdobler, Andreas; Bergqvist, Simon; Feng, Zheng; Swanson, Terri A.; Simmons, Brett H.; Lippincott, John; Casperson, Gerald F.; Levin, Wendy J.; Stampino, Corrado Gallo; Shalinsky, David R.; Ferrara, Katherine W.; Fiedler, Walter; Bertolini, Francesco

    2011-01-01

    Genetic and molecular studies suggest that activin receptor-like kinase 1 (ALK1) plays an important role in vascular development, remodeling, and pathologic angiogenesis. Here we investigated the role of ALK1 in angiogenesis in the context of common pro-angiogenic factors (PAFs; vascular endothelial growth factor [VEGF] A and basic fibroblast growth factor [bFGF]). We observed that PAFs stimulated ALK1-mediated signaling, including Smad1/5/8 phosphorylation, nuclear translocation and Id-1 expression, cell spreading, and tubulogenesis of endothelial cells (ECs). An antibody specifically targeting ALK1 (anti-ALK1) markedly inhibited these events. In mice, anti-ALK1 suppressed MatrigelTM angiogenesis stimulated by PAFs, and inhibited xenograft tumor growth by attenuating both blood and lymphatic vessel angiogenesis. In a human melanoma model with acquired resistance to a VEGF receptor kinase inhibitor, anti-ALK1 also delayed tumor growth and disturbed vascular normalization associated with VEGF receptor inhibition. In a human/mouse chimera tumor model, targeting human ALK1 decreased human vessel density, and improved antitumor efficacy when combined with bevacizumab (anti-VEGF). Anti-angiogenesis and antitumor efficacy were associated with disrupted colocalization of ECs with desmin+ perivascular cells, and reduction of blood flow primarily in large/mature vessels as assessed by contrast-enhanced ultrasonography. Thus, ALK1 may play a role in stabilizing angiogenic vessels and contribute to resistance to anti-VEGF therapies. Given our observation of its expression in the vasculature of many human tumor types and in circulating ECs from patients with advanced cancers, ALK1 blockade may represent an effective therapeutic opportunity complementary to the current anti-angiogenic modalities in the clinic. PMID:21212415

  3. The effectiveness of non-invasive complementary therapies in reducing postoperative nausea and vomiting following abdominal laparoscopic surgery in women: a systematic review.

    Science.gov (United States)

    Hewitt, Vivien; Watts, Robin

    2009-01-01

    Postoperative nausea and vomiting (PONV) are common adverse events following surgery and anaesthesia. The reported incidence is particularly high in patients undergoing laparoscopic surgery, ranging from 40-77%. PONV can be very distressing for patients and can result in unplanned readmission in ambulatory surgery. Antiemetics are only partially effective for both prophylaxis and treatment, can have adverse effects and in the case of the newer medications are expensive. The effectiveness of a number of complementary therapies in reducing the incidence of PONV continues to be investigated, given their relative ease of application, relatively low cost, lack of significant side effects, and patient interest and acceptability. The objective of this review was to determine from the available evidence the most effective non-invasive complementary therapies for reducing the incidence and/or severity of postoperative nausea and vomiting in women undergoing abdominal laparoscopies. A literature search was undertaken using: relevant health care databases (eg. AMED, CINAHL, MEDLINE/PubMed, Current Contents, Science Direct); databases of reports, theses, and conference papers (eg Dissertation Abstracts, Conference Papers Index, National Research Register [UK]); and major sources of evidence-based practice information (e.g. Cochrane Library, Agency for Healthcare Research Quality, and clinical trials databases or registers) between the years 1980 and 2007. In addition reference lists of relevant journal articles and selected web sites were checked. Randomised controlled trials and quasi-experimental studies investigating the effects of non-invasive complementary interventions on postoperative nausea and/or vomiting, and the need for rescue medication following abdominal laparoscopic surgery in women were considered for inclusion in the review. Trials with only a 'no-treatment' control group were not included. Assessment of the eligibility of studies for inclusion in the review

  4. [Complementary and alternative medicine in oncology].

    Science.gov (United States)

    Hübner, J

    2013-06-01

    Complementary and alternative medicine are frequently used by cancer patients. The main benefit of complementary medicine is that it gives patients the chance to become active. Complementary therapy can reduce the side effects of conventional therapy. However, we have to give due consideration to side effects and interactions: the latter being able to reduce the effectiveness of cancer therapy and so to jeopardise the success of therapy. Therefore, complementary therapy should be managed by the oncologist. It is based on a common concept of cancerogenesis with conventional therapy. Complement therapy can be assessed in studies. Alternative medicine in contrast rejects common rules of evidence-based medicine. It starts from its own concepts of cancerogenesis, which is often in line with the thinking of lay persons. Alternative medicine is offered as either "alternative" to recommended cancer treatment or is used at the same time but without due regard for the interactions. Alternative medicine is a high risk to patients. In the following two parts of the article, the most important complementary and alternative therapies cancer patients use nowadays are presented and assessed according to published evidence.

  5. A feasibility pilot study on the use of complementary therapies delivered via mobile technologies on Icelandic surgical patients' reports of anxiety, pain, and self-efficacy in healing.

    Science.gov (United States)

    Hansen, Margaret M

    2015-03-28

    Complementary therapies (CT), such as relaxation technique, massage, guided imagery, and accupuncture have shown to benefit patients undergoing surgery. The aim of this study was to determine the feasibility of using audio relaxation technique (ART), music intervention (MI), nature video application with music (NVAM), and nature video application without music (NVA) delivered via mobile technologies in a clinical setting. Secondary, the effects of ART, MI, NVAM and NVA on patients' state anxiety, pain perception, and perceived self-efficacy in healing were determined. A randomized clinical trial (RCT) involving 105 same day surgery (SDS) patients, who were assigned to an ART (n = 25), MI (n = 25), NVAM (n = 15), NVA (n = 16), or a control group (n = 24) were assessed for state anxiety, self-reported pain, and self-efficacy four days prior to surgery, immediately prior and following a surgical intervention, and day five post-operative. ANOVA found no statistically significant differences in anxiety scores; pain, or perceived self-efficacy between the five groups. Matched pairs t-Test revealed all participants had an increase in anxiety from pre-op to day 10 follow-up; a significant change in pain levels from pre-op to day 10 follow-up; and all participants had a significant increase in general self-efficacy from pre-op to day 10 follow-up. Mean pain level scores from day 1 to pre-op showed a significant decrease in pain for the ART group and NVAM group. Matched pairs t-Test for self-efficacy scores indicated the MI group and the NVA group had significant increases in self-efficacy. A significant decrease in anxiety from pre-op to day 10 for participants reporting a prior history of anxiety and for those reporting prior history of taking anti-anxiety medications. Despite the non-significant findings between the five groups, at any measurement point, there were valuable trends toward significance and confirmed feasibility in a clinical setting

  6. Complementary and Integrative Medicine

    Science.gov (United States)

    ... medical treatments that are not part of mainstream medicine. When you are using these types of care, it may be called complementary, integrative, or alternative medicine. Complementary medicine is used together with mainstream medical ...

  7. Complementary and Alternative Medicine

    Science.gov (United States)

    ... Your Parents - or Other Adults Complementary and Alternative Medicine KidsHealth > For Teens > Complementary and Alternative Medicine Print ... replacement. continue How Is CAM Different From Conventional Medicine? Conventional medicine is based on scientific knowledge of ...

  8. Investigation of dietary supplements prevalence as complementary therapy: Comparison between hospitalized psoriasis patients and non-psoriasis patients, correlation with disease severity and quality of life.

    Science.gov (United States)

    Yousefzadeh, Hadis; Mahmoudi, Mahmoud; Banihashemi, Mahnaz; Rastin, Maryam; Azad, Farahzad Jabbari

    2017-08-01

    Psoriasis patients are often displeased with traditional medical treatments and they may self-prescribe dietary supplements as an alternative or complementary treatments. We aimed to investigate the prevalence of self-medication of dietary supplements among psoriasis and non-psoriasis cases and its impact on disease severity and quality of life. This case-control study evaluated 252 records of psoriasis patients and 245 non-psoriasis cases. Dietary supplementation over last 30days and characteristics, including age, age at onset of disease, co-morbidities, smoking and education were recorded. Psoriasis area and severity index (PASI) and dermatology quality of life index (DLQI) were calculated. P value less than 0.05 was considered as significant level. This study consisted 138 psoriasis (females; 54) and 138 non-psoriasis cases (females; 50), aged between 21 and 91 years. Among psoriasis patients, 72% reported using at least one of dietary supplements, which was different from non-psoriasis cases (25.36%, P=0.01). Multivitamin/mineral supplements (MVM) were the most frequent used dietary supplements (26.81%) and the most common reasons for the consumption of these supplements were to maintain and improve health. The consumption of folic acid (21.73%), omega-3 fatty acids or fish oil (10.14%), herbs (12.31%) and vitamin E (1.44%) had the most frequencies after MVM. No significant differences in PASI and DLQI were found among patients with consumption of different supplements (P>0.05). There was non-significant and negative correlation between education and use of supplements (P=0.21, r=-0.02). Self-medicating of MVM over last 30days was prevalent among studied psoriasis patients. They took dietary supplements in order to improve and maintain their health. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Evaluating College Student Interest in Pet Therapy

    Science.gov (United States)

    Adamle, Kathleen N.; Riley, Tracy A.; Carlson, Tracey

    2009-01-01

    The first year of college can be extremely stressful, especially for students residing on campus. Objective: The authors obtained information from college freshmen about their relationships with pets and investigated interest in a pet therapy program as social support for transient stressful periods. Participants: As part of a university…

  10. Evaluation of Patients' Knowledge on Warfarin Therapy Among ...

    African Journals Online (AJOL)

    Evaluation of patient knowledge is the first step to improve the quality of anticoagulation therapy and patient care. This study assessed the level of patients' knowledge on warfarin therapy among outpatients who were receiving warfarin in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. It was based on cross ...

  11. Evaluation of abrasives in acne therapy.

    Science.gov (United States)

    Mills, O H; Kligman, A M

    1979-05-01

    Various abrasive materials, such as pumice, polyethylene, and aluminum oxide are widely used as adjuncts in the therapy of acne. The apparent rationale is that abrasion should unseat comedones and deter their formation. We assessed the efficacy of various abrasives and abradant pads. Varying degrees of peeling and erythema were produced, but there was no appreciable reduction of comedones. Aggravation was noted in some cases. Generally, the resorption of papules and pustules was enhanced.

  12. A dosimetric evaluation of volumetric modulated arc therapy, intensity modulated radiation therapy, and three-dimensional conformal radiation therapy for the lower extremity soft tissue sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sol Min; Song, Seong Chan; Hyun, Sung Eun; Park, Heung Deuk; Lee, Jaegi; Kim, Young Suk; Kim, Gwi Eon [Dept. of Radiation Oncology, Jeju National University Hospital, Jeju (Korea, Republic of)

    2016-06-15

    A dosimetric evaluation of volumetric modulated arc therapy, intensity modulated radiation therapy, and three-dimensional conformal radiation therapy for the lower extremity soft tissue sarcoma For the lower extremity soft tissue sarcoma, volumetric modulated arc therapy, intensity modulated radiation therapy, and three-dimensional conformal radiation therapy were evaluated to compare these three treatment planning technique. The mean doses to the planning target volume and the femur were calculated to evaluate target coverage and the risk of bone fracture during radiation therapy. Volumetric modulated arc therapy can reduce the dose to the femur without compromising target coverage and reduce the treatment time compared with intensity modulated radiation therapy.

  13. Evaluation of hay-type and grazing-tolerant alfalfa cultivars in season-long or complementary rotational stocking systems for beef cows.

    Science.gov (United States)

    Hermann, M L; Russell, J R; Barnhart, S K

    2002-03-01

    Alfalfa (Medicago sativa L.) persistence and forage and cow-calf production were evaluated on pastures containing smooth bromegrass with or without grazing-tolerant or hay-type alfalfa cultivars rotationally stocked in either a season-long or complementary system. In 1997, six 2.02-ha pastures were seeded with smooth bromegrass, a mixture of a grazing-tolerant alfalfa (Amerigraze variety) and smooth brome-grass, or a mixture of a hay-type alfalfa (Affinity variety) and smooth bromegrass to be used in season-long stocking systems. Four 2.02-ha pastures were seeded with smooth bromegrass on 1.21 ha of each pasture, and mixtures of either the grazing-tolerant or hay-type alfalfa cultivars and smooth bromegrass on the 0.81 ha of each pasture to be used in complementary stocking systems. All 10 pastures were divided into 10 paddocks and rotationally strip-stocked at 1.98 cow-calf units/ha with crossbred cows and calves for 120 and 141 d starting May 18, 1998 (yr 1), and May 6, 1999 (yr 2), respectively. Each year, first harvest forage was harvested as hay from 40% of all 10 pastures, this being the portions of the pasture seeded with the alfalfa-smooth brome-grass mixtures for pastures with the complementary stocking systems. In yr 1 and 2, the remaining 60% of each pasture was grazed for the first 44 and 54 d, and 100% of each pasture was grazed on d 45 to 120 and d 55 to 141, respectively. Proportions of alfalfa in the live dry matter of pastures seeded with the grazing-tolerant and hay-type alfalfa cultivars decreased by 70 and 55% in paddocks stocked season-long and by 60 and 42% in paddocks used for complementary stocking (alfalfa cultivar, P cultivars and stocking systems in yr 2. Total (P mixtures increased calf and total cow/calf weight gains in comparison with grazing of smooth bromegrass, but alfalfa persistence, measured as a proportion of the live dry matter, was not affected by alfalfa cultivar.

  14. Conhecimento, crença e uso de medicina alternativa e complementar por fonoaudiólogas Knowledge, beliefs and practices toward alternative and complementary therapies among speech-language pathologists

    Directory of Open Access Journals (Sweden)

    Thaise Manzini

    2008-06-01

    Full Text Available O objetivo do presente estudo é entender o conhecimento, as crenças e o uso das medicinas alternativas e complementares entre fonoaudiólogas que atuam no setor público de saúde. O estudo foi realizado em um hospital terciário de Ribeirão Preto, SP. Um questionário desenvolvido para os propósitos do estudo foi administrado em uma casuística de 40 fonoaudiólogas. Os itens do questionário foram criados conforme uma revisão da literatura. A aceitação de medicinas alternativas e complementares, como acupuntura e homeopatia, é expressiva entre as profissionais entrevistadas. Os resultados do presente estudo sugerem que o uso e a prática destas medicinas são feitos de forma racional, com certa prudência. As entrevistadas admitem que um tratamento complementar deve ser submetido a testes científicos antes de sua aceitação, e que é desaconselhável a um paciente buscar um tratamento alternativo ou complementar sem antes consultar o médico.The purpose of this study is to understand the knowledge, beliefs, concerns and practices toward alternative and complementary therapies among speech-language pathologists in a Brazilian public hospital. The current study was conducted in a large tertiary hospital in Ribeirão Preto, Southeastern Brazil. A questionnaire developed to measure knowledge, beliefs and practices on alternative and complementary therapies was answered by forty speech-language pathologists. The questionnaire items were created via literature review. Alternative and complementary therapies as acupuncture and homeopathy have high acceptance among the interviewed professionals. The results of the present study suggest that the use and practice of these techniques are made in a rational manner, with some prudence. The interviewed professionals admit that complementary treatment must be submitted to scientific tests before its acceptance, and that it is inadvisable for the patient to try treatment with alternative and

  15. Factors related to complementary/alternative medicine use among cancer patients in central Anatolia.

    Science.gov (United States)

    Er, Ozlem; Mistik, Selcuk; Ozkan, Metin; Ozturk, Ahmet; Altinbas, Mustafa

    2008-01-01

    We aimed to evaluate the prevalence of and factors related to the use of complementary/alternative medicine among cancer patients undergoing or following conventional treatment at the Erciyes University Oncology Hospital in Central Anatolia. Face-to-face interview and a questionnaire were carried out with cancer patients attending the outpatient clinic of Medical Oncology. Questionnaire items included patients' demographic data, treatment, use of complementary/alternative medicine and possible related factors. Multivariate analysis was performed to compare the factors related to use of complementary/alternative medicine. A total of 268 consecutive cancer patients were enrolled in the study. Overall, 43% of the patients were using or had used complementary/alternative medicine. Totally, 90% of the patients using complementary/alternative medicine utilized herbs, and most of the herbs used were stinging nettle. Nearly half of the patients using complementary/alternative medicine (46.1%) were aiming to fight the disease. Among users, nearly half of them regarded the method used as effective and 54 (50.5%) suggested the use of complementary/alternative medicine to other patients. Only 23.1% of the patients discussed the use of complementary/alternative medicine with their physician. In logistic regression analysis, younger age, higher educational status, advanced stage of the disease, longer duration of the disease and current treatment status were significantly associated with the use of complementary/alternative medicine. In our regression model, the predictivity rate of these variables was 72.2% for use of complementary/alternative medicine according to the backward Wald test. Use of complementary/alternative medicine among cancer patients in our center is modestly high, and the most common method is herbal therapy. Communication between the patient and the physician should be improved on this subject.

  16. BASED COMPLEMENTARY FOODS USING GERMINAT

    African Journals Online (AJOL)

    user

    2010-08-08

    Aug 8, 2010 ... Sensory evaluation. Gruels of the five formulated complementary foods were prepared by mixing 15 g of sorghum flour with 100 ml water and cooked for 25 minutes at 92. 0. C. Panelists were ... instructed to rank the gruels on the basis of appearance (color), taste, odor and texture. (mouth feel) using a nine ...

  17. Internet-based randomised controlled trials for the evaluation of complementary and alternative medicines: probiotics in spondyloarthropathy

    Directory of Open Access Journals (Sweden)

    Gravenor Michael B

    2008-01-01

    Full Text Available Abstract Background The clinical effectiveness of complementary and alternative medicines (CAMs is widely debated because of a lack of clinical trials. The internet may provide an effective and economical approach for undertaking randomised controlled trials (RCTs of low-risk interventions. We investigated whether the internet could be used to perform an internet-based RCT of a CAM fulfilling the revised CONSORT (Consolidated Standards of Reporting Trials statement quality checklist for reporting of RCTs. A secondary aim was to examine the effect of probiotics compared to placebo in terms of well-being over 12 weeks. Methods People aged ≥18 years with confirmed spondyloarthropathy living in the United Kingdom with internet access were invited to participate in an internet-based RCT of probiotic compared to placebo for improving well-being and bowel symptoms. The intervention was a probiotic containing 4 strains of live bacteria or identical placebo taken by mouth daily for 3 months. The primary outcome measure was the performance of the trial according to the revised CONSORT statement. Results 147 people were randomised into the trial. The internet-based trial of the CAM fulfilled the revised CONSORT statement such as efficient blinding, allocation concealment, intention to treat analysis and flow of participants through the trial. Recruitment of the required number of participants was completed in 19 months. Sixty-five percent (96/147 completed the entire 3 months of the trial. The trial was low cost and demonstrated that in an intention to treat analysis, probiotics did not improve well-being or bowel symptoms. Conclusion The internet-based RCT proved to be a successful and economical method for examining this CAM intervention. Recruitment, adherence and completion rate were all similar to those reported with conventional RCTs but at a fraction of the cost. Internet-based RCTs can fulfil all the criteria of the revised CONSORT statement and

  18. Impact of complementary therapies via mobile technologies on Icelandic same day surgical patients' reports of anxiety, pain and self-efficacy in healing: a randomized controlled trial in process.

    Science.gov (United States)

    Hansen, Margaret M

    2013-01-01

    Complementary and Alternative Therapies (CAT) are increasingly being utilized in conjunction with conventional medicine. Health Information Technology (HIT) and CAT are being scrutinized for evidence based health outcomes. The aim of this randomized controlled trial (RCT) is to determine if the use of mobile technologies delivering CAT, specifically relaxation technique (RT), medical music intervention (MMI), nature landscape applications with (NLAM) and without music (NLAWM) compared with no intervention (control group) will assist in decreasing pre- and post-surgical patients' anxiety and pain levels while increasing post-operative healing self-efficacy levels.

  19. Evaluation of evidence within occupational therapy in stroke rehabilitation

    DEFF Research Database (Denmark)

    Kristensen, Hanne Kaae; Persson, Dennis; Nygren, Carita

    2010-01-01

    therapy intervention related to the use of everyday life occupations and client-centred practice within stroke rehabilitation. Design: Systematic searches of research studies published in English during 2000-2007 in peer-reviewed journals were undertaken. Thirty-nine articles and one Cochrane review were...... after rehabilitation. There is also considerable evidence for the use of everyday life occupations in occupational therapy. Occupational therapy was evaluated as an important aspect of stroke rehabilitation improving outcomes in everyday life occupations including activities of daily living (ADL......) and participation. Discussion: As research of relevance for the profession to a large extent includes qualitative research it gives rise to reflection on including more tools than the evidence hierarchy while evaluating evidence within occupational therapy....

  20. Ultrasound Evaluation of Morton Neuroma Before and After Laser Therapy.

    Science.gov (United States)

    Gimber, Lana H; Melville, David M; Bocian, Darin A; Krupinski, Elizabeth A; Guidice, Matthew P Del; Taljanovic, Mihra S

    2017-02-01

    The objective of our study was to retrospectively assess for differences in imaging appearances of Morton neuromas before and after laser therapy using diagnostic ultrasound (US). A retrospective review was performed to identify patients who underwent US imaging to evaluate for Morton neuroma during the study period (June 1, 2013-July 1, 2014); of the 42 patients identified, 21 underwent US evaluations before and after laser therapy. US reports and images were reviewed and correlated with clinical history. The final study group consisted of 21 patients who had a total of 31 Morton neuromas evaluated using US after treatment. A retrospective review was then performed to characterize the appearances of these lesions before and after therapy followed by an analysis of variables. Retrospective US review of 31 pretreatment Morton neuromas showed fusiform, heterogeneously hypoechoic masses with well-defined borders in most cases and that pain was reported when transducer pressure was applied in 97% (30/31) of cases. After treatment, lesions showed ill-defined borders (23/31), and pain with application of transducer pressure was either significantly decreased or absent (29/31); these findings were concordant with the clinical findings. Both of these characteristics were statistically significant (p laser therapy of Morton neuromas. Posttreatment changes include ill-defined borders and less pain or the absence of pain with the application of transducer pressure. These criteria may be applied in future clinical studies evaluating the efficacy of laser therapy for Morton neuroma.

  1. Access, delivery and perceived efficacy of physiotherapy and use of complementary and alternative therapies by people with progressive multiple sclerosis in the United Kingdom: An online survey.

    Science.gov (United States)

    Campbell, Evan; Coulter, Elaine; Mattison, Paul; McFadyen, Angus; Miller, Linda; Paul, Lorna

    2017-02-01

    All people with progressive MS in the United Kingdom should have access to physiotherapy through the National Health Service (NHS). However levels of access and delivery are unknown. Furthermore there is no research on perceived efficacy of physiotherapy or the use of complementary and alternative medicine in people with progressive MS in the United Kingdom. An online survey was carried out via the UK MS Register. Inclusion criteria were diagnosis of progressive MS, a member of UK MS Register and 18 years or older. The survey asked participants regarding access and delivery of physiotherapy; perceived efficacy of physiotherapy and interventions received; barriers to accessing physiotherapy and use of complementary and alternative medicine. The following additional data were supplied from the UK MS Register: demographics, EQ5D, MSIS-29 physical and psychological sub-scales and geographical data. Total number of respondents was 1,298 from an identified 2,538 potential registrants: 87% could access physiotherapy services, 77% received physiotherapy from the NHS and 32% were currently receiving physiotherapy. The most common interventions received were home exercise programme (86%), exercises with a physiotherapist (74%) and advice/education (67%). 40% had recently used complementary and alternative medicine. Perceived efficacy of physiotherapy was high with 70% reporting it to be either 'beneficial' or 'very beneficial'. Main barriers to accessing physiotherapy were mobility, fatigue, continence, transport issues, requiring someone to go with them and pain. Access to physiotherapy was high with most people reporting it as beneficial. However 13% reported not having access indicating a gap in accessibility. Considering some of the barriers reported may allow physiotherapy services to address this gap in accessibility. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Evaluating Art Therapy to Heal the Effects of Trauma Among Refugee Youth: The Burma Art Therapy Program Evaluation.

    Science.gov (United States)

    Rowe, Cassandra; Watson-Ormond, Rose; English, Lacey; Rubesin, Hillary; Marshall, Ashley; Linton, Kristin; Amolegbe, Andrew; Agnew-Brune, Christine; Eng, Eugenia

    2016-03-01

    Art therapy uses the creative process to encourage personal growth and alleviate symptoms of mental illness. The Art Therapy Institute provides programs for refugee adolescents from Burma to decrease their trauma-related symptoms. This article describes and discusses the methods and findings from an evaluation of this program. The challenges of assessing art therapy with this population and assessment tool gaps are explored and suggestions for future evaluations discussed. Four validated clinical assessment tools were administered to 30 participants at baseline and follow-up to measure symptoms of anxiety, depression, and behavioral problems. Focus group discussions with clinicians were used to assess the evaluation. Nearly all participants had experienced one or more traumatic events. At baseline, results showed a higher prevalence of depression than national rates among adolescents. Follow-up results showed improvements in anxiety and self-concept. Qualitative findings suggest that specific benefits of art therapy were not adequately captured with the tools used. This evaluation showed some effects of art therapy; however, symptom-focused assessment tools are not adequate to capture clients' growth resulting from the traumatic experience and this unique intervention. Future evaluations will benefit by using an art-based assessment and measuring posttraumatic growth. © 2016 Society for Public Health Education.

  3. Metrics for Performance Evaluation of Patient Exercises during Physical Therapy.

    Science.gov (United States)

    Vakanski, Aleksandar; Ferguson, Jake M; Lee, Stephen

    2017-06-01

    The article proposes a set of metrics for evaluation of patient performance in physical therapy exercises. Taxonomy is employed that classifies the metrics into quantitative and qualitative categories, based on the level of abstraction of the captured motion sequences. Further, the quantitative metrics are classified into model-less and model-based metrics, in reference to whether the evaluation employs the raw measurements of patient performed motions, or whether the evaluation is based on a mathematical model of the motions. The reviewed metrics include root-mean square distance, Kullback Leibler divergence, log-likelihood, heuristic consistency, Fugl-Meyer Assessment, and similar. The metrics are evaluated for a set of five human motions captured with a Kinect sensor. The metrics can potentially be integrated into a system that employs machine learning for modelling and assessment of the consistency of patient performance in home-based therapy setting. Automated performance evaluation can overcome the inherent subjectivity in human performed therapy assessment, and it can increase the adherence to prescribed therapy plans, and reduce healthcare costs.

  4. A Critical Evaluation of Nicotine Replacement Therapy for Teenage Smokers.

    Science.gov (United States)

    Patten, Christi A.

    2000-01-01

    Evaluates the appropriateness and feasibility of nicotine replacement therapy (NRT) in teenage smokers. Available forms of NRT, theoretical rationale and efficacy of NRT, ethical considerations, and the feasibility of NRT in teenage smokers are addressed. Several characteristics similar to adult nicotine dependent smokers have been found in teen…

  5. Adult Use of Complementary and Integrative Approaches to Improve Athletic Performance.

    Science.gov (United States)

    Evans, Marion Willard; Ndetan, Harrison; Ka Sekhon, Vishaldeep; Williams, Ronald; Oliver, Brittney; Perko, Michael; Woolsey, Conrad; Singh, Karan P

    2017-10-02

    Context • In the United States in 2007, approximately 38% of adults, or 4 in 10, used some form of complementary and alternative medicine (CAM). An area in which little is known is the personal integration of CAM therapies by those individuals seeking to improve athletic performance. Objectives • The study intended to assess the use of integrative care by adult athletes in the United States as well as their satisfaction with it, as reported in the 2012 National Health Interview Survey (NHIS). Design • A secondary analysis of the data from the Adult Alternative Health/Complementary Medicine file of the 2012 NHIS was performed. The analysis was performed at the Research Institute of Parker University (Dallas, TX, USA). Participants • The NHIS survey was a representative sample of Americans, with more than 30 000 respondents. Outcome Measures • National population estimates were generated for all related variables. The study assessed the likelihood that a respondent who reported use of a specific complementary and integrative therapy as their first top therapeutic modality to enhance sport or athletic performance had perceived it helpful compared with those who used it for other non-sport-related reasons. Results • Complementary and integrative therapies were used by more than 14 million adults (20.5%) to improve athletic performance, with 97.6% of them perceiving therapies as helpful. The most used therapies were yoga, herbal supplements, manipulation, and massage. The median age of those reporting specific use to improve athletic performance was slightly less than 38 y, and women were almost 3 times as likely as men to report therapies as helpful. Conclusions • Complementary and integrative therapies were used for improvement of athletic performance by respondents of the 2012 NHIS, with high satisfaction among users. Future research could evaluate athletic-specific use, adverse effects, physiological mechanisms that may exist for the modalities, and

  6. Complementary and Alternative Approaches to Pain Relief during Labor

    Directory of Open Access Journals (Sweden)

    Michel Tournaire

    2007-01-01

    Full Text Available This review evaluated the effect of complementary and alternative medicine on pain during labor with conventional scientific methods using electronic data bases through 2006 were used. Only randomized controlled trials with outcome measures for labor pain were kept for the conclusions. Many studies did not meet the scientific inclusion criteria. According to the randomized control trials, we conclude that for the decrease of labor pain and/or reduction of the need for conventional analgesic methods: (i There is an efficacy found for acupressure and sterile water blocks. (ii Most results favored some efficacy for acupuncture and hydrotherapy. (iii Studies for other complementary or alternative therapies for labor pain control have not shown their effectiveness.

  7. The effectiveness of complementary manual therapies for pregnancy-related back and pelvic pain: A systematic review with meta-analysis

    National Research Council Canada - National Science Library

    Hall, Helen; Cramer, Holger; Sundberg, Tobias; Ward, Lesley; Adams, Jon; Moore, Craig; Sibbritt, David; Lauche, Romy

    2016-01-01

    .... The aim of this systematically review was to critically appraise and synthesize the best available evidence regarding the effectiveness of manual therapies for managing pregnancy-related low back and pelvic pain...

  8. Study protocol of a pragmatic, randomised controlled pilot trial: clinical effectiveness on smoking cessation of traditional and complementary medicine interventions, including acupuncture and aromatherapy, in combination with nicotine replacement therapy

    Science.gov (United States)

    Jang, Soobin; Park, Sunju; Jang, Bo-Hyoung; Park, Yu Lee; Lee, Ju Ah; Cho, Chung-Sik; Go, Ho-Yeon; Shin, Yong Cheol; Ko, Seong-Gyu

    2017-01-01

    Introduction Nicotine dependence is a disease, and tobacco use is related to 6 million deaths annually worldwide. Recently, in many countries, there has been growing interest in the use of traditional and complementary medicine (T&CM) methods, especially acupuncture, as therapeutic interventions for smoking cessation. The aim of this pilot study is to investigate the effectiveness of T&CM interventions on smoking cessation. Methods and analysis The STOP (Stop Tobacco Programme using traditional Korean medicine) study is designed to be a pragmatic, open-label, randomised pilot trial. This trial will evaluate whether adding T&CM methods (ie, ear and body acupuncture, aromatherapy) to conventional cessation methods (ie, nicotine replacement therapy (NRT), counselling) increases smoking cessation rates. Forty participants over 19 years old who are capable of communicating in Korean will be recruited. They will be current smokers who meet one of the following criteria: (1) smoke more than 10 cigarettes a day, (2) smoke less than 10 cigarettes a day and previously failed to cease smoking, or (3) smoke fewer than 10 cigarettes a day and have a nicotine dependence score (Fagerstrom Test for Nicotine Dependence) of 4 points or more. The trial will consist of 4 weeks of treatment and a 20 week follow-up period. A statistician will perform the statistical analyses for both the intention-to-treat (all randomly assigned participants) and per-protocol (participants who completed the trial without any protocol deviations) data using SAS 9.1.3. Ethics and dissemination This study has been approved by the Institutional Review Board (IRB) of the Dunsan Korean Medicine Hospital of Daejeon University (IRB reference no: DJDSKH-15-BM-11–1, Protocol No. version 4.1.).The protocol will be reapproved by IRB if it requires amendment. The trial will be conducted according to the Declaration of Helsinki, 7th version (2013). This study is designed to minimise the risk to participants

  9. Care seeking, complementary therapy and herbal medicine use among people with type 2 diabetes and cardiovascular disease CAMELOT phase II: Surveying for diversity

    DEFF Research Database (Denmark)

    Manderson, Lenore; Oldenburg, Brian; Lin, Vivian

    2012-01-01

    prior to the survey, 43% of all respondents had used CAM products or practitioners, including 11% who used Western herbal medicines. The data offers considerable opportunities to tease out the drivers, costs and benefits of CAM use by people with chronic disease. Although findings will be published...... across a number of articles, here we profile the demographic and health status characteristics of survey respondents and compare the characteristics of users of naturopathy and Western herbal medicine practitioner with this.......Many Australians manage their health through the combined use of conventional medicine and complementary and alternative medicine, with substantial direct and indirect costs to government and consumers. Our interest was in the varied health practices of people with type 2 diabetes...

  10. Evaluation of clinical evidences for progesterone therapy in catamenial epilepsy

    Directory of Open Access Journals (Sweden)

    Tao CHEN

    2014-12-01

    Full Text Available Objective To formulate the best treatment plan for catamenial epilepsy patients by evaluating the efficacy and side effect of progesterone therapy via evidence-based medicine.  Methods Catamenial epilepsy, drug therapy, progesterone, allopregnanolone, systematic review and randomized controlled trial (RCT both in Chinese and English were used as retrieval words. Databases including Wanfang Data, VIP, China National Knowledge Infrastructure (CNKI, Cochrane Library, PubMed and Google Scholar were used with applying of manual searching. Systematic reviews, RCTs, open-label trials, prospective and retrospective case analysis, case-observation studies and reviews were collected and evaluated by Jadad Scale.  Results After screening, 18 relevant resources were selected, including one systematic review, 3 RCTs, one open-label trial, 2 prospective case-controlled studies, one follow-up study and 10 reviews. Ten of the articles were evaluated to be high quality (Jadad Scale score ≥ 4, and the other 8 were of low quality (Jadad Scale score < 4. After the efficacy and safety of those clinical studies were evaluated, the results were summarized as follows: 1 progesterone combined with antiepileptic drugs (AEDs was well tolerated and resulted in a significant reduction of seizure frequency in a majority of patients with catamenial epilepsy. 2 Both natural progesterone and synthetic progesterone could be used in the treatment for catamenial epilepsy. 3 There were two ways of progestogen therapy for catamenial epilepsy: cyclical progesterone hormone therapy and suppressive therapy. The former was more commonly used.  Conclusions Using evidence-based medicine evaluation can provide best clinical evidence for the progesterone treatment on catamenial epilepsy. doi: 10.3969/j.issn.1672-6731.2014.12.007

  11. Social Franchising and a Nationwide Mass Media Campaign Increased the Prevalence of Adequate Complementary Feeding in Vietnam: A Cluster-Randomized Program Evaluation.

    Science.gov (United States)

    Rawat, Rahul; Nguyen, Phuong Hong; Tran, Lan Mai; Hajeebhoy, Nemat; Nguyen, Huan Van; Baker, Jean; Frongillo, Edward A; Ruel, Marie T; Menon, Purnima

    2017-04-01

    Background: Rigorous evaluations of health system-based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM).Objective: We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators.Methods: A cluster-randomized, nonblinded evaluation design with cross-sectional surveys (n = ∼500 children aged 6-23.9 mo and ∼1000 children aged 24-59.9 mo/group) implemented at baseline (2010) and endline (2014) was used. Difference-in-difference estimates (DDEs) of impact were calculated for intent-to-treat (ITT) analyses and modified per-protocol analyses (MPAs; mothers who attended the social franchising at least once: 62%).Results: Groups were similar at baseline. In ITT analyses, there were no significant differences between groups in changes in CF practices over time. In the MPAs, greater improvements in the intensive than in the nonintensive group were seen for minimum dietary diversity [DDE: 6.4 percentage points (pps); P social franchising approach to improve IPC, delivered through the existing health care system, significantly improved CF practices, but not child growth, among mothers who used counseling services at least once. A greater impact may be achieved with strategies designed to increase service utilization. This trial was registered at clinicaltrials.gov as NCT01676623.

  12. Complementary Chinese herbal medicine therapy improves survival of patients with gastric cancer in Taiwan: A nationwide retrospective matched-cohort study.

    Science.gov (United States)

    Hung, Kuo-Feng; Hsu, Ching-Ping; Chiang, Jen-Huai; Lin, Hung-Jen; Kuo, Yi-Ting; Sun, Mao-Feng; Yen, Hung-Rong

    2017-03-06

    Many patients with gastric cancer seek traditional medicine consultations in Asian countries. This study aimed to investigate the prescription of Chinese herbal medicine (CHM) and its benefits for the patients with gastric cancer in Taiwan. From the Registry for Catastrophic Illness Patients Database, we included all patients with gastric cancer whose age at diagnosis was ≥18 from 1997 to 2010 in Taiwan. We used 1:1 frequency matching by age, sex, Charlson comorbidity score, treatment and index year to compare the CHM users and non-CHM users. We used the Cox regression model to compare the hazard ratios (HR) for the risk of mortality and the Kaplan-Meier curve for the survival time. There was a total of 1333 patients in the CHM-cohort and 44786 patients in the non-CHM cohort. After matching, we compared 962 newly diagnosed CHM users and 962 non-CHM users. Adjusted HRs (aHR) were higher among patients of above 60-year-old group, with a Charlson Comorbidity Index score ≥2 before the index date, and those who need surgery combined with chemotherapy or radiotherapy. CHM users had a lower HR of mortality risk (adjusted HR: 0.55, 95% CI: 0.48-0.62). Compared to the non-CHM users, the aHR among CHM-users is 0.37 (95% CI:0.2-0.67) for those who used CHM more than 180 days annually. The Kaplan-Meier curve revealed that the survival probability was higher for complementary CHM-users. Bai-Hua-She-She-Cao (Herba Hedyotidis Diffusae) was the most commonly used single herb and Xiang-Sha-Liu-Jun-Zi-Tang was the most commonly used herbal formula among CHM prescriptions. Complementary CHM improves the overall survival among patients with gastric cancer in Taiwan. Further ethnopharmacological investigations and clinical trials are required to validate the efficacy and safety. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  13. Lymphoscintigraphic evaluation of manual lymphatic therapy: the Godoy & Godoy technique.

    Science.gov (United States)

    de Godoy, José Maria Pereira; Santana, Kleber Roberto; Godoy, Maria de Fátima Guerreiro

    2015-02-01

    The objective of this study was to evaluate the transport of radiotracers in lymphatic collectors during manual lymphatic therapy. The legs of four male and two female patients with leg lymphedema were assessed using lymphoscintigraphy before, during and after manual lymphatic therapy. The ages of the patients, treated in Hospital de Base in Sao Jose do Rio Preto, ranged from 42 to 64 years with a mean age of 51.2 years. Consecutive patients with grade II leg lymphedema were enrolled in this study. Patients with lymphedema secondary to lymphadenectomy, active infections and weight greater than 130  kg were excluded. Patients were submitted to manual lymphatic therapy, which consists of the collapsing of capillaries using manual compression which is then slid along the skin in a stroking action in the direction of the lymph flow within lymphatic vessels towards the lymph nodes. Two dynamic studies were performed; the first was over 40 minutes (3 images every 10 minutes) which was immediately followed by an entire body scan. A second dynamic evaluation was performed taking images at 10-second intervals over 2 minutes during manual lymphatic therapy. To evaluate the displacement of radiotracers, the path of lymphatic collectors from the knee to a lymph node in the upper thigh was divided into five similarly sized regions of interest. The concentration of radiotracer was quantified in each of the regions of interest. The paired t-test was used for statistical analysis with an alpha error of 5% (p value Manual lymphatic therapy improves the transport of radiotracers in lymphatic collectors. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  14. Potential of Red Spinach Leaves Ethanolic Extract (Amaranthus tricolor L. as a Complementary Therapy For Hiperlipidemia: Study in Vivo of Histopathologic and Activity of Alanin Aminotransferase (ALT

    Directory of Open Access Journals (Sweden)

    Dimas Adhi Pradana

    2016-12-01

    Full Text Available This study was conducted to determine the potential of ethanolic extract of red spinach leaves (Amaranthus tricolor L. with control quality as a complementary treatment of hyperlipidemic based on histopathology and activity of alanin aminotrasferase (ALT. A total of 24 male Wistar rats were randomized in 6 groups: normal group; positive control group were given the drug simvastatin; negative control group; 1st treatment group was given extract at dose of 400mg/kgBW rat, 2nd group was given extract at dose of 400mg/kgBW rat and simvastatin dose 0.18 mg/kgBW rat; 3rd treatment groups were given extract at dose of 800mg/kgBW rat and simvastatin dose 0.18 mg/kgBW rat. Induction hyperlipidemic using high fat diet and poloxamer. The data obtained were tested normality with the Shapiro-Wilk test. Statistical analysis using Oneway ANOVA and Post-Hoc Tukey HSD to determine the significance of differences between groups for ALT parameter. Result show the use of ethanolic extract of red spinach leaves can reduce fatty liver condition based on decreased level of ALT and liver histopathologic. It is concluded that the ethanolic extract of red spinach leaves dose 400mg/kgBW rat combine with simvastatin can reduce activity of ALT until 31.57 U1-1.

  15. African Journal of Traditional, Complementary and Alternative ...

    African Journals Online (AJOL)

    The use of complementary and alternative therapies in childhood cancer: a questionnaire based on a descriptive survey from the western black sea region of Turkey · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL ... Karl Peltzer, Win Myint Oo, Supa Pengpid, 150-155.

  16. Enzyme replacement therapy for Anderson-Fabry disease: A complementary overview of a Cochrane publication through a linear regression and a pooled analysis of proportions from cohort studies.

    Science.gov (United States)

    El Dib, Regina; Gomaa, Huda; Ortiz, Alberto; Politei, Juan; Kapoor, Anil; Barreto, Fellype

    2017-01-01

    Anderson-Fabry disease (AFD) is an X-linked recessive inborn error of glycosphingolipid metabolism caused by a deficiency of alpha-galactosidase A. Renal failure, heart and cerebrovascular involvement reduce survival. A Cochrane review provided little evidence on the use of enzyme replacement therapy (ERT). We now complement this review through a linear regression and a pooled analysis of proportions from cohort studies. To evaluate the efficacy and safety of ERT for AFD. For the systematic review, a literature search was performed, from inception to March 2016, using Medline, EMBASE and LILACS. Inclusion criteria were cohort studies, patients with AFD on ERT or natural history, and at least one patient-important outcome (all-cause mortality, renal, cardiovascular or cerebrovascular events, and adverse events) reported. The pooled proportion and the confidence interval (CI) are shown for each outcome. Simple linear regressions for composite endpoints were performed. 77 cohort studies involving 15,305 participants proved eligible. The pooled proportions were as follows: a) for renal complications, agalsidase alfa 15.3% [95% CI 0.048, 0.303; I2 = 77.2%, p = 0.0005]; agalsidase beta 6% [95% CI 0.04, 0.07; I2 = not applicable]; and untreated patients 21.4% [95% CI 0.1522, 0.2835; I2 = 89.6%, p<0.0001]. Effect differences favored agalsidase beta compared to untreated patients; b) for cardiovascular complications, agalsidase alfa 28% [95% CI 0.07, 0.55; I2 = 96.7%, p<0.0001]; agalsidase beta 7% [95% CI 0.05, 0.08; I2 = not applicable]; and untreated patients 26.2% [95% CI 0.149, 0.394; I2 = 98.8%, p<0.0001]. Effect differences favored agalsidase beta compared to untreated patients; and c) for cerebrovascular complications, agalsidase alfa 11.1% [95% CI 0.058, 0.179; I2 = 70.5%, p = 0.0024]; agalsidase beta 3.5% [95% CI 0.024, 0.046; I2 = 0%, p = 0.4209]; and untreated patients 18.3% [95% CI 0.129, 0.245; I2 = 95% p < 0.0001]. Effect differences favored agalsidase beta

  17. [Evaluation and results of ablative therapies in prostate cancer].

    Science.gov (United States)

    Renard-Penna, R; Sanchez-Salas, R; Barret, E; Cosset, J M; de Vergie, S; Sapetti, J; Ingels, A; Gangi, A; Lang, H; Cathelineau, X

    2017-11-01

    To perform a state of the art about methods of evaluation and present results in ablative therapies for localized prostate cancer. A review of the scientific literature was performed in Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of keywords. Publications obtained were selected based on methodology, language and relevance. After selection, 102 articles were analysed. Analyse the results of ablative therapies is presently difficult considering the heterogeneity of indications, techniques and follow-up. However, results from the most recent and homogeneous studies are encouraging. Oncologically, postoperative biopsies (the most important criteria) are negative (without any tumor cells in the treated area) in 75 to 95%. Functionally, urinary and sexual pre-operative status is spared (or recovered early) in more than 90% of the patients treated. More and more studies underline also the correlation between the results and the technique used considering the volume of the gland and, moreover, the "index lesion" localization. The post-treatment pathological evaluation by biopsies (targeted with MRI or, perhaps in a near future, with innovative ultrasonography) is the corner stone of oncological evaluation of ablative therapies. Ongoing trials will allow to standardize the follow-up and determine the best indication and the best techniques in order to optimize oncological and functional results for each patient treated. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. Evaluation of Wet Cupping Therapy: Systematic Review of Randomized Clinical Trials.

    Science.gov (United States)

    Al Bedah, Abdullah M N; Khalil, Mohamed K M; Posadzki, Paul; Sohaibani, Imen; Aboushanab, Tamer Shaaban; AlQaed, Meshari; Ali, Gazzaffi I M

    2016-10-01

    Wet cupping is a widely used traditional therapy in many countries, which justifies a continuous scientific evaluation of its efficacy and safety. To perform a systematic review to critically evaluate and update the available evidence of wet cupping in traditional and complementary medicine. Ten electronic databases were searched from their inceptions to February 2016. Included studies were randomized clinical trials (RCTs) that evaluated wet cupping against any type of control interventions in patients with any clinical condition, as well as healthy individuals. Cochrane risk of bias tool was used to appraise the included RCTs. Fourteen RCTs met the eligibility criteria. The included studies evaluated the following clinical conditions: nonspecific low back pain (NSLBP), hypertension, brachialgia, carpal tunnel syndrome (CTS), chronic neck pain, metabolic syndrome, migraine headaches, oxygen saturation in smokers with chronic obstructive pulmonary disease (COPD), and oral and genital ulcers due to Behçet disease. Two RCTs evaluated physiologic and biochemical parameters of healthy individuals. Overall, 9 RCTs favored wet cupping over various control interventions in NSLBP (n = 2), hypertension (n = 1), brachialgia (n = 1), CTS (n = 1), chronic neck pain (n = 2), oxygen saturation in smokers with COPD (n = 1), and oral and genital ulcers due to Behçet disease (n = 1). Five RCTs showed no statistically significant between-group differences: NSLBP (n = 1), metabolic syndrome (n = 1), migraine headaches (n = 1), and physiologic and biochemical parameters of healthy individuals (n = 2). Included RCTs had a variable risk of bias across all domains and suffered methodologic limitations. There is a promising evidence in favor of the use of wet cupping for musculoskeletal pain, specifically NSLBP, neck pain, CTS, and brachialgia. Better-quality trials are needed to generate solid evidence and firmly inform policy makers.

  19. Use of Complementary and Alternative Medicine for Work Related ...

    African Journals Online (AJOL)

    Conclusion: Complementary and alternative medicine therapies may improve quality of life, reduce work disruptions and enhance job satisfaction for dentists who suffer from work-related musculoskeletal disorders. It is important that dentists incorporate complementary and alternative medicine strategies into practice to ...

  20. Evaluation of drug therapy problems among renal patients receiving ...

    African Journals Online (AJOL)

    Conclusion: Drug therapy problems among renal patients were high. Inappropriate drug selection and drug interactions were the commonest drug therapy problems. The acceptance of pharmacists' interventions by prescribers was appreciable. Keywords: Drug therapy problems, Renal patients, Therapy, Intervention, ...

  1. Scalp Dose Evaluation According Radiation Therapy Technique of Whole Brain Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Joon Yung; Park, Soo Yun; Kim, Jong Sik; Choi, Byeong Gi; Song, Gi Won [Dept. of Radiation Oncology, Samsung Medical Center, Seoul (Korea, Republic of)

    2011-09-15

    Opposing portal irradiation with helmet field shape that has been given to a patient with brain metastasis can cause excess dose in patient's scalp, resulting in hair loss. For this reason, this study is to quantitatively analyze scalp dose for effective prevention of hair loss by comparing opposing portal irradiation with scalp-shielding shape and tomotherapy designed to protect patient's scalp with conventional radiation therapy. Scalp dose was measured by using three therapies (HELMET, MLC, TOMO) after five thermo-luminescence dosimeters were positioned along center line of frontal lobe by using RANDO Phantom. Scalp dose and change in dose distribution were compared and analyzed with DVH after radiation therapy plan was made by using Radiation Treatment Planning System (Pinnacle3, Philips Medical System, USA) and 6 MV X-ray (Clinac 6EX, VARIAN, USA). When surface dose of scalp by using thermo-luminescence dosimeters was measured, it was revealed that scalp dose decreased by average 87.44% at each point in MLC technique and that scalp dose decreased by average 88.03% at each point in TOMO compared with HELMET field therapy. In addition, when percentage of volume (V95%, V100%, V105% of prescribed dose) was calculated by using Dose Volume Histogram (DVH) in order to evaluate the existence or nonexistence of hotspot in scalp as to three therapies (HELMET, MLC, TOMO), it was revealed that MLC technique and TOMO plan had good dose coverage and did not have hot spot. Reducing hair loss of a patient who receives whole brain radiotherapy treatment can make a contribution to improve life quality of the patient. It is expected that making good use of opposing portal irradiation with scalp-shielding shape and tomotherapy to protect scalp of a patient based on this study will reduce hair loss of a patient.

  2. Preclinical evaluation of the proteasome inhibitor bortezomib in cancer therapy

    Directory of Open Access Journals (Sweden)

    Morgan Gareth

    2005-06-01

    Full Text Available Abstract Bortezomib is a highly selective, reversible inhibitor of the 26S proteasome that is indicated for single-agent use in the treatment of patients with multiple myeloma who have received at least 2 prior therapies and are progressing on their most recent therapy. Clinical investigations have been completed or are under way to evaluate the safety and efficacy of bortezomib alone or in combination with chemotherapy in multiple myeloma, both at relapse and presentation, as well as in other cancer types. The antiproliferative, proapoptotic, antiangiogenic, and antitumor activities of bortezomib result from proteasome inhibition and depend on the altered degradation of a host of regulatory proteins. Exposure to bortezomib has been shown to stabilize p21, p27, and p53, as well as the proapoptotic Bid and Bax proteins, caveolin-1, and inhibitor κB-α, which prevents activation of nuclear factor κB-induced cell survival pathways. Bortezomib also promoted the activation of the proapoptotic c-Jun-NH2 terminal kinase, as well as the endoplasmic reticulum stress response. The anticancer effects of bortezomib as a single agent have been demonstrated in xenograft models of multiple myeloma, adult T-cell leukemia, lung, breast, prostate, pancreatic, head and neck, and colon cancer, and in melanoma. In these preclinical in vivo studies, bortezomib treatment resulted in decreased tumor growth, angiogenesis, and metastasis, as well as increased survival and tumor apoptosis. In several in vitro and/or in vivo cancer models, bortezomib has also been shown to enhance the antitumor properties of several antineoplastic treatments. Importantly, bortezomib was generally well tolerated and did not appear to produce additive toxicities when combined with other therapies in the dosing regimens used in these preclinical in vivo investigations. These findings provide a rationale for further clinical trials using bortezomib alone or in combination regimens with

  3. A systematic review of economic evaluations of therapy in asthma

    Directory of Open Access Journals (Sweden)

    Katayoun Bahadori

    2010-08-01

    Full Text Available Katayoun Bahadori1, Bradley S Quon2, Mary M Doyle-Waters1, Carlo Marra3, J Mark FitzGerald21Centre for Clinical Epidemiology and Evaluation (C2E2, 2Department of Medicine, Respiratory Division, 3Faculty of Pharmaceutical Sciences, UBC, Vancouver, BC, CanadaBackground: Asthma’s cost-effectiveness is a major consideration in the evaluation of its treatment options. Our objective was to perform a systematic review of the cost-effectiveness of asthma medications.Methods: We performed a systematic search of MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, OHE-HEED, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Health Technology Assessments Database, NHS Economic Evaluation Database, and Web of Science and reviewed references from key articles between 1990 and Jan 2008.Results: A total of 49 RCTs met the inclusion criteria. Maintenance therapy with inhaled corticosteroids was found to be very cost-effective and in uncontrolled asthmatics patients currently being treated with ICS, the combination of an ICS/LABA represents a safe, cost-effective treatment. The simplified strategy using budesonide and formoterol for maintenance and reliever therapy was also found to be as cost-effective as salmeterol/fluticasone plus salbutamol. Omalizumab was found to be cost-effective. An important caveat with regard to the published literature is the relatively high proportion of economic evaluations which are funded by the manufacturers of specific drug treatments.Conclusion: Future studies should be completed independent of industry support and ensure that the comparator arms within studies should include dosages of drugs that are equivalent.Keywords: asthma, medication, cost-effectiveness, cost of illness, economic costs

  4. Clinical Efficacy of 1-Year Intensive Systematic Dietary Manipulation as Complementary and Alternative Medicine Therapies on Female Patients With Interstitial Cystitis/Bladder Pain Syndrome.

    Science.gov (United States)

    Oh-Oka, Hitoshi

    2017-08-01

    To evaluate the clinical efficacy of intensive systematic dietary manipulation (ISDM) for female patients with interstitial cystitis (IC)/bladder pain syndrome (BPS) in stable condition who were followed up in our hospital. In cooperation with the nutrition control team, we created a basic IC/BPS diet menu for 1 month. Data regarding daily food intake and food-related symptoms were collected by conducting a detailed interview of each patient, and we set meal menu to control IC/BPS symptoms and advised the patients to reduce the intake of specific food items to the maximum possible extent. The following food items were removed from or restricted in the diet of patients: tomatoes, tomato products, soybean, tofu product, spices, excessive potassium, citrus, high-acidity-inducing substances, etc. We evaluated the following factors 3 months and 1 year after the start of the intervention: O'Leary-Sant symptom index, O'Leary-Sant problem index, urgency visual analogue scale score, bladder or pelvic pain visual analogue scale score, and numerical patient-reported quality of life index. All evaluated factors improved statistically significantly when the intensive group was compared with the nonintensive group (baseline to 3 months and 3 months to 1 year ISDM, P <.05, respectively). ISDM was found to alleviate the symptoms of IC/BPS in almost 3 months and continued clinical efficacy for at least 1 year. ISDM as one of the conservative treatment modality for IC/BPS should be attempted more strictly because of its noninvasiveness, without alterations to the other treatments. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Ibuanyidanda (Complementary Reflection), Communalism and ...

    African Journals Online (AJOL)

    Fr. Prof. Asouzu

    Complementary Reflection, Communalism and Theory Formulation in African Philosophy 9. Ibuanyidanda (Complementary ...... Metaphysics,. Phenomenology and African Philosophy. Lagos: FADEC Publishers, pp.337-355. Van Steenberghen, Fernand. 1952. Ontology. Flynn, Martin J. trans. London: Joseph F. Wagner.

  6. Economic evaluation of manual therapy for musculoskeletal diseases: a protocol for a systematic review and narrative synthesis of evidence.

    Science.gov (United States)

    Kim, Chang-Gon; Mun, Su-Jeong; Kim, Ka-Na; Shin, Byung-Cheul; Kim, Nam-Kwen; Lee, Dong-Hyo; Lee, Jung-Han

    2016-05-13

    Manual therapy is the non-surgical conservative management of musculoskeletal disorders using the practitioner's hands on the patient's body for diagnosing and treating disease. The aim of this study is to systematically review trial-based economic evaluations of manual therapy relative to other interventions used for the management of musculoskeletal diseases. Randomised clinical trials (RCTs) on the economic evaluation of manual therapy for musculoskeletal diseases will be included in the review. The following databases will be searched from their inception: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Econlit, Mantis, Index to Chiropractic Literature, Science Citation Index, Social Science Citation Index, Allied and Complementary Medicine Database (AMED), Cochrane Database of Systematic Reviews (CDSR), National Health Service Database of Abstracts of Reviews of Effects (NHS DARE), National Health Service Health Technology Assessment Database (NHS HTA), National Health Service Economic Evaluation Database (NHS EED), CENTRAL, five Korean medical databases (Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Service System (RISS), DBPIA, Korean Traditional Knowledge Portal (KTKP) and KoreaMed) and three Chinese databases (China National Knowledge Infrastructure (CNKI), VIP and Wanfang). The evidence for the cost-effectiveness, cost-utility and cost-benefit of manual therapy for musculoskeletal diseases will be assessed as the primary outcome. Health-related quality of life and adverse effects will be assessed as secondary outcomes. We will critically appraise the included studies using the Cochrane risk of bias tool and the Drummond checklist. Results will be summarised using Slavin's qualitative best-evidence synthesis approach. The results of the study will be disseminated via a peer-reviewed journal and/or conference presentations

  7. Effects and safety of mechanical bathing as a complementary therapy for terminal stage cancer patients from the physiological and psychological perspective: a pilot study.

    Science.gov (United States)

    Fujimoto, Sawako; Iwawaki, Yoko; Takishita, Yukie; Yamamoto, Yoko; Murota, Masako; Yoshioka, Saori; Hayano, Azusa; Hosokawa, Toyoshi; Yamanaka, Ryuya

    2017-11-01

    In palliative care hospitals in Japan, mechanical bathing is conducted to maintain cleanliness. However, the physiological and psychological influence of mechanical bathing on patients has not been sufficiently studied. The objective of this study was to assess, using physiological and psychological indices, the effects of mechanical bathing care for patients in the terminal stage of cancer. Mechanical bathing was performed using a Marine Court SB7000 in a supine or semi-seated position. The heart rate variability analysis method was used to measure autonomic nervous system function. The patients' state of anxiety was assessed using the State-Trait Anxiety Inventory (STAI), a psychological index, and patients' verbal responses were also collected after mechanical bathing. Twenty-four patients were enrolled in this study. Their sympathetic and parasympathetic nervous activity did not differ before and after bathing. A significant difference was found between pre- and post-bathing anxiety, as evaluated by STAI (P mechanical bathing according to STAI evaluation and their verbal responses. The findings suggest that the method of bathing used in this study is safe and pain-relieving for terminal stage cancer patients. It is thus possible to provide safe and comfortable care for terminal stage cancer patients using mechanical baths.

  8. A Pilot Evaluation of an Art Therapy Program for Refugee Youth from Burma

    Science.gov (United States)

    Kowitt, Sarah Dorothy; Emmerling, Dane; Gavarkavich, Diane; Mershon, Claire-Helene; Linton, Kristin; Rubesin, Hillary; Agnew-Brune, Christine; Eng, Eugenia

    2016-01-01

    Art therapy is a promising form of therapy to address mental health concerns for refugee youth. This article describes the development and implementation of a pilot evaluation of an art therapy program for refugee adolescents from Burma currently living in the United States. Evaluation activities were based on the Centers for Disease Control and…

  9. The evaluation of music therapy process in the intersubjective perspective: the music therapy rating scale. A pilot study

    OpenAIRE

    Raglio, Alfredo; Traficante,; Oasi,

    2011-01-01

    A Raglio1, D Traficante2, O Oasi31Sospiro Foundation, Cremona, Italy; 2Education Technologies Research Center (CRTI), 3Department of Psychology, Catholic University of the Sacred Heart, Milan, ItalyAbstract: This study presents a tool (Music Therapy Rating Scale [MTRS]) to evaluate the progression of the relationship between the patient and the therapist during music therapy sessions. The rating scale was developed from an intersubjective framework and from an improvisational music therapy te...

  10. Complementary and Alternative Medicine Treatment Options for Otitis Media

    Science.gov (United States)

    Marom, Tal; Marchisio, Paola; Tamir, Sharon Ovnat; Torretta, Sara; Gavriel, Haim; Esposito, Susanna

    2016-01-01

    Abstract Otitis media (OM) has numerous presentations in children. Together with conventional medical therapies aimed to prevent and/or treat OM, a rising number of complementary and alternative medicine (CAM) treatment options can be offered. Since OM is common in children, parents may ask healthcare professionals about possible CAM therapies. Many physicians feel that their knowledge is limited regarding these therapies, and that they desire some information. Therefore, we conducted a literature review of CAM therapies for OM, taking into account that many of these treatments, their validity and efficacy and have not been scientifically demonstrated. We performed a search in MEDLINE (accessed via PubMed) using the following terms: “CAM” in conjunction with “OM” and “children. Retrieved publications regarding treatment of OM in children which included these terms included randomized controlled trials, prospective/retrospective studies, and case studies. The following CAM options for OM treatment in children were considered: acupuncture, homeopathy, herbal medicine/phytotherapy, osteopathy, chiropractic, xylitol, ear candling, vitamin D supplement, and systemic and topical probiotics. We reviewed each treatment and described the level of scientific evidence of the relevant publications. The therapeutic approaches commonly associated with CAM are usually conservative, and do not include drugs or surgery. Currently, CAM is not considered by physicians a potential treatment of OM, as there is limited supporting evidence. Further studies are warranted in order to evaluate the potential value of CAM therapies for OM. PMID:26871802

  11. Complementary and Integrative Medicine for Neurologic Conditions.

    Science.gov (United States)

    Wells, Rebecca Erwin; Baute, Vanessa; Wahbeh, Helané

    2017-09-01

    Although many neurologic conditions are common, cures are rare and conventional treatments are often limited. Many patients, therefore, turn to complementary and alternative medicine (CAM). The use of selected, evidence-based CAM therapies for the prevention and treatment of migraine, carpal tunnel syndrome, and dementia are presented. Evidence is growing many of modalities, including nutrition, exercise, mind-body medicine, supplements, and acupuncture. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Dosimetric evaluation of Plastic Water Diagnostic-Therapy.

    Science.gov (United States)

    Ramaseshan, Ramani; Kohli, Kirpal; Cao, Fred; Heaton, Robert K

    2008-04-29

    High-precision radiotherapy planning and quality assurance require accurate dosimetric and geometric phantom measurements. Phantom design requires materials with mechanical strength and resilience, and dosimetric properties close to those of water over diagnostic and therapeutic ranges. Plastic Water Diagnostic Therapy (PWDT: CIRS, Norfolk, VA) is a phantom material designed for water equivalence in photon beams from 0.04 MeV to 100 MeV; the material has also good mechanical properties. The present article reports the results of computed tomography (CT) imaging and dosimetric studies of PWDT to evaluate the suitability of the material in CT and therapy energy ranges. We characterized the water equivalence of PWDT in a series of experiments in which the basic dosimetric properties of the material were determined for photon energies of 80 kVp, 100 kVp, 250 kVp, 4 MV, 6 MV, 10 MV, and 18 MV. Measured properties included the buildup and percentage depth dose curves for several field sizes, and relative dose factors as a function of field size. In addition, the PWDT phantom underwent CT imaging at beam qualities ranging from 80 kVp to 140 kVp to determine the water equivalence of the phantom in the diagnostic energy range. The dosimetric quantities measured with PWDT agreed within 1.5% of those determined in water and Solid Water (Gammex rmi, Middleton, WI). Computed tomography imaging of the phantom was found to generate Hounsfield numbers within 0.8% of those generated using water. The results suggest that PWDT material is suitable both for regular radiotherapy quality assurance measurements and for intensity-modulated radiation therapy (IMRT) verification work. Sample IMRT verification results are presented.

  13. Evaluating UK research in speech and language therapy.

    Science.gov (United States)

    Lewison, Grant; Carding, Paul

    2003-01-01

    There has been a steady growth in recent years in British higher-degree training in speech and language therapy. But what is the standing of UK research in the subject and its component areas which should underpin and inform such training? How can such research be evaluated? The intention was to compare UK publications relevant to speech and language therapy with those of other countries, both quantitatively and qualitatively. We sought then to examine the UK papers in more detail to analyse their sources of funding, their geographical distribution and the ways in which they could appropriately be evaluated. Papers were selectively retrieved from the Science Citation Index and the Social Sciences Citation Index for 1991-2000 by means of a filter based on journal names and paper title words. They were subsequently checked to remove many false positives. The papers were classified into one of seven subject areas and by their research level (from clinical to basic). Their importance was estimated through their potential impact on other researchers, as determined by the citation score of their journals, by the numbers of citations they actually received and by the subjective esteem in which the various journals were held by UK speech and language researchers. World output of speech and language therapy papers has averaged 1000 papers per year during the 1990s, and has grown by half over the period. UK output has been about 12% of the total, compared with 10% in biomedicine, and is published in high impact journals relative to the norm for the field, which is quite a low rate compared with biomedicine overall. Almost half the UK papers had no funding acknowledgements, with the private-non-profit and industrial sectors playing less of a role than in other biomedical areas. Papers in seven subject areas showed substantial differences in their performance on the four criteria selected. The state of British speech and language research appears to be satisfactory, with an

  14. Microbial evaluation and public health implications of urine as alternative therapy in clinical pediatric cases: health implication of urine therapy

    Directory of Open Access Journals (Sweden)

    Adenike Adedayo O. Ogunshe

    2010-05-01

    Full Text Available BACKGROUND: Cultural means of pediatric treatment during ill health is a mainstay in Africa, and though urine has been known to contain enteric pathogens, urine therapy is still culturally applicable in some health conditions and also advocated as alternative therapy. The study therefore, is to evaluate the microbial contents and safety of urine.

  15. Reconstructive surgery in immunocompromised patients: evaluation and therapy

    Science.gov (United States)

    Dunda, Sebastian E.; Bozkurt, Ahmet; Pallua, Norbert; Krapohl, Björn Dirk

    2015-01-01

    Background: An increasing number of patients undergoing reconstructive surgery are immunocompromised due to different reasons and different medical treatments. Some of the used immunosuppressive drugs may affect the process of wound healing and thereby, impair the long-term success of surgical treatment. Therefore, this retrospective analysis aimed at the evaluation of the perioperative treatment and surgical outcome of immunocompromised patients undergoing different reconstructive procedures. Methods: A retrospective review was performed of 8 immunocompromised patients with different primary diseases who needed reconstructive surgery: 2 patients with non-Hodgkin lymphoma, 1 patient with an acute myeloid leukemia, 1 patient with colitis ulcerosa, 1 patient with liver cirrhosis, 1 patient with chronic polyarthritis, and 2 patients with malignant melanoma. Results: In 7 of our 8 presented cases, multiple operations with wound debridements have been necessary to optimize the granulation of the wound bed before reconstructive surgery. 3 out of these 7 patients required further operations due to wound dehiscence or necrosis, with 2 of them as a result of increased immunosuppressive therapy. 5 out of 8 patients needed no further surgical treatment. Conclusions: Both the perioperative drug therapy and the reconstructive surgery concept need to be determined carefully in each individual case of the immunocompromised patients. Thus, the appropriate point in time of operation to achieve the best possible wound healing as well as the complexity of the procedure will require the consideration of a ‘less is more’ strategy in selected cases. PMID:26734539

  16. Reconstructive surgery in immunocompromised patients: evaluation and therapy

    Directory of Open Access Journals (Sweden)

    Dunda, Sebastian E.

    2015-12-01

    Full Text Available Background: An increasing number of patients undergoing reconstructive surgery are immunocompromised due to different reasons and different medical treatments. Some of the used immunosuppressive drugs may affect the process of wound healing and thereby, impair the long-term success of surgical treatment. Therefore, this retrospective analysis aimed at the evaluation of the perioperative treatment and surgical outcome of immunocompromised patients undergoing different reconstructive procedures.Methods: A retrospective review was performed of 8 immunocompromised patients with different primary diseases who needed reconstructive surgery: 2 patients with non-Hodgkin lymphoma, 1 patient with an acute myeloid leukemia, 1 patient with colitis ulcerosa, 1 patient with liver cirrhosis, 1 patient with chronic polyarthritis, and 2 patients with malignant melanoma.Results: In 7 of our 8 presented cases, multiple operations with wound debridements have been necessary to optimize the granulation of the wound bed before reconstructive surgery. 3 out of these 7 patients required further operations due to wound dehiscence or necrosis, with 2 of them as a result of increased immunosuppressive therapy. 5 out of 8 patients needed no further surgical treatment.Conclusions: Both the perioperative drug therapy and the reconstructive surgery concept need to be determined carefully in each individual case of the immunocompromised patients. Thus, the appropriate point in time of operation to achieve the best possible wound healing as well as the complexity of the procedure will require the consideration of a ‘less is more’ strategy in selected cases.

  17. [Vocalab: a new software for voice evaluation and therapy].

    Science.gov (United States)

    Menin-Sicard, A; Sicard, E

    2003-01-01

    When handling vocal pathologies, speech therapists need tools to visualise voice and speech, in order to correlate personal auditory analysis with accurate data. Vocalab2 is a spectral analysis tool designed for speech therapists, developed in partnership with INSA Toulouse, France. Vocalab is a simple and user-friendly tool with important features to be used during evaluation and therapy. The software is based on a set of phoniatric data and sophisticated real-time signal analysis (Fourier transform, fundamental detection). One of the key tools of Vocalab2 is the real-time spectrum for visualising, differentiating and comparing every cord approximation and speech movement. Animations are proposed for illustrating most phonemes, and videos related to folding cords in the case of pathologic and normal sound production are also proposed. An extensive test has been conducted during 18 month, with important feedback that has considerably improved the tool. The satisfaction ratio is around 8/10.

  18. Evaluating current trends in psychiatric music therapy: a descriptive analysis.

    Science.gov (United States)

    Silverman, Michael J

    2007-01-01

    Approximately 21% of music therapists report working in the mental health field, more so than another other specific client population category (AMTA, 2005). The purpose of this study was to descriptively evaluate psychiatric music therapists and their institutions, philosophies, interventions, and clinical objectives. A survey was designed and posted online or mailed to music therapists who did not have email addresses in the 2005 Member Sourcebook (AMTA, 2005). A total of 176 psychiatric music therapists completed various parts of the survey for an overall response rate of 42.9%. Respondents reported working a mean of 11.3 years in the psychiatric setting, being Board-Certified Music Therapists for 13.3 years, and working at their institution for 8.4 years. Most respondents (90.6%) indicated they did not have a music therapist as a supervisor. Group music therapy was the dominant modality in psychiatric institutions for music therapists. Respondents indicated they read music therapy journals (80%) and other types of psychiatric periodicals (57.1%), presented educational sessions at conferences (44.6%), conducted in-services for hospital staff (64.8%), worked with an interdisciplinary treatment team (77.9%), and trained practica students (43.5%) and interns (37.4%). Respondents also indicated that although most were not bilingual (85.7%), they still worked with non-English speaking consumers (58.2%). Participants noted that they enjoyed working with the psychiatric population and felt they had a positive influence on treatment as indicated by Likert-type scales. Respondents reported using primarily behavioral or psychodynamic approaches but considered their primary psychological philosophy as eclectic. Participants predominantly indicated they addressed goal areas such as socialization, communication, self-esteem, coping skills, and stress reduction/management. Participants noted they employed a variety of music therapy techniques such as music assisted relaxation

  19. [Complementary treatment of pneumonia with pleural effusion].

    Science.gov (United States)

    Rampp, Thomas; Michalsen, Andreas

    2006-04-01

    A 43-year-old male patient was diagnosed with acute sinistral pleuropneumonia and a pronounced thoracic pain syndrome. Despite of his painful ailments the patient refused antibiotic treatment. A complementary therapy comprising physiotherapy, hydrotherapy, herbal therapy and vitamin C, cupping and QiGong was initiated. A cantharidin blister was applied topically to the left thorax in order to treat the pain syndrome. The multimodal CAM treatment resulted in a rapid clinical and x-ray resolution of pneumonia, and cantharidin treatment effectively relieved pain. The case and the potential of topical cantharidin in pain syndromes are discussed.

  20. Complementary and alternative medicine in radiation oncology : Survey of patients' attitudes.

    Science.gov (United States)

    Lettner, Sabrina; Kessel, Kerstin A; Combs, Stephanie E

    2017-05-01

    Complementary and alternative medicine (CAM) are gaining in importance, but objective data are mostly missing. However, in previous trials, methods such as acupuncture showed significant advantages compared to standard therapies. Thus, the aim was to evaluate most frequently used methods, their significance and the general acceptance amongst cancer patients undergoing radiotherapy (RT). A questionnaire of 18 questions based on the categorical classification released by the National Centre for Complementary and Integrative Health was developed. From April to September 2015, all patients undergoing RT at the Department of Radiation Oncology, Technical University of Munich, completed the survey. Changes in attitude towards CAM were evaluated using the questionnaire after RT during the first follow-up visit (n = 31). Of 634 patients, 333 answered the questionnaire (52.5%). Of all participants, 26.4% used CAM parallel to RT. Before RT, a total of 39.3% had already used complementary medicine. The most frequently applied methods during therapy were vitamins/minerals, food supplements, physiotherapy/manual medicine, and homeopathy. The majority (71.5%) did not use any complementary treatment, mostly stating that CAM was not offered to them (73.5%). The most common reasons for use were to improve the immune system (48%), to reduce side effects (43.8%), and to not miss an opportunity (37.8%). Treatment integrated into the individual therapy concept, e.g. regular acupuncture, would be used by 63.7% of RT patients. In comparison to other studies, usage of CAM parallel to RT in our department is considered to be low. Acceptance amongst patients is present, as treatment integrated into the individual oncology therapy would be used by about two-third of patients.

  1. Patients' motives for choosing a physician: comparison between conventional and complementary medicine in Swiss primary care

    Directory of Open Access Journals (Sweden)

    Busato André

    2007-12-01

    Full Text Available Abstract Background The study is part of a nationwide evaluation of complementary and alternative medicine (CAM in primary care in Switzerland. The Objective was to identify patients' expectations and reasons governing the choice of complementary medicine compared with conventional primary care (CONV. Methods The data were derived from the PEK study (Programm Evaluation Komplementärmedizin, which was conducted in 2002–2003 with 7879 adult patients and parents of 1291 underage patients, seeking either complementary (CAM or conventional (CONV primary care. The study was performed as a cross-sectional survey. The respondents were asked to document their (or their children's self-perceived health status, reasons governing their choice, and treatment expectations. Physicians were practicing conventional medicine and/or complementary methods (homeopathy, anthroposophic medicine, neural therapy, and traditional Chinese medicine. Reasons governing the choice of physician were evaluated on the basis of a three-part classification (physician-related, procedure-related, and pragmatic/other reasons Results and Discussion Patients seeing CAM physicians tend to be younger and more often female. CAM patients referred to procedure-related reasons more frequently, whereas pragmatic reasons dominated among CONV patients. CAM respondents expected fewer adverse side effects compared to conventional care patients. Conclusion The majority of alternative medicine users appear to have chosen CAM mainly because they wish to undergo a certain procedure; additional reasons include desire for more comprehensive treatment, and expectation of fewer side-effects.

  2. Complementary and alternative medicine for Duchenne and Becker muscular dystrophies: characteristics of users and caregivers.

    Science.gov (United States)

    Zhu, Yong; Romitti, Paul A; Conway, Kristin M; Andrews, Jennifer; Liu, Ke; Meaney, F John; Street, Natalie; Puzhankara, Soman; Druschel, Charlotte M; Matthews, Dennis J

    2014-07-01

    Complementary and alternative medicine is frequently used in the management of chronic pediatric diseases, but little is known about its use by those with Duchenne or Becker muscular dystrophy. Complementary and alternative medicine use by male patients with Duchenne or Becker muscular dystrophy and associations with characteristics of male patients and their caregivers were examined through interviews with 362 primary caregivers identified from the Muscular Dystrophy Surveillance, Tracking, and Research Network. Overall, 272 of the 362 (75.1%) primary caregivers reported that they had used any complementary and alternative medicine for the oldest Muscular Dystrophy Surveillance, Tracking, and Research Network male in their family. The most commonly reported therapies were from the mind-body medicine domain (61.0%) followed by those from the biologically based practice (39.2%), manipulative and body-based practice (29.3%), and whole medical system (6.9%) domains. Aquatherapy, prayer and/or blessing, special diet, and massage were the most frequently used therapies. Compared with nonusers, male patients who used any therapy were more likely to have an early onset of symptoms and use a wheel chair; their caregivers were more likely to be non-Hispanic white. Among domains, associations were observed with caregiver education and family income (mind-body medicines [excluding prayer and/or blessing only] and whole medical systems) and Muscular Dystrophy Surveillance, Tracking, and Research Network site (biologically based practices and mind-body medicines [excluding prayer and/or blessing only]). Complementary and alternative medicine use was common in the management of Duchenne and Becker muscular dystrophies among Muscular Dystrophy Surveillance, Tracking, and Research Network males. This widespread use suggests further study to evaluate the efficacy of integrating complementary and alternative medicine into treatment regimens for Duchenne and Becker muscular

  3. Alternative and Complementary Therapies for Hepatitis C

    Science.gov (United States)

    ... response. Thymus extract supplements are made from the thymus glands of cows or calves and are sold as capsules and tablets. Although thymus extract products often carry claims of boosting the immune ...

  4. Integrative Medicine and Complementary and Alternative Therapies

    Science.gov (United States)

    ... Donate Menu About LLS Who We Are Mission Leadership Financials History News Network Our Partners National Awards Nomination What ... Shop Donate About LLS Who We Are Mission Leadership Financials History News Network Our Partners National Awards Nomination What ...

  5. Mental disorders frequency alternative and complementary ...

    African Journals Online (AJOL)

    Mental disorders frequency alternative and complementary medicine usage among patients with hypertension and type 2 diabetes mellitus. ... the study were administered the sociodemographic data form, the Primary Care Evaluation of Mental Disorders (PRIME‑MD) questionnaire and the alternative medicine inquiry form.

  6. A novel PET tracer for evaluation of gene therapy

    Energy Technology Data Exchange (ETDEWEB)

    Goldman, S.; Monclus, M.; Cool, V. [Cliniques Universitaires de Bruxelles-Hopital Erasme, Brussels (Belgium)] [and others

    1996-05-01

    A promising approach of gene therapy for cancer consist in the transduction of neoplastic cells with the herpes virus thymidine-kinase gene (HSV-tk) which renders transduced cells sensitive to the lethal effect of anti-viral agent such as ganciclovir (GCV). Pet with adapted radiotracers represents an adequate tool to determine in vivo the level of HSV-tk expression and to establish the optimal protocol of gene and GCV administrations in human. We have developed a new potential PET tracer, 9-((1-[F-18]fluoro-3-hydroxy-2-propoxy)methyl)guanine [F-18]FHPG should theoretically accumulate in cells expressing HSV-tk. [F-18]FHPG was obtained by nucleophilic substitution on a ditosylate precursor followed by hydrolysis. To determine the biological behavior of this compound, we synthetized the corresponding non radioactive fluorinated analog (FHPG) and tested its inhibitory activity on HSV-tk transduced 9L gliosarcoma cells maintained in culture. FHPG at 100 {mu}M suppress cell growth by 50% while GCV and acyclovir induced 100% suppression at 10 and 100 {mu}M, respectively. We then tested the in vitro uptake of n.c.a. [F-18]FHPG in cultured cells transduced with HSV-tk or a control gene (neomycin). Ratio of [F-18]FHPG uptake in HSV-tk versus control cells was 240 after 6 hours of incubation. In vivo uptake of [F-18]FHPG was tested in experimental tumors obtained by stereotactical implantion of transduced 9L cells in the brain of male Fischer 344 rats. Ratio of [F-18]FHPG uptake in HSV-tk versus control tumors was 2.5, 3 hours after intravenous tracer injection. Uptake in HSV-tk tumor was 19-fold higher than in the cortex. We concluded that [F-18]FHPG is a promising PET tracer for the evaluation of gene therapy involving viral thymidine kinase genes.

  7. A complementary care study combining flaxseed oil, caffeine, fasting, and exercise in women diagnosed with advanced ovarian cancer: findings from a case study.

    Science.gov (United States)

    Albrecht, Tara A; Anderson, Joel G; Jones, Randy; Bourguignon, Cheryl; Taylor, Ann Gill

    2012-01-01

    This article presents the experiences of 1 participant with advanced ovarian cancer enrolled in a proof of concept complementary therapy study evaluating the effects of a combined intervention of flaxseed oil, fasting, caffeine, and exercise. Improvements were observed in physical and psychological symptoms. The participant adopted positive lifestyle modifications.

  8. The Reliability and Validity of the Clinical Competence Evaluation Scale in Physical Therapy

    National Research Council Canada - National Science Library

    Yoshino, Jun; Usuda, Shigeru

    2013-01-01

    [Purpose] To examine the internal consistency, criterion-related validity, factorial validity, and content validity of the Clinical Competence Evaluation Scale in Physical Therapy (CEPT). [Subjects...

  9. Usefulness of pharmacy dispensing records in the evaluation of adherence to antiretroviral therapy in Brazilian children and adolescents

    Directory of Open Access Journals (Sweden)

    Aline Santarem Ernesto

    Full Text Available INTRODUCTION: Adherence, which is crucial to the success of antiretroviral therapy (HAART, is currently a major challenge in the care of children and adolescents living with HIV/AIDS. OBJECTIVE: To evaluate the prevalence of nonadherence to HAART using complementary instruments in a cohort of children and adolescents with HIV/AIDS followed in a reference service in Campinas, Brazil. METHODS: The level of adherence of 108 patients and caregivers was evaluated by an adapted standardized questionnaire and pharmacy dispensing records (PDR. Non-adherence was defined as a drug intake lower than 95% (on 24-hour or seven-day questionnaires, or as an interval of 38 days or more for pharmacy refills. The association between adherence and clinical, immunological, virological, and psychosocial characteristics was assessed by multivariate analysis. RESULTS: Non-adherence prevalence varied from 11.1% (non-adherent in three instruments, 15.8% (24-hour self-report, 27.8% (seven-day self-report, 45.4% (PDR, and 56.3% (at least one of the outcomes. 24-hour and seven-day self-reports, when compared to PDR, showed low sensitivity (29% and 43%, respectively but high specificity (95% and 85%, respectively. In multivariate analysis, medication intolerance, difficulty of administration by caregiver, HAART intake by the patient, lower socioeconomical class, lack of virological control, missed appointments in the past six months, and lack of religious practice by caregiver were significantly associated with non-adherence. CONCLUSION: A high prevalence of HAART non-adherence was observed in the study population, and PDR was the most sensitive of the tested instruments. The instruments employed were complementary in the identification of non-adherence.

  10. Complementary Safety Assessment of AREVA's nuclear facilities; Evaluations complementaires de la surete nucleaire (ECS) des sites d'AREVA

    Energy Technology Data Exchange (ETDEWEB)

    Gac, M.; Sidaner, J.F. [Areva, Direction Surete Sante Developpement Durable - D3SDD, 33 rue La Fayette, 75009 Paris (France)

    2012-01-15

    The aim of complementary safety assessment (CSA) is to analyse the robustness of a nuclear facility for extreme situations such as those that led to the Fukushima accident. This article presents the methodology that has been followed to draw CSA for AREVA's nuclear facilities: La Hague, Tricastin, Romans-sur-Isere and Melox. A 4-step approach has been followed for each site. First, a review of the measures already taken into account in the design of the facility and their conformity to applicable regulations. Secondly, a study to transpose the concept of severe accident in a nuclear power plant to the context of a fuel cycle facility. Thirdly, to assess the robustness of the facility and the real safety margin. Fourthly, the analysis of external or internal means that could be used in case of accidents to restore or maintain a minimal level of safety. (A.C.)

  11. Complementary and alternative medicine for pediatric otitis media.

    Science.gov (United States)

    Levi, Jessica R; Brody, Robert M; McKee-Cole, Katie; Pribitkin, Edmund; O'Reilly, Robert

    2013-06-01

    To review the literature involving complementary and alternative medicine (CAM) for pediatric otitis media. Multiple modalities are discussed, including prevention involving breastfeeding, nutrition, and vaccination; symptomatic treatment involving homeopathy, natural health products, and probiotics; manual manipulations involving osteopathy and chiropractics; and traditional Chinese and Japanese medicine. The information presented will assist physicians in advising patients on their decision-making during the early stages of otitis media when antibiotics and surgery are not yet indicated. A systematic literature search was conducted through January 2012 in PubMed using MESH term "otitis media" in conjunction with "complementary therapies," "homeopathy," "manipulation, osteopathic," "manipulation, chiropractic," "acupuncture therapy," "probiotics," "naturopathy," and "xylitol." Theses searches yielded 163 unique results. Abstracts and titles were evaluated for relevance. Case reports, case series, randomized controlled trials, and basic science research were included. Publications not relevant to the discussion of alternative medicine in otitis media were excluded. Bibliographies were checked for further publications. Thirty-six unique publications were reviewed. Of all therapies in complementary and alternative medicine, only xylitol has been studied in well-designed, randomized, blinded trials; it is likely effective, but compliance limits its applicability. Management of acute otitis media begins with watchful waiting. Herbal eardrops may help relieve symptoms. Homeopathic treatments may help decrease pain and lead to faster resolution. Prevention should be emphasized with elimination of risk factors, such as second hand smoke and bottle-feeding, as well as maintaining nutrition and vaccinations. Vitamin supplementation may be helpful. Probiotics and xylitol may be beneficial as well. Traditional Chinese/Japanese therapies show promising results but remain

  12. Complementary Medicine Journal of Faculty of Nursing and Midwifery

    OpenAIRE

    Seraji; Vakilian

    2011-01-01

    Introduction: Half of the pregnant women suffer from the excruciating degrees of labor pain. Nowadays, however, the use of painkillers for decreasing labor pain due to their adverse effects on the mother and child is less common and attention has been shifted towards non-medical methods and complementary medicine such as message therapy, acupuncture, hydrotherapy, and herbal medicine. One of the branches of complementary medicine is hydrotherapy with herbal essences. Breathing techniques, on ...

  13. Complementary and alternative medicine for the treatment of multiple sclerosis

    Science.gov (United States)

    Yadav, Vijayshree; Shinto, Lynne; Bourdette, Dennis

    2010-01-01

    Multiple sclerosis (MS) is a chronic disabling disease of the CNS that affects people during early adulthood. Despite several US FDA-approved medications, the treatment options in MS are limited. Many people with MS explore complementary and alternative medicine (CAM) treatments to help control their MS and treat their symptoms. Surveys suggest that up to 70% of people with MS have tried one or more CAM treatment for their MS. People with MS using CAM generally report deriving some benefit from the therapies. The CAM therapies most frequently used include diet, omega-3 fatty acids and antioxidants. There is very limited research evaluating the safety and effectiveness of CAM in MS. The most promising among CAM therapies that warrant further investigation are a low-fat diet, omega-3 fatty acids, lipoic acid and vitamin D supplementation as potential anti-inflammatory and neuroprotective agents in both relapsing and progressive forms of MS. There is very limited research evaluating the safety and effectiveness of CAM in MS. However, in recent years, the NIH and the National MS Society have been actively supporting the research in this very important area. PMID:20441425

  14. Theoretical dosimetric evaluation of carbon and oxygen minibeam radiation therapy.

    Science.gov (United States)

    González, Wilfredo; Peucelle, Cécile; Prezado, Yolanda

    2017-05-01

    Charged particles have several advantages over x-ray radiations, both in terms of physics and radiobiology. The combination of these advantages with those of minibeam radiation therapy (MBRT) could help enhancing the therapeutic index for some cancers with poor prognosis. Among the different ions explored for therapy, carbon ions are considered to provide the optimum physical and biological characteristics. Oxygen could be advantageous due to a reduced oxygen enhancement ratio along with a still moderate biological entrance dose. The aforementioned reasons justified an in-depth evaluation of the dosimetric features of carbon and oxygen minibeam radiation therapy to establish the interest of further explorations of this avenue. The GATE/Geant4 6.2 Monte Carlo simulation platform was employed to simulate arrays of rectangular carbon and oxygen minibeams (600 μm × 2 cm) at a water phantom entrance. They were assumed to be generated by means of a magnetic focusing. The irradiations were performed with a 2-cm-long spread-out Bragg peak (SOBP) centered at 7-cm-depth. Several center-to-center (c-t-c) distances were considered. Peak and valley doses, as well as peak-to-valley dose ratio (PVDR) and the relative contribution of nuclear fragments and electromagnetic processes were assessed. In addition, the type and proportion of the secondary nuclear fragments were evaluated in both peak and valley regions. Carbon and oxygen MBRT lead to very similar dose distributions. No significant advantage of oxygen over carbon ions was observed from physical point of view. Favorable dosimetric features were observed for both ions. Thanks to the reduced lateral scattering, the standard shape of the depth dose curves (in the peaks) is maintained even for submillimetric beam sizes. When a narrow c-t-c is considered (910-980 μm), a (quasi) homogenization of the dose can be obtained at the target, while a spatial fractionation of the dose is maintained in the proximal normal tissues with

  15. Fluorescence guided evaluation of photodynamic therapy as acne treatment

    Science.gov (United States)

    Ericson, Marica B.; Horfelt, Camilla; Cheng, Elaine; Larsson, Frida; Larko, Olle; Wennberg, Ann-Marie

    2005-08-01

    Photodynamic therapy (PDT) is an attractive alternative treatment for patients with acne because of its efficiency and few side effects. Propionibacterium acnes (P.acnes) are bacteria present in the skin, which produce endogenous porphyrins that act as photosensitisers. In addition, application of aminolaevulinic acid or its methyl ester (mALA) results in increased accumulation of porphyrins in the pilosebaceous units. This makes it possible to treat acne with PDT. This initial study investigates the possibility of fluorescence imaging as assessment tool in adjunct to PDT of patients with acne. Twenty-four patients with acne on the cheeks have been treated with PDT with and without mALA. Fluorescence images have been obtained before and after treatment. The clinical acne score was assessed as base line before PDT, and at every follow up visit. Additionally the amount of P.acnes was determined. The clinical evaluation showed a general improvement of acne, even though no difference between treatment with and without mALA was observed. By performing texture analysis and multivariate data analsysis on the fluorescence images, the extracted texture features were found to correlate with the corresponding clinical assessment (67%) and amount of P.acnes (72%). The analysis showed that features describing the highly fluorescent pores could be related to the clinical assessment. This result suggests that fluorescence imaging can be used as an objective assessment of acne, but further improvement of the technique is possible, for example by including colour images.

  16. A retrospective evaluation of term infants treated with surfactant therapy

    Directory of Open Access Journals (Sweden)

    Özge Sürmeli-Onay

    2015-04-01

    Full Text Available Aim: To investigate the clinical and therapeutic characteristics and outcomes of term infants who received surfactant therapy (ST for severe respiratory failure in our neonatal intensive care unit (NICU. Methods: The medical records of term infants (gestational age ≥ 370/7 weeks who received ST between 2003-2012 in NICU of Hacettepe University Ihsan Dogramaci Children’s Hospital were evaluated retrospectively. Results: During ten years period, 32 term infants received ST; the mean gestational age was 38.1 ± 0.88 wk and the mean birth weight was 2,936 ± 665 g. The underlying lung diseases were severe congenital pneumonia (CP in 13 (40.6%, acute respiratory distress syndrome (ARDS in 5 (15.6%, meconium aspiration syndrome (MAS in 5 (15.6%, congenital diaphragmatic hernia (CDH in 4 (12.5%, respiratory distress syndrome in 3 (9.4% and pulmonary hemorrhage in 2 (6.3% infants. The median time of the first dose of ST was 7.75 (0.5-216 hours. Pulmonary hypertension accompanied the primary lung disease in 9 (28.1% infants. Mortality rate was 25%. Conclusion: In term infants, CP, ARDS and MAS were the main causes of respiratory failure requiring ST. However, further prospective studies are needed for defining optimal strategies of ST in term infants with respiratory failure.

  17. Evaluation of energy, protein, and selected micronutrient density of homemade complementary foods consumed by children between 6 months and 23 months in food insecure woredas of Wolayita zone, Southern Ethiopia

    Directory of Open Access Journals (Sweden)

    Abeshu MA

    2016-09-01

    Full Text Available Motuma Adimasu Abeshu,1,2 Abdulaziz Adish,3 Gulelat D Haki,4 Azeb Lelisa,5 Bekesho Geleta6 1John Snow, Inc, 2Addis Ababa University, Center for Food Science and Nutrition, 3Micronutrient Initiative Africa, Addis Ababa, Ethiopia; 4Department of Food Science and Technology, University of Botswana, Gaborone, Botswana; 5Micronutrient Initiative Ethiopia, 6Ethiopian Public Health Institute, Addis Ababa, Ethiopia Abstract: Complementary feeding should be timely, adequate, and given in a way that is appropriate for the age of the child, applying responsive feeding to fill the gap between what is provided by breastfeeding and the total nutritional requirements of the infant. The purpose of this study was to assess nutrient composition and evaluate adequacy of observed nutrient densities (energy, protein, calcium [Ca], iron [Fe], and zinc [Zn] in homemade complementary foods for children of age 6–23 months, in comparison to the desired levels in food insecure woredas of the Wolayita zone, Southern Ethiopia. A cross-sectional weighed food record method was used to assess the energy and micronutrient compositions of homemade complementary foods and evaluate adequacy of observed nutrient densities in relation to the desired levels. Multistage sampling was used to locate the children. Observation and measurement of complementary food preparations throughout the day was made. Representative portions from the diets were sampled for further laboratory analysis and to evaluate adequacy of observed nutrient levels. More than 20 different complementary food types (mostly an extension of family foods prepared from various food items were observed. Dietary diversity of the foods was very poor. The average dietary diversity score was only 2.54, while animal-source foods and vitamin A-rich fruits and vegetables were virtually absent. The energy and protein compositions of the diets, however, were sufficient. Energy density of 0.92 kcal/g, 1.24 kcal/g, and 1.41

  18. Complementary Barrier Infrared Detector

    Science.gov (United States)

    Ting, David Z.; Bandara, Sumith V.; Hill, Cory J.; Gunapala, Sarath D.

    2009-01-01

    The complementary barrier infrared detector (CBIRD) is designed to eliminate the major dark current sources in the superlattice infrared detector. The concept can also be applied to bulk semiconductor- based infrared detectors. CBIRD uses two different types of specially designed barriers: an electron barrier that blocks electrons but not holes, and a hole barrier that blocks holes but not electrons. The CBIRD structure consists of an n-contact, a hole barrier, an absorber, an electron barrier, and a p-contact. The barriers are placed at the contact-absorber junctions where, in a conventional p-i-n detector structure, there normally are depletion regions that produce generation-recombination (GR) dark currents due to Shockley-Read- Hall (SRH) processes. The wider-bandgap complementary barriers suppress G-R dark current. The barriers also block diffusion dark currents generated in the diffusion wings in the neutral regions. In addition, the wider gap barriers serve to reduce tunneling dark currents. In the case of a superlattice-based absorber, the superlattice itself can be designed to suppress dark currents due to Auger processes. At the same time, the barriers actually help to enhance the collection of photo-generated carriers by deflecting the photo-carriers that are diffusing in the wrong direction (i.e., away from collectors) and redirecting them toward the collecting contacts. The contact layers are made from materials with narrower bandgaps than the barriers. This allows good ohmic contacts to be made, resulting in lower contact resistances. Previously, THALES Research and Technology (France) demonstrated detectors with bulk InAsSb (specifically InAs0.91Sb0.09) absorber lattice-matched to GaSb substrates. The absorber is surrounded by two wider bandgap layers designed to minimize impedance to photocurrent flow. The wide bandgap materials also serve as contacts. The cutoff wavelength of the InAsSb absorber is fixed. CBIRD may be considered as a modified

  19. Is complementary and alternative medicine (CAM cost-effective? a systematic review

    Directory of Open Access Journals (Sweden)

    Caspi Opher

    2005-06-01

    Full Text Available Abstract Background Out-of-pocket expenditures of over $34 billion per year in the US are an apparent testament to a widely held belief that complementary and alternative medicine (CAM therapies have benefits that outweigh their costs. However, regardless of public opinion, there is often little more than anecdotal evidence on the health and economic implications of CAM therapies. The objectives of this study are to present an overview of economic evaluation and to expand upon a previous review to examine the current scope and quality of CAM economic evaluations. Methods The data sources used were Medline, AMED, Alt-HealthWatch, and the Complementary and Alternative Medicine Citation Index; January 1999 to October 2004. Papers that reported original data on specific CAM therapies from any form of standard economic analysis were included. Full economic evaluations were subjected to two types of quality review. The first was a 35-item checklist for reporting quality, and the second was a set of four criteria for study quality (randomization, prospective collection of economic data, comparison to usual care, and no blinding. Results A total of 56 economic evaluations (39 full evaluations of CAM were found covering a range of therapies applied to a variety of conditions. The reporting quality of the full evaluations was poor for certain items, but was comparable to the quality found by systematic reviews of economic evaluations in conventional medicine. Regarding study quality, 14 (36% studies were found to meet all four criteria. These exemplary studies indicate CAM therapies that may be considered cost-effective compared to usual care for various conditions: acupuncture for migraine, manual therapy for neck pain, spa therapy for Parkinson's, self-administered stress management for cancer patients undergoing chemotherapy, pre- and post-operative oral nutritional supplementation for lower gastrointestinal tract surgery, biofeedback for patients with

  20. Complementary and conventional providers in cancer care: experience of communication with patients and steps to improve communication with other providers.

    Science.gov (United States)

    Stub, Trine; Quandt, Sara A; Arcury, Thomas A; Sandberg, Joanne C; Kristoffersen, Agnete E

    2017-06-08

    Effective interdisciplinary communication is important to achieve better quality in health care. The aims of this study were to compare conventional and complementary providers' experience of communication about complementary therapies and conventional medicine with their cancer patients, and to investigate how they experience interdisciplinary communication and cooperation. This study analyzed data from a self-administrated questionnaire. A total of 606 different health care providers, from four counties in Norway, completed the questionnaire. The survey was developed to describe aspects of the communication pattern among oncology doctors, nurses, family physicians and complementary therapists (acupuncturists, massage therapists and reflexologists/zone-therapists). Between-group differences were analyzed using chi-square, ANOVA and Fisher's exact tests. Significance level was defined as p cancer patients regarding complementary therapies. While complementary therapists advised their patients to apply both complementary and conventional modalities, medical doctors were less supportive of their patients' use of complementary therapies. Of conventional providers, nurses expressed more positive attitudes toward complementary therapies. Opportunities to improve communication between conventional and complementary providers were most strongly supported by complementary providers and nurses; medical doctors were less supportive of such attempts. A number of doctors showed lack of respect for complementary therapists, but asked for more research, guidelines for complementary modalities and training in conventional medicine for complementary therapists. For better quality of care, greater communication about complementary therapy use is needed between cancer patients and their conventional and complementary providers. In addition, more communication between conventional and complementary providers is needed. Nurses may have a crucial role in facilitating communication, as

  1. Process and Outcome Evaluation of an Art Therapy Program for People Living with HIV/AIDS

    Science.gov (United States)

    Feldman, Matthew B.; Betts, Donna J.; Blausey, Daniel

    2014-01-01

    Program evaluation offers an opportunity for improving the implementation and impact of art therapy. This article describes a process and outcomes evaluation of an art therapy program within the mental health services unit of a community-based organization for people living with HIV/AIDS. The aims were to assess utilization patterns and program…

  2. [Integrating complementary medicines into care].

    Science.gov (United States)

    Graz, Bertrand

    2016-04-01

    More and more research is being carried out into complementary medicines. It is no longer possible to say that these treatments have no scientific basis, as for some, their efficacy has been proven by clinical studies. Health services must move beyond ideological arguments and integrate safe and cost-effective complementary medicines. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. [Evaluation of the animal-assisted therapy in Alzheimer's disease].

    Science.gov (United States)

    Quibel, Clémence; Bonin, Marie; Bonnet, Magalie; Gaimard, Maryse; Mourey, France; Moesch, Isabelle; Ancet, Pierre

    Animal-assisted therapy sessions have been set up in a protected unit for patients with a dementia-related syndrome. The aim is to measure the effects of animal-assisted therapy on behavioural disorders in daily life and care. The results obtained provided some interesting areas to explore and recommendations with a view to optimising the implementation of such a system. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. Complementary safety assessment assessment of nuclear facilities - Tricastin facility - AREVA; Evaluation complementaire de la surete des installations nucleaires de base - Site du Tricastin - AREVA

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This complementary safety assessment analyses the robustness of the Areva part of the Tricastin nuclear site to extreme situations such as those that led to the Fukushima accident. This study includes the following facilities: Areva NC Pierrelatte, EURODIF production, Comurhex Pierrelatte, Georges Besse II plant and Socatri. Robustness is the ability for the plant to withstand events beyond which the plant was designed. Robustness is linked to safety margins but also to the situations leading to a sudden deterioration of the accidental sequence. Moreover, safety is not only a matter of design or engineered systems but also a matter of organizing: task organization (including subcontracting) as well as the setting of emergency plans or the inventory of nuclear materials are taken into consideration in this assessment. This report is divided into 10 main chapters: 1) the feedback experience of the Fukushima accident; 2) description of the site and its surroundings; 3) featuring of the site's activities and installations; 4) accidental sequences; 5) protection from earthquakes; 6) protection from floods; 7) protection from other extreme natural disasters; 8) the loss of electrical power and of the heat sink; 9) the management of severe accidents; and 10) subcontracting policy. This analysis has identified 5 main measures to be taken to limit the risks linked to natural disasters: -) continuing the program for replacing the current conversion plant and the enrichment plant; -) renewing the storage of hydrofluoric acid at the de-fluorination workshop; -) assessing the seismic behaviour of some parts of the de-fluorination workshop and of the fluorine fabrication workshop; -) improving the availability of warning and information means in case of emergency; and -) improving the means to mitigate accidental gaseous releases. (A.C.)

  5. Pharmacoeconomic evaluation of the costs incurred by the ASP Messina for home therapy with liquid oxygen

    Directory of Open Access Journals (Sweden)

    Salvatore Coppolino

    2010-03-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a very frequent disease in all industrialized countries. The cost for the community includes cost for hospitalisations, doctor visits, home care, rehabilitation, loss of working days, etc. From a therapeutical point of view, an effective progression of therapy and patients survival can be obtained only by stopping smoking and by following a long term oxygen therapy. The aim of this retrospective study is to evaluate costs of liquid oxygen therapy performed at home. Obtained results are very encouraging because a part from being cheap they also provide a better evaluation of the prescribed therapy which can also be extended to gaseous oxygen.

  6. Evaluating interest in narrative therapy for decision making about pectus excavatum treatment

    DEFF Research Database (Denmark)

    Ticchi, Davide; Eisinger, Robert S; Pilegaard, Hans K

    2018-01-01

    was to assess whether PE patients would be interested in formal assistance with the decision-making process surrounding PE surgery using narrative therapy principles. METHODS: Ninety-seven untreated PE patients at 5 different institutions in 4 countries completed a questionnaire consisting of 13 questions......, with 3 questions specifically evaluating interest in narrative therapy. RESULTS: Eighty-two percent of participants were interested in narrative therapy to assist with the decision-making process surrounding PE surgery. Individuals most interested in narrative therapy tend to be more interested...... in correction (P narrative therapy to aid the decision-making process about treatment. We propose that narrative therapy should be offered to PE patients during the treatment evaluation...

  7. Complementary approaches for the evaluation of biocompatibility of (90)Y-labeled superparamagnetic citric acid (Fe,Er)3O4 coated nanoparticles.

    Science.gov (United States)

    Antic, Bratislav; Boskovic, Marko; Nikodinovic-Runic, Jasmina; Ming, Yue; Zhang, Hongguo; Bozin, Emil S; Janković, Drina; Spasojevic, Vojislav; Vranjes-Djuric, Sanja

    2017-06-01

    Magnetic nanoparticles (MNPs) are of immense interest for diagnostic and therapeutic applications in medicine. Design and development of new iron oxide-based MNPs for such applications is of rather limited breadth without reliable and sensitive methods to determine their levels in body tissues. Commonly used methods, such as ICP, are quite problematic, due to the inability to decipher the origin of the detected iron, i.e. whether it originates from the MNPs or endogenous from tissues and bodily fluids. One of the approaches to overcome this problem and to increase reliability of tracing MNPs is to partially substitute iron ions in the MNPs with Er. Here, we report on the development of citric acid coated (Fe,Er)3O4 nanoparticles and characterization of their physico-chemical and biological properties by utilization of various complementary approaches. The synthesized MNPs had a narrow (6-7nm) size distribution, as consistently seen in atomic pair distribution function, transmission electron microscopy, and DC magnetization measurements. The particles were found to be superparamagnetic, with a pronounced maximum in measured zero-field cooled magnetization at around 90K. Reduction in saturation magnetization due to incorporation of 1.7% Er(3+) into the Fe3O4 matrix was clearly observed. From the biological standpoint, citric acid coated (Fe,Er)3O4 NPs were found to induce low toxicity both in human cell fibroblasts and in zebrafish (Danio rerio) embryos. Biodistribution pattern of the MNPs after intravenous administration in healthy Wistar rats was followed by the radiotracer method, revealing that (90)Y-labeled MNPs were predominantly found in liver (75.33% ID), followed by lungs (16.70% ID) and spleen (2.83% ID). Quantitative agreement with these observations was obtained by ICP-MS elemental analysis using Er as the detected tracer. Based on the favorable physical, chemical and biological characteristics, citric acid coated (Fe,Er)3O4 MNPs could be further

  8. Family strategies for managing childhood cancer: using complementary and alternative medicine in Jordan.

    Science.gov (United States)

    Al-Qudimat, Mohammad R; Rozmus, Cathy L; Farhan, Nemah

    2011-03-01

    This paper is a report of a study that examined the use of complementary and alternative medicine therapies among children with cancer in Jordan. Complementary and alternative medicine use by oncology patients has been gaining acceptance in the developed countries and developing countries. Healthcare professionals are becoming increasingly aware that patients use complementary and alternative medicine either covertly or overtly. A descriptive cross-sectional design was used with parents of children with cancer under treatment and follow-up in a paediatric oncology department in Jordan between August 2007 and April 2008. Parents of 69 children with cancer in Jordan were surveyed for their use of complementary and alternative medicine with their children. A total of 65.2% of the sample had used at least one type of complementary and alternative medicine during the course of their child's treatment. The use of biological and nutritional complementary and alternative medicine was 70.5% among the users. Use of body and soul complementary and alternative medicine strategies was reported for 22.2% of the children using complementary and alternative medicine. Twenty per cent of the sample used body movement complementary and alternative medicine for their children. A total of 45.5% of complementary and alternative medicine users perceived benefits in using complementary and alternative medicine for their children with cancer. However, 40% of complementary and alternative medicine users had stopped using complementary and alternative medicine for multiple reasons. Parents used complementary and alternative medicine to support their children's medical treatment and to use all possible methods to cure their children. The reason for parents not using complementary and alternative medicine included not being aware of complementary and alternative medicine. Most of the patients have not discussed the issue of using complementary and alternative medicine with the medical staff.

  9. Intricate Assessment and Evaluation of Dental Implants in Patients on Bisphosphonate Therapy: A Retrospective Analysis.

    Science.gov (United States)

    Suvarna, Suraj; Dutt, Poonam; Misra, Animesh; Usmani, Nausheen; Singh, Abhishek; Suvarna, Chandini

    2016-05-01

    Osteonecrosis is one of the prevalent side effects of bisphosphonate (BP) therapy in oral cancer patients. In case of patients with various oncologic lesions, standard guidelines contraindicate the use of dental implants if the patients are on BP therapy. Literature also quotes studies that emphasize on the safety of dental implants in patients on BP therapy. Hence, this study aimed to retrospectively evaluate the clinical outcome of dental implants in patients on BP therapy. In this retrospective analysis, a total of 140 dental implants in 112 patients were included. Inclusion criteria included only those patients who were on or had history of BP therapy. Calculation of implant failure and survival rate was done. Ten cases of implant failure occurred, giving a success rate of above 92%, which was comparable to the results found in previous studies in patients who were not on BP therapy. No significant risk of implant failure is seen in patients on BP therapy compared with other patients.

  10. Food allergy and complementary feeding.

    Science.gov (United States)

    Shreffler, Wayne G; Radano, Marcella

    2011-01-01

    The relationship between complementary feeding and the development of atopic disease is the source of significant interest and debate in both the scientific and lay communities. A small number of early studies, which had considerable influence on recommended feeding practices, reported protective effects associated with delaying the introduction of commonly allergenic foods such as cow's milk, egg, and nuts. Despite more conservative recommendations, however, food allergy prevalence has continued to rise. Our understanding of the development of food allergy, its relationship with IgE sensitization and atopic dermatitis, and the relationship of each of these outcomes with the timing of food introduction has evolved considerably. Based on multiple observational studies, and extrapolating from immunotherapy trials and animal models of mucosal immunity, there is mounting evidence that delayed introduction or avoidance of commonly allergenic foods is at best neutral and may be detrimental with regard to atopic outcomes. There is an obvious and critical need for additional high-caliber studies to further evaluate this connection. In the meantime, multiple health considerations, not allergy alone, should be involved in decisions regarding nutritional intake, including common allergenic foods, during the period of transition to the family diet. Copyright © 2011 S. Karger AG, Basel.

  11. Complementary and alternative medicine (CAM) in prostate and bladder cancer.

    Science.gov (United States)

    Philippou, Yiannis; Hadjipavlou, Marios; Khan, Shahid; Rane, Abhay

    2013-12-01

    To provide an overview of the scientific and clinical studies underlying the most common vitamin and herbal preparations used in prostate and bladder cancer and evaluate the evidence behind them. A literature search was undertaken on PubMed using various keywords relating to the use of complementary and alternative medicine (CAM) in prostate and bladder cancer.Vitamin E and selenium supplementation can potentially have adverse effects by increasing the risk of prostate cancer. Initial clinical studies of pomegranate and green tea, investigating their chemotherapeutic properties in prostate and bladder cancer have yielded encouraging results. Curcumin, resveratrol, and silibinin have potential anticancer properties through multiple molecular targets; their clinical effectiveness in prostate and bladder cancer is yet to be evaluated. Zyflamend, like PC-SPES, is a combined CAM therapy used in prostate cancer. Acupuncture is popular among patients experiencing hot flushes who are receiving androgen-deprivation therapy for prostate cancer. Conclusive evidence for the use of CAM in prostate and bladder cancer is lacking and not without risk.

  12. A Note on Complementary Medicines

    Science.gov (United States)

    ... turn Javascript on. Photo: iStock Herbal supplements, meditation, chiropractic manipulation, and acupuncture are types of complementary and ... useful to include acupuncture along with standard care. Chiropractic provides some benefit for low back pain, however ...

  13. Fibromyalgia and Complementary Health Approaches

    Science.gov (United States)

    ... R S T U V W X Y Z Fibromyalgia: In Depth Share: On This Page What’s the ... about the effectiveness of complementary health approaches for fibromyalgia? Although some studies of tai chi , yoga , mindfulness ...

  14. Emerging issues in complementary feeding

    DEFF Research Database (Denmark)

    Michaelsen, Kim F.; Grummer-Strawn, Laurence; Bégin, France

    2017-01-01

    The complementary feeding period (6-24 months) is a window of opportunity for preventing stunting, wasting, overweight, and obesity and for improving long-term development and health. Because WHO published its guiding principles for complementary feeding in 2003, new knowledge and evidence have...... addressed these issues. There are several emerging research areas that are likely to provide a better understanding of how complementary feeding influences growth, development, and health. These include the effect of the young child's diet on body composition, gastrointestinal microbiota, and environmental...... enteric dysfunction. However, at present, findings from these research areas are not likely to influence guidelines. Several emerging issues will be relevant to address when complementary feeding guidelines will be updated. With the increasing prevalence of obesity globally, it is important...

  15. Complementary and Alternative Medicine for Chronic Prostatitis/Chronic Pelvic Pain Syndrome

    Directory of Open Access Journals (Sweden)

    Jillian L. Capodice

    2005-01-01

    Full Text Available To discuss challenges concerning treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS and review complementary and alternative medical (CAM therapies being evaluated for this condition, we performed a comprehensive search of articles published from 1990–2005 using the PubMed, Medline databases. Data from the articles were abstracted and pooled by subject. Keywords cross-searched with CP/CPPS included: complementary, alternative, integrative, therapies, interventions, nutrition, antioxidants, herbs, supplements, biofeedback and acupuncture. Listed articles with no abstracts were not included. Various CAM therapies for CP/CPPS exist including biofeedback, acupuncture, hyperthermia and electrostimulation. Additionally, a variety of in vitro and in vivo studies testing herbal and nutritional supplements were found. Saw palmetto, cernilton and quercetin were the most frequently tested supplements for CP/CPP Although many CAM therapies demonstrate positive preliminary observations as prospective treatments for CP/CPPS, further exploratory studies including more randomized, controlled trials are necessary for significant validation as treatment options for this complex disorder.

  16. Evaluation of the effect of cognitive therapy on perioperative anxiety ...

    African Journals Online (AJOL)

    Study Objective: Surgical paients have been known to benefit immensely from psychological interventions. This study set out to assess the pre and postoperative anxiety levels and depression and the effect of cognitive therapy among Nigerian surgical patients. The effects of gender and educational status on perioperative ...

  17. EVALUATION OF MEVLANA'S THOUGHTS IN THE CONTEXT OF COGNITIVE THERAPY

    Directory of Open Access Journals (Sweden)

    MEHMET AK

    2017-08-01

    Full Text Available In the works of Mevlana (Rumi, the social, religious and philosophical dimensions of human life were examined and the psychological aspects as well. The cognitive behavioral therapies are among the most commonly usedtherapy methods and also the most studied ones in the literature. According to the this model, the person can distorte the objective state by the present cognitive substructure. As a result of these distortions, the automatic thinkings arises which lead to the emergence of a number of dysfunctional emotions and often behaviors associated with these emotions. Spontaneously occured automatic thoughts, related to problematic behaviors or disturbing emotions are accepted without any hesitations are existed at the top of the mind. In the cognitive therapy, it is suggested that the focus of the therapy should be the individual's thoughts and beliefs, because some individuals may have the potential to destroy-reduce other¸s experiences with their ability to influence them with their own experiences. Mevlana's books emphasized that the relationship between thoughts and feelings, and also included a lotsof recommendations that suggest awareness and cognitive changes to get rid of various mental problems. In this rewiev, the aim was to examine the Mevlana's approach to thought in the context of cognitive therapy. The main books of Mevlana; Mesnevi, Fihi-Ma-Fih and Divan-ý Kebir were examined and discussed in the sections related to thought. [JCBPR 2017; 6(2.000: 82-87

  18. Evaluation of Group Cognitive Behavioral Therapy for Adults with ADHD

    Science.gov (United States)

    Bramham, Jessica; Young, Susan; Bickerdike, Alison; Spain, Deborah; McCartan, Denise; Xenitidis, Kiriakos

    2009-01-01

    Objective: A brief cognitive behavioral therapy (CBT) group intervention was designed to treat comorbid anxiety, depression, and low self-esteem and self-efficacy in adults with ADHD. It was hypothesised that participants would gain knowledge about ADHD, experience a reduction in comorbid symptoms, and benefit from the supportive aspect of group…

  19. Evaluation of drug therapy problems among renal patients receiving ...

    African Journals Online (AJOL)

    Purpose: To determine the prevalence of drug therapy problems (DTPs), identify the types of DTPs and assess outcomes of DTP interventions among renal patients receiving care in three Nigerian tertiary hospitals. Methods: This prospective descriptive study was conducted in nephrology units of three tertiary hospitals in ...

  20. Clinical evaluation of correction of pathologic migration with periodontal therapy.

    Science.gov (United States)

    Rohatgi, Sumidha; Narula, Satish Chander; Sharma, Rajinder Kumar; Tewari, Shikha; Bansal, Pankaj

    2011-01-01

    there is a paucity of clinical evidence regarding the amount and frequency of repositioning of pathologically migrated teeth after conventional periodontal treatment. The present study was carried out to find and relate these two parameters of periodontal success with severity of migration. a total of 45 subjects with a history of recently formed diastema or noticeable increase in already existing diastema were selected. Twenty-nine patients with 76 diastema sites participated in the study (16 patients were lost to follow-up). Repositioning was assessed by measuring the sites on study models obtained at baseline, reevaluation at 6 weeks after nonsurgical periodontal therapy, and 4 months after surgery. after nonsurgical therapy, 65.78% of sites demonstrated some degree of repositioning, while 7.89% closed completely. Four months after surgical treatment, 32.30% of sites showed complete repositioning and 47.69% of sites showed an additional partial repositioning. This corresponds to a 79.99% rate of positive responses to therapy. When sites measuring ⋜ 1 mm were considered, 65.38% showed complete closure and 96.15% demonstrated positive response to therapy. the findings suggest that there is an inverse relationship between the severity of migration and amount (as well as frequency) of repositioning. The results emphasize the importance of early diagnosis in the successful treatment of pathologic migration to prevent more complex and time-consuming orthodontic and prosthodontic procedures.

  1. Avatar-Based Therapy within Prison Settings: Pilot Evaluation

    Science.gov (United States)

    van Rijn, Biljana; Cooper, Mick; Jackson, Andrew; Wild, Ciara

    2017-01-01

    The paper presents an introduction of a newly developed, avatar-based virtual reality therapy, as an addition to the therapeutic programme, within a therapeutic community prison in the UK. The participants had six group sessions facilitated by a counsellor. The aim of the project was to investigate whether this approach would improve mental health…

  2. Evaluating Animal-Assisted Therapy in Group Treatment for Child Sexual Abuse

    Science.gov (United States)

    Dietz, Tracy J.; Davis, Diana; Pennings, Jacquelyn

    2012-01-01

    This study evaluates and compares the effectiveness of three group interventions on trauma symptoms for children who have been sexually abused. All of the groups followed the same treatment protocol, with two of them incorporating variations of animal-assisted therapy. A total of 153 children ages 7 to 17 who were in group therapy at a Child…

  3. Evaluation of fusidic acid in therapy of experimental Staphylococcus aureus meningitis

    DEFF Research Database (Denmark)

    Østergaard, Christian; Yieng-Kow, Runa Vavia; Knudsen, Jenny Dahl

    2003-01-01

    Combination therapy that includes fusidic acid, an antimicrobial agent highly active against staphylococci, has been recommended in the treatment of patients with Staphylococcus aureus meningitis. The aim of this study was to evaluate the pharmacokinetic, CSF bactericidal and anti...

  4. Occupational therapy evaluation: use of self-report and/or observation?

    DEFF Research Database (Denmark)

    Nielsen, Kristina Tomra; Wæhrens, Eva Elisabet Ejlersen

    2015-01-01

    BACKGROUND: The Occupational Therapy Intervention Process Model (OTIPM) serves to guide occupational therapists in their professional reasoning. The OTIPM prescribes evaluation of task performance based on both self-report and observation. Although this approach seems ideal, many clinicians raise...

  5. Evaluation and diagnosis in cognitive-behavioral therapy

    Directory of Open Access Journals (Sweden)

    Cristiane Figueiredo Araújo

    2002-06-01

    Full Text Available One of the main characteristics of cognitive-behavior therapy is that it is based on a specific clinical formulation of the case. This means that the therapist, using interviews and inventories, in a particular way, needs to understand and integrate the history of his/her client and his/her current problems. Clinical strategies can be then tailored to deal with the client’s difficulties. The establishment of adequate and warm interpersonal and therapeutical relationship depends greatly on this empathic and accurate understanding of the client’s problems. The present article intends to present this approach to case formulation based on a cognitive behavior perspective. It also includes a brief review of theoretic-clinical aspects, assessment tools and suggested procedures. The conclusion is that an adequate  formulation is essential to success in psychotherapy. Keywords: cognitive-behavior therapy; case formulation; psychodiagnosis.

  6. Therapy Videotape Presentation for Eating Disorder Clients: Development and Evaluation

    OpenAIRE

    Quakenbush, Benita J.

    1998-01-01

    Eating disorder clients show low motivation, poor follow-through, and inordinate premature dropout rates in treatment. Earlier studies support the use of pretherapy training to help clients understand the tasks and challenges of therapy. However, a pretherapy intervention, such as showing prospective clients a video that outlines recovery issues and themes, had not yet been developed specifically for the prevalent, recalcitrant problem of eating disorders. Thus, of particular interest to clin...

  7. drug use evaluation on cotrimoxazole preventive therapy for people

    African Journals Online (AJOL)

    user

    BACKGROUND: Drug use evaluation is a performance improvement method that focuses on evaluation and improvement of drug use ... KEY WORDS: drug use evaluation, cotrimoxazole, HIV/AIDS, Jimma, Ethiopia. INTRODUCTION .... female was pregnant but the pregnancy history of 11. (35.5%) females was not ...

  8. Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials.

    Science.gov (United States)

    Kronenberg, Fredi; Fugh-Berman, Adriane

    2002-11-19

    Women commonly use soy products, herbs, and other complementary and alternative medicine (CAM) therapies for menopausal symptoms. Randomized, controlled trials have evaluated the efficacy and short-term safety of these therapies. To review randomized, controlled trials of CAM therapies for menopausal symptoms in order to better inform practice and guide future research. Searches of MEDLINE for articles published from January 1966 through March 2002, of the Alternative and Complementary Database (AMED) of the British Library for articles published from January 1985 through December 2000, and of the authors' own extensive files. Search terms were hot flash/flush, menopause, and climacteric, combined with phytoestrogens, alternative medicine, herbal medicine, traditional medicine, Traditional Chinese Medicine (TCM ), Ayurveda, naturopathy, chiropractic, osteopathy, massage, yoga, relaxation therapy, homeopathy, aromatherapy, and therapeutic touch. 29 randomized, controlled clinical trials of CAM therapies for hot flashes and other menopausal symptoms were identified; of these, 12 dealt with soy or soy extracts, 10 with herbs, and 7 with other CAM therapies. Each author extracted information from half of the studies on the number of patients, study design, outcome measures, and results; the other author then checked these results. Soy seems to have modest benefit for hot flashes, but studies are not conclusive. Isoflavone preparations seem to be less effective than soy foods. Black cohosh may be effective for menopausal symptoms, especially hot flashes, but the lack of adequate long-term safety data (mainly on estrogenic stimulation of the breast or endometrium) precludes recommending long-term use. Single clinical trials have found that dong quai, evening primrose oil, a Chinese herb mixture, vitamin E, and acupuncture do not affect hot flashes; two trials have shown that red clover has no benefit for treating hot flashes. Black cohosh and foods that contain

  9. Evaluating the Efficacy of ERG-Targeted Therapy in Vivo for Prostate Tumors

    Science.gov (United States)

    2015-04-01

    therapeutic attack and prevention through diet and nutrition . Semin Cancer Biol (2015). In press. PMID: 25869442. 3. Invited Articles (Since the...Award Number: W81XWH-11-1-0272 TITLE: Evaluating the Efficacy of ERG-Targeted Therapy in Vivo for Prostate Tumors PRINCIPAL INVESTIGATOR...TITLE AND SUBTITLE Evaluating the Efficacy of ERG-Targeted Therapy in Vivo for Prostate Tumors 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-11-1-0272 5c

  10. Textbook Evaluation for the Students of Speech Therapy

    Directory of Open Access Journals (Sweden)

    Tahereh Jamshidi

    2013-07-01

    Full Text Available This study aimed to evaluate an ESP textbook in terms of McDonough and Shaw (2003 based on external and internal evaluation. The ESP textbook was Special English for Computer Sciences (2010 by Hojjat Baghban. This study also discussed the external evaluation and a detailed evaluation of a chapter of the ESP textbook. This ESP textbook was designed for teaching to students of computer sciences in the department of computer sciences in  Islamic Azad University, Larestan Iran. This evaluation revealed that the ESP textbook would be appropriate with some modifications and also with some additional materials to meet the needs of the students of computer sciences.

  11. Use of complementary and alternative medicine (CAM) by Washington State hospices.

    Science.gov (United States)

    Kozak, Leila E; Kayes, Lucy; McCarty, Rachelle; Walkinshaw, Catharine; Congdon, Sean; Kleinberger, Janis; Hartman, Valerie; Standish, Leanna J

    To assess the use of complementary and alternative medicine in hospice care in the state of Washington. Hospices offering inpatient and outpatient care in Washington State were surveyed by phone interview. Response rate was 100%. Results indicated that 86% of Washington State hospices offered complementary and alternative services to their patients, most frequently massage (87%), music therapy (74%), energy healing (65%), aromatherapy (45%), guided imagery (45%), compassionate touch (42%), acupuncture (32%), pet therapy (32%), meditation (29%), art therapy (22%), reflexology (19%), and hypnotherapy (16%). Most hospices relied on volunteers with or without small donations to offer such services. Complementary and alternative therapies are widely used by Washington State hospices but not covered under hospice benefits. Extensive use of these therapies seems to warrant the inclusion of complementary and alternative providers as part of hospice staff, and reimbursement schedules need to be integrated into hospice care.

  12. Technology evaluation: HIV ribozyme gene therapy, Gene Shears Pty Ltd.

    Science.gov (United States)

    de Feyter, R; Li, P

    2000-06-01

    Ribozymes (catalytic RNAs) can be made to specifically cleave target RNAs that are involved in disease conditions and therefore have potential as therapeutic agents. Gene Shears Pty Ltd is developing hammerhead ribozyme technology for therapy against HIV infection, targeting either the tat gene or the RNA packaging sequence (Psi) of HIV. These ribozymes have been expressed from constructs that were introduced into hematopoietic cells in culture, thereby protecting the cells against viral infection. Two phase I clinical trials are underway to test the safety and feasibility of the approach with the anti-tat ribozyme in human subjects.

  13. Complementary and alternative medicine on wikipedia: opportunities for improvement.

    Science.gov (United States)

    Koo, Malcolm

    2014-01-01

    Wikipedia, a free and collaborative Internet encyclopedia, has become one of the most popular sources of free information on the Internet. However, there have been concerns over the quality of online health information, particularly that on complementary and alternative medicine (CAM). This exploratory study aimed to evaluate several page attributes of articles on CAM in the English Wikipedia. A total of 97 articles were analyzed and compared with eight articles of broad categories of therapies in conventional medicine using the Mann-Whitney U test. Based on the Wikipedia editorial assessment grading, 4% of the articles attained "good article" status, 34% required considerable editing, and 56% needed substantial improvements in their content. The median daily access of the articles over the previous 90 days was 372 (range: 7-4,214). The median word count was 1840 with a readability of grade 12.7 (range: 9.4-17.7). Medians of word count and citation density of the CAM articles were significantly lower than those in the articles of conventional medicine therapies. In conclusion, despite its limitations, the general public will continue to access health information on Wikipedia. There are opportunities for health professionals to contribute their knowledge and to improve the accuracy and completeness of the CAM articles on Wikipedia.

  14. Complementary and Alternative Medicine on Wikipedia: Opportunities for Improvement

    Directory of Open Access Journals (Sweden)

    Malcolm Koo

    2014-01-01

    Full Text Available Wikipedia, a free and collaborative Internet encyclopedia, has become one of the most popular sources of free information on the Internet. However, there have been concerns over the quality of online health information, particularly that on complementary and alternative medicine (CAM. This exploratory study aimed to evaluate several page attributes of articles on CAM in the English Wikipedia. A total of 97 articles were analyzed and compared with eight articles of broad categories of therapies in conventional medicine using the Mann-Whitney U test. Based on the Wikipedia editorial assessment grading, 4% of the articles attained “good article” status, 34% required considerable editing, and 56% needed substantial improvements in their content. The median daily access of the articles over the previous 90 days was 372 (range: 7–4,214. The median word count was 1840 with a readability of grade 12.7 (range: 9.4–17.7. Medians of word count and citation density of the CAM articles were significantly lower than those in the articles of conventional medicine therapies. In conclusion, despite its limitations, the general public will continue to access health information on Wikipedia. There are opportunities for health professionals to contribute their knowledge and to improve the accuracy and completeness of the CAM articles on Wikipedia.

  15. Acupuncture as a complementary treatment for cancer patients receiving chemotherapy.

    Science.gov (United States)

    Tas, Demet; Uncu, Dogan; Sendur, Mehmet Ali; Koca, Nuran; Zengin, Nurullah

    2014-01-01

    Medical treatment for eliminating the side effects of cancer therapy may not always be efficacious. Acupuncture is one of the most widely accepted alternative and complementary therapies in use today. In this study, we investigated the efficacy of acupuncture in patients experiencing cancer treatment side effects, including nausea, vomiting, pain, poor sleep quality and anxiety. A total of 45 inpatients who underwent chemotherapy between February and April 2013 in the Oncology Department of Numune Hospital were included in our study. Acupuncture was administered to the patients one day prior to chemotherapy, on the day of chemotherapy and one day after chemotherapy. The patients were evaluated on nausea, vomiting, pain, sleep quality and anxiety before the chemotherapy and on the 4th day of chemotherapy. Of the 45 patients included in the study, 18 (40%) were female and 27 (60%) were male. A total of 25 (55.6%) had an elementary school education; 32 patients (71%) had stage 4 cancer and were treated with palliative chemotherapy (the patient characteristics are shown in Table 1). Statistically significant decreases (panxiety scores were observed after the acupuncture treatment compared to baseline. There were no differences in the age, gender, education level, stage or metastasis levels between the patient groups whose symptoms improved or were unchanged. Our study showed that acupuncture has positive effects in cancer treatment patients who experience nausea, vomiting, pain, poor sleep quality and anxiety as side effects of chemotherapy. Chemotherapy-related side effects in cancer patients could be decreased by the concurrent use of acupuncture.

  16. [Alternative and complementary medicine from the primary care physician's viewpoint].

    Science.gov (United States)

    Soós, Sándor Árpád; Eőry, Ajándék; Eőry, Ajándok; Harsányi, László; Kalabay, László

    2015-07-12

    The patients initiate the use of complementary and alternative medicine and this often remains hidden from their primary care physician. To explore general practitioners' knowledge and attitude towards complementary and alternative medicine, and study the need and appropriate forms of education, as well as ask their opinion on integration of alternative medicine into mainstream medicine. A voluntary anonymous questionnaire was used on two conferences for general practitioners organized by the Family Medicine Department of Semmelweis University. Complementary and alternative medicine was defined by the definition of the Hungarian Academy of Sciences and certified modalities were all listed. 194 general practitioners answered the questionnaire (39.8% response rate). 14% of the responders had licence in at least one of the complementary and alternative therapies, 45% used complementary and alternative therapy in their family in case of illness. It was the opinion of the majority (91.8%) that it was necessary to be familiar with every method used by their patients, however, 82.5% claimed not to have enough knowledge in complementary medicine. Graduate and postgraduate education in the field was thought to be necessary by 86% of the responders; increased odds for commitment in personal education was found among female general practitioners, less than 20 years professional experience and personal experience of alternative medicine. These data suggest that general practitioners would like to know more about complementary and alternative medicine modalities used by their patients. They consider education of medical professionals necessary and a special group is willing to undergo further education in the field.

  17. Interest of the PET with {sup 18}F-F.D.G. in the early evaluation of the therapy response to the Hodgkin lymphoma; Interet de la TEP au 18F-FDG dans l'evaluation precoce de la reponse therapeutique du lymphome de Hodgkin

    Energy Technology Data Exchange (ETDEWEB)

    Edera, V.; Boursot, C.; Baulieu, F.; Baulieu, J.L. [Service de medecine nucleaire, CHU de Tours, (France); Senecal, D.; Colombat, P. [service d' hematologie et therapie cellulaire, CHU de Tours, (France)

    2009-05-15

    This retrospective study included 38 consecutive patients having received of an initial and reevaluation PET with {sup 18}F-F.D.G. after two treatments of chemotherapy with a backward step of follow-up of, at least, eighteen months. In conclusion, the evaluation of the early therapy response by the PET with {sup 18}F-F.D.G. to two treatments is complementary of the Goelams prognosis score to evaluate the final prognosis and manage the treatment. Prospective data must confirm these results. (N.C.)

  18. [Acute bronchiolitis: evaluation of evidence-based therapy].

    Science.gov (United States)

    Martinón-Torres, F; Rodríguez Núñez, A; Martinón Sánchez, J M

    2001-10-01

    Bronchiolitis is the leading cause of lower respiratory tract infection in infants and produces significant morbidity. Limited progress has been made in the treatment of this disease and, in many cases, the therapy employed is controversial and mainly based on general recommendations and not on evidence-based strategies. This report uses evidence-based methodology to provide a critical review of the data available on the treatment of acute bronchiolitis (understood as the first episode of respiratory syncytial virus bronchiolitis in a previously healthy infant). After this analysis, we conclude that the only justifiable therapeutic interventions in these patients are supportive treatment, nebulized epinephrine and mechanical ventilation. Other therapies such us physiotherapy, nebulization, heliox, anticholinergics or exogenous surfactant, among others, require further randomized controlled trials to determine their utility. No evidence supports the routine use of corticosteroids, beta-adrenergic drugs, antibiotics, immunoglobulins, interferon, vitamin A or ribavirin in these patients. Finally, we consider that a national consensus review for the implementation of evidence-based clinical practical guidelines on the management of acute bronchiolitis would be of great interest.

  19. Lipidomic Evaluation of Feline Neurologic Disease after AAV Gene Therapy

    Directory of Open Access Journals (Sweden)

    Heather L. Gray-Edwards

    2017-09-01

    Full Text Available GM1 gangliosidosis is a fatal lysosomal disorder, for which there is no effective treatment. Adeno-associated virus (AAV gene therapy in GM1 cats has resulted in a greater than 6-fold increase in lifespan, with many cats remaining alive at >5.7 years of age, with minimal clinical signs. Glycolipids are the principal storage product in GM1 gangliosidosis whose pathogenic mechanism is not completely understood. Targeted lipidomics analysis was performed to better define disease mechanisms and identify markers of disease progression for upcoming clinical trials in humans. 36 sphingolipids and subspecies associated with ganglioside biosynthesis were tested in the cerebrospinal fluid of untreated GM1 cats at a humane endpoint (∼8 months, AAV-treated GM1 cats (∼5 years old, and normal adult controls. In untreated GM1 cats, significant alterations were noted in 16 sphingolipid species, including gangliosides (GM1 and GM3, lactosylceramides, ceramides, sphingomyelins, monohexosylceramides, and sulfatides. Variable degrees of correction in many lipid metabolites reflected the efficacy of AAV gene therapy. Sphingolipid levels were highly predictive of neurologic disease progression, with 11 metabolites having a coefficient of determination (R2 > 0.75. Also, a specific detergent additive significantly increased the recovery of certain lipid species in cerebrospinal fluid samples. This report demonstrates the methodology and utility of targeted lipidomics to examine the pathophysiology of lipid storage disorders.

  20. [Evaluation of the benefit of different complementary exams in the search for a TB diagnosis algorithm for HIV patients put on ART in Niamey, Niger].

    Science.gov (United States)

    Ouedraogo, E; Lurton, G; Mohamadou, S; Dillé, I; Diallo, I; Mamadou, S; Adehossi, E; Hanki, Y; Tchousso, O; Arzika, M; Gazeré, O; Amadou, F; Illo, N; Abdourahmane, Y; Idé, M; Alhousseini, Z; Lamontagne, F; Deze, C; D'Ortenzio, E; Diallo, S

    2016-12-01

    In Niger, the tuberculosis (TB) screening among people living with human immunodeficiency virus (HIV) (PLHIV) is nonsystematic and the use of additional tests is very often limited. The objective of this research is to evaluate the performance and the cost-effectiveness of various paraclinical testing strategies of TB among adult patients with HIV, using available tests in routine for patients cared in Niamey. This is a multicentric prospective intervention study performed in Niamey between 2010 and 2013. TB screening has been sought in newly diagnosed PLHIV, before ART treatment, performing consistently: a sputum examination by MZN (Ziehl-Nielsen staining) and microscopy fluorescence (MIF), chest radiography (CR), and abdominal ultrasound. The performance of these different tests was calculated using sputum culture as a gold standard. The various examinations were then combined in different algorithms. The cost-effectiveness of different algorithms was assessed by calculating the money needed to prevent a patient, put on ART, dying of TB. Between November 2010 and November 2012, 509 PLHIV were included. TB was diagnosed in 78 patients (15.3%), including 35 pulmonary forms, 24 ganglion, and 19 multifocal. The sensitivity of the evaluated algorithms varied between 0.35 and 0.85. The specificity ranged from 0.85 to 0.97. The most costeffective algorithm was the one involving MIF and CR. We recommend implementing a systematic and free direct examination of sputum by MIF and a CR for the detection of TB among newly diagnosed PLHIV in Niger.

  1. THE EVALUATION OF COMPLIANCE TO ANTIHYPERTENSIVE THERAPY IN PATIENTS AFTER STROKE AND POSTSTROKE DEPRESSION DURING ANTIDEPRESSANT THERAPY

    Directory of Open Access Journals (Sweden)

    B. B. Fishman

    2010-01-01

    Full Text Available Aim. To study the effect of the antidepressant paroxetine on the compliance to antihypertensive therapy in patients with arterial hypertension (HT and post-stroke depression.Material and methods. Patients (n=24 aged 55-73 with controlled HT (blood pressure, BP<140/90 mm Hg and with subclinical poststroke depression after rehabilitation course were included into the study. Patients were split into two groups. Patients of group 1 (n=12 received adequate antihypertensive therapy and selective serotonin reuptake inhibitor paroxetine. Patients of group 2 (n=12 received antihypertensive therapy only. The study duration was 16 weeks. Patient compliance to antihypertensive therapy, BP and severity of depressive disorders, motor and intellectual functions was evaluated initially and after 16 weeks.Results. BP>140/80 mmHg after 16 weeks was found in 10 (41.6% patients. Clinical post-stroke depression was found in 7 (30.4% patients, 5 (41.6% of them were from group 2 (OR=0.35, 95% CI 0.12-0.78. High treatment compliance was in 15 (65.2% patients, and 9 (81.8% of them were from group 1. Nine (39.1% patients did not receive an adequate antihypertensive therapy, 5 (41.6% of them were from group 2 and could not explain their refusal from medication. General index of intellectual function was higher in patients of group 1 (p=0.034 than this in group 2; index of motor function did not change significantly (p>0.05.Conclusion. Reduction of compliance to antihypertensive therapy and rehabilitation in hypertensive patients after stroke is associated with unmotivated refusal from treatment because of clinical post-stroke depression.

  2. Evaluation of Helicobacter Pylori eradication in pediatric patients by triple therapy plus lactoferrin and probiotics compared to triple therapy alone

    Directory of Open Access Journals (Sweden)

    Tolone Salvatore

    2012-10-01

    Full Text Available Abstract Background To evaluate whether the addition of a probiotic could improve Helicobacter pylori (H.P. eradication rates and reduce the side effects of treatment in children. Methods Between July 2008 and July 2011 all patients with a clinical, laboratory and endoscopic diagnosis of H.P. positive gastritis referred to our Unit were included in the study. Patients suffering from allergy to any of drugs used in the study, with previous attempts to eradicate H.P. and those who received antibiotics, PPIs or probiotics within 4 weeks were excluded from the present study. Patients were randomized into two therapy regimens (group A and B: both groups received standard triple treatment (omeprazole, amoxicillin and clarithromycin while only group B patients were also given a probiotic (Probinul - Cadigroup. Patients compliance was evaluated at the end of the treatment. Successful eradication was defined as a negative 13 C-urea breath test (C13-ubt result four weeks after therapy discontinuation. Results A total of 68 histopathologically proven H.P.-infection children (32 male and 36 females were included in the study. All of the patients in both groups used more than 90% of the therapies and no patients were lost at follow up. All side effects were selflimiting and disappeared once the therapy was terminated. Epigastric pain was observed in 6 (17.6% group A vs 2 (5.8% group B patients (P Conclusion The addition of a probiotic formula to triple therapy significantly decreased the frequency of epigastric pain, nausea, vomiting and diarrhea.

  3. 'It really makes good sense': the role of outcome evaluation in aphasia therapy in Denmark

    DEFF Research Database (Denmark)

    Isaksen, J. K.

    2014-01-01

    BackgroundMeasuring or evaluating outcomes is a common activity for many speech-language therapists (SLTs). A major focus has been on external forces claiming outcome evaluation to optimize quality and the use of resources without integrating the viewpoints of SLTs. AimsTo identify the purpose...... of outcome evaluation by letting SLTs identify not only the actual demands for outcome evaluation, but also the role of outcome evaluation in aphasia therapy in the clinic. Methods & ProceduresTwelve SLTs participated in semi-structured interviews to identify the demands they met for outcome evaluation...... evaluated outcomes because of external demands and interests. However, they also describe the process as a necessary activity inherent to therapy and state that they would not want to be without it. The outcome evaluation is seen as an interactive process between SLTs, clients and possibly significant...

  4. Complementary Health Practitioners in the Acute and Critical Care Setting: Nursing Considerations.

    Science.gov (United States)

    Kramlich, Debra

    2017-06-01

    In response to the rising demand by patients and their families for complementary health approaches, hospitals are increasingly integrating complementary health approaches with their conventional medical practices to create healing environments. Results of the 2010 Complementary and Alternative Medicine Survey of Hospitals indicated that the top 6 inpatient modalities included pet therapy, massage therapy, music or art therapy, guided imagery, relaxation therapy, and Reiki and therapeutic touch. Whether complementary health approaches are provided by complementary health practitioners through hospital-based integrative medicine programs, volunteer practitioners, or bedside nurses, the regulatory, legal, ethical, and safety concerns remain constant. Previous articles in this column of Critical Care Nurse provided an overview of complementary health approaches that nurses may encounter in their practices, with specific attention to implications for acute and critical care nurses, as well as important legal, ethical, safety, quality, and financial implications that acute and critical care nurses should consider when integrating complementary health approaches with conventional care. This column provides the acute and critical care nurse with key information about validation of credentials, experience, and competence of nurses and volunteers providing complementary health approaches, as well as about institutional policies and scope of practice. ©2017 American Association of Critical-Care Nurses.

  5. Evaluation of Photoelectron Therapy Effect on Hepatocellular Carcinoma

    Directory of Open Access Journals (Sweden)

    bahram Mofid

    2007-10-01

    Full Text Available Mofid B1, Navabpoor M2, Alizadeh Azimi M3 1. Assistant professor, Department of Radiotherapy, Faculty of Para-Medicine, Shahid Beheshti University of medical sciences 2. Instructor, Department of Technology of radiology, Faculty of Para-Medicine, Shahid Beheshti University of medical sciences Abstract Background: Photoelectron therapy method has been usad successfully, on the body phantom, cancer cells culture and animals. In this method, drugs containing x-Ray opaque factors–with high atomic numbers–are injected into the patient’s vein. After appropriate drug accumulation, about at least ten percent of the total injected amounts, 200kev. up to 300kev. of localized x-Ray beams is radiated to the site of the tumor. The Ethic Committee of Shahid Beheshti University of Medical Education and Health Services authorized the implementation of this new cancer treatment method, initially only on the group of patients who suffered from hepato-cellular carcinoma. Hepato cellular carcinoma is one of the most current malignancies of liver. In some cases, in addition to surgery, several approaches exist to come near the aim of predominating hepato-cellular carcinoma such as chemotherapy, current Radiation Therapy, Radio-Frequency application (RF, Trans-Artepical Chemo Embolization, (TACE, and Percutaneous Ethanol Injection (PEI. The effectiveness of the above-mentioned methods is about 10%-47%, applied alone or along side each other. Materials and methods: This study was a clinical-trial one. In this study, first, lipiodol (an x-ray opaque material with a high atomic number was transferred into the main vessel terminating to the tumor by angio-catheterization. Then,200kev. up to 250kev. of localized x-ray was radiated to the site of the tumor in one session. The drug volume was proportionally selected to the volume of the tumor, and the irradiation intensity was between 400 to 600cent.Gy. the beam energy absorption capacity of this drug is as times as

  6. Noise evaluation of Compton camera imaging for proton therapy

    CERN Document Server

    Ortega, P G; Cerutti, F; Ferrari, A; Gillam, J E; Lacasta, C; Llosá, G; Oliver, J F; Sala, P R; Solevi, P; Rafecas, M

    2015-01-01

    Compton Cameras emerged as an alternative for real-time dose monitoring techniques for Particle Therapy (PT), based on the detection of prompt-gammas. As a consequence of the Compton scattering process, the gamma origin point can be restricted onto the surface of a cone (Compton cone). Through image reconstruction techniques, the distribution of the gamma emitters can be estimated, using cone-surfaces backprojections of the Compton cones through the image space, along with more sophisticated statistical methods to improve the image quality. To calculate the Compton cone required for image reconstruction, either two interactions, the last being photoelectric absorption, or three scatter interactions are needed. Because of the high energy of the photons in PT the first option might not be adequate, as the photon is not absorbed in general. However, the second option is less efficient. That is the reason to resort to spectral reconstructions, where the incoming γ energy is considered as a variable in the recons...

  7. [Complementary treatment methods for depression in children and adolescents].

    Science.gov (United States)

    Dolle, Kathrin; Schulte-Körne, Gerd

    2014-01-01

    Depressive disorders are among the more common mental illnesses around the world, about 1- 3% of prepubertal children and 6% of postpubertal children and adolescents are affected. They markedly impair psychosocial development and are associated with higher rate of morbidity and mortality throughout life. Many physicians are unsure about which treatment approaches are effective and how the treatment should be planned. A systematic literature search was carried out in electronic databases and study registries and as a manual search. More than 450 studies (mostly randomized controlled trials = RCTs) were identified and summarized in evidence tables. The ensuing recommendations were agreed upon in a consensus conference. The review summarizes the evidence of complementary treatment methods. The evidence for complementary treatment methods (art and music therapy, sleep deprivation, exercise, electroconvulsive therapy, massage, transcranial magnetic stimulation, relaxation, bibliotherapy, computer based therapy, light therapy, omega-3 treatment) is low or there is no evidence due to missing studies or studies of poor quality. For some methods, i. e. light therapy, relaxation and stress reduction and sleep deprivation there is limited indication for effectiveness without sufficient evidence for a practical guidance. There is an urgent need for adequately informative comparative studies on treatment of depression in children and adolescents considering also complementary methods.

  8. Evaluation of food additives as alternative or complementary chemicals to conventional fungicides for the control of major postharvest diseases of stone fruit.

    Science.gov (United States)

    Palou, Lluis; Smilanick, Joseph L; Crisosto, Carlos H

    2009-05-01

    To evaluate potential alternatives to conventional fungicides to control decay, more than 20 food additives and generally regarded as safe compounds were tested at three concentrations in in vivo primary screenings with several cultivars of California peaches, nectarines, and plums that had been artificially inoculated with seven major postharvest pathogens: Monilinia fructicola, Botrytis cinerea, Geotrichum candidum, Alternaria alternata, Penicillium expansum, Mucor piriformis, and Rhizopus stolonifer. Overall, the best compounds were 200 mM potassium sorbate (PS), 200 mM sodium benzoate (SB), 200 mM sodium sorbate, 100 mM 2-deoxy-D-glucose, 400 mM sodium carbonate, and 250 mM potassium carbonate. Sodium and ammonium molybdates, acid lactic, and hydrogen peroxide were somewhat effective but were phytotoxic to fruit skin tissues. However, the best compounds lacked effectiveness and persistence when tested against brown rot in small-scale trials of 60-s dips in aqueous solutions at ambient temperatures; PS and SB reduced brown rot incidence by less than 40%. Rinsing treated fruit with tap water reduced the efficacy of the compounds by up to 30%. In contrast, heating the solutions to 55 or 60 degrees C significantly increased treatment efficacy. Brown rot incidence and severity were reduced by 35 and 25%, respectively, on PS-treated peaches after 7 days of incubation at 20 degrees C. However, treatment efficacy was not superior to that with water alone at these temperatures. In semicommercial trials, mixtures of fludioxonil with PS, SB, or 2-deoxy-D-glucose applied as fruit coatings on a packing line were not synergistic in their effect on brown rot, gray mold, and sour rot.

  9. Impact Evaluation of a Cognitive Behavioral Group Therapy Model in Brazilian Sexually Abused Girls

    Science.gov (United States)

    Habigzang, Luisa Fernanda; Damasio, Bruno Figueiredo; Koller, Silvia Helena

    2013-01-01

    This study evaluated the impact of a cognitive behavioral group therapy model in Brazilian girls who had experienced sexual abuse. The effect of the waiting period before treatment and the enduring effectiveness of the treatment after six and 12 months were also evaluated. Forty-nine female sexual abuse victims between the ages of 9 and 16…

  10. Industrial Evolution Through Complementary Convergence

    DEFF Research Database (Denmark)

    Frøslev Christensen, Jens

    2011-01-01

    The article addresses the dynamics through which product markets become derailed from early product life cycle (PLC)-tracks and engaged in complementary convergence with other product markets or industries. We compare and contrast the theories that can explain, respectively, the PLC...

  11. Multicenter evaluation of rectal cancer reimaging post neoadjuvant (MERRION) therapy.

    LENUS (Irish Health Repository)

    Hanly, Ann M

    2014-04-01

    The aim of this study was to evaluate the utility of reimaging rectal cancer post-CRT (chemoradiotherapy) with magnetic resonance (MR) imaging of the pelvis for local staging and computed tomography of thorax, abdomen, and pelvis (CT TAP) to identify distant metastases.

  12. Disease specific methods for economic evaluations of breast cancer therapies

    NARCIS (Netherlands)

    Frederix, G.W.J.

    2013-01-01

    Cost-effectiveness analyses (CEAs) are widely considered to be helpful tools for making informative decisions in a resource constrained environment. Since the introduction of economic evaluations in reimbursement submissions in Australia as a formal requirement in 1993, CEAs have become widespread

  13. [Alternatives to hormone replacement therapy for menopause: an epidemiological evaluation].

    Science.gov (United States)

    Ringa, V

    2004-05-01

    Recent results put into question the risks/benefits ratio of hormone replacement therapy and emphasize the importance of precise knowledge of the effects of other treatments that exist for postmenopausal symptoms or diseases. Our aim is to analyze their effect. A review of randomized trials or epidemiological studies was undertaken. Bisphophonates, calcitonin, parathormone, strontium ranelate, calcium and vitamin D have specific effects on bone. The efficacy of bisphophonates for prevention and treatment of osteoporosis has been proven and parathormone and strontium ranelate seem promising. These treatments are useful for women at high risk of osteoporosis who do not suffer from menopausal symptoms. Tibolone, SERMs and phytoestrogens exert effects on various tissues. SERMs are very promising, but they do not improve climacteric symptoms and their long term effects are still unknown. Tibolone has beneficial effects on climacteric symptoms and on bone loss, but recent results concerning its effects on the risk of breast cancer call into question its interest. The beneficial effects of phytoestrogens on bone and on vasomotor symptoms need to be confirmed. At this time, none of the existing treatments for postmenopausal symptoms or diseases is ideal. The existence of several options for treatments of symptoms or diseases of the postmenopause is helpful as it affords several choices for physicians and for women who sometimes need to be treated for many years. However several questions remain unanswered concerning the long term effects of these treatments.

  14. Evaluation of patients' engagement in radiation therapy safety.

    Science.gov (United States)

    Pernet, A; Mollo, V; Bibault, J-E; Giraud, P

    2016-12-01

    Treatment safety has become a priority in health policies after several incidents occurred around the world in radiation oncology departments. The aim of this study was to analyse the patients' contribution in that field and to understand which actions empower the patient in that regard. Several methods were used in a general hospital and in a comprehensive cancer centre to analyse the activities of the radiation therapists and the patients and the interactions between them: treatment session observations, semidirective interviews with radiation therapists and patients, self and alloconfrontation with radiation therapists and explanatory interviews with patients. Cooperation of the patients in treatment safety acts as an additional step that contributes to safer treatments. Radiation therapy sessions are a creative opportunity for the patient to observe, learn and analyse what is happening. Changes between treatment sessions are a source of anxiety for the patients. This study highlights the factors that favour the patients' participation. A trusting relationship and support from the health professionals can be leveraged in that manner. There is a common will shared between the patients and the health professionals towards better treatment safety. The cooperation is still not well-known and underused. This empowerment of the patient cannot be mandatory but should be promoted and developed. Copyright © 2016. Published by Elsevier SAS.

  15. Evaluation of therapy response in breast and ovarian cancer patients by positron emission tomography (PET)

    Energy Technology Data Exchange (ETDEWEB)

    Baum, R. P.; Przetak, C. [Zentralklinik Bad Berka, Clinic of Nuclear Medicine, Center for PET, Bad Berka (Germany)

    2001-09-01

    Positron emission tomography (PET) has the potential to contribute significantly to treatment planning and to the evaluation of response to therapy in patients with cancer. For disease recurrence PET imaging provides information non-invasively. The final goal is to biologically characterize an individual patients' tumor and to predict the response to treatment at the earliest possible time. Quantitative and/or semi-quantitative PET studies yield valuable information in breast cancer regarding prognosis and response to chemohormontherapy in a timely fashion. In ovarian cancer, up to now only few studies have been performed applying PET techniques for the evaluation of treatment response. These preliminary studies indicate that serial assessment of tumor metabolism by FDG-PET early during effective chemotherapy may predict subsequent response to such therapy. PET studies can be repeated without any side-effects and with low radiation exposure and results can be directly correlated with clinical laboratory data and histology. Therapy monitoring by PET could help to optimize neoadjuvant therapy protocols and to avoid ineffective preoperative therapy in non-responders, but this has to be proven in a larger number of patients and in different neoadjuvant settings such as chemotherapy, radiation therapy, hormone therapy or a combination of these.

  16. 9. Evaluation of an Art Therapy Programme for Clients with Difficult Life Situations

    Directory of Open Access Journals (Sweden)

    Krčmáriková Zuzana Ťulák

    2016-03-01

    Full Text Available The paper evaluates selected art therapy programmes (NAT=19 that were realized by therapeutic pedagogues – art therapists in the years 2009-2014 as parts of research projects. The quantitative aspect of the research processes the fulfilment of the conditions of art therapy programmes. In the framework of interpretative phenomenological analysis, we processed the data of each category as a part of the qualitative aspect of the research and supplemented them with authentic statements of clients (NP=8. The quantitative and qualitative aspect indicates a narrower characterisation of art therapy programmes in the group of clients with difficult life situations.

  17. Multimodal Imaging of Patients With Gliomas Confirms 11C-MET PET as a Complementary Marker to MRI for Noninvasive Tumor Grading and Intraindividual Follow-Up After Therapy

    Directory of Open Access Journals (Sweden)

    Kai R. Laukamp MD

    2017-01-01

    Full Text Available The value of combined L-(methyl-[11C] methionine positron-emitting tomography (MET-PET and magnetic resonance imaging (MRI with regard to tumor extent, entity prediction, and therapy effects in clinical routine in patients with suspicion of a brain tumor was investigated. In n = 65 patients with histologically verified brain lesions n = 70 MET-PET and MRI (T1-weighted gadolinium-enhanced [T1w-Gd] and fluid-attenuated inversion recovery or T2-weighted [FLAIR/T2w] examinations were performed. The computer software “visualization and analysis framework volume rendering engine (Voreen” was used for analysis of extent and intersection of tumor compartments. Binary logistic regression models were developed to differentiate between World Health Organization (WHO tumor types/grades. Tumor sizes as defined by thresholding based on tumor-to-background ratios were significantly different as determined by MET-PET (21.6 ± 36.8 cm3, T1w-Gd-MRI (3.9 ± 7.8 cm3, and FLAIR/T2-MRI (64.8 ± 60.4 cm3; P < .001. The MET-PET visualized tumor activity where MRI parameters were negative: PET positive tumor volume without Gd enhancement was 19.8 ± 35.0 cm3 and without changes in FLAIR/T2 10.3 ± 25.7 cm3. FLAIR/T2-MRI visualized greatest tumor extent with differences to MET-PET being greater in posttherapy (64.6 ± 62.7 cm3 than in newly diagnosed patients (20.5 ± 52.6 cm3. The binary logistic regression model differentiated between WHO tumor types (fibrillary astrocytoma II n = 10 from other gliomas n = 16 with an accuracy of 80.8% in patients at primary diagnosis. Combined PET and MRI improve the evaluation of tumor activity, extent, type/grade prediction, and therapy-induced changes in patients with glioma and serve information highly relevant for diagnosis and management.

  18. Multimodal Imaging of Patients With Gliomas Confirms (11)C-MET PET as a Complementary Marker to MRI for Noninvasive Tumor Grading and Intraindividual Follow-Up After Therapy.

    Science.gov (United States)

    Laukamp, Kai R; Lindemann, Florian; Weckesser, Matthias; Hesselmann, Volker; Ligges, Sandra; Wölfer, Johannes; Jeibmann, Astrid; Zinnhardt, Bastian; Viel, Thomas; Schäfers, Michael; Paulus, Werner; Stummer, Walter; Schober, Otmar; Jacobs, Andreas H

    2017-01-01

    The value of combined L-( methyl-[(11)C]) methionine positron-emitting tomography (MET-PET) and magnetic resonance imaging (MRI) with regard to tumor extent, entity prediction, and therapy effects in clinical routine in patients with suspicion of a brain tumor was investigated. In n = 65 patients with histologically verified brain lesions n = 70 MET-PET and MRI (T1-weighted gadolinium-enhanced [T1w-Gd] and fluid-attenuated inversion recovery or T2-weighted [FLAIR/T2w]) examinations were performed. The computer software "visualization and analysis framework volume rendering engine (Voreen)" was used for analysis of extent and intersection of tumor compartments. Binary logistic regression models were developed to differentiate between World Health Organization (WHO) tumor types/grades. Tumor sizes as defined by thresholding based on tumor-to-background ratios were significantly different as determined by MET-PET (21.6 ± 36.8 cm(3)), T1w-Gd-MRI (3.9 ± 7.8 cm(3)), and FLAIR/T2-MRI (64.8 ± 60.4 cm(3); P PET visualized tumor activity where MRI parameters were negative: PET positive tumor volume without Gd enhancement was 19.8 ± 35.0 cm(3) and without changes in FLAIR/T2 10.3 ± 25.7 cm(3). FLAIR/T2-MRI visualized greatest tumor extent with differences to MET-PET being greater in posttherapy (64.6 ± 62.7 cm(3)) than in newly diagnosed patients (20.5 ± 52.6 cm(3)). The binary logistic regression model differentiated between WHO tumor types (fibrillary astrocytoma II n = 10 from other gliomas n = 16) with an accuracy of 80.8% in patients at primary diagnosis. Combined PET and MRI improve the evaluation of tumor activity, extent, type/grade prediction, and therapy-induced changes in patients with glioma and serve information highly relevant for diagnosis and management.

  19. Complementary and Integrative Approaches for Pediatric Headache.

    Science.gov (United States)

    Kedia, Sita

    2016-02-01

    In this article, the use of complementary and integrative medicine for the management of pediatric headache is reviewed. Despite limited numbers of studies for pediatric headaches, children and families seek these services. Integrative medicine focuses on treating the whole person, integrating conventional medicine with mind-body-spirit methods. Nutriceuticals include dietary supplements in the form of vitamins (vitamin D), minerals (magnesium), coenzyme Q, butterbur, and melatonin. Acupuncture, stimulation, physical therapy and Transcutaneous Electrical Nerve Stimulations (TENS) or Transcranial Magnetic Stimulation (TMS) may also be useful in selected patients. The efficacy of all these therapeutic alternatives in pediatric headache is presented here. Primary care providers, neurologists, and headache specialists alike need to be informed of such interventions and integrate these approaches, when appropriate, in the management of children with headaches. Copyright © 2016. Published by Elsevier Inc.

  20. Evaluating interest in narrative therapy for decision making about pectus excavatum treatment.

    Science.gov (United States)

    Ticchi, Davide; Eisinger, Robert S; Pilegaard, Hans K; Torre, Michele; Sesia, Sergio B; Infante, Maurizio; Voulaz, Emanuele; Quesada, Mauricio Arce; Sisask, Merike

    2017-09-26

    The decision to proceed with surgical treatment for pectus excavatum (PE) is rarely clear-cut. Patients interested in treatment are referred for evaluation by numerous different specialists, but psychosocial counselling is currently not included in this process. Our objective was to assess whether PE patients would be interested in formal assistance with the decision-making process surrounding PE surgery using narrative therapy principles. Ninety-seven untreated PE patients at 5 different institutions in 4 countries completed a questionnaire consisting of 13 questions, with 3 questions specifically evaluating interest in narrative therapy. Eighty-two percent of participants were interested in narrative therapy to assist with the decision-making process surrounding PE surgery. Individuals most interested in narrative therapy tend to be more interested in correction (P < 0.05) to improve the way they feel about their body (P < 0.05). The majority of PE patients are interested in narrative therapy to aid the decision-making process about treatment. We propose that narrative therapy should be offered to PE patients during the treatment evaluation process to address the psychosocial difficulties associated with PE and the surgical decision-making process overall. Future studies should assess the effectiveness of this interdisciplinary model.

  1. Preclinical Evaluation of Bioabsorbable Polyglycolic Acid Spacer for Particle Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Akasaka, Hiroaki [Division of Radiation Oncology, Kobe University Graduate School of Medicine, Hyogo Japan (Japan); Sasaki, Ryohei, E-mail: rsasaki@med.kobe-u.ac.jp [Division of Radiation Oncology, Kobe University Graduate School of Medicine, Hyogo Japan (Japan); Miyawaki, Daisuke; Mukumoto, Naritoshi; Sulaiman, Nor Shazrina Binti [Division of Radiation Oncology, Kobe University Graduate School of Medicine, Hyogo Japan (Japan); Nagata, Masaaki [Division of Gastroenterology, Kobe University Graduate School of Medicine, Hyogo Japan (Japan); Yamada, Shigeru [Research Center Hospital, Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Murakami, Masao [Radiation Oncology Center, Dokkyo Medical University, Tochigi (Japan); Demizu, Yusuke [Department of Radiology, Hyogo Ion Beam Medical Center, Hyogo (Japan); Fukumoto, Takumi [Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine, Hyogo Japan (Japan)

    2014-12-01

    Purpose: To evaluate the efficacy and safety of a polyglycolic acid (PGA) spacer through physical and animal experiments. Methods and Materials: The spacer was produced with surgical suture material made of PGA, forming a 3-dimensional nonwoven fabric. For evaluation or physical experiments, 150-MeV proton or 320-MeV carbon-ion beams were used to generate 60-mm width of spread-out Bragg peak. For animal experiments, the abdomens of C57BL/6 mice, with or without the inserted PGA spacers, were irradiated with 20 Gy of carbon-ion beam (290 MeV) using the spread-out Bragg peak. Body weight changes over time were scored, and radiation damage to the intestine was investigated using hematoxylin and eosin stain. Blood samples were also evaluated 24 days after the irradiation. Long-term thickness retention and safety were evaluated using crab-eating macaques. Results: No chemical or structural changes after 100 Gy of proton or carbon-ion irradiation were observed in the PGA spacer. Water equivalency of the PGA spacer was equal to the water thickness under wet condition. During 24 days' observation after 20 Gy of carbon-ion irradiation, the body weights of mice with the PGA spacer were relatively unchanged, whereas significant weight loss was observed in those mice without the PGA spacer (P<.05). In mice with the PGA spacer, villus and crypt structure were preserved after irradiation. No inflammatory reactions or liver or renal dysfunctions due to placement of the PGA spacer were observed. In the abdomen of crab-eating macaques, thickness of the PGA spacer was maintained 8 weeks after placement. Conclusions: The absorbable PGA spacer had water-equivalent, bio-compatible, and thickness-retaining properties. Although further evaluation is warranted in a clinical setting, the PGA spacer may be effective to stop proton or carbon-ion beams and to separate normal tissues from the radiation field.

  2. Evaluation of biological rhythms in elderly cancer patients. A complementary translational research within the frame of the trans-hospital pilot program of oncogeriatrics launched at CHC-Liège.

    Science.gov (United States)

    Focan, C; Warzée, E; Sondag, C; Guillaume, T

    2013-04-01

    Thanks to the sponsoring of Belgian Cancer Plan, we have launched a trans-hospital project of oncogeriatrics implying any concerned actors from medical (oncology, geriatrics, various specialties) and paramedical staffs (nurses, physiotherapists, ergotherapists, dieteticians, social workers, psychologists…). We aim to recruit 300 consecutive patients aged over 70 and presenting with a new diagnosed cancer. They will benefit from both detailed Comprehensive Geriatrical (CGA) and Oncological (COA) assessments. A multidisciplinary concertation will try to define for each patient an individualized treatment planning taking into account CGA, CGO, co-morbidities, predictive indexes of chemotherapy toxicity (MAX2, i.e.). Detailed records will be obtained in collaboration with the data-management staff. Furthermore, a complementary translational research will include patients for a simple evaluation of their circadian rhythmicities through cortisol titration at 8a.m. and 4p.m. and actometry recordings of the rest-activity rhythms. Future steps could be developed aiming at the restoration of circadian structure disturbances with revalidation (physical exercise, tai-chi, yoga) and resynchronization (melatonin, hydrocortisone, bright light…) programs. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  3. Evaluation of dog owners' perceptions concerning radiation therapy

    Directory of Open Access Journals (Sweden)

    Egenvall Agneta

    2009-04-01

    Full Text Available Abstract Background External radiation therapy (RT has been available for small animals in Sweden since 2006. This study was designed to obtain information on owner experiences and perceptions related to RT of cancer in their dogs. Another survey was used to determine the attitudes about use of RT in a group of Swedish veterinarians. Their responses were analyzed and compared to their level of knowledge of oncology and RT. Methods Owners of all dogs (n = 23 who had undergone RT for malignancy at Jönköping Small Animal Hospital between March 2006 to September 2007 were interviewed. A questionnaire was given to a selected group of veterinarians. Results All 23 owners responded. All owners thought that their dog did well during RT and most that their dog was also fine during the following phase when acute RT-related skin reactions occur and heal. Three owners stated that their dog had pain that negatively impacted quality of life because of radiation dermatitis. Five owners reported that RT positively impacted quality of life of the dog during the first weeks after RT because palliation was achieved. The owners were not disturbed by the efforts required of them. All but one owner (22 of 23 stated that they would make the same decision about RT again if a similar situation occurred. The most important factor for this decision was the chance to delay occurrence of tumour-related discomfort. The chance for cure was of less importance but still essential, followed by expected side effects. Time commitments, travel, number of treatments required and financial cost; all had low impact. The veterinarian survey showed that less background knowledge of small animal oncology/RT was associated with more negative expectations of RT for small animals. Conclusion The results show that for these owners, RT was a worthwhile treatment modality and that the discomfort for the dog was manageable and acceptable relative to the benefits. Improved continuing education

  4. Exploring frontiers: use of complementary and alternative medicine among patients with early-stage breast cancer.

    Science.gov (United States)

    Saghatchian, Mahasti; Bihan, Céline; Chenailler, Catherine; Mazouni, Chafika; Dauchy, Sarah; Delaloge, Suzette

    2014-06-01

    Complementary and alternative medicine (CAM) is increasingly popular among cancer patients but can interfere with conventional therapies; timely data are needed to adapt current patients' care. This transversal, prospective study evaluated the use of CAM among patients receiving adjuvant chemotherapy or endocrine therapy for early stage breast cancer. We assessed the prevalence of use, the motivations and predictive factors for use, as well as patients' information needs over a three months period. 69/184 responders (37.5%) reported using at least one CAM. CAM use was associated with younger age (p = 0.03) and higher education level (p cancer patients are common users of CAM concomitantly to their conventional cancer treatments and should be investigated regarding their current consumption of CAM. Furthermore, they need advice evidence-based data on these treatments and potential interactions with on-going treatments. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Compliance with antimicrobial therapy: Evaluating the related factors

    Directory of Open Access Journals (Sweden)

    Mandana Moradi

    2015-10-01

    Full Text Available Background: Uncontrolled and irrational use of antibiotics increases the rate of antimicrobial resistance and treatment failure. Compliance with antibiotics is an important indicator to show how patients use their prescribed drugs and it can explain the relationship between drug administration and treatment outcome that needs to be monitored and promoted. We decided to evaluate compliance to antimicrobial drugs in this study.Methods: In a cross-sectional study, 100 patients referring to 4 different specialists’ offices were enrolled. The rate and type of non prescribed antibiotic administration were evaluated using predesigned questionnaires. The data were analyzed by SPSS 17.0 software using descriptive statistics and chi-square test for categorical data.Results: Our results showed that 62.4% of the study population had poor compliance and 37.6 % had good compliance with their prescribed regimen. “Feeling better “and “getting worse” on prescribed regimen were major reasons for drug discontinuation. About 70% of our study population get non prescribed antibiotic from pharmacies at least once a year. Most of the requested antibiotics were not first line options. Level of education was the only factor significantly related to the rate of patient compliance. Conclusion: This study shows the high rate of non prescribed antibiotic administration and low rate of compliance among the study population that emerge the need for particular patient education and putting restrictive rules to bound  non-prescribed and unsupervised  antibiotic marketing.

  6. American Academy of Pediatrics. The use of complementary and alternative medicine in pediatrics.

    Science.gov (United States)

    Kemper, Kathi J; Vohra, Sunita; Walls, Richard

    2008-12-01

    The American Academy of Pediatrics is dedicated to optimizing the well-being of children and advancing family-centered health care. Related to these goals, the American Academy of Pediatrics recognizes the increasing use of complementary and alternative medicine in children and, as a result, the need to provide information and support for pediatricians. From 2000 to 2002, the American Academy of Pediatrics convened and charged the Task Force on Complementary and Alternative Medicine to address issues related to the use of complementary and alternative medicine in children and to develop resources to educate physicians, patients, and families. One of these resources is this report describing complementary and alternative medicine services, current levels of utilization and financial expenditures, and associated legal and ethical considerations. The subject of complementary and alternative medicine is large and diverse, and consequently, an in-depth discussion of each method of complementary and alternative medicine is beyond the scope of this report. Instead, this report will define terms; describe epidemiology; outline common types of complementary and alternative medicine therapies; review medicolegal, ethical, and research implications; review education and training for complementary and alternative medicine providers; provide resources for learning more about complementary and alternative medicine; and suggest communication strategies to use when discussing complementary and alternative medicine with patients and families.

  7. Evaluation of current trends and recent development in insulin therapy for management of diabetes mellitus.

    Science.gov (United States)

    Nawaz, Muhammad Sarfraz; Shah, Kifayat Ullah; Khan, Tahir Mehmood; Rehman, Asim Ur; Rashid, Haroon Ur; Mahmood, Sajid; Khan, Shahzeb; Farrukh, Muhammad Junaid

    2017-12-01

    Diabetes mellitus is a major health problem in developing countries. There are various insulin therapies to manage diabetes mellitus. This systematic review evaluates various insulin therapies for management of diabetes mellitus worldwide. This review also focuses on recent developments being explored for better management of diabetes mellitus. We reviewed a number of published articles from 2002 to 2016 to find out the appropriate management of diabetes mellitus. The paramount parameters of the selected studies include the insulin type & its dose, type of diabetes, duration and comparison of different insulin protocols. In addition, various newly developed approaches for insulin delivery with potential output have also been evaluated. A great variability was observed in managing diabetes mellitus through insulin therapy and the important controlling factors found for this therapy include; dose titration, duration of insulin use, type of insulin used and combination therapy of different insulin. A range of research articles on current trends and recent advances in insulin has been summarized, which led us to the conclusion that multiple daily insulin injections or continuous subcutaneous insulin infusion (insulin pump) is the best method to manage diabetes mellitus. In future perspectives, development of the oral and inhalant insulin would be a tremendous breakthrough in Insulin therapy. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  8. [Complementary and alternative medicine: use in Montes Claros, Minas Gerais].

    Science.gov (United States)

    Neto, Joao Felício Rodrigues; Faria, Anderson Antônio de; Figueiredo, Maria Fernanda Santos

    2009-01-01

    To determine prevalence of utilization and social and economic profile of those using complementary and alternative medicine in the medium sized Brazilian city of Montes Claros, MG. A transversal descriptive study was conducted. The sample of 3090 people was probabilistic, by clusters using the household as the sample unit for interview of both genders, older than 18 years. Data were collected by semi-structured questionnaires. Utilization of complementary and alternative medicine was of 8.9% when only those involving costs such as homeopathy, acupuncture, chiropractics, techniques of relaxation/ meditation and massage are considered and of 70.0%, when all therapies found were included. Prevalent were prayers to God (52.0%), popular medicines (30.9%), physical exercises (25.5%), faith healers (15.0%), popular diets (7.1%), massage (4.9%), relaxation/meditation (2.8%), homeopathy (2.4%), and groups of self-help (1.9%), chiropractics (1.7%), acupuncture (1.5%) and orthomolecular medicine (0.2%). Women, Catholic, married of higher income and education were positively associated with utilization of therapies involving expenses. Complementary and alternative medicine is used by a significant number of those interviewed. Gender, religion, marital status, income and education were positively associated with utilization of complementary and alternative medicine. Access of those with less income and education could increase the utilization of the options that involve expenses.

  9. Office of Cancer Complementary and Alternative Medicine

    Science.gov (United States)

    ... Information. Outreach. The Office of Cancer Complementary and Alternative Medicine (OCCAM) was established in October 1998 to coordinate ... Institute (NCI) in the arena of complementary and alternative medicine (CAM). More about us. CAM at the NCI ...

  10. Comparative oncology evaluation of intravenous recombinant oncolytic Vesicular Stomatitis Virus therapy in spontaneous canine cancer.

    Science.gov (United States)

    Naik, Shruthi; Galyon, Gina D; Jenks, Nathan J; Steele, Michael B; Miller, Amber C; Allstadt, Sara D; Suksanpaisan, Lukkana; Peng, Kah Whye; Federspiel, Mark J; Russell, Stephen J; LeBlanc, Amy K

    2017-11-20

    Clinical translation of intravenous therapies to treat disseminated or metastatic cancer is imperative. Comparative oncology, the evaluation of novel cancer therapies in animals with spontaneous cancer, can be utilized to inform and accelerate clinical translation. Preclinical murine studies demonstrate that single shot systemic therapy with a VSV-IFNβ-NIS, a novel recombinant oncolytic Vesicular stomatitis virus (VSV), can induce curative remission in tumor bearing mice. Clinical translation of VSV-IFNβ-NIS therapy is dependent on comprehensive assessment of clinical toxicities, virus shedding, pharmacokinetics, and efficacy in clinically relevant models. Dogs spontaneously develop cancer with comparable etiology, clinical progression and response to therapy as human malignancies. A comparative oncology study was carried out to investigate feasibility and tolerability of intravenous oncolytic VSV-IFNβ-NIS therapy in pet dogs with spontaneous cancer. Nine dogs with various malignancies were treated with a single intravenous dose of VSV-IFNβ-NIS. Two dogs with high-grade peripheral T-cell lymphoma had rapid but transient remission of disseminated disease and transient hepatotoxicity that resolved spontaneously. There was no shedding of infectious virus. Correlative pharmacokinetic studies revealed elevated levels of VSV RNA in blood in dogs with measurable disease remission. This is the first evaluation of intravenous oncolytic virus therapy for spontaneous canine cancer, demonstrating that VSV-IFNβ-NIS is well-tolerated and safe in dogs with advanced or metastatic disease. This approach has informed clinical translation, including dose and target indication selection, leading to a clinical investigation of intravenous VSV-IFNβ-NIS therapy, and provided preliminary evidence of clinical efficacy, and potential biomarkers that correlate with therapeutic response. Copyright ©2017, American Association for Cancer Research.

  11. Implementing Cognitive Behavioral Therapy for Chronic Fatigue Syndrome in a Mental Health Center: A Benchmarking Evaluation

    Science.gov (United States)

    Scheeres, Korine; Wensing, Michel; Knoop, Hans; Bleijenberg, Gijs

    2008-01-01

    Objective: This study evaluated the success of implementing cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) in a representative clinical practice setting and compared the patient outcomes with those of previously published randomized controlled trials (RCTs) of CBT for CFS. Method: The implementation interventions were the…

  12. Acceptance and Commitment Therapy for Self-Stigma around Sexual Orientation: A Multiple Baseline Evaluation

    Science.gov (United States)

    Yadavaia, James E.; Hayes, Steven C.

    2012-01-01

    This study evaluated the effectiveness of 6 to 10 sessions of Acceptance and Commitment Therapy (ACT) for self-stigma around sexual orientation linked to same-sex attraction (what has generally been referred to as internalized homophobia; IH) in a concurrent multiple-baseline across-participants design. Three men and 2 women showed sizeable…

  13. Art Enrichment: Evaluating a Collaboration between Head Start and a Graduate Art Therapy Program

    Science.gov (United States)

    Klorer, P. Gussie; Robb, Megan

    2012-01-01

    Head Start, a U.S. federally funded program, prepares children for school through early childhood intervention in social-emotional and cognitive arenas. This article describes program evaluation survey results from the past 5 years of an 18-year collaboration between a university graduate art therapy program and 8 Head Start centers. Graduate art…

  14. Qualitative systemic review of randomized controlled trials on complementary and alternative medicine treatments in fibromyalgia.

    Science.gov (United States)

    Baranowsky, Julia; Klose, Petra; Musial, Frauke; Häuser, Winfried; Haeuser, Winfried; Dobos, Gustav; Langhorst, Jost

    2009-11-01

    The objectives of the study were identification, quality evaluation and summary of RCTs on complementary and alternative medicine as defined by the National Institute of Health with the exception of dietary and nutritional supplements. A computerized search of databases from 1990 (year of publication of the ACR criteria for fibromyalgia) to July 2007 was performed. The RCTs were assessed by a methodological quality score. A total of 23 RCTs issued from 1992 to 2007 on acupuncture, balneotherapy, thermotherapy, magnetic therapy, homeopathy, manual manipulation, mind-body medicine, diet therapy and music therapy were identified. The RCTs had an average group size of 25 with the number of groups ranging from two to four. The quality score assessment of the RCTs yielded a mean score of 51 out of 100. The average methodological quality of the identified studies was fairly low. Best evidence was found for balneotherapy/hydrotherapy in multiple studies. Positive results were also noted for homeopathy and mild infrared hyperthermia in 1 RCT in each field. Mindfulness meditation showed mostly positive results in two trials and acupuncture mixed results in multiple trials with a tendency toward positive results. Tendencies for improvement were furthermore noted in single trials of the Mesendieck system, connective tissue massage and to some degree for osteopathy and magnet therapy. No positive evidence could be identified for Qi Gong, biofeedback, and body awareness therapy.

  15. Complementary and Alternative Medicine for Cancer Pain: An Overview of Systematic Reviews

    Directory of Open Access Journals (Sweden)

    Yanju Bao

    2014-01-01

    Full Text Available Background and Objective. Now with more and more published systematic reviews of Complementary and Alternative Medicine (CAM on adult cancer pain, it is necessary to use the methods of overview of systematic review to summarize available evidence, appraise the evidence level, and give suggestions to future research and practice. Methods. A comprehensive search (the Cochrane Library, PubMed, Embase, and ISI Web of Knowledge was conducted to identify all systematic reviews or meta-analyses of CAM on adult cancer pain. And the evidence levels were evaluated using GRADE approach. Results. 27 systematic reviews were included. Based on available evidence, we could find that psychoeducational interventions, music interventions, acupuncture plus drug therapy, Chinese herbal medicine plus cancer therapy, compound kushen injection, reflexology, lycopene, TENS, qigong, cupping, cannabis, Reiki, homeopathy (Traumeel, and creative arts therapies might have beneficial effects on adult cancer pain. No benefits were found for acupuncture (versus drug therapy or shame acupuncture, and the results were inconsistent for massage therapy, transcutaneous electric nerve stimulation (TENS, and Viscum album L plus cancer treatment. However, the evidence levels for these interventions were low or moderate due to high risk of bias and/or small sample size of primary studies. Conclusion. CAM may be beneficial for alleviating cancer pain, but the evidence levels were found to be low or moderate. Future large and rigor randomized controlled studies are needed to confirm the benefits of CAM on adult cancer pain.

  16. Complementary and alternative medicine for cancer pain: an overview of systematic reviews.

    Science.gov (United States)

    Bao, Yanju; Kong, Xiangying; Yang, Liping; Liu, Rui; Shi, Zhan; Li, Weidong; Hua, Baojin; Hou, Wei

    2014-01-01

    Background and Objective. Now with more and more published systematic reviews of Complementary and Alternative Medicine (CAM) on adult cancer pain, it is necessary to use the methods of overview of systematic review to summarize available evidence, appraise the evidence level, and give suggestions to future research and practice. Methods. A comprehensive search (the Cochrane Library, PubMed, Embase, and ISI Web of Knowledge) was conducted to identify all systematic reviews or meta-analyses of CAM on adult cancer pain. And the evidence levels were evaluated using GRADE approach. Results. 27 systematic reviews were included. Based on available evidence, we could find that psychoeducational interventions, music interventions, acupuncture plus drug therapy, Chinese herbal medicine plus cancer therapy, compound kushen injection, reflexology, lycopene, TENS, qigong, cupping, cannabis, Reiki, homeopathy (Traumeel), and creative arts therapies might have beneficial effects on adult cancer pain. No benefits were found for acupuncture (versus drug therapy or shame acupuncture), and the results were inconsistent for massage therapy, transcutaneous electric nerve stimulation (TENS), and Viscum album L plus cancer treatment. However, the evidence levels for these interventions were low or moderate due to high risk of bias and/or small sample size of primary studies. Conclusion. CAM may be beneficial for alleviating cancer pain, but the evidence levels were found to be low or moderate. Future large and rigor randomized controlled studies are needed to confirm the benefits of CAM on adult cancer pain.

  17. Grasps Recognition and Evaluation of Stroke Patients for Supporting Rehabilitation Therapy

    Directory of Open Access Journals (Sweden)

    Beatriz Leon

    2014-01-01

    Full Text Available Stroke survivors often suffer impairments on their wrist and hand. Robot-mediated rehabilitation techniques have been proposed as a way to enhance conventional therapy, based on intensive repeated movements. Amongst the set of activities of daily living, grasping is one of the most recurrent. Our aim is to incorporate the detection of grasps in the machine-mediated rehabilitation framework so that they can be incorporated into interactive therapeutic games. In this study, we developed and tested a method based on support vector machines for recognizing various grasp postures wearing a passive exoskeleton for hand and wrist rehabilitation after stroke. The experiment was conducted with ten healthy subjects and eight stroke patients performing the grasping gestures. The method was tested in terms of accuracy and robustness with respect to intersubjects’ variability and differences between different grasps. Our results show reliable recognition while also indicating that the recognition accuracy can be used to assess the patients’ ability to consistently repeat the gestures. Additionally, a grasp quality measure was proposed to measure the capabilities of the stroke patients to perform grasp postures in a similar way than healthy people. These two measures can be potentially used as complementary measures to other upper limb motion tests.

  18. Lead poisoning from complementary and alternative medicine in multiple sclerosis

    OpenAIRE

    Fisher, A; Le Couteur, D.G.

    2000-01-01

    A patient with multiple sclerosis is described who was treated for neurological symptoms thought to be a progression of his disease but subsequently found to be caused by lead poisoning secondary to the use of alternative medicine. His clinical signs improved with oral chelation therapy. Neurologists should consider asking about the use of complementary and alternative medicine before simply attributing symptoms and signs to exacerbation of multiple sclerosis.



  19. Complementary and alternative exercise for fibromyalgia: a meta-analysis

    OpenAIRE

    Mist, Scott; Firestone,Kari; Jones,Kim Dupree

    2013-01-01

    Scott David Mist, Kari Firestone, Kim Dupree Jones Fibromyalgia Research and Treatment Group, School of Nursing, Oregon Health and Science University, Portland, OR, USA Abstract: Complementary and alternative medicine includes a number of exercise modalities, such as tai chi, qigong, yoga, and a variety of lesser-known movement therapies. A meta-analysis of the current literature was conducted estimating the effect size of the different modalities, study quality and bias, and adverse events....

  20. Evaluation of occlusal splint therapy in temporomandibular joint disorder patients using real-time ultrasonography.

    Science.gov (United States)

    Telkar, Swaroop; Khan, Mubeen K; Shukla, Anil Kumar; Dodamani, Arun; Yalsangi, Shilpa; Telkar, Deepti

    2010-11-01

    The aim of the present study was to evaluate the effect of occlusal splint therapy by determining the cross-sectional dimension of masseter muscle using ultrasound in patients with temporomandibular joint disc displacement with reduction. Twenty-seven patients aged between 20 and 40 years were included in the study. A detailed history was obtained, and a comprehensive clinical examination was carried out. Subjective assessment with structured pro forma was performed pre-occlusal and post-occlusal splint therapy. The objective measurement of the bilateral masseter muscle thickness was recorded using real-time ultrasonography before and after splint therapy. The mean ultrasound thickness of the masseter muscle in the pre-clenching state before splint therapy was 9.45 mm (SD 1.39), and the post-clenching state was 13.15 mm (SD 2.23). After splint therapy, the mean thickness in the pre-clenching state was 9.14 mm (SD 1.31), and the post-clenching state was 12.78 mm (SD 2.23; P<0.001). Ultrasonographic measurements of the masseter muscle in patients with temporomandibular joint disc displacement with reduction can be a useful tool to assess the effectiveness of occlusal splint therapy. Such conservative measures can significantly reduce masticatory muscle tenderness, especially of the temporalis and masseter. © 2010 Blackwell Publishing Asia Pty Ltd.

  1. A Diagnostic Post-Occupancy Evaluation of the Nacadia® Therapy Garden.

    Science.gov (United States)

    Sidenius, Ulrik; Karlsson Nyed, Patrik; Linn Lygum, Victoria; K Stigsdotter, Ulrika

    2017-08-05

    The design of the Nacadia® therapy garden is based on a model for evidence-based health design in landscape architecture (EBHDL). One element of the model is a diagnostic post-occupancy evaluation (DPOE), which has not previously been fully developed. The present study develops a generic DPOE for therapy gardens, with a focus on studying the effects of the design on patients' health outcomes. This is done in order to identify successes and failures in the design. By means of a triangulation approach, the DPOE employs a mixture of methods, and data is interpreted corroborating. The aim of the present study is to apply the DPOE to the Nacadia® therapy garden. The results of the DPOE suggest that the design of the Nacadia® therapy garden fulfills its stated aims and objectives. The overall environment of the Nacadia ® therapy garden was experienced as protective and safe, and successfully incorporated the various elements of the nature-based therapy programme. The participants encountered meaningful spaces and activities which suited their current physical and mental capabilities, and the health outcome measured by EQ-VAS (self-estimated general health) indicated a significant increase. Some design failures were identified, of which visual exposure was the most noteworthy. The DPOE model presented appears to be efficient but would nonetheless profit from being validated by other cases.

  2. A Diagnostic Post-Occupancy Evaluation of the Nacadia® Therapy Garden

    Science.gov (United States)

    Sidenius, Ulrik; Karlsson Nyed, Patrik; Linn Lygum, Victoria; K. Stigsdotter, Ulrika

    2017-01-01

    The design of the Nacadia® therapy garden is based on a model for evidence-based health design in landscape architecture (EBHDL). One element of the model is a diagnostic post-occupancy evaluation (DPOE), which has not previously been fully developed. The present study develops a generic DPOE for therapy gardens, with a focus on studying the effects of the design on patients’ health outcomes. This is done in order to identify successes and failures in the design. By means of a triangulation approach, the DPOE employs a mixture of methods, and data is interpreted corroborating. The aim of the present study is to apply the DPOE to the Nacadia® therapy garden. The results of the DPOE suggest that the design of the Nacadia® therapy garden fulfills its stated aims and objectives. The overall environment of the Nacadia ® therapy garden was experienced as protective and safe, and successfully incorporated the various elements of the nature-based therapy programme. The participants encountered meaningful spaces and activities which suited their current physical and mental capabilities, and the health outcome measured by EQ-VAS (self-estimated general health) indicated a significant increase. Some design failures were identified, of which visual exposure was the most noteworthy. The DPOE model presented appears to be efficient but would nonetheless profit from being validated by other cases. PMID:28783060

  3. A Diagnostic Post-Occupancy Evaluation of the Nacadia® Therapy Garden

    Directory of Open Access Journals (Sweden)

    Ulrik Sidenius

    2017-08-01

    Full Text Available The design of the Nacadia® therapy garden is based on a model for evidence-based health design in landscape architecture (EBHDL. One element of the model is a diagnostic post-occupancy evaluation (DPOE, which has not previously been fully developed. The present study develops a generic DPOE for therapy gardens, with a focus on studying the effects of the design on patients’ health outcomes. This is done in order to identify successes and failures in the design. By means of a triangulation approach, the DPOE employs a mixture of methods, and data is interpreted corroborating. The aim of the present study is to apply the DPOE to the Nacadia® therapy garden. The results of the DPOE suggest that the design of the Nacadia® therapy garden fulfills its stated aims and objectives. The overall environment of the Nacadia ® therapy garden was experienced as protective and safe, and successfully incorporated the various elements of the nature-based therapy programme. The participants encountered meaningful spaces and activities which suited their current physical and mental capabilities, and the health outcome measured by EQ-VAS (self-estimated general health indicated a significant increase. Some design failures were identified, of which visual exposure was the most noteworthy. The DPOE model presented appears to be efficient but would nonetheless profit from being validated by other cases.

  4. Evaluation of the benefits of low back pain patients' education workshops during spa therapy.

    Science.gov (United States)

    Gremeaux, Vincent; Benaïm, Charles; Poiraudeau, Serge; Hérisson, Christian; Dupeyron, Arnaud; Coudeyre, Emmanuel

    2013-01-01

    To evaluate the medium-term impact of education workshops on low back pain (LBP) in the setting of a thermal spa on: fear-avoidance beliefs, disability, pain, and satisfaction. Randomized prospective alternate-month design-type study including 360 individuals having thermal spa therapy for LBP: 188 in the intervention group (three standardized education workshops lasting 1 h 30 each and usual thermal therapy for 3 weeks), 172 in the control group (usual thermal therapy and non-standardized verbal information). The principal analysis criterion was the difference in the fear-avoidance beliefs (physical FABQ) score between baseline and 6 months after the therapy; secondary criteria were: evolution of disability (Quebec Scale) and pain intensity (Visual Analogue Scale), and satisfaction with the information received. There was a significant reduction in the physical FABQ score at 6 months (Pspa therapy by reducing the effect of fear-avoidance beliefs as well as relieving pain. Extending the use of such workshops could contribute to enhance the positive impact of spa therapy in the management of chronic disabling diseases. Copyright © 2012 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  5. Parental concerns about complementary feeding

    DEFF Research Database (Denmark)

    Nielsen, Annemette; Michaelsen, Kim F.; Holm, Lotte

    2013-01-01

    of the family's food, and the mother's focus was on the immediate well-being and safety of the child. In the later phase, health concerns shifted towards a longer-term perspective, and the aim of integrating the child into the family's social world became as important as concerns about well-being and safety......Background/objectives:To investigate and analyze differences in parental concerns during earlier and later phases of complementary feeding.Subject/methods:Eight focus group interviews were conducted with 45 mothers of children aged 7 or 13 months. Deductive and inductive coding procedures were...

  6. [Complementary medicine--Jewish medical ethics].

    Science.gov (United States)

    Katz, Yisrae; Schiff, Elad

    2011-08-01

    In Israel, as in the Western world, the use of different methods of complementary and alternative medicine ICAM) is spreading. CAM raises ethical questions of concern to healthcare providers and to the public: Can physicians recommend a treatment that has no scientific evidence? Should the government include such therapies in the health budget? Can complementary therapists receive protection against lawsuits if their treatment is recognized? The purpose of this article is to present a Jewish perspective on these issues. The fundamental sources that deal with the subject are based on the approach of rabbinic authorities toward unproven medicine, as expressed in the "Mishnah" and "Talmud" (200-500 C.E). The great Jewish scholar who discusses the subject in detail is Maimonides (1135-1204), who defines what "medicine" is and claims that medicine has to rely on reason or experience. Contemporary Jewish commentators present their position based on the interpretation of Maimonides' texts. In this article we claim that treatments can be divided into four groups, each group having a different halachic status: (1) Treatment that might be dangerous--should not be used. (2) Treatment that is safe--can be used, but has no other special status. (3) Treatment recognized by alternative therapists--has consequences for the observant Jew, such as laws of Kashrut and Shabbat. (4) Treatment that was tested and proven using modern medical methods has public significance--the therapist is entitled to legal defense if he made a reasonable mistake; the government can consider funding such treatment using public money. This article presents the Jewish halachic sources upon which we propose an ethical-practical approach to CAM.

  7. The reliability and validity of the clinical competence evaluation scale in physical therapy.

    Science.gov (United States)

    Yoshino, Jun; Usuda, Shigeru

    2013-12-01

    [Purpose] To examine the internal consistency, criterion-related validity, factorial validity, and content validity of the Clinical Competence Evaluation Scale in Physical Therapy (CEPT). [Subjects] The subjects were 278 novice physical therapy trainees and 119 tutors from 21 medical facilities. [Methods] The trainees self-evaluated their clinical competences and the tutors evaluated trainee competences using the CEPT. Overall trainee autonomy was evaluated using a visual analog scale (VAS) for self-evaluation and the trainees were also evaluated by their tutors. The content validity of the CEPT was examined by asking if the CEPT could evaluate the competence of novice physical therapists on a four-point scale. [Results] Cronbach's alpha of the CEPT was 0.96 for the trainees and 0.97 for the tutors. The correlation coefficient between the total score of the CEPT and whole competence by VAS was 0.83 for the trainees and 0.87 for the tutors. Factor analysis identified two factors, "the specialty of the physical therapist" and "the essential competence of a health professional". Ninety percent or more of the trainees and the tutors answered that the CEPT could sufficiently evaluate the competence of novice physical therapists. [Conclusion] The CEPT is a reliable and valid scale for clinical competence evaluation of novice physical therapists.

  8. Percepção de médicos e enfermeiros da Estratégia de Saúde da Família sobre terapias complementares Percepción de médicos y enfermeros de la Estrategia de Salud de la Familia sobre terapias complementarias Family Health Strategy doctors and nurses' perceptions of complementary therapies

    Directory of Open Access Journals (Sweden)

    Sônia de Castro S Thiago

    2011-04-01

    TODOS: Se realizó estudio con 177 médicos y enfermeros a partir de un cuestionario auto-aplicado en 2008. Las variables consideradas fueron "interés por las prácticas integrales y complementarias" y "concordancia con la Política Nacional de prácticas integrales y complementarias". Sexo, edad, estudio universitario, postgrado, tiempo de formación y de trabajo, poseer hijos, oferta de prácticas integrales y complementarias en el lugar de trabajo y uso de homeopatía o acupuntura conformaron las variables independientes. Los datos fueron analizados por la prueba de chi-cuadrado y la prueba exacta de Fisher. RESULTADOS: Diecisiete centros de salud ofrecían prácticas integrales y complementarias; 12,4% de los profesionales poseían especialización en homeopatía o acupuntura; 43,5% de los médicos eran especialistas en medicina de familia y comunidad/salud de la familia. De los participantes, 88,7% desconocían las directrices nacionales para el área, a pesar de que el 81,4% concordasen con su inclusión en el Sistema Único de Salud. La mayoría (59,9% mostró interés en capacitaciones y todos concordaran que esas prácticas deberían ser abordadas en el estudio universitario. La concordancia con la inclusión de tales prácticas se mostró asociada significativamente con el hecho de ser enfermero (p=0,027 y con el uso de homeopatía para sí mismo (p=0,019. Interés por las prácticas complementarias estuvo asociado con el uso de homeopatía para sí mismo (p=0,02 y acupuntura para familiares (p=0,013. CONCLUSIONES: Existe aceptación de las prácticas integrales y complementarias por los profesionales estudiados, asociada al contacto previo con las mismas y posiblemente relacionada a la residencia/especialización en medicina de familia y comunidad/salud de la familia.OBJECTIVE: To analyze Estratégia de Saúde da Família (Family Health Strategy professionals' perception of complementary and integrative therapies. METHODS: A study with 177 doctors and nurses was

  9. Timing of renal replacement therapy and patient outcomes in the randomized evaluation of normal versus augmented level of replacement therapy study.

    Science.gov (United States)

    Jun, Min; Bellomo, Rinaldo; Cass, Alan; Gallagher, Martin; Lo, Serigne; Lee, Joanne

    2014-08-01

    To explore the relationship between timing of continuous renal replacement therapy commencement and clinical outcomes in critically ill patients with acute kidney injury. The primary outcomes were all-cause mortality at 28 and 90 days. Nested observational cohort study using data from the Randomized Evaluation of Normal Versus Augmented Level Replacement Therapy Study. Twenty-three ICUs in Australia and New Zealand. Four hundred thirty-nine critically ill patients with acute kidney injury Risk, Injury, Failure, Loss, End-stage kidney disease-injury (RIFLE-I) criteria. None. The time between RIFLE-I acute kidney injury and randomization in the Randomized Evaluation of Normal Versus Augmented Level Replacement Therapy Study (proxy for continuous renal replacement therapy commencement) was the variable of interest. All baseline variables in the Randomized Evaluation of Normal Versus Augmented Level Replacement Therapy Study were assessed. Multivariable Cox, logistic, and linear regression models were used to assess the independent relationship of time of onset of RIFLE-I acute kidney injury and randomization and patient outcomes. The median time between RIFLE-I acute kidney injury and continuous renal replacement therapy commencement was 17.6 hours (interquartile range, 7.1-46 hr). Based on four groups of continuous renal replacement therapy commencement ([group 1; reference]: Study, earlier commencement of continuous renal replacement therapy relative to RIFLE-I acute kidney injury was not significantly associated with improved survival. Additional studies with larger sample sizes and broader commencement times are warranted.

  10. A prospective evaluation of Dignity Therapy in advanced cancer patients admitted to palliative care

    DEFF Research Database (Denmark)

    Houmann, Lise Jul; Chochinov, Harvey M; Kristjanson, Linda J

    2014-01-01

    Organisation for Research and Treatment of Cancer QLQ-C15-PAL (ClinicalTrials.gov number: NCT01507571).Setting/participants:Consecutive patients with incurable cancer, ≥18 years, informed of prognosis and not having cognitive impairment/physical limitations precluding participation were included at a hospice......Background:Dignity Therapy is a brief, psychosocial intervention for patients with incurable disease.Aim:To investigate participation in and evaluation of Dignity Therapy and longitudinal changes in patient-rated outcomes.Design:A prospective (pre/post) evaluation design was employed. Evaluation...... questionnaires were completed when patients received the generativity document (T1) and 2 weeks later (T2). Changes from baseline (T0) were measured in sense of dignity, Structured Interview for Symptoms and Concerns items, Patient Dignity Inventory, Hospital Anxiety and Depression Scale and European...

  11. Is cardiovascular evaluation necessary prior to and during beta-blocker therapy for infantile hemangiomas? : A cohort study

    NARCIS (Netherlands)

    Raphaël, Martine F.; Breugem, Corstiaan C; Vlasveld, Florine A E; de Graaf, Marlies; Slieker, Martijn G; Pasmans, Suzanne G M A; Breur, Johannes M P J Breur

    2015-01-01

    BACKGROUND: Although consensus guidelines for pretreatment evaluation and monitoring of propranolol therapy in patients with infantile hemangiomas (IH) have been formulated, little is known about the cardiovascular side effects. OBJECTIVES: We sought to analyze cardiovascular evaluations in patients

  12. Online Wavelet Complementary velocity Estimator.

    Science.gov (United States)

    Righettini, Paolo; Strada, Roberto; KhademOlama, Ehsan; Valilou, Shirin

    2018-01-02

    In this paper, we have proposed a new online Wavelet Complementary velocity Estimator (WCE) over position and acceleration data gathered from an electro hydraulic servo shaking table. This is a batch estimator type that is based on the wavelet filter banks which extract the high and low resolution of data. The proposed complementary estimator combines these two resolutions of velocities which acquired from numerical differentiation and integration of the position and acceleration sensors by considering a fixed moving horizon window as input to wavelet filter. Because of using wavelet filters, it can be implemented in a parallel procedure. By this method the numerical velocity is estimated without having high noise of differentiators, integration drifting bias and with less delay which is suitable for active vibration control in high precision Mechatronics systems by Direct Velocity Feedback (DVF) methods. This method allows us to make velocity sensors with less mechanically moving parts which makes it suitable for fast miniature structures. We have compared this method with Kalman and Butterworth filters over stability, delay and benchmarked them by their long time velocity integration for getting back the initial position data. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

  13. The Music Therapy Session Assessment Scale (MT-SAS): Validation of a new tool for music therapy process evaluation.

    Science.gov (United States)

    Raglio, Alfredo; Gnesi, Marco; Monti, Maria Cristina; Oasi, Osmano; Gianotti, Marta; Attardo, Lapo; Gontero, Giulia; Morotti, Lara; Boffelli, Sara; Imbriani, Chiara; Montomoli, Cristina; Imbriani, Marcello

    2017-11-01

    Music therapy (MT) interventions are aimed at creating and developing a relationship between patient and therapist. However, there is a lack of validated observational instruments to consistently evaluate the MT process. The purpose of this study was the validation of Music Therapy Session Assessment Scale (MT-SAS), designed to assess the relationship between therapist and patient during active MT sessions. Videotapes of a single 30-min session per patient were considered. A pilot study on the videotapes of 10 patients was carried out to help refine the items, define the scoring system and improve inter-rater reliability among the five raters. Then, a validation study on 100 patients with different clinical conditions was carried out. The Italian MT-SAS was used throughout the process, although we also provide an English translation. The final scale consisted of 7 binary items accounting for eye contact, countenance, and nonverbal and sound-music communication. In the pilot study, raters were found to share an acceptable level of agreement in their assessments. Explorative factorial analysis disclosed a single homogeneous factor including 6 items (thus supporting an ordinal total score), with only the item about eye contact being unrelated to the others. Moreover, the existence of 2 different archetypal profiles of attuned and disattuned behaviours was highlighted through multiple correspondence analysis. As suggested by the consistent results of 2 different analyses, MT-SAS is a reliable tool that globally evaluates sonorous-musical and nonverbal behaviours related to emotional attunement and empathetic relationship between patient and therapist during active MT sessions. Copyright © 2017 John Wiley & Sons, Ltd.

  14. [Touching cancer: shiatsu as complementary treatment to support cancer patients].

    Science.gov (United States)

    Argash, Oz; Caspi, Opher

    2008-01-01

    In recent years there has been an increase in the interest of cancer patients in receiving complementary medicine therapies as supportive measures to cure the disease. In response, medical units that combine conventional and complementary medicine (integrative medicine) have been established in leading cancer centers worldwide. In Israel, a special integrative medicine unit that combines mind-body, Chinese medicine, nutrition, herbs, supplements, and manual therapies (such as shiatsu) before, during and after conventional anti-cancer therapies has been established as an integral part of the Davidoff Comprehensive Cancer Center in 2006. Shiatsu represents a group of manual therapeutic techniques, including acupressure. Shiatsu offers cancer patients a non-pharmacologic method to relieve symptoms and improve quality of life throughout the course of illness. Research indicates that acupressure is relatively effective and safe for common cancer-related symptoms such as nausea, vomiting and insomnia. In our experience, shiatsu is also relatively effective and safe for other common symptoms such as fatigue, muscular pain and body image dissatisfaction. Yet, insufficient evidence exists to delineate the best means by which shiatsu and other manual therapies could or should be integrated into routine cancer care. The purpose of the present paper is to describe what is currently known about this topic in order to support decision-making that is based on facts, rather than on myths and misconceptions. We call for more research that examines the effectiveness and safety of shiatsu and other manual therapies in the care of cancer patients.

  15. Evaluating an Adjunctive Mobile App to Enhance Psychological Flexibility in Acceptance and Commitment Therapy.

    Science.gov (United States)

    Levin, Michael E; Haeger, Jack; Pierce, Benjamin; Cruz, Rick A

    2017-11-01

    The primary aims of this study were to evaluate the feasibility and potential efficacy of a novel adjunctive mobile app designed to enhance the acquisition, strengthening, and generalization of acceptance and commitment therapy (ACT) skills being taught in therapy. A sample of 14 depressed/anxious clients receiving ACT used the ACT Daily app for 2 weeks in a pre-post, open trial design. Participants reported a high degree of program satisfaction. Clients significantly improved over the 2-week period on depression and anxiety symptoms as well as a range of psychological inflexibility measures. Analyses of mobile app data indicated effects of ACT Daily skill coaching on in-the-moment measures of inflexibility and symptoms, with unique effects found for acceptance and mindfulness. Adjunctive ACT mobile apps appear promising in enhancing therapy effects on psychological inflexibility and outcomes. A tailored skill coaching approach like ACT Daily based on randomly prompted assessments may be especially promising.

  16. A Mathematical Model of Antiretroviral Therapy Evaluation for HIV Type 1

    Science.gov (United States)

    Raimundo, Silvia Martorano; Venturino, Ezio; Mo Yang, Hyun

    2009-09-01

    Treating HIV-infected patients with a combination of several antiretroviral drugs can lead to emergence of the drug-resistant strain. This work proposes a mathematical model to evaluate the emergence of HIV-1 drug resistant during antiretroviral therapy. The model assumes that all susceptible individuals who can be infected by the wildtype strain (sensible to the treatment) or by drug-resistant virus receive antiretroviral therapy. Patients on treatment regimen can evolve to a state of success or failure and for the individuals in therapeutic fail the therapeutic schema is changed. The analysis of system is performed. The existence and stability of the steady states are considered. We address an analytical expression for the reproductive number in a community where antiretroviral therapy are widely used to treat HIV and where both drug sensitive and drug resistant strains are co-circulating.

  17. MULTIDIMETIONAL OUTCOME AND LONG-TERM EVALUATION OF NON-AVOIDANCE STUTTERUNG THERAPY

    Directory of Open Access Journals (Sweden)

    Dobrinka GEORGIEVA

    2015-11-01

    Full Text Available nternational Classification of Functioning, Disability, and Health (ICF, WHO, 2001 is a constructive framework for quality assessment and treatment in Logopedics (Speech Language Therapy. The current research study makes an attempt to introduce this standard into logopedical practice and applied research to measure the quality of life of persons with fluency disorders, such as stuttering. The quality of life is a modern multidimensional construct that covers health-medical, psychological, social and economic factors. Good level of communication and stabilized fluency is of key importance to improve the quality of life of persons who stutter. The purpose of the study was to show a model of assessment, treatment and evaluation of the efficacy of the non-avoidance approach in adult stuttering therapy. According to the results of the Index of disability, 47% of the people with multiple sclerosis have limited independence in providing daily activities leading up to 31% of the examinees with rare participation in the everyday social activities, the result obtained by the Frenchay Index of activities. We can conclude that the Index of disability is higher with older respondents and it is often followed by a drop of the daily activity frequency. Methods: CharlesVan Riper’s non-avoidance approach for an intensive therapy. Participants were 15 adults who stutter with an average age 25.2 years. Results: Specific significant decreasing of the two main parameters: index of dysfluencies immediately after the intensive therapy as well as duration of disfluences in seconds. The changes in speech fluency before and after the intensive therapy as well as 3 years after this therapy were obtained regarding the duration of disfluencies and index of dysfluency. Conclusion: The present model of an intensive non-avoidance therapy format for adults with stuttering disorders was successfully applied for the Bulgarian conditions. Improved fluency is an important factor

  18. A fuller picture: evaluating an art therapy programme in a multidisciplinary mental health service.

    Science.gov (United States)

    Brady, Catherina; Moss, Hilary; Kelly, Brendan D

    2017-03-01

    Art therapy has a long history in mental healthcare, but requires an enhanced evidence base in order to better identify its precise role in contemporary services. This paper describes an evaluation of an art therapy programme in an acute adult psychiatry admission unit in Ireland. A mixed method research design was used. Quantitative data were collected through a survey of 35 staff members and 11 service users. Qualitative data included free text comments collected in the survey and individual feedback from service users. Both methods aimed to assess the role of art therapy as part of a multidisciplinary mental health service. Thematic content analysis was employed to analyse qualitative data. Staff demonstrated overwhelming support for art therapy as one element within multidisciplinary services available to patients in the acute psychiatry setting, Qualitative feedback associated art therapy with improvements in quality of life and individual support, and emphasised its role as a non-verbal intervention, especially useful for those who find talking therapy difficult. Creative self-expression is valued by staff and service users as part of the recovery process. Recommendations arising from the research include continuing the art therapy service, expanding it to include patients under rehabilitation, provision of information and education sessions to staff, and further research to identify other potential long-term effects. The low response of staff and small sample in this study, however, must be noted as limitations to these findings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Evaluating effects of normobaric oxygen therapy in acute stroke with MRI-based predictive models

    Directory of Open Access Journals (Sweden)

    Wu Ona

    2012-03-01

    Full Text Available Abstract Background Voxel-based algorithms using acute multiparametric-MRI data have been shown to accurately predict tissue outcome after stroke. We explored the potential of MRI-based predictive algorithms to objectively assess the effects of normobaric oxygen therapy (NBO, an investigational stroke treatment, using data from a pilot study of NBO in acute stroke. Methods The pilot study of NBO enrolled 11 patients randomized to NBO administered for 8 hours, and 8 Control patients who received room-air. Serial MRIs were obtained at admission, during gas therapy, post-therapy, and pre-discharge. Diffusion/perfusion MRI data acquired at admission (pre-therapy was used in generalized linear models to predict the risk of lesion growth at subsequent time points for both treatment scenarios: NBO or Control. Results Lesion volume sizes 'during NBO therapy' predicted by Control-models were significantly larger (P = 0.007 than those predicted by NBO models, suggesting that ischemic lesion growth is attenuated during NBO treatment. No significant difference was found between the predicted lesion volumes at later time-points. NBO-treated patients, despite showing larger lesion volumes on Control-models than NBO-models, tended to have reduced lesion growth. Conclusions This study shows that NBO has therapeutic potential in acute ischemic stroke, and demonstrates the feasibility of using MRI-based algorithms to evaluate novel treatments in early-phase clinical trials.

  20. [Evaluation of curative effect of initial therapy on the patients with aggressive periodontitis].

    Science.gov (United States)

    Liu, Bo; Zha, Xi-Da; Zhang, Jian-Quan; Zhao, Xue; Pan, Ya-Ping

    2010-12-01

    To evaluate the clinical outcome of periodontal initial therapy on the patients with aggressive periodontitis. A total of 48 patients with aggressive periodontitis, including 20 patients with localized aggressive periodontitis (LAgP) and 28 patients with generalized aggressive periodontitis (GAgP), were chosen for the study from the patients referred to the Department of Periodontology of the School of Stomatology of China Medical University from September 2006 to December 2008. All subjects were performed periodontal initial therapy. Probing depth (PD), clinical attachment loss (CAL), bleeding index (BI) and tooth mobility were recorded at baseline and 1, 3 and 6 months after initial treatment. At 1, 3 and 6 months after periodontal initial therapy, there were significant improvements in PD, CAL, BI and tooth mobility of patients with LAgP and GAgP than those in the baseline (P periodontal initial therapy (P Periodontal initial therapy showed effectiveness in treatment of aggressive periodontitis. In the mid-term, there were differences in therapeutic effect between patients with LAgP and GAgP.

  1. Murine model imitating chronic wound infections for evaluation of Antimicrobial Photodynamic Therapy efficacy

    Directory of Open Access Journals (Sweden)

    Grzegorz Fila

    2016-08-01

    Full Text Available It is generally acknowledged that the age of antibiotics could come to an end, due to their widespread and inappropriate use. Particularly for chronic wounds alternatives are being thought. Antimicrobial Photodynamic Therapy is a potential candidate, and while approved for some indications, such as periodontitis, chronic sinusitis and other niche indications, its use in chronic wounds is not established. To further facilitate the development of Antimicrobial Photodynamic Therapy in chronic wounds we present an easy to use animal model exhibiting the key hallmarks of chronic wounds, based on full-thickness skin wounds paired with an optically transparent cover. The moisture-retaining wound exhibited rapid expansion of pathogen colonies up to 8 days while not jeopardizing the host survival. Use of two bioluminescent pathogens; methicillin resistant Staphylococcus aureus and Pseudomonas aeruginosa permits real time monitoring of the pathogens.The murine model was employed to evaluate the performance of four different photosensitizers as mediators in Photodynamic Therapy. While all four photosensitizers, Rose Bengal, porphyrin TMPyP, New Methylene Blue and TLD1411 demonstrated good to excellent antimicrobial efficacy in planktonic solutions at 1 to 50 µM concentrations, whereas in in vivo the growth delay was limited with 24-48 hr delay in pathogen expansion for methicillin resistant Staphylococcus aureus, and we noticed longer growth suppression of Pseudomonas aeruginosa with TLD1411 mediated Photodynamic Therapy. The murine model will enable developing new strategies for enhancement of Antimicrobial Photodynamic Therapy for chronic wound infections.

  2. Economic evaluation of occupational therapy in Parkinson's disease: A randomized controlled trial.

    Science.gov (United States)

    Sturkenboom, Ingrid H W M; Hendriks, Jan C M; Graff, Maud J L; Adang, Eddy M M; Munneke, Marten; Nijhuis-van der Sanden, Maria W G; Bloem, Bastiaan R

    2015-07-01

    A large randomized clinical trial (the Occupational Therapy in Parkinson's Disease [OTiP] study) recently demonstrated that home-based occupational therapy improves perceived performance in daily activities of people with Parkinson's disease (PD). The aim of the current study was to evaluate the cost-effectiveness of this intervention. We performed an economic evaluation over a 6-month period for both arms of the OTiP study. Participants were 191 community-dwelling PD patients and 180 primary caregivers. The intervention group (n = 124 patients) received 10 weeks of home-based occupational therapy; the control group (n = 67 patients) received usual care (no occupational therapy). Costs were assessed from a societal perspective including healthcare use, absence from work, informal care, and intervention costs. Health utilities were evaluated using EuroQol-5d. We estimated cost differences and cost utility using linear mixed models and presented the net monetary benefit at different values for willingness to pay per quality-adjusted life-year gained. In our primary analysis, we excluded informal care hours because of substantial missing data for this item. The estimated mean total costs for the intervention group compared with controls were €125 lower for patients, €29 lower for caregivers, and €122 higher for patient-caregiver pairs (differences not significant). At a value of €40,000 per quality-adjusted life-year gained (reported threshold for PD), the net monetary benefit of the intervention per patient was €305 (P = 0.74), per caregiver €866 (P = 0.01) and per patient-caregiver pair €845 (P = 0.24). In conclusion, occupational therapy did not significantly impact on total costs compared with usual care. Positive cost-effectiveness of the intervention was only significant for caregivers. © 2015 International Parkinson and Movement Disorder Society.

  3. Paying for Complementary Health Approaches

    Science.gov (United States)

    ... practices, adults and children most often turn to chiropractic or osteopathic manipulation, yoga, meditation, and massage therapy. ... PDF ) , researchers analyzed 2012 NHIS data on acupuncture, chiropractic, and massage―and compared that with data from ...

  4. Headaches and Complementary Health Approaches

    Science.gov (United States)

    ... type headache in adults: are they beneficial? CNS Neuroscience & Therapeutics. 2009;15(2):183–205. Vickers AJ, ... 5:13. Vickers A, Zollman C, Payne DK. Hypnosis and relaxation therapies . Western Journal of Medicine. 2001; ...

  5. Narrative journalism as complementary inquiry

    Directory of Open Access Journals (Sweden)

    Jørgen Jeppesen

    2011-10-01

    Full Text Available Narrative journalism is a method to craft stories worth reading about real people. In this article, we explore the ability of that communicative power to produce insights complementary to those obtainable through traditional qualitative and quantitative research methods. With examples from a study of journalistic narrative as patient involvement in professional rehabilitation, interview data transcribed as stories are analyzed for qualities of heterogeneity, sensibility, transparency, and reflexivity. Building on sociological theories of thinking with stories, writing as inquiry, and public journalism as ethnography, we suggest that narrative journalism as a common practice might unfold dimensions of subjective otherness of the self. Aspiring to unite writing in both transparently confrontational and empathetically dialogic ways, the narrative journalistic method holds a potential to expose dynamics of power within the interview.

  6. [Behavioral, stress and immunological evaluation methods of music therapy in elderly patients with senile dementia].

    Science.gov (United States)

    Suzuki, Mizue; Kanamori, Masao; Nagasawa, Shingo; Saruhara, Takayuki

    2005-01-01

    The purpose of this study was to clarify the efficacy of behavioral, stress and immunological evaluation methods in music therapy (MT) with elderly patients with senile dementia. The MT group consisted of 8 elderly patients with dementia and the control group included 8 similarly matched patients. A total of 25 sessions of music therapy were conducted for one hour, twice each week for three months. The Mini-Mental State Exam (MMSE), Gottfries-Brane-Steen Scale (GBS), and Behavioral Pathology in Alzheimer's Disease Rating Scale (Behave-AD) were used to evaluate behavioral changes. Saliva Chromogranin A (Cg A) and Immunoglobulin A (Ig A) were used to assess changes in stress and immunological status, respectively. The results of the study were as follows: 1. In GBS, the mean score of "different symptoms common in dementia" improved significantly after MT. 2. The mean Behave-AD score of "paranoid and delusional ideation" was also significantly improved (pdementia.

  7. Evaluative comparison of systemic aspirin therapy effects on gingival bleeding in post non-surgical periodontal therapy individuals

    Directory of Open Access Journals (Sweden)

    Elanchezhiyan Sundram

    2012-01-01

    Full Text Available Background: Gingival bleeding is considered as an important clinical sign for diagnosis of periodontal disease pathogenesis. Immune inflammatory reactions caused by local factors are considered as essential reasons for gingival bleeding, as also for the systemic bleeding disorders. In disease-free conditions of gingiva, the bleeding disorders are considered to be the main contender for bleeding. Other than these variables, many systemic drugs including systemic aspirin could also cause gingival bleeding. The main aim of the study was to evaluate the effect of buffered aspirin therapy on gingival bleeding. Materials and Methods: Totally, 36 systemically healthy individuals were included in the 15-day randomized, double-blinded, placebo-controlled clinical trial. The 15 days were divided as: control period for the first 7 days and study period for the following 7 days. On the 1 st day, all individuals were given oral prophylaxis after recording gingival parameters such as Plaque Index, probing depth, and Bleeding Index, and then blood samples were collected for hematological investigations. Then, all individuals were administered placebo capsules for 1 week as once daily dose. On the 8 th day, all procedures were repeated and the individuals were prescribed with 325 coated aspirin capsules for 1 week. On the 15 th day, all parameters were repeated and the results were statistically analyzed. Results: In the study period, the parameters such as Bleeding Index, bleeding time, and prothrombin time were increased significantly, compared to the control period. Conclusion: The variables such as systemic drug therapy should be considered for the examination of gingiva while the diagnosis is considered mainly based on gingival bleeding.

  8. Complementary and Alternative Medicine practices in military personnel and families presenting to a military emergency department.

    Science.gov (United States)

    Ross, Elliot M; Darracq, Michael A

    2015-03-01

    Limited published literature is available on Complementary and Alternative Medicine (CAM) use and attitudes toward CAM in the military community. We sought to evaluate past experiences with CAM, common conditions for which CAM is used, and willingness to use acupuncture for acute conditions in an Emergency Department (ED) setting by patients and family members presenting to a tertiary military treatment facility (MTF). After institutional review board approval, an 18-item questionnaire was distributed to a convenience sample of ED patients presenting to a Navy MTF. A response was obtained from 1,005 respondents with 45% describing previous or current CAM use. Massage, chiropractic, herbal, and acupuncture were most frequently employed. The most common reasons for use of CAM therapies are described. The majority (88%) of surveyed participants reported that CAM therapies should be offered by the MTF and 80% reported a willingness to use acupuncture in the ED setting. CAM therapies are used by the military community for a wide variety of conditions. The use of acupuncture in the ED for treatment of presenting complaints was met with interest by respondents. Further studies are necessary to determine indications, efficacy, and patient satisfaction with such therapy in an emergent setting. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

  9. Systematic review: Complementary and alternative medicine in the irritable bowel syndrome.

    LENUS (Irish Health Repository)

    Hussain, Z

    2012-02-03

    BACKGROUND: Complementary and alternative medical therapies and practices are widely employed in the treatment of the irritable bowel syndrome. AIM: To review the usage of complementary and alternative medicine in the irritable bowel syndrome, and to assess critically the basis and evidence for its use. METHODS: A systematic review of complementary and alternative medical therapies and practices in the irritable bowel syndrome was performed based on literature obtained through a Medline search. RESULTS: A wide variety of complementary and alternative medical practices and therapies are commonly employed by irritable bowel syndrome patients both in conjunction with and in lieu of conventional therapies. As many of these therapies have not been subjected to controlled clinical trials, some, at least, of their efficacy may reflect the high-placebo response rate that is characteristic of irritable bowel syndrome. Of those that have been subjected to clinical trials most have involved small poor quality studies. There is, however, evidence to support efficacy for hypnotherapy, some forms of herbal therapy and certain probiotics in irritable bowel syndrome. CONCLUSIONS: Doctors caring for irritable bowel syndrome patients need to recognize the near ubiquity of complementary and alternative medical use among this population and the basis for its use. All complementary and alternative medicine is not the same and some, such as hypnotherapy, forms of herbal therapy, specific diets and probiotics, may well have efficacy in irritable bowel syndrome. Above all, we need more science and more controlled studies; the absence of truly randomized placebo-controlled trials for many of these therapies has limited meaningful progress in this area.

  10. Complementary and alternative medicine use in dermatology in the United States.

    Science.gov (United States)

    Landis, Erin T; Davis, Scott A; Feldman, Steven R; Taylor, Sarah

    2014-05-01

    Complementary and alternative medicine (CAM) has an increasing presence in dermatology. Complementary therapies have been studied in many skin diseases, including atopic dermatitis and psoriasis. This study sought to assess oral CAM use in dermatology relative to medicine as a whole in the United States, using the National Ambulatory Medical Care Survey. Variables studied include patient demographic characteristics, diagnoses, and CAM documented at the visits. A brief literature review of the top 5 CAM treatments unique to dermatology visits was performed. Most CAM users in both dermatology and medicine as a whole were female and white and were insured with private insurance or Medicare. Fish oil, glucosamine, glucosamine chondroitin, and omega-3 were the most common complementary supplements used in both samples. CAM use in dermatology appears to be part of a larger trend in medicine. Knowledge of common complementary therapies can help dermatologists navigate this expanding field.

  11. [Music therapy for chronic headaches. Evaluation of music therapeutic groups for patients suffering from chronic headaches].

    Science.gov (United States)

    Risch, M; Scherg, H; Verres, R

    2001-04-01

    This paper presents a new approach to music therapeutic treatments. We developed a short time treatment ( 8 group sessions) for patients suffering from chronic headaches. The multimodal concept of this headache treatment and particularly the effect of a sound trance on headache patients are explained and evaluated in this paper. An evaluation study was done with 34 patients, who belonged to four therapy groups. In order to evaluate this treatment the patients were interviewed and had to fill out several self-rating scales about pain and some psychological variables (e. g. depression) before, directly after and 6-12 months after the treatment. This treatment group (n=26) was compared to a small waiting group (n=9). A case study elucidated the psycho-social anamnesis, and the process and outcome of the music therapy. The case study shows that the sound trance caused a loss of the affect control or at least reduced it. This experience enabled the patients to develop creative solutions, which resulted in a pain relief 6-12 month later. The comparison of the statistic means directly before and after the treatment did not reveal many therapeutic effects. Yet, 6-12 months later many patients reported less days at which they suffered from headaches; and they also significantly improved their ability of pain control. The results indicate that music therapy groups are more successful than a waiting group. The study's results agree with numerous other psychological evaluation studies and shows once more that music therapists working with patients suffering from chronic headaches are able to achieve successful results particularly long-dated. Thus, creative therapeutic approaches supplement the medical treatment, as they help the patients to develop an adaptive way of coping their pain. Yet, it will need further research to confirm the benefit of music therapy for patients suffering from chronic pain.

  12. Clinical and Radiographic Evaluation of Procedural Accidents and Errors during Root Canal Therapy

    OpenAIRE

    Mozayeni, Mohammad Ali; Asnaashari, Mohammad; Modaresi, Seyed Jalil

    2006-01-01

    INTRODUCTION: Root canal therapy (RCT)_like other dental practices_ can be accompanied with some accidents or unpredictable conditions that are called "procedural accidents". Having the knowledge about these accidents and their etiology is essential to have RCT completion and to prevent the repeat of these accidents. This study was designed to evaluate accidents occurring during RCT in patients referred to endodontic department of Shaheed Beheshti dental school during 2002. MATERIALS AND METH...

  13. Design and evaluation of a virtual reality exposure therapy system with automatic free speech interaction

    OpenAIRE

    Ter Heijden, N.; Brinkman, W.P.

    2011-01-01

    Research on Virtual Reality Exposure Therapy (VRET) to treat social phobia is not new. Still few studies focus on creating an elaborate conversation between the patient and characters in a virtual environment. This study focuses on techniques to run a semi-scripted conversation between virtual characters and a patient considering both manual and automatic speech response. Techniques evaluated are a speech detector and a speech recognizer. They were compared to a human control condition. We an...

  14. A multicenter evaluation of oral pressure therapy for the treatment of obstructive sleep apnea

    OpenAIRE

    Colrain, IM; Black, J.; Siegel, LC; Bogan, RK; Becker, PM; Farid-Moayer, M; Goldberg, R.; Lankford, DA; Goldberg, AN; Malhotra, A

    2013-01-01

    Objective: We aimed to evaluate the impact of a novel noninvasive oral pressure therapy (OPT) (Winx®, ApniCure) system on polysomnographic measures of sleep-disordered breathing, sleep architecture, and sleep stability in obstructive sleep apnea (OSA). Subjects and methods: A 4-week, multicenter, prospective, open-label, randomized, crossover, first-night order of control vs treatment, single-arm trial was conducted in five American Academy of Sleep Medicine (AASM) - accredited sleep clinics ...

  15. Complementary and alternative medicine in radiation oncology. Survey of patients' attitudes

    Energy Technology Data Exchange (ETDEWEB)

    Lettner, Sabrina [Technische Universitaet Muenchen (TUM), Department of Radiation Oncology, Muenchen (Germany); Kessel, Kerstin A.; Combs, Stephanie E. [Technische Universitaet Muenchen (TUM), Department of Radiation Oncology, Muenchen (Germany); Helmholtz Zentrum Muenchen, Institute of Innovative Radiotherapy (iRT), Neuherberg (Germany)

    2017-05-15

    Complementary and alternative medicine (CAM) are gaining in importance, but objective data are mostly missing. However, in previous trials, methods such as acupuncture showed significant advantages compared to standard therapies. Thus, the aim was to evaluate most frequently used methods, their significance and the general acceptance amongst cancer patients undergoing radiotherapy (RT). A questionnaire of 18 questions based on the categorical classification released by the National Centre for Complementary and Integrative Health was developed. From April to September 2015, all patients undergoing RT at the Department of Radiation Oncology, Technical University of Munich, completed the survey. Changes in attitude towards CAM were evaluated using the questionnaire after RT during the first follow-up visit (n = 31). Of 634 patients, 333 answered the questionnaire (52.5%). Of all participants, 26.4% used CAM parallel to RT. Before RT, a total of 39.3% had already used complementary medicine. The most frequently applied methods during therapy were vitamins/minerals, food supplements, physiotherapy/manual medicine, and homeopathy. The majority (71.5%) did not use any complementary treatment, mostly stating that CAM was not offered to them (73.5%). The most common reasons for use were to improve the immune system (48%), to reduce side effects (43.8%), and to not miss an opportunity (37.8%). Treatment integrated into the individual therapy concept, e.g. regular acupuncture, would be used by 63.7% of RT patients. In comparison to other studies, usage of CAM parallel to RT in our department is considered to be low. Acceptance amongst patients is present, as treatment integrated into the individual oncology therapy would be used by about two-third of patients. (orig.) [German] Komplementaer- und alternativmedizinische Behandlungen (CAM) nehmen in vielen medizinischen Bereichen trotz oftmals fehlender objektiver Daten zu. In Therapiestudien zeigen Verfahren wie Akupunktur

  16. Complementary Health Approaches Used in the Intensive Care Unit.

    Science.gov (United States)

    Erdoğan, Zeynep; Atik, Derya

    Intensive care units are care centers where, in order to provide the maximum benefit to individuals whose life is in danger, many lifesaving technological tools and devices are present, and morbidity and mortality rates are high. In the intensive care unit, when classic treatments fail or become unbearable because of side effects, complementary methods have been suggested to be the best alternative. Complementary health approaches are methods that are used both for the continuation and the improvement of the well-being of an individual and as additions to medical treatments that are based on a holistic approach. These applications are especially helpful in the treatment of the stresses, anxieties, and other symptoms of unstable patients in the intensive care unit who do not tolerate traditional treatment methods well, increasing their psychological and physiological well-being, helping them sleep and rest. In intensive care patients, in order to decrease the incidence of postoperative atrial fibrillation, antiemetic and medicine needs, mechanical ventilation duration, and the intensity of the disease as well as to cope with symptoms such as pain, anxiety, physiological parameters, dyspnea, and sleep problems, body-mind interventions such as massage, reflexology, acupressure, aromatherapy, music therapy, energy therapies (healing touch, therapeutic touch, the Yakson method), and prayer are used as complementary health approaches.

  17. Treatment of Diabetic Gastroparesis by Complementary and Alternative Medicines

    Directory of Open Access Journals (Sweden)

    Hao Liu

    2015-08-01

    Full Text Available Gastroparesis is a common gastrointestinal complication in diabetes, induced by hyperglycemia and characterized by delayed gastric emptying and upper abdominal symptoms, such asnausea, vomiting, early satiety, bloating and epigastric pain. Diabetic gastroparesis (DGP affects life quality and glycemic control, and is a challenge to treat in both Western and Eastern medicine. Routine treatment in Western medicine includes gastric emptying promoted by prokinetic agents, gastric pacemaking, or surgery combined with lifetime hormono-therapy, all of which have unavoidable side effects and limitations, and are very expensive. Complementary and alternative medical treatments like acupuncture, moxibustion, and massage are becoming more and more attractive because of their effectiveness, fewer side effects, and reliable safety. This article aims to introduce representative methods of complementary and alternative medicine to treat DGP, which were searched in English through Pubmed and in Chinese through CNKI (China Knowledge Resource Integrated Database. Several lines of evidence demonstrated the effects of single or combined complementary alternative therapies on DGP outcomes; however, the mechanisms were rarely investigated. Randomized controlled trials are undoubtedly required in future studies.

  18. On complementary channels and the additivity problem

    OpenAIRE

    Holevo, A. S.

    2005-01-01

    We explore complementarity between output and environment of a quantum channel (or, more generally, CP map), making an observation that the output purity characteristics for complementary CP maps coincide. Hence, validity of the mutiplicativity/additivity conjecture for a class of CP maps implies its validity for complementary maps. The class of CP maps complementary to entanglement-breaking ones is described and is shown to contain diagonal CP maps as a proper subclass, resulting in new clas...

  19. An Investigation of the Use of Traditional Chinese Medicine and Complementary and Alternative Medicine in Stroke Patients.

    Science.gov (United States)

    Yeh, Mei-Ling; Chiu, Wei-Ling; Wang, Yu-Jen; Lo, Chyi

    This study aimed to investigate the use of traditional Chinese medicine and complementary and alternative medicine in stroke patients in Taiwan. Chinese herbal medicine, massage, acupuncture, natural products, and exercise were widely used among stroke patients. Integrating safe and effective traditional Chinese medicine and complementary and alternative medicine into conventional therapies is suggested.

  20. Safety, effectiveness and economic evaluation of intra-operative radiation therapy: a systematic review.

    Science.gov (United States)

    Najafipour, Farshad; Hamouzadeh, Pejman; Arabloo, Jalal; Mobinizadeh, Mohammadreza; Norouzi, Amir

    2015-01-01

    Intra-operative radiation therapy (IORT) is the transfer of a single large radiation dose to the tumor bed during surgery with the final goal of improving regional tumor control. This study aimed to investigate the safety, effectiveness and economic evaluation of intra-operative radiation therapy. The scientific literature was searched in the main biomedical databases (Centre for Reviews and Dissemination, Cochrane Library and PubMed) up to March 2014. Two independent reviewers selected the papers based on pre-established inclusion criteria, with any disagreements being resolved by consensus. Data were then extracted and summarized in a structured form. RESULTS from studies were analyzed and discussed within a descriptive synthesis. Sixteen studies met the inclusion criteria. It seems that outcomes from using intraoperative radiation therapy can be considered in various kinds of cancers like breast, pancreatic and colorectal cancers. The application of this method may provide significant survival increase only for colorectal cancer, but this increase was not significant for other types of cancer. This technology had low complications; and it is relatively safe. Using intra-operative radiation therapy could potentially be accounted as a cost-effective strategy for controlling and managing breast cancer. According to the existing evidences, that are the highest medical evidences for using intra-operative radiation therapy, one can generally conclude that intra-operative radiation therapy is considered as a relatively safe and cost-effective method for managing early-stage breast cancer and it can significantly increase the survival of patients with colorectal cancer. Also, the results of this study have policy implications with respect to the reimbursement of this technology.

  1. Clinical evaluation of photodynamic therapy efficacy in the treatment of oral leukoplakia.

    Science.gov (United States)

    Pietruska, Małgorzata; Sobaniec, Stefan; Bernaczyk, Piotr; Cholewa, Magdalena; Pietruski, Jan Krzysztof; Dolińska, Ewa; Skurska, Anna; Duraj, Ewa; Tokajuk, Grażyna

    2014-03-01

    The aim of the study was clinical evaluation of photodynamic therapy efficacy in the treatment of oral leukoplakia lesions. Twenty-three consecutive patients aged 21-79 were included to the study. In all patients 44 homogeneous, flat leukoplakia lesions were clinically diagnosed and confirmed histopathologically. Photodynamic therapy was performed with the use of Photolon(®) photosensitizer, containing 20% Chlorine-e6 and 10% dimethyl sulfoxide and a semiconductor laser, with power up to 300mW and a wavelength of 660nm. Ten illumination sessions were conducted with the use of superficial light energy density of 90J/cm(2). At baseline the mean size of leukoplakia lesion was 6.5±5.10cm(2) while after photodynamic therapy 3±2.99cm(2). Significant reduction (on average by 53.8%) of leukoplakia lesions sizes was observed after therapy. Twelve (27.27%) lesions had been completely cured, 22 (50%) partially cured, although 10 (22.73%) lasted unchanged. The efficacy of PTD was comparable in women and men irrespective of age. There have been no adverse site effects during therapy noted. Within the limits of the study it can be concluded that photodynamic therapy with the use of Chlorine-e6 can lead to considerable reduction of oral leukoplakia lesions size thus may be useful in clinical practice. However there is a need of further studies on larger number of cases and longer follow-up time. Copyright © 2013 Elsevier B.V. All rights reserved.

  2. Music therapy for prisoners: pilot randomised controlled trial and implications for evaluating psychosocial interventions.

    Science.gov (United States)

    Gold, Christian; Assmus, Jörg; Hjørnevik, Kjetil; Qvale, Liv Gunnhild; Brown, Fiona Kirkwood; Hansen, Anita Lill; Waage, Leif; Stige, Brynjulf

    2014-12-01

    Mental health problems are common among prison inmates. Music therapy has been shown to reduce mental health problems. It may also be beneficial in the rehabilitation of prisoners, but rigorous outcome research is lacking. We compared group music therapy with standard care for prisoners in a pilot randomised controlled trial that started with the establishment of music therapy services in a prison near Bergen in 2008. In all, 113 prisoners agreed to participate. Anxiety (STAI-State [State-Trait Anxiety Inventory], STAI-Trait), depression (HADS-D [Hospital Anxiety and Depression Scale]), and social relationships (Quality of Life Enjoyment and Satisfaction Questionnaire [Q-LES-Q]) were assessed at baseline; every 2 weeks in the experimental group; after 1, 3, and 6 months in the control group; and at release. No restrictions were placed on the frequency, duration, or contents of music therapy. Duration of stay in the institution was short (62% stayed less than 1 month). Only a minority reached clinical cutoffs for anxiety and depression at baseline. Between-group analyses of effects were not possible. Music therapy was well accepted and attractive among the prisoners. Post hoc analysis of within-group changes suggested a reduction of state anxiety after 2 weeks of music therapy (d = 0.33, p = .025). Short sentences and low baseline levels of psychological disturbance impeded the examination of effects in this study. Recommendations for planning future studies are given, concerning the careful choice of participants, interventions and settings, comparison condition and design aspects, choice of outcomes, and integration of research approaches. Thus, the present study has important implications for future studies evaluating interventions for improving prisoners' mental health. ISRCTN22518605. © The Author(s) 2013.

  3. The use of complementary and alternative medicine by women transitioning through menopause in Germany : Results of a survey of women aged 45-60 years

    NARCIS (Netherlands)

    Buhling, K. J.; v Daniels, B.; v Studnitz, F. S. G.; Eulenburg, C.; Mueck, A. O.

    Objectives: To describe prevalence rates of complementary and alternative medicine therapies (CAM) for the relief of menopausal complaints among German women. Furthermore, to investigate the perceived effectiveness of these therapies. Design: A self-administered questionnaire was sent to 9785

  4. The perceived efficacy of various "future-ologies" and complementary medicine.

    Science.gov (United States)

    Furnham, A

    2000-02-01

    To examine the relationship between beliefs in ways of telling the future (astrology, graphology, palmistry etc) and beliefs in complementary and alternative medicine (CAM). Participants completed a short questionnaire that requested that they rate the efficacy of 8 CAM therapies along with 12 other ways of predicting the future ranging from the well known and established (astrology) to the less well known (tasseography, oneiromancy). Short descriptions of each were provided. They also answered four attitude statements on science as applied to medicine. Two hundred three (130 female, 73 male) adult Britains obtained from a university subject panel served as unpaid volunteer subjects. CAM therapies were judged as modestly effective and most of the other "-ologies" ineffective. Further analysis confirmed two clear factors with the different methods loading on two different factors. Regressions showed females who were less concerned with scientific evaluations but more concerned with treatment believed more in the efficacy of the "future-ologies." Also females, who had heard of fewer "future-ologies" but more CAM practices were more likely to believe in the efficacy of CAM therapies. Belief in CAM is unrelated to belief in "future-ologies." Interest in the scientific evaluations of treatment is the best predictor of beliefs about efficacy.

  5. Evaluating outcomes of palliative photodynamic therapy: instrument development and preliminary results

    Science.gov (United States)

    Goodell, Teresa T.; Bargo, Paulo R.; Jacques, Steven L.

    2002-06-01

    Background: Subjective measures are considered the gold standard in palliative care evaluation, but no studies have evaluated palliative photodynamic therapy (PDT) subjectively. If PDT is to be accepted as a palliative therapy for later-stage obstructing esophageal and lung cancer, evidence of its effectiveness and acceptability to patients must be made known. Study Design/Materials and Methods: This ongoing study's major aim is to evaluate subjective outcomes of PDT in patients with obstructing esophageal and lung cancer. Existing measures of health status, dysphagia and performance status were supplemented with an instrument developed to evaluate PDT symptom relief and side effect burden, the PDT Side Effects Survey (PSES). Results: PDT patients treated with porfimer sodium (Photofrin) and 630-nm light experienced reduced dysphagia grade and stable performance status for at least one month after PDT (N= 10-17), but these effects did not necessarily persist at three months. Fatigue, appetite and quality of life may be the most burdensome issues for these patients. Conclusions: Preliminary data suggest that the PSES is an acceptable and valid tool for measuring subjective outcomes of palliative PDT. This study is the first attempt to systematically evaluate subjective outcomes of palliative PDT. Multi-center outcomes research is needed to draw generalizable conclusions that will establish PDT's effectiveness in actual clinical practice and enhance the wider adoption of PDT as a cancer symptom relief modality.

  6. Complementary and alternative exercise for fibromyalgia: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Mist SD

    2013-03-01

    Full Text Available Scott David Mist, Kari Firestone, Kim Dupree Jones Fibromyalgia Research and Treatment Group, School of Nursing, Oregon Health and Science University, Portland, OR, USA Abstract: Complementary and alternative medicine includes a number of exercise modalities, such as tai chi, qigong, yoga, and a variety of lesser-known movement therapies. A meta-analysis of the current literature was conducted estimating the effect size of the different modalities, study quality and bias, and adverse events. The level of research has been moderately weak to date, but most studies report a medium-to-high effect size in pain reduction. Given the lack of adverse events, there is little risk in recommending these modalities as a critical component in a multimodal treatment plan, which is often required for fibromyalgia management. Keywords: fibromyalgia, exercise, complementary and alternative, efficacy, safety

  7. Qualidade de vida de pacientes com câncer colorretal em terapia adjuvante Calidad de vida de pacientes con cáncer de rectocolon en terapia adyuvante Quality of life of patients with colorectal cancer who were receiving complementary therapy

    Directory of Open Access Journals (Sweden)

    Adriana Cristina Nicolussi

    2009-01-01

    , insomnio, fatiga, constipación y pérdida del apetito. Los pacientes en radioterapia relataron más dolor y los asintomáticos a la quimioterapia son los que obtuvieron mejor calidad de vida general. CONCLUSIÓN: La calidad de vida fue satisfactoria, relativamente peor en las mujeres, en radioterapia y que presentaron efectos colaterales de la quimioterapiaOBJECTIVE: To evaluate quality of life and the main demographic, clinical, and therapeutic characteristics of patients with colorectal cancer. In addition, the objective of the study was to examine the relationship between those characteristics and quality of life. METHODS: This cross-sectional study was conducted in a specialized oncology center in Ribeirão Preto. The sample consisted of 22 patients with colorectal cancer who were receiving complementary therapy. Data were collected from July 2006 through September 2007. The quality of life Core-30 Questionnaire was used to measure quality of life. RESULTS: Patients had a satisfactory quality of life score (mean = 79.13. The most affected domains were emotional functioning, pain, insomnia, and fatigue. Women had worse scores on emotional and cognitive functioning, pain, insomnia, fatigue, constipation, and loss of appetite. Patients who were receiving radiotherapy had a worse pain score. Patients who had no symptoms during chemotherapy had higher scores on quality of life. CONCLUSION: The quality of life scores in this sample of patients was satisfactory. Lower quality of life scores were observed among women, and patients who were receiving radiotherapy and/or had side effects of chemotherapy.

  8. Evaluation of laser therapy and routine treatment modalities in the management of myofascial pain dysfunction syndrome

    Directory of Open Access Journals (Sweden)

    Smriti B Jagdhari

    2015-01-01

    Full Text Available Objective: To evaluate the efficacy of laser as a monotherapy and in combination with exercise therapy in comparison to only exercise in the treatment of Myofascial Pain Dysfunction Syndrome (MPDS or Temporomandibular Myofascial Pain. Materials and Methods: A total of 60 patients with MPDS were included in the study and were randomly divided into three groups: exercise, laser, and the combination of both (exercise and laser. Results: Significant reduction in pain at rest and pain on movement was observed with all three types of treatment modalities. Pain reduction was more in those patients who received combination of exercise and laser therapy. Similarly, decrease in the muscle tenderness was more when combination of exercise and laser therapy was used. Conclusion: The ideal therapy should be fast, cheap, and have a long-term effect. Laser (Helium Neon as monotherapy or in combination with exercise had shown promising results and can be used as an effective treatment modality for the treatment of MPDS.

  9. Evaluation of the effectiveness of biofeedback therapy for functional constipation in children.

    Science.gov (United States)

    Jarzebicka, Dorota; Sieczkowska, Joanna; Dadalski, Maciej; Kierkus, Jaroslaw; Ryzko, Jozef; Oracz, Grzegorz

    2016-09-01

    Defecation disorders are one of the most common problems in pediatric gastroenterology. Treatment includes changes in the diet, pharmacotherapy, and biofeedback therapy. The aim of the present study was to evaluate the effectiveness of biofeedback therapy as assessed by clinical improvement as well as by changes in manometric parameters in children with constipation and pelvic floor dyssynergia (PFD). A total of 44 children with constipation and PFD hospitalized between 2000 and 2015 were enrolled in this retrospective study. All patients underwent anorectal manometry, and in case of diagnosed PFD, the patient qualified for biofeedback therapy. Amplitudes between extreme and basic pressures during defecation maneuvers in the first and last sessions as well as the difference between them were compared between groups with and without clinical improvement after the last session. A clinical improvement was achieved in 38 (86%) patients. There were no significant differences found in the amplitudes in the first session (mmHg), 94, 65, 115 vs. 112, 55, 170 (median, first quartile, third quartile, respectively; NS: not significant); last session, 36, 27, 52 vs. 41, -38, 66, respectively; or between them, 71, 11, 124 vs. 81, 17, 109, respectively, in the group with versus the group without clinical improvement, respectively. Biofeedback therapy has high clinical efficacy, and despite the lack of manometric improvement, it should be used as a treatment method in children in whom dietary and pharmacological procedures do not work, even if we consider the exercises more as a form of psychological training.

  10. A data-driven approach for evaluating multi-modal therapy in traumatic brain injury.

    Science.gov (United States)

    Haefeli, Jenny; Ferguson, Adam R; Bingham, Deborah; Orr, Adrienne; Won, Seok Joon; Lam, Tina I; Shi, Jian; Hawley, Sarah; Liu, Jialing; Swanson, Raymond A; Massa, Stephen M

    2017-02-16

    Combination therapies targeting multiple recovery mechanisms have the potential for additive or synergistic effects, but experimental design and analyses of multimodal therapeutic trials are challenging. To address this problem, we developed a data-driven approach to integrate and analyze raw source data from separate pre-clinical studies and evaluated interactions between four treatments following traumatic brain injury. Histologic and behavioral outcomes were measured in 202 rats treated with combinations of an anti-inflammatory agent (minocycline), a neurotrophic agent (LM11A-31), and physical therapy consisting of assisted exercise with or without botulinum toxin-induced limb constraint. Data was curated and analyzed in a linked workflow involving non-linear principal component analysis followed by hypothesis testing with a linear mixed model. Results revealed significant benefits of the neurotrophic agent LM11A-31 on learning and memory outcomes after traumatic brain injury. In addition, modulations of LM11A-31 effects by co-administration of minocycline and by the type of physical therapy applied reached statistical significance. These results suggest a combinatorial effect of drug and physical therapy interventions that was not evident by univariate analysis. The study designs and analytic techniques applied here form a structured, unbiased, internally validated workflow that may be applied to other combinatorial studies, both in animals and humans.

  11. SU-E-P-07: Evaluation of Productivity Systems for Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ramsey, C; Usynin, A [Thompson Cancer Survival Center, Knoxville, TN (United States)

    2014-06-01

    Purpose: Health systems throughout the United States are under increased financial pressure to reduce operating cost. As a result, productivity models developed by third-party consultants are being used to optimize staff to treatment volumes. The purpose of this study was to critically evaluate productivity systems for radiation oncology. Methods: Staffing efficiency was evaluated using multiple productivity models. The first model evaluated staffing levels using equal weighting of procedure codes and hours worked. A second productivity model was developed using hours worked by job class and relative value units for each procedure code. A third model was developed using the measured procedure times extracted from the electronic medical record, which tracks the wait and treatment times for each patient for each treatment fraction. A MatLab program was developed to query and analyze the daily treatment data. A model was then created to determine any theoretical gains in treatment productivity. Results: Productivity was evaluated for six radiation therapy departments operating nine linear accelerators delivering over 40,000 treatment fractions per year. Third party productivity models that do not take into consideration the unique nature of radiation therapy can be counterproductive. For example, other outpatient departments can compress their daily schedule to decrease the worked hours. This approach was tested using the treatment schedule evaluation tool developed as part of this study. It was determined that the maximum possible savings for treatment schedule compression was $32,000 per year per linac. All annual cost savings would be lost if only two patients per year choose to be treated elsewhere because of limited or restricted appointment times. Conclusion: The use of productivity models in radiation therapy can easily result in a loss of treatment revenue that is greater than any potential cost savings in reduced hours worked by staff.

  12. The evaluation of lens absorbed dose according to the optimold for whole brain radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Yong Mo; Park, Byoung Suk; Ahn, Jong Ho; Song, Ki Won [Dept. of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2014-06-15

    In the current whole brain Radiation Therapy, Optimold was used to immobilize the head. However, skin dose was increased about 22% due to the scattering radiation by the Optimold. Since the minimum dose causing cataracts was 2 Gy, it could be seen that the effects were large especially on the lens. Therefore, in the whole brain Radiation Therapy, it was to compare and to evaluate the lens absorbed dose according to the presence of Optimold in the eyeball part. In order to compare and to evaluate the lens absorbed dose according to the presence of Optimold in the eyeball part, the Optimold mask was made up to 5 mm bolus on the part of the eye lens in the human model phantom (Anderson Rando Phantom, USA). In the practice treatment, to measure the lens dose, the simulation therapy was processed by placing the GafChromic EBT3 film under bolus, and after the treatment plan was set up through the treatment planning system (Pinnacle, PHILIPS, USA), the treatments were measured repeatedly three times in the same way. After removing the Optimold mask in the eyeball part, it was measured in the same way as above. After scanning the film and measuring the dose by using the Digital Flatbed Scanner (Expression 10000XL, EPSON, USA), the doses were compared and evaluated according to the presence of Optimold mask in the eyeball part. When there was the Optimold mask in the eyeball part, it was measured at 10.2cGy ± 1.5 in the simulation therapy, and at 24.8cGy ± 2.7 in the treatment, and when the Optimold mask was removed in the eye part, it was measured at 12.9cGy ± 2.2 in the simulation therapy, and at 17.6cGy ± 1.5 in the treatment. In case of removing the Optimold mask in the eyeball part, the dose was increased approximately 3cGy in the simulation therapy and was reduced approximately 7cGy in the treatment in comparison to the case that the Optimold mask was not removed. During the whole treatment, since the lens absorbed dose was reduced about 27%, the chance to cause

  13. Special Section: Complementary and Alternative Medicine (CAM):Quiz on Complementary and Alternative Medicine

    Science.gov (United States)

    ... Special Section CAM Quiz on Complementary and Alternative Medicine Past Issues / Winter 2009 Table of Contents For ... low back pain. True False Complementary and alternative medicine (CAM) includes: Meditation Chiropractic Use of natural products, ...

  14. Review of Efficacy of Complementary and Alternative Medicine Treatments for Menopausal Symptoms.

    Science.gov (United States)

    Moore, Thea R; Franks, Rachel B; Fox, Carol

    2017-05-01

    Complementary and alternative medicine (CAM) treatments have been used for thousands of years around the world. There has been increased interest in utilizing CAM for menopausal symptoms since the release of results of the Women's Health Initiative elucidated long-term adverse effects associated with hormone therapy. Women looking for more natural or safer means to treat hot flushes, night sweats, and other menopausal symptoms often turn to CAM such as yoga, phytoestrogens, or black cohosh. Yet there have been few well-conducted studies looking at the efficacy of these treatments. This review examines randomized clinical trials, systematic reviews, and meta-analyses evaluating the effectiveness of commonly used CAM for the treatment of menopausal symptoms. © 2017 by the American College of Nurse-Midwives.

  15. EU FP7 project 'CAMbrella' to build European research network for complementary and alternative medicine

    DEFF Research Database (Denmark)

    Weidenhammer, Wolfgang; Lewith, George; Falkenberg, Torkel

    2011-01-01

    . A coordination project funded by the EU has been launched to improve the knowledge about CAM in Europe. OBJECTIVES AND METHODS: The project aims to evaluate the conditions surrounding CAM use and provision in Europe and to develop a roadmap for European CAM research. Specific objectives are to establish an EU...... and will run for 36 months starting from January 2010. The project will be delivered in 9 work packages coordinated by a Management Board and directed by a Scientific Steering Committee with support of an Advisory Board. OUTPUT: The outcomes generated will be disseminated through the project's website, peer......BACKGROUND: The status of complementary and alternative medicine (CAM) within the EU needs clarification. The definition and terminology of CAM is heterogeneous. The therapies, legal status, regulations and approaches used vary from country to country but there is widespread use by EU citizens...

  16. The complementary medicine (CAM) for the treatment of chronic pain: scientific evidence regarding the effects of healing touch massage

    National Research Council Canada - National Science Library

    Marletta, Giuseppe; Canfora, Angela; Roscani, Francesco; Cernicchiaro, Lucia; Cutrera, Maria; Russo, Marianna; Artioli, Giovanna; Sarli, Leopoldo

    2015-01-01

    ... of complementary therapies with particular reference to the method of healing touch massage, a review of the literature was conducted in order to gather evidence of the efficacy of the specific...

  17. Children and Complementary Health Approaches

    Science.gov (United States)

    ... al. Do dietary supplements improve micronutrient sufficiency in children and adolescents? Journal of Pediatrics . 2012;161(5):837–842. Black ... chiropractic and other manual therapies for infants and children: a review of the literature. Journal of Manipulative and Physiological Therapeutics . 2015;38(9): ...

  18. Complementary and Alternative Medicine Use in Women With Gynecologic Malignancy Presenting for Care at a Comprehensive Cancer Center.

    Science.gov (United States)

    Abdallah, Reem; Xiong, Yin; Lancaster, Johnathan M; Judson, Patricia L

    2015-11-01

    We evaluated complementary and alternative medicine (CAM) practices among women presenting to a National Cancer Institute-designated Comprehensive Cancer Center with a gynecologic malignancy. Women with a gynecologic malignancy who had consented to enrollment in our institutional prospective clinical registry between January 2003 and January 2014 and who had completed a questionnaire assessing sociodemographic characteristics, medical histories, quality of life, and CAM use were considered for analysis. Among the 2508 women identified, responses to questions on CAM use were provided by 534 (21.3%). The majority of CAM question respondents were white (93.5%) and older than 50 years (76%). Overall, 464 women (87% of CAM question respondents) used at least 1 CAM therapy during the previous 12 months. The most commonly used CAM categories were biologically based approaches (83.5%), mind and body interventions (30.6%), and manipulative and body-based therapies (18.8%). The most commonly used individual CAM therapies were vitamins and minerals (78%), herbal supplements (27.9%), spiritual healing and prayer (15.1%), and deep breathing relaxation exercises (13.1%). Complementary and alternative medicine use was greatest in age groups 20 to 30 years and older than 65 years and was more prevalent among those who were widowed (P cancer type, race, or ethnicity. Complementary and alternative medicine use is common among women being treated for gynecologic malignancy. Given the potential interactions of some CAM modalities with conventional treatment and the possible benefits in controlling symptoms and improving quality of life, providers should discuss CAM with their patients.

  19. One-year evaluation of the effect of physical therapy for masticatory muscle pain : A randomized controlled trial

    NARCIS (Netherlands)

    Craane, B.; Dijkstra, P. U.; Stappaerts, K.; De Laat, A.

    Physical therapy is widely used to decrease pain and restore function in patients suffering from masticatory muscle pain. Controlled studies on its efficacy are scarce. This study evaluated the 1-year effect of a 6-week physical therapy programme in a single blind, randomized, controlled trial.

  20. African Journal of Traditional, Complementary and Alternative ...

    African Journals Online (AJOL)

    Focus and Scope. The African Journal of Traditional, Complementary and Alternative medicines (AJTCAM), a new broad-based journal, is founded on two key tenets: To publish exciting research in all areas of applied medicinal plants, Traditional medicines, Complementary Alternative Medicines, food and agricultural ...

  1. Complementary and alternative medicine: challenge and change

    National Research Council Canada - National Science Library

    Wellman, Beverly Sheila; Kelner, Merrijoy; Saks, Mike; Pescosolido, Bernice A

    2000-01-01

    ... for those who would like to see a greater integration of social science research into CAM research funding portfolios.' The Journal of Complementary and Alternative Medicine Title PageComplementary and Alternative Medicine: Challenge and Change Editors Merrijoy Kelner and Beverly Wellman University of Toronto, Canada Associate Editors Bernice Pescosolid...

  2. Complementary Feeding Practices And Nutrient Intake From ...

    African Journals Online (AJOL)

    Complementary Feeding Practices And Nutrient Intake From Habitual Complementary Foods Of Infants And Children Aged 6-18 Months Old In Lusaka, Zambia. ... Compared with the recommended daily allowance (RDA) at 6-8, 9-11 and 12-18 months of age, the daily nutrient intakes were 88%, 121% and 94% for energy ...

  3. Synthesis and evaluation of boron compounds for neutron capture therapy of malignant brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Soloway, A.H.; Barth, R.F.

    1990-01-01

    Boron neutron capture therapy offers the potentiality for treating brain tumors currently resistant to treatment. The success of this form of therapy is directly dependent upon the delivery of sufficient numbers of thermal-neutrons to tumor cells which possess high concentrations of B-10. The objective of this project is to develop chemical methodology to synthesize boron-containing compounds with the potential for becoming incorporated into rapidly-dividing malignant brain tumor cells and excluded from normal components of the brain and surrounding tissues, to develope biological methods for assessing the potential of the compound by use of cell culture or intratumoral injection, to develop analytical methodology for measuring boron in cells and tissue using direct current plasma atomic emission spectroscopy (DCP-AES) and alpha track autoradiography, to develop biochemical and HPLC procedures for evaluating compound uptake and tissue half-life, and to develop procedures required to assess both in vitro and vivo efficacy of BNCT with selected compounds.

  4. Novel approach to lung stereotactic body radiation therapy plan evaluation and delivery

    Science.gov (United States)

    Jurkovic, Ines-Ana

    Stereotactic body radiation therapy is currently being used as an efficient treatment for Stage I/II medically inoperable and surgically unrespectable non small cell and metastatic lung cancer. Hypofractional dose and dose escalation used in stereotactic body radiation therapy have the potential of increasing the likelihood of the tumor control and the long term progression free survival. Currently available commercial treatment planning systems are capable of calculating accurate dose distributions for static case, where the tumor and surrounding healthy tissues are not moving during the dose delivery. However, respiratory induced organ motion can result in significant movement of the lesion leading to the discrepancies between the dose delivered and the dose planned. The precision and conformity of the stereotactic body radiation therapy makes it very susceptible to motion, i.e. patient respiration can lead to significant dose delivery errors. Conventional stereotactic body radiation therapy treatment plans use free breathing three-dimensional computed tomography images where margins are added to delineated gross tumor volume to create planning tumor volume and avoid geometrical misses of the target. The specific hypothesis of the study is that the true four-dimensional delivery of the four-dimensional plans will allow for more accurate radiation therapy treatment and critical organ sparing along with radiobiological evaluation of the dose distributions. The specific aims are designed to provide in depth understanding of the radiation therapy treatments and influence of the four-dimensional planning and delivery, heterogeneity corrections and various radiobiological factors on the outcome. The primary focus of the Specific Aim 1 was the evaluation of the tumor volume based on the four-dimensional computed tomography scan data through its motion, volume and computed tomography number. The results indicated that tumor motion parameters will exceed the typical

  5. Evaluation of pain in single and multi rooted teeth treated in single visit endodontic therapy.

    Science.gov (United States)

    Raju, T B V G; Seshadri, Abitha; Vamsipavani, B; Abhilash, K; Subhash, A V; Kumari, K V Halini

    2014-02-01

    The incidence of post-operative pain was compared following single-visit canal treatment in single- and multi-rooted teeth, with and without periapical radiolucency. The article also reviews the issues of postoperative pain and healing, following single-visit and multi-visit endodontic therapy. Single-visit endodontic therapy (SVE) was performed in 50 single-rooted teeth and 60 multiple-rooted teeth. Single-visit endodontic therapy (SVE) was performed in 50 single-rooted teeth and 60 multiple-rooted teeth. The subjects were divided as follows: Group I -Single-rooted teeth with periapical radiolucency (n=25); Group II-Single-rooted teeth without periapical radiolucency (n=25); Group III-Multiple-rooted teeth with periapical radiolucency (n=30); and Group IV-Multiple-rooted teeth without periapical radiolucency (n=30). Assessment of postoperative pain was done at 24hrs, 3 days and 1 week using a self report questionnaire. The data was analyzed using non-parametric Kruskal -Wallis test. No statistically significant difference was observed in postoperative pain following SVE between the single-rooted and multiple-rooted teeth groups at 24hrs, 3 days and 1 week. The presence or absence of periapical radiolucency had no significant influence on the incidence of reported postoperative pain following SVE. There was no difference in incidence of pain in single rooted teeth and multi-rooted teeth with and without periapical radiolucencies following SVE. Thus, incidence of post-operative pain does not seem to be a valid comparison criterion between single- and multiple-visit endodontic therapies. Also, the literature suggests similar success rates with single-visit and multiple-visit root canal treatment. How to cite the article: Raju TB, Seshadri A, Vamsipavani B, Abhilash K, Subhash AV, Kumari KV. Evaluation of Pain in Single and Multi Rooted Teeth Treated in Single Visit Endodontic Therapy. J Int Oral Health 2014;6(1):27-32.

  6. Evaluation of low level laser therapy in reducing diabetic polyneuropathy related pain and sensorimotor disorders.

    Science.gov (United States)

    Bashiri, Homayoon

    2013-09-09

    Over the past three decades physicians have used light level laser therapy (LLLT) for the management and the treatment of diabetic peripheral neuropathy and have obtained results that calls for further investigations. This study aimed to investigate the effectiveness of LLLT in treatment of pain symptoms in patients with diabetic polyneuropathy. In this study 60 patients with diabetic peripheral neuropathy were matched based on their sex, age, BMI, type of diabetes, duration of diabetes, and duration of pain, and randomized to case and control groups based on their established scores on the visual analog scale (VAS) and the Toronto clinical scoring system (TCSS). Cases received laser therapy with wavelength of 78 nm and 2.5 j/cm2 two times a week, each time for 5 min, for one month. During the same period, controls received sham laser therapy. Comparing the differences between the two groups' VAS and TCSS mean scores before the intervention with that of the 2 weeks and 4 weeks after the intervention we were able to see a statistically significant difference between the two groups (P<0.05). On the other hand, when we compared their VAS and TCSS mean scores 4 weeks and 2 weeks after the intervention we did not find any statistically significant difference between the two groups. We achieved the same results when we examined cases' and controls' pre and post VAS and TCSS scores independent from each other; no improvement in the assessment based on their 2 and 4 weeks comparisons tests. Laser therapy resulted in improved neuropathy outcomes in diabetic patients who received it relative to the group that received sham therapy, evaluating before and after LLLT assessments. Further studies are needed to test types of lasers, as well as different dosage and exposure levels required in different phase of neuropathic care, so as to obtain reproducible results.

  7. Comparative evaluation of vortioxetine as a switch therapy in patients with major depressive disorder.

    Science.gov (United States)

    Thase, Michael E; Danchenko, Natalya; Brignone, Melanie; Florea, Ioana; Diamand, Francoise; Jacobsen, Paula L; Vieta, Eduard

    2017-08-01

    Switching antidepressant therapy is a recommended strategy for depressed patients who neither respond to nor tolerate an initial pharmacotherapy course. This paper reviews the efficacy and tolerability of switching to vortioxetine. All three published studies of patients with major depressive disorder (MDD) switched from SSRI/SNRI therapy to vortioxetine due to lack of efficacy or tolerability were selected. Vortioxetine was evaluated versus agomelatine directly (REVIVE) and versus sertraline, venlafaxine, bupropion, and citalopram in an indirect treatment comparison (ITC) from switch studies retrieved in a literature review. Vortioxetine׳s impact on SSRI-induced treatment-emergent sexual dysfunction (TESD) was assessed directly versus escitalopram (NCT01364649) in stable patients with MDD. Vortioxetine׳s tolerability in the switch population was compared to the overall MDD population. Vortioxetine showed significant benefits over agomelatine on efficacy, functioning, and quality-of-life outcomes, with fewer withdrawals due to adverse events (AEs) (REVIVE). Vortioxetine had numerically higher remission rates versus all therapies included (ITC). Withdrawal rates due to AEs were significantly lower for vortioxetine versus sertraline, venlafaxine, and bupropion, and numerically lower versus citalopram. Switching to vortioxetine was statistically superior to escitalopram in improving TESD (NCT01364649). Tolerability was similar in the switch and overall MDD populations. These findings suggest that vortioxetine is an effective switch therapy for patients with MDD whose response to SSRI/SNRI therapy is inadequate. Vortioxetine was well tolerated and, for patients with a history of TESD, showed significant advantages versus escitalopram. Vortioxetine appears to be a valid option for patients with MDD who have not been effectively treated with first-line pharmacotherapies. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  8. Use of complementary and alternative medicines in haemodialysis patients: a cross-sectional study from Palestine.

    Science.gov (United States)

    Zyoud, Sa'ed H; Al-Jabi, Samah W; Sweileh, Waleed M; Tabeeb, Ghada H; Ayaseh, Nora A; Sawafta, Mayas N; Khdeir, Razan L; Mezyed, Diana O; Daraghmeh, Dala N; Awang, Rahmat

    2016-07-11

    Complementary and alternative medicine (CAM), and herbal therapies, are accepted worldwide, and have been important from medical, sociological and economic perspectives, among haemodialysis (HD) patients. The primary aim of this study was to evaluate the use of CAM among patients with end-stage renal disease (ESRD) who are undergoing HD. Face-to-face interviews of patients with ESRD undergoing HD from ten outpatient renal departments at a national level in Palestine were conducted from June 2014 to January 2015. A survey questionnaire, which included questions on socio-demographic and clinical characteristics, and on the CAM therapies that were used, was administered. Out of 267 patients interviewed, 172 patients used at least one type of CAM in the last month prior to the interview, and thus the utilisation rate was 64.4 %. Forty one (15.4 %) patients reported using one type of CAMs, while 18.7 % used two different CAMs and 30.3 % used more than two types of CAMs for their health status. Of the patients who used CAM, herbal therapies were used most often (43.5 %), followed by honey (35.6 %), diet (22.8 %), and exorcism in Islam (16.9 %). The herbal therapies mentioned most often were Nigella sativa L. (18.7 %), followed by Salvia officinalis L. (16.9 %), and Pimpinella anisum L. (10.5 %). In conclusion, the prevalence of CAM is relatively high in the selected population. Most patients used biological therapies such as herbal remedies, thus highlighting a greater need for patient education regarding CAM therapies and possible herb-drug interactions. Health care providers must be aware of the potential benefits and risks related to CAM use. There is a need for more clinical research pertaining to CAM to reach stronger evidence regarding potential benefits and risks related to CAM use.

  9. Evaluation of antihypertensive therapy in diabetic hypertensive patients: impact of ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Shraim NY

    2009-03-01

    Full Text Available Macrovascular complications are common in diabetic hypertensive patients. Appropriate antihypertensive therapy and tight blood pressure control are believed to prevent or delay such complication. Objective: To evaluate utilization patterns of antihypertensive agents and blood pressure (BP control among diabetic hypertensive patients with and without ischemic heart disease (IHD. Methods: Retrospective cohort study of all diabetic hypertensive patients attending Al-watani medical center from August 2006 until August 2007. Proportions of use of different antihypertensive drug classes were compared for all patients receiving 1, 2, 3, or 4 or more drugs, and separately among patients with and without IHD. Blood pressure control (equal or lower 130/80 mmHg was compared for patients receiving no therapy, monotherapy, or combination therapy and separately among patients with and without IHD. Results: 255 patients were included in the study; their mean age was 64.4 (SD=11.4 years. Sixty one (23.9% of the included patients was on target BP. Over 60% of the total patients were receiving angiotensin-converting enzyme inhibitors (ACEI/ angiotensin receptor blocker (ARB, followed by diuretics (40.8%, calcium channel blockers (25.1% and beta-blockers (12.5%. The majority (> 55% of patients were either on mono or no drug therapy. More than 55% of patients with controlled BP were using ACE-I. More than half (50.8% of the patients with controlled BP were on combination therapy while 42.3% of patients with uncontrolled BP were on combination therapy (p=0.24. More patient in the IHD achieved target BP than those in non-IHD group (p=0.019. Comparison between IHD and non-IHD groups indicated no significant difference in the utilization of any drug class with ACE-I being the most commonly utilized in both groups. Conclusions: Patterns of antihypertensive therapy were generally but not adequately consistent with international guidelines. Areas of improvement include

  10. Physical evaluation system to determine medical risk and indicated dental therapy modifications.

    Science.gov (United States)

    McCarthy, F M; Malamed, S F

    1979-08-01

    The physical evaluation system allows the practitioner to rapidly classify each patient according to medical risk and thus to provide dental treatment comfortably and safely. The evaluation system serves as a guide to the level of dental therapy, deisions of management, and modification of treatment for the medically compromised patient. Extensive use of the ADA physical status classification system in dentistry would allow meaningful studies of morbidity and mortality that are related to various management protocols and could conceivably have an impact on insurance schedules associated with psychosedation modalities and general anethesia on an out patient basis. A physical evaluation system cannot substitute for knowledge and good judgment. Recommended categories of physical status and modification of treatment should not be considered as absolutes, but as guides. Wheras the guidelines may appear to be inflexible, they should not be considered as such. Deviation from recommendations is often justified and is expected.

  11. Current status of Complementary Therapies in Spain in nursing degree Situación actual de las Terapias Complementarias en España en el Grado de Enfermería Estado atual do ensino de Terapias Complementares na formação superior de Enfermagem na Espanha

    Directory of Open Access Journals (Sweden)

    Ana Belén Fernández-Cervilla

    2013-06-01

    Full Text Available OBJECTIVE: Describe the current situation of complementary therapies in nursing education in schools and nursing schools in Spain. METHOD: Descriptive study. Study population all faculties andschools ascribed to Spain. Data collection through observation sheet. Analysis units Curricula. Variables (credits, course type, location, type of therapy. Descriptive analysis of relative and absolute data using Excel spreadsheet. RESULTS: Most of the faculties and schoolsofnursingscrutinized the subject of Complementary Therapies has disappeared and those that aparace is an optional subject. CONCLUSION: Complementary Therapies training in Spain is deficient because it is not collected as a core subject and / or obligatory. The absence of Complementary Therapies in the curriculum, questions such as their value in training, conceptualization which teachers, the impact on quality of care, training of teachers responsible for teaching the subject, as well as the number of credits and the course being in the degree of Grado. OBJETIVO: Describir la situación actual de las Terapias Complementarias en la formación enfermera en las escuelas y facultades de enfermería en España. MÉTODO: estudio observacional descriptivo transversal. Población de estudio todas las facultades, escuelas públicas y adscritas de España. Recolección de datos mediante una ficha de observación. Unidades de análisis los Planes de Estudio. Variables (créditos, tipo de asignatura, ubicación, tipo de terapia. Análisis descriptivo de los datos relativos y absolutos mediante hoja de Excel. RESULTADOS: en la mayoría de las facultades y escuelas escrutadas la asignatura de Terapias Complementarias ha desaparecido y en aquellas que aparece es una asignatura optativa. CONCLUSÍON: la formación en Terapias Complementarias en España es deficiente, debido a que no se recoge como asignatura troncal y/o obligatoria. La ausencia de las Terapias Complementarias en el currículum, plantea

  12. The Paediatric Rheumatology International Trials Organisation provisional criteria for the evaluation of response to therapy in juvenile dermatomyositis

    DEFF Research Database (Denmark)

    Ruperto, Nicolino; Pistorio, Angela; Ravelli, Angelo

    2010-01-01

    To develop a provisional definition for the evaluation of response to therapy in juvenile dermatomyositis (DM) based on the Paediatric Rheumatology International Trials Organisation juvenile DM core set of variables....

  13. Evaluation of a continuous quality improvement program in anticoagulant therapy: Feasibility, satisfaction and perception.

    Science.gov (United States)

    Cantin, Ariane; Lahaie, Alexandre; Odobasic, Bojan; Tremblay, Marie-Philip; Wazzan, Dana; Caron, Stéphanie; Leblanc, Caroline; Martineau, Josée; Lalonde, Lyne

    2016-11-01

    The ACO Program (Programme ACO), a continuous quality improvement program (CQIP) in anticoagulation therapy, was offered in community pharmacies as a pilot project. To evaluate the participants' appreciation for the various activities of the program. Participants had access to training activities, including an audit with feedback, online training activities (OTA), clinical tools and support from facilitators. Cognitive behavioural learning determinants were evaluated before and 5 months after the beginning of the program. Participants' satisfaction and perception were documented via online questionnaires and a semistructured interview. Of the 52 pharmacists in the ACO Program, 47 participated in this evaluation. Seventy-seven percent of the participants completed at least 1 OTA and 6% published on the forum. The feeling of personal effectiveness rose from 8.01 (7.67-8.35) to 8.62 (8.24-8.99). The audit and feedback, as well as the high-quality OTA and their lecturers, were the most appreciated elements. There was a high OTA participation rate. The facilitators seemed to play a key role in the CQIP. The low level of participation in the forum reflects the known phenomenon of social loafing. Technical difficulties affecting the platform and data collection for the audit with feedback constituted limitations. The CQIP in anticoagulation therapy is appreciated by community pharmacists and is associated with an improved feeling of personal effectiveness.

  14. Evaluation of an agency-based occupational therapy intervention to facilitate aging in place.

    Science.gov (United States)

    Sheffield, Chava; Smith, Charles A; Becker, Mary

    2013-12-01

    The United States faces a growing population of older adults and accompanying functional disabilities, coupled with constrained public resources and diminishing informal supports. A variety of interventions that aim to improve client outcomes have been studied, but to date, there is limited translational research that examines the efficacy of moving such interventions from clinical trials to agency settings. A randomized controlled trial was conducted to evaluate a restorative occupational therapy intervention relative to "usual care" among community-dwelling older adults. The intervention included a detailed assessment from a person-environment perspective and provision of adaptive equipment and home modifications where appropriate. The intervention (n = 31) and control groups (n = 29) were evaluated at 3 months and assessed for changes in functional status, home safety, falls, health-related quality of life (HRQoL; EQ5D), depression, social support, and fear of falling; a 4 subgroup analysis also examined outcomes by waiting list status. An informal economic evaluation compared the intervention to usual care. Findings indicated improvements in home safety (p occupational therapy interventions for older adults, and the findings support the concept that restorative approaches can be successfully implemented in public agencies.

  15. Evaluation of a Consumer-Generated Marketing Plan for Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Brian J. Isetts

    2012-01-01

    Full Text Available The purpose of this project was to utilize a consumer-directed, care model redesign methodology to develop and evaluate a marketing plan for medication therapy management services (MTMS provided in community pharmacies. This was accomplished through a six-step process: (1 application of "design thinking" for eliciting consumer input on redesigning MTMS and marketing approaches, (2 exploratory research, (3 focus group analysis, (4 marketing plan development, (5 marketing plan implementation, and (6 marketing plan evaluation. The findings showed that the application of "design thinking" and focus group analysis was useful for creating a consumer-directed marketing plan for medication therapy management services (MTMS. Implementation and evaluation of the MTMS Marketing Plan revealed that the most successful pharmacies were those that had established business associate agreements with the medical clinics closest to their site of practice, including access to electronic health records. This "virtual electronic presence" of pharmacists in the medical care system was highly consistent with the consumer demand we uncovered for a visible relationship between pharmacists, physicians and other health care providers.   Type: Original Research

  16. Neonatal tolerance induction enables accurate evaluation of gene therapy for MPS I in a canine model.

    Science.gov (United States)

    Hinderer, Christian; Bell, Peter; Louboutin, Jean-Pierre; Katz, Nathan; Zhu, Yanqing; Lin, Gloria; Choa, Ruth; Bagel, Jessica; O'Donnell, Patricia; Fitzgerald, Caitlin A; Langan, Therese; Wang, Ping; Casal, Margret L; Haskins, Mark E; Wilson, James M

    2016-09-01

    High fidelity animal models of human disease are essential for preclinical evaluation of novel gene and protein therapeutics. However, these studies can be complicated by exaggerated immune responses against the human transgene. Here we demonstrate that dogs with a genetic deficiency of the enzyme α-l-iduronidase (IDUA), a model of the lysosomal storage disease mucopolysaccharidosis type I (MPS I), can be rendered immunologically tolerant to human IDUA through neonatal exposure to the enzyme. Using MPS I dogs tolerized to human IDUA as neonates, we evaluated intrathecal delivery of an adeno-associated virus serotype 9 vector expressing human IDUA as a therapy for the central nervous system manifestations of MPS I. These studies established the efficacy of the human vector in the canine model, and allowed for estimation of the minimum effective dose, providing key information for the design of first-in-human trials. This approach can facilitate evaluation of human therapeutics in relevant animal models, and may also have clinical applications for the prevention of immune responses to gene and protein replacement therapies. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Evaluation of a Consumer-Generated Marketing Plan for Medication Therapy Management Services

    Directory of Open Access Journals (Sweden)

    Brian J. Isetts, Ph.D.

    2012-01-01

    Full Text Available The purpose of this project was to utilize a consumer-directed, care model redesign methodology to develop and evaluate a marketing plan for medication therapy management services (MTMS provided in community pharmacies. This was accomplished through a six-step process: (1 application of “design thinking” for eliciting consumer input on redesigning MTMS and marketing approaches, (2 exploratory research, (3 focus group analysis, (4 marketing plan development, (5 marketing plan implementation, and (6 marketing plan evaluation.The findings showed that the application of “design thinking” and focus group analysis was useful for creating a consumer-directed marketing plan for medication therapy management services (MTMS. Implementation and evaluation of the MTMS Marketing Plan revealed that the most successful pharmacies were those that had established business associate agreements with the medical clinics closest to their site of practice, including access to electronic health records. This “virtual electronic presence” of pharmacists in the medical care system was highly consistent with the consumer demand we uncovered for a visible relationship between pharmacists, physicians and other health care providers.

  18. Evaluating the use of gas discharge visualization to measure massage therapy outcomes.

    Science.gov (United States)

    Haun, Jolie; Patel, Nitin; Schwartz, Gary; Ritenbaugh, Cheryl

    2015-09-01

    The purpose of this study was to evaluate the short-term effects of massage therapy using gas discharge visualization (GDV), a computerized biophysical electrophoton capture (EPC), in tandem with traditional self-report measures to evaluate the use of GDV measurement to assess the bioenergetic whole-person effects of massage therapy. This study used a single treatment group, pre-post-repeated measures design with a sample of 23 healthy adults. This study utilized a single 50-min full-body relaxation massage with participants. GDV measurement method, an EPC, and traditional paper-based measures evaluating pain, stress, muscle tension, and well-being were used to assess intervention outcomes. Significant differences were found between pre- and post-measures of well-being, pain, stress, muscle tension, and GDV parameters. Pearson correlations indicate the GDV measure is correlated with pain and stress, variables that impact the whole person. This study demonstrates that GDV parameters may be used to indicate significant bioenergetic change from pre- to post-massage. Findings warrant further investigation with a larger diverse sample size and control group to further explore GDV as a measure of whole-person bioenergetic effects associated with massage.

  19. Comparison of complementary and alternative medicine with conventional mind-body therapies for chronic back pain: protocol for the Mind-body Approaches to Pain (MAP) randomized controlled trial.

    Science.gov (United States)

    Cherkin, Daniel C; Sherman, Karen J; Balderson, Benjamin H; Turner, Judith A; Cook, Andrea J; Stoelb, Brenda; Herman, Patricia M; Deyo, Richard A; Hawkes, Rene J

    2014-06-07

    The self-reported health and functional status of persons with back pain in the United States have declined in recent years, despite greatly increased medical expenditures due to this problem. Although patient psychosocial factors such as pain-related beliefs, thoughts and coping behaviors have been demonstrated to affect how well patients respond to treatments for back pain, few patients receive treatments that address these factors. Cognitive-behavioral therapy (CBT), which addresses psychosocial factors, has been found to be effective for back pain, but access to qualified therapists is limited. Another treatment option with potential for addressing psychosocial issues, mindfulness-based stress reduction (MBSR), is increasingly available. MBSR has been found to be helpful for various mental and physical conditions, but it has not been well-studied for application with chronic back pain patients. In this trial, we will seek to determine whether MBSR is an effective and cost-effective treatment option for persons with chronic back pain, compare its effectiveness and cost-effectiveness compared with CBT and explore the psychosocial variables that may mediate the effects of MBSR and CBT on patient outcomes. In this trial, we will randomize 397 adults with nonspecific chronic back pain to CBT, MBSR or usual care arms (99 per group). Both interventions will consist of eight weekly 2-hour group sessions supplemented by home practice. The MBSR protocol also includes an optional 6-hour retreat. Interviewers masked to treatment assignments will assess outcomes 5, 10, 26 and 52 weeks postrandomization. The primary outcomes will be pain-related functional limitations (based on the Roland Disability Questionnaire) and symptom bothersomeness (rated on a 0 to 10 numerical rating scale) at 26 weeks. If MBSR is found to be an effective and cost-effective treatment option for patients with chronic back pain, it will become a valuable addition to the limited treatment options

  20. Evaluating Sarconesiopsis magellanica blowfly-derived larval therapy and comparing it to Lucilia sericata-derived therapy in an animal model.

    Science.gov (United States)

    Díaz-Roa, Andrea; Gaona, María A; Segura, Nidya A; Ramírez-Hernández, Alejandro; Cortés-Vecino, Jesús A; Patarroyo, Manuel A; Bello, Felio

    2016-02-01

    Larval therapy is used as alternative treatment for hard-to-heal chronic and infected wounds. Lucilia sericata is the most used blowfly species. However, it has been shown recently that Sarconesiopsis magellanica larval excretions and secretions have potent antibacterial activity; this blowfly belongs to the Calliphoridae family. The present work has dealt with evaluating larval therapy using S. magellanica on wounds induced in diabetic rabbits and its action was compared to the effect induced by L. sericata. Twelve New Zealand White rabbits (Oryctolagus cuniculus) were used; they were divided into 4 groups, the first two being treated with larval therapy derived from both aforementioned necrophagous blowflies, an antibiotic was used in the third and the fourth was used as control. All the animals were wounded on the back and infected with Pseudomonas aeruginosa and Staphylococcus aureus. Samples of the secretion from each animal's infected wound were taken and sown on blood agar. The colony forming units were then counted. The PUSH scale was used for the macroscopic evaluation of the wounds. Bacterial control was encountered 48 h post-treatment in the treatments involving larval therapy and to a lesser extent with the antibiotic. Likewise, wound debridement was quicker and more efficient with larval therapy compared to the antibiotic group; however, wound closing time was 23 days in all treatments. The group treated with S. magellanica larvae had relatively quicker evolution until the proliferation phase and the start of maturation, even though there were no significant differences between both blowfly species evaluated here regarding treatments by the end of the treatment period. The present study has validated the diabetic rabbit model for inducing chronic wounds regarding larval therapy and has likewise confirmed the effectiveness of S. magellanica-derived larval therapy as an alternative for curing and healing wounds. Copyright © 2015 Elsevier B.V. All rights

  1. Consequences of overutilization and underutilization of thrombolytic therapy in clinical practice. TRACE Study Group. TRAndolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Ottesen, M M; Køber, L; Jørgensen, S

    2001-01-01

    OBJECTIVES: The aim of this study was to evaluate the consequences, measured as mortality and in-hospital stroke, of the use of thrombolytic therapy among patients with acute myocardial infarction (AMI), who do not fulfill accepted criteria or who have contraindications to thrombolytic therapy (i...... and recorded characteristics, in-hospital complications and long-term mortality. RESULTS: Overall, 41% of the patients received thrombolytic therapy. Thrombolytic therapy was underutilized in 14.3% and overutilized in 12.9% of the patients. The use of thrombolytic therapy was associated with reduced mortality...... in every subgroup examined, including patients without an accepted indication, with an accepted indication and in patients with prior stroke. The risk ratio of in-hospital stroke was not increased in connection with thrombolytic therapy, not even in patients with prior stroke (relative risk = 0.237, 95...

  2. Evaluation of the Effects of Intravenous and Percutaneous Low Level Laser Therapy in the Management of Shoulder Myofascial Pain Syndrome.

    Science.gov (United States)

    Momenzadeh, Sirous; Akhyani, Vahid; Razaghi, Zahra; Ebadifar, Asghar; Abbasi, Mohammadzaki

    2016-01-01

    Myofascial pain syndrome (MPS) treatment is challenging with a high recurrence rate and still lacks a clear treatment frame. Therefore research on new, more efficient and long lasting effect treatment modalities is necessary. This study looked at the effects of intravenous laser therapy (IVL) and percutaneous low level laser (PLLL) in the management of shoulder MPS. In this randomized controlled trial, 30 patients fulfilling inclusion criteria were randomly equally allocated to 3 groups, control, IVL and PLLL. Control group received 12 sessions of placebo low level laser, IVL group received 12 sessions of IVL therapy, and PLLL group received 12 sessions of PLLL therapy. All patients were trained for better body posture, body mechanics, gentle massage of trigger points, stretching exercises of affected muscle (trapezius), and received 10 mg of oral nortriptyline regimen every night for 3 months. Outcomes included pain severity, functional disability, and quality of life. Patients were assessed using Numeric Rating Scale (NRS), Pain Disability Index (PDI), and Short Form Health Survey (SF-12). Data collected were analyzed using analysis of variance (ANOVA), Mann-Whitney and t tests. The mean of PDI and maximum pain intensity during day and night significantly reduced in both PLLL and IVL groups compared to control group. Although pain severity and PDI reduction was more pronounced in IVL group compared to PLLL group, the differences were not statistically significant. Also, quality of life statistically significantly improved in both IVL and PLLL groups compared to control group was more, and although higher in IVL group, the difference was not statistically significant when compared to PLLL group. No side effects were observed in the intervention groups. Intravenous laser and PLLL therapy had a positive effect on pain severity and PDI reduction, and quality of life in this study. Also no adverse event was recorded. Thus, intravenous lasers and PLLL therapy seem to

  3. Clinical and research implications of the evaluation of women's group therapy for anorgasmia: a review.

    Science.gov (United States)

    Kuriansky, J B; Sharpe, L

    1981-01-01

    This paper reviews some important clinical and research implications of studies which have evaluated the effectiveness of short-term behavioral group therapy for anorgasmia. Though formal research data on curative factors is very sparse, the experience of sharing within a group, and the focus on arousal seem consistent with treatment outcome; however, the emphasis on assertiveness and the woman-only approach may have countertherapeutic as well as therapeutic effects. A potentially important intervening variable is the woman's level of ego development. The use of certain assessment scales and criteria for success of treatment are critiqued, and recommendations made for further study.

  4. Complementary and alternative medicine use among newly diagnosed prostate cancer patients.

    Science.gov (United States)

    McDermott, Cara L; Blough, David K; Fedorenko, Catherine R; Arora, Neeraj K; Zeliadt, Steven B; Fairweather, Megan E; Oakley-Girvan, Ingrid; Van Den Eeden, Stephen K; Ramsey, Scott D

    2012-01-01

    We surveyed prostate cancer patients about complementary and alternative medicine (CAM) use and evaluated patient factors that correlated with CAM use 6 months following diagnosis. The Prostate CAncer Therapy Selection study was a prospective, observational multi-site study of men's treatment decision-making process after a diagnosis of local stage prostate cancer. Recruitment occurred in community urology practices in Washington State, hospital-based urology clinics affiliated with the University of Southern California, and Kaiser Permanente in Northern California. Eligible study participants included men over age 21 diagnosed with local stage prostate cancer between May 1, 2005 and December 31, 2006. Fifty-two percent of survey respondents (379) reported using one or more types of CAM. Of the patients, 51% used one CAM method, 26% used two methods, and 23% used three or more methods. The most commonly reported category was mind-body therapies (65%). Only 43% of patients discussed their CAM use with a health professional; of those, 20% informed their primary care physician and 30% told the doctor managing their prostate cancer care. Less than half thought the CAM they used was "very helpful", but a majority thought it was somewhat helpful for their condition. Further research is needed to characterize the goals prostate cancer patients have for CAM, whether the treatments met those goals, and how this translates into the perceived helpfulness of these therapies. The implications of patients not discussing CAM use with health professionals at the time of prostate cancer treatment need further studies.

  5. Evaluation of effect of topical ozone therapy on salivary Candidal carriage in oral candidiasis.

    Science.gov (United States)

    Khatri, Isha; Moger, Ganapathi; Kumar, N Anil

    2015-01-01

    Ozone is highly valued for various therapeutic applications such as antimicrobial, antihypoxic, analgesic, and immunostimulating for more than a century in the medical profession. Ozone therapy is now gaining a strong foothold in dentistry. Ozone has bactericidal, fungicidal, and virucidal properties. Oral candidiasis is one of the most common opportunistic fungal infections of the oral cavity. Hence, a study was conducted to evaluate and compare the ability of ozonated water and topical clotrimazole in reducing the Candidal species colony-forming unit (CFU) count in oral candidiasis. The study included 40 candidiasis patients of either sex aged between 18 and 60 years attending the Department of Oral Medicine and Radiology. The patients were randomly assigned to either topical ozone therapy or topical clotrimazole groups. Salivary Candidal CFU counts were assessed during and after the treatments. There was gradual but significant reduction in Candidal CFU count in both groups. At the end of the treatment, Candidal CFU count reduction in ozone group (60.5% reduction) was more than the clotrimazole group (32.3% reduction). 14 patients (70%) with candidiasis in ozone group were reduced to 6 (30%) whereas only 8 patients (40%) out of 13 (65%) in clotrimazole group, although intergroup comparison was not statistically significant. Ozone therapy was much more effective in reducing the patients with candidiasis to a state of carriers. These findings suggest that ozonated water might be useful to treat oral candidiasis.

  6. A national evaluation of the Australian Occupational Therapy Competency Standards (1994): a multistakeholder perspective.

    Science.gov (United States)

    Rodger, Sylvia; Clark, Michele; Banks, Rebecca; O'Brien, Mia; Martinez, Kay

    2009-12-01

    This paper summarises results from an evaluation of the adequacy and utility of the Australian Competency Standards for Entry-Level Occupational Therapists (OT AUSTRALIA, 1994a). It comprised a two-part study, incorporating an online survey of key national stakeholders (n = 26), and 13 focus groups (n = 152) conducted throughout Australia with occupational therapy clinicians, academics, OT AUSTRALIA association and Occupational Therapy Registration Board representatives, as well as university program accreditors. The key recommendations were that: (i) urgent revision to reflect contemporary practice, paradigms, approaches and frameworks is required; (ii) the standards should exemplify basic competence at graduation (not within two years following); (iii) a revision cycle of five years is required; (iv) the Australian Qualifications Framework should be retained, preceded by an introduction describing the scope and nature of occupational therapy practice in the national context; (v) access to the standards should be free and unrestricted to occupational therapists, students and the public via the OT AUSTRALIA (national) website; (vi) the standards should incorporate a succinct executive summary and additional tools or templates formatted to enable occupational therapists to develop professional portfolios and create working documents specific to their workplace; and (vii) language must accommodate contextual variation while striking an appropriate balance between providing instruction and encouraging innovation in practice.

  7. Efficacy of low level laser therapy in myofascial pain syndrome: an algometric and thermographic evaluation.

    Science.gov (United States)

    Hakgüder, Aral; Birtane, Murat; Gürcan, Süleyman; Kokino, Siranuş; Turan, Fatma Nesrin

    2003-01-01

    The efficacy of low level laser therapy (LLLT) in myofascial pain syndrome (MPS) seems controversial. Our aim was to clarify the effect of LLLT in MPS by using algometry and thermography. Sixty-two patients with MPS having an active trigger point in the neck or upper back region were randomly divided into two equal groups according to therapy applied (group 1: LLLT + stretching exercises, group 2: stretching exercises alone). The outcome measures were pain measured with visual analogue scale (VAS), algometry on the trigger point, algometric difference, thermographic difference, and thermal asymmetry. Comparison was made within and between the groups pre- and post-therapeutically and 3 weeks after therapy. Mean pain values decreased more significantly in group 1 from baseline to 3 weeks follow up (7.54-3.06) while these values were 7.03-5.19 in group 2 (P < 0.05). Group comparisons revealed significant favorable differences in group 1 patients in terms of all other parameters at the first and the second evaluation post therapeutically (P < 0.05). LLLT seemed to be beneficial for pain in MPS by using algometry and thermography. Copyright 2003 Wiley-Liss, Inc.

  8. A review of targeted therapies evaluated by the Pediatric Preclinical Testing Program for osteosarcoma

    Directory of Open Access Journals (Sweden)

    Valerie eSampson

    2013-05-01

    Full Text Available Osteosarcoma, the most common malignant bone tumor of childhood, is a high grade primary bone sarcoma that occurs mostly in adolescence. Standard treatment consists of surgery in combination with multi-agent chemotherapy regimens. The development and approval of imatinib for Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL in children and the fully human monoclonal antibody, anti-GD2, as part of an immune therapy for high-risk neuroblastoma patients have established the precedent for use of targeted inhibitors along with standard chemotherapy backbones. However, few targeted agents tested have achieved traditional clinical end points for osteosarcoma. Many biological agents demonstrating anti-tumor responses in preclinical and early phase clinical testing have failed to reach response thresholds to justify randomized trials with large numbers of patients. The development of targeted therapies for pediatric cancer remains a significant challenge. To aid in the prioritization of new agents for clinical testing, the Pediatric Preclinical Testing Program (PPTP has developed reliable and robust preclinical pediatric cancer models to rapidly screen agents for activity in multiple childhood cancers and establish pharmacological parameters and effective drug concentrations for clinical trials. In this article, we examine a range of standard and novel agents that have been evaluated by the PPTP, and we discuss the preclinical and clinical development of these for the treatment of osteosarcoma. We further demonstrate that committed resources for hypothesis-driven drug discovery and development are needed to yield clinical successes in the search for new therapies for this pediatric disease.

  9. The development and evaluation of a Biblically-based therapy programme for a congregation

    Directory of Open Access Journals (Sweden)

    N.L. Joubert

    2004-08-01

    Full Text Available The aim of the research underlying this article was to develop a Biblically-based therapy programme for a congregation and to evaluate its impact. The aim of the programme was to enhance participants’ acceptance of self, their acceptance of others and their ability to have a meaningful relationship with God. A preand post-test design that included an experimental group (n = 27 and a control group (n = 23 was used. The programme consisted of six weekly individual therapy sessions that were conducted by one of the researchers, and a support and prayer group that supported the experimental group. The impact of the programme presentation was assessed by nine measuring instruments. Results obtained indicated that the participants in the experimental group experienced significant growth in almost all the psychological and spiritual dimensions that had been assessed. It was concluded that a Biblically-based therapy programme could be used to enhance individuals’ intra-psychic, interpersonal and, ultimately, spiritual growth.

  10. [Evaluation of low level laser and interferential current in the therapy of complex regional pain syndrome by infrared thermographic camera].

    Science.gov (United States)

    Kocić, Mirjana; Lazović, Milica; Dimitrijević, Irena; Mancić, Dragan; Stanković, Anita

    2010-09-01

    BACKGROUND/AIM; Complex regional pain syndrom type I (CRPS I) is characterised by continuous regional pain, disproportional according to duration and intensity and to the sort of trauma or other lesion it was caused by. The aim of the study was to evaluate and compare, by using thermovison, the effects of low level laser therapy and therapy with interferential current in treatment of CRPS I. The prospective randomized controlled clinical study included 45 patients with unilateral CRPS 1, after a fracture of the distal end of the radius, of the tibia and/or the fibula, treated in the Clinical Centre in Nis from 2004 to 2007. The group A consisted of 20 patients treated by low level laser therapy and kinesy-therapy, while the patients in the group B (n = 25) were treated by interferential current and kinesy-therapy. The regions of interest were filmed by a thermovision camera on both sides, before and after the 20 therapeutic procedures had been applied. Afterwards, the quantitative analysis and the comparing of thermograms taken before and after the applied therapy were performed. There was statistically significant decrease of the mean maximum temperature difference between the injured and the contralateral extremity after the therapy in comparison to the status before the therapy, with the patients of the group A (p infrared thermovision we showed that in the treatment of CRPS I both physical medicine methods were effective, but the effectiveness of laser therapy was statistically significantly higher compared to that of the interferential current therapy.

  11. Tumor Response After Stereotactic Body Radiation Therapy to Nonspine Bone Metastases: An Evaluation of Response Criteria

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, Rachel [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Probyn, Linda [Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Poon, Ian; Erler, Darby; Brotherston, Drew; Soliman, Hany; Cheung, Patrick; Chung, Hans; Chu, William; Loblaw, Andrew; Thavarajah, Nemica [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Lang, Catherine [Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Chin, Lee [Department of Physics, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Chow, Edward, E-mail: Edward.Chow@sunnybrook.ca [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada); Sahgal, Arjun [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario (Canada)

    2015-11-15

    Purpose: To evaluate the applicability of the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) and University of Texas MD Anderson (MDA) Cancer Center criteria in the setting of stereotactic body radiation therapy (SBRT) to nonspine bone metastases. Methods: Patients who were treated with SBRT to nonspine bone metastases were identified by retrospective chart review. An independent musculoskeletal radiologist evaluated response to treatment using computed tomography (CT) scans. Results: Thirty-three patients were treated to 42 nonspine bone metastases. The most common primary cancer cites were renal cell carcinoma (RCC) (33.3%), lung (24.2%), and prostate (18.2%). Bone metastases were either mainly lytic (57.1%), mainly sclerotic (28.6%), or mixed (14.3%). When lytic and sclerotic lesions were evaluated according to RECIST 1.1, local control (LC) was 83%, 85%, 88%, and 80% for those with CT imaging between months 1 to 3, 4 to 6, 7 to 9, and 10 to 12, respectively. When evaluated by the MDA criteria by density, LC within each time period was slightly greater. Overall LC decreased considerably when evaluated by MDA in terms of size. Conclusions: Consensus definitions of response are required as they have implications on clinical trials and disease management. Without consistent response criteria, outcomes from clinical trials cannot be compared and treatment efficacy remains undetermined.

  12. Alternative, Complementary, and Forgotten Remedies for Atopic Dermatitis

    Directory of Open Access Journals (Sweden)

    Allison L. Goddard

    2015-01-01

    Full Text Available Atopic dermatitis, perhaps more than other dermatologic diseases, has garnered much attention in the realm of alternative medicine. This may be because its etiopathogenesis is incompletely understood, it is increasingly common, and it waxes and wanes often without clear precipitants, opening up many opportunities for misinterpretation. Herein we explore the evidence for a number of different alternative and complementary therapies, from textiles to vitamin supplements. By definition, none have enough data to be deemed “effective” in a conventional sense, but it is hopeful that some show promising evidence that may one day lead to mainstream acceptance with further research.

  13. Alternative, Complementary, and Forgotten Remedies for Atopic Dermatitis.

    Science.gov (United States)

    Goddard, Allison L; Lio, Peter A

    2015-01-01

    Atopic dermatitis, perhaps more than other dermatologic diseases, has garnered much attention in the realm of alternative medicine. This may be because its etiopathogenesis is incompletely understood, it is increasingly common, and it waxes and wanes often without clear precipitants, opening up many opportunities for misinterpretation. Herein we explore the evidence for a number of different alternative and complementary therapies, from textiles to vitamin supplements. By definition, none have enough data to be deemed "effective" in a conventional sense, but it is hopeful that some show promising evidence that may one day lead to mainstream acceptance with further research.

  14. Complementary and alternative exercise for fibromyalgia: a meta-analysis

    Science.gov (United States)

    Mist, Scott David; Firestone, Kari A; Jones, Kim Dupree

    2013-01-01

    Complementary and alternative medicine includes a number of exercise modalities, such as tai chi, qigong, yoga, and a variety of lesser-known movement therapies. A meta-analysis of the current literature was conducted estimating the effect size of the different modalities, study quality and bias, and adverse events. The level of research has been moderately weak to date, but most studies report a medium-to-high effect size in pain reduction. Given the lack of adverse events, there is little risk in recommending these modalities as a critical component in a multimodal treatment plan, which is often required for fibromyalgia management. PMID:23569397

  15. Avaliação da celulase e pectinase como enzimas complementares, no processo de hidrólise-sacarificação do farelo de mandioca para produção de etanol Evaluation of the cellulase and pectinase by complementary enzymes in the process of hydrolysis-saccharification of cassava fibrous waste for alcohol production

    Directory of Open Access Journals (Sweden)

    Magali LEONEL

    1999-01-01

    Full Text Available Neste trabalho objetivou-se avaliar o uso de enzimas complementares no processo enzimático de hidrólise e sacarificação para a produção de etanol a partir do resíduo fibroso das fecularias. Os resultados obtidos demonstraram que 63,42% do amido foram hidrolisados no tratamento em que não se utilizaram enzimas complementares. No tratamento com as duas enzimas complementares foram hidrolisados 89,55%, no tratamento com celulase 65,42% e no tratamento com pectinase 88,73%. A prensagem do resíduo após o processo de hidrólise e sacarificação mostrou-se eficiente, ficando 10,43% do total de açúcares obtidos retidos no resíduo fibroso final. Portanto, o tratamento em que se utilizou a pectinase como enzima complementar na hidrólise foi o melhor. A celulase não apresentou efeito significativo no rendimento do processo.This work it was proposed to evaluate the use of complementary enzymes (cellulase and pectinase in the enzymatic process of hydrolysis-saccharification of the cassava fibrous waste for alcohol production. The results indicated that 63,42% of starch was hydrolyzed in the treatment without complementary enzymes, 89,55% in the treatment with the enzymes, 65,42% with the cellulase by complementary and 88,73% in the pectinase treatment. The pressing was efficacious for sugar recuperation and 10% of total sugar was retaining in the final fibrous residue. The pectinase was the better complementary enzyme enhance the yield.

  16. Contextualising complementary feeding in a broader framework for stunting prevention.

    Science.gov (United States)

    Stewart, Christine P; Iannotti, Lora; Dewey, Kathryn G; Michaelsen, Kim F; Onyango, Adelheid W

    2013-09-01

    An estimated 165 million children are stunted due to the combined effects of poor nutrition, repeated infection and inadequate psychosocial stimulation. The complementary feeding period, generally corresponding to age 6-24 months, represents an important period of sensitivity to stunting with lifelong, possibly irrevocable consequences. Interventions to improve complementary feeding practices or the nutritional quality of complementary foods must take into consideration the contextual as well as proximal determinants of stunting. This review presents a conceptual framework that highlights the role of complementary feeding within the layers of contextual and causal factors that lead to stunted growth and development and the resulting short- and long-term consequences. Contextual factors are organized into the following groups: political economy; health and health care systems; education; society and culture; agriculture and food systems; and water, sanitation and environment. We argue that these community and societal conditions underlie infant and young child feeding practices, which are a central pillar to healthy growth and development, and can serve to either impede or enable progress. Effectiveness studies with a strong process evaluation component are needed to identify transdisciplinary solutions. Programme and policy interventions aimed at preventing stunting should be informed by careful assessment of these factors at all levels. © 2013 John Wiley & Sons Ltd.

  17. ECONOMIC EVALUATION OF COMBINED THERAPY OF ARTERIAL HYPERTENSION BY MARKOV’S MODELING

    Directory of Open Access Journals (Sweden)

    N. S. Maksimchuk-Kolobova

    2015-09-01

    Full Text Available Aim. To evaluate the economic effectiveness of the combined two-drug antihypertensive therapy in patients with arterial hypertension (HT and high cardiovascular risk by Markov’s modeling.Material and methods. Patients (n= 65; 19 males and 46 females with essential HT accompanied by metabolic disorders, history of previous ineffective antihypertensive therapy were included into the study. Patients were randomized into 2 groups. Group V/A was treated with valsartan and amlodipine in fixed-dose combinations of 160/5 and 160/10 mg depending on blood pressure (BP level. Patients of group L/A were treated with losartan 100 mg and amlodipine 5 or 10 mg daily. Treatment duration was 24 weeks. Changes in BP level, and left ventricular hypertrophy (LVH regression were assessed. Economic evaluation was performed on the basis of modeling with specialized software Decision Tree 4.xla.Results. Effect of the two variants of combination therapy on LVH was used to estimate treatment effectiveness and to build the model. Patients were distributed according to the left ventricular mass (LVM at baseline and after 24 weeks of therapy. Significant decrease in LVM was observed in V/A group: from 225.1±71.7 to 186.3±44.5 g (p<0.05. There was no LVM dynamics in L/A group. The model took into account economic and frequency factors for 10 years forecast. V/A therapy is able to prevent 94 deaths, 22 strokes, and 64 myocardial infarction per 1000 patients. Absence of need in treatment of these prevented events can save about 5.5 million RUR for every 1000 patients. It would reduce the total costs per patient during 10 years. V/A therapy is able to save maximal number of quality adjusted life years (QALY due to LVM regression (5.016 years. L/A combination is the most economical variant of pharmacotherapy due to low cost of treatment (16.491.25 RUR per 1 QALY. It would take 286.698.7 RUR additionally for one additional QALY in the treatment with V/A, and it is

  18. Complementary and Alternative Medicine for Osteoporosis.

    Science.gov (United States)

    Hejazi, Zahra Alsadat; Namjooyan, Forough; Khanifar, Marjan

    2016-05-01

    A systemic skeletal disease is characterized by low bone mass and micro-architectural deterioration with a consequent increase in bone fragility and susceptibility to fracture. Asia has the highest increment in the elderly population; therefore, osteoporotic fracture should be a noticeable health issue. The incidence rate of hip fractures in Asia could rise to 45% by the year 2050. Complementary and alternative medicine (CAM) is a group of various medical and health care systems, practices, and products that are not presently considered as part of formal medicine. CAMs have been described as "diagnosis, treatment, and/or prevention which complements mainstream medicine as a holistic, subjective and various natural approaches to medical problems by contributing to a common whole, satisfying claims not met by orthodoxy, or diversifying the conceptual frameworks of medicine". Peer-reviewed publications were identified through a search in Scopus, Science Direct, Cochrane, PubMed, and Google scholar using keywords "osteopenia", "osteoporosis", "menopause", "CAM", "phytoestrogens", "phytotherapy" and "herbal medicine". The search was completed in July 2015 and was limited to articles published in English. Relevant articles were identified based on the expertise and clinical experience of the authors. We categorized our results in different classifications including: lifestyle modifications (cigarette, alcohol, exercise and food regimen), supportive cares (intake supplements including vitamin D, C and K), treatments synthetic (routine and newer options for hormone replacement and none hormonal therapies) and natural options (different types of CAM including herbal medicines, yoga and chiropractic). Established osteoporosis is difficult to treat because bone density has fallen below the fracture threshold and trabecular elements may have been lost. Antiresorptive agents can be used to prevent further bone loss and stimulation of new bone formation by the use of anabolic

  19. Evaluation of client progress in music therapy : An illustration of an N-of-1 design in individual short-term improvisational music therapy with clients with depression

    NARCIS (Netherlands)

    Aalbers, Sonja; Spreen, Marinus; Bosveld-van Haandel, Linda; Bogaerts, S.

    2017-01-01

    This article introduces music therapy clinicians to a research design that can be easily implemented in clinical practice to evaluate and monitor the impact of interventions on individual clients: the systemic N-of-1 design. In this single-case design, the client’s network, consisting of

  20. Fidelity to the Cognitive Processing Therapy Protocol: Evaluation of Critical Elements.

    Science.gov (United States)

    Farmer, Courtney C; Mitchell, Karen S; Parker-Guilbert, Kelly; Galovski, Tara E

    2017-03-01

    The contributions of individual therapy elements to the overall efficacy of evidence-based practices for the treatment of posttraumatic stress disorder (PTSD) are not well-understood. This study first examined the extent to which theoretically important treatment components of Cognitive Processing Therapy (CPT; i.e., skill in Socratic questioning; prioritizing assimilation; attention to practice assignments; emphasis on expression of natural affect) were successfully administered across the course of therapy for 68 PTSD-positive survivors of interpersonal trauma. Therapist fidelity in the administration of these four elements was evaluated in 533 taped CPT sessions of study participants included in one of two randomized controlled CPT treatment trials. Second, we examined therapist fidelity to these components as a predictor of session-to-session PTSD and depression symptom change. Third, follow-up analyses examined the influence of high therapist competence for these four components across an entire course of therapy on symptom change from pre- to posttreatment. Results showed consistently high adherence and more variable competence for these four treatment components. There were no significant effects of therapist fidelity on session-to-session symptom change. However, results showed that overall high therapist competence for "skill in Socratic questioning" and "prioritizing assimilation before overaccommodation" were related to greater client improvement in PTSD severity, but "attention to practice assignments" and "emphasis on expression of natural affect" were not. Overall competence ratings for the four components were not significantly associated with improvement in depressive symptoms. Findings contribute to increased understanding of the relationship between the key treatment components of CPT and symptom change. Copyright © 2016. Published by Elsevier Ltd.

  1. Ultrasound Evaluation of Thyroid Gland Pathologies After Radiation Therapy and Chemotherapy to Treat Malignancy During Childhood

    Energy Technology Data Exchange (ETDEWEB)

    Lollert, André, E-mail: andre.lollert@unimedizin-mainz.de [Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz (Germany); Gies, Christina; Laudemann, Katharina [Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz (Germany); Faber, Jörg [Department of Pediatrics and Adolescent Medicine, Medical Center of the Johannes Gutenberg University, Mainz (Germany); Jacob-Heutmann, Dorothee [Department of Radio-oncology and Radiotherapy, Medical Center of the Johannes Gutenberg University, Mainz (Germany); König, Jochem [Institute for Medical Biostatistics, Epidemiology and Informatics, Medical Center of the Johannes Gutenberg University, Mainz (Germany); Düber, Christoph; Staatz, Gundula [Department of Diagnostic and Interventional Radiology, Section of Pediatric Radiology, Medical Center of the Johannes Gutenberg University, Mainz (Germany)

    2016-01-01

    Purpose: The purpose of this study was to evaluate correlations between treatment of malignancy by radiation therapy during childhood and the occurrence of thyroid gland pathologies detected by ultrasonography in follow-up examinations. Methods and Materials: Reductions of thyroid gland volume below 2 standard deviations of the weight-specific mean value, occurrence of ultrasonographically detectable thyroid gland pathologies, and hypothyroidism were retrospectively assessed in 103 children and adolescents 7 months to 20 years of age (median: 7 years of age) at baseline (1997-2013) treated with chemoradiation therapy (with the thyroid gland dose assessable) or with chemotherapy alone and followed by ultrasonography and laboratory examinations through 2014 (median follow-up time: 48 months). Results: A relevant reduction of thyroid gland volume was significantly correlated with thyroid gland dose in univariate (P<.001) and multivariate analyses for doses above 2 Gy. Odds ratios were 3.1 (95% confidence interval: 1.02-9.2; P=.046) for medium doses (2-25 Gy) and 14.8 (95% confidence interval: 1.4-160; P=.027) for high doses (>25 Gy). Thyroid gland dose was significantly higher in patients with thyroid gland pathologies during follow-up (P=.03). Univariate analysis revealed significant correlations between hypothyroidism and thyroid gland dose (P<.001). Conclusions: Ultrasonographically detectable changes, that is, volume reductions, pathologies, and hypothyroidism, after malignancy treatment during childhood are associated with thyroid gland dose. Both ultrasonography and laboratory follow-up examinations should be performed regularly after tumor therapy during childhood, especially if the treatment included radiation therapy.

  2. EVALUATION OF ULTRASOUND REMISSION CRITERIA IN PATIENTS WITH RHEUMATOID ARTHRITIS DURING TOCILIZUMAB THERAPY

    Directory of Open Access Journals (Sweden)

    Rita Aleksandrovna Osipyants

    2013-01-01

    Full Text Available Objective: to study the association of ultrasound (US remission criteria with the clinical and laboratory indicators of inflammatory activity, functional status, and X-ray changes in patients with rheumatoid arthritis (RA during tocilizumab (TCZ therapy.Subjects and methods. The trial included 36 patients with RA (meeting the 1987 American College of Rheumatology (ACR criteria who had received TCZ for 6 months. The authors made a clinical and laboratory assessment of RA activity (DAS28-CRP, and SDAI, functional impairments (HAQ index and US verification of wrist joint synovitis (a Voluson-i device, GE, 4-13-MHz linear transducer at baseline and 6 months after therapy. No signs of grey-scale (B-mode and power Doppler (PD synovitis (B = 0; PD = 0 or minimal B-mode synovitis, and not more one PD hypervascular signal (В ≤1; PD ≤1 were arbitrarily taken as US remission criteria. Destruction changes were evaluated by hand and foot X-ray using the Sharp method modified by van der Heijde (SHS.Results. After 6 months of therapy, about 80% of the patients in clinical remission retained moderate or significant synovitis, as evidenced by US studies. There were no clinical differences in clinical activity indices and functional impairments between the patients who were and were not in US remission (p > 0.05. The 12-month follow-up SHS score was significantly higher with the preservation of 6-month therapy signs of B-mode synovitis and PD hypervascularization (of not more than one signal than that in US remission (p < 0.05. There was no relationship of X-ray progression to the clinical and functional statuses (p > 0.05.Conclusion. Subclinical synovitis is observed even in clinical remission of RA. Destruction progression is significantlyrelated to synovitis persistence, as shown by ultrasonography.

  3. The use of complementary and integrative practices in oral health

    Directory of Open Access Journals (Sweden)

    Camila da Silva Gonçalo

    2014-10-01

    Full Text Available The World Health Organization recognizes the medical practices derived from the culture of each country, as Traditional Medicine, but all over the world, there has been no consensus about the denomination of these practices. InBrazil, the Ministry of Health recognizes the use of the following, as Complementary and Integrative Practices (CIP: Acupuncture, Homeopathy, Medicinal Plants/Phytotherapy, Thermal Water/Crenotherapy, Anthroposophic Medicine. Based on the therapies recognized by the Ministry of Health, the Brazilian Federal Council of Dentistry regulated the use of CIP in oral health: Acupuncture, Homeopathy, Phytotherapy, Laser Therapy, Flower Therapy and Hypnosis. This article presents the results of a systematic review about positive and negative evidence of the use of PIC in oral health. We analyzed 91 papers published between 2000 and 2010. Laser therapy and Phytotherapy were the CIP most tested. Laser therapy studies reported more negative results, while the Phytotherapy studies reported more positive results. Papers on Flower Therapy were not included because we found no RCT about this CIP. We found more positive than negative outcomes for the use of CIP in oral health and analysis of the papers showed that only a few authors reported the clinical outcomes. Due to the holistic perspective of CIP, we believe it is possible to show more consistent results of use of these practices in oral health, provided that a broader view (beyond quantitative parameters is incorporated from the planning to analysis of studies in this area.

  4. Knowledge, Attitude, and Practice of Complementary and Alternative Medicine Among Residents of Wayu Town, Western Ethiopia.

    Science.gov (United States)

    Belachew, Negash; Tadesse, Tarekegne; Gube, Addisu Alemayehu

    2017-10-01

    Complementary and alternative medicine covers a wide variety of therapies and practices, which vary from country to country and region to region. The study was conducted to assess the knowledge, attitude, and practice of complementary and alternative medicine among the residents of Wayu town, Western Ethiopia. A descriptive cross-sectional study was carried out on 302 residents. A systematic sampling was used to select households. Data were entered in SPSS (version 20; IBM Corp) and descriptive statistics was carried out. Of 302 participants, 51.65% have a good knowledge, 78.6% were aware of complementary and alternative medicine, and 74.22% used it in the past 2 years. A total of 23.83% believe that complementary and alternative medicine is more effective than modern medicine and 28.8% preferred complementary and alternative medicine to modern medicine. This study revealed that in Wayu town, there is relatively high public interest in complementary and alternative medicine practices and a significant number has a good knowledge but generally the attitude toward complementary and alternative medicine is relatively low.

  5. Proprioceptive evaluation in healthy women undergoing Infrared Low Level Laser Therapy

    Directory of Open Access Journals (Sweden)

    Grazieli da Silva

    2017-05-01

    Full Text Available Abstract Aim To evaluate if the application of infrared low-level laser therapy (LLLT alters proprioception in young women. Methods 26 female volunteers were evaluated statically and dynamically by means of electronic baropodometry in the variables: distance from the foot center, maximum and medium pressure, and surface. Proprioception was also functionally assessed by the Star Excursion Balance Test (SEBT. The intervention occurred in two distinct periods, separated by one week apart, as this was a crossover study, so volunteers were submitted to placebo or LLLT (830 nm, 8 J/cm2, on the muscles: gastrocnemius, soleus, tibialis previous and long and short fibular. Results the analysis of baropodometry for both dynamic and static found no significant differences for the intervention group and the control group. Similar results were observed for SEBT. Conclusion The application of the LLLT, in the proposed parameters, did not influence the proprioception in young women.

  6. Evaluation of umbilical cord serum therapy in acute ocular chemical burns.

    Science.gov (United States)

    Sharma, Namrata; Goel, Manik; Velpandian, Thirumurthy; Titiyal, Jeewan S; Tandon, Radhika; Vajpayee, Rasik B

    2011-02-25

    To evaluate the role of umbilical cord serum therapy in cases of acute ocular chemical burns. In a double-blind prospective randomized controlled clinical study, 33 eyes of 32 patients with acute ocular chemical burns of grade III, IV, and V severity were randomized into three groups: umbilical cord serum (n = 12), autologous serum (n = 11), and artificial tears (0.5% HPMC+0.3% glycerin; n = 10). In addition, all eyes received standard medical therapy. The parameters evaluated were pain score, size, and area of epithelial defect, extent of limbal ischemia, corneal clarity, and symblepharon formation. The patients were followed up at day 1, 3, 7, 14, and 21 and at the end of months 1, 2, and 3. Mean time to complete epithelialization was 21.16 ± 26.81, 56.6 ± 35.5, and 40.13 ± 35.79 days in cord serum, autologous serum, and artificial tears groups respectively (P = 0.02). By day 21, the mean percentage decrease in epithelial defect diameter was 94.63 ± 11.99 with cord serum compared with 53.17 ± 34.81 and 64.22 ± 42.43 with autologous serum and artificial tears, respectively (P = 0.01). By month 3, the extent of limbal ischemia with cord serum showed a mean percentage decrease of 73.43 ± 25.51 compared with 35.64 ± 25.60 and 43.71 ± 28.71 with autologous serum and artificial tears, respectively (P = 0.008). More patients had clear corneas with cord serum compared with autologous serum and artificial tears (P = 0.048). No significant difference was seen between the groups with regard to symblepharon formation (P = 0.07). Umbilical cord serum therapy is more effective than autologous serum eye drops or artificial tears in ocular surface restoration after acute chemical injuries. (www.controlled-trials.com number, ISRCTN08131903.).

  7. Clinical evaluation of endodotic therapy on periodontal tissue healing in chronic advanced periodontitis

    Directory of Open Access Journals (Sweden)

    Sadeghi R.

    2004-08-01

    Full Text Available Statement of Problem: There is a controversy about the relationship between pulpal and periodontal diseases. The interrelationship between pulp and periodontium could have an important effect on the treatment plan of the tooth. Purpose: The aim of the present research is to evaluate root canal therapy effects on periodontal healing of teeth with chronic advanced periodontitis. Materials and Methods: In this randomized controlled clinical trial 32 single rooted teeth which had necrotic pulp or irreversible pulpitis in 7 patients with chronic advanced periodontitis were selected based on specific criteria. Using a split mouth design, teeth were randomly put in two groups of test and control. In the test group root canal therapy ,scaling & root planing were done.In the control group, only scaling & root planing were performed. Clinical parameters including Pocket Depth (PD, Clinical Attachment Level (CAL, mobility, pattern of bone destruction and plaque index (PI were evaluated in two groups at base line, 1 and 3 months after treatment. Appropriate tests such as paired Wilcoxon and Mann-Whitney were performed. Results: Statistically significant reductions were found in the test group when comparing baseline and one-month post treatment values for Clinical Attachment level (CAL but not after 3-months. In the control group the CAL reductions were not statistically significant between baseline and one month post-treatment, but a increase were observed between one month and three months after treatment. There was a statstically significant difference between the test and the control groups. Other parameters didn’t show any significant differences in each group and between two groups. Conclusion: Since clinical attachment level was the most important parameter we found it can high lighted the role of pathogene with pulpal origin in progression of periodeontal disease and it is concluded that beside periodontal treatment in some advanced periodontal

  8. Evaluation of three definitions of progression-free survival in preoperative cancer therapy (JCOG0801-A).

    Science.gov (United States)

    Nakamura, Kenichi; Shibata, Taro; Takashima, Atsuo; Yamamoto, Seiichiro; Fukuda, Haruhiko

    2012-10-01

    Progression-free survival is an often-used endpoint in clinical trials comparing preoperative therapy and surgery-first therapy. Because the surgery date is always later in the preoperative arm than in the surgery-first arm, it is difficult to define progression-free survival optimally. We evaluated three progression-free survival definitions that used different methods to handle incomplete resection. The three definitions specify the event date of incomplete resection (IR) as follows: 'IR = event' method, date of surgery; 'IR not event' method, date of radiological or clinical progression after incomplete resection; landmark method, landmark time. According to these definitions, the theoretical strengths and weaknesses of the three definitions are investigated. Three patterns of progression-free survival and overall survival were estimated using the data of the Japan Clinical Oncology Group studies. Theoretically, 'IR = event' inflates alpha error while 'IR not event' method and landmark method reduce the statistical power under the alternative hypothesis. In JCOG9907, hazard ratios for the three definitions were: 'IR = event', 0.80 (95% confidence interval, 0.59-1.07; P = 0.13); 'IR not event', 0.81 (95% confidence interval, 0.60-1.09; P = 0.16); landmark, 0.80 (95% confidence interval, 0.59-1.07; P = 0.15). No P value of any methods corresponded with the positive result for overall survival (P = 0.03). In the preoperative arms of the four studies, maximum differences in median and percentage of 1 year progression-free survival among the three definitions were 0-6.4 months and 1.2-5.2%. Progression-free survival sometimes fails as a surrogate of overall survival, and differences among results obtained with various progression-free survival definitions can be large. Overall survival should be used as primary endpoint in studies evaluating preoperative therapy.

  9. Evaluating baculovirus as a vector for human prostate cancer gene therapy.

    Directory of Open Access Journals (Sweden)

    Stephanie L Swift

    Full Text Available Gene therapy represents an attractive strategy for the non-invasive treatment of prostate cancer, where current clinical interventions show limited efficacy. Here, we evaluate the use of the insect virus, baculovirus (BV, as a novel vector for human prostate cancer gene therapy. Since prostate tumours represent a heterogeneous environment, a therapeutic approach that achieves long-term regression must be capable of targeting multiple transformed cell populations. Furthermore, discrimination in the targeting of malignant compared to non-malignant cells would have value in minimising side effects. We employed a number of prostate cancer models to analyse the potential for BV to achieve these goals. In vitro, both traditional prostate cell lines as well as primary epithelial or stromal cells derived from patient prostate biopsies, in two- or three-dimensional cultures, were used. We also evaluated BV in vivo in murine prostate cancer xenograft models. BV was capable of preferentially transducing invasive malignant prostate cancer cell lines compared to early stage cancers and non-malignant samples, a restriction that was not a function of nuclear import. Of more clinical relevance, primary patient-derived prostate cancer cells were also efficiently transduced by BV, with robust rates observed in epithelial cells of basal phenotype, which expressed BV-encoded transgenes faster than epithelial cells of a more differentiated, luminal phenotype. Maximum transduction capacity was observed in stromal cells. BV was able to penetrate through three-dimensional structures, including in vitro spheroids and in vivo orthotopic xenografts. BV vectors containing a nitroreductase transgene in a gene-directed enzyme pro-drug therapy approach were capable of efficiently killing malignant prostate targets following administration of the pro-drug, CB1954. Thus, BV is capable of transducing a large proportion of prostate cell types within a heterogeneous 3-D prostate

  10. Evaluation of muscle regeneration in aged animals after treatment with low-level laser therapy

    Directory of Open Access Journals (Sweden)

    Adriana Pertille

    Full Text Available BACKGROUND: The aging process and its associated morphophysiological changes trigger a reduction in the regenerative ability of the satellite cells, a reduction of vascular tissue and an increase in the production of fibroblasts, developing a cellular environment unfavorable for muscle regeneration. OBJECTIVE: The aim of this study was to evaluate the effect of low-level laser therapy on the muscle regeneration of old experimental rat models after contusion. METHOD: A total of 25 old rats,18 months old, were divided into three groups: control group (CT without treatment; injury group (IN with muscle contusion and without treatment and laser group (LA with contusion and low-level laser therapy, 830 nm, 30 mW e 4 J/cm². The no invasive contusion was induced in the Tibialis Anterior muscle and the samples were collected after 7 and 21 treatment sessions. The muscle was evaluated by Light Microscopy and Immunoblotting. RESULTS: After 21 days of treatment there was a significant reduction in the areas of inflammation/regeneration of the LA 21 group compared to IN 21 group. The cross-sectional area of the fibers in regeneration was not statistically different between the groups. Molecular analysis showed that the content of MyoD was statistically reduced in the IN 21 group compared to the CT group. The Myogenin content was increased in the IN 21 group compared to the CT group. Ultimately, the content of TGF-β1 on the IN 21 group was higher when compared to the CT group. CONCLUSION: Considering the parameters used, the laser therapy demonstrated to be effective for muscle regeneration in old rats, however only through its anti-inflammatory effect.

  11. Physician Evaluation of Internet Health Information on Proton Therapy for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Anand, E-mail: as4351@columbia.edu [Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Department of Radiation Oncology, Columbia University Medical Center, New York, New York (United States); Paly, Jonathan J.; Efstathiou, Jason A. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Bekelman, Justin E. [Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2013-03-15

    Purpose: Many patients considering prostate cancer (PCa) treatment options report seeking proton beam therapy (PBT) based in part on information readily available on the Internet. There is, however, potential for considerable variation in Internet health information (IHI). We thus evaluated the characteristics, quality, and accuracy of IHI on PBT for PCa. Methods and Materials: We undertook a qualitative research study using snowball-purposive sampling in which we evaluated the top 50 Google search results for “proton prostate cancer.” Quality was evaluated on a 5-point scale using the validated 15-question DISCERN instrument. Accuracy was evaluated by comparing IHI with the best available evidence. Results: Thirty-seven IHI websites were included in the final sample. These websites most frequently were patient information/support resources (46%), were focused exclusively on PBT (51%), and had a commercial affiliation (38%). There was a significant difference in quality according to the type of IHI. Substantial inaccuracies were noted in the study sample compared with best available or contextual evidence. Conclusions: There are shortcomings in quality and accuracy in consumer-oriented IHI on PBT for PCa. Providers must be prepared to educate patients how to critically evaluate IHI related to PBT for PCa to best inform their treatment decisions.

  12. CLINICAL CONSIDERATIONS ON THE EVALUATION OF PERIODONTAL THERAPY IN CHILDREN AND YOUNG ADULTS

    Directory of Open Access Journals (Sweden)

    Anca Mihaela Stupu

    2011-12-01

    Full Text Available Introduction: In the periodontal pathology of the pediatric pacient, the therapeutical management depends on an early, as precise as possible diagnosis, as well as on a correct evaluation of the causes and risk factors involved in such processes. The aim of the study: The paper discusses a clinicostatistical study devoted to the evaluation and comparison of the periodontal health condition of a group of children and teenagers subjected to a local etiological treatment. Materials and method: The experimental study was formed of 70 patients selected from the total number of patients having addressed a dentist. Over the whole period of the therapy, oral hygiene, the aspect of marginal gingiva, and the vitality of the teeth under treatment wer