O'Reilly, Erin; Sevigny, Marika; Sabarre, Kelley-Anne; Phillips, Karen P
Infertility patients are increasingly using complementary and alternative medicine (CAM) to supplement or replace conventional fertility treatments. The objective of this study was to determine the roles of CAM practitioners in the support and treatment of infertility. Ten semi-structured interviews were conducted in Ottawa, Canada in 2011 with CAM practitioners who specialized in naturopathy, acupuncture, traditional Chinese medicine, hypnotherapy and integrated medicine. CAM practitioners played an active role in both treatment and support of infertility, using a holistic, interdisciplinary and individualized approach. CAM practitioners recognized biological but also environmental and psychosomatic determinants of infertility. Participants were receptive to working with physicians, however little collaboration was described. Integrated infertility patient care through both collaboration with CAM practitioners and incorporation of CAM's holistic, individualized and interdisciplinary approaches would greatly benefit infertility patients.
... Alternative Medicine in Thyroid Disease Complementary and Alternative Medicine in Thyroid Disease (CAM) WHAT IS COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM)? Complementary and Alternative Medicine (CAM) is defined ...
Burman, Mary E.
Directors of family nurse practitioner education programs (n=141) reported inclusion of some complementary/alternative medicine content (CAM), most commonly interviewing patients about CAM, critical thinking, evidence-based medicine, laws, ethics, and spiritual/cultural beliefs. Definition of CAM was medically, not holistically based. More faculty…
Describes the fundamental difference between complementary and alternative medicine (CAM) and holistic medicine, highlighting holistic medicine's emphasis on the promotion of healthy lifestyles for practitioners and patients alike. Asserts that offering physicians-to-be more course work in holistic medicine could lay the groundwork for future…
Zachariae, Robert; Johannesen, Helle
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...... effects of CAM can and should be produced, and how the existing evidence should be interpreted. This represents a considerable challenge for oncologists; both in terms of patient needs for an informed dialogue regarding CAM, and because some types of CAM may interact with standard treatments....... There is a need for insight into which kinds of CAM may work, for whom they work, what the possible effects and side-effects are, and in what ways such effects may come about. The present article presents a framework for evaluating effects of CAM by suggesting a taxonomy of different levels of evidence related...
Yen, Laurann; Jowsey, Tanisha; McRae, Ian S
The use of complementary and alternative medicines (CAM) and CAM practitioners is common, most frequently for the management of musculoskeletal conditions. Knowledge is limited about the use of CAM practitioners by older people, and specifically those with other long term or chronic conditions. In 2011 we conducted an Australia wide survey targeting older adults aged over 50 years (n = 2540). Participants were asked to identify their chronic conditions, and from which health professionals they had 'received advice or treatment from in the last 3 months', including 'complementary health practitioners, e.g. naturopath'. Descriptive analyses were undertaken using SPSS and STATA software. Overall, 8.8% of respondents reported seeing a CAM practitioner in the past three months, 12.1% of women and 3.9% of men; the vast majority also consulting medical practitioners in the same period. Respondents were more likely to report consulting a CAM practitioner if they had musculoskeletal conditions (osteoporosis, arthritis), pain, or depression/anxiety. Respondents with diabetes, hypertension and asthma were least likely to report consulting a CAM practitioner. Those over 80 reported lower use of CAM practitioners than younger respondents. CAM practitioner use in a general older population was not associated with the number of chronic conditions reported, or with the socio-economic level of residence of the respondent. Substantial numbers of older Australians with chronic conditions seek advice from CAM practitioners, particularly those with pain related conditions, but less often with conditions where there are clear treatment guidelines using conventional medicine, such as with diabetes, hypertension and asthma. Given the policy emphasis on better coordination of care for people with chronic conditions, these findings point to the importance of communication and integration of health services and suggest that the concept of the 'treating team' needs a broad interpretation.
... 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, ...
Yarnell, Eric; Abascal, Kathy; Greenfield, Russell Howard; Romm, Aviva; Sudberg, Sidney
This article discusses how practitioners, regardless of other professional licenses they may hold, could be credentialed in botanical medicine. The article reviews the field of clinical botanical medicine and the history and modern status of botanical medicine, as well as organizations currently involved in botanical medicine credentialing. Many different types of professionals prescribe botanical medicines, and the potential for collaboration among them is great. The current trend treats botanical medicine as a narrow subdivision of allopathic medicine and does not acknowledge the breadth, depth, and diversity of botanical medicine and ultimately will not provide maximum benefits for patients. An alternative approach that instead credentials practitioners skilled in the use of a wide variety of botanical medicines in a responsible, scientific fashion is presented.
Woodbury, Anna; Soong, Stephen Neal; Fishman, David; García, Paul S
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.
Full Text Available AIM: To investigate the factors predicting adolescent visits to practitioners of complementary and alternative medicine (CAM. METHODS: A longitudinal cohort study conducted in an adolescent total population in Central Norway (The Nord-Trøndelag Health Studies (HUNT. In Young-HUNT 1, all inhabitants aged 13 to 19 years (N = 8944, 89% response rate were invited to participate, and the youngest group (13 to 15 year olds was surveyed again 4 years later (Young-HUNT 2, N = 2429, 82% response rate. The participants completed a comprehensive questionnaire on health and life style which included a question regarding visits to a CAM practitioner in the last 12 months. RESULTS: One in eleven (8.7%, 95%CI 7.6-9.8% had visited a CAM practitioner, an increase of 26% in 4 years (1.8% points. The final multivariable analysis predicted increased odds of an adolescent becoming a CAM visitor four years later (p<0.05 if she or he had previously visited a CAM practitioner (adjOR 3.4, had musculoskeletal pain (adjOR 1.5, had migraine (adjOR 2.3, used asthma medicines (adjOR 1.8 or suffered from another disease lasting more than three months (adjOR 2.1. Being male predicted reduced odds of visiting a CAM practitioner in the future (adjOR 0.6. CONCLUSION: We can conclude from this study that future visits to a CAM practitioner are predicted by both predisposing factors (being female, having visited a CAM practitioner previously and medical need factors (having had musculoskeletal pain, migraine, used asthma medicines or experienced another disease lasting more than three months. None of the specific variables associated with CAM visits were predictive for CAM visits four years later.
... to discuss with your health care providers any complementary and alternative medicines you take or are thinking about starting. Photo: ... adults 50 and older use some form of complementary and alternative medicine (CAM). But less than one-third who use ...
Dalla Libera, D; Colombo, B; Pavan, G; Comi, G
The use of complementary alternative medicine (CAM) in paediatric populations is considerably increased, especially for pain and chronic conditions, as demonstrated by epidemiological surveys both in Europe and in the USA. In our study, CAM was used in 76 % patients of a cohort of 124 children affected by headache (age 4-16 years; 67 % female; 70 % migraine without aura, 12 % migraine with aura, 18 % tensive headache according to IHS criteria) consecutively recruited at a Pediatric Headache University Center. CAM was used as preventive treatment in 80 % cases. The main reasons for seeking CAM were: the wish of avoiding chronic use of drugs with their related side effects, the desire of an integrated approach, the reported inefficacy of conventional medicine, and a more suitable children disposition to CAM than to pharmacological compound. Female gender, younger age, migraine without aura, parents' higher educational status, maternal use of CAM and other associated chronic conditions, correlated with CAM use (p CAM also to treat other diseases (i.e. allergies, colitis, asthma, insomnia, muscle-scheletric disorders and dysmenorrhoea). The most assumed CAM were: herbal remedies (64 %) such as Valeriana, Ginkgo biloba, Boswellia serrata, Vitex agnus-castus, passion flower, Linden tree; vitamins/minerals supplements (40 %) with magnesium, 5-Hydroxytryptophan, vitamin B6 or B12, Multivitamin compounds; Homeopathy (47 %) with Silicea, Ignatia Amara, Pulsatilla, Aconitum, Nux Vomica, Calcarea phosphorica; physical treatment (45 %) such as Ayurvedic massage, shiatsu, osteopathy; yoga (33 %); acupuncture (11 %). CAM-often integrated with conventional care-was auto-prescribed in 30 % of the cases, suggested by non-physician in 22 %, by the General Practitioner in 24 % and by paediatrician in 24 %. Both general practitioners and neurologists were mostly unaware of their patients' CAM use. In conclusion, neurologists should inquire for CAM use and be prepared to learn about CAM
Full Text Available Abstract Background There has been a marked increase in the use of complementary and alternative medicine (CAM in recent years worldwide. In Germany, apart from 'Heilpraktiker' (= state-licensed, non-medical CAM practitioners, some general practitioners (GPs provide CAM in their practices. This paper aims to explore the attitudes of GPs about the role of CAM in Germany, in relation to the healthcare system, quality of care, medical education and research. Furthermore, experiences of GPs integrating CAM in their daily practice were explored. Methods Using a qualitative methodological approach 3 focus groups with a convenience sample of 17 GPs were conducted. The discussions were transcribed verbatim and analysed using qualitative content analysis. Results The majority of the participating GPs had integrated one or more CAM therapies into their every-day practice. Four key themes were identified based on the topics covered in the focus groups: the role of CAM within the German healthcare system, quality of care, education and research. Within the theme 'role of CAM within the healthcare system' there were five categories: integration of CAM, CAM in the Statutory Health Insurance, modernisation of the Statutory Health Insurance Act, individual healthcare services and 'Heilpraktiker'. Regarding quality of care there were two broad groups of GPs: those who thought patients would benefit from standardizing CAM and those who feared that quality control would interfere with the individual approach of CAM. The main issues identified relating to research and education were the need for the development of alternative research strategies and the low quality of existing CAM education respectively. Conclusion The majority of the participating GPs considered CAM as a reasonable complementary approach within primary care. The study increased our understanding of GPs attitudes about the role of CAM within the German healthcare system and the use of
Gardiner, Paula; Filippelli, Amanda C; Lebensohn, Patricia; Bonakdar, Robert
Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate whether residency programs are implementing such competencies into their curriculum using an online survey tool. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. A survey was distributed by the Council of Academic Family Medicine (CAFM) Educational Research Alliance to RDs via e-mail. The survey was distributed to 431 RDs. Of those who received it, 212 responded, giving a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into the residency curriculum. Forty-five percent of RDs were aware of the competencies. In terms of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum; yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%); and financial resources (29%). While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers that prevent residencies from implementing the STFM CAM/IM competencies. © 2013 Elsevier Inc. All rights reserved.
Lo-Fo-Wong, Deborah N. N.; Ranchor, Adelita V.; de Haes, Hanneke C. J. M.; Sprangers, Mirjam A. G.; Henselmans, Inge
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
Lo-Fo-Wong, Deborah N. N.; Ranchor, Adelita V.; de Haes, Hanneke C. J. M.; Sprangers, Mirjam A. G.; Henselmans, Inge
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
Amidst the substantial change currently gripping primary health care are two developments central to contemporary debate regarding the very nature, territory and identity of general practice - the integration of complementary and alternative medicine (CAM) and the rise of evidence-based medicine (EBM). This paper reports findings from a study based upon 25 in-depth interviews with general practitioners (GPs) personally practising complementary therapies alongside more conventional medicine to treat their NHS patients. The paper outlines the GPs' perceptions of EBM, its relationship to their personal development of CAM, and their notions of good clinical practice more generally. Analysis of the GPs' accounts demonstrates how CAM can be seen as a useful resource with which some GPs defend their clinical autonomy from what they perceive to be the threat of EBM. Copyright 2000 Harcourt Publishers Ltd.
The purpose of this study was to examine the frequency of complementary and alternative medicine usage in Chronic Obstructive Pulmonary Disease (COPD) patients living in the eastern part of Turkey. In this study a descriptive design was used. The study was conducted with 216 patients who were present at the clinic.
... Home Current Issue Past Issues Special Section CAM Low Back Pain and CAM Past Issues / Winter 2009 Table of ... benefit from CAM treatment for conditions such as low back pain. Photo courtesy of Glenn Scimonelli "Oh, my aching ...
Joos, Stefanie; Musselmann, Berthold; Szecsenyi, Joachim; Goetz, Katja
The use of Complementary and Alternative medicine (CAM) has increased over the past years. In Germany, many general practitioners (GPs) use CAM in their daily practice. However, little is known about possible differences of GPs using CAM compared to GPs not using CAM. The aim of the study was to explore differences in personal and practice characteristics, work load and job satisfaction of GPs depending on their use of and attitude towards CAM. Furthermore, predictors for CAM use should be explored. A questionnaire was developed based on qualitatively derived data. In addition, a validated instrument assessing job satisfaction was included in the questionnaire, which was sent to 3000 randomly selected GPs in Germany. 1027 returned the questionnaire of which 737 indicated to use CAM in daily practice. We found that GPs using CAM are more female, younger and have a trend towards a healthier life style. Their practices have higher proportions of privately insured patients and are slightly better technically equipped with ultrasound. GPs with a positive attitude had significant better values within the job satisfaction scale and lower working hours per week compared to GPs with neutral/negative attitude. Significant predictors for CAM use were a positive attitude towards CAM, holding a special qualification in CAM, own CAM use and the availability of an ultrasound in practice. The identified differences suggest that those GPs using and believing in CAM have a different medical orientation and approach which in turn may influence their job satisfaction. With this finding CAM use turns out to be a relevant factor regarding job satisfaction and, with this, may be a possible lever to counteract the growing dissatisfaction of GPs in Germany. This finding could also be important for designing strategies to promote the recruitment of young doctors to general practice.
Full Text Available Abstract Background The use of Complementary and Alternative medicine (CAM has increased over the past years. In Germany, many general practitioners (GPs use CAM in their daily practice. However, little is known about possible differences of GPs using CAM compared to GPs not using CAM. The aim of the study was to explore differences in personal and practice characteristics, work load and job satisfaction of GPs depending on their use of and attitude towards CAM. Furthermore, predictors for CAM use should be explored. Methods A questionnaire was developed based on qualitatively derived data. In addition, a validated instrument assessing job satisfaction was included in the questionnaire, which was sent to 3000 randomly selected GPs in Germany. Results 1027 returned the questionnaire of which 737 indicated to use CAM in daily practice. We found that GPs using CAM are more female, younger and have a trend towards a healthier life style. Their practices have higher proportions of privately insured patients and are slightly better technically equipped with ultrasound. GPs with a positive attitude had significant better values within the job satisfaction scale and lower working hours per week compared to GPs with neutral/negative attitude. Significant predictors for CAM use were a positive attitude towards CAM, holding a special qualification in CAM, own CAM use and the availability of an ultrasound in practice. Conclusions The identified differences suggest that those GPs using and believing in CAM have a different medical orientation and approach which in turn may influence their job satisfaction. With this finding CAM use turns out to be a relevant factor regarding job satisfaction and, with this, may be a possible lever to counteract the growing dissatisfaction of GPs in Germany. This finding could also be important for designing strategies to promote the recruitment of young doctors to general practice.
Willingness of Herbal Medicine Practitioners and Herbs Vendors to Contribute Financially to Conservation of Medicinal Plants in Ibadan, ... PROMOTING ACCESS TO AFRICAN RESEARCH ... The earlier version of this paper had some errors.
Liem, Andrian; Newcombe, Peter A; Pohlman, Annie
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.
Kessel, Kerstin A.; Lettner, Sabrina; Kessel, Carmen; Bier, Henning; Biedermann, Tilo; Friess, Helmut; Herrschbach, Peter; Gschwend, J?rgen E.; Meyer, Bernhard; Peschel, Christian; Schmid, Roland; Schwaiger, Markus; Wolff, Klaus-Dietrich; Combs, Stephanie E.
Introduction To understand if and which patients would be open-minded to Complementary and Alternative Medicine (CAM) use parallel to their oncological treatment. Moreover, we sought to determine which methods are most accepted and which are the primary motivators to use CAM. Methods We developed and anonymously conducted a questionnaire for patients in the oncology center (TU Munich). Questions focus on different CAM methods, previous experiences, and willingness to apply or use CAM when off...
Christon, Lillian M.; Mackintosh, Virginia H.; Myers, Barbara J.
Parents of children with autism spectrum disorders (ASDs) may elect to use complementary and alternative medicine (CAM) treatments with their children in place of, or in addition to, conventional treatments. CAM treatments are controversial and understudied and, for most, the efficacy has not been established. The current study (n = 248) examined…
Fox, Patricia; Butler, Michelle; Coughlan, Barbara; Murray, Mary; Boland, Noreen; Hanan, Terry; Murphy, Hilary; Forrester, Pauline; O' Brien, Marie; O' Sullivan, Nollaig
To investigate complementary and alternative medicine (CAM) use among women with breast cancer in Ireland using a mixed methods modified sequential explanatory design. Semi-structured interviews were conducted with oncology professionals (n = 20) and CAM practitioners (n = 20) and this was followed by a survey of 406 women with breast cancer using the 'Use of Complementary and Alternative Therapies Survey' questionnaire (UCATS) (Lengacher et al., 2003). Follow up interviews were subsequently undertaken with a subset of this survey sample (n = 31). Over half of those surveyed (55.7%, n = 226) used some form of CAM since diagnosis. The most frequently used therapies were massage, herbal supplements (including herbs with oestrogenic properties), antioxidants, relaxation, counselling, health supplements, reflexology, reiki and support groups. Dietary interventions were used primarily to reduce symptoms and/or side effects while reduction of psychological stress was the primary reason for use of stress-reducing therapies. Most respondents reported that the CAM therapies they had used were helpful. The qualitative data elaborated on and provided clarification of the survey results. Similar to international studies, CAM is popular among women with breast cancer in Ireland. As such, the challenge for Irish oncology professionals is to identify low risk CAM therapies that are likely to benefit patients while educating patients and themselves on therapies which may be of concern. This study clearly illustrates the benefits of using a mixed methods approach to enhance our understanding of a complex clinical issue and thus we recommend that this method should be the method of choice when planning health services research. Copyright © 2012 Elsevier Ltd. All rights reserved.
Doering, Jan H; Reuner, Gitta; Kadish, Navah E; Pietz, Joachim; Schubert-Bast, Susanne
Parents of pediatric patients with chronic conditions such as epilepsy increasingly opt for complementary and alternative medicine (CAM). However, data on the pattern and reasons of CAM use in childhood epilepsy are scarce. The objectives of this study were as follows: first, to characterize CAM use among pediatric patients with epilepsy by assessing its spectrum, prevalence, costs, and frequency of use; second, to evaluate the influence of CAM use on compliance and satisfaction with conventional care as well as to explore parent-child neurologist communication concerning CAM; and third, to investigate predictors of CAM use. A postal survey was administered to all parents of pediatric outpatients with epilepsy aged 6 to 12, who have received treatment at the neuropediatric outpatient clinic of the University Children's Hospital Heidelberg between 2007 and 2009. One hundred thirty-two of the 297 distributed questionnaires were suitable for inclusion in statistical analysis (44.7%). Forty-nine participants indicated that their children used CAM during the previous year (37.1%). Thirty different types of CAM were used, with homeopathy (55.1%), osteopathy (24.5%), and kinesiology (16.3%) being the most commonly named. A mean of 86€ (0€-500€) and 3h (1 h-30 h) per month was committed to CAM treatment. Only 53% of the users informed their child neurologist of the additional CAM treatment, while 85.6% of all parents wished to discuss CAM options with their child neurologist. Seventy-five percent of users considered the CAM treatment effective. Among the participants most likely to seek CAM treatment are parents whose children show a long duration of epileptic symptoms, parents who make use of CAM treatment themselves, and parents who value a holistic and natural treatment approach. A substantial portion of pediatric patients with epilepsy receive CAM treatment. The high prevalence of use and significant level of financial and time resources spent on CAM indicate the
Sebastian J Padayatty
Full Text Available Anecdotal information and case reports suggest that intravenously administered vitamin C is used by Complementary and Alternate Medicine (CAM practitioners. The scale of such use in the U.S. and associated side effects are unknown.We surveyed attendees at annual CAM Conferences in 2006 and 2008, and determined sales of intravenous vitamin C by major U.S. manufacturers/distributors. We also queried practitioners for side effects, compiled published cases, and analyzed FDA's Adverse Events Database. Of 199 survey respondents (out of 550, 172 practitioners administered IV vitamin C to 11,233 patients in 2006 and 8876 patients in 2008. Average dose was 28 grams every 4 days, with 22 total treatments per patient. Estimated yearly doses used (as 25 g/50 ml vials were 318,539 in 2006 and 354,647 in 2008. Manufacturers' yearly sales were 750,000 and 855,000 vials, respectively. Common reasons for treatment included infection, cancer, and fatigue. Of 9,328 patients for whom data is available, 101 had side effects, mostly minor, including lethargy/fatigue in 59 patients, change in mental status in 21 patients and vein irritation/phlebitis in 6 patients. Publications documented serious adverse events, including 2 deaths in patients known to be at risk for IV vitamin C. Due to confounding causes, the FDA Adverse Events Database was uninformative. Total numbers of patients treated in the US with high dose vitamin C cannot be accurately estimated from this study.High dose IV vitamin C is in unexpectedly wide use by CAM practitioners. Other than the known complications of IV vitamin C in those with renal impairment or glucose 6 phosphate dehydrogenase deficiency, high dose intravenous vitamin C appears to be remarkably safe. Physicians should inquire about IV vitamin C use in patients with cancer, chronic, untreatable, or intractable conditions and be observant of unexpected harm, drug interactions, or benefit.
Longitudinal analysis of associations between women's consultations with complementary and alternative medicine practitioners/use of self-prescribed complementary and alternative medicine and menopause-related symptoms, 2007-2010.
Peng, Wenbo; Adams, Jon; Hickman, Louise; Sibbritt, David W
This study aims to determine associations between consultations with complementary and alternative medicine (CAM) practitioners/use of self-prescribed CAM and menopause-related symptoms. Data were obtained from the Australian Longitudinal Study on Women's Health. Generalized estimating equations were used to conduct longitudinal data analyses, which were restricted to women born in 1946-1951 who were surveyed in 2007 (survey 5; n = 10,638) and 2010 (survey 6; n = 10,011). Women with menopause-related symptoms were more likely to use self-prescribed CAM but were not more likely to consult a CAM practitioner. Overall, CAM use was lower among women who had undergone hysterectomy or women who had undergone oophorectomy, compared with naturally postmenopausal women, and decreased with increasing age of postmenopausal women. Weak associations between CAM use and hot flashes were observed. Women experiencing hot flashes were more likely to consult a massage therapist (odds ratio, 1.09; 95% CI, 1.00-1.20) and/or use self-prescribed herbal medicines (odds ratio, 1.13; 95% CI, 1.03-1.23) than women not experiencing hot flashes. Consultations with CAM practitioners and use of self-prescribed CAM among naturally or surgically postmenopausal women are associated with menopause-related symptoms. Our study findings should prompt healthcare providers, in particular family medicine practitioners, to be cognizant of clinical evidence for CAM typically used for the management of common menopause-related symptoms in their aim to provide safe, effective, and coordinated care for women.
Olsen, Sherri A
Multiple sclerosis (MS) is a chronic, unpredictable disease of the central nervous system without a known cure. Because of this, people with MS often seek complementary and alternative medicines (CAM) to manage their disease symptoms. The goal of this review article was to describe the use of CAM by individuals diagnosed with MS. Evidence was obtained by searching Medline (1950-2007), EBSCOhost and PubMed for studies relating CAM to MS. Results from the literature showed that people with MS reported that they used CAM from 27 to 100%. The major reasons for choosing CAM were as follows: conventional treatment was not effective, anecdotal reports of CAM's help, and doctor referral. The types of CAM reported by people with MS included exercise, vitamins, herbal and mineral supplements, relaxation techniques, acupuncture, cannabis and massage. The major symptoms treated by CAM as noted in the literature were pain, fatigue and stress. There is a need for further research to evaluate the effectiveness of CAM with MS patients and their application by occupational therapists. The limitation of this literature review was the low response rate in many of the surveys reported. 2009 John Wiley & Sons, Ltd
Galicia-Connolly, Elaine; Adams, Denise; Bateman, Justin; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W James; Vohra, Sunita
Previous studies have found that up to 60% of children with neurologic conditions have tried complementary and alternative medicine (CAM). To assess the use of CAM among patients presenting to neurology clinics at two academic centers in Canada. A survey instrument was developed to inquire about use of CAM products and therapies, including reasons for use, perceived helpfulness, and concurrent use with conventional medicine, and administered to patients or their parents/guardians at the Stollery Children's Hospital in Edmonton and the Children's Hospital of Eastern Ontario (CHEO) in Ottawa. Overall CAM use at the Stollery was 78%, compared to 48% at CHEO. The most common CAM products used were multi-vitamins (84%), vitamin C (37%), homeopathic remedies (24%), and fish oil/omega 3 s (22%). The most common CAM practices used were massage (47%), chiropractic (37%), faith healing (18%), aromatherapy (16%), homeopathy (16%), and relaxation (16%). Many patients used CAM products at the same time as conventional medicine but just over half (57%) discussed this concurrent use with their physician. CAM use is common in pediatric neurology patients and most respondents felt that it was helpful, with few or no harms associated. However, this use is often undisclosed, increasing possibility of interactions with conventional drugs. We urge clinicians to inquire about CAM use during routine history taking at every patient visit. Parents would clearly like more information about CAM from their specialty clinics; such information would be easier to share if more primary data were available about the safety and effectiveness of commonly used therapies.
Koehl, Benjamin; Muenstedt, Karsten; Micke, Oliver; Muecke, Ralph; Buentzel, Jens; Stoll, Christoph; Prott, Franz Josef; Dennert, Gabriele; Senf, Bianca; Huebner, Jutta
In total, 40-70% of cancer patients use complementary or alternative medicine (CAM). Many of them ask for advice from non-medical practitioners (NMPs). Our aim was to investigate the attitude of NMPs regarding their treatments for cancer patients. A survey was performed on members of NMP associations, using an online questionnaire on diagnosis and treatment, goals for using CAM, communication with the oncologist, and sources of information. Of the 1,500 members of the NMP associations, 299 took part. The treatments were found to be heterogeneous. Homeopathy is used by 45% of the NMPs; 10% believe it to be a treatment directly against cancer. Herbal therapy, vitamins, orthomolecular medicine, ordinal therapy, mistletoe preparations, acupuncture, and cancer diets are used by more than 10% of the NMPs. None of the treatments is discussed with the respective physician on a regular basis. Many therapies provided by NMPs are biologically based and therefore may interfere with conventional cancer therapy. Thus, patients are at risk of interactions, especially as most NMPs do not adjust their therapies to those of the oncologist. Moreover, risks may arise from these CAM methods as NMPs partly believe them to be useful anticancer treatments. This may lead to the delay or even omission of effective therapies. © 2014 S. Karger GmbH, Freiburg.
Yang, Lu; Peng, Wenbo; Adams, Jon; Sibbritt, David William
Emerging evidence has shown that traditional Chinese medicine (TCM) has a positive effect on arthritis. This research provides the first critical, systematic examination of TCM practitioners' perceptions of TCM use for people with arthritis. An online survey was distributed to all TCM professionals including acupuncturists and Chinese herbal medicine practitioners registered with the Practitioner Research and Collaborate Initiative (PRACI) practitioner database. The survey questions focus on practitioner characteristics, practice characteristics and clinical management approaches regarding arthritis care. The survey attracted a response rate of 53% (n=52). The average age of the respondents was 49.9 years, more than half were female, and the majority held a bachelor degree or higher qualification. More than two thirds of TCM practitioners in our study worked with other health professionals, while they had a high level of referral relationships with a wide range of conventional, allied health and complementary and alternative medicine (CAM) providers. Most of the TCM practitioners reported that their patients with arthritis used other treatments alongside TCM and a large number of the TCM practitioners who participated believed that TCM was effective for treating arthritis. The TCM profession represents a substantial component of the healthcare field in Australia, and treating patients with arthritis appears to be an important area of TCM practice, among others. Further detailed research is needed to help ensure effective, safe patient care for those with arthritis who may be utilising TCM alongside a broader range of conventional medicine, allied health, and other CAM treatments. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Full Text Available The use of complementary and alternative medicine (CAM is growing. However the factors contributing to changes over time and to birth cohort differences in CAM use are not well understood.We used data from 10186 participants, who were aged 20-69 years at the first cycle of data collection in the longitudinal component of the Canadian National Population Health Survey (1994/95-2010/11. We examined chiropractic and other practitioner-based CAM use with a focus on five birth cohorts: pre-World War II (born 1925-1934; World War II (born 1935-1944; older baby boomers (born 1945-1954; younger baby boomers (born 1955-1964; and Gen Xers (born 1965-1974. The survey collected data every two years on predisposing (e.g., sex, education, enabling (e.g., income, behavior-related factors (e.g., obesity, need (e.g., chronic conditions, and use of conventional care (primary care and specialists.The findings suggest that, at corresponding ages, more recent cohorts reported greater CAM (OR = 25.9, 95% CI: 20.0; 33.6 for Gen Xers vs. pre-World War and chiropractic use than their predecessors (OR = 2.2, 95% CI: 1.7; 2.8 for Gen Xers vs. pre-World War. There was also a secular trend of increasing CAM use, but not chiropractic use, over time (period effect across all ages. Factors associated with cohort differences were different for CAM and chiropractic use. Cohort differences in CAM use were partially related to a period effect of increasing CAM use over time across all ages while cohort differences in chiropractic use were related to the higher prevalence of chronic conditions among recent cohorts. The use of conventional care was positively related to greater CAM use (OR = 1.8, 95% CI: 1.6; 2.0 and chiropractic use (OR = 1.2, 95% CI: 1.1; 1.4 but did not contribute to changes over time or to cohort differences in CAM and chiropractic use.The higher CAM use over time and in recent cohorts could reflect how recent generations are approaching their healthcare needs
Versnik Nowak, Amy L.; DeGise, Joe; Daugherty, Amanda; O'Keefe, Richard; Seward, Samuel, Jr.; Setty, Suma; Tang, Fanny
Objective: Determine prevalence and types of complementary and alternative medicine (CAM) therapies used and test the significance of demographics and social cognitive constructs as predictors of CAM use in a college sample. Secondary purpose was to guide the integration of CAM therapies into college health services. Participants: Random,…
Barikani, Ameneh; Beheshti, Akram; Javadi, Maryam; Yasi, Marzieh
Orientation of public and physicians to the complementary and alternative medicine (CAM) is one of the most prominent symbols of structural changes in the health service system. The aim of his study was a determination of knowledge, attitude, and practice of general practitioners in complementary and alternative medicine. This cross- sectional study was conducted in Qazvin, Iran in 2013. A self-administered questionnaire was used for collecting data including four information parts: population information, physicians' attitude and knowledge, methods of getting information and their function. A total of 228 physicians in Qazvin comprised the population of study according to the deputy of treatment's report of Qazvin University of Medical Sciences. A total of 150 physicians were selected randomly, and SPSS Statistical program was used to enter questionnaires' data. Results were analyzed as descriptive statistics and statistical analysis. Sixty percent of all responders were male. About sixty (59.4) percent of participating practitioners had worked less than 10 years.96.4 percent had a positive attitude towards complementary and alternative medicine. Knowledge of practitioners about traditional medicine in 11 percent was good, 36.3% and 52.7% had average and little information, respectively. 17.9% of practitioners offered their patients complementary and alternative medicine for treatment. Although there was little knowledge among practitioners about traditional medicine and complementary approaches, a significant percentage of them had attitude higher than the lower limit.
The Australian Nuclear Science and Technology Organisation (ANSTO) has a major research program in nuclear medicine; this article describes the information support given to the program by the Lucas Heights Research Laboratories (LHRL) Library. The INIS database is a prime indicator of the information held at LHRL Library, however, other databases also cover nuclear medicine. As part of the Australian library system the ANSTO Library's resources are accessed by subscription. The ANSTO Library staff can also search INIS for a fee for external enquiries but the other databases can presently only be searched for LHRL staff and affiliates. Even so, most major library and information services can provide access to these databases
Hasan, Syed S; Yong, Chew S; Babar, Muneer G; Naing, Cho M; Hameed, Abdul; Baig, Mirza R; Iqbal, Shahid M; Kairuz, Therese
In recent times the basic understanding, perceptions and CAM use among undergraduate health sciences students have become a topic of interest. This study was aimed to investigate the understanding, perceptions and self-use of CAM among pharmacy students in Malaysia. This cross-sectional study was conducted on 500 systematically sampled pharmacy students from two private and one public university. A validated, self-administered questionnaire comprised of seven sections was used to gather the data. A systematic sampling was applied to recruit the students. Both descriptive and inferential statistics were applied using SPSS® version 18. Overall, the students tend to disagree that complementary therapies (CM) are a threat to public health (mean score = 3.6) and agreed that CMs include ideas and methods from which conventional medicine could benefit (mean score = 4.7). More than half (57.8%) of the participants were currently using CAM while 77.6% had used it previously. Among the current CAM modalities used by the students, CM (21.9%) was found to be the most frequently used CAM followed by Traditional Chinese Medicine (TCM) (21%). Most of the students (74.8%) believed that lack of scientific evidence is one of the most important barriers obstructing them to use CAM. More than half of the students perceived TCM (62.8%) and music therapy (53.8%) to be effective. Majority of them (69.3%) asserted that CAM knowledge is necessary to be a well-rounded professional. This study reveals a high-percentage of pharmacy students who were using or had previously used at least one type of CAM. Students of higher professional years tend to agree that CMs include ideas and methods from which conventional medicine could benefit.
Baig Mirza R
Full Text Available Abstract Background In recent times the basic understanding, perceptions and CAM use among undergraduate health sciences students have become a topic of interest. This study was aimed to investigate the understanding, perceptions and self-use of CAM among pharmacy students in Malaysia. Methods This cross-sectional study was conducted on 500 systematically sampled pharmacy students from two private and one public university. A validated, self-administered questionnaire comprised of seven sections was used to gather the data. A systematic sampling was applied to recruit the students. Both descriptive and inferential statistics were applied using SPSS® version 18. Results Overall, the students tend to disagree that complementary therapies (CM are a threat to public health (mean score = 3.6 and agreed that CMs include ideas and methods from which conventional medicine could benefit (mean score = 4.7. More than half (57.8% of the participants were currently using CAM while 77.6% had used it previously. Among the current CAM modalities used by the students, CM (21.9% was found to be the most frequently used CAM followed by Traditional Chinese Medicine (TCM (21%. Most of the students (74.8% believed that lack of scientific evidence is one of the most important barriers obstructing them to use CAM. More than half of the students perceived TCM (62.8% and music therapy (53.8% to be effective. Majority of them (69.3% asserted that CAM knowledge is necessary to be a well-rounded professional. Conclusions This study reveals a high-percentage of pharmacy students who were using or had previously used at least one type of CAM. Students of higher professional years tend to agree that CMs include ideas and methods from which conventional medicine could benefit.
Galbraith, Niall; Moss, Tim; Galbraith, Victoria; Purewal, Satvinder
Complementary and alternative medicine (CAM) use is widespread despite the controversy over its effectiveness. Although previous reviews have examined the demographics and attitudes of CAM users, there is no existing review on the traits or cognitions which characterise either CAM users or those who believe in CAM effectiveness. The current systematic review set out to address these gaps in the literature by applying a narrative synthesis. A bibliographic search and manual searches were undertaken and key authors were contacted. Twenty-three papers were selected. The trait openness to experience was positively associated with CAM use but not CAM belief. Absorption and various types of coping were also positively associated with CAM use and belief. No other trait was reliably associated with CAM use or belief. Intuitive thinking and ontological confusions were positively associated with belief in CAM effectiveness; intuitive thinking was also positively associated with CAM use. Studies researching cognitions in CAM use/belief were mostly on non-clinical samples, whilst studies on traits and CAM use/belief were mostly on patients. The quality of studies varied but unrepresentative samples, untested outcome measures and simplistic statistical analyses were the most common flaws. Traits and cognition might be important correlates of CAM use and also of faith in CAM.
Corrao, Salvatore; Argano, Christiano; Colomba, Daniela; Ippolito, Calogero; Gargano, Vincenzo; Arcoraci, Vincenzo; Licata, Giuseppe
In recent years, there has been a growing interest about complementary and alternative medicine (CAM), and the use of CAM interventions has become more common among people. For these reasons, health professionals must be able to effectively manage information in this field of knowledge according to an evidence-based point of view. This study assessed the anatomy of the available information about CAMs using PubMed, to give practical instructions to manage information in this field. We also analyzed the anatomy of information according to each alternative medicine branch, narrow and broad search methods, subset filters for indexed-for-Medline and non-indexed citations, and different publication types including randomized controlled trials (RCTs) and meta-analyses. Our results demonstrated that the use of CAMs subset (supplied by PubMed search engine) leads to a great number of citations determining an information overload. Our data reveal that it would be more useful to search for the CAM separately, identifying specific items and study design. Moreover, we found the largest number of randomized clinical trials and meta-analyses related to herbal medicine and acupuncture, neither RCTs nor meta-analyses were available for bach and flower remedies, auriculoacupuncture, iridology, and pranotherapy. For the first time, our study gives a comprehensive view of the anatomy of information regarding CAMs and each branch of them. We suggest a methodological approach to face with searching information about this emerging issue from an evidence-based point of view. Finally, our data pointed out some "grey zones" since neither RCTs nor meta-analyses were available for some CAMs.
Objectives: To assess the attitude and knowledge of family medicine practitioners (FMPs) towards the association between periodontal disease and obesity. Materials and Methods: A cross-sectional study was performed and a 13-item survey questionnaire was given to FMPs practicing in 12 different teaching hospitals in ...
Chao, Maria T.; Wade, Christine; Kronenberg, Fredi
Background Complementary and alternative medicine (CAM) is often used alongside conventional medical care, yet fewer than half of patients disclose CAM use to medical doctors. CAM disclosure is particularly low among racial/ethnic minorities, but reasons for differences, such as type of CAM used or quality of conventional healthcare, have not been explored. Objective We tested the hypotheses that disclosure of CAM use to medical doctors is higher for provider-based CAM and among non-Hispanic whites, and that access to and quality of conventional medical care account for racial/ethnic differences in CAM disclosure. Methods Bivariate and multiple variable analyses of the 2002 National Health Interview Survey and 2001 Health Care Quality Survey were performed. Results Disclosure of CAM use to medical providers was higher for provider-based than self-care CAM. Disclosure of any CAM was associated with access to and quality of conventional care and higher among non-Latino whites relative to minorities. Having a regular doctor and quality patient–provider relationship mitigated racial/ethnic differences in CAM disclosure. Conclusion Insufficient disclosure of CAM use to conventional providers, particularly for self-care practices and among minority populations, represents a serious challenge in medical encounter communications. Efforts to improve disclosure of CAM use should be aimed at improving consistency of care and patient–physician communication across racial/ethnic groups. PMID:19024232
Moran, Meena S.; Ma Shuangge; Jagsi, Reshma; Yang, Tzu-I Jonathan; Higgins, Susan A.; Weidhaas, Joanne B.; Wilson, Lynn D.; Lloyd, Shane; Peschel, Richard; Gaudreau, Bryant; Rockwell, Sara
Purpose: Although complementary and alternative medicine (CAM) utilization in breast cancer patients is reported to be high, there are few data on CAM practices in breast patients specifically during radiation. This prospective, multi-institutional study was conducted to define CAM utilization in breast cancer during definitive radiation. Materials/Methods: A validated CAM instrument with a self-skin assessment was administered to 360 Stage 0-III breast cancer patients from 5 centers during the last week of radiation. All data were analyzed to detect significant differences between users/nonusers. Results: CAM usage was reported in 54% of the study cohort (n=194/360). Of CAM users, 71% reported activity-based CAM (eg, Reiki, meditation), 26% topical CAM, and 45% oral CAM. Only 16% received advice/counseling from naturopathic/homeopathic/medical professionals before initiating CAM. CAM use significantly correlated with higher education level (P<.001), inversely correlated with concomitant hormone/radiation therapy use (P=.010), with a trend toward greater use in younger patients (P=.066). On multivariate analysis, level of education (OR: 6.821, 95% CI: 2.307-20.168, P<.001) and hormones/radiation therapy (OR: 0.573, 95% CI: 0.347-0.949, P=.031) independently predicted for CAM use. Significantly lower skin toxicity scores were reported in CAM users vs nonusers, respectively (mild: 34% vs 25%, severe: 17% vs 29%, P=.017). Conclusion: This is the first prospective study to assess CAM practices in breast patients during radiation, with definition of these practices as the first step for future investigation of CAM/radiation interactions. These results should alert radiation oncologists that a large percentage of breast cancer patients use CAM during radiation without disclosure or consideration for potential interactions, and should encourage increased awareness, communication, and documentation of CAM practices in patients undergoing radiation treatment for breast
Hirai, K; Komura, K; Tokoro, A; Kuromaru, T; Ohshima, A; Ito, T; Sumiyoshi, Y; Hyodo, I
This study explored the psychological and behavioral mechanisms of complementary and alternative medicine (CAM) use in Japanese cancer patients using two applied behavioral models, the transtheoretical model (TTM), and theory of planned behavior (TPB). Questionnaires were distributed to 1100 patients at three cancer treatment facilities in Japan and data on 521 cancer patients were used in the final analysis. The questionnaire included items based on TTM and TPB variables, as well as three psychological batteries. According to the TTM, 88 patients (17%) were in precontemplation, 226 (43%) in contemplation, 33 (6%) in preparation, 71 (14%) in action, and 103 (20%) in maintenance. The model derived from structural equation modeling revealed that the stage of CAM use was significantly affected by the pros, cons, expectation from family, norms of medical staff, use of chemotherapy, period from diagnosis, and place of treatment. The primary factor for the stage of CAM use was the expectation from family. The findings revealed the existence of a number of psychologically induced potential CAM users, and psychological variables including positive attitude for CAM use and perceived family expectation greatly influence CAM use in cancer patients.
Kessel, Kerstin A; Lettner, Sabrina; Kessel, Carmen; Bier, Henning; Biedermann, Tilo; Friess, Helmut; Herrschbach, Peter; Gschwend, Jürgen E; Meyer, Bernhard; Peschel, Christian; Schmid, Roland; Schwaiger, Markus; Wolff, Klaus-Dietrich; Combs, Stephanie E
To understand if and which patients would be open-minded to Complementary and Alternative Medicine (CAM) use parallel to their oncological treatment. Moreover, we sought to determine which methods are most accepted and which are the primary motivators to use CAM. We developed and anonymously conducted a questionnaire for patients in the oncology center (TU Munich). Questions focus on different CAM methods, previous experiences, and willingness to apply or use CAM when offered in a university-based setting. A total of 171 of 376 patients (37.4% women, 62.0% men, 0.6% unknown) participated. This corresponds to a return rate of 45%. Median age was 64 years (17-87 years). Of all participants, 15.2% used CAM during their oncological therapy; 32.7% have used it in the past. The majority (81.9%) was not using CAM during therapy; 55.5% have not used CAM in the past respectively. The analysis revealed a significant correlation between education and CAM use during therapy (r = 0.18; p = 0.02), and CAM use in the past (r = 0.17; p = 0.04). Of all patients using CAM during therapy, favored methods were food supplements (42.3%), vitamins/minerals (42.3%), massage (34.6%). Motivations are especially the reduction of side effect and stress, the positive effect of certain CAM-treatments on the immune system and tumor therapy. Results showed no difference between women and men. Most patients not having had any experience with CAM complain about the deficiency of information by their treating oncologist (31.4%) as well as missing treatment possibilities (54.3%). Since many patients believe in study results demonstrating the efficacy of CAM, it stresses our task to develop innovative study protocols to investigate the outcomes of certain CAM on symptom reduction or other endpoints. Thus, prospective trials and innovative evidence-based treatment concepts to include CAM into high-end oncology is what patients demand and what a modern oncology center should offer.
Kerstin A Kessel
Full Text Available To understand if and which patients would be open-minded to Complementary and Alternative Medicine (CAM use parallel to their oncological treatment. Moreover, we sought to determine which methods are most accepted and which are the primary motivators to use CAM.We developed and anonymously conducted a questionnaire for patients in the oncology center (TU Munich. Questions focus on different CAM methods, previous experiences, and willingness to apply or use CAM when offered in a university-based setting.A total of 171 of 376 patients (37.4% women, 62.0% men, 0.6% unknown participated. This corresponds to a return rate of 45%. Median age was 64 years (17-87 years. Of all participants, 15.2% used CAM during their oncological therapy; 32.7% have used it in the past. The majority (81.9% was not using CAM during therapy; 55.5% have not used CAM in the past respectively. The analysis revealed a significant correlation between education and CAM use during therapy (r = 0.18; p = 0.02, and CAM use in the past (r = 0.17; p = 0.04. Of all patients using CAM during therapy, favored methods were food supplements (42.3%, vitamins/minerals (42.3%, massage (34.6%. Motivations are especially the reduction of side effect and stress, the positive effect of certain CAM-treatments on the immune system and tumor therapy. Results showed no difference between women and men. Most patients not having had any experience with CAM complain about the deficiency of information by their treating oncologist (31.4% as well as missing treatment possibilities (54.3%.Since many patients believe in study results demonstrating the efficacy of CAM, it stresses our task to develop innovative study protocols to investigate the outcomes of certain CAM on symptom reduction or other endpoints. Thus, prospective trials and innovative evidence-based treatment concepts to include CAM into high-end oncology is what patients demand and what a modern oncology center should offer.
The use of complementary and alternative medicines (CAM), such as herbs and dietary supplements, has become more popular among cancer patients. Cancer patients use these supplements for different reasons such as reduction of side effects and improvement of their quality of life. In general, the use
Berretta, Massimiliano; Della Pepa, Chiara; Tralongo, Paolo; Fulvi, Alberto; Martellotta, Ferdinando; Lleshi, Arben; Nasti, Guglielmo; Fisichella, Rossella; Romano, Carmela; De Divitiis, Chiara; Taibi, Rosaria; Fiorica, Francesco; Di Francia, Raffaele; Di Mari, Anna; Del Pup, Lino; Crispo, Anna; De Paoli, Paolo; Santorelli, Adriano; Quagliariello, Vincenzo; Iaffaioli, Rosario Vincenzo; Tirelli, Umberto; Facchini, Gaetano
Complementary and Alternative Medicine (CAM) include a wide range of products (herbs, vitamins, minerals, and probiotics) and medical practices, developed outside of the mainstream Western medicine. Patients with cancer are more likely to resort to CAM first or then in their disease history; the potential side effects as well as the costs of such practices are largely underestimated. We conducted a descriptive survey in five Italian hospitals involving 468 patients with different malignancies. The survey consisted of a forty-two question questionnaire, patients were eligible if they were Italian-speaking and receiving an anticancer treatment at the time of the survey or had received an anticancer treatment no more than three years before participating in the survey. Of our patients, 48.9% said they use or have recently used CAM. The univariate analysis showed that female gender, high education, receiving treatment in a highly specialized institute and receiving chemotherapy are associated with CAM use; at the multivariate analysis high education (Odds Ratio, (OR): 1.96 95% Confidence Interval, CI, 1.27-3.05) and receiving treatment in a specialized cancer center (OR: 2.75 95% CI, 1.53-4.94) were confirmed as risk factors for CAM use. Roughly half of our patients receiving treatment for cancer use CAM. It is necessary that health professional explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision.
JALILI, Mohammad; SADEGHIPOUR ROODSARI, Gholamreza; BASSIR NIA, Anahita
Abstract Background Emergency physicians are at risk of burnout, which can affect their mental health, as well as patient care. We assessed burnout level among Iranian emergency physicians and investigated demographic, work-related factors and stressors associated with higher burnout. Methods In a cross-sectional study, we surveyed all 188 emergency medicine residents and practitioners in Iran. We measured burnout using 22-item Maslach Burnout Inventory assessing emotional exhaustion, deperso...
Al Asmi, Abdullah; Al Maniri, Abdullah; Al-Farsi, Yahya M; Burke, David T; Al Asfoor, Fatema M H; Al Busaidi, Ibrahim; Al Breiki, Mohamed H A; Lahiri, Shaon; Braidy, Nady; Essa, Musthafa M; Al-Adawi, Samir
Nonpharmacological treatment strategies that originate from sociocultural teachings and are beyond the scope of allopathic medicine are commonly used among people with epilepsy (PWE) in many parts of the world. The present study explored the types and sociodemographic correlates of complementary and alternative medicine (CAM) use among PWE in Oman among attendees of a neurological unit at a tertiary care center. Data on the types of CAM were gathered from telephone interviews. The relevant demographic and clinical characteristics of the participants were obtained from electronic medical records. Of the total of 101 participants, 73.3% were CAM users. The majority of these participants have not disclosed their CAM use to their allopathic health-care providers. The most common types of CAM reported were those falling under the 'mind-body' type (incantations and fumigation) and biologically based (herbal concoctions) or a combination of them. Compared to non-CAM users, a significant and greater proportion of CAM users attributed the etiology of their illness to nonbiomedical factors such as 'evil eyes' (P=0.04). The multivariate logistic regression model indicated that the use of CAM was highly associated with age of Oman. The most utilized type of CAM falls under the umbrella of mind-body practice. © 2013 Elsevier Inc. All rights reserved.
Mercer Stewart W
Full Text Available Abstract Background Despite Hong Kong government's official commitment to the development of traditional Chinese medicine (TCM over the last ten years, there appears to have been limited progress in public sector initiated career development and postgraduate training (PGT for public university trained TCM practitioners. Instead, the private TCM sector is expected to play a major role in nurturing the next generation of TCM practitioners. In the present study we evaluated TCM graduates' perspectives on their career prospects and their views regarding PGT. Method Three focus group discussions with 19 local TCM graduates who had worked full time in a clinical setting for fewer than 5 years. Results Graduates were generally uncertain about how to develop their career pathways in Hong Kong with few postgraduate development opportunities; because of this some were planning to leave the profession altogether. Despite their expressed needs, they were dissatisfied with the current quality of local PGT and suggested various ways for improvement including supervised practice-based learning, competency-based training, and accreditation of training with trainee involvement in design and evaluation. In addition they identified educational needs beyond TCM, in particular a better understanding of western medicine and team working so that primary care provision might be more integrated in the future. Conclusion TCM graduates in Hong Kong feel let down by the lack of public PGT opportunities which is hindering career development. To develop a new generation of TCM practitioners with the capacity to provide quality and comprehensive care, a stronger role for the government, including sufficient public funding, in promoting TCM graduates' careers and training development is suggested. Recent British and Australian experiences in prevocational western medicine training reform may serve as a source of references when relevant program for TCM graduates is planned in
Schafer Lisa M
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.
Schafer, Lisa M; Hsu, Clarissa; Eaves, Emery Rose; Ritenbaugh, Cheryl; Turner, Judith; Cherkin, Daniel C; Sims, Colette; Sherman, Karen J
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. 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. 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. 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.
Hoenders, H.J.R.; Appelo, M.T.; van den Brink, E.H.; Hartogs, B.M.A.; de Jong, J.T.V.M.
Background: Complementary and alternative medicine (CAM) is subject to heated debates and prejudices. Studies show that CAM is widely used by psychiatric patients, usually without the guidance of a therapist and without the use of a solid working method, leading to potential health risks. Aim: The
Sheikhazadi, Ardeshir; Mehrzad, Kiani; Fakhredin, Taghaddosinejad
: To survey the extent of abuse and violence directed toward legal medicine practitioners during the course of their professional duties and to categorize the characteristics of such aggression. : Retrospective survey of the views of a large sample of Tehran's legal medicine practitioners by using a piloted anonymous questionnaire. : In all, 105 (86.1%) of the responders had experienced verbal abuse during the previous 12 months, 79 (64.7%) had experienced some sort of verbal abuse at least once a month, 39 (32%) had experienced verbal abuse every week, and 13 (10.7%) had experienced verbal abuse every day. Of the 122 legal medicine physicians, 39 (32%) were exposed to specific threats, 8 (6.6%) were exposed to physical action without injury, and 7 (5.7%) had experience serious incidents including threats with a weapon or attacks leading to physical injury over the previous year. Even assuming that all the nonresponders did not experience any violence, the aggression by patients affected 75% of legal medicine practitioners in the Tehran province. : Violence toward Tehran's legal medicine practitioners is very common and may be increasing. Some of the participating factors of aggression are potentially avoidable and practices should make strenuous attempts to identify such factors and remedy them. Staff training in interpersonal skills and recognizing anxious patients are essential. Doctors should avoid delays for patients by rearranging the booking policies, visit times, and duration. Victims of aggression must be followed up.
Bücker, B; Groenewold, M; Schoefer, Y; Schäfer, T
The objective of this study was to evaluate the patterns of use of complementary alternative medicine (CAM) in a representative adult population in Germany. A population-based telephone survey was conducted in Lübeck, Germany. We performed computer-assisted telephone interviews (CATI) in order to obtain information on demographics, health status, prevalence of CAM usage, motivation for using CAM, type of CAM and health problems for which CAM were used. 1,001 adults (median age 48 years) participated in the study (response 46.8%). 79.6% of the interviewed subjects reported health problems. The most frequently named problems were chronic pain (45.3%), circulation problems (32.9%) and colds with fever (27.8%). Non-users of CAM had a lower incidence (76.6%) of overall illness than users (83.5%) (OR 0.65, 0.47-0.89). 42.3% of the participants had used CAM. The CAM user group consisted of significantly more females (72.8 vs. 55.5%) (OR 2.32, 1.74-3.08) and involved better educated subjects (school education >12 years, 36.6 vs. 27.9%, OR 3.25, 1.35-7.81) than the non-user group. The main health problems for which CAM was used were chronic pain (36.3%), some cases of uncomplicated colds (16.9%) and for improving general health (14.7%). Three procedures accounted for the majority of usage: Acupuncture (34.5%), homeopathy (27.3%) and herbal medicine (9.7%). A large number of participants reported as the main reason for using CAM the wish to avoid drugs as much as possible (31.7%). 26.7% reported opting for CAM due to the recommendation of their physician. 23.9% gave unsatisfactory results of conventional medicine as reason for CAM usage. CAM is used widely for different complaints by the general population. This frequent use of CAM has implications for the health-care system and health policy.
Klafke, Nadja; Eliott, Jaklin A; Olver, Ian N; Wittert, Gary A
To explore how men's Significant Others (SOs), including family members and close friends, contribute to the uptake and maintenance of specific CAM therapies. This study was the second, qualitative phase of a mixed-methods project investigating the use of CAM in an Australian male cancer population. Male participants were purposefully selected from a pool of 403 patients who answered a survey in the first quantitative phase (94% response rate and 86% consent rate for follow-up interview). Then semi-structured interviews among 26 men with a variety of cancers and 24 SOs were conducted. All 43 interviews were recorded, transcribed, and analysed thematically. Men used CAM/Natural products to cope with physical concerns, and this was actively supported by men's SOs who contributed to the uptake and maintenance of these CAMs. The shared CAM preparation and consumption functioned to strengthen the bond between men and their SOs, and also helped men's SOs to cope with uncertainty and regain control. In contrast, men practiced CAM/Mind-body medicine to receive emotional benefits, and only rarely shared this practice with their SOs, indicating a need for coping with emotions in a private way. Men's CAM use is a multifaceted process that can be better understood by considering CAM categories separately. CAM/Natural products help men to cope with physical concerns, while CAM/Mind-body medicine assist men to cope with their emotions in a private way. Oncology professionals can use this information to better promote and implement integrative cancer care services. Copyright © 2014 Elsevier Ltd. All rights reserved.
Obalum, D C; Ogo, C N
Osteoarthritis (OA), a chronic degenerative disease of synovial joints is characterised by pain and stiffness. Aim of treatment is pain relief. Complementary and alternative medicine (CAM) refers to practices which are not an integral part of orthodox medicine. To determine the pattern of usage of CAM among OA patients in Nigeria. Consecutive patients with OA attending orthopaedic clinic of Havana Specialist Hospital, Lagos, Nigeria were interviewed over a 6- month period st st of 1 May to 31 October 2007 on usage of CAM. Structured and open-ended questions were used. Demographic data, duration of OA and treatment as well as compliance to orthodox medications were documented. One hundred and sixty four patients were studied.120 (73.25%) were females and 44(26.89%) were males. Respondents age range between 35-74 years. 66(40.2%) patients used CAM. 35(53.0%) had done so before presenting to the hospital. The most commonly used CAM were herbal products used by 50(75.8%) of CAM users. Among herbal product users, 74.0% used non- specific local products, 30.0% used ginger, 36.0% used garlic and 28.0% used Aloe Vera. Among CAM users, 35(53.0%) used local embrocation and massage, 10(15.2%) used spiritual methods. There was no significant difference in demographics, clinical characteristics and pain control among CAM users and non-users. Many OA patients receiving orthodox therapy also use CAM. Medical doctors need to keep a wary eye on CAM usage among patients and enquire about this health-seeking behaviour in order to educate them on possible drug interactions, adverse effects and long term complications.
Zakavi, R.; Derakhshan, A.; Pourzadeh, Z.
Nuclear medicine is an important department in most of scientific hospitals in the world. Rapid improvement in the filed of nuclear medicine needs continuing education of medical students. We tried to evaluate the knowledge of general practitioners in the flied of nuclear medicine, hoping that this study help mangers in accurate planning of teaching programs. Methods and materials: We prepared a questionnaire with 14 questions regarding applications of nuclear medicine techniques in different specialities of medicine. We selected questions as simple as possible with considering the most common techniques and best imaging modality in some disease. One question in nuclear cardiology, one in lung disease, two questions in thyroid therapy, another two in gastrointestinal system, two in genitourinary system and the last two in nuclear oncology. Also 4 questions were about general aspects of nuclear medicine. We have another 4 questions regarding the necessity of having a nuclear medicine subject during medical study, the best method of teaching of nuclear medicine and the preferred method of continuing education. Also age, sex, graduation date and university of education of all subjects were recorded. Results: One hundred (General practitioners) were studied. including, 58 male and 42 female with age range of 27-45 years did . About 60% of cases were 27-30 years old and 40 cases were older than 40. Seventy two cases were graduated in the last 5 years. Mashad University was the main university of education 52 cases with Tehran University (16 cases) and Tabriz University (6 cases) in the next ranks. Also 26 cases were graduated from other universities. From four questions in the field of general nuclear nedione 27% were correctly answered to all questions, 37% correctly answered two questions and 10% had correct answered only one question. No correct answer was noted in 26% . correct answer was noted in 80% the held of nuclear cardiology and in 72% in the field of lung
Full Text Available With tens of thousands of plant species on earth, we are endowed with an enormous wealth of medicinal remedies from Mother Nature. Natural products and their derivatives represent more than 50% of all the drugs in modern therapeutics. Because of the low success rate and huge capital investment need, the research and development of conventional drugs are very costly and difficult. Over the past few decades, researchers have focused on drug discovery from herbal medicines or botanical sources, an important group of complementary and alternative medicine (CAM therapy. With a long history of herbal usage for the clinical management of a variety of diseases in indigenous cultures, the success rate of developing a new drug from herbal medicinal preparations should, in theory, be higher than that from chemical synthesis. While the endeavor for drug discovery from herbal medicines is “experience driven,” the search for a therapeutically useful synthetic drug, like “looking for a needle in a haystack,” is a daunting task. In this paper, we first illustrated various approaches of drug discovery from herbal medicines. Typical examples of successful drug discovery from botanical sources were given. In addition, problems in drug discovery from herbal medicines were described and possible solutions were proposed. The prospect of drug discovery from herbal medicines in the postgenomic era was made with the provision of future directions in this area of drug development.
Pan, Si-Yuan; Zhou, Shu-Feng; Gao, Si-Hua; Yu, Zhi-Ling; Zhang, Shuo-Feng; Tang, Min-Ke; Sun, Jian-Ning; Ma, Dik-Lung; Han, Yi-Fan; Fong, Wang-Fun; Ko, Kam-Ming
With tens of thousands of plant species on earth, we are endowed with an enormous wealth of medicinal remedies from Mother Nature. Natural products and their derivatives represent more than 50% of all the drugs in modern therapeutics. Because of the low success rate and huge capital investment need, the research and development of conventional drugs are very costly and difficult. Over the past few decades, researchers have focused on drug discovery from herbal medicines or botanical sources, an important group of complementary and alternative medicine (CAM) therapy. With a long history of herbal usage for the clinical management of a variety of diseases in indigenous cultures, the success rate of developing a new drug from herbal medicinal preparations should, in theory, be higher than that from chemical synthesis. While the endeavor for drug discovery from herbal medicines is "experience driven," the search for a therapeutically useful synthetic drug, like "looking for a needle in a haystack," is a daunting task. In this paper, we first illustrated various approaches of drug discovery from herbal medicines. Typical examples of successful drug discovery from botanical sources were given. In addition, problems in drug discovery from herbal medicines were described and possible solutions were proposed. The prospect of drug discovery from herbal medicines in the postgenomic era was made with the provision of future directions in this area of drug development.
Pan, Si-Yuan; Zhou, Shu-Feng; Gao, Si-Hua; Yu, Zhi-Ling; Zhang, Shuo-Feng; Tang, Min-Ke; Sun, Jian-Ning; Han, Yi-Fan; Fong, Wang-Fun; Ko, Kam-Ming
With tens of thousands of plant species on earth, we are endowed with an enormous wealth of medicinal remedies from Mother Nature. Natural products and their derivatives represent more than 50% of all the drugs in modern therapeutics. Because of the low success rate and huge capital investment need, the research and development of conventional drugs are very costly and difficult. Over the past few decades, researchers have focused on drug discovery from herbal medicines or botanical sources, an important group of complementary and alternative medicine (CAM) therapy. With a long history of herbal usage for the clinical management of a variety of diseases in indigenous cultures, the success rate of developing a new drug from herbal medicinal preparations should, in theory, be higher than that from chemical synthesis. While the endeavor for drug discovery from herbal medicines is “experience driven,” the search for a therapeutically useful synthetic drug, like “looking for a needle in a haystack,” is a daunting task. In this paper, we first illustrated various approaches of drug discovery from herbal medicines. Typical examples of successful drug discovery from botanical sources were given. In addition, problems in drug discovery from herbal medicines were described and possible solutions were proposed. The prospect of drug discovery from herbal medicines in the postgenomic era was made with the provision of future directions in this area of drug development. PMID:23634172
Soo Yeon Kim
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.
Wagstaff, C R D; Gilmore, S; Thelwell, R C
Despite the emergence of and widespread uptake of a growing range of medical and scientific professions in elite sport, such environs present a volatile professional domain characterized by change and unprecedentedly high turnover of personnel. This study explored sport medicine and science practitioners' experiences of organizational change using a longitudinal design over a 2-year period. Specifically, data were collected in three temporally defined phases via 49 semi-structured interviews with 20 sport medics and scientists employed by three organizations competing in the top tiers of English football and cricket. The findings indicated that change occurred over four distinct stages; anticipation and uncertainty, upheaval and realization, integration and experimentation, normalization and learning. Moreover, these data highlight salient emotional, behavioral, and attitudinal experiences of medics and scientists, the existence of poor employment practices, and direct and indirect implications for on-field performance following organizational change. The findings are discussed in line with advances to extant change theory and applied implications for prospective sport medics and scientists, sport organizations, and professional bodies responsible for the training and development of neophyte practitioners. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Ong, Fangyi; Seah Lee, Way; Lin, Charlotte; Ng, Ruey Terng; Yee Wong, Shin; Lim, Su Lin; Quak, Seng Hock; Aw, Marion
The use of complementary and alternative medicine (CAM) has been associated with adverse effects and self-imposed dietary restrictions. The prevalence of its use in Asian children with inflammatory bowel disease (IBD) is unknown. We aimed to determine the prevalence, types, and factors associated with the use of CAM among children with IBD from Singapore and Malaysia, and to ascertain if dietary restriction was prevalent in patients who used CAM. A cross-sectional study was conducted in which parents of children with IBD attending two tertiary pediatric IBD referral centres in Singapore and Malaysia were interviewed. Data about demographics, conventional treatment, complementary therapies and dietary patterns were collected in a questionnaire. Of 64 children with IBD interviewed, 83% (n = 53) reported the use of CAM (Singapore [90%] vs. Malaysia [76%]; p = 0.152). The median number of CAM agents used was two (range 1-10). The three most common types of CAM used were probiotics (64%), vitamin and mineral supplements (55%), and food-based therapies (36%). Among individual CAM categories, the use of food-based therapies was correlated significantly with nationality (r = 0.497, p history of weight loss due to IBD (r = 0.340, p = 0.013) and avoidance of certain foods to prevent a relapse (r = 0.289, p = 0.036). Parents who rated their child's disease activity as more severe were less likely to use CAM (r = -0.257, p = 0.041). Fifty-nine percent of CAM users reported physician awareness of their CAM use. The overall self-perceived efficacy of CAM in improving IBD symptoms was 34%. Of the dietary patterns explored, only intake of dairy products was associated with CAM use (r = 0.306, p = 0.019). Use of CAM is prevalent in children with IBD in Malaysia and Singapore. Further studies to elucidate reasons influencing CAM use, dietary patterns and efficacy of commonly used CAM would be required. Copyright © 2018. Published by Elsevier B.V.
Alavi, S Shohreh; Makarem, Jalil; Mehrdad, Ramin
General practitioners (GPs) who work in occupational medicine (OM) should be trained continuously. However, it seems that ethical issues have been neglected. This cross-sectional study aimed to determine educational priorities for GPs working in OM. A total of 410 GPs who participated in OM seminars were asked to answer a number of questions related to items that they usually come across in their work. The respondents were given scores on 15 items, which pertained to their frequency of experience in OM, their felt needs regarding education in the field, and their knowledge and skills. Ethical issues were the most frequently utilised item and the area in which the felt need for education was the greatest. The knowledge of and skills in ethical issues and matters were the poorest. Ethical principles and confidentiality had the highest calculated educational priority scores. It is necessary to consider ethical issues as an educational priority for GPs working in the field of OM.
Jalili, Mohammad; Sadeghipour Roodsari, Gholamreza; Bassir Nia, Anahita
Emergency physicians are at risk of burnout, which can affect their mental health, as well as patient care. We assessed burnout level among Iranian emergency physicians and investigated demographic, work-related factors and stressors associated with higher burnout. In a cross-sectional study, we surveyed all 188 emergency medicine residents and practitioners in Iran. We measured burnout using 22-item Maslach Burnout Inventory assessing emotional exhaustion, depersonalization and personal accomplishment, also demographic factors, work related factors and sources of stress in emergency department using anonymous self-administered questionnaire. Descriptive analysis, univariate analysis to evaluate association with higher score of burnout, and multivariate logistic regression analysis to predict high burnout in 3 subscales was performed. Totally, 165 questionnaires were filled (response rate: 88%; mean age: 33.6 years, 91% male). Mean burnout scores were 22.94 for emotional exhaustion (95% CI=20.78-25.01; moderate), 9.3 for depersonalization (95% CI=8.24-10.36; moderate to high), and 31.47 for personal accomplishment (95% CI=29.87-33.07; moderate to high). Frequent reported sources of stress were shortage of equipment, problem with work physical environment, and relationship with other services. All 19 sources of stress were associated with higher score of emotional exhaustion and depersonalization; while twelve out of 19 were significantly associated with lower level of personal accomplishment. In logistic regression model, the significant predictors for high emotional exhaustion were work overload, feeling of insecurity for future career and difficulties to balance professional and private life. Burnout is high among Iranian emergency medicine practitioners and some interventions can be proposed to reduce stress.
Self-reported changes in quality of life among people with multiple sclerosis who have participated in treatments based on collaboration between conventional healthcare providers and CAM practitioners
Bjerre, Liv; Henningsen, Inge Biehl; Skovgaard, Lasse
Aim of the study: This study assesses the changes in self-reported quality of life (QoL) from hospitalisation to 18 months later among people with multiple sclerosis (MS) who have participated in treatments based on collaboration between conventional healthcare providers and CAM practitioners...... interventions by a team of five healthcare providers and five CAM practitioners. The outcome measure was a change in QoL (measured as the difference in total score and sub-scores on the Functional Assessment of Multiple Sclerosis (FAMS) QoL scale). Results: From hospitalisation and through an 18-month period....... Materials and methods: A pre- and post-test evaluation design including an intervention group and a comparison group was employed in this study. 142 people with MS were analysed in the intervention group and 142 in the comparison group. Each person in the intervention group was treated with combined...
McEachrane-Gross, F Patricia; Liebschutz, Jane M; Berlowitz, Dan
Abstract Background Complementary and alternative medicine (CAM) is emerging as an important form of care in the United States. We sought to measure the prevalence of selected CAM use among veterans attending oncology and chronic pain clinics and to describe the characteristics of CAM use in this population. Methods The self-administered, mail-in survey included questions on demographics, health beliefs, medical problems and 6 common CAM treatments (herbs, dietary supplements, chiropractic ca...
Johnson, Ping; Priestley, Jennifer; Porter, Kandice Johnson; Petrillo, Jane
Background: Interest in and use of complementary and alternative medicine (CAM) in the United States is increasing. However, CAM remains an area of nascency for researchers and western practitioners. Purpose: The purpose of this study was to examine U.S. health educators' attitudes toward CAM and their use of common CAM therapies. Methods: A…
Full Text Available Abstract Background This study explored consumer perceptions of complementary and alternative medicine (CAM and relationships with CAM and conventional medicine practitioners. A problem detection study (PDS was used. The qualitative component to develop the questionnaire used a CAM consumer focus group to explore conventional and CAM paradigms in healthcare. 32 key issues, seven main themes, informed the questionnaire (the quantitative PDS component - 36 statements explored using five-point Likert scales. Results Of 300 questionnaires distributed (Brisbane, Australia, 83 consumers responded. Results indicated that consumers felt empowered by using CAM and they reported positive relationships with CAM practitioners. The perception was that CAM were used most effectively as long-term therapy (63% agreement, but that conventional medicines would be the best choice for emergency treatment (81% agreement. A majority (65% reported that doctors appeared uncomfortable about consumers' visits to CAM practitioners. Most consumers (72% believed that relationships with and between health practitioners could be enhanced by improved communication. It was agreed that information sharing between consumers and healthcare practitioners is important, and reported that "enough" information is shared between CAM practitioners and consumers. Consumers felt comfortable discussing their medicines with pharmacists, general practitioners and CAM practitioners, but felt most comfortable with their CAM practitioners. Conclusions This PDS has emphasized the perceived importance of open communication between consumers, CAM and conventional providers, and has exposed areas where CAM consumers perceive that issues exist across the CAM and conventional medicine paradigms. There is a lot of information which is perceived as not being shared at present and there are issues of discomfort and distrust which require resolution to develop concordant relationships in healthcare
Background PubMed is the largest bibliographic index in the life sciences. It is freely available online and is used by professionals and the public to learn more about medical research. While primarily intended to serve researchers, PubMed provides an array of tools and services that can help a wider readership in the location, comprehension, evaluation, and utilization of medical research. Objective This study sought to establish the potential contributions made by a range of PubMed tools and services to the use of the database by complementary and alternative medicine practitioners. Methods In this study, 10 chiropractors, 7 registered massage therapists, and a homeopath (N = 18), 11 with prior research training and 7 without, were taken through a 2-hour introductory session with PubMed. The 10 PubMed tools and services considered in this study can be divided into three functions: (1) information retrieval (Boolean Search, Limits, Related Articles, Author Links, MeSH), (2) information access (Publisher Link, LinkOut, Bookshelf ), and (3) information management (History, Send To, Email Alert). Participants were introduced to between six and 10 of these tools and services. The participants were asked to provide feedback on the value of each tool or service in terms of their information needs, which was ranked as positive, positive with emphasis, negative, or indifferent. Results The participants in this study expressed an interest in the three types of PubMed tools and services (information retrieval, access, and management), with less well-regarded tools including MeSH Database and Bookshelf. In terms of their comprehension of the research, the tools and services led the participants to reflect on their understanding as well as their critical reading and use of the research. There was universal support among the participants for greater access to complete articles, beyond the approximately 15% that are currently open access. The abstracts provided by PubMed were
Lee, Jieun; Bhowmick, Amrita; Wachholtz, Amy
Chronic migraine is a disabling condition that impacts multiple aspects of migraineurs' lives. Although pharmacological treatments can help to treat the pain associated with migraine headache, chronic migraineurs often experience side-effects of pharmacological treatments. Those experiences may contribute to the observed growth in complementary and alternative medicine (CAM) use among migraineurs. Relatively little is known about the patterns of CAM treatment and the characteristics of chronic migraineurs. Therefore, the purpose of the present study is to investigate the characteristics of chronic migraineurs who use CAM treatment and the relationship among satisfaction with current CAM use, negative life impact, migraine outcomes, and psychiatric comorbidities among chronic migraineurs. 2907 participants were recruited from a well-known online migraine headache resource. All participants were US adults aged 18 years or older. Migraineurs are referred to this website through various routes (e.g., referral from healthcare providers, internet search, obtaining information from research papers, personal invitation from other users, and information shared on social media etc.). Participants completed a 30-min self-report-survey in the spring of 2014. Almost half of the participants reported that they are currently using more than three different CAM treatments even though the majority of the participants reported neutral or dissatisfied with their current CAM treatment. Chronic migraineurs who use CAM treatments were more likely to experience prolonged or frequent migraine headaches (p = .018, η(2) = .0021), and experience greater negative life impact from their headaches (p = .000, η(2) = .0172) compared to non-CAM users. CAM treatment satisfaction was inversely related to the number of psychiatric comorbidities, frequency of migraines, and number of migraine symptoms (p's < .05). However, CAM treatment satisfaction was more strongly correlated with
Raidoo Deshandra M
Full Text Available Abstract Background The purpose of this study was to determine, among the Indian community of Chatsworth, South Africa, the prevalence and utilisation patterns of complementary and alternative medicine (CAM, attitudes associated with CAM use and communication patterns of CAM users with their primary care doctors. Methods Face-to-face structured interviews were conducted in Chatsworth, a suburb of Durban in which South Africans of Indian origin predominantly reside. Participants were 200 randomly selected adult English-speaking Indian residents. Results The prevalence of CAM usage for period 2000/2001 was 38.5% (95% confidence interval 31.7% to 45.6%. Spiritual healing and herbal/natural medicines, including vitamins were the most common types of CAM used, accounting for 42.8% and 48.1% respectively of overall CAM usage. People used CAM to treat conditions including diabetes mellitus, headaches, arthritis and joint pains, stress, skin disorders, backaches, hypertension and nasal disorders. Half of the CAM users used allopathic medicines concurrently. The cost of CAM utilization over this 1-year period, incurred by 80.5% of users for the duration of therapy for their most troublesome condition was below R500 (approximately US$50. Age, sex, marital status, religion, level of education and income were shown not to influence the use of CAM. Greater than half (51.9% of CAM users did so either upon the advice of someone they knew, or after noticing a CAM advertisement in the local press. Seventy-nine percent of CAM users indicated that they had positive outcomes with their treatments. Fifty four percent of CAM users (excluding those using spiritual healing only failed to inform their doctors that they used CAM. The main reason given by half of this group was that informing their doctors did not seem necessary. Conclusion The prevalence of CAM in Chatsworth is similar to findings in other parts of the world. Although CAM was used to treat many different
Sirois, Fuschia M; Salamonsen, Anita; Kristoffersen, Agnete E
Research on continued CAM use has been largely atheoretical and has not considered the broader range of psychological and behavioral factors that may be involved. The purpose of this study was to test a new conceptual model of commitment to CAM use that implicates utilitarian (trust in CAM) and symbolic (perceived fit with CAM) in psychological and behavioral dimensions of CAM commitment. A student sample of CAM consumers, (N = 159) completed a survey about their CAM use, CAM-related values, intentions for future CAM use, CAM word-of-mouth behavior, and perceptions of being an ongoing CAM consumer. Analysis revealed that the utilitarian, symbolic, and CAM commitment variables were significantly related, with r's ranging from .54 to .73. A series hierarchical regression analyses controlling for relevant demographic variables found that the utilitarian and symbolic values uniquely accounted for significant and substantial proportion of the variance in each of the three CAM commitment indicators (R(2) from .37 to .57). The findings provide preliminary support for the new model that posits that CAM commitment is a multi-dimensional psychological state with behavioral indicators. Further research with large-scale samples and longitudinal designs is warranted to understand the potential value of the new model.
Hoenders, H J Rogier; Appelo, Martin T; van den Brink, Erik H; Hartogs, Bregje M A; de Jong, Joop T V M
Complementary and alternative medicine (CAM) is subject to heated debates and prejudices. Studies show that CAM is widely used by psychiatric patients, usually without the guidance of a therapist and without the use of a solid working method, leading to potential health risks. The purpose of this study is to facilitate the judicious use of CAM alongside conventional psychiatry in an outpatient psychiatric clinic. A search was made through scientific and legal articles and discussion in focus groups. In the Centre for Integrative Psychiatry (CIP) of Lentis in The Netherlands, some carefully selected CAM are offered under strict conditions, alongside conventional treatments. Because of the controversy and the potential health risks, Lentis designed a protocol that is presented. The CIP hopes, by using this protocol, to better serve and respect the individual needs and preferences of the diversity of psychiatric patients in our Dutch multicultural society, and better protect them from harm.
McEachrane-Gross, F Patricia; Liebschutz, Jane M; Berlowitz, Dan
Complementary and alternative medicine (CAM) is emerging as an important form of care in the United States. We sought to measure the prevalence of selected CAM use among veterans attending oncology and chronic pain clinics and to describe the characteristics of CAM use in this population. The self-administered, mail-in survey included questions on demographics, health beliefs, medical problems and 6 common CAM treatments (herbs, dietary supplements, chiropractic care, massage therapy, acupuncture and homeopathy) use. We used the chi-square test to examine bivariate associations between our predictor variables and CAM use. Seventy-two patients (27.3%) reported CAM use within the past 12 months. CAM use was associated with more education (p = 0.02), higher income (p = 0.006), non-VA insurance (p = 0.003), additional care outside the VA (p = 0.01) and the belief that lifestyle contributes to illness (p = 0.015). The diagnosis of chronic pain versus cancer was not associated with differential CAM use (p = 0.15). Seventy-six percent of CAM non-users reported that they would use it if offered at the VA. Use of 6 common CAM treatments among these veterans is lower than among the general population, but still substantial. A large majority of veterans reported interest in using CAM modalities if they were offered at the VA. A national assessment of veteran interest in CAM may assist VA leaders to respond to patients' needs.
Weeks, Laura C; Strudsholm, Tina
The use of complementary and alternative medicine (CAM) has become more common in Western developed countries in recent years, as has media reporting on CAM and related issues. Correspondingly, media reports are a primary information source regarding decisions to use CAM. Research on CAM related media reports is becoming increasingly relevant and important; however, identifying key concepts to guide future research is problematic due to the dispersed nature of completed research in this field. A scoping review was conducted to: 1) determine the amount, focus and nature of research on CAM and the mass media; and 2) summarize and disseminate related research results. The main phases were: 1) searching for relevant studies; 2) selecting studies based on pre-defined inclusion criteria; 3) extracting data; and 4) collating, summarizing and reporting the results. Of 4,454 studies identified through various search strategies, 16 were relevant to our objectives and included in a final sample. CAM and media research has focused primarily on print media coverage of a range of CAM therapies, although only a few studies articulated differences within the range of therapies surveyed. Research has been developed through a variety of disciplinary perspectives, with a focus on representation research. The research reviewed suggests that journalists draw on a range of sources to prepare media reports, although most commonly they cite conventional (versus CAM) sources and personal anecdotes. The tone of media reports appears generally positive, which may be related to a lack of reporting on issues related to risk and safety. Finally, a variety of discourses within media representations of CAM are apparent that each appeal to a specific audience through resonance with their specific concerns. Research on CAM and the mass media spans multiple disciplines and strategies of inquiry; however, despite the diversity in approach, it is clear that issues related to production and reception
Italia, Salvatore; Brand, Helmut; Heinrich, Joachim; Berdel, Dietrich; von Berg, Andrea; Wolfenstetter, Silke Britta
The use of complementary and alternative medicine (CAM) is widespread among children in Germany and other European countries. Only a few studies are available on trends in pediatric CAM use over time. The study's objective was to present updated results for prevalence, predictors, and costs of CAM use among German children and a comparison with findings from a previous follow-up of the same birth cohort. Data were collected for 3013 children on their utilization of medicinal products (during the last 4 weeks) and consultation with CAM providers (in the preceding year) from a German birth cohort study (GINIplus, 15-year follow-up) using a self-administered questionnaire. The reported medicinal CAMs were classified into six categories (homeopathy, herbal drugs, nutritionals, minerals and trace elements, microorganisms, further CAM). Drug prices were traced using pharmaceutical identification numbers (PZNs), or otherwise conservatively estimated. Finally, the results were compared with data obtained from the 10-year follow-up of the same birth cohort study by adopting the identical methodology. In all, 26% of the reported 2489 drugs were medicinal CAM. The 4-week prevalence for homeopathy and herbal drug use was 7.5% and 5.6%, respectively. Some 13.9% of the children used at least one type of medicinal CAM in the preceding 4 weeks. The 1-year prevalence for consultation with CAM providers was 10.8%. From the drugs identified as CAM, 53.7% were homeopathic remedies, and 30.8% were herbal drugs. Factors associated with higher medicinal CAM use were female gender, residing in Munich, and higher maternal education. A homeopathy user utilized on average homeopathic remedies worth EUR 15.28. The corresponding figure for herbal drug users was EUR 16.02, and EUR 18.72 for overall medicinal CAM users. Compared with the 10-year follow-up, the prevalence of homeopathy use was more than halved (-52%) and dropped substantially for herbal drug use (-36%) and overall CAM use (-38
Litchy, Andrew P
The use of Complimentary and Alternative Medicine (CAM) is increasing in the United States; there is a need for physician level practitioners who possess extensive training in both CAM and conventional medicine. Naturopathic physicians possess training that allows integration of modern scientific knowledge and the age-old wisdom of natural healing techniques. Naturopathic philosophy provides a framework to implement CAM in concert with conventional therapies. The naturopathic physician's expertise in both conventional medicine and CAM allows a practice style that provides excellent care through employing conventional and CAM modalities while utilizing modern research and evidence-based medicine.
Oltean, H.; Robbins, C.S.; van Tulder, M.W.; Berman, B.M.; Bombardier, C.; Gagnier, J.J.
BACKGROUND: Low-back pain (LBP) is a common condition and imposes a substantial economic burden upon people living in industrialized societies. A large proportion of people with chronic LBP use complementary and alternative medicine (CAM), visit CAM practitioners, or both. Several herbal medicines
Hartmann, Nicole; Neininger, Martina P; Bernhard, Matthias K; Syrbe, Steffen; Nickel, Petra; Merkenschlager, Andreas; Kiess, Wieland; Bertsche, Thilo; Bertsche, Astrid
The use of complementary and alternative medicine (CAM) is popular. Parents of children suffering from epilepsy may also consider administering CAM to their children. Systematic data about frequency of and motivations for CAM use, however, are scarce. In a university hospital's neuropaediatric department parents of patients aged 0-18 years suffering from epilepsy were consecutively invited to take part in a structured interview during 4 months in 2014. Of the invited parents, 164/165 (99%) agreed to participate. From those, 21/164 (13%) stated that they used CAM in their child. The highest independent predictive value of CAM use was the occurrence of adverse drug events (ADE) of anticonvulsants as judged by parents. Patients affected by ADE had a 5.6 higher chance of receiving CAM compared to patients without ADE. Most commonly used were homeopathy (14/21, 67%) and osteopathy (12/21, 57%). The internet was the most frequently used source of information (14/21, 67%). Of the parents, 10/21 (48%) described positive effects of CAM on seizure frequency, 12/21 (57%) on general condition of their child, and 20/21 (95%) wished to continue CAM for epilepsy therapy. From the non-users of CAM, 91/143 (66%) expressed the desire to learn more about CAM for epilepsy therapy. Our study was performed in a university hospital in a large urban city in Eastern Germany. CAM user rates can differ in other parts of Germany and Europe, in other institutions and for chronic diseases other than epilepsy. The main reason for CAM use was the occurrence of ADE of anticonvulsants. More than half of the parents saw a benefit of CAM for their children. Almost all parents wished to continue CAM use, even those who did not see concrete positive effects. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.
Pedersen, Christina Gundgaard; Christensen, Søren; Jensen, Anders Bonde; Zachariae, Robert
Turning to faith in God or a higher spiritual power is a common way of coping with life-threatening disease such as cancer. Little, however, is known about religious faith among cancer patients in secular societies. The present study aimed at exploring the prevalence of religious faith among Danish breast cancer patients and at identifying whether socio-demographic, pre-cancer health status, clinical, and health behavior characteristics, including their use of complementary and alternative medicine (CAM), were associated with their degree of faith. Information on faith in God or a higher spiritual power and use of CAM was provided by a nationwide sample of 3,128 recurrence-free Danish women who had received surgery for early-stage breast cancer 15-16 months earlier. Socio-demographic, clinical, and health status variables were obtained from national longitudinal registries, and health behaviors had been assessed at 3-4 months post-surgery. Of the women, 47.3% reported a high degree of faith (unambiguous believers), 35.9% some degree of faith (ambiguous believers), while the remaining 16.8% were non-believers. Unambiguous believers were more likely than ambiguous believers to experience their faith as having a positive impact on their disease and their disease-related quality-of-life. When compared to non-believers, unambiguous believers were also older, had poorer physical function, and were more frequent users of CAM, and more inclined to believe that their use of CAM would have a beneficial influence on their cancer. Disease- and treatment-related variables were unrelated to faith. While overall religious faith appears equally prevalent among Danish and US breast cancer patients, the majority of Danish breast cancer patients experienced ambiguous faith, whereas the majority of US patients have been found to express unambiguous faith. Our results suggest that future studies may benefit from exploring the role of faith for health behaviors, adherence to
Ho, Tiffany F; Rowland-Seymour, Anastasia; Frankel, Eitan S; Li, Susan Q; Mao, Jun J
More people are supplementing conventional medicine with complementary and alternative medicine (CAM), but studies have not compared CAM use between baby boomers (adults born from 1946 to 1964) and the so-called silent generation (born from 1925 to 1945). This study compares CAM usage between baby boomers (n = 7734) and the silent generation (n = 4682) through secondary analyses of the 2007 National Health Interview Survey data. The analysis also compares chronic disease and pain status. Multivariate logistic regression models were developed to identify generational differences. Although the silent generation reported twice as many chronic disease (51.3% vs 26.1%; P painful conditions (56.1% vs 52.2%; P CAM within the past year (43.1% vs 35.4%; P CAM than adults from the silent generation. Chronic pain status was independently associated with greater CAM use (adjusted odds ratio, 2.26; 95% confidence interval, 2.03-2.52). Baby boomers reported significantly higher rates of CAM use than the silent generation for both chronic diseases and painful conditions. Family physicians caring for the aging population must use patient-centered communication about the risks/benefits of CAM, which is necessary to promote effective coping with chronic illnesses and pain. © Copyright 2014 by the American Board of Family Medicine.
Klafke, Nadja; Eliott, Jaklin A; Olver, Ian N; Wittert, Gary A
Complementary and alternative medicine (CAM) is frequently used in cancer patients, often with contribution of the significant others (SOs), but without consultation of healthcare professionals. This research explored how cancer patients integrate and maintain CAM use in their everyday life, and how SOs are involved in it. In this qualitative study, male participants were selected from a preceding Australian survey on CAM use in men with cancer (94 % response rate and 86 % consent rate for follow-up interview). Semistructured interviews were conducted with 26 men and 24 SOs until data saturation was reached. Interview transcripts were coded and analyzed thematically, thereby paying close attention to participants' language in use. A major theme associated with high CAM use was "CAM routines and rituals," as it was identified that men with cancer practiced CAM as (1) functional routines, (2) meaningful rituals, and (3) mental/spiritual routines or/and rituals. Regular CAM use was associated with intrapersonal and interpersonal benefits: CAM routines provided men with certainty and control, and CAM rituals functioned for cancer patients and their SOs as a means to create meaning, thereby working to counter fear and uncertainty consequent upon a diagnosis of cancer. SOs contributed most to men's uptake and maintenance of dietary-based CAM in ritualistic form resulting in interpersonal bonding and enhanced closeness. CAM routines and rituals constitute key elements in cancer patients' regular and satisfied CAM use, and they promote familial strengthening. Clinicians and physicians can convey these benefits to patient consultations, further promoting the safe and effective use of CAM.
Liebschutz Jane M
Full Text Available Abstract Background Complementary and alternative medicine (CAM is emerging as an important form of care in the United States. We sought to measure the prevalence of selected CAM use among veterans attending oncology and chronic pain clinics and to describe the characteristics of CAM use in this population. Methods The self-administered, mail-in survey included questions on demographics, health beliefs, medical problems and 6 common CAM treatments (herbs, dietary supplements, chiropractic care, massage therapy, acupuncture and homeopathy use. We used the chi-square test to examine bivariate associations between our predictor variables and CAM use. Results Seventy-two patients (27.3% reported CAM use within the past 12 months. CAM use was associated with more education (p = 0.02, higher income (p = 0.006, non-VA insurance (p = 0.003, additional care outside the VA (p = 0.01 and the belief that lifestyle contributes to illness (p = 0.015. The diagnosis of chronic pain versus cancer was not associated with differential CAM use (p = 0.15. Seventy-six percent of CAM non-users reported that they would use it if offered at the VA. Conclusion Use of 6 common CAM treatments among these veterans is lower than among the general population, but still substantial. A large majority of veterans reported interest in using CAM modalities if they were offered at the VA. A national assessment of veteran interest in CAM may assist VA leaders to respond to patients' needs.
Baig Mirza R; Hameed Abdul; Naing Cho M; Babar Muneer G; Yong Chew S; Hasan Syed S; Iqbal Shahid M; Kairuz Therese
Abstract Background In recent times the basic understanding, perceptions and CAM use among undergraduate health sciences students have become a topic of interest. This study was aimed to investigate the understanding, perceptions and self-use of CAM among pharmacy students in Malaysia. Methods This cross-sectional study was conducted on 500 systematically sampled pharmacy students from two private and one public university. A validated, self-administered questionnaire comprised of seven secti...
Hughes, Ciara M; Liddle, S D; Sinclair, Marlene; McCullough, Julie E M
Low back and pelvic girdle pain (LBPGP) is a common complaint among pregnant women, which increases throughout pregnancy and women use various complementary and alternative medicine (CAM) therapies to manage their pain. Using an online survey, CAM treatments used by pregnant women in the UK and their perceptions of these therapies to relieve LBPGP were investigated. 191 women completed the survey and 70% experienced LBPGP lasting more than one week. Over half of women who sought treatment from a GP or physiotherapist were dissatisfied. 25% of participants used CAM during pregnancy, the most popular being aromatherapy (21%), acupuncture (21%), and reflexology (15%). 81% of women used CAM to manage their LBPGP and 85% found it useful for pregnancy symptoms. Women experience high levels of pain during pregnancy with limited treatment options. Research into effective CAM treatments for LBPGP is required to allow women to make informed decisions regarding treatment options. Copyright © 2018 Elsevier Ltd. All rights reserved.
Papke, J; Freier, W
Levels of experience and competence in palliative medicine vary considerably among physicians. The aim of the study was to collect information from specially interested general practitioners on education, pivotal lectures and experience regarding the delivery of palliative care. 92 general practitioners (41 women and 22 men) attending a basic course in palliative medicine were asked to fill in a standardized questionnaire relating to their knowledge and experience of palliative medicine. 63 responded (68%), 54 in general private practice, nine worked in a hospital. The same number worked in urban and in rural health care facilities. The majority of those questioned (53%) gained their first experience in palliative medicine as junior hospital doctors about a quarter (26%) only after starting in private practice. Many of the doctors (31%) admitted to taking more interest in palliative medicine only after having made mistakes, a significant percentage (20%) after the death of a relative. 28% expressed the view that practical courses were an important part in learning about palliative medicine. The implementation of practice-based c tuition of medical students and of continuing education of established general practitioners and hospital physicians in palliative medicine is indispensable.
Kristoffersen, Agnete Egilsdatter; Fønnebø, Vinjar; Norheim, Arne Johan
Self-reported use of complementary and alternative medicine (CAM) among patients varies widely between studies, possibly because the definition of a CAM user is not comparable. This makes it difficult to compare studies. The aim of this study is to present a six-level model for classifying patients' reported exposure to CAM. Prayer, physical exercise, special diets, over-the-counter products/CAM techniques, and personal visits to a CAM practitioner are successively removed from the model in a reductive fashion. By applying the model to responses given by Norwegian patients with cancer, we found that 72% use CAM if the user was defined to include all types of CAM. This proportion was reduced successively to only 11% in the same patient group when a CAM user was defined as a user visiting a CAM practitioner four or more times. When considering a sample of 10 recently published studies of CAM use among patients with breast cancer, we found 98% use when the CAM user was defined to include all sorts of CAM. This proportion was reduced successively to only 20% when a CAM user was defined as a user of a CAM practitioner. We recommend future surveys of CAM use to report at more than one level and to clarify which intensity level of CAM use the report is based on.
Goldstein, Carly M; Minges, Karl E; Schoffman, Danielle E; Cases, Mallory G
Behavioral medicine training is due for an overhaul given the rapid evolution of the field, including a tight funding climate, changing job prospects, and new research and industry collaborations. The purpose of the present study was to collect responses from trainee and practicing members of a multidisciplinary professional society about their perceptions of behavioral medicine training and their suggestions for changes to training for future behavioral medicine scientists and practitioners. A total of 162 faculty and 110 students (total n = 272) completed a web-based survey on strengths of their current training programs and ideas for changes. Using a mixed-methods approach, the survey findings are used to highlight seven key areas for improved preparation of the next generation of behavioral medicine scientists and practitioners, which are grant writing, interdisciplinary teamwork, advanced statistics and methods, evolving research program, publishable products from coursework, evolution and use of theory, and non-traditional career paths.
A randomized, multicenter, controlled study, comparing efficacy and safety of a new complementary and alternative medicine (CAM) versus Solifenacin Succinate in women with overactive bladder syndrome.
Vecchioli-Scaldazza, Carlo; Morosetti, Carolina; Maruccia, Serena; Casellato, Stefano; Rociola, Wilma; Illiano, Ester; Garofalo, Francesco
To assess efficacy and tolerability of a new complementary and alternative medicine (CAM) consisting of vitamins (C and D), herbal products (cucurbita maxima, capsicum annum, polygonum capsicatum) and amino acid L-Glutammina, in the treatment of female Overactive Bladder syndrome (OAB). 90 consecutive women with OAB symptoms were enrolled in this prospective, randomized, controlled study. Women were divided randomly into two groups of 45 patients each. In group A, women received Solifenacin Succinate (SS), 5 mg. once a day for 12 weeks. In group B, women received CAM, 930 mg, twice daily for 12 weeks. Women were assessed with 3-day micturition diary, Patient Perception of Intensity of Urgency Scale (PPIUS), Overactive Bladder questionnaire Short Form (OAB-q SF) and Patient Global Impression of Improvement questionnaire (PGI-I). 8 patients in group A and 1 patient in group B dropped out from therapy because of side effects. A reduction in the number of daily micturitions, nocturia and episodes of urge incontinence was present with both SS and CAM with statistically highly significant differences, but CAM was significantly more effective than SS. PPIUS and OAB-q SF showed improvements with both SS and CAM with a more significant efficacy of CAM. PGI-I, demonstrated improvements in the two groups of patients with a greater satisfaction expressed by patients treated with CAM. the small number of patients does not permit definitive conclusions; however, the results of the research showed the greater effectiveness and tolerability of CAM.
Visser, G.J.; Peters, L.
A questionnaire on alternative medicine was sent to 600 general practitioners in the Netherlands. Most of the 360 (60%) GPs who replied expressed on interest in alternative practice; and 47% revealed that they used one or more alternative methods themselves, most often homoeopathy. However, the
Butler, Dennis J; Holloway, Richard L; Fons, Dominique
This article describes the development of a Behavioral Medicine track in a family medicine residency designed to train physicians to proactively and consistently apply advanced skills in psychosocial medicine, psychiatric care, and behavioral medicine. The Behavioral Medicine track emerged from a behavioral science visioning retreat, an opportunity to restructure residency training, a comparative family medicine-psychiatry model, and qualified residents with high interest in behavioral science. Training was restructured to increase rotational opportunities in core behavioral science areas and track residents were provided an intensive longitudinal counseling seminar and received advanced training in psychopharmacology, case supervision, and mindfulness. The availability of a Behavioral Medicine track increased medical student interest in the residency program and four residents have completed the track. All track residents have presented medical Grand Rounds on behavioral science topics and have lead multiple workshops or research sessions at national meetings. Graduate responses indicate effective integration of behavioral medicine skills and abilities in practice, consistent use of brief counseling skills, and good confidence in treating common psychiatric disorders. As developed and structured, the Behavioral Medicine track has achieved the goal of producing "assertive practitioners of behavioral science in family medicine" residents with advanced behavioral science skills and abilities who globally integrate behavioral science into primary care.
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.
Klafke, Nadja; Homberg, Angelika; Glassen, Katharina; Mahler, Cornelia
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 Â© 2016 Elsevier Ltd. All rights reserved.
Robert J Adams
Full Text Available Robert J Adams1, Sarah L Appleton1, Antonia Cole2, Tiffany K Gill3, Anne W Taylor3, Catherine L Hill11The Health Observatory, 2Rheumatology Unit, 3Population Research and Outcomes Unit, SA Health, The University of Adelaide Discipline of Medicine, Queen Elizabeth Hospital, Woodville, AustraliaObjectives: To determine whether chronic conditions and patient factors, such as risk perception and decision-making preferences, are associated with complementary medicine and alternative practitioner use in a representative longitudinal population cohort.Participants and setting: Analysis of data from Stage 2 of the North West Adelaide Health Study of 3161 adults who attended a study clinic visit in 2004–2006. The main outcome measures were the medications brought by participants to the study clinic visit, chronic health conditions, attitudes to risk, levels of satisfaction with conventional medicine, and preferred decision-making style.Results: At least one oral complementary medicine was used by 27.9% of participants, and 7.3% were visiting alternative practitioners (naturopath, osteopath. Oral complementary medicine use was significantly associated with arthritis, osteoporosis, and mental health conditions, but not with other chronic conditions. Any pattern of complementary medicine use was generally significantly associated with female gender, age at least 45 years, patient-driven decision-making preferences (odds ratio [OR] 1.38, 95% confidence interval [CI]: 1.08–1.77, and frequent general practitioner visits (>five per year; OR 3.62, 95% CI: 2.13–6.17. Alternative practitioner visitors were younger, with higher levels of education (diploma/trade [OR 1.88, 95% CI: 1.28–2.76], bachelor’s degree [OR 1.77, 95% CI: 1.11–2.82], income > $80,000 (OR 2.28, 95% CI: 1.26–4.11, female gender (OR 3.15, 95% CI: 2.19–4.52, joint pain not diagnosed as arthritis (OR 1.68, 95% CI: 1.17–2.41, moderate to severe depressive symptoms (OR 2.15, 95% CI
Fisher, Carole; Adams, Jon; Frawley, Jane; Hickman, Louise; Sibbritt, David
To explore the prevalence with which Australian Western herbalists treat menstrual problems and their related treatment, experiences, perceptions, and interreferral practices with other health practitioners. Members of the Practitioner Research and Collaboration Initiative practice-based research network identifying as Western Herbalists (WHs) completed a specifically developed, online questionnaire. Western Herbalists regularly treat menstrual problems, perceiving high, though differential, levels of effectiveness. For menstrual problems, WHs predominantly prescribe individualised formulas including core herbs, such as Vitex agnus-castus, and problem-specific herbs. Estimated clients' weekly cost (median = $25.00) and treatment duration (median = 4-6 months) covering this Western herbal medicine treatment appears relatively low. Urban-based women are more likely than those rurally based to have used conventional treatment for their menstrual problems before consulting WHs (p = .001). Only 19% of WHs indicated direct contact by conventional medical practitioners regarding treatment of clients' menstrual problems despite 42% indicating clients' conventional practitioners recommended consultation with WH. Western herbal medicine may be a substantially prevalent, cost-effective treatment option amongst women with menstrual problems. A detailed examination of the behaviour of women with menstrual problems who seek and use Western herbal medicine warrants attention to ensure this healthcare option is safe, effective, and appropriately co-ordinated within women's wider healthcare use. Copyright © 2017 John Wiley & Sons, Ltd.
Jun J. Mao
Full Text Available Despite cancer patients' extensive use of complementary and alternative medicine (CAM, validated instruments to measure attitudes, and beliefs predictive of CAM use are lacking. We aimed at developing and validating an instrument, attitudes and beliefs about CAM (ABCAM. The 15-item instrument was developed using the theory of planned behavior (TPB as a framework. The literature review, qualitative interviews, expert content review, and cognitive interviews were used to develop the instrument, which was then administered to 317 outpatient oncology patients. The ABCAM was best represented as a 3-factor structure: expected benefits, perceived barriers, and subjective norms related to CAM use by cancer patients. These domains had Eigenvalues of 4.79, 2.37, and 1.43, and together explained over 57.2% of the variance. The 4-item expected benefits, 7-item perceived barriers, and 4-item subjective norms domain scores, each had an acceptable internal consistency (Cronbach's alpha of 0.91, 0.76, and 0.75, respectively. As expected, CAM users had higher expected benefits, lower perceived barriers, and more positive subjective norms (all <0.001 than those who did not use CAM. Our study provides the initial evidence that the ABCAM instrument produced reliable and valid scores that measured attitudes and beliefs related to CAM use among cancer patients.
Adams, Robert J; Appleton, Sarah L; Cole, Antonia; Gill, Tiffany K; Taylor, Anne W; Hill, Catherine L
To determine whether chronic conditions and patient factors, such as risk perception and decision-making preferences, are associated with complementary medicine and alternative practitioner use in a representative longitudinal population cohort. Analysis of data from Stage 2 of the North West Adelaide Health Study of 3161 adults who attended a study clinic visit in 2004-2006. The main outcome measures were the medications brought by participants to the study clinic visit, chronic health conditions, attitudes to risk, levels of satisfaction with conventional medicine, and preferred decision-making style. At least one oral complementary medicine was used by 27.9% of participants, and 7.3% were visiting alternative practitioners (naturopath, osteopath). Oral complementary medicine use was significantly associated with arthritis, osteoporosis, and mental health conditions, but not with other chronic conditions. Any pattern of complementary medicine use was generally significantly associated with female gender, age at least 45 years, patient-driven decision-making preferences (odds ratio [OR] 1.38, 95% confidence interval [CI]: 1.08-1.77), and frequent general practitioner visits (>five per year; OR 3.62, 95% CI: 2.13-6.17). Alternative practitioner visitors were younger, with higher levels of education (diploma/trade [OR 1.88, 95% CI: 1.28-2.76], bachelor's degree [OR 1.77, 95% CI: 1.11-2.82], income >$80,000 (OR 2.28, 95% CI: 1.26-4.11), female gender (OR 3.15, 95% CI: 2.19-4.52), joint pain not diagnosed as arthritis (OR 1.68, 95% CI: 1.17-2.41), moderate to severe depressive symptoms (OR 2.15, 95% CI: 1.04-4.46), and risk-taking behavior (3.26, 1.80-5.92), or low-to-moderate risk aversion (OR 2.08, 95% CI: 1.26-4.11). Although there is widespread use of complementary medicines in the Australian community, there are differing patterns of use between those using oral complementary medicines and those using alternative practitioners.
Babar, Zaheer-Ud-Din; Grover, Piyush; Butler, Rachael; Bye, Lynne; Sheridan, Janie
The objective of this study was to evaluate general practitioners' (GPs) perceptions regarding access to medicines in New Zealand. Qualitative. Primary care. GPs. GPs' views and perceptions. GPs were of the view that the current range of medicines available in New Zealand was reasonable; however, it was acknowledged that there were some drugs that patients were missing out on. When considering the range of subsidised medicines available in New Zealand, some GPs felt that there had been an improvement over recent years. It was highlighted that unexpected funding changes could create financial barriers for some patients and that administrative procedures and other complexities created barriers in receiving a subsidy for restricted medicines. GPs also reported problems with the availability and sole supply of certain medicines and claimed that switching from a branded medicine to its generic counterpart could be disruptive for patients. The research concluded that although there were some issues with the availability of certain drugs, most GPs were satisfied with the broader access to medicines situation in New Zealand. This view is to contrary to the situation presented by the pharmaceutical industry. The issues around sole supply, the use of generic medicines and the administrative barriers regarding funding of medicines could be improved with better systems. The current work provides a solid account of what GPs see as the advantages and disadvantages of the current system and how they balance these demands in practice.
Cottingham, Phillip; Adams, Jon; Vempati, Ram; Dunn, Jill; Sibbritt, David
Despite the popularity of naturopathic and herbal medicine in New Zealand there remains limited data on New Zealand-based naturopathic and herbal medicine practice. In response, this paper reports findings from the first national survey examining the characteristics, perceptions and experiences of New Zealand-based naturopaths and herbal medicine practitioners across multiple domains relating to their role and practice. An online survey (covering 6 domains: demographics; practice characteristics; research; integrative practice; regulation and funding; contribution to national health objectives) was administered to naturopaths and herbal medicine practitioners. From a total of 338 naturopaths and herbal medicine practitioners, 107 responded providing a response rate of 32%. Data were statistically analysed using STATA. A majority of the naturopaths and herbal medicine practitioners surveyed were female (91%), and aged between 45 and 54 years. Most practiced part-time (64%), with practitioner caseloads averaging 8 new clients and over 20 follow-up clients per month. Our analysis shows that researched information impacts upon and is useful for naturopaths and herbal medicine practitioners to validate their practices. However, the sources of researched information utilised by New Zealand naturopaths and herbal medicine practitioners remain variable, with many sources beyond publications in peer-reviewed journals being utilised. Most naturopathic and herbal medicine practitioners (82%) supported registration, with statutory registration being favoured (75%). Integration with conventional care was considered desirable by the majority of naturopaths and herbal medicine practitioners surveyed (83%). Naturopaths and herbal medicine practitioners feel that they contribute to several key national health objectives, including: improved nutrition (93%); increased physical activity (85%); reducing incidence and impact of CVD (79%); reducing incidence and impact of cancer (68
McDowell, Andrew; Pai, Madhukar
Mumbai is a hot spot for drug-resistant TB, and private practitioners trained in AYUSH systems (Ayurveda, yoga, Unani, Siddha and homeopathy) are major healthcare providers. It is important to understand how AYUSH practitioners manage patients with TB or presumptive TB. We conducted semi-structured interviews of 175 Mumbai slum-based practitioners holding degrees in Ayurveda, homeopathy and Unani. Most providers gave multiple interviews. We observed 10 providers in clinical interactions, documenting: clinical examinations, symptoms, history taking, prescriptions and diagnostic tests. No practitioners exclusively used his or her system of training. The practice of biomedicine is frequent, with practitioners often using biomedical disease categories and diagnostics. The use of homeopathy was rare (only 4% of consultations with homeopaths resulted in homeopathic remedies) and Ayurveda rarer (3% of consultations). For TB, all mentioned chest x-ray while 31 (17.7%) mentioned sputum smear as a TB test. One hundred and sixty-four practitioners (93.7%) reported referring TB patients to a public hospital or chest physician. Eleven practitioners (6.3%) reported treating patients with TB. Nine (5.1%) reported treating patients with drug-susceptible TB with at least one second-line drug. Important sources of health care in Mumbai's slums, AYUSH physicians frequently use biomedical therapies and most refer patients with TB to chest physicians or the public sector. They are integral to TB care and control. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: email@example.com.
Evans, Maggie; Shaw, Alison; Thompson, Elizabeth A; Falk, Stephen; Turton, Pat; Thompson, Trevor; Sharp, Deborah
Background Complementary and Alternative Medicine (CAM) is increasingly popular with cancer patients and yet information provision or discussion about CAM by health professionals remains low. Previous research suggests that patients may fear clinicians' 'disapproval' if they raise the subject of CAM, and turn to other sources to acquire information about CAM. However, little empirical research has been conducted into how cancer patients acquire, and, more importantly evaluate CAM information before deciding which CAM therapies to try. Methods Qualitative study, comprising semi-structured interviews with 43 male cancer patients of varying ages, cancer type and stage of illness, 34 of whom had used CAM. They were recruited from a range of NHS and non-NHS settings in Bristol, England. Results As a result of the lack of CAM information from health professionals, men in this study became either 'pro-active seekers' or 'passive recipients' of such information. Their main information resource was the 'lay referral' network of family, friends and acquaintances, especially females. 'Traditional' information sources, including books, magazines, leaflets and the media were popular, more so in fact than the internet. Views on the internet ranged from enthusiasm or healthy scepticism through to caution or disinterest. CAM information was generally regarded as 'empowering' as it broadened treatment and self-care options. A minority of participants were information averse fearing additional choices that might disrupt their fragile ability to cope. There was general consensus that CAM information should be available via the NHS, to give it a 'stamp of approval', which combined with guidance from informed health professionals, could help patients to make 'guided' choices. However, a small minority of these men valued the independence of CAM from the NHS and deliberately sought 'alternative' information sources and treatment options. Men were selective in identifying particular
Margaret A. White
Full Text Available Little is known about men with prostate cancer who decline conventional treatment and use only complementary and alternative medicine (CAM. Objectives To 1 explore why men decline conventional prostate cancer treatment and use CAM 2 understand the role of holistic healing in their care, and 3 document their recommendations for health care providers. Methods Semi-structured interviews and follow-up focus groups. Sample Twenty-nine men diagnosed with prostate cancer who declined all recommended conventional treatments and used CAM. Results Based on strong beliefs about healing, study participants took control by researching the risks of delaying or declining conventional treatment while using CAM as a first option. Most perceived conventional treatment to have a negative impact on quality of life. Participants sought healing in a broader mind, body, spirit context, developing individualized CAM approaches consistent with their beliefs about the causes of cancer. Most made significant lifestyle changes to improve their health. Spirituality was central to healing for one-third of the sample. Participants recommended a larger role for integrated cancer care. Conclusion Men who decline conventional prostate cancer treatment and use CAM only may benefit from a whole person approach to care where physicians support them to play an active role in healing while carefully monitoring their disease status.
Full Text Available Introduction: To assess efficacy and tolerability of a new complementary and alternative medicine (CAM consisting of vitamins (C and D, herbal products (cucurbita maxima, capsicum annum, polygonum capsicatum and amino acid L-Glutammina, in the treatment of female Overactive Bladder syndrome (OAB. Materials and methods: 90 consecutive women with OAB symptoms were enrolled in this prospective, randomized, controlled study. Women were divided randomly into two groups of 45 patients each. In group A, women received Solifenacin Succinate (SS, 5 mg. once a day for 12 weeks. In group B, women received CAM, 930 mg, twice daily for 12 weeks. Women were assessed with 3-day micturition diary, Patient Perception of Intensity of Urgency Scale (PPIUS, Overactive Bladder questionnaire Short Form (OAB-q SF and Patient Global Impression of Improvement questionnaire (PGI-I. Results: 8 patients in group A and 1 patient in group B dropped out from therapy because of side effects. A reduction in the number of daily micturitions, nocturia and episodes of urge incontinence was present with both SS and CAM with statistically highly significant differences, but CAM was significantly more effective than SS. PPIUS and OAB-q SF showed improvements with both SS and CAM with a more significant efficacy of CAM. PGI-I, demonstrated improvements in the two groups of patients with a greater satisfaction expressed by patients treated with CAM. Conclusions: the small number of patients does not permit definitive conclusions; however, the results of the research showed the greater effectiveness and tolerability of CAM.
Bjerså, Kristofer; Stener Victorin, Elisabet; Fagevik Olsén, Monika
Previous studies show an increased interest and usage of complementary and alternative medicine (CAM) in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals. A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included. A total of 737 (42.0%) questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in such research. Half of the participants (55.8%) were
Full Text Available Abstract Background Previous studies show an increased interest and usage of complementary and alternative medicine (CAM in the general population and among health care workers both internationally and nationally. CAM usage is also reported to be common among surgical patients. Earlier international studies have reported that a large amount of surgical patients use it prior to and after surgery. Recent publications indicate a weak knowledge about CAM among health care workers. However the current situation in Sweden is unknown. The aim of this study was therefore to explore perceived knowledge about CAM among registered healthcare professions in surgical departments at Swedish university hospitals. Method A questionnaire was distributed to 1757 registered physicians, nurses and physiotherapists in surgical wards at the seven university hospitals in Sweden from spring 2010 to spring 2011. The questionnaire included classification of 21 therapies into conventional, complementary, alternative and integrative, and whether patients were recommended these therapies. Questions concerning knowledge, research, and patient communication about CAM were also included. Result A total of 737 (42.0% questionnaires were returned. Therapies classified as complementary; were massage, manual therapies, yoga and acupuncture. Alternative therapies; were herbal medicine, dietary supplements, homeopathy and healing. Classification to integrative therapy was low, and unfamiliar therapies were Bowen therapy, iridology and Rosen method. Therapies recommended by > 40% off the participants were massage and acupuncture. Knowledge and research about CAM was valued as minor or none at all by 95.7% respectively 99.2%. Importance of possessing knowledge about it was valued as important by 80.9%. It was believed by 61.2% that more research funding should be addressed to CAM research, 72.8% were interested in reading CAM-research results, and 27.8% would consider taking part in
Prevalence, socio-demographic and clinical predictors of post-diagnostic utilisation of different types of complementary and alternative medicine (CAM) in a nationwide cohort of Danish women treated for primary breast cancer
Pedersen, Christina Gundgaard; Christensen, Søren; Jensen, Anders Bonde
This study investigated the prevalence and predictors of use of complementary and alternative medicine (CAM) in a nationwide inception cohort of Danish women treated for early-stage breast cancer as well as differences in user patterns for individual types of CAM.......This study investigated the prevalence and predictors of use of complementary and alternative medicine (CAM) in a nationwide inception cohort of Danish women treated for early-stage breast cancer as well as differences in user patterns for individual types of CAM....
Full Text Available Abstract Background To assess pediatricians' attitudes toward & practice of Complementary/Alternative Medicine (CAM including their knowledge, experience, & referral patterns for CAM therapies. Methods An anonymous, self-report, 27-item questionnaire was mailed nationally to fellows of the American Academy of Pediatrics in July 2004. 648 of 3500 pediatricians' surveyed responded (18%. Results The median age ranged from 46–59 yrs; 52% female, 81% Caucasian, 71% generalists, & 85% trained in the US. Over 96% of pediatricians' responding believed their patients were using CAM. Discussions of CAM use were initiated by the family (70% & only 37% of pediatricians asked about CAM use as part of routine medical history. Majority (84% said more CME courses should be offered on CAM and 71% said they would consider referring patients to CAM practitioners. Medical conditions referred for CAM included; chronic problems (headaches, pain management, asthma, backaches (86%, diseases with no known cure (55.5% or failure of conventional therapies (56%, behavioral problems (49%, & psychiatric disorders (47%. American born, US medical school graduates, general pediatricians, & pediatricians who ask/talk about CAM were most likely to believe their patients used CAM (P Conclusion Pediatricians' have a positive attitude towards CAM. Majority believe that their patients are using CAM, that asking about CAM should be part of routine medical history, would consider referring to a CAM practitioner and want more education on CAM.
Da Frè Monica
Full Text Available Abstract Background The growing popularity of CAM among the public is coupled with an ongoing debate on its effectiveness, safety, and its implications on the reimbursement system. This issue is critically important for GPs, who have a "gatekeeping" role with respect to health care expenditure. GPs must be aware of medications' uses, limitations and possible adverse effects. Our objective was to explore GPs' knowledge of CAM and patterns of recommendation and practice, as well as the relationship between such patterns and GPs' life-styles. Methods A cross-sectional study was conducted in Tuscany, a region of central Italy. One hundred percent female GPs (498 and a 60% random sample of male GPs (1310 practising in the region were contacted through a self-administered postal questionnaire followed by a postal reminder and telephone interview. Results Overall response rate was 82.1%. Most respondents (58% recommended CAM but a far smaller fraction (13% practised it; yet 36% of CAM practitioners had no certificated training. Being female, younger age, practising in larger communities, having had some training in CAM as well as following a vegetarian or macrobiotic diet and doing physical activity were independent predictors of CAM recommendation and practice. However, 42% of GPs did not recommend CAM to patients mostly because of the insufficient evidence of its effectiveness. Conclusion CAM knowledge among GPs is not as widespread as the public demand seems to require, and the scarce evidence of CAM effectiveness hinders its professional use among a considerable number of GPs. Sound research on CAM effectiveness is needed to guide physicians' behaviour, to safeguard patients' safety, and to assist policy-makers in planning regulations for CAM usage.
Dunne, Alexandra; Phillips, Christine
More than half the patients who use complementary and alternative medicine (CAM) in Australia do not discuss it with their doctors. Many consumers use popular media, especially women's magazines, to learn about CAM. To explore representations of CAM in popular Australian women's magazines. Content analysis of three Australian magazines: Australian Women's Weekly, Dolly and New Idea published from January to June 2008. Of 220 references to CAM (4-17 references per issue), most were to biologically based practices, particularly 'functional foods', which enhance health. Most representations of CAM were positive (81.3% positive, 16.4% neutral, 2.3% negative). Explanations of modes of action of CAM tended to be biological but relatively superficial. Australian magazines cast CAM as safe therapy which enhances patient engagement in healthcare, and works in ways analogous to orthodox medical treatments. General practitioners can use discussions with their patients about CAM to encourage health promoting practices.
Whayne, Thomas F
Alternative medications as a term call up many different meanings, significance, and perceptions to various medical practitioners. Some are good; others are bad. A wide range of alternative medications with relevance or connection to cardiovascular (CV) disease have been considered. While many are worthless, others have definite benefit, and at least one, chelation therapy, is associated with definite harm, significant risk, no benefit, and enrichment of the practitioners who prescribe it. The issues concerning alternative therapies will likely never be studied with randomized clinical trials due to the lack of a profit motive on the part of pharmaceutical companies--only rarely do other institutions, such as the National Institutes of Health, support medicinal studies. Basic knowledge of alternative therapies is essential for the CV specialist and other practicing physicians and other practitioners, since at least a few of their patients will take these medications regardless of medical advice. The result is that a number of these alternative medications will then interact with conventional CV medications, many times unfavorably.
Spychalla, Megan T; Heathman, Joanne H; Pearson, Katherine A; Herber, Andrew J; Newman, James S
Hospital medicine is a growing field with an increasing demand for additional healthcare providers, especially in the face of an aging population. Reductions in resident duty hours, coupled with a continued deficit of medical school graduates to appropriately meet the demand, require an additional workforce to counter the shortage. A major dilemma of incorporating nonphysician providers such as nurse practitioners and physician assistants (NPPAs) into a hospital medicine practice is their varying academic backgrounds and inpatient care experiences. Medical institutions seeking to add NPPAs to their hospital medicine practice need a structured orientation program and ongoing NPPA educational support. This article outlines an NPPA orientation and training program within the Division of Hospital Internal Medicine (HIM) at the Mayo Clinic in Rochester, MN. In addition to a practical orientation program that other institutions can model and implement, the division of HIM also developed supplemental learning modalities to maintain ongoing NPPA competencies and fill learning gaps, including a formal NPPA hospital medicine continuing medical education (CME) course, an NPPA simulation-based boot camp, and the first hospital-based NPPA grand rounds offering CME credit. Since the NPPA orientation and training program was implemented, NPPAs within the division of HIM have gained a reputation for possessing a strong clinical skill set coupled with a depth of knowledge in hospital medicine. The NPPA-physician model serves as an alternative care practice, and we believe that with the institution of modalities, including a structured orientation program, didactic support, hands-on learning, and professional growth opportunities, NPPAs are capable of fulfilling the gap created by provider shortages and resident duty hour restrictions. Additionally, the use of NPPAs in hospital medicine allows for patient care continuity that is otherwise missing with resident practice models.
Ijaz, Nadine; Boon, Heather
The World Health Organization (WHO) has called for the increased statutory regulation of traditional and complementary medicine practitioners and practices, currently implemented in about half of nations surveyed. According to recent WHO data, however, the absence of policy guidelines in this area represents a significant barrier to implementation of such professional regulations. This commentary reviews several key challenges that distinguish the statutory regulation of traditional medicine practitioners and practices from biomedical professional regulation, providing a foundation for the development of policy making parameters in this area. Foremost in this regard are the ongoing impacts of the European colonial encounter, which reinforce biomedicine's disproportionate political dominance across the globe despite traditional medicine's ongoing widespread use (particularly in the global South). In this light, the authors discuss the conceptual and historical underpinnings of contemporary professional regulatory structures, the tensions between institutional and informal traditional medicine training pathways, and the policy challenges presented by the prospect of standardizing internally diverse indigenous healing approaches. Epistemic and evidentiary tensions, as well as the policy complexities surrounding the intersection of cultural and clinical considerations, present additional challenges to regulators. Conceptualizing professional regulation as an intellectual property claim under the law, the authors further consider what it means to protect traditional knowledge and prevent misappropriation in this context. Overall, the authors propose that innovative professional regulatory approaches are needed in this area to address safety, quality of care, and accessibility as key public interest concerns, while prioritizing the redress of historical inequities, protection of diverse indigenous knowledges, and delivery of care to underserved populations.
Markel, Arie; Gavish, Israel; Kfir, Hila; Rimbrot, Sofia
Venous thromboembolism (VTE) is the third most common cause of death and the leading cause of sudden death in hospitalized medical patients. Despite the existence of guidelines for prevention and treatment of this disorder, their implementation in everyday life is not always accomplished. We performed a survey among directors of Internal Medicine departments in our country in order to evaluate their attitude and approach to this issue. A questionnaire with pertinent questions regarding prevention and treatment of VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE) was sent to each one of the directors of Internal Medicine Departments around the country. Sixty-nine out of 97 (71%) of the Internal Medicine departments directors responded the questionnaire. We found that several of the current guidelines were followed in a reasonable way. On the other hand, heterogeneity of responses was also present and the performance of current guidelines was imperfectly followed, and showed to be deficient in several aspects. An effort should be done in order to reemphasize and put in effect current guidelines for the prevention and treatment of VTE among hospitalists and Internal Medicine practitioners.
Cottingham, Phillip; Adams, Jon; Vempati, Ram; Dunn, Jill; Sibbritt, David
Background Despite the popularity of naturopathic and herbal medicine in New Zealand there remains limited data on New Zealand-based naturopathic and herbal medicine practice. In response, this paper reports findings from the first national survey examining the characteristics, perceptions and experiences of New Zealand-based naturopaths and herbal medicine practitioners across multiple domains relating to their role and practice. Methods An online survey (covering 6 domains: demographics; pr...
Sébastia , Brigitte ,
article retravaillé et publié sous le titre '‘Coping with diseases of modernity: the use of siddha medical knowledge and practices for treating diabetics" voir HAL; It is often after an initial recourse to biomedicine that Indians turn to traditional medicines, notably to siddha. Siddha practitioners have mostly been consulted for joint and bone disorders, digestive and sexual problems, and skin diseases, but they are increasingly approached for the treatment of metabolic pathologies, notably...
de Bruijn MC
Full Text Available Matthijs C de Bruijn,1 Boudewijn J Kollen,2 Frank Baarveld21Center for Sports Medicine, 2Department of General Practice, University Medical Center Groningen, University of Groningen, The NetherlandsBackground: In The Netherlands, sports medicine physicians are involved in the care of about 8% of all sports injuries that occur each year. Some patients consult a sports physician directly, without being referred by a general practitioner. This study aims to determine how many patients consult a sports physician directly, and to explore differences in the profiles of these patients compared with those who are referred.Methods: This was an exploratory cross-sectional study in which all new patients presenting with an injury to a regional sports medical center during September 2010 were identified. The characteristics of patients who self-referred and those who were referred by other medical professionals were compared.Results: A total of 234 patients were included (mean age 33.7 years, 59.1% male. Most of the injuries occurred during soccer and running, particularly injuries of the knee and ankle. In this cohort, 39.3% of patients consulted a sports physician directly. These patients were significantly more often involved in individual sports, consulted a sports physician relatively rapidly after the onset of injury, and had received significantly less care before this new event from medical professionals compared with patients who were referred.Conclusion: In this study, 39.3% of patients with sports injuries consulted a sports physician directly without being referred by another medical professional. The profile of this group of patients differed from that of patients who were referred. The specific roles of general practitioners and sports physicians in medical sports care in The Netherlands needs to be defined further.Keywords: sports injuries, sports medicine physician, primary care, secondary care
Wong, V. C. N.
A cross-sectional survey of the use of CAM by children was undertaken in the Duchess of Kent Children's Hospital in Hong Kong (March-December 2006). A questionnaire survey concerning the use of CAM was administered to chief caretakers (only the mothers) who accompanied children with neurodevelopmental disabilities followed up in our…
Land, Michael H; Wang, Julie
The use of complementary and alternative practices in the field of Allergy/Immunology is growing. A recent survey of American Academy of Allergy, Asthma, and Immunology members examining patterns of complementary and alternative medicine (CAM) use and adverse effects from CAM revealed that a majority of practitioners (81% of respondents) had patients who are using CAM therapies over conventional treatments and many practitioners (60% of survey respondents) have encountered patients experiencing adverse reactions. During routine office visits, a majority of practitioners do not ask patients about CAM use, and when they do, most do not have a standard intake form to take a CAM history. There is a strong need to increase knowledge and improve measures to prevent adverse reactions to CAMs. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.
Eaves, Emery R; Howerter, Amy; Nichter, Mark; Floden, Lysbeth; Gordon, Judith S; Ritenbaugh, Cheryl; Muramoto, Myra L
This article presents findings from qualitative interviews conducted as part of a research study that trained Acupuncture, Massage, and Chiropractic practitioners' in Arizona, US, to implement evidence-based tobacco cessation brief interventions (BI) in their routine practice. The qualitative phase of the overall study aimed to assess: the impact of tailored training in evidence-based tobacco cessation BI on complementary and alternative medicine (CAM) practitioners' knowledge and willingness to implement BIs in their routine practice; and their patients' responses to cessation intervention in CAM context. To evaluate the implementation of skills learned from a tailored training program, we conducted semi-structured qualitative interviews with 54 CAM practitioners in Southern Arizona and 38 of their patients. Interview questions focused on reactions to the implementation of tobacco cessation BIs in CAM practice. After participating in a tailored BI training, CAM practitioners reported increased confidence, knowledge, and motivation to address tobacco in their routine practice. Patients were open to being approached by CAM practitioners about tobacco use and viewed BIs as an expected part of wellness care. Tailored training motivated CAM practitioners in this study to implement evidence-based tobacco cessation BIs in their routine practice. Results suggest that CAM practitioners can be a valuable point of contact and should be included in tobacco cessation efforts.
Hierl, Marina; Pfirstinger, Jochen; Andreesen, Reinhard; Holler, Ernst; Mayer, Stephanie; Wolff, Daniel; Vogelhuber, Martin
Surveys state a widespread use of complementary and alternative medicine (CAM) in patients with malignant diseases. CAM methods might potentially interfere with the metabolization of tumor-specific therapy. However, there is little communication about CAM use in hematology/oncology patients between patients, CAM providers, and oncologists. A self-administered questionnaire was handed out to all patients attending to the hematology/oncology outpatient clinic of Regensburg University Hospital. Subsequently, a chart review of all CAM users was performed. Questionnaires of 1,016 patients were analyzed. Of these patients, 30% used CAM, preferably vitamins and micronutrients. Main information sources for CAM methods were physicians/nonmedical practitioners and friends/relatives. CAM therapies were provided mainly by licensed physicians (29%), followed by nonmedical practitioners (14%) and the patients themselves (13%). Although 62% of the CAM users agreed that the oncologist may know about their CAM therapy, a chart entry about CAM use was found only in 41%. CAM is frequently used by hematology/oncology patients. Systematic communication about CAM is essential to avoid possible drug interactions. © 2017 S. Karger AG, Basel.
de Almeida Andrade, Fabiana; Schlechta Portella, Caio Fabio
The scientific literature presents a modest amount of evidence in the use of complementary and alternative medicine (CAM). On the other hand, in practice, relevant results are common. The debates among CAM practitioners about the quality and execution of scientific research are important. Therefore, the aim of this review is to gather, synthesize and describe the differentiated methodological models that encompass the complexity of therapeutic interventions. The process of bringing evidence-based medicine into clinical practice in CAM is essential for the growth and strengthening of complementary medicines worldwide. Copyright © 2017 Shanghai Changhai Hospital. Published by Elsevier B.V. All rights reserved.
Feijen-de Jong, Esther I.; Jansen, Danielle E. M. C.; Baarveld, Frank; Spelten, Evelien; Schellevis, Francois; Reijneveld, Sijmen A.
Background: Pregnant women visit complementary/alternative health care practitioners in addition to regular maternal health care practitioners. A wide variation has been reported with regard to rates and determinants of use of complementary/alternative medicine (CAM), which may be due to
Md. Nasir Ahmed
Full Text Available Schizophrenia is a subtle disorder of brain development and plasticity; it affects the most basic human processes of perception, emotion, and judgment. In Bangladesh the traditional medical practitioners of rural and remote areas characterized the schizophrenia as an insanity or a mental problem due to possession by ghosts or evil spirits and they have used various plant species’ to treat such symptoms. The aim of the present study was to conduct an ethnomedicinal plant survey and documentation of the formulations of different plant parts used by the traditional medical practitioners of Rangamati district of Bangladesh for the treatment of schizophrenia like psychosis. It was observed that the traditional medical practitioners used a total of 15 plant species to make 14 formulations. The plants were divided into 13 families, used for treatment of schizophrenia and accompanying symptoms like hallucination, depression, oversleeping or insomnia, deterioration of personal hygiene, forgetfulness, and fear due to evil spirits like genies or ghost. A search of the relevant scientific literatures showed that a number of plants used by the medicinal practitioners have been scientifically validated in their uses and traditional medicinal knowledge has been a means towards the discovery of many modern medicines. Moreover, the antipsychotic drug reserpine, isolated from the dried root of Rauvolfia serpentina species, revolutionized the treatment of schizophrenia. So it is very much possible that formulations of the practitioner, when examined scientifically in their entireties, can form discovery of lead compounds which can be used as safe and effective antipsychotic drug to treat schizophrenia.
Ahmed, Md Nasir; Kabidul Azam, Md Nur
Schizophrenia is a subtle disorder of brain development and plasticity; it affects the most basic human processes of perception, emotion, and judgment. In Bangladesh the traditional medical practitioners of rural and remote areas characterized the schizophrenia as an insanity or a mental problem due to possession by ghosts or evil spirits and they have used various plant species' to treat such symptoms. The aim of the present study was to conduct an ethnomedicinal plant survey and documentation of the formulations of different plant parts used by the traditional medical practitioners of Rangamati district of Bangladesh for the treatment of schizophrenia like psychosis. It was observed that the traditional medical practitioners used a total of 15 plant species to make 14 formulations. The plants were divided into 13 families, used for treatment of schizophrenia and accompanying symptoms like hallucination, depression, oversleeping or insomnia, deterioration of personal hygiene, forgetfulness, and fear due to evil spirits like genies or ghost. A search of the relevant scientific literatures showed that a number of plants used by the medicinal practitioners have been scientifically validated in their uses and traditional medicinal knowledge has been a means towards the discovery of many modern medicines. Moreover, the antipsychotic drug reserpine, isolated from the dried root of Rauvolfia serpentina species, revolutionized the treatment of schizophrenia. So it is very much possible that formulations of the practitioner, when examined scientifically in their entireties, can form discovery of lead compounds which can be used as safe and effective antipsychotic drug to treat schizophrenia.
Mark, John D; Chung, Youngran
To provide a comprehensive review of complementary and alternative medicine (CAM) therapies for the treatment of pulmonary disorders in children. The use of complementary medicine (CAM) is commonly used by both children and adults with breathing problems, and especially in chronic pulmonary disorders such as asthma and cystic fibrosis. Many clinics and hospitals now offer CAM, even though most of the conventionally trained health practitioners have little knowledge or education regarding CAM therapies. Research in CAM that demonstrates overall benefit is lacking, especially in children. Often parents do not report CAM use to their child's healthcare provider and this could compromise their overall quality of care. Although many research studies evaluating CAM therapies have methodological flaws, data exist to support CAM therapies in treating children with pulmonary disorders. This review examines the latest evidence of CAM use and effectiveness in children with pulmonary disorders. Physicians should be aware of the many CAM therapy options and the research surrounding them in order to provide their patients with the most current and accurate information available.
Alissa R. Link
Full Text Available Purpose. We examine factors associated with self-care, use of practitioner-based complementary and alternative medicine (CAM, and their timing in a cohort of women with breast cancer. Methods. Study participants were women with breast cancer who participated in the Long Island Breast Cancer Study Project. Self-care is defined as the use of multivitamins, single vitamins, botanicals, other dietary supplements, mind-body practices, special diets, support groups, and prayer. Within each modality, study participants were categorized as continuous users (before and after diagnosis, starters (only after diagnosis, quitters (only before diagnosis, or never users. Multivariable logistic regression was used for the main analyses. Results. Of 764 women who provided complete data, 513 (67.2% initiated a new form of self-care following breast cancer diagnosis. The most popular modalities were those that are ingestible, and they were commonly used in combination. The strongest predictor of continuous use of one type of self-care was continuous use of other types of self-care. Healthy behaviors, including high fruit/vegetable intake and exercise, were more strongly associated with continuously using self-care than starting self-care after diagnosis. Conclusions. Breast cancer diagnosis was associated with subsequent behavioral changes, and the majority of women undertook new forms of self-care after diagnosis. Few women discontinued use of modalities they used prior to diagnosis.
Footracer, Katherine G.; Monaghan, Melissa; Wisniewski, Nicole P.; Mandel, Ellen
Introduction Research into opinions about complementary and alternative medicine (CAM) has focused on conventional medical practitioners with little exploration of CAM practitioners’ views. Purpose To survey attitudes and practices of massage therapists toward conventional medicine. Research Design An anonymous online survey consisting of Likert-type scales, fill-in answers, and multiple-choice questions was used. Participants Members of the Associated Bodywork & Massage Professionals (ABMP), the largest massage therapy association in the US with over 77,000 members. Main Outcome Measures Participants were asked about their years of practice and training, choice of health care practitioners, sources for information about CAM and Western/allopathic medicine, client referral patterns, optimal treatment approaches for various medical conditions, and overall impressions of CAM and Western/ allopathic medicine. Results Analysis of n = 3,148 responses indicated that while 66.9% of respondents had a neutral or worse impression of Western/allopathic medicine, 64.3% use a conventional medicine practitioner as their primary health care provider, 61.9% have referred clients to a conventional medicine practitioner in the past six months, and 90.5% seek out information on Western/allopathic medicine. The mode response of the best treatment approach to various medical problems was a mix of Western/allopathic medicine and CAM. Conclusions This study suggests that despite the ambivalence of many massage therapists towards conventional medicine, many use it, encourage clients to do so, and see involvement of both as crucial to health. PMID:22553480
Mist, Scott; Ritenbaugh, Cheryl; Aickin, Mikel
To investigate whether a training process that focused on a questionnaire-based diagnosis in Traditional Chinese Medicine (TCM), and developing diagnostic consensus, would improve the agreement of TCM diagnoses among 10 TCM practitioners evaluating patients with temporomandibular joint disorder (TMJD). Evaluation of a diagnostic training program at the Department of Family and Community Medicine, University of Arizona, Tucson, Arizona, and the Oregon College of Oriental Medicine, Portland, Oregon. Screened participants for a study of TCM for TMJD. PRACTITIONERS: Ten (10) licensed acupuncturists with a minimum of 5 years licensure and education in Chinese herbs. A training session using a questionnaire-based diagnostic form was conducted, followed by waves of diagnostic sessions. Between sessions, practitioners discussed the results of the previous round of participants with a focus on reducing variability in primary diagnosis and severity rating of each diagnosis: 3 waves of 5 patients were assessed by 4 practitioner pairs for a total of 120 diagnoses. At 18 months, practitioners completed a recalibration exercise with a similar format with a total of 32 diagnoses. These diagnoses were then examined with respect to the rate of agreement among the 10 practitioners using inter-rater correlations and kappas. The inter-rater correlation with respect to the TCM diagnoses among the 10 practitioners increased from 0.112 to 0.618 with training. Statistically significant improvements were found between the baseline and 18 month exercises (p reliability of TCM diagnosis may be improved through a training process and a questionnaire-based diagnosis process. The improvements varied by diagnosis, with the greatest congruence among primary and more severe diagnoses. Future TCM studies should consider including calibration training to improve the validity of results.
Kune, Randall; Kune, Gabriel
Mainstream medical philosophy and practice differ in many respects from those of complementary and alternative medicine (CAM), differences which are explored in this article. Because of a resurgence of CAM therapies, courts and tribunals will scrutinise CAM in more and more contexts in the future. Such court cases may require the resolution of conflicts between opinions of CAM and medical experts. This article considers how courts evaluate such opinions where experts hold conflicting ideologies or philosophical approaches, and addresses the following questions: Do the opinions of CAM practitioners qualify as "expert" opinions in court? How do the courts examine the basis of such opinions? Are they systematically given less weight than the opinions of mainstream medical practitioners? Will recent procedural reforms for hearing expert evidence make it easier for courts to resolve these issues?
de Bruijn, Matthijs C; Kollen, Boudewijn J; Baarveld, Frank
Background In The Netherlands, sports medicine physicians are involved in the care of about 8% of all sports injuries that occur each year. Some patients consult a sports physician directly, without being referred by a general practitioner. This study aims to determine how many patients consult a sports physician directly, and to explore differences in the profiles of these patients compared with those who are referred. Methods This was an exploratory cross-sectional study in which all new patients presenting with an injury to a regional sports medical center during September 2010 were identified. The characteristics of patients who self-referred and those who were referred by other medical professionals were compared. Results A total of 234 patients were included (mean age 33.7 years, 59.1% male). Most of the injuries occurred during soccer and running, particularly injuries of the knee and ankle. In this cohort, 39.3% of patients consulted a sports physician directly. These patients were significantly more often involved in individual sports, consulted a sports physician relatively rapidly after the onset of injury, and had received significantly less care before this new event from medical professionals compared with patients who were referred. Conclusion In this study, 39.3% of patients with sports injuries consulted a sports physician directly without being referred by another medical professional. The profile of this group of patients differed from that of patients who were referred. The specific roles of general practitioners and sports physicians in medical sports care in The Netherlands needs to be defined further. PMID:24379706
Kim, Do Yeun; Park, Wan Beom; Kang, Hee Cheol; Kim, Mi Jung; Park, Kyu-Hyun; Min, Byung-Il; Suh, Duk-Joon; Lee, Hye Won; Jung, Seung Pil; Chun, Mison; Lee, Soon Nam
The current status of complementary and alternative medicine (CAM) education in Korean medical schools is still largely unknown, despite a growing need for a CAM component in medical education. The prevalence, scope, and diversity of CAM courses in Korean medical school education were evaluated. Participants included academic or curriculum deans and faculty at each of the 41 Korean medical schools. A mail survey was conducted from 2007 to 2010. Replies were received from all 41 schools. CAM was officially taught at 35 schools (85.4%), and 32 schools (91.4%) provided academic credit for CAM courses. The most common courses were introduction to CAM or integrative medicine (88.6%), traditional Korean medicine (57.1%), homeopathy and naturopathy (31.4%), and acupuncture (28.6%). Educational formats included lectures by professors and lectures and/or demonstrations by practitioners. The value order of core competencies was attitude (40/41), knowledge (32/41), and skill (6/41). Reasons for not initiating a CAM curriculum were a non-evidence-based approach in assessing the efficacy of CAM, insufficiently reliable reference resources, and insufficient time to educate students in CAM. This survey reveals heterogeneity in the content, format, and requirements among CAM courses at Korean medical schools. Korean medical school students should be instructed in CAM with a more consistent educational approach to help patients who participate in or demand CAM.
Holikatti, Prabhakar C; Kar, Nilamadhab
It is common knowledge that patients seek treatment for psychiatric illnesses from various sources including the alternative medicine. Views and attitudes of clinicians often influence the provision of appropriate mental health care for these patients. In this context, it was intended to study the views of the practitioners of alternative medicine toward psychiatric disorders, patients and interventions. The study was conducted as a questionnaire-based survey among a sample of practitioners of alternative medicine specifically Ayurveda and Homeopathy, who were practicing in Solapur and adjoining areas of Maharashtra and Karnataka states in India. A semi-structured Attitudinal Inventory for Psychiatry questionnaire was used. Demographic and professional data were collected. Out of 62 practitioners approached, 50 responded (80.6%). There were no significant differences in the views of practitioners toward psychiatry and psychiatrists based on respondents' gender, place of residence, location of practice, type of alternative medicine, exposure to psychiatric patients, or if they knew someone with psychiatric illness. Attitudes were generally positive, but variable. Among negative observations were that approximately 60% of respondents felt that a patient can be disadvantaged by being given a psychiatric label and 58% believed that emotions are difficult to handle. A considerable proportion (40%) of the respondents felt doctors other than psychiatrists were unable to identify psychiatric disorders. This study's findings suggest that practitioners of alternative medicine have mixed views about mental illness, patients and treatment. Some of their negative views and perceived inability to identify psychiatric disorders may be addressed through further training, information sharing and collaborative work.
What Is Important During the Selection of Traditional Chinese Medicine (TCM) in a Health Care Reimbursement or Insurance System?" Critical Issues of Assessment from the Perspective of TCM Practitioners.
Zhang, Fang; Xie, Jing-Min; Zhang, Yi-Ye; Kong, Lin-Lin; Li, Shu-Chuen
Complementary and alternative medicine (CAM) has gained increasing popularity over the last several decades internationally, leading to an increasing interest from decision makers and researchers as to how to assess the effectiveness of CAM. The attempts, however, have been unsatisfactory. The most important reason is a lack of attention to the theoretical characteristics of CAM, which are completely different from those of allopathic medicine or biomedicine. This study attempted to survey expert Traditional Chinese Medicine (TCM) practitioners in China to elucidate critical issues when assessing the effectiveness of TCM. A questionnaire (with 20 close-ended and 2 open-ended questions) about the influencing factors of measuring the cost and effectiveness of TCM was distributed to TCM practitioners who had been working in the field of research for at least 5 years and had published at least one related scientific article in the last 5 years. Internal consistency test was performed for all questions to verify the reliability of the questionnaire. Principal-component analysis was performed for remaining items after Kaiser-Meyer-Olkin (KMO) index and Bartlett's test of sphericity. A linear combination model was then built to evaluate the contribution of various factors involved for the selection of TCM into the health care reimbursement or insurance system. Of 429 questionnaires issued, 137 were returned from respondents from 31 medical and research institutions, giving a recovery rate of 31.93%. Internal consistency coefficient obtained was 0.745, indicating good reliability of this measurement scale, and the data passed the KMO test and Bartlett's test of sphericity (KMO index = 0.691). In addition, eight common factors were extracted after the rotation of principal-component analysis with a cumulative variance of 70.92%. Our findings suggested that factors to be considered during the selection of TCM in health care reimbursement or insurance system include patient
Tan, Gabriel; Craine, Michael H; Bair, Matthew J; Garcia, M Kay; Giordano, James; Jensen, Mark P; McDonald, Shelley M; Patterson, David; Sherman, Richard A; Williams, Wright; Tsao, Jennie C I
Complementary and alternative medicine (CAM) is a group of diverse medical and healthcare systems, therapies, and products that are not presently considered part of conventional medicine. This article provides an up-to-date review of the efficacy of selected CAM modalities in the management of chronic pain. Findings are presented according to the classification system developed by the National Institutes of Health National Center for Complementary and Alternative Medicine (formerly Office of Alternative Medicine) and are grouped into four domains: biologically based medicine, energy medicine, manipulative and body-based medicine, and mind-body medicine. Homeopathy and acupuncture are discussed separately as "whole or professionalized CAM practices." Based on the guidelines of the Clinical Psychology Division of the American Psychological Association, findings indicate that some CAM modalities have a solid track record of efficacy, whereas others are promising but require additional research. The article concludes with recommendations to pain practitioners.
Full Text Available The meeting of the APASL, Asian Pacific Association for the Study of the Liver, was held in December 2004, in New Delhi, India. The meeting was held under the patronage of the APASL Committee and Board of Presidents of the National Liver Association and in conjunction with the annual conference of the Indian Association for the Study of Liver (INASL. The congress was designed to have a core meeting with three parallel sessions running throughout, dedicated research workshops and intensive breakfast sessions. This report concentrates on the two sessions devoted to complementary and alternative medicine (CAM and shows the latest research in CAM for liver disease and the concerns of doctors about integrating CAM with more traditional treatments. With researchers and practitioners gathering from all over the world, it was a unique opportunity for an intercultural discussion on CAM and liver disease.
Akram, Z; Abduljabbar, T; Hanif, A; Khan, A; Vohra, F
To assess the attitude and knowledge of family medicine practitioners (FMPs) towards the association between periodontal disease and obesity. A cross-sectional study was performed and a 13-item survey questionnaire was given to FMPs practicing in 12 different teaching hospitals in Karachi, Pakistan. The questions were aimed at exploring the knowledge of FMP's regarding the association of obesity and periodontal disease and their attitude towards the association of obesity and periodontal disease. Chi-square and Spearman co-efficient were conducted to compare subgroups and correlate factors with the knowledge score of FMPs. A total of 314 questionnaires were completed (response rate = 92%). Median age of participants was 41 years and 57% were females. Almost 61% of FMPs answered all the knowledge questions correctly and 64% reported moderate understanding of the association between periodontal health and obesity. Nearly 73% FMPs inquired from obese patients regarding the periodontal disease and more than half (58%) refer patients to a dentist for evaluation. More than half of FMPs perform periodontal disease screening. Nearly all FMPs considered informing obese patients regarding periodontal disease as one of their roles. FMP's play an important role in the early diagnosis, prevention and treatment of periodontal conditions in obese patients. More than two thirds of FMPs showed good knowledge of the association of obesity and periodontal disease. The attitudes of FMPs towards assessing and referring obese patients at a risk of having periodontal disease were reassuring.
Kassam, H; Tzortziou Brown, V; O'Halloran, P; Wheeler, P; Fairclough, J; Maffulli, N; Morrissey, D
Sport and exercise medicine (SEM) aims to manage sporting injuries and promote physical activity. This study explores general practitioners' (GPs) awareness, understanding and utilisation of their local SEM services. A questionnaire survey, including patient case scenarios, was administered between February and May 2011. 693 GPs working in Cardiff and Vale, Leicester and Tower Hamlets were invited to participate. 244 GPs responded to the questionnaire (35.2% response rate). Less than half (46%; 112/244) were aware of their nearest SEM service and only 38% (92/244) had a clear understanding on referral indications. The majority (82%; 199/244) felt confident advising less active patients about exercise. There were divergent management opinions about the case scenarios of patients who were SEM referral candidates. Overall, GPs were significantly more likely to refer younger patients and patients with sport-related problems rather than patients who would benefit from increasing their activity levels in order to prevent or manage chronic conditions (pHealth Service which may be resulting in suboptimal utilisation especially for patients who could benefit from increasing their activity levels. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Slader, Cassandra A; Reddel, Helen K; Jenkins, Christine R; Armour, Carol L; Bosnic-Anticevich, Sinthia Z
Consumer interest in complementary and alternative medicine (CAM) has grown dramatically in Western countries in the past decade. However, very few patients volunteer information about CAM use unless directly questioned by their health-care practitioner. Therefore, by being informed about the prevalence and modality of CAM use for asthma, as well as characteristics of users, health-care practitioners may be better able to identify patients who use CAM. In turn, this may facilitate proactive discussion and optimization of the patient's overall asthma management. This review aims to summarize the current knowledge about use of CAM by people with asthma, and to assess the applicability of the available studies to the broader asthmatic population. Computerized literature searches were conducted on Medline, Embase, Cochrane and Allied and Complementary Medicine (AMED) databases from their inception to 13 April 2005. Search terms included: complementary medicine/therapies, alternative medicine/therapies and asthma. The bibliographies of accessible articles were searched for further papers. Seventeen studies have examined the use of CAM by people with asthma. The reported level of use for adults ranged from 4% to 79%, and for children from 33% to 89%. Among the most commonly used CAMs were: breathing techniques, herbal products, homeopathy and acupuncture. There is no strong evidence for effectiveness for any of these modalities. There is little consistency among available prevalence studies making conclusions difficult. Nevertheless, the high rates of CAM use reported in some studies indicate that CAM use should be taken into account when managing patients with asthma.
Bellows, Jennifer Whitfield; Douglass, Katherine; Atilla, Ridvan; Smith, Jeffrey; Kapur, G Bobby
Background The specialty of Emergency Medicine has enjoyed recognition for nearly 20 years in Turkey. However, the majority of underserved and rural Turkish emergency departments are staffed by general practitioners who lack formal training in the specialty and have few opportunities to increase emergency medicine-specific knowledge and skills. Methods To address this ?practitioner gap,? the authors developed a four-phase comprehensive emergency medicine education and training program for gen...
Exploring self-use, attitude and interest to study complementary and alternative medicine (CAM) among final year undergraduate medical, pharmacy and nursing students in Sierra Leone: a comparative study.
James, Peter Bai; Bah, Abdulai Jawo; Kondorvoh, Idrissa Momoh
CAM inclusion into the curricula of health training institutions, a strategy for its integration into the main stream healthcare delivery system is growing globally. Future healthcare professionals knowledge and perception of CAM are key determinants to its successful integration. Thus, the main objective of this study was to compare the use, attitude and interest to study CAM among final year undergraduate medical, pharmacy and nursing students at the College of Medicine and Allied Health Sciences University of Sierra Leone (COMAHS-USL). A questionnaire based cross-sectional survey was carried out among final year medical, pharmacy and nursing students enrolled at the College of Medicine and Allied Health Sciences University of Sierra Leone (COMAHS-USL). Chi square, fisher exact two tailed test and Kruskal-wallis test were used to analyze data collected. Close to two-thirds (61 %) of all the three groups of final year students used one form of CAM or the other with pharmacy (72.7 %) and nursing (55.6 %) students being the highest and least users respectively. No significant difference was observed among the three groups. In general, final year students in all three cadres demonstrated a positive attitude toward CAM (33.80 ± 3. 2) with medical students showing more positive attitude than pharmacy (p = 0.022) and nursing student (p = 0.008). No significant difference in attitude was observed between students in pharmacy and nursing programs (p = 0.354). More than three quarter (76.6 %) of the students in all the three groups indicated their interest in studying CAM, with preference for the subject to be taught as an elective module (81.6 %). An appreciable number of final year medical, pharmacy and nursing students at COMAHS-USL have used at least one CAM modality and demonstrated an overall positive attitude towards CAM. Interest to study CAM was also observed among most of them even though they preferred it to be taught as an elective module.
Sabalic, Maja; Schoener, Jason D.
Virtual reality-based technologies have been used in dentistry for almost two decades. Dental simulators, planning software and CAD/CAM (computer-aided design/computer-aided manufacturing) systems have significantly developed over the years and changed both dental education and clinical practice. This study aimed to assess the knowledge, attitudes…
Esterhuizen, Tonya; Gathiram, Prem
ABSTRACT Background Family physicians are trained to treat a wide range of diseases, treatment being centred on the patient, family and community irrespective of age, gender, or ethnic or racial background. To deal with inequalities in health care, the South African government introduced the concept of a district health system in 1997. It was only in August 2007, however, that family medicine was legislated as a speciality. This study was undertaken prior to the enactment of this legislation. Method A descriptive quantitative study using a self-administered questionnaire was undertaken. A convenience sampling technique was used (N = 60) to assess the reactions of medical practitioners towards the impending legislation. Results Overall, 60% of the sample was in favour of the legislation. There were no significant differences between those working in the private and public sectors or between generalists and specialists. With regard to those not in favour of the legislation compared to those in favour of the legislation, a significantly increased number answered the following statements in the affirmative: (i) ‘I already carry out the functions of a family physician’ (p = 0.001), (ii) ‘They [specialist family physicians] will not be as qualified as specialists in other categories’ (p = 0.005), (iii) ‘It will have a negative impact on general practice’ (p competitiveness’ (p = 0.021), (v) ‘It will not have any effect on patient care’ (p = 0.010) and (vi) ‘There is no need for such a speciality’ (p = 0.001). Conclusion We concluded that the majority were in favour of the legislation being implemented.
Ditte, Darja; Schulz, Wolfgang; Ernst, Gundula; Schmid-Ott, Gerhard
The use of complementary and alternative medicine (CAM) is increasing in Europe as well as in the USA, but CAM courses are infrequently integrated into medical curricula. In Europe, but also especially in the USA and in Canada, the attitudes of medical students and health science professionals in various disciplines towards CAM have been the subject of investigation. Most studies report positive attitudes. The main aim of this study was to compare the attitudes towards CAM of medical and psychology students in Germany. An additional set of questions concerned how CAM utilisation and emotional and physical condition affect CAM-related attitudes. Two hundred thirty-three medical students and 55 psychology students were questioned concerning their attitudes towards CAM using the Questionnaire on Attitudes Towards Complementary Medical Treatment (QACAM). Both medical students and psychology students were sceptical about the diagnostic and the therapeutic proficiency of doctors and practitioners of CAM. Students' attitudes towards CAM correlated neither with their experiences as CAM patients nor with their emotional and physical condition. It can be assumed that German medical and psychology students will be reluctant to use or recommend CAM in their professional careers. Further studies should examine more closely the correlation between attitudes towards CAM and the students' worldview as well as their existing knowledge of the effectiveness of CAM.
Vickers Andrew J
Full Text Available Abstract Background Evidence-based medicine (EBM is being embraced by an increasing number of practitioners and advocates of complementary and alternative medicine (CAM. A significant constituency within CAM, however, appears to have substantive doubts about EBM and some are expressly hostile. Discussion Many of the arguments raised against EBM within the CAM community are based on a caricature radically at odds with established, accepted and published principles of EBM practice. Contrary to what has sometimes been argued, EBM is not cookbook medicine that ignores individual needs. Neither does EBM mandate that only proven therapies should be used. Before EBM, decisions on health care tended to be based on tradition, power and influence. Such modes usually act to the disadvantage of marginal groups. Conclusion By placing CAM on an equal footing with conventional medicine - what matters for both is evidence of effectiveness - EBM provides an opportunity for CAM to find an appropriate and just place in health care.
Skovgaard, Lasse; Pedersen, Inge Kryger; Verhoef, Marja
BACKGROUND: A survey of members of the Danish MS Society revealed that a minority of MS patients choose to forgo all types of conventional treatment and use complementary and alternative medicine (CAM) exclusively. A qualitative follow-up study was performed to elucidate the choice of exclusive C......-care practitioners, patient organizations, and health authorities within the MS field should be aware of possible changes in patients' attitudes toward both CAM and conventional treatment interventions....
Jonas, W B
Complementary and alternative medicine (CAM) is an area of great public interest and activity, both nationally and worldwide. Many alternative medical practices have existed for hundreds, even thousands of years. Patients and professionals are turning to CAM for a variety of reasons. Most have tried conventional medicine for a particular (usually chronic) medical condition and have found the results inadequate. Some are concerned over the side effects of conventional therapies. Some are seeking out a more "holistic" orientation in health care where they can address body, mind, and spirit. A continuing challenge will be how to address CAM services that are based on time, practitioner-patient interactions, and self-care, using modern standards of evidence, education, licensing, and reimbursement. For most CAM therapies, there is insufficient research to say definitively that it works and CAM research is especially limited in the area of cancer. Given that situation, the questions (but not answers) facing the medical practitioner are clear-cut. Should the practitioner await the definitive results of formal Phase III randomized clinical trials, or should the practitioner rely on limited data, seeking out evidence that makes physiological sense and small trials that seem to offer some benefit to the patient? When and at what point do you discourage, permit, or recommend an available alternative therapy? The answers are not simple. There may be differences of opinion and values among the patient, the practitioner, and the organizations that pay for a therapy. CAM areas should be approached with every patient who enters the office recognizing that there are precautions to consider when patients are using, or plan to use, such therapies. This paper presents a broad survey of what complementary and alternative medicine is from the perspectives of both the public as user and the conventional medical practitioner, as well as provides examples of issues pertinent to
Buckley, Thomas; Stasa, Helen; Cashin, Andrew; Stuart, Meg; Dunn, Sandra V
The purpose of this study was to investigate the sources, both print and electronic formats, which Australian nurse practitioners (NPs) currently use to obtain information regarding quality use of medicines (QUM). An additional aim was to document NPs' preferences for continuing education in relation to QUM. A national electronic survey of Australian NPs was conducted in 2007 and again in 2010. Eighty percent of respondents accessed information on QUM from professional literature, which may include scholarly journal articles, reports, and independent publications. There was a decrease in the percentage of respondents who obtained information from drug industry representatives. NPs prefer to receive medicines information in an electronic form, rather than a paper-based version, and over the time period more NPs are utilizing electronic sources rather than paper. These findings provide important insights into medical information products for the developers who may be able to use these results to ensure that their products meet the needs of NP clinicians. Additionally, the finding that NPs prefer to receive their continuing information related to medicines in electronic format, but also highly value conference proceedings, may help to inform future planning of NP education needs in relation to QUM. ©2014 American Association of Nurse Practitioners.
Lu, Zhaoxue; Moody, Jennifer; Marx, Benjamin L; Hammerstrom, Tracy
Complementary and alternative medicine is increasingly integrated into cancer care. We sought detail on the treatment of chemotherapy-induced peripheral neuropathy (CIPN) with acupuncture and oriental medicine (AOM) by surveying practitioners at integrative oncology (IO) sites across the United States. Online survey of licensed acupuncturists. IO sites in the United States. Fifteen licensed acupuncturists who completed the survey between February 2014 and June 2014. Demographics, IO setting characteristics, AOM treatment characteristics, and practitioner-reported outcomes. Respondents reported an average of 31.3 ± 17.2 patients per week, and one-third (10.1 mean; 7.2 standard deviation [SD]) were treated for CIPN. Medical doctors (86.7%) were the most common providers with whom respondents worked. Traditional Chinese medicine style acupuncture was utilized by a majority of respondents (86.7%), and the most commonly used points were local, typically in the hands and feet, such as Ba Feng, Ba Xie, LV3, and LI4. In addition to acupuncture, nutritional advice was the most frequent auxiliary modality provided by respondents (85.7%). On average, respondents provided 12.75 ± 4.17 treatments for CIPN patients, and a majority (53%) reported treating patients once per week. Timing of the treatments relative to chemotherapy infusion was evenly distributed between "1-2 days after infusion" (60%), "at time of infusion" (53.3%), and "1-2 days before infusion" (46.7%). Sixty percent of respondents rated outcomes as "moderately successful with moderate improvement seen." This survey provides detail regarding IO sites using acupuncture for CIPN as well as real-world treatment patterns, including common point combinations, visit characteristics, and practitioner-reported outcomes. This information contributes to the emerging evidence on the use of acupuncture to address unmet needs of CIPN patients, and supports the development of best practice guidelines for the treatment
Heusser, Peter; Scheffer, Christian; Neumann, Melanie; Tauschel, Diethart; Edelhäuser, Friedrich
To develop the hypothesis that reductionism in medical anthropology, professional education and health care influences empathy development, communication and patient satisfaction. We identified relevant literature and reviewed the material in a structured essay. We reflected our hypothesis by applying it to Anthroposophic Medicine (AM), an example of holistic theory and practice. Reductionism in medical anthropology such as in conventional medicine seems to lead to a less empathetic and less communicative health care culture than holism such as in CAM disciplines. However, reductionism can be transformed into a systemic, multi-perspective holistic view, when the emergent properties of the physical, living, psychic, spiritual and social levels of human existence and the causal relations between them are more carefully accounted for in epistemology, medical anthropology and professional education. This is shown by the example of AM and its possible benefits for communication with and satisfaction of patients. A non-reductionistic understanding of the human being may improve communication with patients and enhance patient benefit and satisfaction. Interdisciplinary qualitative and quantitative studies are warranted to test this hypothesis and to understand the complex relations between epistemology, medical anthropology, education, health care delivery and benefit for patients. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Abstract Background The present study describes Complementary and Alternative Medicine (CAM use amongst Italian women transitioning through menopause. Popularity and perceived effectiveness of CAM treatments, use of pharmaceutical medications, characteristics of CAM users, the extent of communication between medical practitioners and women about their use of CAM, and variables associated with CAM use were also investigated. Methods Women, aged 45-65 years attending Family Planning and Women's Health clinics or Menopause Centres in Bologna were invited to complete a voluntary, anonymous, self administered questionnaire, which was used in a previous study in Sydney. The questionnaire was translated and adapted for use amongst Italian women. Data on general demographic and health characteristics, menopause related symptoms and the use of CAM and pharmaceutical treatments during the previous 12 months were collected. Results In total, 1,203 women completed the survey, of which 1,106 were included in the final sample. Of women who had symptoms linked with menopause and/or used remedies to alleviate symptoms, 33.5% reported to have used CAM. Among these, 23.5% had consulted one or more practitioners and 24% had used at least one CAM product. Approximately nine out of ten respondents reported medical practitioners did not seek information about their use of CAM; while one third of CAM users did not disclose the use of CAM to their physician. Nevertheless, medical practitioners were the most popular source of information. From the multivariate analysis, variables associated with CAM use were: professional employment, time since the last natural menses, use of CAM for conditions other than menopause, and presence of some severe symptoms. Conclusions The relatively high prevalence of CAM use by women transitioning through menopause should encourage research initiatives into determining which CAM treatments are the safest and effective. The increasing and
Cardini, Francesco; Lesi, Grazia; Lombardo, Flavia; van der Sluijs, Corinne
The present study describes Complementary and Alternative Medicine (CAM) use amongst Italian women transitioning through menopause. Popularity and perceived effectiveness of CAM treatments, use of pharmaceutical medications, characteristics of CAM users, the extent of communication between medical practitioners and women about their use of CAM, and variables associated with CAM use were also investigated. Women, aged 45-65 years attending Family Planning and Women's Health clinics or Menopause Centres in Bologna were invited to complete a voluntary, anonymous, self administered questionnaire, which was used in a previous study in Sydney. The questionnaire was translated and adapted for use amongst Italian women. Data on general demographic and health characteristics, menopause related symptoms and the use of CAM and pharmaceutical treatments during the previous 12 months were collected. In total, 1,203 women completed the survey, of which 1,106 were included in the final sample. Of women who had symptoms linked with menopause and/or used remedies to alleviate symptoms, 33.5% reported to have used CAM. Among these, 23.5% had consulted one or more practitioners and 24% had used at least one CAM product.Approximately nine out of ten respondents reported medical practitioners did not seek information about their use of CAM; while one third of CAM users did not disclose the use of CAM to their physician. Nevertheless, medical practitioners were the most popular source of information. From the multivariate analysis, variables associated with CAM use were: professional employment, time since the last natural menses, use of CAM for conditions other than menopause, and presence of some severe symptoms. The relatively high prevalence of CAM use by women transitioning through menopause should encourage research initiatives into determining which CAM treatments are the safest and effective. The increasing and likely concomitant use of CAM with HRT and other pharmaceuticals
Kang, Se Sik; Kim, Jung Hoon [Dep. of Radiological Science, College of Health Science, Catholic University of Pusan, Busan (Korea, Republic of); Cho, Yong In [Dept. of Diagnostic Radiology, Dongnam Institute of Radiological and Medical Science, Busan (Korea, Republic of)
In the case of nuclear medicine practitioners in medical institutions, a wide range of exposure dose to individual workers can be found, depending on the type of source, the amount of radioactivity, and the use of shielding devices in handling radioactive isotopes. In this regard, this study evaluated the organ dose on practitioners as well as the dose reduction effect of the L-block shielding device in handling the diagnostic radiation source through the simulation based on the Monte Carlo method. As a result, the distribution of organ dose was found to be higher as the position of the radiation source was closer to the handling position of a practitioner, and the effective dose distribution was different according to the ICRP tissue weight. Furthermore, the dose reduction effect according to the L-block thickness tended to decrease, which showed the exponential distribution, as the shielding thickness increased. The dose reduction effect according to each radiation source showed a low shielding effect in proportion to the emitted gamma ray energy level.
Dang, Catherine; Phuong, Thomas; Beddag, Mahmoud; Vega, Anabel; Denis, Céline
To present a data model for clinical legal medicine and the software based on that data model for both practitioners and researchers. The main functionalities of the presented software are computer-assisted production of medical certificates and data capture, storage and retrieval. The data model and the software were jointly developed by the department of forensic medicine of the Jean Verdier Hospital (Bondy, France) and an bioinformatics laboratory (LIMICS, Paris universities 6-13) between November 2015 and May 2016. The data model was built based on four sources: i) a template used in our department for producing standardised medical certificates; ii) a random sample of medical certificates produced by the forensic department; iii) anterior consensus between four healthcare professionals (two forensic practitioners, a psychologist and a forensic psychiatrist) and iv) anatomical dictionaries. The trial version of the open source software was first designed for examination of physical assault survivors. An UML-like data model dedicated to clinical legal practice was built. The data model describes the terminology for examinations of sexual assault survivors, physical assault survivors, individuals kept in police custody and undocumented migrants for age estimation. A trial version of a software relying on the data model was developed and tested by three physicians. The software allows files archiving, standardised data collection, extraction and assistance for certificate generation. It can be used for research purpose, by data exchange and analysis. Despite some current limitations of use, it is a tool which can be shared and used by other departments of forensic medicine and other specialties, improving data management and exploitation. Full integration with external sources, analytics software and use of a semantic interoperability framework are planned for the next months. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights
Tan, Michelle G E; Win, Ma Thin; Khan, Shariq Ali
The use of complementary and alternative medicine (CAM) in Singapore for a variety of conditions has been reported to be high. However in Asian chronic pain patients, there is no data on their use of CAM and its perceived benefits. A cross-sectional survey of 210 patients was carried out in Pain Management Centre. Patients were interviewed directly on their use of CAM. The outcomes were prevalence of CAM use, the types of CAM used, the perceived efficacy and factors influencing its use. The prevalence of CAM users in chronic pain is 84%. The most common class of CAM is traditional Chinese medicine (68%) the subset of which, acupuncture, was most frequently utilised (49% of patients using CAM). In univariate analyses, ethnicity was significantly linked to CAM use but not gender, age, education level and income (P = 0.027). Specifically for neck pain, it was significant that patients were more likely to see a chiropractor, to use massage, to take take vitamins and ginseng to alleviate their symptoms. With upper limb pain, it was the use of Tui na, massage and seeing a TCM practitioner. For abdominal pain, it was the use of herbal medicines. The majority felt that CAM helped with their pain (72%) although less expressed satisfaction with CAM (64%). Reasons for using CAM included: having more control over their pain; fewer side effects; safety and lower costs compared to conventional medicine. The use of CAM in chronic pain patients is higher than the general population. Most felt that it improved their pain. As part of multimodal therapy, CAM may have a role in the management of chronic pain.
Ebel, Marie-Desirée; Rudolph, Ivonne; Keinki, Christian; Hoppe, Andrea; Muecke, Ralph; Micke, Oliver; Muenstedt, Karsten; Huebner, Jutta
A high percentage of cancer patients use complementary and alternative medicine (CAM). The aim of our study was to learn more about the association of CAM usage, information needs, perceived impact of disease, locus of control and self-efficacy of cancer patients. We asked patients attending a series of lectures on CAM using a standardized questionnaire which integrated questions on information needs, CAM and validated short questionnaires on self-efficacy, perception of the disease and locus of control of reinforcement. One hundred and eighty-five patients answered the questionnaire, from whom 45 % used CAM. Sixty percentage disclosed using CAM to the general practitioner and 57 % to the oncologist. Physicians and nurses, print media and the Internet are the most important source of information on CAM (used by 20-25 % each). Impact on neither daily life, perceived personal control nor coherence was associated with CAM usage, disclosure to physicians or sources of information. There also was no association between CAM usage and self-efficacy. In contrast, there was a significant association between CAM user rate and a high external locus of control. While CAM usage is agreed upon by many physicians due to the idea that it helps patients to become active and feel more in control of the disease, our data are in favor of the contrary. A strong perception of external locus of control seems to be a driver of CAM usage. Physicians should be aware of this association when counseling on CAM.
A number of health-related interventions--from widespread therapies such as acupuncture, herbal medicine, homeopathy and yoga, to less well-known modalities such as Feldenkrais, iridology, reflexology and reiki--have increasingly come under the general heading of complementary and alternative medicine (CAM). A few, such as biofeedback, chiropractic and physical therapy, are considered conventional by some, alternative by others. Several national surveys estimate that around 40% of the US populace uses a CAM therapy in a given year. While a few people use CAM therapies instead of conventional medicine, the vast majority of CAM users continue to access the official health care system. Many, however, do not discuss their CAM use with their physician. Medical doctors, for their part, are sharply divided on their attitudes toward CAM, with strong advocates and vehement opponents writing and speaking about this issue. CAM therapists are even more diverse, spanning the spectrum from conventional-appearing registered and certified practitioners to iconoclasts promoting anomalous therapies in the place of conventional treatment. The majority, however, both respect and want to work with conventional medicine, as do their patients. Nearly everyone is calling for more and better evidence, and an ever-increasing number of randomized controlled trials and meta-analyses are now appearing in the literature. Over the past few years, a number of calls for "integrated medicine" have been made, and a few attempts at integrating CAM and conventional medicine have been launched. This article reviews these issues, citing our own interview-based work and the relevant literature. Whether the CAM phenomenon represents a short-lived social movement or the beginnings of a radical transformation of medicine has yet to be determined.
Bardenheier Barbara H
Full Text Available Abstract Background While many Complementary/Alternative Medicine (CAM practitioners do not object to immunization, some discourage or even actively oppose vaccination among their patients. However, previous studies in this area have focused on childhood immunizations, and it is unknown whether and to what extent CAM practitioners may influence the vaccination behavior of their adult patients. The purpose of this study was to describe vaccination coverage levels of adults aged ≥ 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage. Methods Data from the 2002 National Health Interview Survey, limited to 30,617 adults that provided at least one valid answer to the CAM supplement, were analyzed. Receipt of influenza vaccine during the past 12 months, pneumococcal vaccine (ever, and ≥ 1 dose of hepatitis B vaccine was self-reported. Coverage levels for each vaccine by CAM use status were determined for adults who were considered high priority for vaccination because of the presence of a high risk condition and for non-priority adults. Multivariable analyses were conducted to evaluate the association between CAM users and vaccination status, adjusting for demographic and healthcare utilization characteristics. Results Overall, 36% were recent CAM users. Among priority adults, adjusted vaccination coverage levels were significantly different between recent and non-CAM users for influenza (44% vs 38%; p-value Conclusion Vaccination coverage levels among recent CAM users were found to be higher than non-CAM users. Because CAM use has been increasing over time in the U.S., it is important to continue monitoring CAM use and its possible influence on receipt of immunizations among adults. Since adult vaccination coverage levels remain below Healthy People 2010 goals, it may be beneficial to work with CAM practitioners to promote adult vaccines as preventive services in
Kumar, Ashutosh; Duda, L; Mainali, G; Asghar, S; Byler, D
Tourette syndrome (TS) is a neuropsychiatric condition defined by both motor and phonic tics over a period of at least 1 year with the onset before 18 years of age. The purpose of this article is to review the use of complementary alternative medicine (CAM) in children and adults with Tourette syndrome with emphasis on recent research. Most patients do not tell their physician about the use of CAM unless if specifically asked. Of the studies reviewed, description of the treatment and the frequency of use were most often reported. Few studies examine the role or effectiveness of CAM in the treatment of TS specifically. Practitioners should be aware of current research regarding various CAM modalities used for TS patients, including efficacy, potential adverse effects, and interactions with medications. Robust data about the use of CAM, efficacy, and potential side effects is lacking and requires further research to clarify optimal use.
The nuclear medicine department of the Nancy CHU hospital is one of the largest in France: 16.000 patients are welcomed each year and 4.000 persons undergo a tomography there. 5 shielded and isolated rooms, dedicated to Iodine 131 treatment, allow the care of 150 to 200 patients each year. The head of the nuclear medicine department gives his meaning about the new regulation on the management of radioactive effluents. According to him, regulations are necessary but the values of the imposed thresholds have to be scientifically justified. Another point is that a lot of money is spent on radiation protection issues while the radioactive risks are almost null, which leads to wasting money. The elaboration of the radioprotection regulations must be made not as a whole but on a specific basis according to the domain: nuclear power plants, research reactors or nuclear medicine, it applies. (A.C.)
Close, Ciara; Sinclair, Marlene; Liddle, S Dianne; Madden, Elaine; McCullough, Julie E M; Hughes, Ciara
To evaluate and summarize the current evidence on the effectiveness of complementary and alternative medicine for the management of low back pain and/or pelvic pain in pregnancy. International research demonstrates that 25-30% of women use complementary and alternative medicine to manage low back and pelvic pain in pregnancy without robust evidence demonstrating its effectiveness. A systematic review of randomized controlled trials to determine the effectiveness of complementary and alternative medicine for low back and/or pelvic pain in pregnancy. Cochrane library (1898-2013), PubMed (1996-2013), MEDLINE (1946-2013), AMED (1985-2013), Embase (1974-2013), Cinahl (1937-2013), Index to Thesis (1716-2013) and Ethos (1914-2013). Selected studies were written in English, randomized controlled trials, a group 1 or 2 therapy and reported pain reduction as an outcome measure. Study quality was reviewed using Risk of Bias and evidence strength the Cochrane Grading of Recommendations and Development Evaluation Tool. Eight studies were selected for full review. Two acupuncture studies with low risk of bias showed both clinically important changes and statistically significant results. There was evidence of effectiveness for osteopathy and chiropractic. However, osteopathy and chiropractic studies scored high for risk of bias. Strength of the evidence across studies was very low. There is limited evidence supporting the use of general CAM for managing pregnancy-related low back and/or pelvic pain. However, the restricted availability of high-quality studies, combined with the very low evidence strength, makes it impossible to make evidence-based recommendations for practice. © 2014 John Wiley & Sons Ltd.
Bradshaw, Michelle L
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.
Murthy, Vijayendra; Sibbritt, David W; Adams, Jon
Back pain is the most prevalent of musculoskeletal conditions, and back pain sufferers have been identified as high users of complementary and alternative medicine (CAM). Despite lacking evidence, CAM treatments (e.g., acupuncture, chiropractic, and massage) and CAM products (eg, vitamins, supplements, and aromatherapy oils) for back pain care have become widely available internationally, and CAM use by back pain sufferers has become a significant health service issue. However, to date, there has been no integrative review on CAM use for back pain. This study aims to conduct an integrative review on CAM use for back pain focusing on prevalence of use, commonly used CAM, characteristics of users, factors influencing decision making, self-perceived effectiveness, and communication with health-care providers. The study is based on an integrative literature review. A comprehensive search of international literature from 2000 to 2014 in MEDLINE, CINHAL, AMED, DARE, EMBASE, ExceptaMedica, psycINFO, and SCOPUS databases was conducted. The search was limited to peer-reviewed articles published in English language and reporting empirical research findings on CAM use for back pain. The review reveals a considerable variation in prevalences of CAM use for back pain internationally. Acupuncture, chiropractic, osteopathy, and massage therapy are the commonly used CAM treatments besides a range of self-prescribed CAM, and back pain sufferers use CAM alongside conventional medical treatments. Female gender, chronicity of back pain, and previous exposure to CAM are key predictors of CAM use for back pain as highlighted from the reviewed literature. Family, friends, and recommendation by doctors appear to influence decision making on CAM use for back pain. The review reveals that users of CAM for back pain tend to report CAM as beneficial, but there is little knowledge on communication between CAM users with back pain and health-care providers about such use. Existing literature is
Abat, Jasmeet K; Mattoo, Autar K; Deswal, Renu
Nitric oxide (NO) is a signaling molecule that affects a myriad of processes in plants. However, the mechanistic details are limited. NO post-translationally modifies proteins by S-nitrosylation of cysteines. The soluble S-nitrosoproteome of a medicinal, crassulacean acid metabolism (CAM) plant, Kalanchoe pinnata, was purified using the biotin switch technique. Nineteen targets were identified by MALDI-TOF mass spectrometry, including proteins associated with carbon, nitrogen and sulfur metabolism, the cytoskeleton, stress and photosynthesis. Some were similar to those previously identified in Arabidopsis thaliana, but kinesin-like protein, glycolate oxidase, putative UDP glucose 4-epimerase and putative DNA topoisomerase II had not been identified as targets previously for any organism. In vitro and in vivo nitrosylation of ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco), one of the targets, was confirmed by immunoblotting. Rubisco plays a central role in photosynthesis, and the effect of S-nitrosylation on its enzymatic activity was determined using NaH14CO3. The NO-releasing compound S-nitrosoglutathione inhibited its activity in a dose-dependent manner suggesting Rubisco inactivation by nitrosylation for the first time.
Bleser, William K.; Elewonibi, Bilikisu Reni; Miranda, Patricia Y.
BACKGROUND: Complementary and alternative medicine (CAM) is increasingly used in the United States. Although CAM is mostly used in conjunction with conventional medicine, some CAM practitioners recommend against vaccination, and children who saw naturopathic physicians or chiropractors were less likely to receive vaccines and more likely to get vaccine-preventable diseases. Nothing is known about how child CAM usage affects influenza vaccination. METHODS: This nationally representative study analyzed ∼9000 children from the Child Complementary and Alternative Medicine File of the 2012 National Health Interview Survey. Adjusting for health services use factors, it examined influenza vaccination odds by ever using major CAM domains: (1) alternative medical systems (AMS; eg, acupuncture); (2) biologically-based therapies, excluding multivitamins/multiminerals (eg, herbal supplements); (3) multivitamins/multiminerals; (4) manipulative and body-based therapies (MBBT; eg, chiropractic manipulation); and (5) mind–body therapies (eg, yoga). RESULTS: Influenza vaccination uptake was lower among children ever (versus never) using AMS (33% vs 43%; P = .008) or MBBT (35% vs 43%; P = .002) but higher by using multivitamins/multiminerals (45% vs 39%; P children ever (versus never) using any AMS or MBBT had lower uptake (respective odds ratios: 0.61 [95% confidence interval: 0.44–0.85]; and 0.74 [0.58–0.94]). CONCLUSIONS: Children who have ever used certain CAM domains that may require contact with vaccine-hesitant CAM practitioners are vulnerable to lower annual uptake of influenza vaccination. Opportunity exists for US public health, policy, and medical professionals to improve child health by better engaging parents of children using particular domains of CAM and CAM practitioners advising them. PMID:27940756
Bellows, Jennifer Whitfield; Douglass, Katherine; Atilla, Ridvan; Smith, Jeffrey; Kapur, G Bobby
The specialty of Emergency Medicine has enjoyed recognition for nearly 20 years in Turkey. However, the majority of underserved and rural Turkish emergency departments are staffed by general practitioners who lack formal training in the specialty and have few opportunities to increase emergency medicine-specific knowledge and skills. To address this "practitioner gap," the authors developed a four-phase comprehensive emergency medicine education and training program for general practitioners practicing in government hospitals in Turkey. From April 2006 until June 2009, 42 courses were taught by 62 trainers across seven regions in Turkey. A total of 2,262 physicians were trained. The mean course pre-test score for all regions was 42.3 (95% CI 39.8 to 44.7). The mean course post-test score was 70.1 (95% CI 67.2 to 72.9). The difference between the mean scores was 27.8 (95% CI 25.3 to 30.4, P emergency medicine department and an emergency medicine society to implement country-wide training of physicians practicing in public emergency departments can serve as a successful model for capacity-building global emergency medicine endeavors.
Hamm, Eric; Muramoto, Myra L; Howerter, Amy; Floden, Lysbeth; Govindarajan, Lubna
To provide a snapshot of provider-based complementary and alternative medicine (pbCAM) use among adult smokers and assess the opportunity for these providers to deliver tobacco cessation interventions. Cross-sectional analysis of data from the 2002 and 2007 National Health Interview Surveys. Nationally representative sample. A total of 54,437 (31,044 from 2002; 23,393 from 2007) adults 18 years and older. The analysis focuses on 10 types of pbCAM, including acupuncture, Ayurveda, biofeedback, chelation therapy, chiropractic care, energy therapy, folk medicine, hypnosis, massage, and naturopathy. The proportions of current smokers using any pbCAM as well as specific types of pbCAM in 2002 and 2007 are compared using SAS SURVEYLOGISTIC. Between 2002 and 2007, the percentage of recent users of any pbCAM therapy increased from 12.5% to 15.4% (p = .001). The largest increases occurred in massage, chiropractic, and acupuncture. Despite a decrease in the national average of current smokers (22.0% to 19.4%; p = .001), proportions of smokers within specific pbCAM disciplines remained consistent. Complementary and alternative medicine (CAM) practitioners, particularly those in chiropractic, acupuncture, and massage, represent new cohorts in the health care community to promote tobacco cessation. There is an opportunity to provide brief tobacco intervention training to CAM practitioners and engage them in public health efforts to reduce the burden of tobacco use in the United States.
Ben-Arye, Eran; Karkabi, Khaled; Karkabi, Sonia; Keshet, Yael; Haddad, Maria; Frenkel, Moshe
The purpose of this cross-cultural study was to evaluate patient perspectives on complementary and alternative medicine (CAM) integration within primary care clinics. It is one of the first multiethnic studies to explore patients' perspectives on the best model for integrating CAM into the conventional care setting. We developed a 13-item questionnaire that addresses issues of CAM use, expectations from the primary care physicians concerning CAM, and attitudes toward CAM integration within a patient's primary care clinic. We constructed the questionnaire with cross-cultural sensitivity concerning the core concepts of CAM and traditional medicine in both the Arab and Jewish communities in northern Israel. Data for statistical analysis were obtained from 3840 patients attending seven primary care clinics. Of the 3713 respondents who were willing to identify their religion, 2184 defined themselves as Muslims, Christians, or Druze and 1529 as Jews. Respondents in the two groups were equally distributed by sex but differed significantly by age, education, self-rated religiosity, and self-reported chronic diseases in their medical background. Respondents in the two groups reported comparable overall CAM use during the previous year, but the Arab respondents reported more use of herbs and traditional medicine. Respondents in both groups stated that their primary expectation from a family physician concerning CAM was to refer them appropriately and safely to a CAM practitioner. Respondents in both groups greatly supported a theoretical scenario of CAM integration into primary medical care. However, Arab respondents were more supportive of the option that non-physician CAM practitioners would provide CAM rather than physicians.
Tracy L Truant
Full Text Available The integration of complementary and alternative medicine (CAM and conventional cancer care in Canada is in its nascent stages. While most patients use CAM during their cancer experience, the majority does not receive adequate support from their oncology health care professionals (HCPs to integrate CAM safely and effectively into their treatment and care. A variety of factors influence this lack of integration in Canada, such as health care professional(HCP education and attitudes about CAM; variable licensure, credentialing of CAM practitioners, and reimbursement issues across the country; an emerging CAM evidence base; and models of cancer care that privilege diseased-focused care at the expense of whole person care. Oncology nurses are optimally aligned to be leaders in the integration of CAM into cancer care in Canada. Beyond the respect afforded to oncology nurses by patients and family members that support them in broaching the topic of CAM, policies, and position statements exist that allow oncology nurses to include CAM as part of their scope. Oncology nurses have also taken on leadership roles in clinical innovation, research, education, and advocacy that are integral to the safe and informed integration of evidence-based CAM therapies into cancer care settings in Canada.
Team, Victoria; Canaway, Rachel; Manderson, Lenore
The growing evidence on the benefits and risks of complementary and alternative medicine (CAM) and its high rate of use (69% of Australians) - particularly for chronic or recurrent conditions - means increasing attention on CAM. However, few people disclose CAM use to their GP, and health professionals tend to inadequately discuss CAM-related issues with their patients, partly due to insufficient knowledge. As clinical and non-clinical chronic condition management guidelines are a means to educate primary health care practitioners, we undertook a content analysis of guidelines relevant to two common chronic conditions - cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) - to assess their provision of CAM-related information. Ten current Australian guidelines were reviewed, revealing scant CAM content. When available, the CAM-relevant information was brief, in some cases unclear, inconclusive and lacking in direction to the GP or health care provider. Although we focus on CVD and T2DM, we argue the value of all chronic condition management guidelines integrating relevant evidence-informed information and advice on CAM risks, benefits and referrals, to increase GP awareness and knowledge of appropriate CAM therapies, and potentially to facilitate doctor-client discussion about CAM.
Full Text Available Scleroderma is an autoimmune disease influenced by interplay among genetic and environmental factors, of which one is stress. Complementary and alternative medicine (CAM is frequently used to treat stress and those diseases in which stress has been implicated. Results are presented from a survey of patients with scleroderma. Respondents were a convenient sample of those attending a national conference in Las Vegas in 2002. Findings implicate stress in the onset, continuation and exacerbation of scleroderma. The implication is that CAM providers may be filling an important patient need in their provision of services that identify and treat stress and its related disorders.
Marletta, Giuseppe; Canfora, Angela; Roscani, Francesco; Cernicchiaro, Lucia; Cutrera, Maria; Russo, Marianna; Artioli, Giovanna; Sarli, Leopoldo
Evidence-based medicine offers effective pathways of pharmacological treatment for chronic pain that may compromise the quality of life of patients; this is one of the main reasons why more and more people resort to traditional and complementary approaches, to try to maintain or regain their health. The effectiveness of the various forms of complementary treatments often cannot be proven objectively, which is why, given the need to find more concrete evidence of the effectiveness 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 method regarding pain and other health outcomes of patients with malignant disease to support a proposal for improvement, based on the practice of healing touch massage conducted by nurses. Systematic review. There are several examples (in some cases specifically regarding patients with tumors) of the positive effects of healing touch massage on pain, anxiety and fatigue, and also on biochemical parameters. The way to full recognition by both the institutional and the scientific community seems to promise fairly well, although it should be noted that the achievement of this goal will require further research avoiding the limitations of previous studies.
Full Text Available More than two-thirds of patients in Germany use complementary and alternative medicine (CAM provided either by physicians or non-medical practitioners (“Heilpraktiker”. There is little information about the number of family physicians (FPs providing CAM. Given the widespread public interest in the use of CAM, this study aimed to ascertain the use of and attitude toward CAM among FPs in Germany. A postal questionnaire developed based on qualitatively derived data was sent to 3000 randomly selected FPs in Germany. A reminder letter including a postcard (containing a single question about CAM use in practice and reasons for non-particpation in the survey was sent to all FPs who had not returned the questionnaire. Of the 3000 FPs, 1027 (34% returned the questionnaire and 444 (15% returned the postcard. Altogether, 886 of the 1471 responding FPs (60% reported using CAM in their practice. A positive attitude toward CAM was indicated by 503 FPs (55%, a rather negative attitude by 127 FPs (14%. Chirotherapy, relaxation and neural therapy were rated as most beneficial CAM therapies by FPs, whereas neural therapy, phytotherapy and acupuncture were the most commonly used therapies in German family practices. This survey clearly demonstrates that CAM is highly valued by many FPs and is already making a substantial contribution to first-contact primary care in Germany. Therefore, education and research about CAM should be increased. Furthermore, with the provision of CAM by FPs, the role of non-medical CAM practitioners within the German healthcare system is to be questioned.
McCormack, Kenneth J. (Inventor)
A cryogenic cam butterfly valve has a body that includes an axially extending fluid conduit formed there through. A disc lug is connected to a back side of a valve disc and has a circular bore that receives and is larger than a cam of a cam shaft. The valve disc is rotatable for a quarter turn within the body about a lug axis that is offset from the shaft axis. Actuating the cam shaft in the closing rotational direction first causes the camming side of the cam of the cam shaft to rotate the disc lug and the valve disc a quarter turn from the open position to the closed position. Further actuating causes the camming side of the cam shaft to translate the valve disc into sealed contact with the valve seat. Opening rotational direction of the cam shaft reverses these motions.
Health related absenteeism costs an estimated $153 billion annually in the United States (Witters and Agrawal, 2011). 1 Chronic conditions (major contributors to absenteeism) are often successfully managed by Complementary and Alternative Medicine (CAM). As CAM becomes an increasingly visible component of healthcare, firms may wish to consider whether CAM therapies can help reduce illness-related absenteeism. This paper aims to extend the literature on healthcare utilization and absenteeism by exploring whether CAM treatment is associated with fewer workdays missed due to illness. Using the 2007 National Health Interview Survey (NHIS) and propensity score matching (PSM), this study estimates the relationship between visits to CAM practitioners, health, and illness-related absenteeism. In a sample of 8820 workers, the average annual number of workdays lost due to illness is 3.69. Visiting an acupuncturist correlates with lower absenteeism among men (1.182 fewer workdays missed, pabsenteeism, and many correlate with improved health. Two limitations of this study are worth noting. First, a small proportion of the sample uses CAM, limiting the generalizability of results. Second, if health conscious individuals are more likely to use CAM, then health attitudes may be contributing to lower absenteeism among the treated. Further research is needed to identify a causal relationship between CAM treatment, health, and absenteeism. Copyright © 2016 Elsevier Ltd. All rights reserved.
Schmidt, K; Jacobs, P A; Barton, A
To investigate whether there is a difference in general practitioners' attitudes towards CAM in the UK and Germany. A descriptive questionnaire was developed and sent to 97 GPs in the UK and 99 GPs in Germany. The overall response rate was 68%. German GPs showed a (non-significant) overall more positive attitude towards CAM than did British GPs. British GPs made more referrals to complementary practitioners. The most popular CAM therapies that UK GPs referred their patients to were chiropractic treatment, acupuncture and osteopathy. German GPs referred their patients mainly to acupuncture treatment, chiropractic treatment and herbal medicine. A significantly higher number of German GPs reported having practised as a CAM practitioner before and having personally used CAM themselves. Seventy percent of British GPs and 76% of German GPs thought it is safe to prescribe complementary medicine and therapies to patients. There are small national differences in referring patients to various CAM modalities. Both nations have an overall positive attitude toward and a high interest in CAM. Lack of scientific evidence and information on training opportunities were important points that were continuously raised by GPs in both countries.
Shivaprasad H. Venkatesha
Full Text Available Rheumatoid arthritis (RA is a debilitating autoimmune disease of global prevalence. The disease is characterized by synovial inflammation leading to cartilage and bone damage. Most of the conventional drugs used for the treatment of RA have severe adverse reactions and are quite expensive. Over the years, increasing proportion of patients with RA and other immune disorders are resorting to complementary and alternative medicine (CAM for their health needs. Natural plant products comprise one of the most popular CAM for inflammatory and immune disorders. These herbal CAM belong to diverse traditional systems of medicine, including traditional Chinese medicine, Kampo, and Ayurvedic medicine. In this paper, we have outlined the major immunological pathways involved in the induction and regulation of autoimmune arthritis and described various herbal CAM that can effectively modulate these immune pathways. Most of the information about the mechanisms of action of herbal products in the experimental models of RA is relevant to arthritis patients as well. The study of immunological pathways coupled with the emerging application of genomics and proteomics in CAM research is likely to provide novel insights into the mechanisms of action of different CAM modalities.
Arvonio, Maria Marra
The use of complementary and alternative medicines (CAM) such as Reiki is on the rise in healthcare centers. Reiki is associated with a spirituality that conflicts with some belief systems. Catholic healthcare facilities are restricted from offering this therapy because it conflicts with the teachings of the Catholic Church. However, hospitals are offering it without disclosing the spiritual aspects of it to patients. This article will address the ethical concerns and possible legal implications associated with the present process of offering Reiki. It will address these concerns based on the Joint Commission's Standard of Cultural Competency and the ethical principles of autonomy and informed consent. A proposal will also be introduced identifying specific information which Reiki/CAM practitioners should offer to their patients out of respect of their autonomy as well as their cultural, spiritual, and religious beliefs. PMID:24899738
Quality of medical service, patient satisfaction and loyalty with a focus on interpersonal-based medical service encounters and treatment effectiveness: a cross-sectional multicenter study of complementary and alternative medicine (CAM) hospitals.
Kim, Chang Eun; Shin, Joon-Shik; Lee, Jinho; Lee, Yoon Jae; Kim, Me-Riong; Choi, Areum; Park, Ki Byung; Lee, Ho-Joo; Ha, In-Hyuk
Treatment effectiveness holds considerable importance in the association between service quality and satisfaction in medical service studies. While complementary and alternative medicine (CAM) use grows more prominent, comprehensive evaluations of the quality of medical service at CAM-oriented hospitals are scarce. This study assesses the quality of medical services provided at a CAM-oriented hospital of Korean medicine using the service encounter system approach and analyzes the influence of treatment effectiveness on patient loyalty. A survey study using one-on-one interviews was conducted using a cross-sectional design in outpatients visiting one of fifteen Korean medicine facilities located throughout Korea. A total of 880 surveys were completed from June to July, 2014, and 728 surveys were included in the final analysis after excluding incomplete or incorrect questionnaires. The reliability and validity of the surveys was confirmed using Cronbach's alpha coefficient and confirmatory factor analysis, and a structural equation modeling analysis was performed to verify causality and association between factors (quality of medical service, treatment effectiveness, patient satisfaction, and intent to revisit). The measured factors of physician performance and quality of service procedures had a positive effect on treatment effectiveness. The impression of the facilities and environment directly impacted satisfaction rates for interpersonal-based medical service encounters, while treatment effectiveness positively affected satisfaction regarding quality of medical service. However, treatment effectiveness had a more significant effect on satisfaction compared to facilities and environment, and it indirectly affected satisfaction and directly influenced intent to revisit. Treatment effectiveness and satisfaction both positively influenced intent to revisit. The importance of treatment effectiveness should be recognized when examining quality of medical services, and
By definition, complementary and alternative medicine (CAM) attempts to diagnose and treat illnesses in unconventional ways. CAM has been classified as: (1) alternative medical systems (eg, traditional Chinese medicine [including acupuncture], naturopathic medicine, ayurvedic medicine, and homeopathy); (2) biologic-based therapies (eg, herbal, special dietary, and individual biologic treatments); (3) energy therapies (eg, Reiki, therapeutic touch, magnet therapy, Qi Gong, and intercessory prayer); (4) manipulative and body-based systems (eg, chiropractic, osteopathy, and massage); and (5) mind-body interventions (eg, meditation, biofeedback, hypnotherapy, and the relaxation response). This review focuses on how to assess the effectiveness of CAM therapies for chronic musculoskeletal pains, emphasizing the role of specific and nonspecific analgesic mechanisms, including placebo. Copyright Â© 2011 Elsevier Inc. All rights reserved.
Bosch, W.J.H.M. van den
The practice guideline 'Anaemia' from the Dutch College of General Practitioners will certainly be a support for the Dutch general practitioner. The inclusion of an algorithm to make a more precise diagnosis is an experiment that needs to be evaluated in the near future. However, many general
Stokley, Shannon; Cullen, Karen A; Kennedy, Allison; Bardenheier, Barbara H
While many Complementary/Alternative Medicine (CAM) practitioners do not object to immunization, some discourage or even actively oppose vaccination among their patients. However, previous studies in this area have focused on childhood immunizations, and it is unknown whether and to what extent CAM practitioners may influence the vaccination behavior of their adult patients. The purpose of this study was to describe vaccination coverage levels of adults aged > or = 18 years according to their CAM use status and determine if there is an association between CAM use and adult vaccination coverage. Data from the 2002 National Health Interview Survey, limited to 30,617 adults that provided at least one valid answer to the CAM supplement, were analyzed. Receipt of influenza vaccine during the past 12 months, pneumococcal vaccine (ever), and > or = 1 dose of hepatitis B vaccine was self-reported. Coverage levels for each vaccine by CAM use status were determined for adults who were considered high priority for vaccination because of the presence of a high risk condition and for non-priority adults. Multivariable analyses were conducted to evaluate the association between CAM users and vaccination status, adjusting for demographic and healthcare utilization characteristics. Overall, 36% were recent CAM users. Among priority adults, adjusted vaccination coverage levels were significantly different between recent and non-CAM users for influenza (44% vs 38%; p-value < 0.001) and pneumococcal (40% vs 33%; p-value < 0.001) vaccines but were not significantly different for hepatitis B (60% vs 56%; p-value = 0.36). Among non-priority adults, recent CAM users had significantly higher unadjusted and adjusted vaccination coverage levels compared to non-CAM users for all three vaccines (p-values < 0.001). Vaccination coverage levels among recent CAM users were found to be higher than non-CAM users. Because CAM use has been increasing over time in the U.S., it is important to continue
... for Educators Search English Español Complementary and Alternative Medicine KidsHealth / For Teens / Complementary and Alternative Medicine What's ... a replacement. How Is CAM Different From Conventional Medicine? Conventional medicine is based on scientific knowledge of ...
Scarton, Lou Ann; Del Fiol, Guilherme; Oakley-Girvan, Ingrid; Gibson, Bryan; Logan, Robert; Workman, T Elizabeth
The research examined complementary and alternative medicine (CAM) information-seeking behaviors and preferences from short- to long-term cancer survival, including goals, motivations, and information sources. A mixed-methods approach was used with cancer survivors from the "Assessment of Patients' Experience with Cancer Care" 2004 cohort. Data collection included a mail survey and phone interviews using the critical incident technique (CIT). Seventy survivors from the 2004 study responded to the survey, and eight participated in the CIT interviews. Quantitative results showed that CAM usage did not change significantly between 2004 and 2015. The following themes emerged from the CIT: families' and friends' provision of the initial introduction to a CAM, use of CAM to manage the emotional and psychological impact of cancer, utilization of trained CAM practitioners, and online resources as a prominent source for CAM information. The majority of participants expressed an interest in an online information-sharing portal for CAM. Patients continue to use CAM well into long-term cancer survivorship. Finding trustworthy sources for information on CAM presents many challenges such as reliability of source, conflicting information on efficacy, and unknown interactions with conventional medications. Study participants expressed interest in an online portal to meet these needs through patient testimonials and linkage of claims to the scientific literature. Such a portal could also aid medical librarians and clinicians in locating and evaluating CAM information on behalf of patients.
Chua, Gin Nie; Hassali, Mohamed Azmi; Shafie, Asrul Akmal; Awaisu, Ahmed
The objective of this study was to evaluate the general practitioners' (GPs') knowledge and perceptions towards generic medicines in a northern state of Malaysia. A postal cross-sectional survey involving registered GPs in Penang, Malaysia was undertaken. A 23-item questionnaire was developed, validated and administered on the GPs. Eighty-seven GPs responded to the survey (response rate 26.8%). The majority of the respondents (85.1%) claimed that they actively prescribed generic medicines in their practice. On the other hand, only 4.6% of the respondents correctly identified the Malaysia's National Pharmaceutical Control Bureau's bioequivalence standard for generic products. There were misconceptions among the respondents about the concepts of "bioequivalence", "efficacy", "safety", and "manufacturing standards" of generic medicines. GPs in this survey believed that a standard guideline on brand substitution process, collaboration with pharmacists, patient education and information on safety and efficacy of generic medicines were necessary to ensure quality use of generics. Furthermore, advertisements and product bonuses offered by pharmaceutical companies, patient's socio-economic factors as well as credibility of manufacturers were factors reported to influence their choice of medicine. Although it appeared that GPs have largely accepted the use of generic medicines, they still have concerns regarding the reliability and quality of such products. GPs need to be educated and reassured about generic products approval system in Malaysia concerning bioequivalence, quality, and safety. The current findings have important implications in establishing generic medicines policy in Malaysia. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.
Author Guidelines. The Nigerian Medical Practitioner, a monthly Journal publishes clinical and research articles in medicine and related fields which are of interest to a large proportion of medical and allied health practitioners. It also publishes miscellaneous articles-hospital administration, business practice, accounting, ...
Meeker William C
Full Text Available Abstract Objective To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions Data Sources A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. Data Selection A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Data Synthesis Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. Results Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Conclusion Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.
Lawrence, Dana J; Meeker, William C
To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.
Esakkimuthu, S; Mutheeswaran, S; Arvinth, S; Paulraj, M Gabriel; Pandikumar, P; Ignacimuthu, S
The burden of cardiometabolic diseases such as dyslipidemia, hyperglycemia, hypertension, visceral obesity and atherosclerotic cardiovascular diseases and the use of traditional medicine for the management of such diseases are high in India; hence there is a need to document and analyze such therapies. This study documented and analyzed the medicinal plants prescribed for cardiometabolic diseases by the non-institutionally trained siddha practitioners of Tiruvallur district of Tamil Nadu, India. The field survey was conducted between December 2014 to November 2015. Successive free listing assisted with field-walks was used to interview the informants. After assessing the sampling sufficiency using rarefaction curve analysis, indices such as Informant Consensus Factor (Fic) and Index of Agreement on Remedies (IAR) were calculated for the data. The indicators of informant's medicinal plant knowledge such as Shannon's index, equitability index, etc., were regressed with the demographic profile of the informants. For this study 70 non-institutionally trained Siddha medical practitioners were approached; the data from 36 practitioners who were treating cardiometabolic diseases were documented. This study recorded the use of 188 species which were used to prepare 368 formulations to treat illnesses categorized under cardiometabolic diseases. In this, 53.04% claims were singletons. Regression analysis showed that single species dominance was reduced and the diversity of medicinal plants was increased with the increase in the age and experience. Increase in the years of formal education increased the equitability in the uses. The plants such as Nelumbo nucifera Gaertn. (cardiovascular diseases), Allium sativum L. (dyslipidemia), Cuminum cyminum L. (hypertension), Macrotyloma uniflorum Verdc. (obesity) and Azadirachta indica A. Juss. (type 2 diabetes) were the highly cited medicinal plants. This survey has identified the plants most commonly used by Siddha practitioners of
Skovgaard, Lasse; Launsø, Laila; Pedersen, Inge Kryger
The use of alternative and complementary medicine (CAM) is prevalent among People with Multiple Sclerosis (PwMS) in Denmark as well as in other Western countries. Many PwMS combine conventional treatments and CAM; however there is little research-based knowledge about the outcomes that PwMS achieve...... from combined treatments. The purpose of this article is to describe which outcomes PwMS have experienced from combination treatment based on collaboration between conventional healthcare providers and CAM practitioners. A second purpose is to identify and study aspects of the courses of treatment...... that have generally characterized the achieved outcomes. During the course of their treatment, 59 PwMS participated in semi-structured individual or group interviews. The analyses show that the participants’ experienced outcomes can be classified in four ways 1) short-term positive outcomes; 2) long...
Werneke, Ursula; McCready, V.Ralph
Complementary alternative medicines (CAMs), including food supplements, are taken widely by patients, especially those with cancer. Others take CAMs hoping to improve fitness or prevent disease. Physicians (and patients) may not be aware of the potential side-effects and interactions of CAMs with conventional treatment. Likewise, their known physiological effects could interfere with radiopharmaceutical kinetics, producing abnormal treatment responses and diagnostic results. Nuclear medicine physicians are encouraged to question patients on their intake of CAMs when taking their history prior to radionuclide therapy or diagnosis. The potential effect of CAMs should be considered when unexpected therapeutic or diagnostic results are found. (orig.)
... the investigation of CAM. Contributors draw upon their own CAM research work and experience to explain and review a range of methods and research issues pertinent to the contemporary of CAM and its future development, such as: ﬁeld * * * * * the issues facing practitioners who wish to conduct research; how and why qualitative methods should...
Although insufficiently studied, schools of complementary and alternative medicine (CAM) provide substantial insight into the transformation of medicine in the United States. Scholars have suggested that the increasing acceptance of CAM is due to its alignment with biomedical models of professionalization, education, research, and practice. At West Coast University, students of acupuncture and Oriental medicine learn to straddle both Western and Eastern medical worlds through an increasingly science-oriented curriculum and the inculcation of professional values associated with West Coast University's emphasis upon integration with Western medicine as a means of achieving professional status and legitimacy vis-à-vis the dominant biomedical paradigm. The implications of integration with biomedicine for the identity of Chinese medicine are discussed: from the perspective of critical medical anthropology, integration reproduces biomedical hegemony; paving the way toward co-optation of Chinese medicine, the subordination of its practitioners, and, ultimately, the constraint of medical pluralism in the United States.
Cant, Sarah; Watts, Peter; Ruston, Annmarie
This qualitative interview study examined the use of complementary and alternative medicine (CAM) by nurses and midwives in NHS hospital settings in 2008 in the UK. It showed that the groundswell of interest in CAM in the 1990s had diminished by this time due to changes to policy and funding, and increasingly stringent clinical governance. Nevertheless, CAM provided an opportunity for committed and self-motivated practitioners to extend their therapeutic repertoire and develop affective dimensions of practice. However, the integration of CAM did not afford the autonomy, status and material gains traditionally associated with a collective professional project. In practice, occupational strategies were individualistic, and grounded in the assertion of competency through expressions of professionalism rather than the credentialism which underpins classic professionalisation. Central to these strategies was CAM related risk, which became a means by which to claim occupational space. However, the extent to which the adoption of CAM enhanced the nurses' and midwives' roles was limited by traditional medical authority; the uncertain status of CAM knowledge; and the absence of collective strategies - which together often left practitioners in a position of vulnerability. Copyright © 2011 Elsevier Ltd. All rights reserved.
Tonob, Dunia; Melby, Melissa K
Complementary and alternative medicine (CAM) is widely used for menopause, although not all women disclose use to their healthcare providers. This narrative review aims to expand providers' understanding of cross-cultural approaches to treating and managing menopause by providing an overarching framework and perspective on CAM treatments. Increased provider understanding and awareness may improve not only provider-patient communication but also effectiveness of treatments. The distinction between illness (what patients suffer) and disease (what physicians treat) highlights the gap between what patients seek and doctors provide, and may help clarify why many women seek CAM at menopause. For example, CAM is often sought by women for whom biomedicine has been unsuccessful or inaccessible. We review the relevance to menopause of three CAM categories: natural products, mind-body practices including meditation, and other complementary health approaches including traditional Chinese medicine (TCM) and Japanese Kampo. Assessing the effectiveness of CAM is challenging because of the individualized nature of illness patterns and associated treatments, which complicate the design of randomized controlled trials. Because many women seek CAM due to inefficacy of biomedical treatments, or cultural or economic marginalization, biomedical practitioners who make an effort to learn about CAM and ask patients about their CAM use or interest may dramatically improve the patient-provider relationship and rapport, as well as harnessing the 'meaning response' (Moerman, 2002) imbued in the clinical encounter. By working with women to integrate their CAM-related health-seeking behaviors and treatments, providers may also boost the efficacy of their own biomedical treatments. Copyright © 2017 Elsevier B.V. All rights reserved.
Münstedt, Karsten; Brenken, Anja; Kalder, Matthias
Our earlier study on complementary and alternative medicine (CAM) methods showed that acupuncture, homeopathy, and aromatherapy are available in most obstetrics departments in Germany but it did not evaluate the clinical indications for using CAM. The present study aimed to explore further the effectiveness of CAM use in obstetrics. We sent all departments of obstetrics in North Rhine-Westphalia a questionnaire designed to delineate their use of acupuncture, homeopathy, and aromatherapy during childbirth. It sought details on who provided the CAM therapy (midwife or physician). We asked respondents to indicate on a five-point scale how reasonable or otherwise they would consider the provision of CAM in each of six common problem situations and to estimate for each the proportion of patients given the CAM treatment. Respondents were also asked about the rationale for offering CAM, quality assurance and side effects. Spearman's bivariate correlation, cross-tabulation and Pearson's chi(2) test were used for statistical analysis. About 73.4% (138/187) of the departments responded. Acupuncture and homoeopathy were most widely used. Although obstetricians are responsible for patient care, decisions to provide CAM were largely taken by midwives, and the midwives' belief in the methods' effectiveness and patient demand were the principle motivating factors. Rates of CAM use in the six problem scenarios evaluated were directly related to practitioners' perceptions of the methods' therapeutic effectiveness. CAM methods were widely offered despite the lack of evidence of effectiveness or information on adverse consequences. In Germany, including CAM in the mandatory national quality assurance measures and perinatal surveys would provide valuable information; CAM use elsewhere merits further study.
Sarmiento, Iván; Zuluaga, Germán; Andersson, Neil
Objectives Examine factors associated with use of traditional medicine during childbirth and in management of childhood diarrhoea. Design Cross-sectional cluster survey, household interviews in a stratified last stage random sample of 90 census enumeration areas; unstructured interviews with traditional doctors. Setting Oil-rich Cross River State in south-eastern Nigeria has 3.5 million residents, most of whom depend on a subsistence agriculture economy. Participants 8089 women aged 15–49 years in 7685 households reported on the health of 11 305 children aged 0–36 months in July–August 2011. Primary and secondary outcome measures Traditional medicine used at childbirth and for management of childhood diarrhoea; covariates included access to Western medicine and education, economic conditions, engagement with the modern state and family relations. Cluster-adjusted analysis relied on the Mantel-Haenszel procedure and Mantel extension. Results 24.1% (1371/5686) of women reported using traditional medicine at childbirth; these women had less education, accessed antenatal care less, experienced more family violence and were less likely to have birth certificates for their children. 11.3% (615/5425) of young children with diarrhoea were taken to traditional medical practitioners; these children were less likely to receive BCG, to have birth certificates, to live in households with a more educated head, or to use fuel other than charcoal for cooking. Education showed a gradient with decreasing use of traditional medicine for childbirth (χ2 135.2) and for childhood diarrhoea (χ2 77.2). Conclusions Use of traditional medicine is associated with several factors related to cultural transition and to health status, with formal education playing a prominent role. Any assessment of the effectiveness of traditional medicine should anticipate confounding by these factors, which are widely recognised to affect health in their own right. PMID:27094939
Sarmiento, Iván; Zuluaga, Germán; Andersson, Neil
Examine factors associated with use of traditional medicine during childbirth and in management of childhood diarrhoea. Cross-sectional cluster survey, household interviews in a stratified last stage random sample of 90 census enumeration areas; unstructured interviews with traditional doctors. Oil-rich Cross River State in south-eastern Nigeria has 3.5 million residents, most of whom depend on a subsistence agriculture economy. 8089 women aged 15-49 years in 7685 households reported on the health of 11,305 children aged 0-36 months in July-August 2011. Traditional medicine used at childbirth and for management of childhood diarrhoea; covariates included access to Western medicine and education, economic conditions, engagement with the modern state and family relations. Cluster-adjusted analysis relied on the Mantel-Haenszel procedure and Mantel extension. 24.1% (1371/5686) of women reported using traditional medicine at childbirth; these women had less education, accessed antenatal care less, experienced more family violence and were less likely to have birth certificates for their children. 11.3% (615/5425) of young children with diarrhoea were taken to traditional medical practitioners; these children were less likely to receive BCG, to have birth certificates, to live in households with a more educated head, or to use fuel other than charcoal for cooking. Education showed a gradient with decreasing use of traditional medicine for childbirth (χ(2) 135.2) and for childhood diarrhoea (χ(2) 77.2). Use of traditional medicine is associated with several factors related to cultural transition and to health status, with formal education playing a prominent role. Any assessment of the effectiveness of traditional medicine should anticipate confounding by these factors, which are widely recognised to affect health in their own right. 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/
Ndao-Brumblay, S Khady; Green, Carmen R
We used Andersen's behavioral model of healthcare utilization to assess the relationship between sociodemographic, physical and psychosocial factors, and Complementary and Alternative Medicine (CAM) use among chronic pain patients. Three practitioner-based alternative therapies were considered: acupuncture, biofeedback/relaxation training, and manipulation services. A retrospective analysis of self-reported clinical data with 5,750 black and white adults presenting for initial assessment between 1994 and 2000 at the University of Michigan Multidisciplinary Pain Center was performed. CAM therapies were used in high frequencies, with 34.7% users. Specifically 8.3% used acupuncture, 13.0% used biofeedback/relaxation, and 24.9% used manipulation techniques. Race and age were predisposing factors associated with CAM use. Blacks used less biofeedback/relaxation and manipulation services than whites. Aging was related to more acupuncture, but less biofeedback/relaxation use. Women marginally used more biofeedback/relaxation services than men, and education was positively associated with all three CAM use. Perceived pain control was a consistent enabling factor positively correlated with the use of all three CAM services. Among need factors, pain characteristics and physical health were positively associated with at least one of the modalities. Depressive symptoms were not related to CAM services use. This study identifies variable patterns of CAM usage based on sociodemographic and health factors in chronic pain patients. Overall, who uses CAM depends on the modality; however, education, pain severity, and pain duration are persistent correlates of CAM usage regardless of the therapy considered. We found that mental health, as measured by depressive symptoms, had no noticeable impact on CAM usage among chronic pain patients. The clinical, policy, and research implications of CAM use are discussed.
... C Research. Information. Outreach. The Office of Cancer Complementary and Alternative Medicine (OCCAM) was established in October 1998 to coordinate ... National Cancer Institute (NCI) in the arena of complementary and alternative medicine (CAM). More about us. CAM at the NCI ...
Leach, Matthew J; Tucker, Basil
Research plays an important role in advancing health and healthcare. However, much research evidence is not reflected in contemporary complementary and alternative medicine (CAM) practice. Understanding and addressing the reasons for this research-practice gap may have positive implications for quality of care. To shed light on the gap between research and CAM practice. Descriptive cross-sectional, mixed-method study. A total of 126 senior CAM academics across Australasia, Europe, UK, and North America. Participants completed a 30-item online survey and a semi-structured interview; both of which explored the research-practice gap in CAM. A total of 43 (34%) academics completed the survey, with 29 (67%) respondents undergoing an interview. There was general agreement among respondents that CAM research should be informed by practice, and practice informed by research; however, most agreed that this did not reflect the current situation. Translational issues were perceived to be the primary reason for the research-practice gap in CAM. Suggested strategies for closing the gap focussed mostly around improving CAM student/practitioner education and training, and researcher-practitioner engagement and collaboration. Study findings point toward the presence of a research-practice gap in CAM, with several factors likely to be instrumental in sustaining this gap. Attention now needs to focus on understanding the views of CAM clinicians on this issue. Insights gained from this research will help inform the development of a multi-modal strategy that will effectively target the barriers to change in order to bring CAM research and practice closer together. Copyright © 2017 Elsevier Inc. All rights reserved.
D'Amico, Richard A; Saltz, Renato; Rohrich, Rod J; Kinney, Brian; Haeck, Phillip; Gold, Alan H; Singer, Robert; Jewell, Mark L; Eaves, Felmont
The American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery launched a joint Cosmetic Medicine Task Force to address the growing trend of non-plastic surgeons entering the cosmetic medicine field. The task force commissioned two surveys in 2007 to determine consumer attitudes about choosing cosmetic medicine providers and to learn about the cosmetic services that plastic surgeons offer. The first survey obtained responses from 1015 women who had undergone a cosmetic procedure or were considering having one within 2 years. The second survey obtained responses from 260 members of the two societies. Compared with other practitioners, plastic surgeons enjoy higher rates of satisfaction among their patients who undergo noninvasive procedures. Injectables present a particularly promising market for plastic surgeons. Half of consumers surveyed said they were very concerned about complications associated with injectables, and generally, the higher the perceived risk of the procedure, the higher the likelihood that a patient would choose a plastic surgeon to perform it. In addition, injectables were among the noninvasive treatments most frequently being considered by consumers. However, almost half of consumers said that if they had a positive experience with a non-plastic surgeon core provider for a noninvasive procedure, that physician would likely be their first choice for a surgical procedure. These findings suggest that plastic surgeons, and especially those who are building young practices, must expand their offerings of nonsurgical cosmetic services to remain at the core of the cosmetic medicine field.
Brett, Jennifer; Brimhall, Joseph; Healey, Dale; Pfeifer, Joseph; Prenguber, Marcia
This review examines the educational accreditation standards of four licensed complementary and alternative medicine (CAM) disciplines (naturopathic medicine, chiropractic health care, acupuncture and oriental medicine, and massage therapy), and identifies public health and other competencies found in those standards that contribute to cooperation and collaboration among the health care professions. These competencies may form a foundation for interprofessional education. The agencies that accredit the educational programs for each of these disciplines are individually recognized by the United States Department (Secretary) of Education. Patients and the public are served when healthcare practitioners collaborate and cooperate. This is facilitated when those practitioners possess competencies that provide them the knowledge and skills to work with practitioners from other fields and disciplines. Educational accreditation standards provide a framework for the delivery of these competencies. Requiring these competencies through accreditation standards ensures that practitioners are trained to optimally function in integrative clinical care settings. © 2013 Elsevier Inc. All rights reserved.
Bishop, Felicity L; Amos, Nicola; Yu, He; Lewith, George T
The aim was to identify similarities and differences between private practice and the National Health Service (NHS) in practitioners' experiences of delivering acupuncture to treat pain. We wished to identify differences that could affect patients' experiences and inform our understanding of how trials conducted in private clinics relate to NHS clinical practice. Acupuncture is commonly used in primary care for lower back pain and is recommended in the National Institute for Health and Clinical Excellence's guidelines. Previous studies have identified differences in patients' accounts of receiving acupuncture in the NHS and in the private sector. The major recent UK trial of acupuncture for back pain was conducted in the private sector. Semi-structured qualitative interviews were conducted with 16 acupuncturists who had experience of working in the private sector (n = 7), in the NHS (n =3), and in both the sectors (n = 6). The interviews lasted between 24 and 77 min (median=49 min) and explored acupuncturists' experiences of treating patients in pain. Inductive thematic analysis was used to identify similarities and differences across private practice and the NHS. The perceived effectiveness of acupuncture was described consistently and participants felt they did (or would) deliver acupuncture similarly in NHS and in private practice. In both the sectors, patients sought acupuncture as a last resort and acupuncturist-patient relationships were deemed important. Acupuncture availability differed across sectors: in the NHS it was constrained by Trust policies and in the private sector by patients' financial resources. There were greater opportunities for autonomous practice in the private sector and regulation was important for different reasons in each sector. In general, NHS practitioners had Western-focussed training and also used conventional medical techniques, whereas private practitioners were more likely to have Traditional Chinese training and to practise
Ford, Emily; Solomon, Daniela; Adams, Jon; Graves, Nicholas
For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities.In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making. Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers. Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM.
Background For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities. In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making. Methods Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers. Conclusions Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM. PMID:21067622
Full Text Available Abstract Background For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities. In a world of scarce health care resources and an emphasis on efficiency and clinical efficacy, CAM, as indeed do all other treatments, requires rigorous evaluation to be considered in budget decision-making. Methods Economic evaluation provides the tools to measure the costs and health consequences of CAM interventions and thereby inform decision making. This article offers CAM researchers an introductory framework for understanding, undertaking and disseminating economic evaluation. The types of economic evaluation available for the study of CAM are discussed, and decision modelling is introduced as a method for economic evaluation with much potential for use in CAM. Two types of decision models are introduced, decision trees and Markov models, along with a worked example of how each method is used to examine costs and health consequences. This is followed by a discussion of how this information is used by decision makers. Conclusions Undoubtedly, economic evaluation methods form an important part of health care decision making. Without formal training it can seem a daunting task to consider economic evaluation, however, multidisciplinary teams provide an opportunity for health economists, CAM practitioners and other interested researchers, to work together to further develop the economic evaluation of CAM.
Kirby, Emma R; Broom, Alex F; Adams, Jon; Sibbritt, David W; Refshauge, Kathryn M
Back pain is an increasingly prevalent health concern amongst Australian women for which a wide range of treatment options are available, offered by biomedical, allied health and complementary and alternative medicine (CAM) providers. Although there is an emerging literature on patterns of provider utilisation, less is known about the reasons why women with back pain select their chosen practitioner. In this paper we explore the influences on back pain sufferers' decision-making about treatment seeking with practitioners for their most recent episode of back pain. Drawing on 50 semi-structured interviews with women aged 60-65 years from the Australian Longitudinal Study on Women's Health (ALSWH) who have chronic back pain, we focus on the factors which influence their choice of practitioner. Analysis followed a framework approach to qualitative content analysis, augmented by NVivo 9 qualitative data analysis software. Key themes were identified and tested for rigour through inter-rater reliability and constant comparison. The women identified four predominant influences on their choice of practitioner for back pain: familiarity with treatment or experiences with individual practitioners; recommendations from social networks; geographical proximity of practitioners; and, qualifications and credentials of practitioners. The therapeutic approach or evidence-base of the practices being utilised was not reported by the women as central to their back pain treatment decision making. Choice of practitioner appears to be unrelated to the therapeutic approaches, treatment practices or the scientific basis of therapeutic practices. Moreover, anecdotal lay reports of effectiveness and the 'treatment experience' may be more influential than formal qualifications in guiding women's choice of practitioner for their back pain. Further work is needed on the interpersonal, collective and subjective underpinnings of practitioner choice, particularly over time, in order to better
Seraj, Syeda; Jahan, Farhana Israt; Chowdhury, Anita Rani; Monjur-Ekhuda, Mohammad; Khan, Mohammad Shamiul Hasan; Aporna, Sadia Afrin; Jahan, Rownak; Samarrai, Walied; Islam, Farhana; Khatun, Zubaida; Rahmatullah, Mohammed
The Bedes form one of the largest tribal or indigenous communities in Bangladesh and are popularly known as the boat people or water gypsies because of their preference for living in boats. They travel almost throughout the whole year by boats on the numerous waterways of Bangladesh and earn their livelihood by selling sundry items, performing jugglery acts, catching snakes, and treating village people by the various riversides with their traditional medicinal formulations. Life is hard for the community, and both men and women toil day long. As a result of their strenuous lifestyle, they suffer from various types of pain, and have developed an assortment of formulations for treatment of pain in different parts of the body. Pain is the most common reason for physician consultation in all parts of the world including Bangladesh. Although a number of drugs are available to treat pain, including non-steroidal, steroidal, and narcotic drugs, such drugs usually have side-effects like causing bleeding in the stomach over prolonged use (as in the case of rheumatic pain), or can be addictive. Moreover, pain arising from causes like rheumatism has no proper treatment in allopathic medicine. It was the objective of the present study to document the formulations used by the Bede traditional practitioners for pain treatment, for they claim to have used these formulations over centuries with success. Surveys were conducted among a large Bede community, who reside in boats on the Bangshi River by Porabari village of Savar area in Dhaka district of Bangladesh. Interviews of 30 traditional practitioners were conducted with the help of a semi-structured questionnaire and the guided field-walk method. It was observed that the Bede practitioners used 53 formulations for treatment of various types of pain, the main ingredient of all formulations being medicinal plants. Out of the 53 formulations, 25 were for treatment of rheumatic pain, either exclusively, or along with other types of
Popper-Giveon, Ariela; Schiff, Elad; Ben-Arye, Eran
Complementary and traditional medicine (CTM) plays an important role in culture-centered care for cancer patients in the Middle East. In this article, we have studied the attitudes of Arab CTM therapists concerning integration of complementary medicine within the conventional supportive cancer care of Arab patients in northern Israel. Semistructured interviews were held with 27 Arab therapists who use medicinal herbs, the Quran, and various CTM modalities, with the aim of characterizing their treatment practices and learning about their perspectives regarding conventional cancer care. We first summarized the different characteristics of the various CTM therapists, including training, typical practice, and so on. Thematic analysis revealed that folk healers and complementary medicine therapists describe their role as supportive and secondary to that of physicians. Their goal was not to cure patients with cancer but rather to enhance their quality of life by reducing the severity of both the disease symptoms and the side effects of cancer treatment. Religious healers, by contrast, purport to cure the disease. While folk healers opt for parallel alternative care and complementary therapists support integrative care, religious healers claimed that they offer an alternative to conventional medicine in terms of both etiology and practice. The majority of Arab CTM therapists support integration of their treatments with the conventional system, but in practice, they are not sure how to bring about this change or create a parallel model in which 2 different systems are active, but not integrated. Our findings emphasized the need to promote doctor-CTM practitioner communication based on structured referral and bidirectional consultation. Moreover, we recommend intensifying research on the efficacy and safety of CTM in the Middle East and the potential role in promoting culture-based supportive care.
Manderson, Lenore; Oldenburg, Brian; Lin, Vivian
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...
Wubetu, Muluken; Abula, Tefera; Dejenu, Getye
One of the services that plants provide for human beings is their wider medicinal application. Although it is not fully assessed, the practice and wider use of traditional medicine is frequent in Ethiopia. Studies conducted previously are confined to the perceptions of modern and traditional health practitioners about traditional medicine. A total of 45 informants were selected purposefully from the study area. For collecting the data, semi-structured interviewees, observation and field walks were employed from August 10 to September 30/2014. To summarize the information, descriptive statistical methods were applied. Sixty species of medicinal plants distributed in 42 families were collected and identified applied locally for the treatment of 55 human disorders. The most commonly treated ones were evil eye, malaria, wound, peptic ulcer disease and rabies. According to this study, leaves were the commonly used plant parts (36.5%) and 39% of the preparations were decoctions. Oral route, 43 (44%) was the commonly used route of application whereas most (54.8%) remedies were administered only once. Fourteen percent of preparations caused vomiting in addition most (40.4%) of the formulations was contraindicated for pregnant patients. Only seventeen percent of the formulations possessed drug food interactions. Most preparations were stored within clothes, 31 (29.8%). There exists a high (ICF = 0.8) evenness of plant use among healers for treating respiratory problems. Alliumsativum (FI = 0.75) for evil eye, Phytolacca dodecandra (FI = 0.8) for rabies and Croton macrostachyus (FI = 0.78) for treating malaria were medicinal plants with highest fidelity levels showing consistency of knowledge on species best treating power. This study also documented that drought, overgrazing and firewood collection are major threats. Dega Damot district is loaded in its medicinal plant diversity and indigenous knowledge though plants are highly affected by drought, overgrazing and
Recent studies indicate increased use of complementary and alternative medicine (CAM) in western societies, to ameliorate health problems. Even if there is substantial research on general patterns of use, there is limited knowledge on individual motives. This study contributes to a qualitative understanding of experiences of choosing and using CAM. This study consists of in-depth interviews with 10 CAM users in Sweden. The participants represent different backgrounds and experiences of using CAM. The interviews have been analysed in accordance with content analysis. In analysing experiences of choosing and using CAM four main themes were identified: frustration and critique, values and ideology, individual responsibility, and combining treatments. In general, the participants were highly reflexive on issues concerning their health. They highlighted their own role and responsibility, combined a variety of treatments, and continuously dealt with questions on risks, even if they had relatively different approaches to if and when to use CAM. The results also show that motives may change over time. Even if initial choices were closely related to frustration and critique of conventional treatments (for example, by perceiving conventional health care as limited, not receiving proper diagnoses, or being critical to conventional drugs) was long-term use motivated by ideological characteristics of CAM (such as holistic and individualized treatments, and extensive interaction with practitioners). Four main themes, concerning experiences of choosing and using CAM were identified. This study also supports the idea that initial motives for choosing CAM may differ from those explaining long-term use. Significance for public healthRecent studies indicate increased use of complementary and alternative medicine (CAM), both in general western populations and specific patient groups. Well-documented motives for choosing CAM are related to disappointment and failure of conventional
Full Text Available Abstract Background People's trust in health care and health care professionals is essential for the effectiveness of health care, especially for chronically ill people, since chronic diseases are by definition (partly incurable. Therefore, it may be understandable that chronically ill people turn to complementary and alternative medicine (CAM, often in addition to regular care. Chronically ill people use CAM two to five times more often than non-chronically ill people. The trust of chronically ill people in health care and health care professionals and the relationship of this with CAM use have not been reported until now. In this study, we examine the influence of chronically ill people's trust in health care and health care professionals on CAM use. Methods The present sample comprises respondents of the 'Panel of Patients with Chronic Diseases' (PPCD. Patients (≥25 years were selected by GPs. A total of 1,625 chronically ill people were included. Trust and CAM use was measured by a written questionnaire. Statistical analyses were t tests for independent samples, Chi-square and one-way analysis of variance, and logistic regression analysis. Results Chronically ill people have a relatively low level of trust in future health care. They trust certified alternative practitioners less than regular health care professionals, and non-certified alternative practitioners less still. The less trust patients have in future health care, the more they will be inclined to use CAM, when controlling for socio-demographic and disease characteristics. Conclusion Trust in future health care is a significant predictor of CAM use. Chronically ill people's use of CAM may increase in the near future. Health policy makers should, therefore, be alert to the quality of practising alternative practitioners, for example by insisting on professional certification. Equally, good quality may increase people's trust in public health care.
Report on short course in educational methodology for university teachers in complementary and alternative medicine (CAM) disciplines - a pilot study conducted at Rajiv Gandhi University of Health Sciences, Karnataka, India.
Munir, Ahmed R; Prem, Kumar D
There is a growing awareness among teachers in the complementary and alternative medicine (CAM) disciplines that a formal training in educational methodology can improve their performance as teachers and student evaluators. The Training of Trainers programs conducted by Rajiv Gandhi University of Health Sciences, Karnataka, in the previous years have brought about a transformation among the teachers who attended those programs. Also the teachers were witness to a changing perception among students towards teachers who adapt innovative teaching/assessment strategies. This report illustrates an innovative training activity that was adapted to design a reference model that can be developed as an operational model for large-scale execution. Teachers who are under the affiliated CAM Institutions in Rajiv Gandhi University of Health Sciences, Karnataka, participated in a three-month 'Short Course in Educational Methodology'. This program was delivered on distance learning mode. The course was organised into four modules. Study material was provided for each of the module in the form of a study guide and related reference articles in electronic form. There were three contact programs - Induction and Introduction that also addressed overview of entire course and the subject matter of Module 1, and this was at the beginning of the course, first contact program to address the learner needs of Modules 2 and 3 and second contact program for the contents in Module 4. The participants were engaged during the entire course duration with interactive contact programs, self-study and application of concepts in their teaching/assessment practices, submission of assignments online, and microteaching presentation and peer review. The documentation and raw data generated during the course of training were used to generate an operational model for training of university teachers of health sciences faculty in general and teachers of CAM disciplines in particular. Establishing a model of
Hubbert, Ann O
The paper presents a historically unique partnership between an American Southwestern, Catholic faith-based, urban hospital and a program it sponsored on the spirituality of American Indian Traditional Indian Medicine (TIM) by a Comanche medicine man. A discussion is offered on the cultural partnerships, experiences and benefits achieved through the cultural accommodations of these spiritual beliefs and practices within this healthcare system. The theory of Culture Care Diversity and Universality (Culture Care Theory), including the Sunrise Enabler, is applied in discussion of these past experiences to explore the relationships among and between the participating cultures. The intent of the partnerships within this program was not to 'learn Indian healing ceremonies' but to share the philosophy of TIM with all people (clients and professionals) as a means to enhance their own way of living. Examples of actual nursing decisions and actions are provided including outcomes from the program within the healthcare system and globally.
Herman, Patricia M; Coulter, Ian D
The purpose of this project was to examine the policy implications of politically defining complementary and alternative medicine (CAM) professions by their treatment modalities rather than by their full professional scope. This study used a 2-stage exploratory grounded approach. In stage 1, we identified how CAM is represented (if considered as professions vs modalities) across a purposely sampled diverse set of policy topic domains using exemplars to describe and summarize each. In stage 2 we convened 2 stakeholder panels (12 CAM practitioners and 9 health policymaker representatives), and using the results of stage 1 as a starting point and framing mechanism, we engaged panelists in a discussion of how they each see the dichotomy and its impacts. Our discussion focused on 4 licensed CAM professions: acupuncture and Oriental medicine, chiropractic, naturopathic medicine, and massage. Workforce policies affected where and how members of CAM professions could practice. Licensure affected whether a CAM profession was recognized in a state and which modalities were allowed. Complementary and alternative medicine research examined the effectiveness of procedures and modalities and only rarely the effectiveness of care from a particular profession. Treatment guidelines are based on research and also focus on procedures and modalities. Health plan reimbursement policies address which professions are covered and for which procedures/modalities and conditions. The policy landscape related to CAM professions and modalities is broad, complex, and interrelated. Although health plan reimbursement tends to receive the majority of attention when CAM health care policy is discussed, it is clear, given the results of our study, that coverage policies cannot be addressed in isolation and that a wide range of stakeholders and social institutions will need to be involved. Copyright © 2016. Published by Elsevier Inc.
van Staden, Anna Maria; Joubert, Georgina B A
Healthcare systems worldwide are changing and the use of complementary, alternative and traditional medicine (CAM) form part of this transformation. South Africa has a large number of CAM practitioners, but they are not included in the official healthcare system. The aim of this study was to determine the perception and usage of CAM among the academic and administrative staff of the University of the Free State (UFS) in Bloemfontein, South Africa. A questionnaire was compiled and sent electronically to all the academic and administrative staff of the UFS who had a university email address, to be completed online. The response rate was 5.5%, with most of the respondents from the Faculty of Health Sciences. The respondents (n=165) were mainly women of 41-60 years of age with more than one tertiary qualification. Most of the respondents were in good health and considered CAM as moderately helpful and mostly safe. Most of the CAM recommendations were not from a medical physician. The respondents wanted alternatives to certain medications, such as antibiotics. They also had good previous experience with CAM and felt that conventional treatment was not always effective to treat their problems. They identified a need for CAM in the health system. The study has limitations due to the data collection method and the low response rate. The results showed that the respondents favored a more integrated healthcare system including different CAM therapies, and that conventional doctors should be better informed about these therapies and its uses.
Full Text Available Science Translational Medicine’s mission is to improve human health care worldwide by providing a forum for communication and interdisciplinary idea exchange between basic scientists and clinical research practitioners from all relevant established and emerging disciplines. The weekly journal debuted in October 2009 and is published by the American Association for the Advancement of Science (AAAS, the publisher of Science and Science Signaling. The journal features peer-reviewed research articles, perspectives and commentary, and is guided by an international Advisory Board, led by Chief Scientific Adviser, Elias A. Zerhouni, M.D., former Director of the National Institutes of Health, and Senior Scientific Adviser, Elazer R. Edelman, M.D., Ph.D., Thomas D. and Virginia W. Cabot Professor of Health Sciences and Technology, Massachusetts Institute of Technology. The Science Translational Medicine editorial team is led by Katrina L. Kelner, Ph.D., AAAS. A profound transition is required for the science of translational medicine. Despite 50 years of advances in our fundamental understanding of human biology and the emergence of powerful new technologies, the rapid transformation of this knowledge into effective health measures is not keeping pace with the challenges of global health care. Creative experimental approaches, novel technologies, and new ways of conducting scientific explorations at the interface of established and emerging disciplines are now required to an unprecedented degree if real progress is to be made. To aid in this reinvention, Science and AAAS have created a new interdisciplinary journal, Science Translational Medicine. The following interview exemplefies the pioneering content found in Science Translational Medicine. It is an excerpt from a Podcast interview with Dr. Samuel Broder, former director of the National Cancer Institute and current Chief Medical Officer at Celera. The Podcast was produced in tangent with Dr
Eaves, Emery R; Sherman, Karen J; Ritenbaugh, Cheryl; Hsu, Clarissa; Nichter, Mark; Turner, Judith A; Cherkin, Daniel C
The relationship between patient expectations about a treatment and the treatment outcomes, particularly for Complementary and Alternative Medicine (CAM) therapies, is not well understood. Using qualitative data from a larger study to develop a valid expectancy questionnaire for use with participants starting new CAM therapies, we examined how participants' expectations of treatment changed over the course of a therapy. We conducted semi-structured qualitative interviews with 64 participants initiating one of four CAM therapies (yoga, chiropractic, acupuncture, massage) for chronic low back pain. Participants just starting treatment were interviewed up to three times over a period of 3 months. Interviews were transcribed verbatim and analyzed using a qualitative mixed methods approach incorporating immersion/crystallization and matrix analysis for a decontexualization and recontextualization approach to understand changes in thematic emphasis over time. Pre-treatment expectations consisted of conjecture about whether or not the CAM therapy could relieve pain and improve participation in meaningful activities. Expectations tended to shift over the course of treatment to be more inclusive of broader lifestyle factors, the need for long-term pain management strategies and attention to long-term quality of life and wellness. Although a shift toward greater acceptance of chronic pain and the need for strategies to keep pain from flaring was observed across participants regardless of therapy, participants varied in their assessments of whether increased awareness of the need for ongoing self-care and maintenance strategies was considered a "positive outcome". Regardless of how participants evaluated the outcome of treatment, participants from all four therapies reported increased awareness, acceptance of the chronic nature of pain, and attention to the need to take responsibility for their own health. The shift in treatment expectations to greater acceptance of pain and
Participants. 463 completed surveys were returned, representing a 58% response rate. Results. The majority of GPs had a positive attitude about incorporating CMs in their clinical practice; however, only 12% perceived they had adequate knowledge to be able to advise patients about CMs. GPs most preferred evidence-based resources for receiving information on CMs (fact sheets, booklets, and journals that contain clinical, pharmacological, and toxicological information. Most GPs perceived a need for an information resource on herbal medicines, vitamins, minerals, and trace elements, and nutritional supplements. Conclusion. GPs are open to integrating CMs into their clinical practice. They identify a current lack of knowledge coupled with a substantive level of interest to learn more. GPs perceive a high level of need for information resources on CMs. These resources should be developed and readily available to GPs to increase their knowledge about CMs and better equip them in communicating with patients about CMs use.
Full Text Available This commentary offers a future health care provider's perspective on the role of complementary and alternative medicine (CAM in Western (namely, in US medical education and practice. As a student of both public health and medicine in the United States, Jeffrey Ghassemi is interested in CAM's contribution to improving medical practice and teaching. The commentary highlights the ambiguous definitions of CAM to Westerners despite the rising popularity of and expenditures for alternative modalities of care. It then argues for collaboration between alternative and established medical communities to ascertain the scientific merits of CAM. It concludes by calling for a new medical paradigm that embraces the philosophies of both communities to advance education and patient care.
Recent policy and organisational changes within UK primary care have emphasised graduated access to care, speed of access to the first available general practitioner (GP) and care being provided by a range of healthcare professionals. These trends have been strengthened by the current GP contract and Quality and Outcomes Framework (QOF). Concern has been expressed that the potential for personal care is being diminished as a result and that this will reduce quality standards. This paper presents data from a study that explored with patients and GPs what personal care means and whether it has continuing importance to them. A semi-structured questionnaire was used to interview participants and Framework Analysis supported analysis of emerging themes. Twenty-nine patients, mainly women with young children, and twenty-three GPs were interviewed from seven practices in Lothian, Scotland, ranged by practice size and relative deprivation score. Personal care was defined mainly, though not exclusively, as care given within the context of a continuing relationship in which there is an interpersonal connection and the doctor adopts a particular consultation style. Defined in this way, it was reported to have benefits for both health outcomes and patients' experience of care. In particular, such care was thought to be beneficial in attending to the emotions that can be elicited when seeking and receiving health care and in enabling patients to be known by doctors as legitimate seekers of care from the health service. Its importance was described as being dependent upon the nature of the health problem and patients' wider familial and social circumstances. In particular, it was found to provide support to patients in their parenting and other familial caring roles. Personal care has continuing salience to patients and GPs in modern primary care in the UK. Patients equate the experience of care, not just outcomes, with high quality care. As it is mainly conceptualised and
Allam, Sahar S. [Fermilab; Tucker, Douglas L. [Fermilab
The Dark Energy Survey (DES) will be taking the next step in probing the properties of Dark Energy and in understanding the physics of cosmic acceleration. A step towards the photometric calibration of DES is to have a quick, bright survey in the DES footprint (PreCam), using a pre-production set of the Dark Energy Camera (DECam) CCDs and a set of 100 mm×100 mm DES filters. The objective of the PreCam Survey is to create a network of calibrated DES grizY standard stars that will be used for DES nightly calibrations and to improve the DES global relative calibrations. Here, we describe the first year of PreCam observation, results, and photometric calibrations.
Frass, Michael; Strassl, Robert Paul; Friehs, Helmut; Müllner, Michael; Kundi, Michael; Kaye, Alan D.
Background The interest in complementary and alternative medicine (CAM) has increased during the past decade and the attitude of the general public is mainly positive, but the debate about the clinical effectiveness of these therapies remains controversial among many medical professionals. Methods We conducted a systematic search of the existing literature utilizing different databases, including PubMed/Medline, PSYNDEX, and PsycLit, to research the use and acceptance of CAM among the general population and medical personnel. A special focus on CAM-referring literature was set by limiting the PubMed search to “Complementary Medicine” and adding two other search engines: CAMbase (www.cambase.de) and CAMRESEARCH (www.camresearch.net). These engines were used to reveal publications that at the time of the review were not indexed in PubMed. Results A total of 16 papers met the scope criteria. Prevalence rates of CAM in each of the included studies were between 5% and 74.8%. We found a higher utilization of homeopathy and acupuncture in German-speaking countries. Excluding any form of spiritual prayer, the data demonstrate that chiropractic manipulation, herbal medicine, massage, and homeopathy were the therapies most commonly used by the general population. We identified sex, age, and education as predictors of CAM utilization: More users were women, middle aged, and more educated. The ailments most often associated with CAM utilization included back pain or pathology, depression, insomnia, severe headache or migraine, and stomach or intestinal illnesses. Medical students were the most critical toward CAM. Compared to students of other professions (ie, nursing students: 44.7%, pharmacy students: 18.2%), medical students reported the least consultation with a CAM practitioner (10%). Conclusions The present data demonstrate an increase of CAM usage from 1990 through 2006 in all countries investigated. We found geographical differences, as well as differences between
Dowell, J; Norbury, M; Steven, K; Guthrie, B
Widening access to medicine in the UK is a recalcitrant problem of increasing political importance, with associated strong social justice arguments but without clear evidence of impact on service delivery. Evidence from the United States suggests that widening access may enhance care to underserved communities. Additionally, rural origin has been demonstrated to be the factor most strongly associated with rural practice. However the evidence regarding socio-economic and rural background and subsequent practice locations in the UK has not been explored. The aim of this study was to investigate the association between general practitioners' (GPs) socio-economic and rural background at application to medical school and demographic characteristics of their current practice. The study design was a cross-sectional email survey of general practitioners practising in Scotland. Socio-economic status of GPs at application to medical school was assessed using the self-coded National Statistics Socio-Economic Classification. UK postcode at application was used to define urban-rural location. Current practice deprivation and remoteness was measured using NHS Scotland defined measures based on registered patients' postcodes. A survey was sent to 2050 Scottish GPs with a valid accessible email address, with 801 (41.5 %) responding. GPs whose parents had semi-routine or routine occupations had 4.3 times the odds of working in a deprived practice compared to those with parents from managerial and professional occupations (95 % CI 1.8-10.2, p = 0.001). GPs from remote and rural Scottish backgrounds were more likely to work in remote Scottish practices, as were GPs originating from other UK countries. This study showed that childhood background is associated with the population GPs subsequently serve, implying that widening access may positively affect service delivery in addition to any social justice rationale. Longitudinal research is needed to explore this association and the
Berg, Oe.; Fantoni, P.; Iguchi, Y.; Meyer, G.; Soerensen, A.; Dyck, C. van.
CAMS (Computerized Accident Management Support) is a system being developed as a joint research activity at the Halden Reactor Project with additional financing from the Swedish Nuclear Inspectorate (SKI) and the Nordic NKS/RAK-2 project. Three types of users are envisaged: the staff in the control room, the staff in the technical support centre and the staff at a national emergency centre. It is still an experimental system. The Swedish Nuclear Inspectorate kindly accepted to test CAMS at a safety exercise on the 4th of May, 1995. CAMS is designed assuming automatic data transfer from the plant. Missing the data link, a simulator running in the next room was updated now and then with data received by phone. As seen from CAMS, it did not matter if the data came from a fake plant or from a real plant, except that the data were delayed. Overall, it seemed that CAMS can be a very important tool for a national authority. A data link from the plant would increase its usefulness. Several comments on design features were collected and will be used to improve the system. The model needs more inputs to control the main parameters, and a larger repertoire of fault conditions should be put into the model. In the second half of 1995 the work on CAMS has concentrated upon designing new modules for signal validation, tracking simulation and state identification. This will provide better capabilities for on-line monitoring and assessment of the plant state. Further, it has been proposed to introduce Probabilistic Safety Assessment (PSA) to assist in risk monitoring. A first prototype has been made on a personal computer showing the main features of such a PSA module. (au)
Gilmour, Joan; Harrison, Christine; Vohra, Sunita
Our goal for this supplemental issue of Pediatrics was to consider what practitioners, parents, patients, institutions, and policy-makers need to take into account to make good decisions about using complementary and alternative medicine (CAM) to treat children and to develop guidelines for appropriate use. We began by explaining underlying concepts and principles in ethical, legal, and clinical reasoning and then used case scenarios to explore how they apply and identify gaps that remain in practice and policy. In this concluding article, we review our major findings, summarize our recommendations, and suggest further research. We focus on several key areas: practitioner and patient/parent relationships; decision-making; dispute resolution; standards of practice; hospital/health facility policies; patient safety; education; and research. Ethical principles, standards, and rules applicable when making decisions about conventional care for children apply to decision-making about CAM as well. The same is true of legal reasoning. Although CAM use has seldom led to litigation, general legal principles relied on in cases involving conventional medical care provide the starting point for analysis. Similarly, with respect to clinical decision-making, clinicians are guided by clinical judgment and the best interests of their patient. Whether a therapy is CAM or conventional, clinicians must weigh the relative risks and benefits of therapeutic options and take into account their patient's values, beliefs, and preferences. Consequently, many of our observations apply to conventional and CAM care and to both adult and pediatric patients.
David R Walwyn
Full Text Available Background A large proportion of HIV positive South Africans regularly consult Traditional Health Practitioners (THPs for their healthcare needs, despite some evidence of negative interactions with antiretrovirals (ARVs and no published peer-reviewed clinical evidence for the efficacy of traditional medicines in the treatment of HIV. In this study, we investigated the dominant practices of THPs towards HIV positive patients and whether these practices have changed following widespread public awareness campaigns covering HIV and its treatment. Method The study used a semi-structured interviewer-administered questionnaire in the home language of the interviewee. A total of 52 THPs from four provinces (Gauteng, Limpopo, Kwazulu Natal and Eastern Cape were interviewed. 38% of the respondents were based in the rural areas, and 69% classified themselves as inyangas, with the remainder being sangomas. Findings All of the THPs in the survey offered treatment for HIV, although only 20% claimed to be able to cure the disease. 88% prepared their own medication, mostly from plant material, and sold their products as aqueous extracts in labelled bottles. None of these products had been systematically evaluated, and there was mostly no record keeping, either of the patient, or of the medicine itself. Quality control practices such as expiry dates, controlled storage conditions and batch records were totally unknown in our sample. Only 38% of the THPs had received training on HIV/AIDS although 75% believed that they were well informed about the disease. Our own assessment was that only 50% had a working knowledge of HIV; more disturbingly 37% believe that only traditional medicines should be used for the treatment of HIV and a further 50% believe that both traditional medicines and ARVs can be taken simultaneously. Interpretation Despite ongoing public educational campaigns on HIV, some of which have specifically targeted THPs, the care of HIV positive
Fisher, Carole; Adams, Jon; Hickman, Louise; Sibbritt, David
To assess the prevalence of cyclic perimenstrual pain and discomfort and to detail the pattern of complementary and alternative (CAM) use adopted by women for the treatment of these symptoms. Data from the 2012 national Australian Longitudinal Study of Women's Health (ALSWH) cross-sectional survey of 7427 women aged 34-39 years were analysed to estimate the prevalence of endometriosis, premenstrual syndrome (PMS), irregular or heavy periods and severe dysmenorrhoea and to examine the association between their symptoms and their visits to CAM practitioners as well as their use of CAM therapies and products in the previous 12 months. The prevalence of endometriosis was 3.7 % and of the perimenstrual symptoms assessed, PMS was most prevalent at 41.2 % whilst irregular bleeding (22.2 %), heavy periods (29.8 %) and severe period pain (24.1 %) were reported at lower levels. Women with endometriosis were more likely than non-sufferers to have consulted with a massage therapist or acupuncturist and to have used vitamins/minerals, yoga/meditation or Chinese medicines (p alternative health practitioner and to have used all forms of CAM therapies except Chinese medicines than women who had infrequent PMS (all p medicines, Chinese medicines and other alternative therapies compared to non-sufferers (all p effective use and to ascertain their significance as a treatment option enabling women with menstrual problems and their care providers to improve their quality of life.
Full Text Available Objectives: This study aimed to determine the knowledge levels and attitudes of School of Health and Vocational School of Health students toward complementary and alternative medicine (CAM. Methods: Three hundred thirty-three (333 students studying at the Mehmet Akif Ersoy University School of Health and the Golhisar Vocational School of Health in Burdur, Turkey, were included in the study. Research data were collected by using a survey method based on the expressed opinions of the participants. Results: Of the participants, 69.7% were female and 97% were single (unmarried. Of cigarette users and those with chronic illnesses, 46.8% and 47.8%, respectively, used CAM. Those using CAM were statistically more likely to be female (P < 0.021, to have higher grades (P < 0.007, to be single (P < 0.005, to be vocational school of health graduates (P < 0.008, and to have fathers at work (P < 0.021. While 9.6% of the students thought CAM to be nonsense, 10.8% thought that the methods of CAM should be tried before consulting a doctor. Conclusion: A majority of the students in the study population were found to use complementary and alternative medicine, but that they lacked information about its methods. As a way to address this, CAM should be included in the curriculum of schools that provide health education, and CAM training programs should be given to healthcare professionals to improve their knowledge of CAM. In Turkey, many more studies should be performed to determine nurses’ and doctors’ knowledge of and attitudes about CAM methods so that they can give correct guidance to society and take more active responsibility in improving patient safety.
Skovgaard, Lasse; Pedersen, Inge Kryger; Verhoef, Marja
Most users of complementary and alternative medicine (CAM) combine it with conventional medicine. Recent risk assessment studies have shown risks of negative interactions between CAM and conventional medicine, particularly when combining herbal medicine and conventional drug therapies (CDT). Little is known about the way users consider such risks. The present paper aims to gain knowledge about this issue by exploring views on risks of negative interactions when combining herbal medicine and CDT among people with multiple sclerosis (MS). This paper draws on a qualitative follow-up study on a survey among members of the Danish MS Society. Semi-structured, in-depth qualitative interviews were conducted with a strategic selection from the survey respondents. The study was inspired by a phenomenological approach and emerging themes were extracted from the data through meaning condensation. Four themes characterized the informants' views on risks of negative interactions when combining herbal medicine and CDT: 1) 'naturalness' in herbal medicine; 2) 'bodily sensations' as guidelines; 3) trust in the CAM practitioner; 4) lack of dialogue with medical doctor. Generally, the combination of herbal medicine and CDT was considered by the informants to be safe. In particular, they emphasized the 'non-chemical' nature of herbal medicine and of their own bodily sensations as warrants of safety. A trustful relation to the CAM practitioner furthermore made some of them feel safe in their use of herbal medicine and CDT in combination. The informants' use of bodily sensations as a non-discursive risk assessment may be a relevant element in understanding these issues.
Medicines can treat diseases and improve your health. If you are like most people, you need to take medicine at some point in your life. You may need to take medicine every day, or you may only need to ...
Bowe, Steven; Adams, Jon; Lui, Chi-Wai; Sibbritt, David
Complementary and alternative medicine (CAM) use is increasingly popular amongst general populations around the world with women constituting substantial CAM users. However, self-prescribed CAM use does raise potential safety concerns and so it is important to identify those risk factors associated with self-prescribed CAM use. Data was obtained from the Australian Longitudinal Study on Women's Health (ALSWH). Longitudinal data analyses were conducted on questionnaire data from the 1973-78 cohort (n=9,145) and the 1946-51 cohort (n=10,638), collected over the period 2006-2010. In the 1973-78 cohort, use of self-prescribed CAM was 73.2% in 2006 and 75.3% in 2009. For the 1946-51 cohort, use of self-prescribed CAM was 73.9% in 2007 and 74.7% in 2010. There were similar levels of use of individual self-prescribed CAM, with the exception that the use of herbal medicine was much higher among the 1946-51 cohort (20% vs. 27%). There was a substantial increase over three years in the use of vitamins/minerals in both cohorts (21% and 19%, respectively). In contrast, there was a considerable decline over three years in use of aromatherapy oils in both cohorts (34% and 28%, respectively). Self-prescribed CAM use is popular amongst women in Australia and it is important that conventional practitioners providing women's health care be cognizant of such use amongst their patients. In order to ensure effective practice, there is a need for further research to explore women's decision-making and experiences around self-prescribed CAM use. Copyright © 2015 Elsevier Ltd. All rights reserved.
Fleming, Sara; Rabago, David P; Mundt, Marlon P; Fleming, Michael F
Abstract Background Complementary and alternative medicine (CAM) is an increasingly common therapy used to treat chronic pain syndromes. However; there is limited information on the utilization and efficacy of CAM therapy in primary care patients receiving long-term opioid therapy. Method A survey of CAM therapy was conducted with a systematic sample of 908 primary care patients receiving opioids as a primary treatment method for chronic pain. Subjects completed a questionnaire designed to as...
Lewis Martyn; Croft Peter; Artus Majid
Abstract Background Chronic musculoskeletal pain is the single most cited reason for use of complementary and alternative medicine (CAM). Primary care is the most frequent conventional medical service used by patients with pain in the UK. We are unaware, however, of a direct evidence of the extent of CAM use by primary care patients, and how successful they perceive it to be. Methods Aims and objectives To determine CAM use among patients with chronic musculoskeletal pain who have consulted a...
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
Løhre, Audhild; Rise, Marit By; Steinsbekk, Aslak
The aim was to investigate characteristics of female and male visitors to practitioners of homeopathy in a large adult population in Norway. A cross-sectional adult total population health survey from Central Norway (the Nord-Trøndelag Health Study--HUNT 3) conducted in 2008. Variables included demographics, lifestyle, health status and health care use. Multivariate logistic regression models were employed to analyse the data. In total 50,827 participated (54% of the total population). The prevalence of visits to practitioners of homeopathy was 1.3%, a decline from 4.3% 10 years earlier. Both female and male visitors were 4-5 times more likely to experience recent somatic complaints. Further, female visitors were characterised by higher education, non-smoking, more chronic complaints, and visiting a physician or a chiropractor the past year whereas male visitors were characterised by seeking help for psychiatric complaints and visiting a chiropractor. There were no associations of age, marital status, physical activity, perceived global health, respiratory, skin, or musculoskeletal diseases with visiting practitioners of homeopathy. CONCLUSIONS AND PROPOSALS: There has been a marked decline in visits to practitioners of homeopathy. The results indicate a change in reasons to consult from complaints that influences the visitors' global health to less chronic complaints. Further research should compare changes in visits complementary and alternative medicine (CAM) practitioners and the characteristics of visitors to practitioners of homeopathy to characteristics of other CAM visitors. Copyright © 2012 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.
Complementary and alternative medicine (CAM) services, such as Reiki, continue to be offered to consumers in many hospitals and other health care organizations. There is growing interest among nurses, doctors, and other health care providers for the integration of CAM therapies into traditional settings. Health care organizations are responding to this need but may not know how to start CAM programs. Starting a Reiki program in a health care setting must be envisioned in a business model approach. This article introduces nurses and other health care providers to the basic concepts of business plan development and important steps to follow when starting a Reiki or CAM program.
... htm Accessed June 8, 2017. Rakel D, ed. Philosophy of integrative medicine. In: Integrative Medicine. 4th ed. ... Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2018. June 09, 2018 Original article: http://www. ...
Chang, Mei-Ying; Liu, Chieh-Yu; Chen, Hsiao-Yu
In this study, we explored the differences in the use of complementary and alternative medicine (CAM) based on data from 2007 and 2011 national surveys in Taiwan. Two cross-sectional, community-based epidemiological surveys were conducted in Taiwan. Participants 18 years and older were interviewed regarding their CAM use in the previous 12 months. Nationally representative random-household telephone surveys using a sampling method with a probability proportional to size were conducted in 2007 and 2011. The data were analysed to compare the results between surveys. We obtained a total of 1260 and 2266 valid responses in 2007 and 2011, respectively. The use of at least one or more CAM therapies during the previous year decreased from 48.9% in 2007 to 37.8% in 2011 (p herbs followed by health supplement products and tuina. We observed the greatest relative increase in CAM use between 2007 and 2011 in health supplement products (12.8% vs. 16.0%) and massage (1.3% vs. 2.9%), whereas the largest relative decrease occurred for tuina (24.4-13.4%) and Chinese medicinal herbs (31.6-25.4%). Widespread CAM use reflects a more personal orientation towards maintaining health and selecting health care support services. Thus, a set of standards should be established for the safety and effectiveness of therapies, and consensus building is required to overcome the differences among practitioners from various backgrounds and traditions. Copyright © 2014. Published by Elsevier Ltd.
... milk, miso, tempeh, and some juices and soy beverages). There is some evidence to suggest that use of probiotics may help people with Crohn’s disease or ulcerative colitis to maintain remission. Scientific studies have also shown that they may be useful ...
Nearly four in ten American use complementary or alternative medicine (CAM) each year. Even with a large number of patients, CAM practitioners face scrutiny from physicians and biomedical researchers who, in an era of evidence-based medicine, argue there is little evidence to support CAM treatments. Examining how CAM has or has not been integrated into American health care is crucial in understanding the contemporary boundaries of healthcare systems. An analytical tool from science and technology studies, boundary objects, can help scholars of medicine understand which practices become integrated into these systems. Using a comparative analysis based on archival and interview data, this paper examines the use of boundary objects in two alternative medical practices - acupuncture and Christian Science. While boundary objects alone cannot explain what health practices succeed or fail, juxtaposing the use of boundary objects by different CAM groups identifies the work boundary objects do to facilitate integration and the conditions under which they "work." I find that acupuncturists' use of sterile needles as a boundary objects assists in their effective integration into U.S. healthcare because needles are both a symbol of biomedical prowess and a potentially unsafe device requiring regulation. Christian Scientists' use of the placebo effect as a boundary object has not succeeded because they fail to acknowledge the different contextual definitions of the placebo effect in biomedical communities. This comparative analysis highlights how context affects which boundary objects "work" for CAM practices and theorizes why alternative health practices succeed or fail to become integrated into healthcare systems. Copyright © 2014 Elsevier Ltd. All rights reserved.
Tapie, L; Lebon, N; Mawussi, B; Fron Chabouis, H; Duret, F; Attal, J-P
As digital technology infiltrates every area of daily life, including the field of medicine, so it is increasingly being introduced into dental practice. Apart from chairside practice, computer-aided design/computer-aided manufacturing (CAD/CAM) solutions are available for creating inlays, crowns, fixed partial dentures (FPDs), implant abutments, and other dental prostheses. CAD/CAM dental solutions can be considered a chain of digital devices and software for the almost automatic design and creation of dental restorations. However, dentists who want to use the technology often do not have the time or knowledge to understand it. A basic knowledge of the CAD/CAM digital workflow for dental restorations can help dentists to grasp the technology and purchase a CAM/CAM system that meets the needs of their office. This article provides a computer-science and mechanical-engineering approach to the CAD/CAM digital workflow to help dentists understand the technology.
Janeva, Nadica; Kovacevska, Gordana; Janev, Edvard
The introduction of computer-aided design/computer-aided manufacturing (CAD/CAM) technology into complete denture (CD) fabrication ushered in a new era in removable prosthodontics. Commercially available CAD/CAM denture systems are expected to improve upon the disadvantages associated with conventional fabrication. The purpose of this report is to present the workflow involved in fabricating a CD with a traditional clinical recording method and CAD/CAM technology and to summarize the advantages to the dental practitioner and the patient.
Full Text Available In this paper we present the criteria which represent the base of optimizing the cam mechanisms and also we perform the calculations for several types of mechanisms. We study the influence of the constructive parameters in case of the simple machines with rotation cam and follower (flat or curve of translation on the curvature radius and that of the transmission angle. As it follows, we present the optimization calculations of the cam and flat rotation follower mechanisms, as well as the calculations for optimizing the cam mechanisms by circular groove followers’ help. For an easier interpretation of the results, we have visualized the obtained cam in AutoCAD according to the script files generated by a calculation program.
Full Text Available Complementary and alternative medicine (CAM therapies have been provided at hospitals along with conventional medicine in industrialized nations. Previous studies conducted in Japan revealed high proportion of Japanese had experience of using CAM, but failed to discuss how it should be provided. The present study aims to clarify the demand for CAM practice at hospitals in Japan. A questionnaire consisting of 41 questions was mailed to 10 000 adults randomly selected from the electoral roll of Mie prefecture, Japan in January 2007. The questionnaire asked the subjects about demand for CAM practice at hospitals, types of CAM therapy to be provided and associated reasons. Sociodemographic characteristics, perceived health status, experience and purpose of CAM use, and information resource for CAM were also surveyed. Completed answers were collected from 2824 (28.6% respondents. Two thousand and nineteen (71.5% of the respondents demanded CAM practice at hospitals with the most likely reason of “patients can receive treatment under the guidance of a physicians”. The three most popular CAM therapies were Kampo, acupressure/massage/Shiatsu and acupuncture/moxibustion. The demand was positively associated with gender, ages of 40–59 years, annual household incomes of 5–7 million yen, occupation of specialist and technical workers and sales workers and poor health status. Higher demand was observed among those who used both CAM and conventional medical therapies for curative purposes. In conclusion, Japanese show a high demand for CAM practice, hoping to use CAM for curative purposes with monitoring by physicians at hospitals.
... therapies are often lacking; therefore, the safety and effectiveness of many CAM therapies are uncertain. The National Center for Complementary and Alternative Medicine (NCCAM) is sponsoring research designed to fill this ...
Tsao, Jennie C I; Meldrum, Marcia; Bursch, Brenda; Jacob, Margaret C; Kim, Su C; Zeltzer, Lonnie K
Patient expectations regarding complementary and alternative medicine (CAM) interventions have important implications for treatment adherence, attrition and clinical outcome. Little is known, however, about parent and child treatment expectations regarding CAM approaches for pediatric chronic pain problems. The present study examined ratings of the expected benefits of CAM (i.e. hypnosis, massage, acupuncture, yoga and relaxation) and conventional medicine (i.e. medications, surgery) interventions in 45 children (32 girls; mean age = 13.8 years +/- 2.5) and parents (39 mothers) presenting for treatment at a specialty clinic for chronic pediatric pain. Among children, medications and relaxation were expected to be significantly more helpful than the remaining approaches (P CAM to be fairly low with parents' expectations only somewhat more positive. The current findings suggest that educational efforts directed at enhancing treatment expectations regarding CAM, particularly among children with chronic pain, are warranted.
Walker, L A; Budd, S
There is no legislation that restricts the practice of CAM in the UK apart from the practice of chiropractic and osteopathy and limits on advertising the treatments of certain conditions such as cancer and tuberculosis. The UK government has increasingly recognised the need for comprehensive regulation of CAM, though it abandoned its original plan for a single overarching regulatory body. Initiatives to examine and hasten the process of regulation have included setting up a central, well-recognised charitable body to facilitate progress for individual professions, and an authoritative survey of the existing professional organisations. One pathway open to individual professions is statutory self-regulation, which requires a single governing body, a systematic corpus of knowledge, recognised training courses and demonstrated efficacy. The other pathway is voluntary self-regulation. Chiropractic and osteopathy have adopted statutory self-regulation, though this has proved expensive for individual members of these professions. A recent House of Lords report on CAM has recommended that the herbal medicine and acupuncture professions should also develop a system of statutory regulation. Other professions, such as aromatherapy, are in the process of establishing single professional bodies as a first step towards self-regulation. Among the issues that remain to be resolved is the relationship between the CAM professions and statutory registered practitioners who also practise CAM.
Demling, J H; Neubauer, S; Luderer, H-J; Wörthmüller, M
We investigated to what extent psychiatric inpatients consult Heilpraktiker, i.e. non-academically trained providers of complementary and alternative medicine (CAM), which diagnostic and therapeutic methods Heilpraktiker employ, how patients assess Heilpraictikers' professional competence, CAM in general and issues of satisfaction for those who have had experience with Heilpraktiker. Four hundred and seventy three patients admitted to a psychiatric university department during a 9-month period filled out a questionnaire developed for this investigation. About one third of the patients had consulted a Heilpraktiker, a quarter of these for their current psychiatric illness. Women were in the majority. Patients with the highest secondary school education consulted Heilpraktiker less often. There was considerable 'customer loyalty' towards Heilpraktiker. Largely the same diagnostic and treatment methods were employed for mental illness as for somatic complaints. Except for iridology, exotic or dangerous methods played a secondary role. Patients generally revealed a very positive attitude toward Heilpraktiker and CAM, although methods were rated differently. CAM enjoyed greater appreciation among women and patients who had consulted Heilpraktiker. Patients with personal experience were, on the whole, very satisfied with the professional competence, with the atmosphere in the practice and staff concern for the patient's well-being. Degree of satisfaction correlated closely with frequency of consultation. More patients with neurotic disorders considered the cost unreasonable than others, despite comparatively frequent visits. Psychiatric patients seek out Heilpraktiker to a considerable degree. Especially those who have relevant experience rank Heilpraktiker highly, in particular due to their 'psychotherapeutic' attitude, but professional competence is also valued. Methods of CAM received mixed reviews from patients but are generally seen in a positive light. It is
Simkin, Deborah R; Popper, Charles W
Complementary and alternative medicine (CAM) defies simple definition, because the distinction between CAM and conventional medicine is largely arbitrary and fluid. Despite inconclusive data on the efficacy and safety of many CAM treatments in child and adolescent psychiatry, there are enough data on certain treatments to provide guidance to clinicians and researchers. CAM treatments, as adjunctive therapy or monotherapy, can be clinically beneficial and sensible. The low stigma and cost-competitiveness of many CAM psychiatric treatments are highly attractive to children and parents. Physicians need to be knowledgeable about CAM treatments to provide clinically valid informed consent for some conventional treatments. Copyright © 2013 Elsevier Inc. All rights reserved.
Anderson, Belinda J; Kligler, Benjamin; Cohen, Hillel W; Marantz, Paul R
Research literacy and the practice of evidence-based medicine (EBM) are important initiatives in complementary and alternative medicine (CAM), which requires cultural change within educational institutions for successful implementation. To determine the self-assessed research and EBM perspectives of Chinese medicine Masters degree students at Pacific College of Oriental Medicine, New York campus (PCOM-NY). A survey with 17 close-ended questions and one open-ended question was administered through Survey Monkey to students at PCOM-NY. The survey was sent to 420 Masters students and 176 (41.9%) responded. Students in all four years of the Masters degree indicated a generally high degree of interest in, and support for the value of research. However, increasing years (one to four years) in the program was associated with lower interest in post-graduation research participation and entering the doctoral program, and the fourth year students reported low levels of interest in having greater research content and training in their Masters degree programs. Students who responded to the open-ended question (23% of respondents) expressed enthusiasm for research and concerns about the relevance of research in Chinese medicine. Consistent with findings in similar studies at CAM colleges, interest in research, and EBM of the PCOM-NY Masters students appeared to decline with increasing years in the program. Concerns around paradigm and epistemological issues associated with research and EBM among Chinese medicine students and practitioners warrants further investigation, and may be an important challenge for integrative medicine. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available Abstract Background Chronic musculoskeletal pain is the single most cited reason for use of complementary and alternative medicine (CAM. Primary care is the most frequent conventional medical service used by patients with pain in the UK. We are unaware, however, of a direct evidence of the extent of CAM use by primary care patients, and how successful they perceive it to be. Methods Aims and objectives To determine CAM use among patients with chronic musculoskeletal pain who have consulted about their pain in primary care. Study design Face-to-face interview-based survey. Setting Three general practices in North Staffordshire. Participants Respondents to a population pain survey who had reported having musculoskeletal pain in the survey and who had consulted about their pain in primary care in the previous 12 months as well as consenting to further research and agreeing to an interview. Information was gathered about their pain and the use of all treatments for pain, including CAM, in the previous year. Results 138 interviews were completed. 116 participants (84% had used at least one CAM treatment for pain in the previous year. 65% were current users of CAM. The ratio of over-the-counter CAM use to care from a CAM provider was 3:2. 111 participants (80% had used conventional treatment. 95 (69% were using a combination of CAM and conventional treatment. Glucosamine and fish oil were the most commonly used CAM treatments (38%, 35% respectively. Most CAM treatments were scored on average as being helpful, and users indicated that they intended to use again 87% of the CAM treatments they had already used. Conclusion We provide direct evidence that most primary care consulters with chronic musculoskeletal pain have used CAM in the previous year, usually in combination with conventional treatments. The high prevalence and wide range of users experiences of benefit and harm from CAM strengthen the argument for more research into this type of medicine
Artus, Majid; Croft, Peter; Lewis, Martyn
Chronic musculoskeletal pain is the single most cited reason for use of complementary and alternative medicine (CAM). Primary care is the most frequent conventional medical service used by patients with pain in the UK. We are unaware, however, of a direct evidence of the extent of CAM use by primary care patients, and how successful they perceive it to be. To determine CAM use among patients with chronic musculoskeletal pain who have consulted about their pain in primary care. Face-to-face interview-based survey. Three general practices in North Staffordshire. Respondents to a population pain survey who had reported having musculoskeletal pain in the survey and who had consulted about their pain in primary care in the previous 12 months as well as consenting to further research and agreeing to an interview. Information was gathered about their pain and the use of all treatments for pain, including CAM, in the previous year. 138 interviews were completed. 116 participants (84%) had used at least one CAM treatment for pain in the previous year. 65% were current users of CAM. The ratio of over-the-counter CAM use to care from a CAM provider was 3:2. 111 participants (80%) had used conventional treatment. 95 (69%) were using a combination of CAM and conventional treatment. Glucosamine and fish oil were the most commonly used CAM treatments (38%, 35% respectively). Most CAM treatments were scored on average as being helpful, and users indicated that they intended to use again 87% of the CAM treatments they had already used. We provide direct evidence that most primary care consulters with chronic musculoskeletal pain have used CAM in the previous year, usually in combination with conventional treatments. The high prevalence and wide range of users experiences of benefit and harm from CAM strengthen the argument for more research into this type of medicine to quantify benefit and assess safety. The observation that most users of conventional medicine also used CAM
Li, Xiao-Qian; Tao, Kun-Ming; Zhou, Qing-Hui; Ling, Chang-Quan
Practitioners and researchers from China, the largest user of complementary and alternative medicine (CAM), have been publishing an increasing number of scientific articles in world-famous CAM journals in recent years. However, the status of CAM research in the three major regions of China, the Mainland, Taiwan and Hong Kong has, until now, not been reported. In this study, we compared articles from these three regions published in international CAM journals from 2000 to 2009 using PubMed database and the Journal Citation Reports. The study results showed that the number of published articles from Mainland China increased significantly from 2000 to 2009, particularly since 2005. Meanwhile, the number of published articles from Taiwan also increased, whereas those from Hong Kong remained steady. Clinical trials and randomized controlled trials from Chinese authors both took a small percentage of the total. The impact factors of the journals in which these articles were published suggested similar academic levels whereas the average number of citation of articles from the Mainland was less than those from the other two regions. Journal of Ethnopharmacology, American Journal of Chinese Medicine, Journal of Alternative and Complementary Medicine and Evidence-based Complementary and Alternative Medicine were the most popular journals for Chinese authors.
Colin P White
Full Text Available Complementary and alternative medicine (CAM is becoming increasingly popular in North America. The use of CAM is also popular in patients with chronic liver disease but is not well documented. The extent of use of CAM in chronic hepatitis C virus (HCV infected patients was determined, and the demographic and clinical data between users and nonusers of CAM was compared.
Macdonald, Chris; Gavura, Scott
Is it ethical to market complementary and alternative medicines? Complementary and alternative medicines (CAM) are medical products and services outside the mainstream of medical practice. But they are not just medicines (or supposed medicines) offered and provided for the prevention and treatment of illness. They are also products and services - things offered for sale in the marketplace. Most discussion of the ethics of CAM has focused on bioethical issues - issues having to do with therapeutic value, and the relationship between patients and those purveyors of CAM. This article aims instead to consider CAM from the perspective of commercial ethics. That is, we consider the ethics not of prescribing or administering CAM (activities most closely associated with health professionals) but the ethics of selling CAM. © 2016 John Wiley & Sons Ltd.
Gyimóthy, Szilvia; Widtfeld Meged, Jane
Coastal communities in Denmark have experienced a steady socioeconomic decline, which has further been aggravated by a stagnating tourism and agricultural sector. Within this context, coastal regions are attempting to harness the potentials of the emerging collaborative economy and its communitar......Coastal communities in Denmark have experienced a steady socioeconomic decline, which has further been aggravated by a stagnating tourism and agricultural sector. Within this context, coastal regions are attempting to harness the potentials of the emerging collaborative economy and its...... communitarian business models, such as car-sharing, social dining and peer rental of property. These sharing models thrive primarily in urban settings with a high density of assets, triggering the question: how can sparse and loosely connected coastal resources be mobilized to create value for tourists...... is augmented by a digital platform on which hikers may directly connect with local citizens and book experiences ranging from private dinners to bird-watching and berry-picking. The platform Camønoen.org is hosted by the regional museum, which neither charges for intermediation, nor is responsible for vetting...
Bilgin, Mehmet Selim; Erdem, Ali; Aglarci, Osman Sami; Dilber, Erhan
Two techological approaches for fabricating dentures; computer-aided design and computer-aided manufacturing (CAD/CAM) and rapid prototyping (RP), are combined with the conventional techniques of impression and jaw relation recording to determine their feasibility and applicability. Maxillary and mandibular edentulous jaw models were produced using silicone molds. After obtaining a gypsum working model, acrylic bases were crafted, and occlusal rims for each model were fabricated with previously determined standard vertical and centric relationships. The maxillary and mandibular relationships were recorded with guides. The occlusal rims were then scanned with a digital scanner. The alignment of the maxillary and mandibular teeth was verified. The teeth in each arch were fabricated in one piece, or set, either by CAM or RP. Conventional waxing and flasking was then performed for both methods. These techniques obviate a practitioner's need for technicians during design and provide the patient with an opportunity to participate in esthetic design with the dentist. In addition, CAD/CAM and RP reduce chair time; however, the materials and techniques need further improvements. Both CAD/CAM and RP techniques seem promising for reducing chair time and allowing the patient to participate in esthetics design. Furthermore, the one-set aligned artificial tooth design may increase the acrylic's durability. © 2015 by the American College of Prosthodontists.
Background Evidence indicates that people who reside in non-urban areas have a higher use of complementary and alternative medicine (CAM) than people who reside in urban areas. However, there is sparse research on the reasons for such differences. This paper investigates the reasons for geographical differences in CAM use by comparing CAM users from four geographical areas (major cities, inner regional, outer region, rural/remote) across a range of health status, healthcare satisfaction, neighbourhood and community factors. Methods A cross-sectional survey of 1,427 participants from the Australian Longitudinal Study on Women's Health (ALSWH) conducted in 2009. Results The average total cost of consultations with CAM practitioners was $416 per annum and was highest for women in the major cities, declining with increasing distance from capital cities/remoteness (p < 0.001). The average total cost of self-prescribed CAM was $349 per annum, but this did not significantly differ across geographical areas. The increased use of CAM in rural and remote areas appears to be influenced by poorer access to conventional medical care (p < 0.05) and a greater sense of community (p < 0.05) amongst these rural and remote residents. In contrast to the findings of previous research this study found that health status was not associated with the differences in CAM use between urban and non-urban areas. Conclusion It appears that a number of factors influence the different levels of CAM use across the urban/non-urban divide. Further research is needed to help tease out and understand these factors. Such research will help support health care policy and practice with regards to this topic. PMID:21981986
The CUPCIG (CAM-Use in Primary Care in Germany) Study:Part I-Pain. Study Protocol of a Pilot-trial to Assess Feasibility, Acceptability and Perceived Effectiveness of CAM in Pain Disorders in Primary Care.
Schencking, Martin; Sönnichsen, Andreas; Bassüner, Susanne; Redaelli, Marcus
There is limited valid data available on CAM procedures for chronic joint and neuropathic pain in primary care in Germany. Indiviual CAM qualifications of the general practitioners (GPs) and the potential of cost reduction through CAM treatment are almost unknown. The aim of this pilot trial preceding the main study is to examine the survey mode, to estimate the response rate by GPs with or without an additional qualification for CAM, and to identify the status quo in therapeutic approaches for chronic pain disorders in primary care. This is a cross-sectional study with an ex post facto design among German GPs consisting of 2 parts: In a first step, a pilot trial precedes the main study targeting 200 GPs with and 200 GPs without additional qualification in CAM in a selected region. The results of the CUPCIG study comprise the distribution of pain types treated in primary care practices, the GPs' attitude toward complementary pain therapy, pharmacological or CAM treatment, the estimate of cost reduction through CAM treatment of pain, the application of diverse CAM procedures, and biographical data. The CUPCIG study serves to compile pain therapy approaches in primary care in Germany with respect to the individual CAM expertise of the GPs. © 2015 S. Karger GmbH, Freiburg.
Aziz, Muhammad Abdul; Khan, Amir Hasan; Adnan, Muhammad; Izatullah, Izatullah
In the study area, knowledge related to the traditional uses of medicinal plants is totally in the custody of elder community members and local herbalists. The younger generation is unaware of the traditional knowledge, however with only few exceptions. Therefore, this study was planned with objective to document the medicinal importance of plants, conserve this precious indigenous knowledge, and share it among other communities through published literature. Data was collected through semi-structured interviews from the community members and local herbalists. The reported plants were collected post interviews and later on pressed on herbarium vouchers for reference. Afterwards, the data was analyzed through Use value (UV) and Relative Frequency of Citation (RFC). In total, 79 medicinal plant species were used for the treatment of different ailments in the study region. Out of the total plant species, 28 species were not reported from any other mountainous communities across the country. In this study, the ethno-medicinal value of Opuntia littoralis (Engelm.) Cockerell and Viola indica W.Becker was reported for the first time, which have moderate confidential level in terms of their medicinal uses in the study area. Important medicinal plants of the region with high UV are Berberis lycium Royle (0.94), V. indica (0.90), Isodon rugosus (Wall. ex Benth.) Codd (0.88), Foeniculum vulgare Mill. (0.87), Peganum harmala L (0.86), Solanum virginianum L. (0.85), and Cassia fistula L. (0.79). Medicinal plants with higher RFC values are Calotropis procera (Aiton) Dryand. (0.86), Cannabis sativa L. (0.82), Mentha piperita L. (0.82), Mentha longifolia (L.) Huds. (0.76), Allium sativum L. (0.73), Coriandrum sativum L. (0.73), and F. vulgare (0.72). Traditional knowledge on folk medicines is directly linked to the local culture, faith and perception. This knowledge is gaining high threat of extinction because of its limitation to a small portion of the society in the region
van de Wiel, A
The prevalence of problem drinking in the Dutch population, affecting about 750,000 persons, is much higher than that of abuse or addiction and contributes substantially to healthcare workload and costs. However, recognition, not only in primary care but also in the hospital environment, can be difficult. The symptoms are often non-specific and are not always immediately related to the use of alcohol. Even in cases of overt abuse, like in injuries and trauma, routine drinking histories are recorded poorly and identification and signalling are inadequate. It is estimated that up to 16% of all emergency room patients have consumed alcohol within six hours before their visit. Since a patient will benefit not only from the treatment of his symptoms but also from the uncovering of the underlying problem, more emphasis should be laid on the early identification of problem drinking. Especially in the early phase of problem drinking, interventions, in most cases by primary-care physicians or nurse practitioners, may be successful. Since the revised version of the practice guideline 'Problematic alcohol consumption' from the Dutch College of General Practitioners contains clear and practical advice on the early recognition and management of problem drinking, its use is recommended not only to primary-care physicians but also to hospital-specialist staff.
van Huyssteen, Mea; Milne, Pieter J; Campbell, Eileen E; van de Venter, Maryna
Diabetes mellitus is a growing problem in South Africa and of concern to traditional African health practitioners in the Nelson Mandela Metropole, because they experience a high incidence of diabetic cases in their practices. A collaborative research project with these practitioners focused on the screening of Bulbine frutescens, Ornithogalum longibracteatum, Ruta graveolens, Tarchonanthus camphoratus and Tulbaghia violacea for antidiabetic and cytotoxic potential. In vitro glucose utilisation assays with Chang liver cells and C2C12 muscle cells, and growth inhibition assays with Chang liver cells were conducted. The aqueous extracts of Bulbine frutescens (143.5%), Ornithogalum longibracteatum (131.9%) and Tarchonanthus camphoratus (131.5%) showed significant increased glucose utilisation activity in Chang liver cells. The ethanol extracts of Ruta graveolens (136.9%) and Tulbaghia violacea (140.5%) produced the highest increase in glucose utilisation in C2C12 muscle cells. The ethanol extract of Bulbine frutescens produced the most pronounced growth inhibition (33.3%) on Chang liver cells. These findings highlight the potential for the use of traditional remedies in the future for the management of diabetes and it is recommended that combinations of these plants be tested in future.
Jaradat, Nidal Amin; Ayesh, Ola Ibrahim; Anderson, Cynthia
Folk herbal medicine knowledge and its utilization by aboriginal cultures are not only useful for conservation of cultural traditions and biodiversity, but also useful for community healthcare and drug discovery in the present and in the future. Using a semi-structured questionnaire, an ethnopharmacological survey of medicinal plants used for treatment of diarrhea in the West Bank/Palestine was investigated. Information about fifty medicinal plants used for treatment of diarrhea, including the names of plants, parts used, mode and methods of preparation was obtained from 100 traditional healers and herbalists. This research is the first scientific work in the Middle East to collect data about plants used by traditional healers for treatments of diarrhea and their evidence based effects against this disease. The fidelity levels were 97% for Salvia fruticosa, Teucrium polium and Musa paradisiaca, 95% for Camellia sinensis and Aegle marmelos, 79% for Oryza sativa and Solanum tuberosum, 77% for Quercus boissieri, 66% for Psidium guajava, 56% for Anthemis palestina, 54% for Solanum nigrum and 52% for Juglans regia while the highest use and choice values were for S. fruticosa, T. polium and M. paradisiaca as well as the factor of informant's consensus for medicinal plants used for treatment of diarrhea was 0.505.The leaves were the most commonly used parts, followed by fruits, roots and rhizomes, while decoctions and infusions are the preferred methods of preparation. The Palestinian traditional medicine is rich with herbal remedies for treatment of diarrhea in comparison with other countries, but most of these herbal remedies lack standard in-vitro and in-vivo evaluations to establish their antidiarrheal effects. Therefore, the information obtained can serve as a basis for further phytochemical and pharmacological studies to determine their efficacy and safety which might contribute to a better integration of Palestinian traditional medicine into the national health
MacArtney, John; Wahlberg, Ayo
Commentators like Goldacre, Dawkins, and Singh and Ernst are worried that the rise in complementary and alternative medicine (CAM) represents a flight from science propagated by enemies of reason. We outline what kind of problem CAM use is for these commentators and find that users of CAM...
Shojaii, Seyed Ruhollah; The ATLAS collaboration
This poster describes an innovative Content Addressable Memory cell with radiation hardened (RH-CAM) architecture. The RH-CAM is designed in a commercial 28 nm CMOS technology. The circuit has been simulated in worst-case conditions, and the effects due to single particles are analyzed injecting a fault current into a circuit node. The proposed architecture can perform on-time pattern recognition tasks in harsh environments, such as very front-end electronics in hadron colliders and in space applications.
Keshet, Yael; Simchai, Dalit
Both as producers and consumers women are more likely than men to engage with complementary and alternative medicine (CAM) and 'New Age' holistic spiritualities. We conducted a literature review of sociological and anthropological articles, with the aim of studying why women in particular use and practice these alternatives, and whether using them presents an opportunity to challenge the conventional gender order and unequal power relations. A systematic search of nine databases, complemented by an informal search resulted in the identification of 114 articles, of which 27 were included in the review. The search period was limited to 2000-2013. Thematic analysis of the literature indicated three major trends: women draw on traditional female resources and perceived 'feminine' characteristics; the realm of CAM and holistic spirituality challenges power relations and gender inequalities in healthcare, wellbeing, and employment, and may serve as an emancipating, empowering alternative; however, factors such as lack of political support, legitimacy, and a solid institutional base for the field of CAM and holistic spirituality, and its use by predominantly white middle- and upper-class women, work against significant change in the realm of healthcare and limit gendered social change. We suggest that the empowerment women experience is a form of feminine strength and personal empowerment that stems from power-from-within, which is not directed toward resistance. The literature review reveals some lacunae in the literature that call for future gendered research: the lack of quantitative studies, of data concerning the financial success of CAM practitioners, of studies linking CAM with a feminist-oriented analysis of the medical world, of understanding gender perceptions in the holistic milieu and CAM, and of studies conducted from an intersectionality perspective. Copyright © 2014 Elsevier Ltd. All rights reserved.
Long, Andrew F
The potential contribution of complementary and alternative medicine (CAM) modalities to promote and support critical health literacy has not received substantial attention within either the health promotion or the CAM literature. This paper explores the potential of one CAM modality, shiatsu, in promoting well-being and critical health literacy. Data are drawn from a longitudinal, 6 months observational, pragmatic study of the effects and experience of shiatsu within three European countries (Austria, Spain and the UK). Client postal questionnaires included: advice received, changes made 6 months later, clients 'hopes' from having shiatsu and features of the client-practitioner relationship. At baseline, three-quarters of clients (n = 633) received advice, on exercise, diet, posture, points to work on at home or other ways of self-care. At 6 months follow-up, about four-fifths reported making changes to their lifestyle 'as a result of having shiatsu treatment', including taking more rest and relaxation or exercise, changing their diet, reducing time at work and other changes such as increased body/mind awareness and levels of confidence and resolve. Building on the findings, an explanatory model of possible ways that a CAM therapy could contribute to health promotion is presented to guide future research, both within and beyond CAM. Supporting individuals to take control of their self-care requires advice-giving within a supportive treatment context and practitioner relationship, with clients who are open to change and committed to maintaining their health. CAM modalities may have an important role to play in this endeavour.
Long Andrew F
Full Text Available Abstract Background The potential contribution of complementary and alternative medicine (CAM modalities to promote and support critical health literacy has not received substantial attention within either the health promotion or the CAM literature. This paper explores the potential of one CAM modality, shiatsu, in promoting well-being and critical health literacy. Methods Data are drawn from a longitudinal, 6 months observational, pragmatic study of the effects and experience of shiatsu within three European countries (Austria, Spain and the UK. Client postal questionnaires included: advice received, changes made 6 months later, clients 'hopes' from having shiatsu and features of the client-practitioner relationship. Result At baseline, three-quarters of clients (n = 633 received advice, on exercise, diet, posture, points to work on at home or other ways of self-care. At 6 months follow-up, about four-fifths reported making changes to their lifestyle 'as a result of having shiatsu treatment', including taking more rest and relaxation or exercise, changing their diet, reducing time at work and other changes such as increased body/mind awareness and levels of confidence and resolve. Building on the findings, an explanatory model of possible ways that a CAM therapy could contribute to health promotion is presented to guide future research, both within and beyond CAM. Conclusion Supporting individuals to take control of their self-care requires advice-giving within a supportive treatment context and practitioner relationship, with clients who are open to change and committed to maintaining their health. CAM modalities may have an important role to play in this endeavour.
Full Text Available Substantial complementary medicines (CAM use is reported worldwide. Australian consumers use CAM for health maintenance, minor self-limiting disease states, and also for chronic conditions. The increasing use of CAM has required pharmacists to become increasingly more knowledgeable about CAM and the ethics of CAM recommendation. When the first Australian non-metropolitan pharmacy program was started at Charles Sturt University, in 1997, it was decided to incorporate two innovative courses to assist rurally educated students to engage with health consumers who expect pharmacists to be able to assist them with CAM. This discussion traces and reflects on the development, implementation and current situation of the Complementary Medicines for Pharmacy course. Over time, this course has evolved from a final year elective with a focus on familiarization to a mandated course with a phytomedicine focus to an integrated topic in final year with a focus on evidence, quality of evidence and professional decision-making demonstrated in a reflective professional portfolio. Of potentially greater importance, however, has been the introduction of complementary medicines as a topic in every year of the course with the goal of facilitating effective professional engagement with health consumers.
Heusser, Peter; Eberhard, Sabine; Berger, Bettina; Weinzirl, Johannes; Orlow, Pascale
Background Integrative medicine (IM) integrates evidence-based Complementary and Alternative Medicine (CAM) with conventional medicine (CON). Medical schools offer basic CAM electives but in postgraduate medical training (PGMT) little has been done for the integration of CAM. An exception to this is anthroposophic medicine (AM), a western form of CAM based on CON, offering an individualized holistic IM approach. AM hospitals are part of the public healthcare systems in Germany and Switzerland...
Hoenders, H.J.R.; Appelo, M.T.; de Jong, J.T.V.M.
Complementary and alternative medicine (CAM) are increasingly used by people in first world countries, almost always in combination with biomedicine. The combination of CAM and biomedicine is now commonly referred to as "integrative medicine" (IM). In Groningen, The Netherlands, we founded a center
A workbook to help patients and doctors talk about the use of complementary and alternative medicine(CAM) during and after cancer care. Worksheets, tips, and resources are provided for patients and doctors to help track CAM use.
A workbook to help patients and doctors talk about the use of complementary and alternative medicine(CAM) during and after cancer care. Worksheets, tips, and resources are provided for patients and doctors to help track CAM use.
A workbook to help patients and doctors talk about the use of complementary and alternative medicine(CAM) during and after cancer care. Worksheets, tips, and resources are provided for patients and doctors to help track CAM use.
Maizes, Victoria; Rakel, David; Niemiec, Catherine
Integrative medicine has emerged as a potential solution to the American healthcare crisis. It provides care that is patient centered, healing oriented, emphasizes the therapeutic relationship, and uses therapeutic approaches originating from conventional and alternative medicine. Initially driven by consumer demand, the attention integrative medicine places on understanding whole persons and assisting with lifestyle change is now being recognized as a strategy to address the epidemic of chronic diseases bankrupting our economy. This paper defines integrative medicine and its principles, describes the history of complementary and alternative medicine (CAM) in American healthcare, and discusses the current state and desired future of integrative medical practice. The importance of patient-centered care, patient empowerment, behavior change, continuity of care, outcomes research, and the challenges to successful integration are discussed. The authors suggest a model for an integrative healthcare system grounded in team-based care. A primary health partner who knows the patient well, is able to addresses mind, body, and spiritual needs, and coordinates care with the help of a team of practitioners is at the centerpiece. Collectively, the team can meet all the health needs of the particular patient and forms the patient-centered medical home. The paper culminates with 10 recommendations directed to key actors to facilitate the systemic changes needed for a functional healthcare delivery system. Recommendations include creating financial incentives aligned with health promotion and prevention. Insurers are requested to consider the total costs of care, the potential cost effectiveness of lifestyle approaches and CAM modalities, and the value of longer office visits to develop a therapeutic relationship and stimulate behavioral change. Outcomes research to track the effectiveness of integrative models must be funded, as well as feedback and dissemination strategies
Vojdani, Aristo; Lambert, Jama; Kellermann, Gottfried
Abundant research has mapped the inflammatory pathways leading to autoimmunity and neuroinflammatory disorders. The latest T helper to be identified, Th17, through its proinflammatory cytokine IL-17, plays a pathogenic role in many inflammatory conditions. Today, healthcare providers have a wealth of anti-inflammatory agents from which to choose. On one hand, pharmaceutical companies market brand-name drugs direct to the public and physicians. Medical botanical knowledge, on the other hand, has been passed down from generation to generation. The demands for natural healing therapies have brought corresponding clinical and laboratory research studies to elucidate the medicinal properties of alternative practices. With a variety of options, it can be difficult to pinpoint the proper anti-inflammatory agent for each case presented. In this review, the authors highlight a vast array of anti-inflammatory medicaments ranging from drugs to vitamins and from botanicals to innate molecules. This compilation may serve as a guide for complimentary and alternative healthcare providers who need to target neuroinflammation driven by Th17 and its inflammatory cytokine IL-17. By understanding the mechanisms of anti-inflammatory agents, CAM practitioners can tailor therapeutic interventions to fit the needs of the patient, thereby providing faster relief from inflammatory complaints.
Holmes, William H
This textbook on statistics is written for students in medicine, epidemiology, and public health. It builds on the important role evidence-based medicine now plays in the clinical practice of physicians, physician assistants and allied health practitioners. By bringing research design and statistics to the fore, this book can integrate these skills into the curricula of professional programs. Students, particularly practitioners-in-training, will learn statistical skills that are required of today’s clinicians. Practice problems at the end of each chapter and downloadable data sets provided by the authors ensure readers get practical experience that they can then apply to their own work. Topics covered include: Functions of Statistics in Clinical Research Common Study Designs Describing Distributions of Categorical and Quantitative Variables Confidence Intervals and Hypothesis Testing Documenting Relationships in Categorical and Quantitative Data Assessing Screening and Diagnostic Tests Comparing Mean...
Pumthong, Ganniga; Nathason, Amornrat; Tuseewan, Musikorn; Pinthong, Pailin; Klangprapun, Supathra; Thepsuriyanon, Daracha; Kotta, Paiwan
The aim of this study was to explore complementary or alternative practices used to promote health and reduce complications of patients with diabetes mellitus (DM). This qualitative, interpretative study recruited 30 adults including practitioners (n=15) and DM patients (n=15). The participants reside in the northeast of Thailand and in Vientiane of Lao People's Democratic Republic, and they have undergone treatment with at least a kind of complementary and alternative medicines (CAMs) for the care and management of DM. They were interviewed about their experiences, and the data were analyzed thematically. The study methodology was informed by hermeneutic phenomenology. After several years of ineffective treatments, practitioners looked for an alternative to conventional health care to treat patients on long-term antidiabetic drugs, yet the patients suffered from progressive complications. They sought out health care that would more effectively meet their self-perceived needs in treatment particularly of a chronic disease such as DM. The result suggested that CAMs such as acupuncture, massage, exercise, and herbalism were able to meet their requirement in terms of health-care effectiveness obtained from experiences, additional cheap cost and availability in their community, and in accordance with the culture and lifestyles in the context of the ASEAN (Association of Southeast Asian Nations) community. The study explored and revealed the social perceptions of practitioners and patients using Chinese acupuncture, Thai massage, stretching exercise, and herbalism, as CAMs for DM management. The perceptions attributed to patient-practitioner consensus can hold a key to a more comprehensive health care, as a means to expand the boundaries for contemporary health-care provision. However, more study is needed in the future clinical trial research. Copyright © 2015 Elsevier Ltd. All rights reserved.
This volume is based on the proceedings of the 28th International Conference on CAD/CAM, Robotics and Factories of the Future. This book specially focuses on the positive changes made in the field of robotics, CAD/CAM and future outlook for emerging manufacturing units. Some of the important topics discussed in the conference are product development and sustainability, modeling and simulation, automation, robotics and handling systems, supply chain management and logistics, advanced manufacturing processes, human aspects in engineering activities, emerging scenarios in engineering education and training. The contents of this set of proceedings will prove useful to both researchers and practitioners.
... Statements Newsletters AAOM: Representing the Discipline of Oral Medicine Oral Medicine is the discipline of dentistry concerned with the ... offers credentialing, resources and professional community for oral medicine practitioners. Our membership provides care to thousands. We ...
Strizich, Garrett; Gammon, Marilie D.; Jacobson, Judith S.; Wall, Melanie; Abrahamson, Page; Bradshaw, Patrick T.; Terry, Mary Beth; Teitelbaum, Susan; Neugut, Alfred I.; Greenlee, Heather
Background Breast cancer patients commonly report using >1 form of complementary and alternative medicine (CAM). However, few studies have attempted to analyze predictors and outcomes of multiple CAM modalities. We sought to group breast cancer patients by clusters of type and intensity of complementary and alternative medicine (CAM) use following diagnosis. Methods Detailed CAM use following breast cancer diagnosis was assessed in 2002?2003 among 764 female residents of Long Island, New York...
Gagnier, Joel J; Oltean, Hanna; van Tulder, Maurits W; Berman, Brian M; Bombardier, Claire; Robbins, Christopher B
Systematic review of randomized controlled trials (RCTs). To determine the effectiveness of herbal medicine for nonspecific low back pain (LBP). Many people with chronic LBP use complementary and alternative medicine (CAM), visit CAM practitioners, or both. Several herbal medicines have been purported for use in treating people with LBP. This is an update of a Cochrane Review first published in 2006. We searched numerous electronic databases up to September 2014; checked reference lists in review articles, guidelines and retrieved trials; and personally contacted individuals with expertise in this area. We included RCTs examining adults (over 18 years of age) suffering from acute, sub-acute, or chronic nonspecific LBP. The interventions were herbal medicines that we defined as plants used for medicinal purposes in any form. Primary outcome measures were pain and function. Two review authors assessed risk of bias, GRADE criteria (GRADE 2004), and CONSORT compliance and a random subset were compared with assessments by a third individual. Two review authors assessed clinical relevance and resolved any disagreements by consensus. Fourteen RCTs (2050 participants) were included. Capsicum frutescens (cayenne) reduces pain more than placebo. Although Harpagophytum procumbens (devil's claw), Salix alba (white willow bark), Symphytum officinale L. (comfrey), Solidago chilensis (Brazilian arnica), and lavender essential oil also seem to reduce pain more than placebo, evidence for these substances was of moderate quality at best. No significant adverse events were noted within the included trials. Additional well-designed large trials are needed to test these herbal medicines against standard treatments. In general, the completeness of reporting in these trials was poor. Trialists should refer to the CONSORT statement extension for reporting trials of herbal medicine interventions. N/A.
Conrad, A C; Muenstedt, K; Micke, O; Prott, F J; Muecke, R; Huebner, J
A high proportion of cancer patients use complementary and alternative medicine (CAM). In oncology, risks of CAM are side effects and interactions. Our aim was to conduct a survey on professionals in palliative care regarding attitudes toward CAM. An internet-based survey with a standardized questionnaire was sent to all members of the German Society for Palliative Care. The questionnaire collected data on attitude toward CAM and experiences. Six hundred and ninety questionnaires (19 %) were returned (49 % physicians, 35 % nurses, 3 % psychologists). Acceptance of CAM is high (92 % for complementary and 54 % for alternative medicine). Most participants had already been asked on CAM by patients (95 %) and relatives (89 %). Forty-four percent already had used complementary methods and 5 % alternative methods. Only 21 % think themselves adequately informed. Seventy-four percent would use complementary methods in a patient with advanced tumor, and 62 % would use alternative therapy in patients if there was no other therapy. Even from those who are skeptical 45 % would treat a patient with alternative methods. In order to inform patients on CAM and to further patients' autonomy, evidence on benefits and harms of CAM must be provided. As awareness of risks from CAM is low and critical appraisal especially of alternative medicine missing, but interest on information on CAM is high, experts should provide evidence-based recommendations for CAM in palliative care to members of different professions. This could be done by a curriculum focusing on the most often used CAM methods.
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
Winter, Klaus; Holtum, Joseph A M
Facultative crassulacean acid metabolism (CAM) describes the optional use of CAM photosynthesis, typically under conditions of drought stress, in plants that otherwise employ C3 or C4 photosynthesis. In its cleanest form, the upregulation of CAM is fully reversible upon removal of stress. Reversibility distinguishes facultative CAM from ontogenetically programmed unidirectional C3-to-CAM shifts inherent in constitutive CAM plants. Using mainly measurements of 24h CO2 exchange, defining features of facultative CAM are highlighted in five terrestrial species, Clusia pratensis, Calandrinia polyandra, Mesembryanthemum crystallinum, Portulaca oleracea and Talinum triangulare. For these, we provide detailed chronologies of the shifts between photosynthetic modes and comment on their usefulness as experimental systems. Photosynthetic flexibility is also reviewed in an aquatic CAM plant, Isoetes howellii. Through comparisons of C3 and CAM states in facultative CAM species, many fundamental biochemical principles of the CAM pathway have been uncovered. Facultative CAM species will be of even greater relevance now that new sequencing technologies facilitate the mapping of genomes and tracking of the expression patterns of multiple genes. These technologies and facultative CAM systems, when joined, are expected to contribute in a major way towards our goal of understanding the essence of CAM. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: firstname.lastname@example.org.
Yu, Jun-Sang; Kim, Chun-Bae; Kim, Ki-Kyong; Lee, Ji-Eun; Kim, Min-Young
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.
Mc Kenna, F
Several International studies have shown the substantial growth in the use of complementary and alternative medicine (CAM). However, no study in the Republic of Ireland to date has looked at its use among the population. A cross-sectional survey of 328 patients attending an urban general practice was conducted. A high number of respondents reported having visited a CAM practitioner within the past 12 months (89 patients; 27%). A significant positive association was found between CAM use and female gender (p = 0.006), middle-aged (p = 0.013), private health insurance (p = 0.016) and full time employment (p = 0.031). Massage was the most common modality used (35 patients; 39.8%), the most common reason for use was \\'to treat an illness for which conventional medicine was already sought\\' (31 patients; 42%), a high rate of non-disclosure to GPs was found (34 patients; 41%) and personal recommendation was the most important source of information (42 patients; 53.2%). This study demonstrates the current popularity of an alternative healthcare system.
Kim, Kisook; Kim, Soo Hyun; Ok, Oh Nam; Kim, Im-Ryung; Lee, Suyeon; Kim, So Hee; Kim, Won Seog; Ryu, Min-Hee; Lee, Moon Hee
We aimed to examine the experience of complementary and alternative medicine (CAM) use and its association with health-related quality of life (HRQOL) in lymphoma survivors in South Korea. The participants were 869 lymphoma survivors from three hospitals in South Korea, all diagnosed with lymphoma at least 24 months prior to participation. Self-reported questionnaires were used to assess CAM use. The questionnaire addressed types of CAM used, sources of information about CAM, reason for CAM use, satisfaction with CAM use, discussion of CAM use with doctors, experience of side effects, costs of CAM use, and intentions to continue using CAM. HRQOL was measured with the EORTC QLQ-C30. Of the 869 participants, 42.2% had experience using CAM, and there were statistically significant differences among CAM users and non-users in terms of sex, religion, and time since diagnosis. A special diet (e.g., ginseng, chitosan, mixed cereals) was the most commonly used type of CAM, and most CAM users (82.1%) were satisfied with their CAM use. Most CAM users (77.5%) did not discuss the use of CAM with their doctors, and only 9.2% reported any side effects from CAM. CAM users showed significantly lower HRQOL scores than did non-users. A significant number of lymphoma survivors in Korea have used CAM, and most CAM users are satisfied with their CAM use. Oncology nurses should be aware of the range of CAM use among patients and reflect their responses in their treatment and/or follow-up care. Copyright © 2018 Elsevier Ltd. All rights reserved.
Makowski, Suzana K E
Complementary and alternative medicine (CAM) is one of the fastest growing segments of the health care industry today, with studies suggesting that between 30% and 50% of the adult population in the United States uses some form of CAM. Many ambulatory care centers are considering integrating CAM into their clinical services. This article will review some of the national trends and present a framework for assessing local market demand for CAM in order to help prioritize an organization's CAM integration strategy.
Ulrich, Anita; Evron, Lotte; Ostenfeld-Rosenthal, Ann
Objectives: In this paper,we investigate Danish cancer patients’ narratives on spiritual beliefs and practices and the relationship these practices may have to complementary and alternative medicine (CAM). Design: Narrative inquiry is used to uncover how spiritual beliefs and practices may......, religious and spiritual issues were not extensively unfolded in participants’ illness narratives. However, these issues were significantly elaborated on in narratives by four female participants. Conclusion: We propose that for some cancer patients CAM may function, not only or primarily as a treatment...... for cancer related symptoms and side effects, but as a spiritual practice as well. For some individuals this may be true to an even higher extent than in established religious institutions....
Mundt Marlon P
Full Text Available Abstract Background Complementary and alternative medicine (CAM is an increasingly common therapy used to treat chronic pain syndromes. However; there is limited information on the utilization and efficacy of CAM therapy in primary care patients receiving long-term opioid therapy. Method A survey of CAM therapy was conducted with a systematic sample of 908 primary care patients receiving opioids as a primary treatment method for chronic pain. Subjects completed a questionnaire designed to assess utilization, efficacy and costs of CAM therapies in this population. Results Patients were treated for a variety of pain problems including low back pain (38.4%, headaches (9.9%, and knee pain (6.5%; the average duration of pain was 16 years. The median morphine equivalent opioid dose was 41 mg/day, and the mean dose was 92 mg/day. Forty-four percent of the sample reported CAM therapy use in the past 12 months. Therapies utilized included massage therapy (27.3%, n = 248, chiropractic treatment (17.8%, n = 162, acupuncture (7.6%, n = 69, yoga (6.1%, n = 55, herbs and supplements (6.8%, n = 62, and prolotherapy (5.9%, n = 54. CAM utilization was significantly related to age female gender, pain severity income pain diagnosis of neck and upper back pain, and illicit drug use. Medical insurance covered chiropractic treatment (81.8% and prolotherapy (87.7%, whereas patients primarily paid for other CAM therapies. Over half the sample reported that one or more of the CAM therapies were helpful. Conclusion This study suggests CAM therapy is widely used by patients receiving opioids for chronic pain. Whether opioids can be reduced by introducing such therapies remains to be studied.
Fleming, Sara; Rabago, David P; Mundt, Marlon P; Fleming, Michael F
Complementary and alternative medicine (CAM) is an increasingly common therapy used to treat chronic pain syndromes. However; there is limited information on the utilization and efficacy of CAM therapy in primary care patients receiving long-term opioid therapy. A survey of CAM therapy was conducted with a systematic sample of 908 primary care patients receiving opioids as a primary treatment method for chronic pain. Subjects completed a questionnaire designed to assess utilization, efficacy and costs of CAM therapies in this population. Patients were treated for a variety of pain problems including low back pain (38.4%), headaches (9.9%), and knee pain (6.5%); the average duration of pain was 16 years. The median morphine equivalent opioid dose was 41 mg/day, and the mean dose was 92 mg/day. Forty-four percent of the sample reported CAM therapy use in the past 12 months. Therapies utilized included massage therapy (27.3%, n = 248), chiropractic treatment (17.8%, n = 162), acupuncture (7.6%, n = 69), yoga (6.1%, n = 55), herbs and supplements (6.8%, n = 62), and prolotherapy (5.9%, n = 54). CAM utilization was significantly related to age female gender, pain severity income pain diagnosis of neck and upper back pain, and illicit drug use. Medical insurance covered chiropractic treatment (81.8%) and prolotherapy (87.7%), whereas patients primarily paid for other CAM therapies. Over half the sample reported that one or more of the CAM therapies were helpful. This study suggests CAM therapy is widely used by patients receiving opioids for chronic pain. Whether opioids can be reduced by introducing such therapies remains to be studied.
Taylor, David McDonald; Dhir, Reetika; Craig, Simon S; Lammers, Thalia; Gardiner, Kaya; Hunter, Kirrily; Joffe, Paul; Krieser, David; Babl, Franz E
To determine the period prevalence and nature of complementary and alternative medicine (CAM) use among paediatric emergency department (ED) patients and the perceptions of CAM among the CAM administrators. A survey was undertaken in four Victorian EDs (January to September 2013). A convenience sample of parents/carers accompanying paediatric patients completed a self-administered questionnaire. The main outcome measures were CAM use and perceptions of CAM. The parents/carers of 883 patients participated. Three hundred eighty-eight (43.9%, 95% confidence interval (CI) 40.6-47.3) and 53 (6.0%, 95% CI 4.6-7.8) patients had taken a CAM within the previous 12 months and on the day of presentation, respectively. There were no gender differences between CAM users and non-users (P = 0.83). The use of CAM was significantly more common among older patients (P effective than prescription medicines and safe when taken with prescription medicines. CAM use is common among paediatric ED patients although rarely reported to the ED doctor. Parents/carers who administer CAM have differing perceptions of CAM safety from those who do not. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
Abstract. Complementary and alternative medicine (CAM) use is common among patients with chronic diseases in developing countries. The rising use of CAM in the management of diabetes is an emerging public health concern given the potential adverse effects, drug interactions and benefits associated with its use.
Shumer, Gregory; Warber, Sara; Motohara, Satoko; Yajima, Ayaka; Plegue, Melissa; Bialko, Matthew; Iida, Tomoko; Sano, Kiyoshi; Amenomori, Masaki; Tsuda, Tsukasa; Fetters, Michael D
There is growing interest in the use of complementary and alternative medicine (CAM) throughout the world, however previous research done in Japan has focused primarily on CAM use in major cities. The purpose of this study was to develop and distribute a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) to assess the use of CAM among people who visit rural Japanese family medicine clinics. Using a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q), a cross-sectional survey was conducted in three rural family medicine clinics. All patients and those accompanying patients who met inclusion criteria were eligible to participate. Data were entered into SPSS Statistics and analyzed for use by age, gender, and location. Of the 519 respondents who participated in the project, 415 participants reported CAM use in the past 12 months (80.0%). When prayer is excluded, the prevalence of CAM use drops to 77.3% in the past year, or 403 respondents. The most common forms of CAM used by respondents were pain relief pads (n = 170, 32.8%), herbal medicines/supplements (n = 167, 32.2%), and massage by self or family (n = 166, 32.0%). Female respondents, individuals with higher levels of education, and those with poorer overall health status were more likely to use CAM than respondents without these characteristics. Only 22.8% of CAM therapies used were reported to physicians by survey participants. These data indicate that CAM use in rural Japan is common. The results are consistent with previous studies that show that Japanese individuals are more interested in forms of CAM such as pain relief pads and massage, than in mind-body forms of CAM like relaxation and meditation. Due to the high utilization of certain CAM practices, and given that most CAM users do not disclose their CAM use to their doctors, we conclude that physicians in rural Japan would benefit by asking about CAM use
Gasim, Maisara Mohyeldin; Chui, Lee Giok; Anwar, Khirul Azhar bin
In Revetec engine (three-lobed) cam replaces the crankshaft to convert the reciprocating motion of the engine piston, to a rotating motion in the drive line. Since the cam controls the piston movement, the cam profile has a great effect on engine performance. In this paper an experimental study was done to a (three- lobed) cam with Cycloidal motion profile but with different ratios between the base circle radius of the cam and the radius of the roller follower. DEWESoft was used to find the displacement and the vibration of the piston, and compare the actual results from the test with the theoretical results from the cam profile equation. The results showed that there is a periods of miss contact between the follower and the cam when the ratio between the base circle radius of the cam and the radius of the roller follower is less than a certain value, and also increasing of vibration. The suggested ratio between the cam and follower radius is to be more than 2:1.
Herman, Patricia M; Sorbero, Melony E; Sims-Columbia, Ann C
Surveys of military personnel indicate substantial use of complementary and alternative medicine (CAM) that possibly exceeds use in the general U.S. Although military treatment facilities (MTFs) are known to offer CAM, surveys do not indicate where service members receive this care. This study offers a comprehensive system-wide accounting of the types of CAM offered across the military health system (MHS), the conditions for which it is used, and its level of use. These data will help MHS policymakers better support their population's healthcare needs. A census survey of MTFs across the MHS on all CAM use, supplemented where possible by MHS utilization data. Types of CAM offered by each MTF, reasons given for offering CAM, health conditions for which CAM is used, and number of patient visits for each CAM type. Of the 142 MTFs in the MHS, 133 (94%) responded. Of these, 110 (83%) offer at least one type of CAM and 5 more plan to offer CAM services in the future. Larger MTFs (those reporting ≥25,000 beneficiaries enrolled) are both more likely to offer CAM services (p 10) of different types of CAM (p = 0.010) than smaller MTFs. Three-fourths of MTFs offering CAM provide stress management/relaxation therapy, two-thirds provide acupuncture, and at least half provide progressive muscle relaxation, guided imagery, chiropractic, and mindfulness meditation. MTFs most commonly report CAM use for pain and mental health conditions. Acupuncture and chiropractic are most commonly used for pain, and stress management/relaxation therapy and mind-body medicine combinations are most often used for mental health-related conditions. We estimate 76,000 CAM patient encounters per month across the MHS. The availability of CAM services in the MHS is widespread and is being used to address a range of challenging pain and mental health conditions.
Schee, E. van der; Groenewegen, P.P.
Background: In the Netherlands, public trust in conventional medicine is relatively high. There is reason to believe that public trust in complementary and alternative medicine (CAM) is rated lower. The aim of this study is to gain insight into public trust in CAM and the determinants that lie at
Background: Complementary and alternative medicine (CAM) is a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine. As cancer incidence rates and survival time increase, use of CAM will likely increase. However, little is known about ...
Bogenschutz, Peter A.; Gettelman, Andrew; Hannay, Cecile; Larson, Vincent E.; Neale, Richard B.; Craig, Cheryl; Chen, Chih-Chieh
This paper documents coupled simulations of two developmental versions of the Community Atmosphere Model (CAM) towards CAM6. The configuration called CAM5.4 introduces new microphysics, aerosol, and ice nucleation changes, among others to CAM. The CAM5.5 configuration represents a more radical departure, as it uses an assumed probability density function (PDF)-based unified cloud parameterization to replace the turbulence, shallow convection, and warm cloud macrophysics in CAM. This assumed PDF method has been widely used in the last decade in atmosphere-only climate simulations but has never been documented in coupled mode. Here, we compare the simulated coupled climates of CAM5.4 and CAM5.5 and compare them to the control coupled simulation produced by CAM5.3. We find that CAM5.5 has lower cloud forcing biases when compared to the control simulations. Improvements are also seen in the simulated amplitude of the Niño-3.4 index, an improved representation of the diurnal cycle of precipitation, subtropical surface wind stresses, and double Intertropical Convergence Zone biases. Degradations are seen in Amazon precipitation as well as slightly colder sea surface temperatures and thinner Arctic sea ice. Simulation of the 20th century results in a credible simulation that ends slightly colder than the control coupled simulation. The authors find this is due to aerosol indirect effects that are slightly stronger in the new version of the model and propose a solution to ameliorate this. Overall, in these early coupled simulations, CAM5.5 produces a credible climate that is appropriate for science applications and is ready for integration into the National Center for Atmospheric Research's (NCAR's) next-generation climate model.
Zheng, Zhen; Xue, Charlie C L
Sixty percent (60%) to 80% of patients who visit chiropractic, osteopathic, or Chinese medicine practitioners are seeking pain relief. This article aimed to identify the amount, quality, and type of complementary and alternative medicine (CAM) pain research in Australia by systematically and critically reviewing the literature. PubMed, Scopus, Australasian Medical Index, and Cochrane library were searched from their inception to July 2009. Australian and New Zealand Clinical Trial Registration and National Health and Medical Research Council databases were searched for human studies yet to be completed. Predefined search terms and selection criteria were used for data identification. Of 204 studies selected, 54% were on chiropractic, 27% on Chinese medicine, 15% about multitherapy, and 4% on osteopathy. Chronic spinal pain was the most studied condition, with visceral pain being the least studied. Half of the articles in Chinese medicine or multitherapy were systematic reviews or randomized control trials. In comparison, only 5% of chiropractic and none of osteopathy studies were in these categories. Government funding was rare, and most studies were self-funded or internally funded. All chiropractic, osteopathic, and Chinese herbal medicine studies were conducted by the researchers of the professions. In contrast, half of the acupuncture studies and all t'ai chi studies were conducted by medical doctors or physiotherapists. Multidisciplinary collaboration was uncommon. The quantity and the quality of CAM pain research in Australia are inconsistent with the high utilization of the relevant CAM therapies by Australians. A substantial increase in government funding is required. Collaborative research examining the multimodality or multidisciplinary approach is needed.
Wardle, J; Adams, J; Sibbritt, D
Homeopathy has attracted considerable recent attention from the Australian conventional medical community. However, despite such increased attention there has been little exploration of the interface between homeopathy and Australian conventional medical practice. This article addresses this research gap by exploring homeopathic practice and referral by rural and regional Australian general practitioners (GPs). A 27-item questionnaire was sent to all 1486 GPs currently practising in rural and regional New South Wales, Australia (response rate 40.7%). Few GPs in this study utilised homeopathy in their personal practice, with only 0.5% of GPs prescribing homeopathy in the past 12 months, and 8.5% referring patients for homeopathic treatment at least a few times over the past 12 months. Nearly two-thirds of GPs (63.9%) reported that they would not refer for homeopathy under any circumstances. Being in a remote location, receiving patient requests for homeopathy, observing positive responses from homeopathy previously, using complementary and alternative medicine (CAM) practitioners as information sources, higher levels of knowledge of homeopathy, and being interested in increasing CAM knowledge were all independently predictive of increased referral to homeopathy amongst GPs in this study. GPs in this study were less likely to refer to homeopathy if they used peer-reviewed literature as the major source of their information on CAM. Homeopathy is not integrated significantly in rural general practice either via GP utilisation or referral. There is significant opposition to homeopathy referral amongst rural and regional GPs, though some level of interaction with homeopathic providers exists. Copyright © 2013 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.
Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie
Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients' conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients' stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members' stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients' opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work.
Crassulacean Acid Metabolism (CAM) as an ecophysiological modification of photosynthetic carbon acquisition has been reviewed extensively before. Cell biology, enzymology and the flow of carbon along various pathways and through various cellular compartments have been well documented and discussed. The present attempt at reviewing CAM once again tries to use a different approach, considering a wide range of inputs, receivers and outputs. Input is given by a network of environmental parameters. Six major ones, CO(2), H(2)O, light, temperature, nutrients and salinity, are considered in detail, which allows discussion of the effects of these factors, and combinations thereof, at the individual plant level ('physiological aut-ecology'). Receivers of the environmental cues are the plant types genotypes and phenotypes, the latter including morphotypes and physiotypes. CAM genotypes largely remain 'black boxes', and research endeavours of genomics, producing mutants and following molecular phylogeny, are just beginning. There is no special development of CAM morphotypes except for a strong tendency for leaf or stem succulence with large cells with big vacuoles and often, but not always, special water storage tissues. Various CAM physiotypes with differing degrees of CAM expression are well characterized. Output is the shaping of habitats, ecosystems and communities by CAM. A number of systems are briefly surveyed, namely aquatic systems, deserts, salinas, savannas, restingas, various types of forests, inselbergs and paramós. While quantitative census data for CAM diversity and biomass are largely missing, intuition suggests that the larger CAM domains are those systems which are governed by a network of interacting stress factors requiring versatile responses and not systems where a single stress factor strongly prevails. CAM is noted to be a strategy for variable, flexible and plastic niche occupation rather than lush productivity. 'Physiological syn-ecology' reveals
Tapie, Laurent; Lebon, Nicolas; Mawussi, Bernardin; Fron-Chabouis, Hélène; Duret, Francois; Attal, Jean-Pierre
As is the case in the field of medicine, as well as in most areas of daily life, digital technology is increasingly being introduced into dental practice. Computer-aided design/ computer-aided manufacturing (CAD/CAM) solutions are available not only for chairside practice but also for creating inlays, crowns, fixed partial dentures (FPDs), implant abutments, and other dental prostheses. CAD/CAM dental practice can be considered as the handling of devices and software processing for the almost automatic design and creation of dental restorations. However, dentists who want to use dental CAD/CAM systems often do not have enough information to understand the variations offered by such technology practice. Knowledge of the random and systematic errors in accuracy with CAD/CAM systems can help to achieve successful restorations with this technology, and help with the purchasing of a CAD/CAM system that meets the clinical needs of restoration. This article provides a mechanical engineering viewpoint of the accuracy of CAD/ CAM systems, to help dentists understand the impact of this technology on restoration accuracy.
Kooreman, P.; Baars, E.
Background Health economists have largely ignored complementary and alternative medicine (CAM) as an area of research, although both clinical experiences and several empirical studies suggest cost-effectiveness of CAM. Objective To explore the cost-effectiveness of CAM compared with conventional
In Lebanon, estimates of Complementary and Alternative Medicine (CAM) use among college students are not available. CAM practices are not well regulated and some products contain unsafe substances. The purpose of this study was to estimate the prevalence and predictors of CAM use among Lebanese college students using the health belief model. A…
Nowak, Amy L. Versnik; Hale, Heidi M.
Research shows that Americans are using increasing amounts of complementary and alternative medicine (CAM) and that education is a significant predictor of CAM use. The purpose of this systematic review is to summarize key research findings on CAM use rates among U.S. college students and recommend future actions for researchers and health…
Ayers, Stephanie L; Kronenfeld, Jennie J
To extend knowledge of complementary and alternative medicine (CAM) use by understanding how poor health influences both trying CAM and number of CAM types used. Using the 2002 National Health Interview Survey's Supplemental Section, zero-inflated models were employed to examine CAM use across 5 domains. Results indicate that level of pain is the only consistent predictor of both the likelihood of trying CAM and how many types of CAM are used. Pain increased the odds ratio and number of CAM types used across all domains. Findings, however, were mixed for health status and chronic conditions. Only prayer was associated with higher odds ratio (OR=1.705, PCAM types used for chronic illnesses (OR=1.024, PCAM use behaviors. Pain is the only consistent predictor of both trying CAM and the number of CAM types used. Chronic illness is only consistently influential for prayer.
Jennie C. I. Tsao
Full Text Available Patient expectations regarding complementary and alternative medicine (CAM interventions have important implications for treatment adherence, attrition and clinical outcome. Little is known, however, about parent and child treatment expectations regarding CAM approaches for pediatric chronic pain problems. The present study examined ratings of the expected benefits of CAM (i.e. hypnosis, massage, acupuncture, yoga and relaxation and conventional medicine (i.e. medications, surgery interventions in 45 children (32 girls; mean age = 13.8 years ± 2.5 and parents (39 mothers presenting for treatment at a specialty clinic for chronic pediatric pain. Among children, medications and relaxation were expected to be significantly more helpful than the remaining approaches (P < 0.01. However, children expected the three lowest rated interventions, acupuncture, surgery and hypnosis, to be of equal benefit. Results among parents were similar to those found in children but there were fewer significant differences between ratings of the various interventions. Only surgery was expected by parents to be significantly less helpful than the other approaches (P < 0.01. When parent and child perceptions were compared, parents expected hypnosis, acupuncture and yoga, to be more beneficial than did children, whereas children expected surgery to be more helpful than did parents (P < 0.01. Overall, children expected the benefits of CAM to be fairly low with parents' expectations only somewhat more positive. The current findings suggest that educational efforts directed at enhancing treatment expectations regarding CAM, particularly among children with chronic pain, are warranted.
(DOAJ), African Journal Online, Bioline International, Open-J-Gate and Pharmacy Abstracts. INTRODUCTION. Complementary and alternative medicine (CAM) .... with apigenin backbone were found in the green ..... products A.D. 2006.
AlGhamdi, Khalid M; Khurrum, Huma; Al-Natour, Sahar H; Alghamdi, Waleed; Mubki, Thamer; Alzolibani, Abdulatif; Hafez, Dhafer Mohammed Y; AlDraibi, Mohammed
Little is known about the prevalence and practice of complementary and alternative medicine (CAM) among dermatology patients in the Arab world. The aim of this study was to determine knowledge and attitudes about CAM, prevalence of its use, reasons for its use, and types of CAM used in dermatology patients in Saudi Arabia. This was a national survey of various regions of Saudi Arabia. In this cross-sectional study, dermatology outpatients were interviewed using a questionnaire. Sociodemographic characteristics, acceptability, utilization pattern, and reasons for CAM use were elicited. Dermatology life quality index (DLQI) was obtained. Overall, 1901 patients returned complete questionnaires out of 2500 distributed (76% response rate). Of these, 808 (40%) were CAM users, and the majority were woman (55.1%), with a mean age of 31.6±12 years. Most were literate (71.2%) and just over half were married (51.9%). Patients with acute skin diseases were found to be more likely to use CAM (P=.027). The mean DLQI score was higher (worse quality of life) among CAM users than among nonusers (P=.002). The results showed that 315 of 801 (40%) and 250 of 601 (30%) CAM users agreed that CAM methods are safer and more effective than modern medicine, respectively, and 83% will continue to use CAM in future. The most commonly used CAM modalities were vitamins, prayers, natural products, and herbs. Responses indicated that 379 of 803 (47.2%) CAM users did not consult their doctor before using CAM, and 219 of 743 (30%) did not obtain sufficient answers regarding CAM use from their dermatologists. There is a significant use of CAM among dermatology outpatients in Saudi Arabia. In view of the common belief that CAM has fewer side effects than conventional medicine, dermatologists need to increase their awareness of CAM. © The Author(s) 2015.
Houzé, Bérengère; El-Khatib, Héjar; Arbour, Caroline
Complementary and alternative medicine (CAM) therapies may be used as a non-pharmacological approach to chronic pain management. While hundreds of trials about individual CAM modality have been conducted, a comprehensive overview of their results is currently lacking for pain clinicians and researchers. This umbrella review synthesized the quality of meta-analytic evidence supporting the efficacy, tolerability and safety of CAM therapies for the management of chronic pain. MEDLINE, EMBASE, CINAHL, and CENTRAL were searched from October 1991 to November 2016. Reviews of clinical trials (randomized and non-randomized) with meta-analysis investigating the utility of any CAM modality for chronic pain were eligible. Pain relief post-intervention was the main outcome and secondary outcomes included patients' adherence and incidence of adverse effects during CAM protocol. Twenty-six reviews (207 clinical trials, >12,000 participants) about 18 CAM modalities, falling under natural products, mind and body practices or other complementary health approaches were included. Inhaled cannabis, graded motor imagery, and Compound Kushen injection (a form of Chinese medicine) were found the most efficient (with moderate-to-high effect sizes and low heterogeneity) and tolerable (≥80% of adherence to study protocols) for chronic pain relief. When reported, adverse effects related to these CAM were minor. Although several CAM were found effective for chronic pain relief, it remains unclear when these modalities are a reasonable choice against or in conjunction with mainstream treatments. In that sense, future research with a clear emphasis on concurrent evaluation of CAM overall efficacy and patient adherence/tolerance is needed. Copyright © 2017 Elsevier Inc. All rights reserved.
Cheng, Chen-Hsiu; Chen, Shih-Chien
Nurse practitioner development affirms the social value of nursing staff and promotes the professional image of nursing. As the medical environment and doctor-patient relations change, how should a nurse practitioner carry out clinical care? Apart from having foundations in medical knowledge and high-quality nursing techniques, nurse practitioners must have other clinical skills, in order to break out of their former difficult position, promote nursing competitiveness, provide a multi -dimensional service, win the people's acclamation and develop international links.
Full Text Available Evidence-based medicine is switching from the analysis of single diseases at a time toward an integrated assessment of a diseased person. Complementary and alternative medicine (CAM offers multiple holistic approaches, including osteopathy, homeopathy, chiropractic, acupuncture, herbal and energy medicine and meditation, all potentially impacting on major human diseases. It is now becoming evident that acupuncture can modify the expression of different endorphin genes and the expression of genes encoding for crucial transcription factors in cellular homeostasis. Extremely low frequency magnetic fields have been found to prime the commitment to a myocardial lineage in mouse embryonic stem cells, suggesting that magnetic energy may direct stem cell differentiation into specific cellular phenotypes without the aid of gene transfer technologies. This finding may pave the way to novel approaches in tissue engineering and regeneration. Different ginseng extracts have been shown to modulate growth and differentiation in pluripotent cells and to exert wound-healing and antitumor effects through opposing activities on the vascular system, prompting the hypothesis that ancient compounds may be the target for new logics in cell therapy. These observations and the subtle entanglement among different CAM systems suggest that CAM modalities may deeply affect both the signaling and transcriptional level of cellular homeostasis. Such a perception holds promises for a new era in CAM, prompting reproducible documentation of biological responses to CAM-related strategies and compounds. To this end, functional genomics and proteomics and the comprehension of the cell signaling networks may substantially contribute to the development of a molecular evidence–based CAM.
Shim, Jae-Mahn; Lee, Yun-Suk
The holistic use of a system of complementary and alternative medicine (CAM) is potentially linked to its treatment outcomes. This paper examines how the use of biomedicine is associated with the holistic use of CAM, focusing on traditional East Asian medicine (EM) that is uniquely integrated in the medical system in South Korea. A representative national sample of EM outpatients in South Korea. 3861 survey respondents. By using the 2011 Korean National Survey of EM patients, ordered logistic regression models specify the relationship between EM outpatients' use of biomedicine and their holistic use of EM modalities. Among EM outpatients who used at least one EM modality in the past 3 months, people who used two (33.3%) or three (29.4%) modalities together are the two highest proportions, followed by users of four (18.1%), five (7.2%), six (2.1%) and seven (0.6%) modalities. The odds for EM users to use EM holistically are 17% greater among EM users who used biomedicine as well, compared with EM users who did not use biomedicine. The healthcare community should recognise that CAM use likely becomes holistic as people use biomedicine concomitantly, when the practice rights over a CAM system are comprehensively and exclusively entitled to a group of CAM professionals who are independent from practitioners of biomedicine. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Jones, Salene M W; Lange, Jane; Turner, Judith; Cherkin, Dan; Ritenbaugh, Cheryl; Hsu, Clarissa; Berthoud, Heidi; Sherman, Karen
Patient expectations may be associated with outcomes of complementary and alternative medicine (CAM) treatments for chronic pain. However, a psychometrically sound measure of such expectations is needed. The purpose of this study was to develop and evaluate a questionnaire to assess individuals' expectations regarding outcomes of CAM treatments for chronic low back pain (CLBP), as well as a short form of the questionnaire. An 18-item draft questionnaire was developed through literature review, cognitive interviews with individuals with CLBP, CAM practitioners, and expert consultation. Two samples completed the questionnaire: (1) a community sample (n = 141) completed it via an online survey before or soon after starting a CAM treatment for CLBP, and (2) participants (n = 181) in randomized clinical trials evaluating CAM treatments for CLBP or fibromyalgia completed it prior to or shortly after starting treatment. Factor structure, internal consistency, test-retest reliability, and criterion validity were examined. Based on factor analyses, 10 items reflecting expectations (used to create a total score) and three items reflecting hopes (not scored) were selected for the questionnaire. The questionnaire had high internal consistency, moderate test-retest reliability, and moderate correlations with other measures of expectations. A three-item short form also had adequate reliability and validity. The Expectations for Complementary and Alternative Medicine Treatments (EXPECT) questionnaire can be used in research to assess individuals' expectations of treatments for chronic pain. It is recommended that the three hope questions are included (but not scored) to help respondents distinguish between hopes and expectations. The short form may be appropriate for clinical settings and when expectation measurement is not a primary focus.
Standardised Chinese herbal treatment delivered by GPs compared with individualised treatment administered by practitioners of Chinese herbal medicine for women with recurrent urinary tract infections (RUTI): study protocol for a randomised controlled trial.
Flower, Andrew; Harman, Kim; Lewith, George; Moore, Michael; Bishop, Felicity L; Stuart, Beth; Lampert, Nicholas
In the UK, urinary tract infections (UTIs) are the most common bacterial infection presented by women in primary care. Recurrent urinary tract infections (RUTIs) are defined as three episodes of UTI in the last 12 months, or two episodes in the last 6 months. Between 20 and 30 % of women who have had one episode of UTI will have an RUTI, and approximately 25 % of these will develop subsequent recurrent episodes. RUTIs can have a significant negative effect on the quality of life, and have a high impact on health care costs as a result of outpatient visits, diagnostic tests and prescriptions. Chinese herbal medicine (CHM) has a recorded history of treatments for the symptoms of UTIs for more than 2000 years. More recent clinical research in China has provided some preliminary evidence that CHM can alleviate the symptoms of UTIs and reduce the rate of recurrence, but more rigorous investigation is required. The RUTI trial is a double-blind, randomised, placebo-controlled, feasibility trial. A total of 80 women will be randomised to 'individualised' herbs prescribed by a Chinese herbal practitioner or to 'standardised' herbs provided by primary care clinicians. Both arms will have herbs for prevention of UTIs and treatment of acute episodes. Treatment duration is for 16 weeks. The primary outcomes are the number of episodes of recurrent UTIs during the trial period and in the 6 months of follow-up, and the number of days of symptoms rated moderately bad or worse based on patient diaries. Secondary outcomes will assess participant expectations and beliefs, adherence to the treatment, adverse events and health economics and provide quantitative and qualitative assessments of the impact of recurrent infections on the lives of women. The RUTI trial is the first instance of CHM delivered as a clinical trial of an investigatory medicinal product in the UK. This study provides important information regarding the feasibility and acceptability of researching and using
Grundmann, Oliver; Yoon, Saunjoo L
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder with a high incidence in the general population. The diagnosis of IBS is mainly based on exclusion of other intestinal conditions through the absence of inflammatory markers and specific antigens. The current pharmacological treatment approaches available focus on reducing symptom severity while often limiting quality of life because of significant side effects. This has led to an effectiveness gap for IBS patients that seek further relief to increase their quality of life. Complementary and alternative medicines (CAM) have been associated with a higher degree of symptom management and quality of life in IBS patients. Over the past decade, a number of important clinical trials have shown that specific herbal therapies (peppermint oil and Iberogast®), hypnotherapy, cognitive behavior therapy, acupuncture, and yoga present with improved treatment outcomes in IBS patients. We propose an integrative approach to treating the diverse symptoms of IBS by combining the benefits of and need for pharmacotherapy with known CAM therapies to provide IBS patients with the best treatment outcome achievable. Initial steps in this direction are already being considered with an increasing number of practitioners recommending CAM therapies to their patients if pharmacotherapy alone does not alleviate symptoms sufficiently. PMID:24574705
Full Text Available The coupled additive and multiplicative (CAM noises model is a stochastic volatility model for derivative pricing. Unlike the other stochastic volatility models in the literature, the CAM model uses two Brownian motions, one multiplicative and one additive, to model the volatility process. We provide empirical evidence that suggests a nontrivial relationship between the kurtosis and skewness of asset prices and that the CAM model is able to capture this relationship, whereas the traditional stochastic volatility models cannot. We introduce a control variate method and Monte Carlo estimators for some of the sensitivities (Greeks of the model. We also derive an approximation for the characteristic function of the model.
In an assembly for an internal combustion engine comprising a cylinder block, a cylinder head detachably affixed to the cylinder block by a plurality of threaded fastening means, a plurality of poppet valves supported for reciprocation in the cylinder head and a camshaft for operating the poppet valves, the improvement is described comprising a cam carrier detachably affixed to the cylinder head and overlying the threaded fastening means, and a bearing cap affixed to the cam carrier. The cam carrier and the bearing cap have bearing surfaces for journaling the camshaft.
Kovalchuk, L I; Prokopchuk, Y V; Naydyonova, O V
The article presents the experience of postgraduate training of general practitioners--family medicine. Identified current trends, forms and methods of pedagogical innovations that enhance the quality of learning and mastering the practical skills of primary professionals providing care.
Nahleh, Zeina; Tabbara, Imad A
Complementary and Alternative Medicine (CAM) is becoming increasingly popular among cancer patients, in particular those with breast cancer. It represents one of the fastest growing treatment modalities in the United States. Therefore, knowledge of CAM therapies is becoming necessary for physicians and other health care providers. CAM encompasses a wide range of modalities including special diet and nutrition, mind-body approaches, and traditional Chinese medicine. We reviewed the biomedical literature on CAM use in breast cancer patients, using Medline search from 1975 until 2002. In addition, consensus reports and books on CAM and breast cancer were included in the review. We evaluated the prevalence of CAM use in breast cancer patients, the reasons cited for its use, the different available modalities, and the reported outcomes. Use of CAM in breast cancer patients ranges between 48% and 70% in the United States. The most commonly used CAM modalities include dietary supplements, mind-body approaches, and acupuncture. The reasons cited for using CAM were to boost the immune system, improve the quality of life, prevent recurrence of cancer, provide control over life, and treat breast cancer and the side effects of treatment. Several studies reported favorable results including improved survival, better pain control, reduced anxiety, improvement in coping strategies and significant efficacy in treating nausea and vomiting. Other less well-organized trials have reported either no benefit or negative effect of CAM and potential toxicity of some commercial products. CAM is a growing field in health care and particularly among breast cancer patients. Knowledge of CAM by physicians, especially oncologists, is necessary. Oncologists should be willing to discuss the role of CAM with their patients and encourage patients to participate in well-organized research about CAM.
Nadareishvili, I; Lunze, K; Tabagari, N; Beraia, A; Pkhakadze, G
In Georgia, like in most countries globally, people commonly resort to complementary and alternative medicine (CAM). However, not much is known about CAM practices there. The aim of the study was to document common practices of CAM in Georgia and related patient attitudes. We collected data from peoples who commonly use CAM at 20 service provision centers in Georgia using cluster sampling from 300 patients. We admininstered a cross-sectional survey and conducted descriptive statistical analyses. People in Georgia use CAM either for prevention to improve general health (33%) or to treat chronic conditions (36%), spending about 25 Euros per month out of pocket. Most (77%) get their knowledge about CAM from family or friends , less than half (44%) from books or media, and 11% from medical providers. A close person's advice or experience was the most common rationale given for CAM use (54%). In our sample, 17% either don't trust or are unsatisfied with conventional medicine, 29% found CAM treatment "very effective" and 61% "quite/partially" effective; only 5% not effective. Conventional treatment was stopped in half of the cases. 35% of respondents informed their physicians of their CAM use, while about half did not. Public mistrust towards conventional medicine, CAM user high satisfaction, relatively low cost of such services in Georgia - are the factors letting us to suggest that CAM use will further increase. Frequent self taking decisions made by patients to stop physician prescribed treatment, not informing physicians on CAM use, as well as other factors put patients health at risk. Further research and capacity building in practice, education and other related aspects are needed to establish evidence-based regulation and standards for CAM in Georgia that ensure informed decision making and patient safety.
National Oceanic and Atmospheric Administration, Department of Commerce — The CAMS system consists of a set of tables and packages that provide authentication services to all other North Pacific Groundfish and Halibut Observing Program...
In the context of data stream research, taming the multidimensionality of real-life data streams in order to efficiently support OLAP analysis/mining tasks is a critical challenge. Inspired by this fundamental motivation, in this paper we introduce CAMS (C ube-based A cquisition model for M ultidimensional S treams), a model for efficiently OLAPing multidimensional data streams. CAMS combines a set of data stream processing methodologies, namely (i) the OLAP dimension flattening process, which allows us to obtain dimensionality reduction of multidimensional data streams, and (ii) the OLAP stream aggregation scheme, which aggregates data stream readings according to an OLAP-hierarchy-based membership approach. We complete our analytical contribution by means of experimental assessment and analysis of both the efficiency and the scalability of OLAPing capabilities of CAMS on synthetic multidimensional data streams. Both analytical and experimental results clearly connote CAMS as an enabling component for next-generation Data Stream Management Systems.
About 128 air samplers and CAMs presently in service to detect and document potential radioactive release from 'H' and 'F' area tank farm ventilation stacks are scheduled for replacement and/or upgrade by Projects S-5764, S-2081, S-3603, and S-4516. The seven CAMs scheduled to be upgraded by Project S-4516 during 1995 are expected to provide valuable experience for the three remaining projects. The attached document provides design guidance for the standardized High Level Waste air sampling system
Brenkert, Antoinette L.; Smith, Steven J.; Kim, Son H.; Pitcher, Hugh M.
The MiniCAM, short for the Mini-Climate Assessment Model, is an integrated assessment model of moderate complexity focused on energy and agriculture sectors. The model produces emissions of greenhouse gases (carbon dioxide, methane and nitrous oxide) and other radiatively important substances such as sulfur dioxide. Through incorporation of the simple climate model MAGICC, the consequences of these emissions for climate change and sea-level rise can be examined. The MiniCAM is designed to be fast and flexible.
Landis, Erin T; Davis, Scott A; Feldman, Steven R; Taylor, Sarah
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.
Zhang, Jisen; Liu, Juan; Ming, Ray
The innovation of crassulacean acid metabolism (CAM) photosynthesis in arid and/or low CO2 conditions is a remarkable case of adaptation in flowering plants. As the most important crop that utilizes CAM photosynthesis, the genetic and genomic resources of pineapple have been developed over many years. Genetic diversity studies using various types of DNA markers led to the reclassification of the two genera Ananas and Pseudananas and nine species into one genus Ananas and two species, A. comosus and A. macrodontes with five botanical varieties in A. comosus. Five genetic maps have been constructed using F1 or F2 populations, and high-density genetic maps generated by genotype sequencing are essential resources for sequencing and assembling the pineapple genome and for marker-assisted selection. There are abundant expression sequence tag resources but limited genomic sequences in pineapple. Genes involved in the CAM pathway has been analysed in several CAM plants but only a few of them are from pineapple. A reference genome of pineapple is being generated and will accelerate genetic and genomic research in this major CAM crop. This reference genome of pineapple provides the foundation for studying the origin and regulatory mechanism of CAM photosynthesis, and the opportunity to evaluate the classification of Ananas species and botanical cultivars. © The Author 2014. Published by Oxford University Press on behalf of the Society for Experimental Biology. All rights reserved. For permissions, please email: email@example.com.
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
Anlauf, Manfred; Hein, Lutz; Hense, Hans-Werner; Köbberling, Johannes; Lasek, Rainer; Leidl, Reiner; Schöne-Seifert, Bettina
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
Anlauf, Manfred; Hein, Lutz; Hense, Hans-Werner; Köbberling, Johannes; Lasek, Rainer; Leidl, Reiner; Schöne-Seifert, Bettina
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 of
Complementary and alternative medicine (CAM), such as acupuncture and herbal medicine, is popular in many countries. Yet, treatment outcomes of CAM are found to vary significantly between medical trials in different social environments. This paper addresses how the social organization of medicine affects medical treatment outcomes. In particular, it examines the extent to which two popular complementary and alternative medicine (CAM) interventions (acupuncture and herbal medicine) are coordinated with biomedicine and how coordination characteristics are related to the treatment outcomes of the two CAM interventions. This paper conducts an archival analysis of the institutional settings of the CAM interventions in Japan and the U.S. It also conducts a systematic content analysis of the treatment outcomes in 246 acupuncture reports and 528 herbal medicine reports that are conducted in Japan or the U.S. and registered in the Cochrane Library's Central Register of Controlled Trials (CENTRAL), and 716 acupuncture reports and 3,485 herbal medicine reports that are from Japan or the U.S. and listed in MEDLINE. It examines the association between the treatment outcomes of the two interventions and the geographical location of the reports; it also explores how the institutional settings of the interventions are related to the treatment outcomes. Japanese herbal medicine is integrated into the national medical system the most and American herbal medicine the least; American acupuncture and Japanese acupuncture fall in the middle. Treatment outcomes are the most favorable for Japanese herbal medicine and the least favorable for American herbal medicine. The outcomes of American acupuncture and Japanese acupuncture fall in the middle. The co-utilization of CAM with biomedicine can produce difficulties due to tensions between CAM and biomedicine. These difficulties and subsequent CAM treatment outcomes vary, depending on how CAM is institutionalized in relation to biomedicine
Lauren M. Denneson, PhD; Kathryn Corson, PhD; Steven K. Dobscha, MD
We describe prior use and willingness to try complementary and alternative medicine (CAM) among 401 veterans experiencing chronic noncancer pain and explore differences between CAM users and nonusers. Participants in a randomized controlled trial of a collaborative intervention for chronic pain from five Department of Veterans Affairs (VA) primary care clinics self-reported prior use and willingness to try chiropractic care, massage therapy, herbal medicines, and acupuncture. Prior CAM users ...
Aburahma, Samah K; Khader, Yousef S; Alzoubi, Karem; Sawalha, Noor
To evaluate the frequency and determinants of complementary and alternative medicine (CAM) use in children attending a pediatric neurology clinic in North Jordan, a parent completed questionnaire survey of children attending the pediatric neurology clinic at King Abdullah University Hospital from March to July 2008 was conducted. A review of 176 completed questionnaires showed that 99 parents (56%) had used CAM for their child's specific neurological illness. The most common modalities were prayer/reciting the Quran (77%), religious healers (30%), massage with olive oil (32%), and consumption of honey products (29%). The most common reason was religious beliefs in 68%. None reported lack of trust in conventional medicine as the reason behind seeking CAM. Factors significantly associated with CAM use were speech delay, belief in its usefulness, father's age more than 30 years, and mothers with education less than high school. CAM had a supplementary role in relation to traditional western medicine use. Copyright 2010 Elsevier Ltd. All rights reserved.
Madsen, Hanne; Andersen, Susie; Nielsen, Rasmus Gaardskaer
Hospital during a 2 week period in the autumn of 2001 were asked to participate. In total, 622 (92%) patients participated. The data were collected in an interviewer administered questionnaire during a short structured interview with the patient and parents. CAM was divided into herbal medicine (herbal......UNLABELLED: The use of complementary/alternative medicine (CAM) is increasing. The aim was to characterise the use of CAM among patients in a paediatric department. All patients (aged 0-18 years), out-patients or hospitalised, in contact with the Department of Paediatrics, Odense University...... patients suffering from gastrointestinal diseases or hospitalised for observation. More than 50% of the users experienced positive effects and 6% had side-effects from AM. Of the CAM users, 11% or 2% of the total paediatric population used CAM instead of conventional medicines. CONCLUSION...
Gerber, L M; Mamtani, R; Chiu, Y-L; Bener, A; Murphy, M; Cheema, S; Verjee, M
The prevalence of use of complementary and alternative medicine (CAM) is widespread and is growing worldwide. This cross-sectional study in Qatar examined the use of CAM and its correlates among Arab women in their midlife years. Women aged 40-60 years (n = 814) were recruited at primary care centres in Qatar and completed a specially designed, pre-tested questionnaire. Overall, 38.2% of midlife women in Qatar had used CAM in the previous 12 months. Nutritional remedies and herbal remedies were the most commonly used CAM therapies, followed by physical methods. Qatari nationality and higher level of education were independently associated with CAM use. Menopause transition status was not independently associated with use of CAM. The prevalence of CAM use by women in Qatar was high, consistent with other reports worldwide. It is essential to educate and inform patients and health-care providers about the benefits and limitations associated with CAM.
CHAO, MARIA T.; WADE, CHRISTINE; KRONENBERG, FREDI; KALMUSS, DEBRA; CUSHMAN, LINDA F.
Objectives Although racial/ethnic differences in the prevalence of complementary and alternative medicine (CAM) utilization have been documented, differences in the reasons for using CAM have not been empirically assessed. In an increasingly diverse society, understanding differences in rates of and reasons for CAM use could elucidate cultural and social factors of health behaviors and inform health care improvements. The current study examines reasons for CAM use among women in four racial/ethnic groups. Design A national telephone survey of 3172 women aged 18 years and older was conducted in four languages. Respondents were asked about their use of remedies or treatments not typically prescribed by a medical doctor. This study focuses on those women who used CAM in the previous year and their reasons for using CAM. Results Non-Hispanic white women were most likely to cite personal beliefs for CAM use. Cost of conventional medicine was most prevalent among Mexican-American women CAM users. Physician referral, family and friends, and media sources were all equally likely to lead to CAM use in non-Hispanic white women. In contrast, informal networks of family and friends were the most important social influences of CAM use among African-, Mexican-, and Chinese-American women. Conclusions Racial/ethnic differences in reasons for CAM use highlight cultural and social factors that are important to consider in public evaluation of the risks and benefits of CAM remedies and treatments. PMID:17034277
, construct their identities in the light of inclusive education, and how they negotiate the tensions and contradictions emerging from the processof becoming inclusive practitioners. Central to this discussion is the understanding that teachers' ...
Mason, Larry W.; Way, J. Douglas; Vlasse, Marcus
The objective of CAM is to develop, test, and analyze thin film membrane materials for separation and purification of carbon dioxide (CO2) from mixtures of gases, such as those found in the Martian atmosphere. The membranes are targeted toward In Situ Resource Utilization (ISRU) applications that will operate in extraterrestrial environments and support future unmanned and human space missions. A primary application is the Sabatier Electrolysis process that uses Mars atmosphere CO2 as raw material for producing water, oxygen, and methane for rocket fuel and habitat support. Other applications include use as an inlet filter to collect and concentrate Mars atmospheric argon and nitrogen gases for habitat pressurization, and to remove CO2 from breathing gases in Closed Environment Life Support Systems (CELSS). CAM membrane materials include crystalline faujasite (FAU) zeolite and rubbery polymers such as silicone rubber (PDMS) that have been shown in the literature and via molecular simulation to favor adsorption and permeation of CO2 over nitrogen and argon. Pure gas permeation tests using commercial PDMS membranes have shown that both CO2 permeance and the separation factor relative to other gases increase as the temperature decreases, and low (Delta)P(Sub CO2) favors higher separation factors. The ideal CO2/N2 separation factor increases from 7.5 to 17.5 as temperature decreases from 22 C to -30 C. For gas mixtures containing CO2, N2, and Ar, plasticization decreased the separation factors from 4.5 to 6 over the same temperature range. We currently synthesize and test our own Na(+) FAU zeolite membranes using standard formulations and secondary growth methods on porous alumina. Preliminary tests with a Na(+) FAU membrane at 22 C show a He/SF6 ideal separation factor of 62, exceeding the Knudsen diffusion selectivity by an order of magnitude. This shows that the membrane is relatively free from large defects and associated non-selective (viscous flow) transport
Johnson, Susan K.; Blanchard, Anita
In this study, the authors investigated the predictors of complementary and alternative medicine (CAM) and herbal supplement use among university students. They investigated demographic factors, trait affectivity, symptom reports, and individuals' worries about modernity as potential contributors to use of CAM and herbals. The authors surveyed 506…
Introduction: the use of complementary and alternative medicine (CAM) has increased over the last few years, and an emergent data suggests that some CAM modalities may be helpful in addressing gastrointestinal (GI) conditions. Our aimwas to find out the prevalence ofsuch practices for GI condition amongst patients ...
Golnik, Allison E.; Ireland, Marjorie
Previous studies suggest over half of children with autism are using complementary alternative medicine (CAM). In this study, physicians responded (n = 539, 19% response rate) to a survey regarding CAM use in children with autism. Physicians encouraged multi-vitamins (49%), essential fatty acids (25%), melatonin (25%) and probiotics (19%) and…
Complementary and alternative medicine (CAM) is garnering increasing interest and acceptance among the general population throughout the world. The use of CAM by cancer patients is very common in China. The referenced English literature has no rural community-based study from China on this subject. This study ...
Background: Complementary and alternative medicines (CAM) are increasingly popular globally with frequent use amongst patients with atopic eczema (AE). Despite increased AE prevalence in South Africa (SA), no local data on CAM-use for this disease exists. Methods: A cross-sectional study utilizing a comprehensive ...
Gan, G G; Leong, Y C; Bee, P C; Chin, E; Teh, A K H
Complementary and alternative medicine (CAM) is often used by cancer patients, but not many studies had been published on the prevalence of CAM use in patients with hematological cancers. This study aims to determine the prevalence of CAM and type of CAM used in this group of patients in a multiracial and multicultural country. This is a cross-sectional survey carried out in two hospitals in Malaysia. Patients with underlying hematological cancers were asked to complete the questionnaires on CAM and the Hospital Anxiety and Depression Scale. A total of 245 patients participated. The prevalence of CAM use was 70.2 %. The most common types of CAM used are biological-based therapies (90.2 %) and mind-body interventions (42 %). Vitamin and diet supplements (68.6 %) and folk/herb remedies (58 %) are the most common biological-based therapies used. There is no significant association of CAM use with age, gender, education level, and household income. Female patients are more likely to use more than one CAM therapies. The most common reason reported for CAM use was to boost immunity (57 %) and cure (24 %). Majority of patients (65 %) felt CAM was effective, and 60 % did not inform their physicians regarding CAM usage. In view of the high prevalence of CAM use in patients with hematological cancers, it is important that the physicians play an active role in seeking information from patients and to monitor possible drug-vitamin-herbal interactions.
Wardle, Jon L; Sibbritt, David W; Adams, Jon
Massage therapists are an important part of the health care setting in rural and regional Australia and are the largest complementary and alternative medicine (CAM) profession based on both practitioner numbers and use. The purpose of this study was to survey medical general practitioners (GPs) in rural and regional New South Wales, Australia, to identify their knowledge, attitudes, relationships, and patterns of referral to massage therapy in primary health care. A 27-item questionnaire was sent to all 1486 GPs currently practicing in rural and regional Divisions of General Practice in New South Wales, Australia. The survey had 5 general areas: the GP's personal use and knowledge of massage, the GP's professional relationships with massage practice and massage practitioners, the GP's specific opinions on massage, the GP's information-seeking behavior in relation to massage, and the GP's assumptions on massage use by patients in their local areas. A total of 585 questionnaires were returned completed, with 49 survey questionnaires returned as "no longer at this address" (response rate of 40.7%). More than three-quarters of GPs (76.6%) referred to massage therapy at least a few times per year, with 12.5% of GPs referring at least once per week. The GP being in a nonremote location (odds ratio [OR], 14.28; 95% confidence interval [CI], 3.7-50.0), graduating from an Australian medical school (OR, 2.03; 95% CI, 1.09-3.70), perceiving a lack of other treatment options (OR, 2.64; 95% CI, 1.15-6.01), perceiving good patient access to a wide variety of medical specialists (OR, 11.1; 95% CI, 1.7-50.0), believing in the efficacy of massage therapy (OR, 2.75; 95% CI, 1.58-4.78), experiencing positive results from patients using massage therapy previously (OR, 13.95; 95% CI, 5.96-32.64), or having prescribed any CAM previously (OR, 1.83; 95% CI, 1.03-3.27) were all independently predictive of increased referral to massage therapy among the GPs in this study. There appears to
Roy, Vandana; Gupta, Monica; Ghosh, Raktim Kumar
Complementary and alternative medicine (CAM) has been practiced in India for thousands of years. The aim of this study was to determine the extent of use, perception and attitude of doctors and patients utilizing the same healthcare facility. This study was conducted among 200 doctors working at a tertiary care teaching Hospital, India and 403 patients attending the same, to determine the extent of usage, attitude and perception toward CAM. The use of CAM was more among doctors (58%) when compared with the patients (28%). Among doctors, those who had utilized CAM themselves, recommended CAM as a therapy to their patients (52%) and enquired about its use from patients (37%) to a greater extent. CAM was used concomitantly with allopathic medicine by 60% patients. Very few patients (7%) were asked by their doctors about CAM use, and only 19% patients voluntarily informed their doctors about the CAM they were using. Most patients who used CAM felt it to be more effective, safer, less costly and easily available in comparison to allopathic medicines. CAM is used commonly by both doctors and patients. There is a lack of communication between doctors and patients regarding CAM, which may be improved by sensitization of doctors and inclusion of CAM in the medical curriculum.
Breillat, Christelle; Thoumine, Olivier; Choquet, Daniel
In order to better probe SynCAM function in neurons, we produced a fusion protein between the extracellular domain of SynCAM1 and the constant fragment of human IgG (SynCAM-Fc). Whether in soluble form or immobilized on latex microspheres, the chimera bound specifically to the surface of hippocampal neurons and recruited endogenous SynCAM molecules. SynCAM-Fc was also used in combination with Quantum Dots to follow the mobility of transfected SynCAM receptors at the neuronal surface. Both immobile and highly mobile SynCAM were found. Thus, SynCAM-Fc behaves as a high affinity ligand that can be used to study the function of SynCAM at the neuronal membrane
Zhang, Shaodian; Qiu, Lin; Chen, Frank; Zhang, Weinan; Yu, Yong; Elhadad, Noémie
Patients discuss complementary and alternative medicine (CAM) in online health communities. Sometimes, patients’ conflicting opinions toward CAM-related issues trigger debates in the community. The objectives of this paper are to identify such debates, identify controversial CAM therapies in a popular online breast cancer community, as well as patients’ stances towards them. To scale our analysis, we trained a set of classifiers. We first constructed a supervised classifier based on a long short-term memory neural network (LSTM) stacked over a convolutional neural network (CNN) to detect automatically CAM-related debates from a popular breast cancer forum. Members’ stances in these debates were also identified by a CNN-based classifier. Finally, posts automatically flagged as debates by the classifier were analyzed to explore which specific CAM therapies trigger debates more often than others. Our methods are able to detect CAM debates with F score of 77%, and identify stances with F score of 70%. The debate classifier identified about 1/6 of all CAM-related posts as debate. About 60% of CAM-related debate posts represent the supportive stance toward CAM usage. Qualitative analysis shows that some specific therapies, such as Gerson therapy and usage of laetrile, trigger debates frequently among members of the breast cancer community. This study demonstrates that neural networks can effectively locate debates on usage and effectiveness of controversial CAM therapies, and can help make sense of patients’ opinions on such issues under dispute. As to CAM for breast cancer, perceptions of their effectiveness vary among patients. Many of the specific therapies trigger debates frequently and are worth more exploration in future work. PMID:28967000
Paludan-Müller, Christine; Lunde, Anita; Johannessen, Helle
levels of evidence and were excluded from further evaluation. Among the 32 high-quality reviews the most reviewed practices were soy/plant hormones (7), Chinese herbal medicine (7), antioxidants (5) and mistletoe (4). Fifteen of the 32 reviews included data on the efficacy of biologically-based CAM......-practices against cancer, but none of the reviews concluded a positive effect on the cancer. Reviews including data on quality of life (10) and/or reduction of side effects (12) showed promising, but yet insufficient evidence for Chinese herbal medicine against pain and side effects of chemotherapy, and mistletoe......Purpose To provide an overview and evaluate the evidence of biologically based CAM-practices for cancer patients. Methods Pubmed, Social Science Citation Index, AMED and the Cochrane library were systematically searched for reviews on effects of biologically based CAM-practices, including herbal...
The aim of this study is to investigate the interest of science for the Complementary and Alternative Medicine (CAM) in the chronic pain treatment using the number of articles registered by PubMed as an indicator. On Medline system with the key words: CAM and Pain 11.671 papers are available; 2.167 with the key words: CAM and chronic pain; 192 papers deal with the topic chronic pain and dementia. The interest of science for CAM in chronic pain is increasing, but few studies deal with the e...
Schmacke, Norbert; Müller, Veronika; Stamer, Maren
Homeopathy is one of the most frequently used areas of complementary and alternative medicine (CAM). Previous research has focused in particular on the pharmacological effectiveness of homeopathy. There is intense discussion among German family medical practitioners as to whether family medicine should adopt elements of homeopathy because of the popularity of this treatment method. For the first time in Germany, patients with chronic conditions were asked about their views on the medical care provided by homeopathic medical practitioners. The survey used questionnaire-based, semi-structured expert interviews, the contents of which were then analysed and summarised. A total of 21 women and five men aged from 29 to 75 years were surveyed. The 'fit' between therapist and patient proved to be particularly important. Both the initial homeopathic consultation and the process of searching for the appropriate medication were seen by patients as confidence-inspiring confirmations of the validity of homeopathic therapy which they considered desirable in this personalised form. The possible adoption by family medicine of elements of homeopathy may be seen as controversial, but this study again indicates the vital importance of successful communication to ensure a sustainable doctor-patient relationship. Advances in this sector not only require continuous efforts in the areas of medical training and professional development, but also touch on basic questions relating to the development of effective medical care, such as those currently being discussed in the context of the 'patient-centred medical home'.
Weidenhammer, Wolfgang; Lewith, George; Falkenberg, Torkel
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...... governing CAM provision, and to explore the needs and attitudes of EU citizens with respect to CAM. Based on this information a roadmap will be created that will enable sustainable and prioritised future European research in CAM. CAMbrella encompasses 16 academic research groups from 12 European countries...... review open access publications and a final conference, with emphasis on current and future EU policies, addressing different target audiences....
Yang, Geliang; Zhang, Huiqing; Gan, Zheng; Fan, Yifu; Gu, Wei; Ling, Changquan
Complementary and alternative medicine (CAM) has been widely used by cancer patients but rarely discussed by oncologists. This study was designed to evaluate the communication gap between China's oncologists and cancer patients on CAM. Two parallel cross-sectional studies assessed 83 oncologists and 402 cancer patients on CAM communication between patients and oncologists, and attitudes toward CAM use and clinical decisions about CAM. A majority (75.1%) of the cancer patients (302/402) were identified as CAM users within the most recent three months while 77.6% of the cancer patients (312/402) were identified as CAM users since diagnosis of cancer. Oncologists and patients responded differently ( P effectiveness of CAM, cancer patients were more likely to believe that CAM was effective while oncologists had more concerns about adverse effects of CAM use. CAM use by patients was predicted by disease duration (≥9 months) in the multivariable logistic regression model. China's oncologists and cancer patients may hold discrepant views on CAM. China's oncologists are encouraged to improve their knowledge on CAM and to initiate more discussions with their patients regarding effective and the safe use of CAM.
Elsas, Siegward M
This paper addresses the challenge on how to obtain information from practitioners with experience in using medicinal plants. Collecting information on medicinal uses of plants is very challenging; since botanical remedies are used within the context of multiple differing medical systems, practitioners differ in training from Western physicians and scientists, and active ingredients of botanicals vary with preparation method, growth, and harvest conditions. A model on how useful data on safety and efficacy can be obtained from botanical practitioners is presented, based on methods developed by the association of anthroposophic physicians in Europe, a system of integrative medicine which includes the use of botanicals and is practiced mostly by medical doctors. Decades of experience by hundreds of practitioners are summarized and made accessible in a manual, which alphabetically lists the most commonly used botanicals and describes the most successful therapeutic experiences which could be confirmed by several of the contributing practitioners. This approach of continuous, multilingual systematic collection of successful therapeutic experiences within a community of practitioners with similar goals and a common therapeutic framework can be used not only for the training of successful future botanical practitioners, but also for helping to identify promising botanicals for scientific research and to further their development, and could support their official registration with governing bodies in countries of their use. This article is part of a Special Issue entitled "Botanicals for Epilepsy". Copyright © 2015 Elsevier Inc. All rights reserved.
Shojaii, Seyed Ruhollah; The ATLAS collaboration
This article describes an innovative Content Addressable Memory (CAM) cell with radiation hardened (RH) architecture. The RH-CAM is designed in a commercial 28 nm CMOS technology. The circuit has been simulated in worst-case conditions, and the effects due to single particles have been analyzed by injecting a current pulse into a circuit node. The proposed architecture is suitable for on-time pattern recognition tasks in harsh environments, such as front-end electronics in hadron colliders and in space applications.
Teets, Raymond Y; Dahmer, Stephen; Scott, Emilie
Chronic pain can be a frustrating condition for patient and clinician. The integrative medicine approach to pain can offer hope, adding safe complementary and alternative medical (CAM) therapies to mitigate pain and suffering. Such CAM therapies include nutrition, supplements and herbs, manual medicine, acupuncture, yoga, and mind-body approaches. The evidence is heterogeneous regarding these approaches, but some evidence suggests efficacy and confirms safety. The integrative medicine approach can be beneficial in a patient with chronic pain. Copyright 2010 Elsevier Inc. All rights reserved.
Simpson, Charles A
This article discusses several issues related to therapies that are considered "complementary" or "alternative" to conventional medicine. A definition of "complementary and alternative medicine" (CAM) is considered in the context of the evolving health care field of complementary medicine. A rationale for pain physicians and clinicians to understand these treatments of chronic pain is presented. The challenges of an evidence-based approach to incorporating CAM therapies are explored. Finally, a brief survey of the evidence that supports several widely available and commonly used complementary therapies for chronic pain is provided. Copyright © 2015 Elsevier Inc. All rights reserved.
Bissels, Gerhard; Chandler, Andrea
Purpose: The purpose of this paper is to describe the further development of the Koha 3.0 library management system (LMS) and the involvement of external software consultants at the Complementary and Alternative Medicine Library and Information Service (CAMLIS), Royal London Homoeopathic Hospital. Design/methodology/approach: The paper takes the…
Guinn, D E
For the most part, those who have written on the ethics of complementary and alternative medicine (CAM) and integrative medicine have attempted simply to apply traditional bioethics (in the form of principles of autonomy, beneficence, nonmaleficence, and justice) to this new area of healthcare. In this article I argue that adopting the practices of CAM requires a new ethical understanding that incorporates the values implicit in those practices. The characteristics of CAM and conventional medicine can be translated into the language of healthcare values in a variety of ways. I suggest that they support 5 core values: integrated humanity, ecological integrity, naturalism, relationalism, and spiritualism. Characteristics of both CAM and conventional medicine are present in value. What is now thought of as principlism is, in this understanding, simply a subset within these values.
Full Text Available Abstract Background The use of complementary and alternative medicine (CAM continues to increase in Taiwan. This study examined the use of CAM and beliefs about CAM as expressed by patients with traumatic brain injury (TBI in Taiwan. Methods TBI patients and their accompanying relatives were interviewed by using a structured questionnaire at an outpatient clinic in a medical center in northern Taiwan. Results A total of 101 patients with TBI participated in the study. Sixty-four (63% patients had used at least one form of CAM after sustaining TBI. CAM users had used an average of 2.72 forms of CAM after sustaining TBI. The most frequently used CAM category was traditional Chinese medicine (37; 57.8%, followed by folk and religious therapies (30; 46.9%, and dietary supplements (30; 46.9%. The majority of the patients (45; 70.3% did not report CAM use because they felt it was unnecessary to do so. Patients who used CAM had a significantly stronger positive belief in CAM than those who did not (t = −2.72; P = .008. After using CAM, most of the patients (54; 85% perceived moderate satisfaction (2.89 ± 0.44, according to a 4-point Likert scale. Conclusion Although the use of CAM is common for TBI patients receiving conventional medical health care in Taiwan, most patients did not inform health care personnel about their CAM use. TBI patients perceive combined use of CAM and conventional medicine as beneficial for their overall health.
Gupta, Devanand; Bhaskar, Dara John; Gupta, Kumar Rajendra; Karim, Bushra; Kanwar, Alpana; Jain, Ankita; Yadav, Ankit; Saini, Priya; Arya, Satya; Sachdeva, Neha
Background High prevalence rates of work-related musculoskeletal disorders (WRMSD) among dentists have been reported. Complementary and alternative medicine (CAM) therapies can be helpful in managing and preventing work-related musculoskeletal disorders. The purpose of this study was to determine if dental professionals are using CAM for work-related musculoskeletal disorders. Who have greater job satisfaction: dentist who uses Complementary and alternative medicine (CAM) or conventional ther...
Evans Paul Kwame Ameade
Full Text Available Interest, use of and research into Complementary and Alternative Medicine (CAM; 補充與替代醫學 bǔ chōng yǔ tì dài yī xué is on the increase in recent times even in developed countries. It may therefore be appropriate if medical students who would become future physicians possess adequate knowledge and better attitude towards CAMS. This study assessed medical students' knowledge of, attitude towards, and usage of CAM as well as their opinion about integrating CAMs into the medical curriculum. In a cross-sectional study, 203 medical students in 2nd, 3rd and 4th year classes completed a questionnaire. Data was analyzed using SPSS 18 and GraphPad 5.01. Association between different variables was tested. The overall mean knowledge score was 19.6%. Students in higher years of study were significantly more knowledgeable in CAMs (p = 0.0006. The best known CAM was herbal medicine (63.6%, with relatives and friends being their main source of information. Students' attitude towards CAM was good (75.1% with majority (71.5% favouring introduction of CAM into the medical curriculum; preferably at the preclinical level (67.5%. Year of study, gender and locality where student grew up did not significantly affect attitude towards CAM use. Up to 117 (59.0% of the students had ever used CAM especially herbal medicine. Although students in this study were deficient in knowledge on CAMs, their attitude and usage was good. Herbal medicine was the best known and used CAM. Majority of the students believed knowledge on CAM would be beneficial to their practice hence, desirous of its introduction into their medical curriculum.
Ameade, Evans Paul Kwame; Amalba, Anthony; Helegbe, Gideon Kofi; Mohammed, Baba Sulemana
Interest, use of and research into Complementary and Alternative Medicine (CAM; bǔ chōng yǔ tì dài yī xué) is on the increase in recent times even in developed countries. It may therefore be appropriate if medical students who would become future physicians possess adequate knowledge and better attitude towards CAMS. This study assessed medical students' knowledge of, attitude towards, and usage of CAM as well as their opinion about integrating CAMs into the medical curriculum. In a cross-sectional study, 203 medical students in 2nd, 3rd and 4th year classes completed a questionnaire. Data was analyzed using SPSS 18 and GraphPad 5.01. Association between different variables was tested. The overall mean knowledge score was 19.6%. Students in higher years of study were significantly more knowledgeable in CAMs (p = 0.0006). The best known CAM was herbal medicine (63.6%), with relatives and friends being their main source of information. Students' attitude towards CAM was good (75.1%) with majority (71.5%) favouring introduction of CAM into the medical curriculum; preferably at the preclinical level (67.5%). Year of study, gender and locality where student grew up did not significantly affect attitude towards CAM use. Up to 117 (59.0%) of the students had ever used CAM especially herbal medicine. Although students in this study were deficient in knowledge on CAMs, their attitude and usage was good. Herbal medicine was the best known and used CAM. Majority of the students believed knowledge on CAM would be beneficial to their practice hence, desirous of its introduction into their medical curriculum.
I have been delivering the flexible family work approaches outlined in this supplement at Aquarius for the past 8 years. Aquarius is an English Midlands-based addictions charity working with people who have problems with alcohol, drugs, or gambling and supporting their family members/concerned others. I have been a practitioner participating in…
Chui, Ping Lei; Abdullah, Khatijah Lim; Wong, Li Ping; Taib, Nur Aishah
The inclusion of prayer-for-health (PFH) in the definition of complementary alternative medicine (CAM) has resulted in higher levels of CAM use. The objective of this study was to assess PFH and CAM use among breast cancer patients undergoing chemotherapy. A cross-sectional study was performed at two chemotherapy providers. Patients were questioned about use of three categories of CAM, mind-body practices (MBPs), natural products (NPs) and traditional medicine (TM). PFH was also examined separately from CAM to better characterise the patterns of CAM and PFH used during chemotherapy. A total of 546 eligible patients participated in the study; 70.7% (n = 386) reported using some form of CAM, and 29.3% (n = 160) were non-CAM users. When PFH was excluded as a CAM, fewer patients reported the use of CAM (66.1%; n = 361). The total number of patients who used MBPs decreased from 342 to 183. The most common CAM use category was NPs (82.8%), followed by MBPs (50.7%), and TM (35.7%). CAM users were more likely to have a tertiary education (OR 2.11, 95% CI 1.15-3.89 vs. primary/lower), have household incomes > RM 3,000 (≈944 USD) per month (OR 2.32, 95% CI 1.40-3.84 vs. ≤RM 3,000 (≈944 USD)), and have advanced cancer (OR 1.75, 95% CI 1.18-2.59 vs. early stage cancer), compared with non-CAM users. The CAM users were less likely to have their chemotherapy on schedule (OR 0.24, 95% CI 0.10-0.58 vs. chemotherapy postponed) than non-CAM users. Most MBPs were perceived to be more helpful by their users, compared with the users of NPs and TM. CAM use was prevalent among breast cancer patients. Excluding PFH from the definition of CAM reduced the prevalence of overall CAM use. Overall, CAM use was associated with higher education levels and household incomes, advanced cancer and lower chemotherapy schedule compliance. Many patients perceived MBP to be beneficial for improving overall well-being during chemotherapy. These findings, while preliminary, clearly indicate the
Ulrich, Anita; Evron, Lotte; Ostenfeld-Rosenthal, Ann
significantly elaborated upon in narratives by four female participants to warrant more detailed consideration and analysis. Conclusion: It is suggested that for some cancer patients CAM may function, not just as a treatment for cancer related symptoms and side effects, but also as a form of spiritual practice...
Vyas, Dhaval; Nijholt, Antinus; Kröner, Alexander
Physical design objects such as sketches, drawings, collages, storyboards and models play an important role in supporting communication and coordination in design studios. CAM (Cooperative Artefact Memory) is a mobile-tagging based messaging system that allows designers to collaboratively store
ABSTRACT. A modification of a cylindrical turning unit has been done to give a non- cylindrical turning attachment for production of irregular shapes, like cams on the lathe machine. To assess the performance of the attachment, cutting forces have been measured using a 'Sigma' Cutting Tool. Dynamometer. Furthermore ...
Mani, Jens; Juengel, Eva; Arslan, Ilhan; Bartsch, Georg; Filmann, Natalie; Ackermann, Hanns; Nelson, Karen; Haferkamp, Axel; Engl, Tobias; Blaheta, Roman A
Objective Many patients use complementary and alternative medicine (CAM) as primary treatment or symptom relief for a variety of illnesses. This study was designed to investigate the influence of surgical removal of a tumor-bearing urogenital organ on CAM use. Methods From 2007 to 2011, 350 patients underwent major urological surgery for kidney, prostate, or bladder cancer at the Goethe-University Hospital, Frankfurt, Germany. Data from 172 patients (49%), who returned a questionnaire, were retrospectively evaluated using the hospital information system along with the questionnaire to objectify CAM use 2 years before and after surgery. Results From the 172 patients returning questionnaires, 56 (33%) used CAM before and/or after surgery and 116 (67%) never used CAM. Of the 56 CAM users, 30 (54%) used CAM presurgery and 53 (95%) used CAM postsurgery, indicating a significant change of mind about CAM use. Patients of German nationality used CAM significantly more than patients of other nationalities. Higher educational status (high-school diploma or higher) was a significant factor in favor of CAM use. The most common type of CAM used before/after surgery was an alternative medical system (63/49%), a manipulative and body-based method (50/19%), and a biological-based therapy (37/32%). Information about CAM, either provided by medical professionals or by other sources, was the main reason determining whether patients used CAM or not. Conclusion The number of patients using CAM almost doubled after surgical removal of a cancer-bearing organ. Better awareness and understanding of CAM use by medical professionals could improve patient counseling. PMID:26491269
Hymel, Glenn M; Rich, Grant J
Health psychology represents a context within which massage therapy research, education, and practice can be positioned for the mutual benefit of both. Furthermore, complementary and alternative medicine (CAM) more often than not plays a mediating role in relating massage therapy to health psychology. On occasion, though, the linkage between health psychology and massage therapy can be quite direct without the mediating influence of CAM. This paper, accordingly, advances a conceptual model via both flowchart and Venn diagram displays for viewing the health psychology context for massage therapy with the possibility of CAM as a mediating factor. Attention is also given to the broad range of issues constituting contemporary health psychology as well as its correspondence to an equally diverse array of client populations and health conditions addressed in massage therapy research. Future directions in the areas of health psychology, CAM, and massage therapy are proposed with a view toward a mutual and reciprocal benefit accruing to these behavioral and health science arenas. Copyright © 2013 Elsevier Ltd. All rights reserved.
Jennie C. I. Tsao
Full Text Available This article is the second in a two-part series reviewing the empirical evidence for complementary and alternative medicine (CAM approaches for the management of pain related to medical procedures in infants up to 6 weeks of age. Part I of this series investigated the effects of sucrose with or without non-nutritive sucking (NNS. The present article examines other CAM interventions for procedural pain including music-based interventions, olfactory stimulation, kangaroo care and swaddling. Computerized databases were searched for relevant studies including prior reviews and primary trials. Preliminary support was revealed for the analgesic effects of the CAM modalities reviewed. However, the overall quality of the evidence for these approaches remains relatively weak. Additional well-designed trials incorporating rigorous methodology are required. Such investigations will assist in the development of evidence-based guidelines on the use of CAM interventions either alone or in concert with conventional approaches to provide safe, reliable analgesia for infant procedural pain.
Schnyer, Rosa N; Allen, John J B
An important methodological challenge encountered in acupuncture clinical research involves the design of treatment protocols that help ensure standardization and replicability while allowing for the necessary flexibility to tailor treatments to each individual. Manualization of protocols used in clinical trials of acupuncture and other traditionally-based complementary and alternative medicine (CAM) systems facilitates the systematic delivery of replicable and standardized, yet individually-tailored treatments. To facilitate high-quality CAM acupuncture research by outlining a method for the systematic design and implementation of protocols used in CAM clinical trials based on the concept of treatment manualization. A series of treatment manuals was developed to systematically articulate the Chinese medical theoretical and clinical framework for a given Western-defined illness, to increase the quality and consistency of treatment, and to standardize the technical aspects of the protocol. In all, three manuals were developed for National Institutes of Health (NIH)-funded clinical trials of acupuncture for depression, spasticity in cerebral palsy, and repetitive stress injury. In Part I, the rationale underlying these manuals and the challenges encountered in creating them are discussed, and qualitative assessments of their utility are provided. In Part II, a methodology to develop treatment manuals for use in clinical trials is detailed, and examples are given. A treatment manual provides a precise way to train and supervise practitioners, enable evaluation of conformity and competence, facilitate the training process, and increase the ability to identify the active therapeutic ingredients in clinical trials of acupuncture.
Aswini Pai; Matthew Skeels
Complementary and alternative medicine (CAM) has become an implicit part of a lifestyle industry in the United States. The World Health Organization (WHO) reports that at least 41% of the population in the US has used CAM at least once in their lives (WHO 2002). Globalization, an influx of various immigrant cultures, and growing wariness of western allopathic medicine...
Kristoffersen, Espen Saxhaug; Aaseth, Kjersti; Grande, Ragnhild Berling; Lundqvist, Christofer; Russell, Michael Bjørn
Chronic headache is associated with disability and high utilisation of health care including complementary and alternative medicine (CAM). We investigated self-reported efficacy of CAM in people with chronic headache from the general population. Respondents with possible self-reported chronic headache were interviewed by physicians experienced in headache diagnostics. CAM queried included acupuncture, chiropractic, homeopathy, naprapathy, physiotherapy, psychological treatment, and psychomotor physiotherapy. Sixty-two % and 73% of those with primary and secondary chronic headache had used CAM.Self-reported efficacy of CAM ranged from 0-43% without significant differences between gender, headache diagnoses, co-occurrence of migraine, medication use or physician contact. CAM is widely used, despite self-reported efficacy of different CAM modalities is modest in the management of chronic headache.
Studies on the widespread use of complementary and alternative medicine (CAM) demonstrate that CAM users base their treatment decisions on both subjective, experience-based knowledge and medical knowledge. The aim of this study was to explore lay and medical risk perceptions associated with CAM and conventional medicine. In this explorative qualitative study, we conducted in-depth interviews with 25 Norwegian CAM users with cancer or multiple sclerosis and 12 doctors. The interviews revealed fundamental differences in risk perceptions influencing treatment decisions and risk communication in a clinical setting. While CAM users considered conventional medicine as potentially risky and related this to experiences of severe adverse effects, CAM was perceived as natural and safe. Doctors' risk perceptions were quite the contrary, mainly because of lack of scientific evidence for CAM as a safe and beneficial treatment option. For the safety of CAM users, such divergent risk perceptions may have far-reaching consequences. CAM users should be taken seriously with their self-perception as decision-makers considering their approaches to experiences, knowledge, and science. An awareness of differing lay and medical risk perceptions associated with CAM and conventional medicine in research, doctor-patient communication, and education of patients and doctors is thus important to optimize patient safety in complex health care systems. © 2015 S. Karger GmbH, Freiburg.
Peng, Wenbo; Adams, Jon; Sibbritt, David W; Frawley, Jane E
This study aims to undertake the first critical review of complementary and alternative medicine (CAM) use among menopausal women (a term here used to include premenopausal, perimenopausal and postmenopausal women) by focusing on the prevalence of CAM use and CAM users' characteristics, motivation, decision-making, and communication with healthcare providers. A comprehensive search of 2002-2012 international literature in the Medline, CINAHL, AMED, and SCOPUS databases was conducted. The search was confined to peer-reviewed articles published in English with abstracts and reporting new empirical research findings regarding CAM use and menopause. A considerable level of CAM use was observed among women in menopause. Many menopausal women use CAM concurrently with their conventional medicine. However, communication regarding CAM between menopausal women and healthcare providers seems less than optimal, with a demand for further information on the safety and efficacy of medicines. Existing literature is of variable methodological rigor, often presenting small sample sizes and low-quality data collection. Further rigorous research on this topic-including quantitative and qualitative methods using large national samples, where relevant-is required. The findings of this critical review provide insights for those practicing and managing health care in this area of women's health. Healthcare providers should prepare to inform menopausal women about all treatment options, including CAM, and should be aware of the possible adverse effects of CAM and potential interactions between CAM and conventional medicine among women in menopause who are under their care.
Chenot, Jean-François; Becker, Annette; Leonhardt, Corinna; Keller, Stefan; Donner-Banzhoff, Norbert; Baum, Erika; Pfingsten, Michael; Hildebrandt, Jan; Basler, Heinz-Dieter; Kochen, Michael M
Although back pain is considered one of the most frequent reasons why patients seek complementary and alternative medical (CAM) therapies little is known on the extent patients are actually using CAM for back pain. This is a post hoc analysis of a longitudinal prospective cohort study embedded in a RCT. General practitioners (GPs) recruited consecutively adult patients presenting with LBP. Data on physical function, on subjective mood, and on utilization of health services was collected at the first consultation and at follow-up telephone interviews for a period of twelve months A total of 691 (51%) respectively 928 (69%) out of 1,342 patients received one form of CAM depending on the definition. Local heat, massage, and spinal manipulation were the forms of CAM most commonly offered. Using CAM was associated with specialist care, chronic LBP and treatment in a rehabilitation facility. Receiving spinal manipulation, acupuncture or TENS was associated with consulting a GP providing these services. Apart from chronicity disease related factors like functional capacity or pain only showed weak or no association with receiving CAM. The frequent use of CAM for LBP demonstrates that CAM is popular in patients and doctors alike. The observed association with a treatment in a rehabilitation facility or with specialist consultations rather reflects professional preferences of the physicians than a clear medical indication. The observed dependence on providers and provider related services, as well as a significant proportion receiving CAM that did not meet the so far established selection criteria suggests some arbitrary use of CAM.
to explore nurses’ knowledge about CAM and their needs for training. Methods: Similar to international investigations a Danish “CAM-knowledge” questionnaire was developed that included multiple choice, yes/no and 5 points scale answers. Validity was established through initial pilot testing. Contacts...... to a randomized sample of 2500 nurses were established through the Danish Nurses Foundation. The questionnaires were mailed by post with the possibility of anonymous return. The data material was analyzed using non-parametic methods. Results: The response rate was 67 % and 1458 completed questionnaires were...... of CAM also tend to have a theoretical background of CAM. Around 75 % of the nurses agree or partly agree that it is important for nurses to receive education about CAM and that nurses have knowledge about CAM that enables them to advise patients. Training needs concerning CAM were indicated by 52...
Williams, J J
Modern design methods of Automotive Cam Design require the computation of a range of parameters. This book provides a logical sequence of steps for the derivation of the relevant equations from first principles, for the more widely used cam mechanisms. Although originally derived for use in high performance engines, this work is equally applicable to the design of mass produced automotive and other internal combustion engines. Introduction to Analytical Methods for Internal Combustion Engine Cam Mechanisms provides the equations necessary for the design of cam lift curves with an associated smooth acceleration curve. The equations are derived for the kinematics and kinetics of all the mechanisms considered, together with those for cam curvature and oil entrainment velocity. This permits the cam shape, all loads, and contact stresses to be evaluated, and the relevant tribology to be assessed. The effects of asymmetry on the manufacture of cams for finger follower and offset translating curved followers is ...
an alternative understanding of collaborative design practice as participatory inquiry. The paper suggests that participatory inquiry, as it more fully takes into account the learning driven and relational nature of design practice, could help inform alternative design educational strategies.......There is an inherent dilemma that some research indicates ways and means of doing design practice, in particular how practitioners bring what this paper identifies as informal resources into play, that are seldom reflected in how and what design students are taught or learn. The question is posed...... as to whether today’s design students are in fact equipped to be tomorrow’s practitioners. This paper introduces a range of literature and empirical observations that describe a number of different appreciations of process and practice, from both design and non-design perspectives. This in order to draw up...
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
Ana V. Pejcic
Full Text Available The aim of this literature review was to summarize available findings from publications that reported expenditure on traditional/complementary and alternative medicine (TM/CAM within a representative general population sample of a nation or a defined geographical area. A total of 24 publications met the inclusion criteria and were included in the review. The expenditure on TM/CAM varies worldwide, but direct comparison of the findings of publications included in this review is limited due to the differences in the definitions of TM/CAM, inclusion of various forms of TM/CAM, use of different names and categorization, as well as differences in reported currencies and time periods in which data were collected. Data about the expenditure on TM/CAM in most countries throughout the world are scarce. Further national studies should be conducted in order to provide up-to-date assessment of the TM/CAM related expenditure patterns and use. Uniform nomenclature, definition of TM/CAM and standardized instruments would provide basis for comparability of data of studies conducted in various regions and time periods.
Shri Kant Mishra
Full Text Available Background: There is a growing trend towards opting for complementary and alternative medicine (CAM in the therapeutic management of various medical disorders. We try to evaluate the current recommendations for CAM therapies in key neurological disorders. Materials and Methods: Sources like PubMed, Embase, UCLA libraries, USC libraries, and National Center for Complementary and Alternative Medicine (NCCAM books were searched to gather data for this review. Results: We discuss the current recommendations for CAM therapies in headaches, neck pains, lower back pains, neuropathic pains, and cancer-related pains. The CAM therapies discussed include natural therapies, mind and body therapies, and several other modalities. Conclusion: We conclude that in spite of vast literature available on the CAM therapies for neurological disorders; there is little evidence for the most beneficial CAM remedies that target common neurological disorders. Although new CAM modalities are brought to light in addition to those that have existed for centuries, further scientific data from evidence-based studies is needed to accurately compare the CAM therapies amongst each other and allopathic treatments.
Zimmermann, Peter Josef; Aarva, Pauliina; Sorsa, Minna
The official acceptance of complementary and alternative medicine (CAM) or integrative medicine in the academic discussion and in health policies in Finland is still poor. This is in contradiction to the fact that modern Finnish citizens use CAM as much as any people elsewhere in the European Union, with rates of 28-46% of the general population, or even more. This was one of the reasons for the foundation of the Finnish Forum for Research in Integrative Medicine and Healthcare (SILF) in November 2014. A first challenge for the SILF was to facilitate a research seminar to address the issue of CAM research as a part of the Finnish academic research. The seminar was organized by the Department of Health Sciences of the University of Tampere on November 13, 2015. Almost one third of the more than 400 participants were health professionals, and again one-third out of this group were physicians. As a result of the seminar, a research network was inaugurated. Obviously there is an increasing interest of health professionals in CAM and maybe even a change of attitude towards CAM also in Finland. However, genuine Finnish CAM research is essential in order to open up the academic discussion. © 2017 S. Karger GmbH, Freiburg.
Manya, Kiran; Champion, Bernard; Dunning, Trisha
Abstract Background Complementary and alternative medicine (CAM) is common in patients with chronic disease such as diabetes mellitus. The primary objective of the study was to determine the overall prevalence and type of CAM use in individuals with diabetes mellitus (DM) in Western Sydney and to compare the prevalence and factors associated with CAM use with the literature. Methods A multicenter cross-sectional study was undertaken using a self-completed questionnaire distributed to patients...
Tracy L Truant; Lynda G Balneaves; Margaret I Fitch
The integration of complementary and alternative medicine (CAM) and conventional cancer care in Canada is in its nascent stages. While most patients use CAM during their cancer experience, the majority does not receive adequate support from their oncology health care professionals (HCPs) to integrate CAM safely and effectively into their treatment and care. A variety of factors influence this lack of integration in Canada, such as health care professional(HCP) education and attitudes about CA...
Shanahan, Madeleine [School of Medical Science, RMIT University, Bundoora, Victoria 3083 (Australia)], E-mail: firstname.lastname@example.org; Herrington, Anthony; Herrington, Jan [Faculty of Education, University of Wollongong, New South Wales (Australia)
Purpose: The Internet is an important information source for health practitioners providing immediate access to the most current health and medical information. Factors limiting practitioner access to the Internet have been identified and the literature shows that access to the Internet varies across and within health professions. There is therefore a need for each health profession to investigate practitioner access to the Internet. There has been, however, no identified empirical research investigating medical radiation science (MRS) practitioner access to or use of the Internet. This research sought to establish the professional use of Internet-based tools by Australian MRS practitioners and issues affecting access to the Internet within MRS workplaces. Methods: Qualitative and quantitative approaches were used in this research. These included interviews with 28 MRS practitioners from the four areas of specialisation, namely nuclear medicine, radiation therapy, radiography and sonography and a survey of MRS practitioners. In 2007 a 4-page postal survey was sent to a random sample of 1142 MRS practitioners with a response rate of 32.8%. Results: The Internet is an important information source widely used by MRS practitioners. MRS practitioners search the Internet (87%), access specific web pages (86%), use email (82%) and listservs (39.4%) to update their professional knowledge. It was evident that access to the Internet within the workplace varied within the MRS profession. Whilst the majority (96.4%) of MRS practitioners had some level of access to the Internet in their workplace, factors shown to affect practitioner access were workplace setting (p = 0.000), work environment (p = 0.000), and geographic location (p = 0.025). The majority of clinical workplaces (81%) did not provide practitioners with remote access to electronic resources available in the workplace such as e-journals and databases. Conclusions: This research provides baseline data to the MRS
Shanahan, Madeleine; Herrington, Anthony; Herrington, Jan
Purpose: The Internet is an important information source for health practitioners providing immediate access to the most current health and medical information. Factors limiting practitioner access to the Internet have been identified and the literature shows that access to the Internet varies across and within health professions. There is therefore a need for each health profession to investigate practitioner access to the Internet. There has been, however, no identified empirical research investigating medical radiation science (MRS) practitioner access to or use of the Internet. This research sought to establish the professional use of Internet-based tools by Australian MRS practitioners and issues affecting access to the Internet within MRS workplaces. Methods: Qualitative and quantitative approaches were used in this research. These included interviews with 28 MRS practitioners from the four areas of specialisation, namely nuclear medicine, radiation therapy, radiography and sonography and a survey of MRS practitioners. In 2007 a 4-page postal survey was sent to a random sample of 1142 MRS practitioners with a response rate of 32.8%. Results: The Internet is an important information source widely used by MRS practitioners. MRS practitioners search the Internet (87%), access specific web pages (86%), use email (82%) and listservs (39.4%) to update their professional knowledge. It was evident that access to the Internet within the workplace varied within the MRS profession. Whilst the majority (96.4%) of MRS practitioners had some level of access to the Internet in their workplace, factors shown to affect practitioner access were workplace setting (p = 0.000), work environment (p = 0.000), and geographic location (p = 0.025). The majority of clinical workplaces (81%) did not provide practitioners with remote access to electronic resources available in the workplace such as e-journals and databases. Conclusions: This research provides baseline data to the MRS
Photoelectric observations of magnetic Ap star 53 Cam made at the Skalnate Pleso Observatory in 1978 and 1979 are analyzed from the point of view of rapid variability. The observations were made with an intermediate passband filter, effective wavelength 526 nm. Besides the differences msub(53Cam)-msub(Comp), the behaviour was also investigated of the deflections for the comparison star during the observation runs. A strong correlation between the behaviour of the comparison and variable star light curve was found and the appearance differs from night to night depending on atmospheric conditions. Each observation run is analyzed in detail and it was concluded that all observed variations are only apparent and due to the variability of atmospheric extinction above the observation site. (author)
Melchels, Ferry; Hutmacher, Dietmar Werner; Wiggenhauser, Paul Severin; Schantz, Jan-Thorsten; Warne, David; Barry, Mark; Ong, Fook Rhu; Chong, Woon Shin
The application of computer-aided design and manufacturing (CAD/CAM) techniques in the clinic is growing slowly but steadily. The ability to build patient-specific models based on medical imaging data offers major potential. In this work we report on the feasibility of employing laser scanning with CAD/CAM techniques to aid in breast reconstruction. A patient was imaged with laser scanning, an economical and facile method for creating an accurate digital representation of the breasts and surrounding tissues. The obtained model was used to fabricate a customized mould that was employed as an intra-operative aid for the surgeon performing autologous tissue reconstruction of the breast removed due to cancer. Furthermore, a solid breast model was derived from the imaged data and digitally processed for the fabrication of customized scaffolds for breast tissue engineering. To this end, a novel generic algorithm for creating porosity within a solid model was developed, using a finite element model as intermediate.
Full Text Available In the form of the Transcendental Meditation program CAM offers a method of eliminating deep-rooted stress, the efficacy of which has been demonstrated in several related studies. Any discussion of CAM and post-traumatic stress disorder should include a study of its application to Vietnam War Veterans in which improvements were observed on all variables, and several participants were able to return to work after several years of being unable to hold a job. The intervention has been studied for its impact on brain and autonomic nervous system function. It has been found to be highly effective against other stress-related conditions such as hypertension, and to improve brain coherence—a measure of effective brain function. It should be considered a possible ‘new and improved mode of treatment’ for PTSD, and further studies of its application made.
To investigate whether personality traits, modern health worries (MHWs) and attitudes to science predict attitudes to, and beliefs about, complementary and alternative medicine (CAM). This study set out to test whether belief in, and use of CAM was significantly associated with high levels of MHWs, a high level of neuroticism and sceptical attitudes towards science. Two hundred and forty-three British adults completed a four part questionnaire that measured MHWs, the Big Five personality traits and beliefs about science and medicine and attitudes to CAM. There were many gender differences in MHWs (females expressed more), though results were similar to previous studies. Contrary to prediction, personality traits were not related to MHWs, CAM usage or beliefs about CAM. Regular and occasional users of CAM did have higher MHWs than those non or infrequent users. Those with high totalled MHWs also tended to believe in the importance of psychological factors in health and illness, as well as the potential harmful effects of modern medicine. Young males who had positive attitudes to science were least likely to be CAM users. Further, positive attitudes to science were associated with increased scepticism about CAM. Concern about health, belief about modern medicine and CAM are logically inter-related. Those who have high MHWs tend to be more sceptical about modern medicine and more convinced of the possible role of psychological factors in personal health and illness.
Manya, Kiran; Champion, Bernard; Dunning, Trisha
Complementary and alternative medicine (CAM) is common in patients with chronic disease such as diabetes mellitus. The primary objective of the study was to determine the overall prevalence and type of CAM use in individuals with diabetes mellitus (DM) in Western Sydney and to compare the prevalence and factors associated with CAM use with the literature. A multicenter cross-sectional study was undertaken using a self-completed questionnaire distributed to patients with DM attending a public hospital and specialist endocrinology clinics in the region. The type of DM and pattern of CAM utilisation were analyzed. Sixty nine people responded to the questionnaire: age range of 18-75 years during a twelve week collection period. Overall, 32 respondents with diabetes were using some form of CAM, resulting in a utilisation rate of 46.3%. Twenty of the 32 CAM users used CAM specifically to treat their diabetes accounting for 28.9% of the respondent sample population. Multivitamins (40%), cinnamon, Co-enzyme q10 and prayer were the most frequently used CAM modalities. There was no significant difference between males and females, age range, income or diabetes complications between CAM and non-CAM users. (p values each > 0.05) The factor most significantly associated with CAM usage was being born overseas (p = 0.044). Almost half the respondents (46.3%) used CAM: 28% used CAM specifically to treat their diabetes. Individuals born overseas were significantly more likely to use CAM than those born in Australia. Other factors such as age, gender, wealth and duration of living with diabetes were not associated with higher rate of CAM usage.
The use of complementary and alternative Medicine (CAM) has increased over the past two decades in Europe. Nonetheless, research investigating the evidence to support its use remains limited. The CAMbrella project funded by the European Commission aimed to develop a strategic research agenda starting by systematically evaluating the state of CAM in the EU. CAMbrella involved 9 work packages covering issues such as the definition of CAM; its legal status, provision and use in the EU; and a synthesis of international research perspectives. Based on the work package reports, we developed a strategic and methodologically robust research roadmap based on expert workshops, a systematic Delphi-based process and a final consensus conference. The CAMbrella project suggests six core areas for research to examine the potential contribution of CAM to the health care challenges faced by the EU. These areas include evaluating the prevalence of CAM use in Europe; the EU cititzens’ needs and attitudes regarding CAM; the safety of CAM; the comparative effectiveness of CAM; the effects of meaning and context on CAM outcomes; and different models for integrating CAM into existing health care systems. CAM research should use methods generally accepted in the evaluation of health services, including comparative effectiveness studies and mixed-methods designs. A research strategy is urgently needed, ideally led by a European CAM coordinating research office dedicated to fostering systematic communication between EU governments, the public, charitable and industry funders, researchers and other stakeholders. A European Centre for CAM should also be established to monitor and further a coordinated research strategy with sufficient funds to commission and promote high quality, independent research focusing on the public’s health needs and pan-European collaboration. There is a disparity between highly prevalent use of CAM in Europe and solid knowledge about it. A strategic approach on
Ge Jin; Fishman, Jessica; Vapiwala, Neha; Li, Susan Q.; Desai, Krupali; Xie, Sharon X.; Mao, Jun J.
Purpose: Despite the extensive use of complementary and alternative medicine (CAM) among cancer patients, patient-physician communication regarding CAM therapies remains limited. This study quantified the extent of patient-physician communication about CAM and identified factors associated with its discussion in radiation therapy (RT) settings. Methods and Materials: We conducted a cross-sectional survey of 305 RT patients at an urban academic cancer center. Patients with different cancer types were recruited in their last week of RT. Participants self-reported their demographic characteristics, health status, CAM use, patient-physician communication regarding CAM, and rationale for/against discussing CAM therapies with physicians. Multivariate logistic regression was used to identify relationships between demographic/clinical variables and patients’ discussion of CAM with radiation oncologists. Results: Among the 305 participants, 133 (43.6%) reported using CAM, and only 37 (12.1%) reported discussing CAM therapies with their radiation oncologists. In multivariate analyses, female patients (adjusted odds ratio [AOR] 0.45, 95% confidence interval [CI] 0.21-0.98) and patients with full-time employment (AOR 0.32, 95% CI 0.12-0.81) were less likely to discuss CAM with their radiation oncologists. CAM users (AOR 4.28, 95% CI 1.93-9.53) were more likely to discuss CAM with their radiation oncologists than were non-CAM users. Conclusions: Despite the common use of CAM among oncology patients, discussions regarding these treatments occur rarely in the RT setting, particularly among female and full-time employed patients. Clinicians and patients should incorporate discussions of CAM to guide its appropriate use and to maximize possible benefit while minimizing potential harm.
Full Text Available Abstract Background Complementary and alternative medicine (CAM is common in patients with chronic disease such as diabetes mellitus. The primary objective of the study was to determine the overall prevalence and type of CAM use in individuals with diabetes mellitus (DM in Western Sydney and to compare the prevalence and factors associated with CAM use with the literature. Methods A multicenter cross-sectional study was undertaken using a self-completed questionnaire distributed to patients with DM attending a public hospital and specialist endocrinology clinics in the region. The type of DM and pattern of CAM utilisation were analyzed. Results Sixty nine people responded to the questionnaire: age range of 18-75 years during a twelve week collection period. Overall, 32 respondents with diabetes were using some form of CAM, resulting in a utilisation rate of 46.3%. Twenty of the 32 CAM users used CAM specifically to treat their diabetes accounting for 28.9% of the respondent sample population. Multivitamins (40%, cinnamon, Co-enzyme q10 and prayer were the most frequently used CAM modalities. There was no significant difference between males and females, age range, income or diabetes complications between CAM and non-CAM users. (p values each > 0.05 The factor most significantly associated with CAM usage was being born overseas (p = 0.044. Conclusions Almost half the respondents (46.3% used CAM: 28% used CAM specifically to treat their diabetes. Individuals born overseas were significantly more likely to use CAM than those born in Australia. Other factors such as age, gender, wealth and duration of living with diabetes were not associated with higher rate of CAM usage.
Full Text Available The purpose of this current study was to justify the incorporation of complementary and alternate medicine (CAM in current cancer treatments. The major drawback of anticancer drugs is their nonselective killing, which ultimately leads to attrition of normal cells. Keeping this as the foundation of our study, we made an effort to compare the cytotoxicity associated with a known chemotherapeutic drug 5-Fluorouracil (5-FU, with certain CAM therapies previously reported to have anticancer activity. The parameters chosen for the study were based on antiproliferative and cytotoxic effects on normal, kidney epithelial cells (NRK-52E. The MTT assay, colony formation assay, DNA fragmentation, and differential staining using AO/EB, following treatment with either 5-FU or CAM therapies, were performed. The CAM therapies under study were various extracts of wheatgrass, roots of Achyranthes aspera (AA, mushroom extracts (Pleurotus ostreatus, Macrolepiota procera, and Auricularia polytricha, and a homeopathic drug, Ruta graveolens (Ruta. The results showed that treatment of normal cells with the CAM therapies led to minimum cell damage in comparison to 5-FU. This evidence-based study will lead to greater acceptance of alternative therapies against cancer.
Villa-Caballero, Leonel; Morello, Candis M; Chynoweth, Megan E; Prieto-Rosinol, Ariadna; Polonsky, William H; Palinkas, Lawrence A; Edelman, Steven V
To evaluate the effect of ethnicity as a predictor of the use of complementary and alternative medicine (CAM) among patients with diabetes. A 16-item questionnaire investigating CAM use was distributed among patients attending the Taking Control of Your Diabetes (TCOYD) educational conferences during 2004-2006. Six TCOYD were held across the United States. Information of diabetes status and sociodemographic data was collected. CAM use was identified as pharmacologic (herbs and vitamins) and nonpharmacologic CAMs (e.g., prayer, yoga, and acupuncture). The prevalence of pharmacologic and non-pharmacologic CAMs among 806 participants with diabetes patients was 81.9% and 80.3%, respectively. Overall, CAM prevalence was similar for Caucasians (94.2%), African Americans (95.5%), Hispanics (95.6%) and Native Americans (95.2%) and lower in Pacific Islanders/others (83.9%) and Asians (87.8%). Pharmacologic CAM prevalence was positively associated with education (p=0.001). The presence of diabetes was a powerful predictor of CAM use. Several significant ethnic differences were observed in specific forms of CAM use. Hispanics reported using frequently prickly pear (nopal) to complement their diabetes treatment while Caucasians more commonly used multivitamins. Treatment with CAM widely used in persons with diabetes. Ethnic group differences determine a variety of practices, reflecting groups' cultural preferences. Future research is needed to clarify the perceived reasons for CAM use among patients with diabetes in clinical practice and the health belief system associated with diabetes by ethnic group. Published by Elsevier Ltd.
Koenig, Christopher J.; Ho, Evelyn Y.; Yadegar, Vivien; Tarn, Derjung M.
Objective To empirically investigate the ways in which patients and providers discuss Complementary and Alternative Medicine (CAM) treatment in primary care visits. Methods Audio recordings from visits between 256 adult patients aged 50 years and older and 28 primary care physicians were transcribed and analyzed using discourse analysis, an empirical sociolinguistic methodology focusing on how language is used to negotiate meaning. Results Discussion about CAM occurred 128 times in 82 of 256 visits (32.0%). The most frequently discussed CAM modalities were non-vitamin, non-mineral supplements and massage. Three physician–patient interactions were analyzed turn-by-turn to demonstrate negotiations about CAM use. Patients raised CAM discussions to seek physician expertise about treatments, and physicians adopted a range of responses along a continuum that included encouragement, neutrality, and discouragement. Despite differential knowledge about CAM treatments, physicians helped patients assess the risks and benefits of CAM treatments and made recommendations based on patient preferences for treatment. Conclusion Regardless of a physician's stance or knowledge about CAM, she or he can help patients negotiate CAM treatment decisions. Practice implications Providers do not have to possess extensive knowledge about specific CAM treatments to have meaningful discussions with patients and to give patients a framework for evaluating CAM treatment use. PMID:22483672
Fleming, Brandy M; Schwab, Emiko L; Nouer, Simonne S; Wan, Jim Y; LeDoux, Mark S
Complementary and Alternative Medicine (CAM) use is on the rise in both the US and Europe, despite questions about its safety and effectiveness, and lack of national standards. We aimed to determine the prevalence and predictors of CAM and integrative medicine use (CAM-I) and perceived effectiveness compared to the standard treatment of botulinum toxin injections in patients with adult-onset primary dystonia. This was a retrospective questionnaire study of 389 dystonia patients examining the effects age, gender, education level and number of affected anatomical regions on botulinum toxin and CAM-I use and their perceived effectiveness. 53% (208) of patients reported CAM-I use, while 90% (349) used the standard treatment (botulinum toxin), and 48% used both. Education was the only significant predictor of CAM-I use - individuals with bachelor's degrees were more likely to try CAM-I whereas those with high school diplomas were less likely. The mean effectiveness rate for botulinum toxin injections (59%) significantly exceeded that for CAM-I (28%, p effectiveness and expense of CAM-I treatments for dystonia and other neurological disorders given that CAM-I use is steadily increasing, there is great variability in what is classified as CAM-I, and the effectiveness of some modalities may be significantly less than conventional medical treatments. Copyright © 2012 Elsevier Ltd. All rights reserved.
Aida Isabel Tavares
Full Text Available Background Portugal has a strong tradition of conventional western healthcare. So it provides a natural case study for the relationship between Complementary/Alternative Medicine (CAM and Western Medicine (WM. This work aims to test the relationship between CAM and WM users in the diagnosis and treatment stages and to estimate the determinants of CAM choice. Methods The forth Portuguese National Health Survey is employed to estimate two single probit models and obtain the correlation between the consumption of CAM and WM medicines in the diagnosis and treatment stages. Results Firstly, both in the diagnosis and the treatment stage, CAM and WM are seen to be complementary choices for individuals. Secondly, self-medication also shows complementarity with the choice of CAM treatment. Thirdly, education has a non-linear relationship with the choice of CAM. Finally, working status, age, smoking and chronic disease are determinant factors in the decision to use CAM. Conclusion The results of this work are relevant to health policy-makers and for insurance companies. Patients need freedom of choice and, for the sake of safety and efficacy of treatment, WM and CAM healthcare ought to be provided in a joint and integrated health system.
Nemutandani, Simon M; Hendricks, Stephen J; Mulaudzi, Mavis F
The indigenous health system was perceived to be a threat to the allopathic health system. It was associated with 'witchcraft', and actively discouraged, and repressed through prohibition laws. The introduction of the Traditional Health Practitioners Act No 22 of 2007 brought hope that those centuries of disrespect for traditional health systems would change. The study examined the perceptions and experiences of allopathic health practitioners on collaboration with traditional health practitioners in post-apartheid South Africa. Qualitative descriptive research methodology was used to collect data from allopathic health practitioners employed by Limpopo's Department of Health. In-depth focus group discussions and meetings were conducted between January and August 2014. Perceptions and experiences of working with traditional health practitioners were explored. Ethical clearance was obtained from the University of Pretoria and approval from the Department's Research Committee. Dominant views were that the two health systems were not compatible with respect to the science involved and the source of knowledge. Overall, quality of health care will be compromised if traditional health practitioners are allowed to work in public health facilities. Allopathic health practitioners do not appear ready to work with traditional health practitioners, citing challenges of quality of health care, differences regarding concept of sciences and source of knowledge; and lack of policy on collaboration. Lack of exposure to traditional medicine seems to impede opportunities to accept and work with traditional healers. Exposure and training at undergraduate level regarding the traditional health system is recommended. Policy guidelines on collaborations are urgently required.
Need of Department of General Practice / Family Medicine at AIIMS (All India Institute of Medical Sciences): Why the apex medical institute in India should also contribute towards training and education of general practitioners and family physicians.
Pal, Ranabir; Kumar, Raman
Family medicine or general practice is the practicing discipline of the majority doctors in India, however formal academic departments of general practice (or family medicine) do not exist in India, as it is not a mandatory requirement as prescribed by the Medical Council of India; the principal regulator of medical education. Currently India has capacity to produce more than 60,000 medical graduates per year, majority of whom are expected to become general practitoners or primary care doctors without under going any vocational training in general practice or family medicine. The 92 nd parliamentary standing committee report (on health and family welfare) of the Indian Parliament recommended that Government of India in coordination with State Governments should establish robust postgraduate programs in Family Medicine and facilitate introducing Family Medicine discipline in all medical colleges. This will not only minimize the need for frequent referrals to specialist and decrease the load on tertiary care but also provide continuous health care for the individuals and families. The authors concur with the parliament of India and strongly feel that "Family Medicine" (community-based comprehensive clinical practice) deserves dedicated and distinct department at all medical colleges in India in order to availability of qualified medical doctors in the community-based health system. AIIMS, New Delhi, along with other newly established AIIMS, should rise to their foundation mandate of supporting excellence in all disciplines of medical science and to this historic responsibility; and not just remain an ivory tower of tertiary care based fragmented (into sub specialties) hospital culture.
Costa, J. M.
Os Lusíadas, escrito por Luis de Camões em 1572, é um poema épico renascentista e a visão Cosmogônica do autor é apresentada, principalmente, no último canto do poema, quando Tétis mostra ao Gama a Máquina do Mundo. A Cosmogonia de Camões neste poema reflete uma visão de uma época de transição, que ainda não incorporou os elementos da revolução Copernicana. É uma visão Grego- Ptolomaica e também medieval. O poeta guia-se pela tradução e notas feita por Pedro Nunes, inventor do Nonio, do Tratado da Esfera "De Sphaera" do Astrônomo Inglês John Holywood, mais conhecido pelo nome latinizado de Johannes Sacrobosco. Outra provável fonte de Camões, de acordo com Luciano Antonio Pereira da Silva em Astronomia de os Lusíadas, é o "Theoricae novae Planetarum" (1460) do astrólogo Alemão Jorge Purbáquio (1423 - 1461). A Astronomia de Os Lusíadas representa a ciência do tempo de Camões. Camões nunca emprega a palavra constelação e seu catálogo é bastante completo. A Máquina do Mundo tem a Terra no centro. Em redor, em círculos concêntricos, a lua (Diana), Mercúrio, Vênus, o Sol (Febo), Marte, Júpiter e Saturno. Envolvendo estes astros tem o firmamento seguido pelo "Céu Áqueo" ou cristalino, depois o 1o Móbil, esfera que arrasta todas as outras consigo. Este trabalho, multidisciplinar, serve tanto para ensinar aos alunos da Física como das Ciências Humanas, a concepção de mundo do renascimento de uma forma belamente poética em versos decassílabos Este trabalho também ajuda na apreciação do maior clássico da língua portuguesa e mostra como as Ciências e as artes, em geral, estão correlacionadas e refletem a visão de mundo da época em que foi produzida.
Huebner, Jutta; Prott, Franz J; Muecke, Ralph; Stoll, Christoph; Buentzel, Jens; Muenstedt, Karsten; Micke, Oliver
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.
Weiland, Sandra A
This Gadamerian hermeneutic study was undertaken to understand the meaning of autonomy as interpreted by nurse practitioners (NPs) through their lived experiences of everyday practice in primary health care. A purposive sample of nine NPs practicing in primary health care was used. Network sampling achieved a broad swath of primary care NPs and practice settings. Data were collected by face-to-face interviews. Because NP autonomy is concerned with gender and marginalization, Gilligan's feminist perspective was utilized during interpretive analysis. Having Genuine NP Practice was the major theme, reflecting the participants' overall meaning of their autonomy. Practicing alone with the patient provided the context within which participants shaped the meaning of Having Genuine NP Practice. Having Genuine NP Practice had four subthemes: relationships, self-reliance, self-empowerment, and defending the NP role. The understanding of Having Genuine NP Practice will enable NPs to articulate their autonomy clearly and better influence healthcare reform. Implications for advanced practice nursing education include integrating findings into classroom discussion to prompt self-reflection of what autonomy means and socialization to the NP role. ©2014 American Association of Nurse Practitioners.
Ganasegeran, Kurubaran; Rajendran, Anantha Kumar; Al-Dubai, Sami Abdo Radman
The use of complementary and alternative medicine (CAM) as a source of cure has gained much spectrum worldwide, despite skeptics and advocates of evidence-based practice conceptualized such therapies as human nostrum. This study aimed to explore the factors affecting CAM use among rural communities in Malaysia. A cross-sectional study was carried out on 288 occupants across four rural villages within the District of Selama, Perak, Malaysia. A survey that consisted of socio-economic characteristics, history of CAM use and the validated Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) were used. The prevalence of self-reported CAM use over the past one year was 53.1%. Multiple logistic regression analyses yielded three significant predictors of CAM use: monthly household income of less than MYR 2500, higher education level, and positive attitude towards CAM. Psycho-socioeconomic factors were significantly associated with CAM use among rural communities in Malaysia.
Ventilation Stack Continuous Air Monitor (CAM) Interlock System failure modes, failure frequencies and system availability have been evaluated for the RPP. The evaluation concludes that CAM availability is as high as assumed in the safety analysis and that the current routine system surveillance is adequate to maintain this availability. Further, requiring an alarm to actuate upon CAM failure is not necessary to maintain the availability credited in the safety analysis, nor is such an arrangement predicted to significantly improve system availability. However, if CAM failures were only detected by the 92-day functional tests required in the Authorization Basis (AB), CAM availability would be much less than that credited in the safety analysis. Therefore it is recommended that the current surveillance practice of daily simple system checks, 30-day source checks and 92-day functional tests be continued in order to maintain CAM availability
Full Text Available Abstract Background There is a paucity of information describing patients with musculoskeletal disorders (MSDs using complementary and alternative medicines (CAMs and almost none distinguishing homeopathy from other CAMs. The objective of this study was to describe and compare patients with MSDs who consulted primary care physicians, either certified homeopaths (Ho or regular prescribers of CAMs in a mixed practice (Mx, to those consulting physicians who strictly practice conventional medicine (CM, with regard to the severity of their MSD expressed as chronicity, co-morbidity and quality of life (QOL. Methods The EPI3-LASER study was a nationwide observational survey of a representative sample of general practitioners and their patients in France. The sampling strategy ensured a sufficient number of GPs in each of the three groups to allow comparison of their patients. Patients completed a questionnaire on socio-demographics, lifestyle and QOL using the Short Form 12 (SF-12 questionnaire. Chronicity of MSDs was defined as more than twelve weeks duration of the current episode. Diagnoses and co-morbidities were recorded by the physician. Results A total of 825 GPs included 1,692 MSD patients (predominantly back pain and osteoarthritis were included, 21.6% in the CM group, 32.4% Ho and 45.9% Mx. Patients in the Ho group had more often a chronic MSD (62.1% than the CM (48.6% or Mx (50.3% groups, a result that was statistically significant after controlling for patients' characteristics (Odds ratio = 1.43; 95% confidence interval (CI: 1.07 - 1.89. Patients seen by homeopaths or mixed practice physicians who were not the regular treating physician, had more often a chronic MSD than those seen in conventional medicine (Odds ratios were1.75; 95% CI: 1.22 - 2.50 and 1.48; 95% CI: 1.06 - 2.12, respectively. Otherwise patients in the three groups did not differ for co-morbidities and QOL. Conclusion MSD patients consulting primary care physicians who
Tulinius, Charlotte; Hølge-Hazelton, Bibi
OBJECTIVES: The profession of medicine has long been characterised by virtues such as authorisation, specialisation, autonomy, self-regulation and adherence to an ethical code of practice, and its complexity has granted it the privilege of self-regulation. Studies have shown continuing professional...... development (CPD) for general practitioners (GPs) to be most effective when it is set up within a multi-method design. This paper reports a research-based evaluation of a 2-year educational CPD project for 21 GPs. METHODS: The project focused on the issue of 'children in need' and was delivered through group...
Lygia Alvares Correa
Full Text Available CIDADE ('liernatii. Laia de Camões — O épico, Revista da Faculdade de Letras. Tomo XVI. 2.°' série. ns. I e 2. Universidade de Lisboa 1950. (Primeiro Parágrafo do Artigo Este segundo volume que a respeito de Camões escreve o Prof. Cidade surge 14 anos após, "Luiz de Camões".
This report describes the test plan for evaluating the Merlin Gerin, Inc., Edgar alpha continuous air monitor (CAM) and associated analysis system to be conducted by Idaho National Engineering Laboratory (INEL) for the Department of Energy. INEL has evaluated other commercial alpha CAM systems to detect transuranic contaminants during waste handling and retrieval operations. This test plan outlines experimental methods, sampling methods, sampling and analysis techniques, and equipment needed and safety and quality requirements to test the commercial CAM. 8 refs., 3 figs
Tsao, Jennie C. I.; Meldrum, Marcia; Kim, Su C.; Jacob, Margaret C.; Zeltzer, Lonnie K.
CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls) (mean age = 14.5 years ± 2.4; range = 8–18 years) presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examin...
Tsang, Vivian Hiu Man; Lo, Phoebe Hiu Wai; Lam, Fong Tao; Chung, Lulu Suet Wing; Tang, Tin Yan; Lui, Hoi Man; Lau, Jordan Tsz Gwan; Yee, Ho Fung; Lun, Yiu Kun; Chan, Hei Tung; Cheung, Jason Pui Yin
To determine the prevalence of complementary and alternative medicine (CAM) use in patients with low back pain (LBP) and to identify its correlation with demographic factors, clinical condition and psychosocial factors. A cross-sectional study was conducted with 278 LBP patients. Use of CAM, demographic parameters and disease duration were determined. Self-reported health status and self-rated scales assessed the effect of disease on quality of life and emotional well-being, respectively. Satisfaction with orthopaedic care and belief partiality towards CAM were assessed. In all, 72.3% patients sought CAM treatment. The most common choice of CAM was traditional Chinese medicine (TCM; n = 166), followed by massage therapy ( n = 114) and chiropractic treatment ( n = 45). Within TCM, acupuncture was the most popular treatment for LBP ( n = 127). Only 32.5% patients informed their doctors of their CAM use. In univariate analyses, factors positively associated with CAM use included duration of LBP (odds ratio (OR) = 1.45, 95% confidence interval (CI): 1.06-1.97), use of CAM in close social circles (OR = 1.98, 95% CI: 1.15-3.43) and summary score for belief partiality towards CAM (OR = 1.18, 95% CI: 1.13-1.23). Variables negatively and significantly associated with status of CAM use include age (OR = 0.97, 95% CI: 0.95-0.99) and summary score for satisfaction with orthopaedic care (OR = 0.93, 95% CI: 0.88-0.99). CAM use in patients with LBP is prevalent and largely unknown to their doctors. Personal beliefs and their satisfaction with conventional medical treatment both play a part in their decisions to use CAM. Future studies may aim at understanding the effect of CAM on patient adherence to conventional medical treatment and patients' perception of well-being and pain.
With the amendment of the German Medicinal Products Act in 1976 and the inclusion of naturopathy and homeopathy into the German Medical Licensure Act from 1988, the German government set up a comparatively favorable framework for Complementary and Alternative Medicine (CAM). But no comprehensive integration into the academic operating systems followed, because the universities as well as the legislative body seemed to have no further interest in CAM. Therefore, research projects in the field and suitable professorships had and still have to be financed by third-party funds. Notwithstanding the success of several CAM-projects, no sustainable development could be established: When the third-party funding runs off and the protagonists retire the institutional structures are supposed to vanish as well. Although the public demand for CAM is high in Germany, the administration detached homeopathy as a compulsory subject from the German Medical Licensure Act in 2002 and restricted severely the refunding of naturopathic medicines by the statutory health insurance in 2004. Moreover, the trend for CAM bashing takes root in the media. Unfortunately the CAM scene does not close ranks and is incapable to implement fundamental data collection processes into daily clinical routine: A wide range of data could justify further efforts to the government as well as to the scientific community. To say something positive, it must be mentioned that the scientific standard of CAM research is high for the most part and that third-party funded projects deliver remarkable results ever and on. Copyright © 2013 S. Karger AG, Basel.
Weidenhammer, Wolfgang; Lewith, George; Falkenberg, Torkel
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. A...... review open access publications and a final conference, with emphasis on current and future EU policies, addressing different target audiences....
Wardle, Jon; Lui, Chi-Wai; Adams, Jon
Contexts: The consumption of complementary and alternative medicine (CAM) in rural areas is a significant contemporary health care issue. An understanding of CAM use in rural health can provide a new perspective on health beliefs and practice as well as on some of the core service delivery issues facing rural health care generally. Purpose: This…
Marchisio, P; Bianchini, S; Galeone, C; Baggi, E; Rossi, E; Albertario, G; Torretta, S; Pignataro, L; Esposito, S; Principi, N
Controlling environmental factors, chemoprophylaxis, immunoprophylaxis and surgery are considered possible means of preventing recurrent acute otitis media (RAOM), but there are no available data concerning the paediatric use of complementary and alternative medicine (CAM). We evaluated the uses of CAM (homeopathy and/or herbal medicine) as means of preventing AOM in children with a history of RAOM. Eight hundred and forty Italian children with RAOM (≥3 episodes in six months) aged 1-7 years were surveyed in 2009 using a face-to-face questionnaire, filled by parents or caregivers, that explored the prevalence, determinants, reasons, cost, and perceived safety and efficacy of CAM. About one-half (46%) of the children used CAM, significantly more than the number who used immunoprophylaxis (influenza vaccine 15%; pUse of CAM in the family was the only important factor positively associated with the use of CAM in children (adjusted OR 7.94; 95% CI: 5.26-11.99). The main reasons for using CAM were a fear of the adverse effects of conventional medicine (40%) and to increase host defences (20%). CAM was widely seen as safe (95%) and highly effective (68%). CAM prescribers were paediatricians in 50.7% of cases; self-initiation was reported by 23% of respondents. CAM expenditure was between Euro 25 and Euro 50/month in 27.6% of cases and ≥ Euro 50/month in 16%. Children with RAOM should be considered among the categories of subjects likely to be using CAM. Together with the fact that paediatricians are the main prescribers, this is worrying because of the current lack of evidence regarding the efficacy, safety and cost-effectiveness of CAM in the prevention of RAOM.
Locke, Amy B; Gordon, Andrea; Guerrera, Mary P; Gardiner, Paula; Lebensohn, Patricia
The use of complementary and alternative medicine (CAM) and Integrative Medicine (IM) has grown steadily over the past decade. Patients seek physician guidance, yet physicians typically have limited knowledge and training. There is some coverage of IM/CAM topics in medical schools and residencies but with little coordination or consistency. In 2008, the Society of Teachers of Family Medicine (STFM) group on Integrative Medicine began the process of designing a set of competencies to educate Family Medicine residents in core concepts of IM. The goal was creation of a set of nationally recognized competencies tied to the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies were to be achievable by diverse programs, including those without significant internal resources. The group compiled existing curricula from programs around the country and distilled these competencies through multiple reviews and discussions. Simultaneously, the Integrative Medicine in Residency program run by the University of Arizona underwent a similar process. In 2009, these competencies were combined and further developed at the STFM annual meeting by a group of experts. In 2010, the STFM Board approved 19 measurable competencies, each categorized by ACGME domain, as recommended for Family Medicine residencies. Programs have implemented these competencies in various ways given individual needs and resources. This paper reviews the development of IM competencies for residency education in Family Medicine and presents those endorsed by STFM. By educating physicians in training about IM/CAM via competency-based curricula, we aim to promote comprehensive patient-centered care. © 2013 Elsevier Inc. All rights reserved.
Full Text Available The chick chorioallantoic membrane (CAM provides a suitable in vivo model to study angiogenesis and evaluate several pro- and anti-angiogenic factors and compounds. In the present work, new developments in image analysis are used to quantify CAM angiogenic response from optical microscopic observations, covering all vascular components, from the large supplying and feeding vessels down to the capillary plexus. To validate our methodology angiogenesis is quantified during two phases of CAM development (day 7 and 13 and after treatment with an antiangiogenic modulator of the angiogenesis. Our morphometric analysis emphasizes that an accurate quantification of the CAM vasculature needs to be performed at various scales.
Zuckerman, Jane N; Leggat, Peter
This 1st edition of Essential Travel Medicine provides an excellent concise introduction to the specialty of Travel Medicine. This core text will enable health care practitioners particularly those new to the clinical practice of Travel Medicine, to gain a fundamental understanding of the diverse and complex issues which can potentially affect the health of the many millions of people who undertake international travel. Jane N Zuckerman is joined by Gary W Brunette from CDC and Peter A Leggat from Australia as Editors. Leading international specialists in their fields have contributed authoritative chapters reflecting current knowledge to facilitate best clinical practice in the different aspects of travel medicine. The aim of Essential Travel Medicine is to provide a comprehensive guide to Travel Medicine as well as a fundamental knowledge base to support international undergraduate and postgraduate specialty training programmes in the discipline of Travel Medicine. The 1st edition of Essential Travel ...
In recent years in South Africa the position of the general practi- tioner in hospitals has ... ments, and it is in these hospitals that difficulties have arisen. On the other hand, ... great extent deprived of contact with his colleagues. He comes to ... eventually lose interest in the results of treatment and advances in medicine. In fact ...
Gad, Ashry; Al-Faris, Eiad; Al-Rowais, Noura; Al-Rukban, Mohamed
The present study aims to detect the frequency and types of complementary and alternative medicine (CAM) therapies used for children and to explore parental motivating factors for using CAM for their children in Riyadh, Saudi Arabia. This is a cross-sectional study that involved 462 families selected through a multistage cluster-sampling technique covering Riyadh region, Saudi Arabia. The sample was selected from 40 clusters, distributed proportionally according to the size of the population in the catchment area of primary health care centres (PHCCs). A structured questionnaire that contains items fulfilling the research objectives was used to collect data by research assistants. The study included 926 parents, comprising 351 fathers and 575 mothers; 37.3% of them reported the use of CAM for their children including reciting the Quran, honey and Ferula asafoetida (26.1%, 21.5% and 18.8%, respectively). CAM was used six times higher for children of parents using CAM for themselves than children of parents who did not use CAM themselves (odds ratio (OR)=6.03, 3.9-9.37). Multivariate logistic regression showed that parental use of CAM (OR=3.0, 2.2-4.0), keeping CAM remedies at home (OR=2.3, 1.8-3.1), perceived success of CAM in practice (OR=1.8, 1.3-2.4) and preference of use of natural materials (OR=1.7, 1.2-2.5) were independent predictors of use of CAM for children. In this study, around one-third of the parents used CAM for their children. Quran (Muslims' holy book) was the most common CAM type used for children. Parents' use of CAM for themselves is the most important predictor of its use for children. An in-depth study to investigate CAM use for specific diseases in children is recommended. Copyright © 2013 Elsevier Ltd. All rights reserved.
Maenaka, Katsumi; Fukushi, Kouji; Aramaki, Hironori; Shirakihara, Yasuo
The P. putida cytochrome P450cam operon repressor CamR has been expressed in E. coli and crystallized in space group P2 1 2 1 2. The Pseudomonas putida cam repressor (CamR) is a homodimeric protein that binds to the camO DNA operator to inhibit the transcription of the cytochrome P450cam operon camDCAB. CamR has two functional domains: a regulatory domain and a DNA-binding domain. The binding of the inducer d-camphor to the regulatory domain renders the DNA-binding domain unable to bind camO. Native CamR and its selenomethionyl derivative have been overproduced in Escherichia coli and purified. Native CamR was crystallized under the following conditions: (i) 12–14% PEG 4000, 50 mM Na PIPES, 0.1 M KCl, 1% glycerol pH 7.3 at 288 K with and without camphor and (ii) 1.6 M P i , 50 mM Na PIPES, 2 mM camphor pH 6.7 at 278 K. The selenomethionyl derivative CamR did not crystallize under either of these conditions, but did crystallize using 12.5% PEG MME 550, 25 mM Na PIPES, 2.5 mM MgCl 2 pH 7.3 at 298 K. Preliminary X-ray diffraction studies revealed the space group to be orthorhombic (P2 1 2 1 2), with unit-cell parameters a = 48.0, b = 73.3, c = 105.7 Å. Native and selenomethionyl derivative data sets were collected to 3 Å resolution at SPring-8 and the Photon Factory
Boon, Heather; Verhoef, Marja J
Abstract The following are abstracts of oral and poster presentations given at the 7th IN-CAM Research Symposium - Evaluating CAM Practices: Effectiveness, Integration, Economics & Safety, and the 4th HomeoNet Research Forum, a pre-Symposium event. The IN-CAM Research Symposium was held November 2 to 4, 2012 at the Leslie Dan Faculty of Pharmacy, University of Toronto, in Toronto, Ontario, Canada. For more information, please visit: www.incamresearch.ca.
AFRL-RY-WP-TR-2017-0198 NEW CONTENT ADDRESSABLE MEMORY (CAM) TECHNOLOGIES FOR BIG DATA AND INTELLIGENT ELECTRONICS ENABLED BY MAGNETO-ELECTRIC...MEMORY (CAM) TECHNOLOGIES FOR BIG DATA AND INTELLIGENT ELECTRONICS ENABLED BY MAGNETO-ELECTRIC TERNARY CAM 5a. CONTRACT NUMBER FA8650-16-1-7655 5b... electronic applications, such as internet of things, big data, wireless sensors, and mobile devices, have begun to focus on the importance of energy
problem in medicine emerged in the 1970s,1 and has been the subject of attention for over 35 ... Depression is seen in 10- 20% of doctors and about 21% who ... (a) Report impairment in another student or practitioner to l1iiiSD the Council if ...
About thirty six percent of the respondents were neurologists, 27.3% were in Internal Medicine while the rest comprised of general practitioners, pediatric neurologists, neurosurgeons, neuroscience nurses and neurophysiologists. There was poor knowledge of the effect of sex hormones on seizure threshold during ...
Skovgaard, Lasse; la Cour, Søren; Kristensen, Mette
The study has investigated the use of complementary and alternative medicine (CAM) at Danish rehabilitation institutions and drug centres. Questionnaires were sent to 147 centre leaders at 52 rehabilitation institutions and 95 drug centres. CAM is offered at 37.5% of the rehabilitation institutio...... and at 61.1% of the drug centres. Twenty-one different CAM modalities were used. Acupuncture and NADA-acupuncture had the highest prevalence. Motives for offering CAM were most often experienced effects within the institution and inspiration from other institutions....
Salamonsen, Anita; Kruse, Tove Elisabeth; Eriksen, Sissel H.
Breast cancer patients are frequent users of complementary and alternative medicine (CAM). They often have complex reasons for, and experiences from, their use of CAM. Bodily experiences are important and almost unexplored elements in CAM use. Our aim was to explore the meaning and importance...... of bodily experiences among breast cancer patients who were using CAM as a supplement or an alternative to conventional treatment (CT). Our findings based on qualitative interviews with 13 women suggest that bodily experiences were particularly important when positioned outside conventional health care...
Pfeilschifter, Maria; Preis, Verena; Behr, Michael; Rosentritt, Martin
To investigate the edge force of CAD/CAM materials as a function of (a) material, (b) thickness, and (c) distance from the margin. Materials intended for processing with CAD/CAM were investigated: eight resin composites, one resin-infiltrated ceramic, and a clinically proven lithiumdisilicate ceramic (reference). To measure edge force (that is, load to failure/crack), plates (d = 1 mm) were fixed and loaded with a Vickers diamond indenter (1 mm/min, Zwick 1446) at a distance of 0.4, 0.5, 0.6, 0.7, 0.8, 0.9, and 1.0 mm from the edge. Edge force was defined as a loading force at a distance of 0.5 mm. The type of failure was determined. To investigate the influence of the thickness, all data were determined on 1-mm and 2-mm plates. To test the influence of bonding and an underlying dentin, individual 1-mm plates were bonded to a 1-mm-thick dentin-like (concerning modulus of elasticity) resin composite. For the 1-mm plates, edge force varied between 64.4 ± 24.2 N (Shofu Block HC) and 183.2 ± 63.3 N (ceramic reference), with significant (p ≤ 0.001) differences between the materials. For the 2-mm plates, values between 129.2 ± 32.5 N (Lava Ultimate) and 230.3 ± 67.5 N (Cerasmart) were found. Statistical comparison revealed no significant differences (p > 0.109) between the materials. Brilliant Crios (p = 0.023), Enamic (p = 0.000), Shofu Blocks HC (p = 0.009), and Grandio Bloc (p = 0.002) showed significantly different edge force between the 1-mm- and 2-mm-thick plates. The failure pattern was either cracking, (severe) chipping, or fracture. Material, material thickness, and distance from the edge impact the edge force of CAD/CAM materials. CAD/CAM materials should be carefully selected on the basis of their individual edge force and performance during milling. Copyright © 2018 Elsevier Ltd. All rights reserved.
Caliebe, W.A. [National Synchrotron Light Source, Brookhaven National Laboratory, Upton, NY 11973 (United States); So, I. [National Synchrotron Light Source, Brookhaven National Laboratory, Upton, NY 11973 (United States); Lenhard, A. [National Synchrotron Light Source, Brookhaven National Laboratory, Upton, NY 11973 (United States); Siddons, D.P. [National Synchrotron Light Source, Brookhaven National Laboratory, Upton, NY 11973 (United States)
We have developed a cam-drive for quickly tuning the energy of an X-ray monochromator through an X-ray absorption edge for quick extended X-ray absorption spectroscopy (QEXAFS). The data are collected using a 4-channel, 12-bit multiplexed VME analog to digital converter and a VME angle encoder. The VME crate controller runs a real-time operating system. This system is capable of collecting 2 EXAFS-scans in 1 s with an energy stability of better than 1 eV. Additional improvements to increase the speed and the energy stability are under way.
Caliebe, W. A.; So, I.; Lenhard, A.; Siddons, D. P.
We have developed a cam-drive for quickly tuning the energy of an X-ray monochromator through an X-ray absorption edge for quick extended X-ray absorption spectroscopy (QEXAFS). The data are collected using a 4-channel, 12-bit multiplexed VME analog to digital converter and a VME angle encoder. The VME crate controller runs a real-time operating system. This system is capable of collecting 2 EXAFS-scans in 1 s with an energy stability of better than 1 eV. Additional improvements to increase the speed and the energy stability are under way.
Caliebe, W.A.; So, I.; Lenhard, A.; Siddons, D.P.
We have developed a cam-drive for quickly tuning the energy of an X-ray monochromator through an X-ray absorption edge for quick extended X-ray absorption spectroscopy (QEXAFS). The data are collected using a 4-channel, 12-bit multiplexed VME analog to digital converter and a VME angle encoder. The VME crate controller runs a real-time operating system. This system is capable of collecting 2 EXAFS-scans in 1 s with an energy stability of better than 1 eV. Additional improvements to increase the speed and the energy stability are under way
Brenton, Joslyn; Elliott, Sinikka
Despite a rich body of sociological research that examines the relationship between gender and health, scholars have paid little attention to the case of complementary and alternative medicine (CAM). One recent study (Sointu 2011) posits that men and women who use CAM challenge traditional ascriptions of femininity and masculinity through the exploration of self-care and emotions, respectively. Drawing on 25 in-depth interviews with middle-class Americans who use CAM, this article instead finds that men and women interpret their CAM use in ways that reproduce traditional gendered identities. Men frame their CAM use in terms of science and rationality, while simultaneously distancing themselves from feminine-coded components of CAM, such as emotions. Women seek CAM for problems such as abusive relationships, low self-esteem, and body image concerns, and frame their CAM use as a quest for self-reinvention that largely reflects and reproduces conventional femininity. Further, the reproduction of gendered identities is shaped by the participants' embrace of neoliberal tenets, such as the cultivation of personal control. This article contributes to ongoing theoretical debates about the doing, redoing and undoing of gender, as well as the literature on health and gender. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.
Morgan, Sherry; Littman, Lynn; Palmer, Christina; Singh, Gurneet; LaRiccia, Patrick J
Complementary and alternative medicine (CAM) comprises a multitude of disciplines, for example, acupuncture, ayurvedic medicine, biofeedback, herbal medicine, and homeopathic medicine. While research on CAM interventions has increased and the CAM literature has proliferated since the mid-1990s, a number of our colleagues have expressed difficulties in deciding where to publish CAM articles. In response, we created a short guide to peer-reviewed MEDLINE-indexed journals that publish CAM articles. We examined numerous English-language sources to identify titles that met our criteria, whether specific to or overlapping CAM. A few of the resources in which we found the journal titles that we included are Alternative Medicine Foundation, American Holistic Nurses Association, CINAHL/Nursing Database, Journal Citation Reports database, MEDLINE, PubMed, and Research Council for Complementary Medicine. We organized the 69 selected titles for easy use by creating 2 user-friendly tables, one listing titles in alphabetical order and one listing them in topical categories. A few examples of the topical categories are Acupuncture, CAM (general), Chinese Medicine, Herbal/Plant/Phytotherapy, Neuroscience/Psychology, Nursing/Clinical Care. Our study is the first to list general CAM journals, specialty CAM journals, and overlapping mainstream journals that are peer reviewed, in English, and indexed in MEDLINE. Our goal was to assist both authors seeking publication and mainstream journal editors who receive an overabundance of publishable articles but must recommend that authors seek publication elsewhere due to space and priority issues. Publishing in journals indexed by and included in MEDLINE (or PubMed) ensures that citations to articles will be found easily. Copyright © 2012 Lippincott Williams & Wilkins.
Cassandra L. Quave
Full Text Available European folk medicine has a long and vibrant history, enriched with the various documented uses of local and imported plants and plant products that are often unique to specific cultures or environments. In this paper, we consider the medicoethnobotanical field studies conducted in Europe over the past two decades. We contend that these studies represent an important foundation for understanding local small-scale uses of CAM natural products and allow us to assess the potential for expansion of these into the global market. Moreover, we discuss how field studies of this nature can provide useful information to the allopathic medical community as they seek to reconcile existing and emerging CAM therapies with conventional biomedicine. This is of great importance not only for phytopharmacovigilance and managing risk of herb-drug interactions in mainstream patients that use CAM, but also for educating the medical community about ethnomedical systems and practices so that they can better serve growing migrant populations. Across Europe, the general status of this traditional medical knowledge is at risk due to acculturation trends and the urgency to document and conserve this knowledge is evident in the majority of the studies reviewed.
Quave, Cassandra L.; Pardo-de-Santayana, Manuel; Pieroni, Andrea
European folk medicine has a long and vibrant history, enriched with the various documented uses of local and imported plants and plant products that are often unique to specific cultures or environments. In this paper, we consider the medicoethnobotanical field studies conducted in Europe over the past two decades. We contend that these studies represent an important foundation for understanding local small-scale uses of CAM natural products and allow us to assess the potential for expansion of these into the global market. Moreover, we discuss how field studies of this nature can provide useful information to the allopathic medical community as they seek to reconcile existing and emerging CAM therapies with conventional biomedicine. This is of great importance not only for phytopharmacovigilance and managing risk of herb-drug interactions in mainstream patients that use CAM, but also for educating the medical community about ethnomedical systems and practices so that they can better serve growing migrant populations. Across Europe, the general status of this traditional medical knowledge is at risk due to acculturation trends and the urgency to document and conserve this knowledge is evident in the majority of the studies reviewed. PMID:22899952
Tsao, Jennie C. I.; Zeltzer, Lonnie K.
In recent years, the use of complementary and alternative medicine (CAM) in pediatric populations has increased considerably, especially for chronic conditions such as cancer, rheumatoid arthritis and cystic fibrosis in which pain may be a significant problem. Despite the growing popularity of CAM approaches for pediatric pain, questions regarding the efficacy of these interventions remain. This review critically evaluates the existing empirical evidence for the efficacy of CAM intervention...
GammaCam trademark, a gamma-ray imaging system manufactured by AIL System, Inc., would benefit a site that needs to locate radiation sources. It is capable of producing a two-dimensional image of a radiation field superimposed on a black and white visual image. Because the system can be positioned outside the radiologically controlled area, the radiation exposure to personnel is significantly reduced and extensive shielding is not required. This report covers the following topics: technology description; performance; technology applicability and alternatives; cost; regulatory and policy issues; and lessons learned. The demonstration of GammaCam trademark in December 1996 was part of the Large-Scale Demonstration Project (LSDP) whose objective is to select and demonstrate potentially beneficial technologies at the Argonne National Laboratory-East (ANL) Chicago Pile-5 Research Reactor (CP-5). The purpose of the LSDP is to demonstrate that by using innovative and improved decontamination and decommissioning (D and D) technologies from various sources, significant benefits can be achieved when compared to baseline D and D technologies
Kaphle, Krishna; Bhuju, Dinesh Raj; Jha, Pramod Kr; Bhattarai, Hom Nath
Nepal the "Shangri-La" in the lap of the Himalayas is gearing up for modern times as it starts rebuilding after a decade of senseless violence and destruction. The nation one of the poorest in the global development index is rich in natural resources and biodiversity. Reports of medicinal plants far exceeding those recorded and reported so far are encouraging and at the same time concerns for medicinal plants under threat as a result of overexploitation are emerging from Nepal. The harsh mountain terrains, lack of industrialization and harnessing potentiality of its areas of strength; water; natural resources and tourism make it poor in per capita income which averages ~ 300 US$, with half the population living under >1$ a day. Nepal is beginning to realize that the way ahead is only possible through the path of Science and Technology (ST). Nepal Academy of Science and Technology formerly known as Royal Academy of Science and Technology organized the fifth national conference held every 4 years that took place in the capital Kathmandu during November 10-12, 2008. The ST initiation event saw the participation of ~ 1400 people representing over 150 organizations from the country and experts from abroad. The theme for the fifth national meet was "Science, Technology and Innovation for Prosperous Nepal". Complementary and Alternative Medicine (CAM) was an important theme in the event as the realization for the need of ST research focused in CAM for harnessing the chemo diversity potential was univocally approved.
Full Text Available Nepal the “Shangri-La” in the lap of the Himalayas is gearing up for modern times as it starts rebuilding after a decade of senseless violence and destruction. The nation one of the poorest in the global development index is rich in natural resources and biodiversity. Reports of medicinal plants far exceeding those recorded and reported so far are encouraging and at the same time concerns for medicinal plants under threat as a result of overexploitation are emerging from Nepal. The harsh mountain terrains, lack of industrialization and harnessing potentiality of its areas of strength; water; natural resources and tourism make it poor in per capita income which averages ~ 300 US$, with half the population living under >1$ a day. Nepal is beginning to realize that the way ahead is only possible through the path of Science and Technology (ST. Nepal Academy of Science and Technology formerly known as Royal Academy of Science and Technology organized the fifth national conference held every 4 years that took place in the capital Kathmandu during November 10-12, 2008. The ST initiation event saw the participation of ~ 1400 people representing over 150 organizations from the country and experts from abroad. The theme for the fifth national meet was “Science, Technology and Innovation for Prosperous Nepal”. Complementary and Alternative Medicine (CAM was an important theme in the event as the realization for the need of ST research focused in CAM for harnessing the chemo diversity potential was univocally approved.
Full Text Available Abstract Background In the U.S., complementary and alternative medicine (CAM use is most prevalent among reproductive age, educated women. We sought to determine general attitudes and approaches to CAM among obstetric and gynecology patients and physicians. Methods Obstetrician-gynecologist members of the American Medical Association in the state of Michigan and obstetric-gynecology patients at the University of Michigan were surveyed. Physician and patient attitudes and practices regarding CAM were characterized. Results Surveys were obtained from 401 physicians and 483 patients. Physicians appeared to have a more positive attitude towards CAM as compared to patients, and most reported routinely endorsing, providing or referring patients for at least one CAM modality. The most commonly used CAM interventions by patients were divergent from those rated highest among physicians, and most patients did not consult with a health care provider prior to starting CAM. Conclusion Although obstetrics/gynecology physicians and patients have a positive attitude towards CAM, physician and patients' view of the most effective CAM therapies were incongruent. Obstetrician/gynecologists should routinely ask their patients about their use of CAM with the goal of providing responsible, evidence-based advice to optimize patient care.
Loquai, Carmen; Dechent, Dagmar; Garzarolli, Marlene; Kaatz, Martin; Kaehler, Katharina C; Kurschat, Peter; Meiss, Frank; Stein, Annette; Nashan, Dorothee; Micke, Oliver; Muecke, Ralph; Muenstedt, Karsten; Stoll, Christoph; Schmidtmann, Irene; Huebner, Jutta
Complementary and alternative medicine (CAM) is used widely among cancer patients. Beside the risk of interaction with cancer therapies, interactions with treatment for comorbidities are an underestimated problem. The aim of this study was to assess prevalence of interactions between CAM and drugs for comorbidities from a large CAM usage survey on melanoma patients and to classify herb-drug interactions with regard to their potential to harm. Consecutive melanoma outpatients of seven skin cancer centers were asked to complete a standardized CAM questionnaire including questions to their CAM use and their taken medication for comorbidities and cancer. Each combination of conventional drugs and complementary substances was evaluated for their potential of interaction. 1089 questionnaires were eligible for evaluation. From these, 61.6% of patients reported taking drugs regularly from which 34.4% used biological-based CAM methods. Risk evaluation for interaction was possible for 180 CAM users who listed the names or substances they took for comorbidities. From those patients, we found 37.2% at risk of interaction of their co-consumption of conventional and complementary drugs. Almost all patients using Chinese herbs were at risk (88.6%). With a high rate of CAM usage at risk of interactions between CAM drugs and drugs taken for comorbidities, implementation of a regular assessment of CAM usage and drugs for comorbidities is mandatory in cancer care.
Michael S. Goldstein
Full Text Available Background: Population-based data about utilization of complementary and alternative medicine (CAM among those with chronic conditions is lacking.Objective: To describe whether CAM use by California adults with cancer and other chronic conditions reflects condition specific patterns or a general tendency to use CAM modalities.Methods: Interviews of 9,187 respondents including all participants with cancer from a prior representative survey of California households, and a stratified sample of all other respondents. Almost 74% of the respondents reported at least one chronic health problem.Results: Use of all forms of CAM among those with chronic health problems is high. Those with a diagnosis of cancer are more likely to use prayer, dietary supplements, and support groups, and less likely to use CAM providers and special diets. Overall, individuals diagnosed with most chronic problems use a similar set of CAM modalities. Demographic correlates of CAM use differ in their impact and vary according to what type of CAM is being used.Conclusions: Clinicians should be aware that while a diagnosis of cancer is associated with a greater use of some forms of CAM, overall patterns of CAM use are similar to those with most other chronic problems.
Michael S. Goldstein
Full Text Available Background Population-based data about utilization of complementary and alternative medicine (CAM among those with chronic conditions is lacking. Objective To describe whether CAM use by California adults with cancer and other chronic conditions reflects condition-specific patterns or a general tendency to use CAM modalities. Methods Interviews of 9,187 respondents including all participants with cancer from a prior representative survey of California households, and a stratified sample of all other respondents. Almost 74% of the respondents reported at least one chronic health problem. Results Use of all forms of CAM among those with chronic health problems is high. Those with a diagnosis of cancer are more likely to use prayer, dietary supplements, and support groups, and less likely to use CAM providers and special diets. Overall, individuals diagnosed with most chronic problems use a similar set of CAM modalities. Demographic correlates of CAM use differ in their impact and vary according to what type of CAM is being used. Conclusions Clinicians should be aware that while a diagnosis of cancer is associated with a greater use of some forms of CAM, overall patterns of CAM use are similar to those with most other chronic problems.
Feinglass, Joe; Lee, Chin; Rogers, Michelle; Temple, Leslie Mendoza; Nelson, Cynthia; Chang, Rowland W
To compare the use of complementary and alternative medicine (CAM) for arthritis between 2 ethnically distinct metropolitan Chicago community areas. A telephone interview survey of adults age 45 years or above living in North (88.9% white) or South (79.7% African American) areas. Of 763 respondents, 405 reported arthritis or chronic joint symptoms and were asked about use and satisfaction with 7 CAM therapies. Differences between areas were compared with population-weighted tests; multiple logistic regression was used to analyze the likelihood of CAM use controlled for demographics, behavioral risk factors, and arthritis severity. South Chicago respondents had a higher prevalence and more severe arthritis symptoms such as mean joint pain and more functional limitations. Use of CAM therapy by South Chicago respondents, most commonly massage and relaxation techniques, was 10% greater than North Chicago respondents (61.5% to 51%) but this was not significantly different. Among CAM users, South Chicago respondents reported higher satisfaction with 6 of the 7 CAM therapies and greater future interest in CAM therapies. Poor overall health status (P=0.03), arthritis pain (P=0.005), and concomitant use of prescription medications (P=0.03) were the only significant predictors of CAM use. Although there were only small differences in overall CAM use by area, older residents of largely African American communities were enthusiastic users of relaxation, massage, and nutritional and dietary techniques. CAM modalities could be important adjuncts to traditional medical treatment of arthritis pain for minority communities.
José A. Olalde Rangel
Full Text Available The Systemic Theory of Living Systems is being published in several parts in eCAM. The theory is axiomatic. It originates from the phenomenological idea that physiological health is based on three factors: integrity of its structure or organization, O, functional organic energy reserve, E, and level of active biological intelligence, I. From the theory is derived a treatment strategy called Systemic Medicine (SM. This is based on identifying and prescribing phytomedicines and/or other medications that strengthen each factor. Energy-stimulating phytomedicines increase available energy and decrease total entropy of an open biological system by providing negative entropy. The same occurs with phytomedicines that act as biological intelligence modulators. They should be used as the first line of treatment in all ailments, since all pathologies, by definition, imply a higher than normal organic entropy. SM postulates that the state of health, H, of an individual, is effectively equal to the product of the strength of each factor H = O × E × I. SM observes that when all three factors are brought back to ideal levels, patients' conditions begin the recovery to normal health.
Use of complementary and alternative medicine (CAM) is widespread among different patient populations despite the availability of evidence-based conventional medicine and lack of supporting evidence for the claims of most CAM types. This study explored the prevalence, patterns, and perceived value of CAM among human immunodeficiency virus (HIV) patients. This quantitative descriptive study was conducted between November 1, 2014 and March 31, 2015 among a cross-sectional, convenience sample of attendees of the HIV clinic of a public tertiary health care institution. Face-to-face interviews using a 34-item questionnaire were conducted. Data analysis included descriptive statistics, chi-square tests, and binary logistic regression analysis. CAM was used by 113 (32.8%) of a total of 343 HIV patients, but Medicinal herbs were the most common type of CAM used (n = 110, 97.3%) followed by spiritual therapy (n = 56, 49.6%), including faith healing/prayer and meditation. The most used medicinal herbs were Aloe vera (n = 54, 49.1%), ginger (n = 33, 30.0%), and garlic (n = 23, 20.9%). The most used vitamins were complex B vitamins (n = 70, 61.9%), followed by vitamin A (n = 58, 51.3%), vitamin E (n = 51, 45.1%), and vitamin D (n = 42, 37.1%). Most CAM users continued using conventional medicine in addition to CAM and were willing to use CAM without supervision and without informing their health care provider. Patients were generally satisfied with CAM therapy (n = 91, 80.5%). The main reasons for CAM use were the desire to take control of their treatment (8.8%) or just trying anything that could help (18.8%). Main influences were the mass media (32.7%) and non-hospital health personnel (19.5%). Predictors of CAM use were being 30-50 years, married and having a secondary school education. About one-third of HIV patients used CAM, but virtually none informed their healthcare provider. Medicinal herbs were the most common type of CAM, followed by spiritual
Clinical practice guidelines in complementary and alternative medicine. An analysis of opportunities and obstacles. Practice and Policy Guidelines Panel, National Institutes of Health Office of Alternative Medicine.
An estimated 1 of 3 Americans uses some form of complementary and alternative medicine (CAM), such as acupuncture, homeopathy, or herbal medicine. In 1995, the National Institutes of Health Office of Alternative Medicine convened an expert panel to examine the role of clinical practice guidelines in CAM. The panel concluded that CAM practices currently are unsuitable for the development of evidence-based practice guidelines, in part because of the lack of relevant outcomes data from well-designed clinical trials. Moreover, the notions of standardization and appropriateness, inherent in guideline development, face challenging methodologic problems when applied to CAM, which considers many different treatment practices appropriate and encourages highly individualized care. Due to different belief systems and divergent theories about the nature of health and illness, CAM disciplines have fundamental differences in how they define target conditions, causes of disease, interventions, and outcome measures of effectiveness. These differences are even more striking when compared with those used by Western medicine. The panel made a series of recommendations on strategies to strengthen the evidence base for future guideline development in CAM and to meet better the current information needs of clinicians, patients, and guideline developers who seek information about CAM treatments.
Vasilyev, Aleksandr; Bakhracheva, Yuliya; Kabore, Ousman; Zelenskiy, Yuriy
This article studies the numerical step-by-step method of cam profile design. The results of the study are used for designing the internal combustion engine valve gear. This method allows to profile the peak efficiency of cams in view of many restrictions, connected with valve gear serviceability and reliability.