Views and experiences of healthcare professionals towards the use of African traditional, complementary and alternative medicines among patients with HIV infection: the case of eThekwini health district, South Africa.

PubMed

Nlooto, Manimbulu

2015-06-06

Many patients with human immunodeficiency virus infection use traditional, complementary, and alternative medicines and other practices to combat the disease, with some also using prescribed antiretroviral therapy provided by the public health sector. This study aimed to establish the awareness of public sector biomedical health care providers on the use of traditional, complementary and alternative medicines by HIV-infected patients who also used highly active antiretroviral therapy, and to determine whether this was based on patients seen or cases being reported to them. Potential risks of interactions between the prescribed antiretroviral and non-prescribed medication therapies may pose safety and effectiveness issues in patients using both types of treatment. A descriptive cross-sectional study, using a researcher administered semi-structured questionnaire, was conducted from June to August 2013 at ten public sector antiretroviral clinics in five regional, three specialised and two district hospitals in eThekwini Health District, South Africa. Questionnaires were administered through face-to face interview to 120 eligible participants consisting of doctors, nurses, pharmacists and post-basic pharmacist assistants in HIV clinical practice. The results are presented as percent or proportion with standard error (SE), or as frequency. Ninety-four respondents completed the questionnaire, yielding a response rate of 78.3 %. Almost half (48/94) were aware of patients using African traditional herbal medicines, over-the-counter supplements, unnamed complementary Ayurveda medicines and acupuncture. Twenty-three of the 94 respondents (24.4 %) said they had consulted patients who were using both antiretroviral therapy and certain types of non-prescribed medication in the previous three months. Awareness among healthcare providers on patient use of traditional, complementary and alternative medicines was relatively high. Few respondents had seen patients who used mostly African traditional medicines, over-the counter supplements, and negligible complementary Ayurveda medicines and acupuncture, with caution being advised in the interpretation of the former. Further research is needed to investigate communication between healthcare providers and patients in this regard, and levels of acceptance of traditional, complementary and alternative medicines by biomedical health care workers in HIV public sector practice.

Scientific Results of Yoga for Health and Well-Being

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Integrating complementary therapies into health care education: a cautious approach.

PubMed

Richardson, J

2001-11-01

The movement of complementary therapy training and education into higher education in the United Kingdom (UK) and the interest in alternative therapeutic approaches within the health professions presents an ideal opportunity for multidisciplinary teaching and shared learning. The diversity and similarities of complementary therapies and areas of convergence with conventional healthcare practice can be explored. The recent publication of the House of Lords Select Committee on Science and Technology report on complementary and alternative medicine (HL Paper 123) provides a broader context for discussion and makes specific recommendations about regulation, education and research in the UK. This paper considers the appropriateness of integrating complementary therapies into education for conventional healthcare practitioners, what we should integrate, and when might be the most appropriate time in the education of healthcare practitioners to introduce different therapeutic modalities and their respective philosophical languages. Rather than present a range of solutions, the paper raises some fundamental issues that are central to the integration of complementary therapeutic approaches. If these issues are neglected as we hurry to incorporate different 'techniques' into our conventional practice, we may simply be left with additional tools that we are ill equipped to use.

Integrating complementary medicine and health care services into practice.

PubMed Central

LaValley, J W; Verhoef, M J

1995-01-01

Complementary medicine and health care services constitute a significant proportion of the use of health care services in Canada, despite a history of limited acceptance of these therapies by the medical profession. However, physician attitudes appear to be changing. A survey of a random sample of general practitioners in Quebec (see page 29 of this issue) shows that four out of five general practitioners perceive at least one of three complementary health care services to be useful. Similar surveys of samples in Alberta and Ontario suggest that physicians there, although somewhat less enthusiastic than their counterparts in Quebec, have also begun to be more open-minded about these types of therapies. However, physicians have reported little understanding of complementary health care services, which suggests the need for more research on and education about these services. The Medical Society of Nova Scotia has responded to this need by establishing a Section of Complementary Medicine. The authors believe that fair, accountable, scientific and rigorous research on complementary therapies will benefit physicians and patients. The problems inherent in applying reductionist analysis to a holistic approach to care can be largely circumvented by focusing on outcomes research. In light of the popularity of these therapies, inquiry into patient use of complementary health care services should become a part of a complete patient history. This measure would promote greater patient-physician communication and integration of complementary health care services into patient care. PMID:7796375

Complementary therapies as resources for mental health in Primary Health Care.

PubMed

Carvalho, Jessica Liz da Silva; Nóbrega, Maria do Perpétuo Socorro de Sousa

2017-01-01

OBJECTIVE To verify the knowledge of Primary Care professionals about Integrative and Complementary Practices (PIC - "Práticas Integrativas e Complementares") and if they perceive these Practices as a care resource in Mental Health. METHOD Quantitative study carried out with 70 professionals from a Basic Unit of Health in the city of São Paulo between May and June of 2016. The data were collected through a questionnaire elaborated by the researchers. For statistical analysis, the frequency distribution of the variables and the Fisher test were considered. RESULTS The professionals said that they were aware of some PIC (73.9%), that users of the service with Mental Health issues would benefit from them (94.2%), that they would like to receive training (91.3%), and that they consider the practices a possible resource for care in Mental Health (92.8%). CONCLUSION The professionals' knowledge needs to be deepened. Still, they consider PIC as a resource for Mental Health in Primary Care.

Infant Feeding Practices of Emirati Women in the Rapidly Developing City of Abu Dhabi, United Arab Emirates.

PubMed

Gardner, Hazel; Green, Katherine; Gardner, Andrew

2015-09-02

Rapid economic and cultural transition in the United Arab Emirates (UAE) has been accompanied by new challenges to public health; most notably a rapid rise in chronic disease. Breastfeeding is known to improve health outcomes in adulthood, is associated with reduced risk of developing chronic disease, and is therefore an important public health issue for this rapidly increasing population. Factors associated with infant feeding practices were examined in a cohort of 125 Emirati women and their infants, with data collected at birth and 3, 6 and 15 months postpartum by questionnaires and interviews. Participants were recruited in the Corniche Hospital, the main maternity hospital in the city of Abu Dhabi. Factors affecting the duration of breastfeeding and the introduction of complementary foods were investigated using univariate and multivariate statistics. Recommended infant feeding practices, such as exclusive breastfeeding for the first six months of life and timely introduction of appropriate complementary foods, were poorly adhered to. Factors implicated in early cessation of breastfeeding included: time to first breastfeed, mother's education level, employment status and early introduction of complementary foods.

Infant Feeding Practices of Emirati Women in the Rapidly Developing City of Abu Dhabi, United Arab Emirates

PubMed Central

Gardner, Hazel; Green, Katherine; Gardner, Andrew

2015-01-01

Rapid economic and cultural transition in the United Arab Emirates (UAE) has been accompanied by new challenges to public health; most notably a rapid rise in chronic disease. Breastfeeding is known to improve health outcomes in adulthood, is associated with reduced risk of developing chronic disease, and is therefore an important public health issue for this rapidly increasing population. Factors associated with infant feeding practices were examined in a cohort of 125 Emirati women and their infants, with data collected at birth and 3, 6 and 15 months postpartum by questionnaires and interviews. Participants were recruited in the Corniche Hospital, the main maternity hospital in the city of Abu Dhabi. Factors affecting the duration of breastfeeding and the introduction of complementary foods were investigated using univariate and multivariate statistics. Recommended infant feeding practices, such as exclusive breastfeeding for the first six months of life and timely introduction of appropriate complementary foods, were poorly adhered to. Factors implicated in early cessation of breastfeeding included: time to first breastfeed, mother’s education level, employment status and early introduction of complementary foods. PMID:26404348

Tai Chi and Qi Gong for Health and Well-Being

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... What Is Complementary, Alternative or Integrative Health? Safety Information Know the Science For Health Care Professionals Clinical Practice Guidelines Literature Reviews All Health Information Research Research Results Results by Date Sponsored by ...

Exclusive Breastfeeding Rate and Complementary Feeding Indicators in China: A National Representative Survey in 2013.

PubMed

Duan, Yifan; Yang, Zhenyu; Lai, Jianqiang; Yu, Dongmei; Chang, Suying; Pang, Xuehong; Jiang, Shan; Zhang, Huanmei; Bi, Ye; Wang, Jie; Scherpbier, Robert W; Zhao, Liyun; Yin, Shian

2018-02-22

Appropriate infant and young child feeding could reduce morbidity and mortality and could improve cognitive development of children. However, nationwide data on exclusive breastfeeding and complementary feeding status in China are scarce. The aim of this study was to assess current exclusive breastfeeding and complementary feeding status in China. A national representative survey (Chinese National Nutrition and Health Survey) of children aged under 6 years was done in 2013. Stratified multistage cluster sampling was used to select study participants. World Health Organization (WHO) infant and young child feeding indicators were firstly used to assess exclusive breastfeeding and complementary feeding practice nationwide. In total, 14,458 children aged under two years (0 to <730 days) were studied from 55 counties in 30 provinces in China. The crude exclusive breastfeeding rate under 6 months was 20.7% (908/4381) and the weighted exclusive breastfeeding rate was 18.6%. The crude prevalence of minimum dietary diversity, minimum meal frequency and minimum acceptable diet were 52.5% (5286/10,071), 69.8% (7027/10,071), and 27.4% (2764/10,071) among children aged 6-23 months, respectively. The weighted rate was 53.7%, 69.1%, and 25.1%, respectively. Residential area, household income and maternal education were positively associated with the three complementary feeding indicators. The exclusive breastfeeding rate under 6 months was low and complementary feeding practice was not optimal in China. Residential area, household income and maternal education might be used to target infants and young children to improve complementary feeding practice.

Exclusive Breastfeeding Rate and Complementary Feeding Indicators in China: A National Representative Survey in 2013

PubMed Central

Duan, Yifan; Yang, Zhenyu; Lai, Jianqiang; Yu, Dongmei; Chang, Suying; Pang, Xuehong; Jiang, Shan; Zhang, Huanmei; Bi, Ye; Wang, Jie; Scherpbier, Robert W.; Zhao, Liyun; Yin, Shian

2018-01-01

Appropriate infant and young child feeding could reduce morbidity and mortality and could improve cognitive development of children. However, nationwide data on exclusive breastfeeding and complementary feeding status in China are scarce. The aim of this study was to assess current exclusive breastfeeding and complementary feeding status in China. A national representative survey (Chinese National Nutrition and Health Survey) of children aged under 6 years was done in 2013. Stratified multistage cluster sampling was used to select study participants. World Health Organization (WHO) infant and young child feeding indicators were firstly used to assess exclusive breastfeeding and complementary feeding practice nationwide. In total, 14,458 children aged under two years (0 to <730 days) were studied from 55 counties in 30 provinces in China. The crude exclusive breastfeeding rate under 6 months was 20.7% (908/4381) and the weighted exclusive breastfeeding rate was 18.6%. The crude prevalence of minimum dietary diversity, minimum meal frequency and minimum acceptable diet were 52.5% (5286/10,071), 69.8% (7027/10,071), and 27.4% (2764/10,071) among children aged 6–23 months, respectively. The weighted rate was 53.7%, 69.1%, and 25.1%, respectively. Residential area, household income and maternal education were positively associated with the three complementary feeding indicators. The exclusive breastfeeding rate under 6 months was low and complementary feeding practice was not optimal in China. Residential area, household income and maternal education might be used to target infants and young children to improve complementary feeding practice. PMID:29470415

An integrated nutrition and health program package on IYCN improves breastfeeding but not complementary feeding and nutritional status in rural northern India: A quasi-experimental randomized longitudinal study.

PubMed

Singh, Veena; Ahmed, Saifuddin; Dreyfuss, Michele L; Kiran, Usha; Chaudhery, Deepika N; Srivastava, Vinod K; Ahuja, Ramesh C; Baqui, Abdullah H; Darmstadt, Gary L; Santosham, Mathuram; West, Keith P

2017-01-01

Undernutrition below two years of age remains a major public health problem in India. We conducted an evaluation of an integrated nutrition and health program that aimed to improve nutritional status of young children by improving breast and complementary feeding practices over that offered by the Government of India's standard nutrition and health care program. In Uttar Pradesh state, through multi-stage cluster random sampling, 81 villages in an intervention district and 84 villages in a comparison district were selected. A cohort of 957 third trimester pregnant women identified during house-to-house surveys was enrolled and, following childbirth, mother-child dyads were followed every three months from birth to 18 months of age. The primary outcomes were improvements in weight-for-age and length-for-age z scores, with improved breastfeeding and complementary feeding practices as intermediate outcomes. Optimal breastfeeding practices were higher among women in intervention than comparison areas, including initiating breastfeeding within one hour of delivery (17.4% vs. 2.7%, p<0.001), feeding colostrum (34.7% vs. 8.4%, p<0.001), avoiding pre-lacteals (19.6% vs. 2.1%, p<0.001) and exclusively breastfeeding up to 6 months (24.1% vs. 15.3%, p = 0.001). However, differences were few and mixed between study arms with respect to complementary feeding practices. The mean weight-for-age z-score was higher at 9 months (-2.1 vs. -2.4, p = 0.0026) and the prevalence of underweight status was lower at 12 months (58.5% vs. 69.3%, p = 0.047) among intervention children. The prevalence of stunting was similar between study arms at all ages. Coefficients to show the differences between the intervention and comparison districts (0.13 cm/mo) suggested significant faster linear growth among intervention district infants at earlier ages (0-5 months). Mothers participating in the intervention district were more likely to follow optimal breast, although not complementary feeding practices. The program modestly improved linear growth in earlier age and weight gain in late infancy. Comprehensive nutrition and health interventions are complex; the implementation strategies need careful examination to improve feeding practices and thus impact growth. The trial was registered with ClinicalTrials.gov, NCT00198835.

An integrated nutrition and health program package on IYCN improves breastfeeding but not complementary feeding and nutritional status in rural northern India: A quasi-experimental randomized longitudinal study

PubMed Central

Ahmed, Saifuddin; Dreyfuss, Michele L.; Srivastava, Vinod K.; Ahuja, Ramesh C.; Baqui, Abdullah H.; Darmstadt, Gary L.; Santosham, Mathuram; West, Keith P.

2017-01-01

Background Undernutrition below two years of age remains a major public health problem in India. We conducted an evaluation of an integrated nutrition and health program that aimed to improve nutritional status of young children by improving breast and complementary feeding practices over that offered by the Government of India’s standard nutrition and health care program. Methods In Uttar Pradesh state, through multi-stage cluster random sampling, 81 villages in an intervention district and 84 villages in a comparison district were selected. A cohort of 957 third trimester pregnant women identified during house-to-house surveys was enrolled and, following childbirth, mother-child dyads were followed every three months from birth to 18 months of age. The primary outcomes were improvements in weight-for-age and length-for-age z scores, with improved breastfeeding and complementary feeding practices as intermediate outcomes. Findings Optimal breastfeeding practices were higher among women in intervention than comparison areas, including initiating breastfeeding within one hour of delivery (17.4% vs. 2.7%, p<0.001), feeding colostrum (34.7% vs. 8.4%, p<0.001), avoiding pre-lacteals (19.6% vs. 2.1%, p<0.001) and exclusively breastfeeding up to 6 months (24.1% vs. 15.3%, p = 0.001). However, differences were few and mixed between study arms with respect to complementary feeding practices. The mean weight-for-age z-score was higher at 9 months (-2.1 vs. -2.4, p = 0.0026) and the prevalence of underweight status was lower at 12 months (58.5% vs. 69.3%, p = 0.047) among intervention children. The prevalence of stunting was similar between study arms at all ages. Coefficients to show the differences between the intervention and comparison districts (0.13 cm/mo) suggested significant faster linear growth among intervention district infants at earlier ages (0–5 months). Interpretation Mothers participating in the intervention district were more likely to follow optimal breast, although not complementary feeding practices. The program modestly improved linear growth in earlier age and weight gain in late infancy. Comprehensive nutrition and health interventions are complex; the implementation strategies need careful examination to improve feeding practices and thus impact growth. Trial registration The trial was registered with ClinicalTrials.gov, NCT00198835. PMID:28931088

Safe Use of Complementary Health Products and Practices

MedlinePlus

... Mind and Body Practices for Children and Teens Dietary Supplement Safety Information Using Dietary Supplements Wisely Dietary Supplement ... Homeopathic Drugs Dietary Supplements—Adverse Event Reporting ( FDA ) Dietary Supplement Alerts and Advisories Alerts and Advisories Clinical Practice ...

Determinants of inadequate complementary feeding practices among children aged 6-23 months in Ghana.

PubMed

Issaka, Abukari I; Agho, Kingsley E; Burns, Penelope; Page, Andrew; Dibley, Michael J

2015-03-01

To explore complementary feeding practices and identify potential risk factors associated with inadequate complementary feeding practices in Ghana by using the newly developed WHO infant feeding indicators and data from the nationally representative 2008 Ghana Demographic and Health Survey. The source of data for the analysis was the 2008 Ghana Demographic and Health Survey. Analysis of the factors associated with inadequate complementary feeding, using individual-, household- and community-level determinants, was done by performing multiple logistic regression modelling. Ghana. Children (n 822) aged 6-23 months. The prevalence of the introduction of solid, semi-solid or soft foods among infants aged 6-8 months was 72.6 % (95 % CI 64.6 %, 79.3 %). The proportion of children aged 6-23 months who met the minimum meal frequency and dietary diversity for breast-fed and non-breast-fed children was 46.0 % (95 % CI 42.3 %, 49.9 %) and 51.4 % (95 % CI 47.4 %, 55.3 %) respectively and the prevalence of minimum acceptable diet for breast-fed children was 29.9 % (95 % CI 26.1 %, 34.1 %). Multivariate analysis revealed that children from the other administrative regions were less likely to meet minimum dietary diversity, meal frequency and acceptable diet than those from the Volta region. Household poverty, children whose mothers perceived their size to be smaller than average and children who were delivered at home were significantly less likely to meet the minimum dietary diversity requirement; and children whose mothers did not have any postnatal check-ups were significantly less likely to meet the requirement for minimum acceptable diet. Complementary feeding was significantly lower in infants from illiterate mothers (adjusted OR=3.55; 95 % CI 1.05, 12.02). The prevalence of complementary feeding among children in Ghana is still below the WHO-recommended standard of 90 % coverage. Non-attendance of postnatal check-up by mothers, cultural beliefs and habits, household poverty, home delivery of babies and non-Christian mothers were the most important risk factors for inadequate complementary feeding practices. Therefore, nutrition educational interventions to improve complementary feeding practices should target these factors in order to achieve the fourth Millennium Development Goal.

Medical doctors and complementary and alternative medicine: the context of holistic practice.

PubMed

Winnick, Terri A

2006-04-01

Consumers, health care financing, external and internal competition are factors identified in the medical literature as prompting change within medicine. I test these factors to determine if they also prompt regular doctors to define themselves as 'holistic MDs' and align themselves with complementary and alternative medicine (CAM). State-level regression analyses on the number of MDs advertising in referral directories for CAM therapies find holistic practice a function of practice locale. The proportion of holistic MDs increases in states with an older population, where more patients survive despite serious disabilities, and where non-physician providers pose a competitive threat. Consumer demand, specialization and licensing do not significantly influence adoption of CAM treatments in these analyses. Health care financing has disparate effects. Indemnity insurance constrains holistic practice while HMO penetration enhances it. These results suggest that holistic practice may be an integral part of the regular profession's ongoing professionalization project.

Homeopathy: An Introduction

MedlinePlus

... are inconsistent with fundamental concepts of chemistry and physics. There are significant challenges in carrying out rigorous clinical research on homeopathic remedies. Tell all your health care providers about any complementary health practices you ...

Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya

PubMed Central

2011-01-01

Background The World Health Organisation (WHO) recommends exclusive breastfeeding during the first six months of life for optimal growth, development and health. Breastfeeding should continue up to two years or more and nutritionally adequate, safe, and appropriately-fed complementary foods should be introduced at the age of six months to meet the evolving needs of the growing infant. Little evidence exists on breastfeeding and infant feeding practices in urban slums in sub-Saharan Africa. Our aim was to assess breastfeeding and infant feeding practices in Nairobi slums with reference to WHO recommendations. Methods Data from a longitudinal study conducted in two Nairobi slums are used. The study used information on the first year of life of 4299 children born between September 2006 and January 2010. All women who gave birth during this period were interviewed on breastfeeding and complementary feeding practices at recruitment and this information was updated twice, at four-monthly intervals. Cox proportional hazard analysis was used to determine factors associated with cessation of breastfeeding in infancy and early introduction of complementary foods. Results There was universal breastfeeding with almost all children (99%) having ever been breastfed. However, more than a third (37%) were not breastfed in the first hour following delivery, and 40% were given something to drink other than the mothers' breast milk within 3 days after delivery. About 85% of infants were still breastfeeding by the end of the 11th month. Exclusive breastfeeding for the first six months was rare as only about 2% of infants were exclusively breastfed for six months. Factors associated with sub-optimal infant breastfeeding and feeding practices in these settings include child's sex; perceived size at birth; mother's marital status, ethnicity; education level; family planning (pregnancy desirability); health seeking behaviour (place of delivery) and; neighbourhood (slum of residence). Conclusions The study indicates poor adherence to WHO recommendations for breastfeeding and infant feeding practices. Interventions and further research should pay attention to factors such as cultural practices, access to and utilization of health care facilities, child feeding education, and family planning. PMID:21615957

Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya.

PubMed

Kimani-Murage, Elizabeth W; Madise, Nyovani J; Fotso, Jean-Christophe; Kyobutungi, Catherine; Mutua, Martin K; Gitau, Tabither M; Yatich, Nelly

2011-05-26

The World Health Organisation (WHO) recommends exclusive breastfeeding during the first six months of life for optimal growth, development and health. Breastfeeding should continue up to two years or more and nutritionally adequate, safe, and appropriately-fed complementary foods should be introduced at the age of six months to meet the evolving needs of the growing infant. Little evidence exists on breastfeeding and infant feeding practices in urban slums in sub-Saharan Africa. Our aim was to assess breastfeeding and infant feeding practices in Nairobi slums with reference to WHO recommendations. Data from a longitudinal study conducted in two Nairobi slums are used. The study used information on the first year of life of 4299 children born between September 2006 and January 2010. All women who gave birth during this period were interviewed on breastfeeding and complementary feeding practices at recruitment and this information was updated twice, at four-monthly intervals. Cox proportional hazard analysis was used to determine factors associated with cessation of breastfeeding in infancy and early introduction of complementary foods. There was universal breastfeeding with almost all children (99%) having ever been breastfed. However, more than a third (37%) were not breastfed in the first hour following delivery, and 40% were given something to drink other than the mothers' breast milk within 3 days after delivery. About 85% of infants were still breastfeeding by the end of the 11th month. Exclusive breastfeeding for the first six months was rare as only about 2% of infants were exclusively breastfed for six months. Factors associated with sub-optimal infant breastfeeding and feeding practices in these settings include child's sex; perceived size at birth; mother's marital status, ethnicity; education level; family planning (pregnancy desirability); health seeking behaviour (place of delivery) and; neighbourhood (slum of residence). The study indicates poor adherence to WHO recommendations for breastfeeding and infant feeding practices. Interventions and further research should pay attention to factors such as cultural practices, access to and utilization of health care facilities, child feeding education, and family planning.

Time to Talk: 5 Things to Know about Complementary Health Practices for Cognitive Function, Dementia, and Alzheimer's ...

MedlinePlus

... as several mind and body practices such as music therapy and mental imagery, which have shown promise ... of some mind and body practices such as music therapy suggest they may be helpful for some ...

Infant and young child feeding practice among mothers with 0-24 months old children in Slum areas of Bahir Dar City, Ethiopia.

PubMed

Demilew, Yeshalem Mulugeta; Tafere, Tadese Ejigu; Abitew, Dereje Berhanu

2017-01-01

Adequate nutrition during infancy and early childhood is essential to ensure the health, growth and development of children. However, infant feeding practice is suboptimal in Bahir Dar City, Ethiopia. The slum area is a heavily populated urban informal settlement characterized by substandard housing, squalor, with a lack of reliable sanitation services, supply of clean water, reliable electricity, law enforcement and other basic services. Residents of the slum area were poor and less educated. This further compromises infant feeding practice. The aim of this study was to assess infant and young child feeding practice among mothers with 0-24 month old children in the study area. A community based cross-sectional study was conducted among 423 mothers with 0-24 month old children from June 01-30 / 2016. Simple random sampling technique was used to select the respondents. Infant and young child feeding practice was assessed using the fifteen World Health Organisation (WHO) criteria. The prevalence of exclusive breastfeeding practice was 113 (84%). Sixty (15%) mothers gave prelacteal feeds and, 96 (23%) mothers used a bottle to feed their index child. Appropriate complementary feeding practice was only 20 (7%). Thirty nine out of forty mothers introduced complementary food timely, 131 (47%) of mothers gave the minimum meal frequency, and 20 (7%) children took the minimum food diversity and acceptable diet. Independent predictors for complementary feeding practice were having secondary and above education of the mother, receiving postnatal care, possession of radio and giving birth at hospital. In this study infant and young child feeding (IYCF) practice was poor. Therefore, there is a need for strengthening the promotion on IYCF practice during postnatal care and using mass media to giving emphasis for optimal complementary feeding practices, especially for mothers with a lower educational status.

Time to Talk: 6 Things to Know about Mind and Body Practices for Fibromyalgia

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... X Y Z 6 Things To Know About Mind and Body Practices for Fibromyalgia Share: Fibromyalgia syndrome is a ... should know about what the science says about mind and body practices for fibromyalgia: Research on complementary health approaches ...

The right to traditional, complementary, and alternative health care

PubMed Central

Stuttaford, Maria; Al Makhamreh, Sahar; Coomans, Fons; Harrington, John; Himonga, Chuma; Hundt, Gillian Lewando

2014-01-01

Background State parties to human rights conventions and declarations are often faced with the seemingly contradictory problem of having an obligation to protect people from harmful practices while also having an obligation to enable access to culturally appropriate effective healing. As people increasingly migrate across the globe, previous distinctions between ‘traditional’ and ‘complementary and alternative medicine’ practices are being transcended. There are connections across transnational healing pathways that link local, national, and global movements of people and knowledge. Objective This paper contributes to the development of the concept and practice of the right to health in all its forms, exploring the right to traditional, complementary, and alternative health (R2TCAH) across different contexts. Design The paper draws on four settings – England, South Africa, Kenya, and Jordan – and is based on key informant interviews and a literature review undertaken in 2010, and updated in 2013. The paper begins by reviewing the international legal context for the right to health. It then considers legal and professional regulations from the global north and south. Results Additional research is needed to establish the legal basis, compare regulatory frameworks, and explore patient and provider perspectives of regulation. This leads to being able to make recommendations on how to balance protection from harm and the obligation to ensure culturally appropriate services. Such an exploration must also challenge Western theories of human rights. Key concepts, such as individual harm, consent, and respect of the autonomy of the individual already established and recognised in international health law, could be adopted in the development of a template for future comparative research. Conclusions Exploration of the normative content of the right to health in all its forms will contribute to supporting traditional, complementary, and alternative health service users and providers in terms of access to information, non-discrimination, clarification of state obligations, and accountability. PMID:24767601

Terms Related to Complementary and Integrative Health

MedlinePlus

... This practice is believed to result in a state of greater physical relaxation, mental calmness, and psychological balance. Practicing meditation can change how a person relates to the flow of emotions and thoughts in the mind. Mindfulness ...

Commentary on Sommer et al. 'A randomized experiment of the effects of including alternative medicine in the mandatory benefit package of health insurance.

PubMed

Heusser, P

2000-03-01

The study by Sommer et al. recently reported in Complementary Therapies in Medicine has been heavily criticised in Switzerland since its original publication. Its major problems are an inadequate reflection of real practice, an inadequate study design relative to the central research objective, questionable value of the applied instrument and procedure for health assessment, methodological and statistical problems, and failure to consider literature relevant to the topic. For these reasons, this experimental study does not allow an answer to its central questions as to costs and effectiveness of complementary medicine made available within Switzerland's mandatory basic health insurance provisions. We propose more practice-related, non-experimental prospective study designs to realistically answer these questions.

Prevalence and Predictors of Complementary and Alternative Medicine Use among Lebanese College Students

ERIC Educational Resources Information Center

Jizi, Lama

2016-01-01

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…

Traditional, complementary, and alternative medicine approaches to mental health care and psychological wellbeing in India and China.

PubMed

Thirthalli, Jagadisha; Zhou, Liang; Kumar, Kishore; Gao, Jie; Vaid, Henna; Liu, Huiming; Hankey, Alex; Wang, Guojun; Gangadhar, Bangalore N; Nie, Jing-Bao; Nichter, Mark

2016-07-01

India and China face the same challenge of having too few trained psychiatric personnel to manage effectively the substantial burden of mental illness within their population. At the same time, both countries have many practitioners of traditional, complementary, and alternative medicine who are a potential resource for delivery of mental health care. In our paper, part of The Lancet and Lancet Psychiatry's Series about the China-India Mental Health Alliance, we describe and compare types of traditional, complementary, and alternative medicine in India and China. Further, we provide a systematic overview of evidence assessing the effectiveness of these alternative approaches for mental illness and discuss challenges in research. We suggest how practitioners of traditional, complementary, and alternative medicine and mental health professionals might forge collaborative relationships to provide more accessible, affordable, and acceptable mental health care in India and China. A substantial proportion of individuals with mental illness use traditional, complementary, and alternative medicine, either exclusively or with biomedicine, for reasons ranging from faith and cultural congruence to accessibility, cost, and belief that these approaches are safe. Systematic reviews of the effectiveness of traditional, complementary, and alternative medicine find several approaches to be promising for treatment of mental illness, but most clinical trials included in these systematic reviews have methodological limitations. Contemporary methods to establish efficacy and safety-typically through randomised controlled trials-need to be complemented by other means. The community of practice built on collaborative relationships between practitioners of traditional, complementary, and alternative medicine and providers of mental health care holds promise in bridging the treatment gap in mental health care in India and China. Copyright © 2016 Elsevier Ltd. All rights reserved.

Probiotics: In Depth

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... people in this age group. Quality Concerns About Probiotic Products Some probiotic products have been found to contain smaller numbers of ... and practices. Don’t use a complementary health product, such as probiotics, as a reason to postpone seeing your health ...

Safe Use of Complementary Health Products and Practices for Anxiety

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... Summer 2015 Table of Contents Anxiety and College Students "Anxiety has now surpassed depression as the most common mental health diagnosis among college students," even though depression is also increasing among young people. In fact, " ...

Menopausal Symptoms and Complementary Health Practices

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... symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice, while taking black cohosh should stop using it and consult a health care provider. See NCCIH’s Web site on black cohosh for more information. DHEA ...

Direct-to-Consumer Marketing: A Complementary Approach to Traditional Dissemination and implementation Efforts for Mental Health and Substance Abuse Interventions.

PubMed

Becker, Sara J

2015-03-01

The overall chasm between those who need treatment for mental health and substance abuse (M/SU) and those who receive effective treatment consists of two, interrelated gaps: the research-to-practice gap and the treatment gap. Prior efforts to disseminate evidence-based practice (EBP) for M/SU have predominantly targeted the research-to-practice gap, by focusing efforts toward treatment providers. This article introduces direct-to-consumer (DTC) marketing that targets patients and caregivers as a complementary approach to existing dissemination efforts. Specific issues discussed include: rationale for DTC marketing based on the concept of push versus pull marketing; overview of key stakeholders involved in DTC marketing; and description of the Marketing Mix planning framework. The applicability of these issues to the dissemination of EBP for M/SU is discussed.

Time to Talk: 4 Things to Know about Menopausal Symptoms and Complementary Health Practices

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... menopausal symptoms: Mind and body practices such as hypnosis, mindfulness meditation, and tai chi may help improve ... joint pain. There is also some evidence that hypnotherapy may help women manage hot flashes. Many natural ...

A review of nurses' knowledge, attitudes, and ability to communicate the risks and benefits of complementary and alternative medicine.

PubMed

Chang, Hsiao-Yun; Chang, Huai-Lu

2015-06-01

This study reviewed existing literature to investigate how frequently nurses include complementary and alternative forms of medicine in their clinical practice. In so doing, we investigated nurses' knowledge of and attitudes towards complementary and alternative medicine as well as their ability to communicate the risks and benefits of these therapies with patients. Little information is available concerning nurses' knowledge and attitudes towards complementary and alternative medicine or how they incorporate these therapies into their practice. In addition, little is known about the ability of nurses to communicate the risks and benefits of complementary and alternative medicine to their patients. This study used a scoping review method to map and synthesise existing literature. Both electronic and manual searches were used to identify relevant studies published between January 2007 and January 2014. The review was conducted in five stages: (1) identification of research question(s), (2) locate studies, (3) selection of studies, (4) charting of data, and (5) collating, summarising, and reporting of results. Fifteen papers met the inclusion criteria for this review, among which 53·7% referenced how frequently nurses include complementary and alternative medicine in their practice. We found that 66·4% of nurses had positive attitudes towards complementary and alternative medicine; however, 77·4% did not possess a comprehensive understanding of the associated risks and benefits. In addition, nearly half of the respondents (47·3-67·7%) reported feeling uncomfortable discussing complementary and alternative medicine therapies with their patients. The lack of knowledge about complementary and alternative medicine among nurses is a cause for concern, particularly in light of its widespread application. Findings from this study suggest that health care professionals need to promote evidence informed decision-making in complementary and alternative medicine practice and be knowledgeable enough to discuss complementary and alternative medicine therapies. Without involvement of complementary and alternative medicine communication on the part of our profession, we may put our patients at risk of uninformed and without medical guidance. © 2015 John Wiley & Sons Ltd.

[Traditional and Complementary Medicine in Brazil: inclusion in the Brazilian Unified National Health System and integration with primary care].

PubMed

Sousa, Islandia Maria Carvalho de; Tesser, Charles Dalcanale

2017-01-23

This study aimed to analyze the inclusion of Traditional and Complementary Medicine in Brazilian Unified National Health System (SUS) and its integration with primary healthcare (PHC). A qualitative study drew on institutional data, indexed articles, and case studies in selected Brazilian cities: Campinas (São Paulo State), Florianópolis (Santa Catarina State), Recife (Pernambuco State), Rio de Janeiro, and São Paulo. The analysis adopted the perspective of inclusion of Traditional and Complementary Medicine in the healthcare network and its integration with primary healthcare, based on the following dimensions: presence of Traditional and Complementary Medicine on the municipal agenda; position in the services; mode of access to Traditional and Complementary Medicine; Traditional and Complementary Medicine practitioners; types of practices; demand profile; and potential for expansion in the SUS. The authors identified and characterized four types of inclusion and integration of Traditional and Complementary Medicine, whether in association or not: Type 1 - in primary healthcare via professionals from the family health teams - Integrated; Type 2 - in primary healthcare via professionals with full-time employment - Juxtaposed; Type 3 - in primary healthcare via matrix-organized teams - Matrix Organization; Type 4 - in specialized services - Without Integration. The combination of types 1 and 3 was considered a potential guideline for the expansion of Traditional and Complementary Medicine in the SUS and can orient the growth and integration of Traditional and Complementary Medicine with primary healthcare. The growing presence of Traditional and Complementary Medicine in the SUS requires conceiving its strategic expansion, while existing experiences should not be wasted.

How 'alternative' is CAM? Rethinking conventional dichotomies between biomedicine and complementary/alternative medicine.

PubMed

Ning, Ana M

2013-03-01

The aim of this article is to interrogate the pervasive dichotomization of 'conventional' and 'alternative' therapies in popular, academic and medical literature. Specifically, I rethink the concepts such as holism, vitalism, spirituality, natural healing and individual responsibility for health care as taken-for-granted alternative ideologies. I explore how these ideologies are not necessarily 'alternative', but integral to the practice of clinical medicine as well as socially and culturally dominant values, norms and practices related to health and health care in Canada and elsewhere. These reflections address both theoretical and applied concerns central to the study of integration of different medical practices in western industrialized nations such as Canada. Overall, in examining homologies present in both biomedicine and complementary/alternative medicine (CAM), this article rethinks major social practices against binary oppositions by illustrating through literature review that the biomedical and CAM models may be homologous in their original inceptions and in recent cross-fertilizations towards a rigorous approach in medicine. By highlighting biomedicine and CAM as homologous symbolic systems, this article also sheds light on the potential for enhancing dialogue between diverse perspectives to facilitate an integrative health care system that meets multiple consumer needs.

Disease Prevention and Health Promotion

PubMed Central

Ali, Ather; Katz, David L.

2015-01-01

As a discipline, preventive medicine has traditionally been described to encompass primary, secondary, and tertiary prevention. The fields of preventive medicine and public health share the objectives of promoting general health, preventing disease, and applying epidemiologic techniques to these goals. This paper discusses a conceptual approach between the overlap and potential synergies of integrative medicine principles and practices with preventive medicine in the context of these levels of prevention, acknowledging the relative deficiency of research on the effectiveness of practice-based integrative care. One goal of integrative medicine is to make the widest array of appropriate options available to patients, ultimately blurring the boundaries between conventional and complementary medicine. Both disciplines should be subject to rigorous scientific inquiry so that interventions that are efficacious and effective are systematically distinguished from those that are not. Furthermore, principles of preventive medicine can be infused into prevalent practices in complementary and integrative medicine, promoting public health in the context of more-responsible practices. The case is made that an integrative preventive approach involves the responsible use of science with responsiveness to the needs of patients that persist when conclusive data are exhausted, providing a framework to make clinical decisions among integrative therapies. PMID:26477898

Recommended Feeding and Dietary Practices To Improve Infant and Maternal Nutrition.

ERIC Educational Resources Information Center

Academy for Educational Development, Washington, DC.

The LINKAGES Project is intended to improve breastfeeding and related complementary feeding and maternal dietary practices. The project, in consultation with technical experts and program managers, identified a set of recommended feeding and dietary practices intended to break the cycle of poor health and nutrition that passes from generation to…

An exploration of complementary feeding of infants and young children in the rural area of Muhoroni, Nyanza province, Kenya: a descriptive study.

PubMed

Harvey, Sophie; Callaby, Jo; Roberts, Lesley

2017-08-01

Inappropriate infant and young child feeding practices contribute to malnutrition, infection and long-term development limitation. To explore complementary feeding and food safety in Muhoroni District, Nyanza Province in rural Kenya. To compare practices with the Infant and Young Child Feeding (IYCF) guidelines, and identify associations with inappropriate practices. Between January and April 2014, a questionnaire completed by primary caregivers of children aged 6-23 months asked about foods the child had received in the previous 24 hours, the introduction of complementary foods, and the food hygiene practices undertaken by the caregiver. The most recent World Health Organization IYCF core indicators (continued breastfeeding at 1 year; minimum dietary diversity; minimum meal frequency; minimum acceptable diet) were determined for 400 children. These indicators were compared with demographic indicators in multivariate analyses to identify associations with appropriate complementary feeding practices. A total of 55.2% of children aged 12-15 months continued to be breastfed at the time of questioning. Of the study population, 61.5% achieved minimum dietary diversity, 70.8% achieved minimum meal frequency and 43.0% achieved minimum acceptable diet. Older children were more likely to achieve minimum dietary diversity and minimum acceptable diet; however, they were also less likely to achieve minimum meal frequency. High levels of hygiene practices were reported in all areas of food safety. Complementary feeding indicators were higher than nationally, although less than half of children (43.0%) were receiving a minimum acceptable diet. Further work should explore the potential relationship between age and adequate infant feeding.

Direct-to-Consumer Marketing: A Complementary Approach to Traditional Dissemination and implementation Efforts for Mental Health and Substance Abuse Interventions

PubMed Central

Becker, Sara J.

2014-01-01

The overall chasm between those who need treatment for mental health and substance abuse (M/SU) and those who receive effective treatment consists of two, interrelated gaps: the research-to-practice gap and the treatment gap. Prior efforts to disseminate evidence-based practice (EBP) for M/SU have predominantly targeted the research-to-practice gap, by focusing efforts toward treatment providers. This article introduces direct-to-consumer (DTC) marketing that targets patients and caregivers as a complementary approach to existing dissemination efforts. Specific issues discussed include: rationale for DTC marketing based on the concept of push versus pull marketing; overview of key stakeholders involved in DTC marketing; and description of the Marketing Mix planning framework. The applicability of these issues to the dissemination of EBP for M/SU is discussed. PMID:25937710

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.

PubMed

1997-01-01

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.

Hot flashes severity, complementary and alternative medicine use, and self-rated health in women with breast cancer.

PubMed

Chandwani, Kavita D; Heckler, Charles E; Mohile, Supriya G; Mustian, Karen M; Janelsins, Michelle; Peppone, Luke J; Bushunow, Peter; Flynn, Patrick J; Morrow, Gary R

2014-01-01

Hot flashes (HF) are a common distressing symptom in women with breast cancer (BC). Current pharmacologic options are moderately effective and are associated with bothersome side effects. Complementary and alternative medicine is commonly used by cancer patients. However, information on the association of hot flashes severity with such use and self-rated health is lacking. To examine the hot flashes severity in women with breast cancer and its association with complementary and alternative medicine use and self-rated health (SRH). Longitudinal multicenter study to assess information needs of cancer outpatients. Patients with a diagnosis of breast cancer who were scheduled to undergo chemotherapy and/or radiotherapy. Hot flashes severity (0 = not present and 10 = as bad as you can imagine), use of complementary and alternative medicine (yes/no), and self-rating of health (SRH) status post-treatment and six-months thereafter (1-5, higher score = better SRH). The majority of women with HF (mean age = 54.4 years) were Caucasian and married, with higher education, and 93% had received surgical treatment for BC. At the end of treatment, 79% women reported experiencing HF [mean severity = 5.87, standard deviation (SD) = 2.9]; significantly more severe HF were reported by younger women with poor SRH, poor performance status, and those reporting doing spiritual practices. At follow-up, 73% had HF (mean severity = 4.86, SD = 3.0), and more severe HF were reported by younger women with poor self-rated health who had undergone chemotherapy plus radiotherapy, used vitamins, and did not exercise. A high percentage of women experienced hot flashes at the end of treatment and at six-month follow-up. A significant association of hot flashes severity with spiritual practice, increased vitamin use, and reduced exercise emphasize the need for future studies to confirm the results. This can facilitate safe use of complementary and alternative medicine and favorable outcomes while managing cancer-related hot flashes. Copyright © 2014 Elsevier Inc. All rights reserved.

[Problems of study designs with randomization, blinding and placebos].

PubMed

Heusser, P

1999-04-01

As randomised double-blind trials are not rarely demanded as a prerequisite for the scientific acceptance of complementary medicine, the author has analysed the soundness of this demand on the basis of the international literature. As a result there appeared a number of methodological, practical and ethical problems which question the theoretically deduced primal value of this study design relative to the needs of medical practice and of health insurance issues. The experimental instruments of randomisation, blinding and placebo deliberately exclude essential therapeutic factors which are integral elements of complementary medical concepts; therefore, it is suggested to supplement quantitatively and collectively oriented experimental research by non-experimental procedures, which adequately reflect the context- and practice-related individual reality.

Ethical responsibilities of pharmacists when selling complementary medicines: a systematic review.

PubMed

Salman Popattia, Amber; Winch, Sarah; La Caze, Adam

2018-04-01

The widespread sale of complementary medicines in community pharmacy raises important questions regarding the responsibilities of pharmacists when selling complementary medicines. This study reviews the academic literature that explores a pharmacist's responsibilities when selling complementary medicines. International Pharmaceutical Abstracts, Embase, PubMed, Cinahl, PsycINFO and Philosopher's index databases were searched for articles written in English and published between 1995 and 2017. Empirical studies discussing pharmacists' practices or perceptions, consumers' expectations and normative studies discussing ethical perspectives or proposing ethical frameworks related to pharmacists' responsibilities in selling complementary medicines were included in the review. Fifty-eight studies met the inclusion criteria. The majority of the studies discussing the responsibilities of pharmacists selling complementary medicines had an empirical focus. Pharmacists and consumers identified counselling and ensuring safe use of complementary medicines as the primary responsibilities of pharmacists. No formal ethical framework is explicitly employed to describe the responsibilities of pharmacists selling complementary medicines. To the degree any ethical framework is employed, a number of papers implicitly rely on principlism. The studies discussing the ethical perspectives of selling complementary medicines mainly describe the ethical conflict between a pharmacist's business and health professional role. No attempt is made to provide guidance on appropriate ways to resolve the conflict. There is a lack of explicit normative advice in the existing literature regarding the responsibilities of pharmacists selling complementary medicines. This review identifies the need to develop a detailed practice-specific ethical framework to guide pharmacists regarding their responsibilities when selling complementary medicines. © 2018 Royal Pharmaceutical Society.

Infant and young child feeding practices in Chepang communities.

PubMed

Subedi, N; Paudel, S; Rana, T; Poudyal, A K

2012-05-01

Infant and young child feeding (IYCF) practices differ in communities due to difference in knowledge, culture, health service utilization, and other socio-economic factors. The objective of this study was to explore the knowledge and practices of Chepang mothers on ICYF and their correlates. Cross sectional descriptive study was conducted in Chepang communities of Makawanpur district. Quantitative methodology was used in which 360 mothers of under children under two were randomly selected. Logistic regression analysis of selected child feeding indicators were done to find their association with socio-economic and health related factors. Feeding practices of mothers were found better than their knowledge level. About 35% had knowledge about early initiation of breastfeeding. Exclusive breastfeeding and introduction of complementary foods at the age of six months were 81% and 90% respectively. Literate mothers were found initiating breastfeeding early than the illiterate (OR=2.61, 95% CI, 1.59-4.27). Growth monitoring service utilization was found to have significant association with exclusive breastfeeding practices (OR= 2.75; 95% CI, 1.30-5.78). Feeding diverse complementary foods was associated with average monthly family income and duration of food sufficiency. Feeding practices in Chepang community were associated with health and socioeconomic determinants. Some of the feeding practices were found good however, meal frequency for the children 9-23 months of age and feeding diverse foods for children 6-23 months were found lower which needs to be improved through health education programs. Qualitative studies are needed to explore cultural factors.

Urgent Need for Improved Mental Health Care and a More Collaborative Model of Care

PubMed Central

Lake, James; Turner, Mason Spain

2017-01-01

Current treatments and the dominant model of mental health care do not adequately address the complex challenges of mental illness, which accounts for roughly one-third of adult disability globally. These circumstances call for radical change in the paradigm and practices of mental health care, including improving standards of clinician training, developing new research methods, and re-envisioning current models of mental health care delivery. Because of its dominant position in the US health care marketplace and its commitment to research and innovation, Kaiser Permanente (KP) is strategically positioned to make important contributions that will shape the future of mental health care nationally and globally. This article reviews challenges facing mental health care and proposes an agenda for developing a collaborative care model in primary care settings that incorporates conventional biomedical therapies and complementary and alternative medicine approaches. By moving beyond treatment delivery via telephone and secure video and providing earlier interventions through primary care clinics, KP is shifting the paradigm of mental health care to a collaborative care model focusing on prevention. Recommendations are to expand current practices to include integrative treatment strategies incorporating evidence-based biomedical and complementary and alternative medicine modalities that can be provided to patients using a collaborative care model. Recommendations also are made for an internal research program aimed at investigating the efficacy and cost-effectiveness of promising complementary and alternative medicine and integrative treatments addressing the complex needs of patients with severe psychiatric disorders, many of whom respond poorly to treatments available in KP mental health clinics. PMID:28898197

Fibromyalgia and Complementary Health Approaches

MedlinePlus

... and alternative medical therapies in fibromyalgia . Current Pharmaceutical Design . 2006;12(1):47–57. Sherman KJ, Cherkin DC, Kahn J, et al. A survey of training and practice patterns of massage therapists ...

4 Tips: Asthma and Complementary Health Practices

MedlinePlus

... 2004, the FDA banned the U.S. sale of dietary supplements containing ephedra. The FDA found that these supplements had an unreasonable risk of injury or illness—particularly cardiovascular complications—and ...

General practitioners, complementary therapies and evidence-based medicine: the defence of clinical autonomy.

PubMed

Adams, J

2000-12-01

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.

Complementary Health Approaches for Smoking Cessation: What the Science Says

MedlinePlus

... Says Share: November 2017 Mind and Body Practices Mindfulness Meditation To date, there have been a few randomized studies on mindfulness-based interventions for smoking cessation, and while the ...

Comparison of Swiss basic health insurance costs of complementary and conventional medicine.

PubMed

Studer, Hans-Peter; Busato, André

2011-01-01

From 1999 to 2005, 5 methods of complementary and alternative medicine (CAM) applied by physicians were provisionally included into mandatory Swiss basic health insurance. Between 2012 and 2017, this will be the case again. Within this process, an evaluation of cost-effectiveness is required. The goal of this study is to compare practice costs of physicians applying CAM with those of physicians applying solely conventional medicine (COM). The study was designed as a cross-sectional investigation of claims data of mandatory health insurance. For the years 2002 and 2003, practice costs of 562 primary care physicians with and without a certificate for CAM were analyzed and compared with patient-reported outcomes. Linear models were used to obtain estimates of practice costs controlling for different patient populations and structural characteristics of practices across CAM and COM. Statistical procedures show similar total practice costs for CAM and COM, with the exception of homeopathy with 15.4% lower costs than COM. Furthermore, there were significant differences between CAM and COM in cost structure especially for the ratio between costs for consultations and costs for medication at the expense of basic health insurance. Patients reported better quality of the patient-physician relationship and fewer adverse side effects in CAM; higher cost-effectiveness for CAM can be deduced from this perspective. This study uses a health system perspective and demonstrates at least equal or better cost-effectiveness of CAM in the setting of Swiss ambulatory care. CAM can therefore be seen as a valid complement to COM within Swiss health care. Copyright © 2011 S. Karger AG, Basel.

Weight Loss and Complementary Health Practices: What the Science Says

MedlinePlus

... lifestyles, including weight-loss and weight management programs. Mindfulness Meditation To date there are only a few studies on the effects of mindfulness as a component of weight-loss programs, but ...

Fibromyalgia: A Puzzling and Painful Condition | NIH MedlinePlus the Magazine

MedlinePlus

... your doctor. Exercise. Research has shown that regular exercise is one of the most effective treatments for fibromyalgia. Try a complementary health approach. Practices such as tai chi, qi gong, ...

Complementary and Alternative Medicine in Cardiac Surgery: Prevalence and Modality of use.

PubMed

Dalmayrac, Emilie; Quignon, Anne; Baufreton, Christophe

2016-07-01

Complementary and alternative medicines are developing at a growing rate but their use in the hospital setting is little known, ignoring risk or benefit in practice. The objectives of the study were to quantify the prevalence of complementary and alternative medicines used by patients admitted to a cardiac surgery department. Patients and staff at the Cardiac Surgery unit of Angers University Hospital (France) were surveyed regarding their modality of complementary and alternative medicines use, between April 01, 2013, and April 18, 2014, by means of an anonymous questionnaire. Of 154 patients included in the study, 58% used a complementary and alternative medicine at least once in their lifetime, 38% during the preceding year, and 14% between the consultation and surgery. In all, 71% used them as a complement to their conventional medical treatment. Of those who used a complementary and alternative medicine during the year of their surgery procedure, only 29% informed their physicians and paramedical staff about it. Complementary and alternative medicines use among patients admitted to cardiac surgery units is common. Yet there is a real lack of knowledge regarding these health practices among physicians and paramedical staff. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Non-governmental organization facilitation of a community-based nutrition and health program: Effect on program exposure and associated infant feeding practices in rural India.

PubMed

Singh, Veena; Ahmed, Saifuddin; Dreyfuss, Michele L; Kiran, Usha; Chaudhery, Deepika N; Srivastava, Vinod K; Ahuja, Ramesh C; Baqui, Abdullah H; Darmstadt, Gary L; Santosham, Mathuram; West, Keith P

2017-01-01

Integrated nutrition and health programs seek to reduce undernutrition by educating child caregivers about infant feeding and care. Data on the quality of program implementation and consequent effects on infant feeding practices are limited. This study evaluated the effectiveness of enhancing a nutrition and health program on breastfeeding and complementary-feeding practices in rural India. Utilizing a quasi-experimental design, one of the implementing districts of a Cooperative for Assistance and Relief Everywhere (CARE) nutrition and health program was randomly selected for enhanced services and compared with a district receiving the Government of India's standard nutrition and health package alone. A cohort of 942 mother-child dyads was longitudinally followed from birth to 18 months. In both districts, the evaluation focused on responses to services delivered by community-based nutrition and health care providers [anganwadi workers (AWWs) and auxiliary nurse midwives (ANMs)]. The CARE enhanced program district showed an improvement in program coverage indicators (e.g., contacts, advice) through outreach visits by both AWWs (28.8-59.8% vs. 0.7-12.4%; all p<0.05) and ANMs (8.6-46.2% vs. 6.1-44.2%; <0.05 for ages ≥6 months). A significantly higher percentage of child caregivers reported being contacted by the AWWs in the CARE program district (20.5-45.6% vs. 0.3-21.6%; p<0.05 for all ages except at 6months). No differences in ANM household contacts were reported. Overall, coverage remained low in both areas. Less than a quarter of women received any infant feeding advice in the intervention district. Earlier and exclusive breastfeeding improved with increasing number or quality of visits by either level of health care provider (OR: 2.04-3.08, p = <0.001), after adjusting for potentially confounding factors. Socio-demographic indicators were the major determinants of exclusive breastfeeding up to 6 month and age-appropriate complementary-feeding practices thereafter in the program-enhanced but not comparison district. An enhanced nutrition and health intervention package improved program exposure and associated breastfeeding but not complementary-feeding practices, compared to standard government package. ClinicalTrials.gov NCT00198835.

Association of Frontline Worker-Provided Services with Change in Block-Level Complementary Feeding Indicators: An Ecological Analysis from Bihar, India

PubMed Central

Das, Aritra; Mahapatra, Sanchita; Sai Mala, Guntur; Chaudhuri, Indrajit; Mahapatra, Tanmay

2016-01-01

Background Insufficiencies in complementary feeding put infants and young children at increased risk of undernutrition. Till now, most Indian studies have looked at the individual level determinants of complementary feeding practices. We aimed to evaluate the association of frontline worker (FLW) provided nutritional counselling services, with change in community level indicators of complementary feeding practices among 9–11 month old children over time. Methods The study data was obtained from five rounds of ‘Lot Quality Assurance Sampling’ survey in eight districts of Bihar, an impoverished Indian state. The surveys were conducted as evaluation exercises for the ‘Integrated Family Health Initiative (IFHI)’–a multi-faceted program aimed at improving the maternal and child health outcomes in Bihar. The main outcome indicators were—current breastfeeding, age-appropriate minimum frequency of semi-solid food, age-appropriate minimum quantity of semi-solid food, initiation of complementary feeding at the right age, and dietary diversity. Repeated measures analysis was performed to determine the association of changes in the outcome indicators with coverage of FLW-provided counselling services. Results Visits by FLW, advices on age-appropriate frequency and handwashing were significant predictors of receiving age-appropriate frequency of feeding. The determinants of receiving age-appropriate quantity were—advices on age appropriate frequency and advices on handwashing. Receiving food support from AWC and FLW visits were significantly associated with initiating complementary feeding at the right age. Conclusions The present study identified the critical elements among the different types of FLW-provided services. The study findings, from an economically and socially underdeveloped region of India, would inform the relevant programs about the nutritional counselling services that need to be emphasized upon for reducing the burden of childhood malnutrition. PMID:27832211

6 Tips: IBS and Complementary Health Practices

MedlinePlus

... as anxiety, depression, disability, and quality of life. Probiotics . Probiotics such as Bifidobacterium and Lactobacillus are live microorganisms ... There is some preliminary evidence that suggests some probiotics may improve symptoms of IBS, such as abdominal ...

The role of global traditional and complementary systems of medicine in the treatment of mental health disorders.

PubMed

Gureje, Oye; Nortje, Gareth; Makanjuola, Victor; Oladeji, Bibilola D; Seedat, Soraya; Jenkins, Rachel

2015-02-01

Traditional and complementary systems of medicine include a broad range of practices, which are commonly embedded in cultural milieus and reflect community beliefs, experiences, religion, and spirituality. Two major components of this system are discernible: complementary alternative medicine and traditional medicine, with different clientele and correlates of patronage. Evidence from around the world suggests that a traditional or complementary system of medicine is commonly used by a large number of people with mental illness. Practitioners of traditional medicine in low-income and middle-income countries fill a major gap in mental health service delivery. Although some overlap exists in the diagnostic approaches of traditional and complementary systems of medicine and conventional biomedicine, some major differences exist, largely in the understanding of the nature and cause of mental disorders. Treatments used by providers of traditional and complementary systems of medicine, especially traditional and faith healers in low-income and middle-income countries, might sometimes fail to meet widespread understandings of human rights and humane care. Nevertheless, collaborative engagement between traditional and complementary systems of medicine and conventional biomedicine might be possible in the care of people with mental illness. The best model to bring about that collaboration will need to be established by the needs of the extant mental health system in a country. Research is needed to provide an empirical basis for the feasibility of such collaboration, to clearly delineate its boundaries, and to test its effectiveness in bringing about improved patient outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Inadequate feeding practices and impaired growth among children from subsistence farming households in Sidama, Southern Ethiopia.

PubMed

Gibson, Rosalind S; Abebe, Yewelsew; Hambidge, K Michael; Arbide, Isabel; Teshome, Aklilu; Stoecker, Barbara J

2009-07-01

Whether current child feeding practices and behaviours among rural households in Sidama, Southern Ethiopia conform to the World Health Organization (WHO) guiding principles for complementary feeding is uncertain. We assessed socio-demographic status, anthropometry, breastfeeding, complementary feeding practices and behaviours, and motor development milestones in a convenience sample of 97 breastfed children aged 6-23 months from three rural Sidama communities. Energy and nutrient intakes from complementary foods were also calculated from 1-day in-home weighed records. Prevalence of stunting ranged from 25% for infants aged 6-8 months to 52% for children aged 12-23 months, whereas for wasting, the corresponding prevalence was 10% and 14%, respectively. Very few children were exclusively breastfed up to 6 months of age (n = 2), or received solids/semi-solids for the recommended minimum number of times containing the recommended number of food groups. Responsive feeding was not practised and no cellular animal products were consumed. Median intakes of energy, and intakes and densities of micronutrients from complementary foods (but not protein) were below WHO recommendations, assuming average breast milk intakes; greatest shortfalls were for retinol, vitamin C and calcium densities. Mothers of stunted children were shorter and lighter, and from households of lower socio-economic status than non-stunted children (P < 0.05). Acquisition of some motor development milestones was delayed in stunted infants compared with their non-stunted counter-parts. In conclusion, interventions that address the WHO guiding principles for complementary feeding practices and behaviours, as well as prenatal influences on growth, are urgently required in this setting.

"Getting the water-carrier to light the lamps": Discrepant role perceptions of traditional, complementary, and alternative medical practitioners in government health facilities in India.

PubMed

Josyula, K Lakshmi; Sheikh, Kabir; Nambiar, Devaki; Narayan, Venkatesh V; Sathyanarayana, T N; Porter, John D H

2016-10-01

The government of India has, over the past decade, implemented the "integration" of traditional, complementary and alternative medical (TCAM) practitioners, specifically practitioners of Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa-rigpa, and Homoeopathy (collectively known by the acronym AYUSH), in government health services. A range of operational and ethical challenges has manifested during this process of large health system reform. We explored the practices and perceptions of health system actors, in relation to AYUSH providers' roles in government health services in three Indian states - Kerala, Meghalaya, and Delhi. Research methods included 196 in-depth interviews with a range of health policy and system actors and beneficiaries, between February and October 2012, and review of national, state, and district-level policy documents relating to AYUSH integration. The thematic 'framework' approach was applied to analyze data from the interviews, and systematic content analysis performed on policy documents. We found that the roles of AYUSH providers are frequently ambiguously stated and variably interpreted, in relation to various aspects of their practice, such as outpatient care, prescribing rights, emergency duties, obstetric services, night duties, and referrals across systems of medicine. Work sharing is variously interpreted by different health system actors as complementing allopathic practice with AYUSH practice, or allopathic practice, by AYUSH providers to supplement the work of allopathic practitioners. Interactions among AYUSH practitioners and their health system colleagues frequently take place in a context of partial information, preconceived notions, power imbalances, and mistrust. In some notable instances, collegial relationships and apt divisions of responsibilities are observed. Widespread normative ambivalence around the roles of AYUSH providers, complicated by the logistical constraints prevalent in poorly resourced systems, has the potential to undermine the therapeutic practices and motivation of AYUSH providers, as well as the overall efficiency and performance of integrated health services. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Gender, symptom experience, and use of complementary and alternative medicine practices among cancer survivors in the U.S. cancer population.

PubMed

Fouladbakhsh, Judith M; Stommel, Manfred

2010-01-01

To identify relationships among gender, physical and psychological symptoms (pain, insomnia, fatigue, and depression), and use of specific complementary and alternative medicine (CAM) practices among survivors in the U.S. cancer population. Secondary analysis of the 2002 National Health Interview Survey (NHIS). The CAM Healthcare Model, an extension of the Behavioral Model for Health Services Use, guided the study. United States. 2,262 adults (aged 18 years and older) diagnosed with cancer representing more than 14.3 million cancer survivors in the United States . NHIS interview data on use of CAM practices (diet, yoga, tai chi, qigong, meditation, guided imagery, relaxation, and deep breathing) were examined in relationship to gender and symptoms. Analysis was conducted using Stata 9.2 software for population estimation. Binary logistic regression, the primary statistical model employed in the analysis, focused on between-subject differences in practice use. Dichotomous outcome variables included use of at least one CAM practice and use of specific individual CAM practices. Independent variables included gender, age, education, race, provider contact, cancer diagnosis, pain, insomnia, fatigue, depression, and health status. CAM practice use was more prevalent among female, middle-aged, Caucasian, and well-educated subjects. Pain, depression, and insomnia were strong predictors of practice use, with differences noted by gender and practice type. CAM practices are widely used in the U.S. cancer population, especially among women. Symptom experience influences likelihood of use, with increased odds when men report symptoms. Study findings inform oncology nurses on the benefits of integrating self-care CAM practices in relationship to gender into the symptom management care plan for cancer survivors. Findings reported in this study will help guide future CAM practice intervention studies.

Complementary and alternative medicine in child and adolescent psychiatry: legal considerations.

PubMed

Cohen, Michael H; Natbony, Suzanne R; Abbott, Ryan B

2013-07-01

The rising popularity of complementary and alternative medicine (CAM) in child and adolescent psychiatry raises unique ethical and legal concerns for psychiatrists and other conventional health care providers. This article explores these concerns and provides clinical advice for promoting patient health and safety while minimizing the psychiatrist's risk. Although any departure from the conventional standard of care is a potential risk, the risk of malpractice liability for practicing integrative medicine in child and adolescent psychiatry is low. CAM is most safely recommended from a legal standpoint when there is some published evidence of safety and efficacy. Copyright © 2013 Elsevier Inc. All rights reserved.

Time to Talk: 7 Things to Know about Complementary Health Practices for Weight Loss

MedlinePlus

... 2004, the FDA banned the U.S. sale of dietary supplements containing ephedra. The FDA found that these supplements had an unreasonable risk of injury or illness—particularly cardiovascular complications—and ...

Irritable Bowel Syndrome and Complementary Health Practices: What the Science Says

MedlinePlus

... controlled trials on various herbal preparations; however, the methodological quality of most of these studies is poor. ... if improperly manufactured. A 2012 systematic review of case reports and case series concluded that using certain ...

Irritable Bowel Syndrome and Complementary Health Practices

MedlinePlus

... series of yoga classes, compared with a waitlist control group. They were still feeling better at the study’s ... 18(7):589–600. Ruepert L, Quartero AO, de Wit NJ, et al. Bulking agents, antispasmodics and ...

Breaking Boundaries: Complementary and Alternative Medicine Provider Framing of Preventive Care.

PubMed

Agarwal, Vinita

2017-11-01

This textual examination extends understandings of how complementary and alternative medicine (CAM) providers constitute preventive care in their discourse by identifying the frame of breaking boundaries referencing relational, structural, and philosophical orientations in their practice with their clients. Analysis of semistructured, in-depth interviews with CAM providers ( n = 17) reveals that the frame of breaking boundaries was comprised of three themes: finding one's own strength; I don't prescribe, so I'm exploring; and ground yourself, and have an escape route. The themes describe preventive care by identifying how CAM providers negotiate their relational positionality in connecting with clients, structural positionality within the field of health care, and philosophical positionality within the ontological understandings that guide how health is defined and conceptualized. The study contributes toward enhancing diverse understandings of constituting preventive care in practice and suggests pragmatic implications for addressing biomedical provider communication with their patients seeking CAM care alongside conventional treatments.

Complementary and alternative medicine - representations in popular magazines.

PubMed

Dunne, Alexandra; Phillips, Christine

2010-09-01

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.

Teaching Evidence-Based Medicine at Complementary and Alternative Medicine Institutions: Strategies, Competencies, and Evaluation

PubMed Central

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

2014-01-01

Abstract Background: As evidence-based medicine (EBM) becomes a standard in health care, it is essential that practitioners of complementary and alternative medicine (CAM) become experts in searching and evaluating the research literature. In support of this goal, the National Institutes of Health (NIH) National Center for Complementary and Alternative Medicine (NCCAM) provided R25 funding to nine CAM colleges to develop individual programs focused on teaching EBM. An overarching goal of these research education grants has been to provide CAM faculty and students with the skills they need to apply a rigorous evidence-based perspective to their training and practice. Methods/Results: This paper reviews the competencies and teaching strategies developed and implemented to enhance research literacy at all nine R25-funded institutions. While each institution designed approaches suitable for its research culture, the guiding principles were similar: to develop evidence-informed skills and knowledge, thereby helping students and faculty to critically appraise evidence and then use that evidence to guide their clinical practice. Curriculum development and assessment included faculty-driven learning activities and longitudinal curricular initiatives to encourage skill reinforcement and evaluate progress. Conclusion: As the field of integrative medicine matures, the NIH-NCCAM research education grants provide essential training for future clinicians and clinician-researchers. Building this workforce will facilitate multidisciplinary collaborations that address the unique needs for research that informs integrative clinical practice. PMID:25380144

MERGING conventional and complementary medicine in a clinic department - a theoretical model and practical recommendations.

PubMed

Pérard, Marion; Mittring, Nadine; Schweiger, David; Kummer, Christopher; Witt, Claudia M

2015-06-09

Today, the increasing demand for complementary medicine encourages health care providers to adapt and create integrative medicine departments or services within clinics. However, because of their differing philosophies, historical development, and settings, merging the partners (conventional and complementary medicine) is often difficult. It is necessary to understand the similarities and differences in both cultures to support a successful and sustainable integration. The aim of this project was to develop a theoretical model and practical steps that are based on theories from mergers in business to facilitate the implementation of an integrative medicine department. Based on a literature search and expert discussions, the cultures were described and model domains were developed. These were applied to two case studies to develop the final model. Furthermore, a checklist with practical steps was devised. Conventional medicine and complementary medicine have developed different corporate cultures. The final model, which should help to foster integration by bridging between these cultures, is based on four overall aspects: culture, strategy, organizational tools and outcomes. Each culture is represented by three dimensions in the model: corporate philosophy (core and identity of the medicine and the clinic), patient (all characteristics of the professional team's contact with the patient), and professional team (the characteristics of the interactions within the professional team). Overall, corporate culture differs between conventional and complementary medicine; when planning the implementation of an integrative medicine department, the developed model and the checklist can support better integration.

Knowledge, Attitude and Practice of General Practitioners toward Complementary and Alternative Medicine: a Cross-Sectional Study.

PubMed

Barikani, Ameneh; Beheshti, Akram; Javadi, Maryam; Yasi, Marzieh

2015-08-01

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.

Competencies for optimal practice in integrated environments: examining attributes of a consensus interprofessional practice document from the licensed integrative health disciplines.

PubMed

Goldblatt, Elizabeth; Wiles, Michael; Schwartz, Jan; Weeks, John

2013-01-01

The Academic Consortium for Complementary and Alternative Health Care (ACCAHC) is committed to advancing human health through the advancement and integration of the complementary and alternative medicine (CAM) professions within the American healthcare system. This will involve the maturation and integration of the licensed CAM professions into conventional healthcare delivery, and in turn, it will involve the development of competency in integrative healthcare and interprofessional education within the CAM professions. In 2010, ACCAHC resolved to identify the competencies necessary for this transformation, and in the process, discovered a parallel process of competency development within conventional healthcare, the Interprofessional Education Collaborative (IPEC), representing the six major conventional healthcare professions. The ACCAHC competency document, its development, and its similarity to the IPEC document are discussed. The ACCAHC competency document identified two domains of competence that were not present in the IPEC document: evidence-informed practice and institutional healthcare practices. These two domains of competency are discussed with respect to their significance in both CAM and conventional healthcare practices. ACCAHC's goal is to foster collaboration among its member professions and with conventional healthcare professions, and to use these competency documents to improve and optimize healthcare delivery, practices, and outcomes in America. It is hoped that ACCAHC's competency document will catalyze interaction with IPEC leading to the adoption of a single shared competency document that will meet the needs of all healthcare providers and educators. © 2013 Elsevier Inc. All rights reserved.

'A necessary evil that does not "really" cure disease': The domestication of biomedicine by Dutch holistic general practitioners.

PubMed

Raaphorst, Nadine; Houtman, Dick

2016-05-01

Against the background of studies about the domestication of complementary and alternative medicine into biomedical settings, this article studies how biomedicine is integrated into holistic settings. Data from 19 in-depth interviews with Dutch holistic general practitioners who combine complementary and alternative medicine with conventional treatments demonstrate that they do not believe that conventional biomedicine 'really' cures patients. They feel that it merely suppresses the physical symptoms of a disease, leaving the more fundamental and non-physical causes intact. As a consequence, they use conventional biomedicine for strictly practical and instrumental reasons. This is the case in life-threatening or acute situations, understood as non-physical causes of disease having been left untreated with complementary and alternative medicine for too long. More mundane reasons for its use are the need to take patients' demands for biomedical treatment seriously or to obey authoritative rules, regulations and protocols. The integration of biomedicine into complementary and alternative medicine, then, follows the same logic of domestication of complementary and alternative medicine into biomedicine: it is made subordinate to the prevailing model of health and illness and treated as a practical add-on that does not 'really' cure people. © The Author(s) 2015.

Time to Talk: 5 Things to Know about Complementary Health Approaches for Quitting Smoking

MedlinePlus

... results on other mind and body practices, including acupuncture and hypnosis, show little evidence of benefit. A ... or no treatment. A 2011 systematic review of acupuncture studies found no consistent evidence that acupuncture is ...

A situational review of infant and young child feeding practices and interventions in Viet Nam.

PubMed

Nguyen, Phuong Hong; Menon, Purnima; Ruel, Mariel; Hajeebhoy, Nemat

2011-01-01

Sub-optimal infant and young child feeding (IYCF) practices are likely a significant contributor to high undernutrition rates in Viet Nam. To date, however, there has been no comprehensive review of IYCF practices in Viet Nam. The objectives of this paper were to review: 1) patterns/trends in IYCF in Viet Nam; 2) the barriers and facilitators to IYCF practices; and 3) interventions and policies and their effectiveness. Methods used include reviewing and analyzing existing data, summarizing and organizing the evidence into broad themes based on a pre-defined conceptual framework. Findings show that the proportion of children ever breastfed is almost universal and the median duration of breastfeeding is 13-18 months. However, exclusive breastfeeding for the first six months is low (8-17%) and appears to be declining over time. Information on complementary feeding is limited, but two key challenges are: early introduction, and low nutrient quality of complementary foods. Facilitators of optimal IYCF were support from 1) government progressive policies, 2) non-profit organizations and 3) family members. Barriers to optimal IYCF included 1) the lack of enforcement of, and compliance with the code of marketing breast milk substitutes, 2) inadequate knowledge among health care providers; and 3) maternal poor knowledge. These findings indicate that the evidence base on complementary feeding is weak in Viet Nam and needs to be strengthened. The review also reinforces that program and policy actions to improve IYCF in Viet Nam must target multiple stakeholders at different levels: the family, the health system and the private sector.

Are health professionals' perceptions of patient safety related to figures on safety incidents?

PubMed

Martijn, Lucie; Harmsen, Mirjam; Gaal, Sander; Mettes, Dirk; van Dulmen, Simone; Wensing, Michel

2013-10-01

The study aims to explore whether health care professionals' perceptions of patient safety in their practice were associated with the number of patient safety incidents identified in patient records. Seventy primary care practices of general practice, general dental practice, midwifery practices and allied health care practices were used in the study. A retrospective audit of 50 patient records was performed to identify patient safety incidents in each of the practices and a survey among health professionals to identify their perceptions of patient safety. All health professions felt that 'communication breakdowns inside the practice' as well as 'communication breakdowns outside the practice' and 'reporting of patient safety concerns' were a threat to patient safety in their work setting. We found little association between the perceptions of health professionals and the number of safety incidents. The only item with a significant relation to a higher number of safety incidents referred to the perception of 'communication problems outside the practice' as a threat to patient safety. This study indicates that the assessment of professionals' perceptions may be complementary to observed safety incidents, but not linked to an objective measure of patient safety. © 2012 John Wiley & Sons Ltd.

The relation of Complementary-Alternative Medicine use with glomerular filtration rate and depression in patients with chronic kidney disease at predialysis stage.

PubMed

Esen, Bennur; Atay, Ahmet Engin; Gokmen, Emel Saglam; Karakoc, Ayten; Sari, Hakan; Sarisakal, Samprie; Kahvecioglu, Serdar; Kayabasi, Hasan; Sit, Dede

2015-05-08

Complementary and alternative medicine is a broad field of health including all health care practices and methods; and their accompanying theories and beliefs. In the present study, we aimed to examine the frequency of complementary-alternative medicine use, and its relation with glomerular filtration rate and depression in patients with chronic kidney disease at predialysis stage. A total of 1053 predialysis patients; 518 female and 535 male, that were followed up with chronic kidney disease for at least 3 months were enrolled into the study. Demographic features, biochemical parameters and findings of physical examination were recorded. Their compliance to diet, and knowledge about disease were questioned. Beck depression inventory and questionnaire regarding to complementary-alternative medicine use were performed. The overall frequency of complementary-alternative medicine use was 40.3% . Total ratio of herbal products was 46%. Complementary-alternative medicine use was significantly more frequent in female or single patients, and patients that informed about chronic kidney disease or under strict diet (p:0.007, p:0.016, p:0.02, p:0.016; respectively). When glomerular filtration rate of participants were considered, complementary-alternative medicine use was similar in different stages of kidney disease. Depression was observed in 41.9% of patients and significantly frequent in patients with alternative method use (p:0.002). Depression score was higher as creatinine increases and glomerular filtration rate decreases (p:0.002; r: 0,093). We determined that complementary-alternative medicine use gradually increases at predialysis stage as glomerular filtration rate decreases and there is a strict relation between complementary-alternative medicine use and depression or female gender. Disorder related stressors may lead to seeking of alternative methods. This article is protected by copyright. All rights reserved.

Integrative oncology in North America.

PubMed

Sagar, Stephen M

2006-01-01

Integrative oncology is an evolving evidence-based specialty that uses complementary therapies in concert with medical treatment to enhance its efficacy, improve symptom control, alleviate patient distress and reduce suffering. In North America the evolution of research into complementary therapies was delayed by the narrow focus of the Flexner Report. A government-funded research agenda and incorporation of complementary therapies into medical school curricula have been driven by early evidence of efficacy and patient demand. Integrative oncology focuses on the role of natural health products (botanicals, vitamins, and minerals), nutrition, acupuncture, meditation and other mind-body approaches, music therapy, touch therapies, fitness therapies, and more. Some natural health products, such as herbs and their constituent phytochemicals, may be biologic response modifiers that could increase cancer control. Current research stretches from the laboratory to health services. Institutions are exploring the effectiveness gap in their clinical services and are determining efficacy of complementary therapies through randomized controlled trials. Eventually, the goal is to establish practice guidelines through determining relative effectiveness and value through cost-utility studies. The aim of integrative oncology should be one medicine, not alternative; it should be patient-focused; it should be evidence-based; and it should provide the best care for cancer cure, prevention, symptom control, and quality of life.

Yoga as a Complementary Therapy for Children and Adolescents

PubMed Central

Peterson, John; Fischer, Colleen; Peterson, Emily

2010-01-01

Yoga is being used by a growing number of youth and adults as a means of improving overall health and fitness. There is also a progressive trend toward use of yoga as a mind-body complementary and alternative medicine intervention to improve specific physical and mental health conditions. To provide clinicians with therapeutically useful information about yoga, the evidence evaluating yoga as an effective intervention for children and adolescents with health problems is reviewed and summarized. A brief overview of yoga and yoga therapy is presented along with yoga resources and practical strategies for clinical practitioners to use with their patients. The majority of available studies with children and adolescents suggest benefits to using yoga as a therapeutic intervention and show very few adverse effects. These results must be interpreted as preliminary findings because many of the studies have methodological limitations that prevent strong conclusions from being drawn. Yoga appears promising as a complementary therapy for children and adolescents. Further information about how to apply it most effectively and more coordinated research efforts are needed. PMID:20877530

Cancer and Complementary Health Approaches

MedlinePlus

... Cancer Institute's activities in research on complementary health approaches. Toll-free in the U.S.: 1-800-4-CANCER (1-800-422-6237) Web ... complementary health approaches. Information on complementary health approaches in cancer treatment: ...

Exploring Biomedicalization Through Complementary and Alternative Medicine in a Postsocialist Context.

PubMed

Klepal, Jaroslav; Stöckelová, Tereza

2018-06-20

Drawing on fieldwork in the postsocialist Czech Republic, we explore the transformative processes of biomedicalization, both within and in relation to complementary and alternative medicine (CAM). We argue that it would be simplistic to understand evidence of these processes in CAM as a sign that CAM has fallen prey to biomedicine. Instead, we show how particular CAM practices play a groundbreaking role in shaping developments in contemporary health care. In this respect, we question the utility of the concept of biomedicalization, arguing that it reduces the transformative processes to aspects of biomedicine.

Complementary and alternative medicine: assessing the evidence for immunological benefits.

PubMed

Goldrosen, Martin H; Straus, Stephen E

2004-11-01

With words such as AIDS, allergy and autoimmunity embedded in the popular lexicon, we often equate health with the precision and the tenor of responses to allergens and microorganisms. This leads many people to seek their own solutions to sustain, restore or even boost their immune competence, hoping to live more comfortably and longer. Here, we consider the social and clinical contexts in which these promises of enhanced immunity are pursued through popular practices known as complementary and alternative medicine and the evidence that supports these.

The Impact of Genomics on Public Health Practice: The Case for Change

PubMed Central

Zimmern, R.L.; Khoury, M.J.

2017-01-01

Public health practice will not be able in the 21st century to ignore the impact of genomics, cell and molecular biology. It will need to take into consideration issues that include, among others: the complementary nature of social and biological models of disease, genetic exceptionalism, the readiness of public and patient to respond to genomic information, the relationship between individuals and populations, and concepts of population stratification. Health systems will need to adapt their practice and organisation to include new sequencing technologies, bioinformatic expertise and proper evaluation of genetic and molecular tests. Links with the commercial sector will increase in importance. The impact on developing countries cannot be ignored and will require special attention. PMID:22488453

5 Things You Should Know: The Science of Chronic Pain and Complementary Health Practices

MedlinePlus

... some evidence that mindfulness-based stress reduction and cognitive-behavioral therapy improves pain and functional limitation compared to usual ... pain found that mindfulness-based stress reduction and cognitive-behavioral therapy resulted in greater improvement in pain and functional ...

Menopausal Symptoms and Complementary Health Practices: What the Science Says

MedlinePlus

... had significantly greater levels of satisfaction than the control group. A 2008 randomized trial found that hypnosis appears ... that acupuncture was no better than sham acupuncture (control) for the treatment of hot flashes. Both groups (sham acupuncture and true acupuncture) had a significant ...

Use of complementary and alternative medicine for work related musculoskeletal disorders associated with job contentment in dental professionals: Indian outlook.

PubMed

Gupta, Devanand; Bhaskar, Dara John; Gupta, Kumar Rajendra; Karim, Bushra; Kanwar, Alpana; Jain, Ankita; Yadav, Ankit; Saini, Priya; Arya, Satya; Sachdeva, Neha

2014-04-01

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 therapy (CT) as a treatment modality for WRMSD. Dentists who registered in Uttar Pradesh state, India under Indian Dental Council, Uttar Pradesh branch (n=1134) were surveyed. Data were analyzed using univariate and bivariate analyses and logistic regression. A response rate of 53% (n=601) was obtained, revealing that 82% (n=487) of the respondents suffered from work-related musculoskeletal disorders. The use of complementary and alternative medicine or conventional therapy was reported among 80% (n=390) of the dentists with work-related musculoskeletal disorders. Complementary and alternative medicine users reported greater overall health compared to conventional therapy users (P<0.001). Of those with work-related musculoskeletal disorders, 35.5% (n=172) considered a career change for once, and 4.0% (n=19) reported having left dentistry. Complementary and alternative medicine therapies may improve quality of life, reduce work disruptions and enhance job satisfaction for dentists who suffer from work-related musculoskeletal disorders. It is important that dentists incorporate complementary and alternative medicine strategies into practice to facilitate musculoskeletal health that will enable longer and healthier careers, increase productivity, provide safer workplace and prevent musculoskeletal disorders.

Use of Complementary and Alternative Medicine for Work Related Musculoskeletal Disorders Associated With Job Contentment in Dental Professionals: Indian Outlook

PubMed Central

Gupta, Devanand; Bhaskar, Dara John; Gupta, Kumar Rajendra; Karim, Bushra; Kanwar, Alpana; Jain, Ankita; Yadav, Ankit; Saini, Priya; Arya, Satya; Sachdeva, Neha

2014-01-01

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 therapy (CT) as a treatment modality for WRMSD Method Dentists who registered in Uttar Pradesh state, India under Indian Dental Council, Uttar Pradesh branch (n=1134) were surveyed. Data were analyzed using univariate and bivariate analyses and logistic regression. Result A response rate of 53% (n=601) was obtained, revealing that 82% (n=487) of the respondents suffered from work-related musculoskeletal disorders. The use of complementary and alternative medicine or conventional therapy was reported among 80% (n=390) of the dentists with work-related musculoskeletal disorders. Complementary and alternative medicine users reported greater overall health compared to conventional therapy users (P<0.001). Of those with work-related musculoskeletal disorders, 35.5% (n=172) considered a career change for once, and 4.0% (n=19) reported having left dentistry. Conclusion Complementary and alternative medicine therapies may improve quality of life, reduce work disruptions and enhance job satisfaction for dentists who suffer from work-related musculoskeletal disorders. It is important that dentists incorporate complementary and alternative medicine strategies into practice to facilitate musculoskeletal health that will enable longer and healthier careers, increase productivity, provide safer workplace and prevent musculoskeletal disorders. PMID:24795512

Knowledge, Attitude, and Practice of Complementary and Alternative Medicine Among Residents of Wayu Town, Western Ethiopia.

PubMed

Belachew, Negash; Tadesse, Tarekegne; Gube, Addisu Alemayehu

2017-10-01

Complementary and alternative medicine covers a wide variety of therapies and practices, which vary from country to country and region to region. The study was conducted to assess the knowledge, attitude, and practice of complementary and alternative medicine among the residents of Wayu town, Western Ethiopia. A descriptive cross-sectional study was carried out on 302 residents. A systematic sampling was used to select households. Data were entered in SPSS (version 20; IBM Corp) and descriptive statistics was carried out. Of 302 participants, 51.65% have a good knowledge, 78.6% were aware of complementary and alternative medicine, and 74.22% used it in the past 2 years. A total of 23.83% believe that complementary and alternative medicine is more effective than modern medicine and 28.8% preferred complementary and alternative medicine to modern medicine. This study revealed that in Wayu town, there is relatively high public interest in complementary and alternative medicine practices and a significant number has a good knowledge but generally the attitude toward complementary and alternative medicine is relatively low.

Knowledge, Attitude, and Practice of Complementary and Alternative Medicine Among Residents of Wayu Town, Western Ethiopia

PubMed Central

Belachew, Negash; Tadesse, Tarekegne

2017-01-01

Complementary and alternative medicine covers a wide variety of therapies and practices, which vary from country to country and region to region. The study was conducted to assess the knowledge, attitude, and practice of complementary and alternative medicine among the residents of Wayu town, Western Ethiopia. A descriptive cross-sectional study was carried out on 302 residents. A systematic sampling was used to select households. Data were entered in SPSS (version 20; IBM Corp) and descriptive statistics was carried out. Of 302 participants, 51.65% have a good knowledge, 78.6% were aware of complementary and alternative medicine, and 74.22% used it in the past 2 years. A total of 23.83% believe that complementary and alternative medicine is more effective than modern medicine and 28.8% preferred complementary and alternative medicine to modern medicine. This study revealed that in Wayu town, there is relatively high public interest in complementary and alternative medicine practices and a significant number has a good knowledge but generally the attitude toward complementary and alternative medicine is relatively low. PMID:29250965

The use of complementary and alternative medicine by pregnant women: a literature review.

PubMed

Hall, Helen G; Griffiths, Debra L; McKenna, Lisa G

2011-12-01

The use of complementary and alternative medicine (CAM) has become increasingly prevalent in industrialised countries, with women being the most prolific users. Some women continue to consume these therapies when they become pregnant. To review the literature exploring prevalence and motivation for use of complementary and alternative medicine by pregnant women. A search for relevant literature published from 2001 was undertaken using a range of databases and by examining relevant bibliographies. Although the estimates vary widely from 1% to 87%, the general trend indicates that a significant number of pregnant women use complementary and alternative medicine. Common modalities used include massage, vitamin and mineral supplements, herbal medicine, relaxation therapies and aromatherapy. Reasons for use are varied and include the belief that these therapies offer safe alternatives to pharmaceuticals, they allow greater choice and control over the childbearing experiences, and they are congruent with their holistic health beliefs. The influence of traditional cultural practices on the use of these therapies is unclear. Most expectant women rely on advice from family and friends, and many do not disclose their use to their pregnancy care providers. Many women use complementary and alternative medicine when they are pregnant. Further research is needed to gain a greater understanding of the true prevalence and expectant women's motivation for the use of complementary and alternative medicine. Health-care professionals are encouraged to ask women about their use of these treatments and seek out relevant information. Copyright © 2010 Elsevier Ltd. All rights reserved.

Diversity, the Individual, and Proof of Efficacy: Complementary and Alternative Medicine in Medical Education

PubMed Central

Park, Constance M.

2002-01-01

Patients will always have access to a variety of possibly effective, but unproved, therapies directed at maintaining health or treating illness. And there will always be complex, potentially therapeutic regimens that cannot be adequately tested for financial, ethical, or methodological reasons. Furthermore, even after adequate study of a given regimen, there will always be the fundamental uncertainty of medical practice: the fact that epidemiological research produces probabilistic results that cannot predict with certainty the best treatment for the single unique patient before us. The exploration of complementary and alternative medicine topics in the medical school curriculum helps to elucidate the complex and uncertain nature of medical practice, sharpens skills for clinical decisionmaking, increases cultural sensitivity, and provides ideas for future research. PMID:12356593

The Montana State University Conceptual Model of Complementary and Alternative Medicine Health Literacy

PubMed Central

Shreffler-Grant, Jean; Nichols, Elizabeth; Weinert, Clarann; Ide, Bette

2016-01-01

This article aims to present and describe a model of complementary and alternative medicine (CAM) health literacy. The model is the conceptual basis for CAM health literacy, which is operationally defined as the information about CAM needed to make informed self-management decisions regarding health. Improving health literacy is a national priority, and widespread use of CAM has added to the complexity of this task. There are no currently available models or measures of health literacy regarding CAM. The authors developed the model using an iterative process of deriving concepts, constructs, and empirical indicators from the literature and the author’s prior work, review and critique by experts, and revision. The model of CAM health literacy can serve as the basis for future research on the use and efficacy of CAM and the constructs and concepts within it can be used to identify points of intervention for research or for clinical practice. It is anticipated that the model will have scientific and clinical application for assessing health literacy in other self care decision-making situations. PMID:23889542

The Montana State University conceptual model of complementary and alternative medicine health literacy.

PubMed

Shreffler-Grant, Jean; Nichols, Elizabeth; Weinert, Clarann; Ide, Bette

2013-01-01

This article aims to present and describe a model of complementary and alternative medicine (CAM) health literacy. The model is the conceptual basis for CAM health literacy, which is operationally defined as the information about CAM needed to make informed self-management decisions regarding health. Improving health literacy is a national priority, and widespread use of CAM has added to the complexity of this task. There are no currently available models or measures of health literacy regarding CAM. The authors developed the model using an iterative process of deriving concepts, constructs, and empirical indicators from the literature and the author's prior work, review and critique by experts, and revision. The model of CAM health literacy can serve as the basis for future research on the use and efficacy of CAM and the constructs and concepts within it can be used to identify points of intervention for research or for clinical practice. It is anticipated that the model will have scientific and clinical application for assessing health literacy in other self care decision-making situations.

Prevalence and determinants of use of complementary and alternative medicine by hypertensive patients attending primary health care facilities in Kinshasa, Democratic Republic of the Congo: a cross-sectional study.

PubMed

Lulebo, Aimée M; Mapatano, Mala A; Mutombo, Paulin B; Mafuta, Eric M; Samba, Gédéon; Coppieters, Yves

2017-04-08

In the Democratic Republic of the Congo the control of hypertension is poor, characterized by an increasing number of reported cases of hypertension related complications. Poor control of hypertension is associated with non-adherence to antihypertensive medication. It is well established that the use of complementary and alternative medicine is one of the main factors of non-adherence to antihypertensive medication. The aim of this study is to determine the prevalence and factors associated with the use of complementary and alternative medicine. A cross-sectional study was carried out at the Kinshasa Primary Health-care (KPHC) facilities network in November 2014. A structured interview questionnaire was administrated to a total of 280hypertensive patients. Complementary and alternative medicine were defined according to the National Institute of Health classification as a group of diverse medical and healthcare systems, practices, and products that are not presently considered to be part of conventional medicine. Data were summarized using proportion and mean (with standard deviation). The student's t test and χ 2 test were used respectively for mean and proportion comparison. Logistic regression analysis identified determinants of the use of complementary and alternative medicine. The prevalence of use of complementary and alternative medicine was 26.1% (95% CI: 20.7% - 31.8%).Determinants of use of complementary and alternative medicine included misperception about hypertension curability (OR = 2.1; 95%CI: 1.1-3.7) and experience of medication side effects (OR = 2.9; 95%CI: 1.7-5.1). The use of CAM for hypertensive patients is a major problem; antihypertensives with fewer side effects must be emphasized. Religious leaders must become involved in the communication for behavioral change activities to improve the quality of life for hypertensive patients.

Boundary objects in complementary and alternative medicine: acupuncture vs. Christian Science.

PubMed

Owens, Kellie

2015-03-01

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.

Student attitudes towards clinical teaching resources in complementary medicine: a focus group examination of Australian naturopathic medicine students.

PubMed

Wardle, Jonathan Lee; Sarris, Jerome

2014-06-01

Complementary medicine is forming an increasingly large part of health care in developed countries and is increasingly being formally taught in tertiary academic settings. An exploratory study of naturopathic student perceptions of, use of and attitudes towards teaching resources in naturopathic clinical training and education. Focus groups were conducted with current and recent students of 4-year naturopathic degree programmes in Brisbane and Sydney to ascertain how they interact with clinical teaching materials, and their perceptions and attitudes towards teaching materials in naturopathic education. Naturopathic students have a complex and critical relationship with their learning materials. Although naturopathic practice is often defined by traditional evidence, students want information that both supports and is critical of traditional naturopathic practices, and focuses heavily on evidence-based medicine. Students remain largely ambivalent about new teaching technologies and would prefer that these develop organically as an evolution from printed materials, rather than depart from dramatically and radically from these previously established materials. Findings from this study will assist publishers, librarians and academics develop clinical information sources that appropriately meet student expectations and support their learning requirements. © 2014 The authors. Health Information and Libraries Journal © 2014 Health Libraries Group.

Use of complementary and alternative medicine and breast cancer survival in the Health, Eating, Activity, and Lifestyle Study.

PubMed

Neuhouser, Marian L; Smith, Ashley Wilder; George, Stephanie M; Gibson, James T; Baumgartner, Kathy B; Baumgartner, Richard; Duggan, Catherine; Bernstein, Leslie; McTiernan, Anne; Ballard, Rachel

2016-12-01

Use of complementary and alternative medicine (CAM) is common among breast cancer patients, but less is known about whether CAM influences breast cancer survival. Health Eating, Activity, and Lifestyle (HEAL) Study participants (n = 707) were diagnosed with stage I-IIIA breast cancer. Participants completed a 30-month post-diagnosis interview including questions on CAM use (natural products such as dietary and botanical supplements, alternative health practices, and alternative medical systems), weight, physical activity, and comorbidities. Outcomes were breast cancer-specific and total mortality, which were ascertained from the Surveillance Epidemiology and End Results registries in Western Washington, Los Angeles County, and New Mexico. Cox proportional hazards regression models were fit to data to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for mortality. Models were adjusted for potential confounding by sociodemographic, health, and cancer-related factors. Among 707 participants, 70 breast cancer-specific deaths and 149 total deaths were reported. 60.2 % of participants reported CAM use post-diagnosis. The most common CAM were natural products (51 %) including plant-based estrogenic supplements (42 %). Manipulative and body-based practices and alternative medical systems were used by 27 and 13 % of participants, respectively. No associations were observed between CAM use and breast cancer-specific (HR 1.04, 95 % CI 0.61-1.76) or total mortality (HR 0.91, 95 % CI 0.63-1.29). Complementary and alternative medicine use was not associated with breast cancer-specific mortality or total mortality. Randomized controlled trials may be needed to definitively test whether there is harm or benefit from the types of CAM assessed in HEAL in relation to mortality outcomes in breast cancer survivors.

Comparison of the complementary feeding practices between mothers with twins and mothers with singletons.

PubMed

Bentil, Helena Joycelyn; Steiner-Asiedu, Matilda; Lartey, Anna

2016-01-01

Several studies have been done on infant feeding practices but few have focused on twins. The aim of this study was to compare the complementary feeding practices between mothers with twins and mothers with singletons. Mother-infant pairs (50 mother-twin pairs and 50 mother-singleton pairs) with children aged 6 to 23 months were recruited from two public health clinics and communities in Tema and Ashaiman. Information was collected on the background characteristics of the mothers. Recumbent length and weight of the children were measured. Dietary information on the infants was collected using 24 hour recall. The differences between two groups were tested using independent t-student test for continuous variables and chi-square test for categorical variables. The minimum dietary diversity (4+ food groups) was met by only 32% of the twins and 40% of the singletons, and 28% of the twins and 38% of the singletons met the requirement for minimum acceptable diet (minimum dietary diversity and the minimum meal frequency). Minimum meal frequency was met by 78% of the twins and 76% of the singletons. There were no significant differences between the two groups of infants. Prevalence of undernutrition was not significantly different among the two groups (twins versus singletons: underweight-26% versus 24%, stunting-20% versus 24% and wasting-14% versus 10%. Complementary feeding practices were suboptimal in both groups of mothers requiring interventions to improve infant feeding practices.

Parish nursing: a unique resource for community and district nurses.

PubMed

Wordsworth, Helen; Moore, Ros; Woodhouse, Daphne

2016-02-01

This paper examines the effect of parish nursing as a faith community initiative to support the work of district and community nurses and improve health outcomes. It discusses the reasons why faith communities might embark upon health initiatives, and describes the practice of parish nursing and its history and development in the UK. With reference to both quantitative and qualitative outcomes, the relevance of the practice in the UK health scene is assessed. The paper suggests that connecting with the third sector through parish nursing could enhance the work of community and district nurses; this would present additional sources of holistic care and health promotion and can be offered in an optional but complementary manner to the care provided through the NHS.

Complementary and alternative medicine use in children with thalassaemia.

PubMed

Efe, Emine; Işler, Ayşegül; Sarvan, Süreyya; Başer, Hayriye; Yeşilipek, Akif

2013-03-01

The aims of this study were to: (1) determine the types of complementary and alternative medicine use among children with thalassaemia as reported by parents and (2) describe sociodemographic and medical factors associated with the use of such treatments in families residing in southern Turkey. Thalassaemia is one of the most common human genetic diseases. Despite the therapeutic efforts, patients will encounter a variety of physical and psychological problems. Therefore, the use of complementary and alternative medicines among children thalassaemia is becoming increasingly popular. This is a descriptive study of complementary and alternative medicine. This study was conducted in the Hematology Outpatient Clinic at Akdeniz University Hospital and in the Thalassemia Centre at Ministry of Health Antalya Education and Research Hospital, Antalya, Turkey, between January 2010-December 2010. Parents of 97 paediatric patients, among 125 parents who applied to the haematology outpatient clinic and thalassaemia centre between these dates, agreed to take part in the study with whom contact could be made were included. Data were collected by using a questionnaire. The proportion of parents who reported using one or more of the complementary and alternative medicine methods was 82·5%. Of these parents, 61·8% were using prayer/spiritual practice, 47·4% were using nutritional supplements and 35·1% were using animal materials. It was determined that a significant portion of the parents using complementary and alternative medicine use it to treat their children's health problems, they were informed about complementary and alternative medicine by their paediatricians and family elders, and they have discussed the use of complementary and alternative medicine with healthcare professionals. To sustain medical treatment and prognosis of thalassaemia, it is important for nurses to consult with their patients and parents regarding the use and potential risks of some complementary and alternative medicine. © 2012 Blackwell Publishing Ltd.

Perceiving integration of a complementary medicine service within a general surgery department through documentation of consultations: a thematic analysis.

PubMed

Schiff, Elad; Ben-Arye, Eran; Attias, Samuel; Sroka, Gideon; Matter, Ibrahim; Keshet, Yael

2012-12-01

This study aims to examine the meaning and practical implications of integration of a complementary medicine-based surgery service in a hospital setting (CISS--Complementary/Integrative Surgery Service) through analysis of consultation reports associated with this service. Thematic analysis was used to evaluate CISS consultation reports in a hospital electronic consultant charting system during the first half year of the service's activity. 304 consultation reports were analyzed. Nurses initiated significantly more consultations than physicians (55% vs 7%). Consultation requests were gradually more focused on specific symptoms, possibly manifesting a better understanding of the scope of complementary medicine in the surgery setting. CISS practitioners responded in more biomedical language over time, albeit offering a more holistic perspective regarding patients' needs as well as clarifications regarding the nature of the treatment they provided. Diverse communication patterns in consultations evolved over time representing dynamics in multiple levels of integration of the CISS. Documented communication through consultations can provide a window to the process of integration of complementary medicine-based services in health systems. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Meditation, Health and Scientific Investigations: Review of the Literature.

PubMed

Sampaio, Cynthia Vieira Sanches; Lima, Manuela Garcia; Ladeia, Ana Marice

2017-04-01

A growing number of people are seeking health recovery treatments with a holistic approach to the human being. Meditation is a mental training capable of producing connection between the mind, body and spirit. Its practice helps people to achieve balance, relaxation and self-control, in addition to the development of consciousness. At present, meditation is classified as a complementary and integrative technique in the area of health. The purpose of this review of the literature was to describe what meditation is, its practices and effects on health, demonstrated by consistent scientific investigations. Recently, the advances in researches with meditation, the discovery of its potential as an instrument of self-regulation of the human body and its benefits to health have shown that it is a consistent alternative therapy when associated with conventional medical treatments.

[Community vegetable gardens as a health promotion activity: an experience in Primary Healthcare Units].

PubMed

Costa, Christiane Gasparini Araújo; Garcia, Mariana Tarricone; Ribeiro, Silvana Maria; Salandini, Marcia Fernanda de Sousa; Bógus, Cláudia Maria

2015-10-01

Urban and peri-urban agriculture (UPA) is being practiced in different settings, contributing to the improvement of health in communities and healthier environments. In order to identify the meanings and implications of the practice of UPA in Primary Healthcare Units (PHU) as an activity of health promotion (HP), and to what extent its therapeutic dimension characterizes it as an activity aligned with complementary and integrative practices (CIP), a qualitative cross-sectional study was performed in Embu das Artes, State of São Paulo. From the analysis, the following main themes arose: health concept, health outcomes, the return to traditional practices and habits and the reorientation of health services. It was possible to identify the close link between the cultivation of vegetable gardens and HP guidelines and fields of action, such as creating healthier environments, boosting community actions, developing personal skills, stimulating autonomy and empowerment and demands for the reorientation of services. The garden activities, set up in PHU areas, proved to be an implementation strategy of CIP. The conclusion reached is that vegetable gardening activities in community gardens are seen to be health promotion practices that integrate key elements of CIP.

Integrative holism in psychiatric-mental health nursing.

PubMed

Zahourek, Rothlyn P

2008-10-01

In this era of high-tech care, many Americans seek more holistic approaches and alternative and complementary treatments for health problems, including mental illness. Psychiatric-mental health (PMH) nurses need to be aware of these approaches as they assess clients, maintain a holistic approach, and in some cases, provide skilled, specific modalities. This article reviews holistic philosophy and integrative approaches relevant to PMH nurses. The emphasis is that whichever modality PMH nurses practice, a holistic framework is essential for providing optimal PMH care.

Feeding Practices and Infant Growth: Quantifying the Effects of Breastfeeding Termination and Complementary Food Introduction on BMI z-Score Growth Velocity through Growth Curve Models.

PubMed

Horodynski, Mildred A; Pierce, Steven J; Reyes-Gastelum, David; Olson, Beth; Shattuck, Mackenzie

2017-12-01

Infant feeding practices are a focus of early obesity prevention. We tested whether infant growth velocity increased after breastfeeding termination and complementary food introduction. Our secondary analysis included a sample of 547 mother-infant dyads from a longitudinal randomized controlled trial conducted in Michigan and Colorado. Infant anthropometrics at birth, baseline, and 6- and 12-month follow-up were standardized to BMI-for-age z-score (ZBMI) according to World Health Organization (WHO) growth charts. We used growth curve models with time-varying predictors to quantify effects of breastfeeding termination and timing of complementary food introduction on growth velocity. Median breastfeeding duration was 2.0 months [confidence interval (CI) = 2.0-2.5]; median introduction of complementary foods occurred at 3.0 months (CI = 2.8-3.2). Breastfed infants not yet introduced to complementary foods had an average ZBMI growth velocity of 0.050 (CI = -0.013 to 0.113) z-score units per month [zpm], not significantly faster than WHO growth trajectory (p = 0.118) defined as 0 zpm. Breastfeeding termination had negligible effect on ZBMI growth velocity (γ 11  = 0.001, CI = -0.027 to 0.030, p = 0.927). Introduction of complementary foods increased ZBMI growth velocity relative to an average child in the sample, but not significantly (γ 12  = 0.033, CI = -0.034 to 0.100, p = 0.334). Growth velocities for infants receiving complementary foods both before and after breastfeeding termination were significantly faster than the WHO growth trajectory (0.083 zpm, CI = 0.052-0.114, and 0.084 zpm, CI = 0.064-0.105, respectively, p's < 0.001). Average postcomplementary food introduction growth velocity was significantly higher than WHO growth trajectory, but did not differ from the sample's initial average trajectory. Growth curve models can accurately estimate effects of feeding practices on infant growth to direct obesity prevention efforts.

Older adults' use of complementary and alternative medicine for mental health: findings from the 2002 National Health Interview Survey.

PubMed

Grzywacz, Joseph G; Suerken, Cynthia K; Quandt, Sara A; Bell, Ronny A; Lang, Wei; Arcury, Thomas A

2006-06-01

To compare complementary and alternative medicine (CAM) use among adults 65 and older with and without self-reported anxiety or depression, and to investigate the prevalence and predictors of CAM use for treatment by persons with anxiety or depression. Cross-sectional survey. Computer-assisted interviews conducted in participants' homes. Subjects included 5827 adults aged 65 and older who participated in the 2002 National Health Interview Survey including the Alternative Health Supplement. None. Overall use of CAM, use of four categories of CAM, and use of 20 CAM modalities. CAM use for treatment of any health condition, and CAM use to treat mental health. Eighty-one and seven tenths percent (81.7%) of older adults with self-reported anxiety or depression who used CAM in the past year, whereas 64.6% of older adults without these conditions used CAM. Differences in CAM use were driven by elevated use of spiritual practices, relaxation techniques, and use of nonvitamin, nonmineral natural products by patients with symptoms of mental conditions. Fewer than 20% of CAM users with self-reported anxiety or depression used CAM for their mental health. Few personal and health-related factors predicted CAM use for treatment among older adults with self-reported anxiety or depression. Older adults with self-reported anxiety or depression were more likely to use spiritual practices, relaxation techniques, and nonvitamin, nonmineral natural products than elders in good mental health. However, for the majority of older adults with self-reported anxiety or depression, CAM was used for purposes other than treating mental health.

Role of complementary and alternative medicine in geriatric care: A mini review

PubMed Central

Siddiqui, Mohammad Jamshed; Min, Chan Sze; Verma, Rohit Kumar; Jamshed, Shazia Qasim

2014-01-01

Since time immemorial homo sapiens are subjected to both health and diseases states and seek treatment for succor and assuagement in compromised health states. Since last two decades the progressive rise in the alternative form of treatment cannot be ignored and population seems to be dissatisfied with the conventional treatment modalities and therefore, resort to other forms of treatment, mainly complementary and alternative medicine (CAM). The use of CAM is predominantly more popular in older adults and therefore, numerous research studies and clinical trials have been carried out to investigate the effectiveness of CAM in the management of both communicable and non-communicable disease. In this current mini review, we attempt to encompass the use of CAM in chronic non-communicable diseases that are most likely seen in geriatrics. The current review focuses not only on the reassurance of good health practices, emphasizing on the holistic development and strengthening the body's defense mechanisms, but also attempts to construct a pattern of self-care and patient empowerment in geriatrics. The issues of safety with CAM use cannot be sidelined and consultation with a health care professional is always advocated to the patient. Likewise, responsibility of the health care professional is to inform the patient about the safety and efficacy issues. In order to substantiate the efficacy and safety of CAMs, evidence-based studies and practices with consolidated standards should be planned and executed. PMID:25125879

Nurses' beliefs, experiences and practice regarding complementary and alternative medicine in Taiwan.

PubMed

Smith, Graeme D; Wu, Shu-Chen

2012-09-01

To gain an insight into this issue, this study used a qualitative approach and aims to explore and describe nurses' beliefs, experiences and practice regarding complementary and alternative medicine in Taiwan. The integration of complementary and alternative medicine with conventional medicine has become more common worldwide in recent years. An increase in patient use and an expansion of nurses using complementary and alternative medicine has spawned further investigation. Most published studies have concentrated on the usage of complementary and alternative medicine in western societies and have focused principally on physicians' attitudes and practice patterns in this regard. Despite the large amount of time and the unique relationship that nurses share with their patients, little research has investigated the nurse's attitudes and practice regarding complementary and alternative medicine. Moreover, there has been no previous research into understanding this issue from the Taiwanese nursing perspective. A qualitative research design. By using an exploratory, descriptive, qualitative approach, data were collected from 11 registered nurses. The methods of the data collection were in-depth, semi-structured interviews, field notes and memos and the data were analysed using the constant comparative method. Three major categories emerged from the data; namely, a 'lack of clear definition', 'limited experience' and 'high interest' towards complementary and alternative medicine. These results suggest that the definition of complementary and alternative medicine is often unclear for nurses in Taiwan. Due to the organisational policies and personal knowledge base, very few nurses integrate complementary and alternative medicine into their daily practice. However, the nurses in Taiwan show a great desire to participate in complementary and alternative medicine continuing education programmes. This study is not only significant in filling the gap in the existing literature, but is also important in understanding this issue from the nurses' perspective, to offer a series of recommendations for policy, nursing education, nursing practice and suggestions for further research. This study highlights the importance of nursing attitude in the use of complementary and alternative medicine. Clinical nurses have the potential to provide appropriate information to their patients to ensure safe complementary and alternative medicine use. © 2012 Blackwell Publishing Ltd.

Integrative veterinary medical education and consensus guidelines for an integrative veterinary medicine curriculum within veterinary colleges

PubMed Central

Memon, M.A.; Shmalberg, J.; Adair, H.S.; Allweiler, S.; Bryan, J.N.; Cantwell, S.; Carr, E.; Chrisman, C.; Egger, C.M.; Greene, S.; Haussler, K.K.; Hershey, B.; Holyoak, G.R.; Johnson, M.; Jeune, S. Le; Looney, A.; McConnico, R.S.; Medina, C.; Morton, A.J.; Munsterman, A.; Nie, G.J.; Park, N.; Parsons-Doherty, M.; Perdrizet, J.A.; Peyton, J.L.; Raditic, D.; Ramirez, H.P.; Saik, J.; Robertson, S.; Sleeper, M.; Dyke, J. Van; Wakshlag, J.

2016-01-01

Integrative veterinary medicine (IVM) describes the combination of complementary and alternative therapies with conventional care and is guided by the best available evidence. Veterinarians frequently encounter questions about complementary and alternative veterinary medicine (CAVM) in practice, and the general public has demonstrated increased interest in these areas for both human and animal health. Consequently, veterinary students should receive adequate exposure to the principles, theories, and current knowledge supporting or refuting such techniques. A proposed curriculum guideline would broadly introduce students to the objective evaluation of new veterinary treatments while increasing their preparation for responding to questions about IVM in clinical practice. Such a course should be evidence-based, unbiased, and unaffiliated with any particular CAVM advocacy or training group. All IVM courses require routine updating as new information becomes available. Controversies regarding IVM and CAVM must be addressed within the course and throughout the entire curriculum. Instructional honesty regarding the uncertainties in this emerging field is critical. Increased training of future veterinary professionals in IVM may produce an openness to new ideas that characterizes the scientific method and a willingness to pursue and incorporate evidence-based medicine in clinical practice with all therapies, including those presently regarded as integrative, complementary, or alternative. PMID:27200270

Integrating Science and Engineering to Implement Evidence-Based Practices in Health Care Settings.

PubMed

Wu, Shinyi; Duan, Naihua; Wisdom, Jennifer P; Kravitz, Richard L; Owen, Richard R; Sullivan, J Greer; Wu, Albert W; Di Capua, Paul; Hoagwood, Kimberly Eaton

2015-09-01

Integrating two distinct and complementary paradigms, science and engineering, may produce more effective outcomes for the implementation of evidence-based practices in health care settings. Science formalizes and tests innovations, whereas engineering customizes and optimizes how the innovation is applied tailoring to accommodate local conditions. Together they may accelerate the creation of an evidence-based healthcare system that works effectively in specific health care settings. We give examples of applying engineering methods for better quality, more efficient, and safer implementation of clinical practices, medical devices, and health services systems. A specific example was applying systems engineering design that orchestrated people, process, data, decision-making, and communication through a technology application to implement evidence-based depression care among low-income patients with diabetes. We recommend that leading journals recognize the fundamental role of engineering in implementation research, to improve understanding of design elements that create a better fit between program elements and local context.

Health and healing: spiritual, pharmaceutical, and mechanical medicine.

PubMed

Hutch, Richard A

2013-09-01

Modern medical practice is identified as a relatively recent way of approaching human ill health in the wide scope of how people have addressed sickness throughout history and across a wide range of cultures. The ideological biases of medical or "allopathic" (disease as "other" or "outsider") practice are identified and grafted onto other perspectives on how people not engaged in modern medicine have achieved healing and health. Alternative forms of healing and health open a consideration of ethnomedicine, many forms of which are unknown and, hence, untested by modern medical research. Ethnomedicine the world over and throughout human history has displayed unique spiritual (vitalism), pharmaceutical (herbs/drugs), and mechanical (manipulation/surgery) approaches to treating illness. The argument is that modern allopathic medicine would do well to consider such "world medicine" as having valuable alternative and complementary therapies, the use of which could enhance contemporary medical advice and practice.

The effectiveness of nutrition education: Applying the Health Belief Model in child-feeding practices to use pulses for complementary feeding in Southern Ethiopia.

PubMed

Mulualem, Demmelash; Henry, Carol J; Berhanu, Getenesh; Whiting, Susan J

2016-01-01

Complementary foods (CFs) in Ethiopia are cereal based and adding locally grown pulses (legumes) to CF would provide needed nutrients. To assess the effects of nutrition education (NEd) using Health Belief Model (HBM) in promoting pulses for CF, a 6-month quasi-experimental study was conducted in 160 mother-child pairs. Knowledge, attitude, and practice (KAP) questions were given to mothers at baseline, midline, and endline, along with anthropometric measurements of children. NEd involving discussions and recipe demonstrations was given twice monthly for 6 months to the intervention group (n = 80) while control mothers received usual education. At baseline, mothers' KAP scores were low at both sites; at 3 and 6 months of NEd, mean KAP scores of mothers increased (p < 0.05) compared to the control site. Significant improvements in children's mean weight, weight for height, and weight for age occurred in the intervention site only. Nutritional status of children improved after providing mothers with pulse-based NEd.

Achieving Adherence to Evidence-Based Practices: Are Health IT and Hospital-Physician Integration Complementary or Substitutive Strategies?

PubMed

Everson, Jordan; Lee, Shoou-Yih Daniel; Adler-Milstein, Julia

2016-12-01

In response to evolving policies and conditions, hospitals have increased health information technology (HIT) adoption and strived to improve hospital-physician integration. While evidence suggests that both HIT and integration confer independent benefits, when combined, they may provide complementary means to achieve high performance or overlap to offset each other's contribution. We explore this relationship in the context of hospital adherence to evidence-based practices (EBPs). Using the American Hospital Association's Annual and IT Supplement surveys, and Centers for Medicare and Medicaid Services's Hospital Compare, we estimate the independent relationships and interactions between HIT and hospital-physician integration with respect to EBP adherence. HIT adoption and tight (but not loose) integration are independently associated with greater adherence to EBPs. The interaction between HIT adoption and tight integration is negative, consistent with an offsetting association between HIT adoption and integration in their relationship to EBP adherence. This finding reveals the need to be aware of potential substitutive effects from simultaneous pursuit of multiple approaches to performance improvement. © The Author(s) 2016.

The complementary medicine (CAM) for the treatment of chronic pain: scientific evidence regarding the effects of healing touch massage.

PubMed

Marletta, Giuseppe; Canfora, Angela; Roscani, Francesco; Cernicchiaro, Lucia; Cutrera, Maria; Russo, Marianna; Artioli, Giovanna; Sarli, Leopoldo

2015-09-09

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.

Minority mothers' healthcare beliefs, commonly used alternative healthcare practices, and potential complications for infants and children.

PubMed

Hannan, Jean

2015-06-01

Complementary and alternative healthcare practices have increased substantially in the United States especially with low-income ethnic minority mothers. These mothers often have provider mistrust, language barriers, differing health belief systems, and as a result are less likely to seek preventive health screening, access healthcare services, and use alternative remedies for their infants and children that are potentially harmful or lethal. Therefore, the purpose of this article is to examine healthcare beliefs, commonly used alternative healthcare practices, and their potential complications for infants and children. A search of CINAHL and PubMed (1980-2012) was conducted using the following terms: alternative healthcare practice, mothers' health beliefs, cultural health beliefs, folk remedies, and infant health practices. Given the changing U.S. population and an increasing immigrant population, examining alternative healthcare practices mothers use for their infants and children is especially important for providers in addressing healthcare for this group. The use of alternative healthcare practices is rarely discussed by parents with healthcare providers for fear of disapproval. When interviewing ethnic minority mothers and caregivers questions should include the use of alternative healthcare practices for infants and children and information regarding the potential dangers should be provided to them. ©2014 American Association of Nurse Practitioners.

Assessment of Salient Beliefs Affecting Mothers' Intention to Adherence to Dietary Diversity in their Children's Complementary Feeding.

PubMed

Karimi-Shahanjarini, Akram; Rahmani, Fatemeh; Roshanei, Ghodratollah; Mahdi Hazavehei, Seyyed M

2017-01-01

Providing a variety of foods has been emphasized as one of the most important features of optimal complementary feeding. This study investigated key beliefs that guide mothers' intention to adherence to dietary diversity in their 1-2-year-old children's complementary feeding. This was a cross-sectional study involving 290 mothers (mean age = 27, standard deviation = 5.32) with child 1-2-year-old attending maternal and child health section of health centers in Rasht, Iran. To represent the socioeconomic status of the participants, 6 centers out of 15 were selected from three different socioeconomic areas (low-, middle-, and high-income areas). Mothers completed a questionnaire assessing intention and belief-based items of theory of planned behavior. Correlations and multiple regression analyses were performed. The mean age of mothers was 27 ± 5.33 (27-43 years). Regression analyses revealed that among behavioral beliefs, the perception that adherence to dietary diversity would lead to improve children's growth was the significant predictor of intention (β = 0.13, P = 0.04). Regarding normative beliefs, perceived social pressure from health-care professionals to adherence to dietary diversity significantly predicted intention (β = 0.15, P = 0.01). Among control beliefs, the perception that daily pressures made difficult adherence to dietary diversity was the key determinant (β = 0.19, P = 0.01). Findings of this study represent the important beliefs that can be addressed in development planning aimed at modifying mothers' child complementary feeding practices.

Caregiver-reported religious beliefs and complementary and alternative medicine use among children admitted to an epilepsy monitoring unit.

PubMed

Beattie, Julia Fleming; Thompson, Matthew D; Parks, Pamela H; Jacobs, Ruth Q; Goyal, Monisha

2017-04-01

Complementary and alternative medicine (CAM) includes a wide range of practices and products that are generally outside the use of conventional medicine as practiced in Western cultures. Use of CAM in persons with epilepsy is high, even compared to individuals with other chronic health conditions. In this study, we surveyed caregivers of children admitted to a regional epilepsy monitoring unit (EMU) in the southeast United States to assess CAM use among patients (N=225). Thirteen percent of respondents indicated current use of CAM by their child, 16% reported past use, and 43% reported interest in future use, most commonly in marijuana as a potential treatment (23%). Over 25% of respondents expressed interest in CAM use related to side effects of anti-epileptic medications. Regarding prayer as a form of CAM, a large majority of respondents in this sample identified as Christian and actively prayed for their child's illness, revealing a high prevalence of spiritual practices in this population. Eighty-one percent of respondents reported that they had not discussed CAM use with their doctor. Discussing CAM use with a health care provider was significantly related to past CAM use (p<.02), but not current use or willingness to try CAM in the future (p>.05). These results have important implications for future practice and support increased communication and patient education, as many anti-epileptic medications interact with certain herbs and supplements, posing a potential health risk and treatment barrier in this population. Copyright © 2017 Elsevier Inc. All rights reserved.

An Evidence-Based Course in Complementary Medicines

PubMed Central

Hughes, Jeff

2012-01-01

Objective. To evaluate the impact of an evidence-based course in complementary medicines on the attitudes, knowledge, and professional practice behavior of undergraduate pharmacy students. Design. A required 12-week evidence-based complementary medicine course was designed and introduced into the third-year undergraduate pharmacy curriculum. The course included a combination of traditional lectures, interactive tutorial sessions, and a range of formal assessments. Assessment. Pre- and post-course survey instruments were administered to assess changes in students’ attitudes, perceptions, knowledge, and the likelihood they would recommend the use of complementary medicines in a pharmacy practice environment. Conclusion. Completion of a required evidence-based complementary medicines course resulted in a positive change in pharmacy students’ perceptions of the value of various complementary medicines as well as in their willingness to recommend them, and provided students with the required knowledge to make patient-centered recommendations for use of complementary medicines in a professional pharmacy practice setting. These findings support the need for greater evidence-based complementary medicine education within pharmacy curricula to meet consumer demand and to align with pharmacists’ professional responsibilities. PMID:23275665

The role of complementary and alternative medicine (CAM) in Germany - a focus group study of GPs.

PubMed

Joos, Stefanie; Musselmann, Berthold; Miksch, Antje; Rosemann, Thomas; Szecsenyi, Joachim

2008-06-12

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. 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. 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. 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 'Heilpraktiker' as a competing CAM-provider. It seems to be a need for increased funding for research, better education and remuneration by the Statutory Health Insurance in order to improve access to 'Integrative medicine' in Germany.

How effective are spiritual care and body manipulation therapies in pediatric oncology? A systematic review of the literature.

PubMed

Poder, Thomas G; Lemieux, Renald

2013-12-10

The effects of cancer and associated treatments have a considerable impact on the well-being and quality of life of pediatric oncology patients. To support children and their families, complementary and alternative medicines are seen by nurses and doctors as practical to integrate to the services offered by hospitals. The purpose of this paper is to examine if the practice of complementary and alternative medicine, specifically spiritual care and treatments based on body manipulation, is likely to improve the health and well-being of children suffering from cancer. This objective is achieved through a systematic review of the literature. The level of evidence associated with each practice of complementary and alternative medicine was assessed according to the methodological design used by the studies reviewed. Studies reviewed are of a methodological quality that could be described as fair due to the small sample size of patients and the existence of a number of biases in the conduct and analysis of these studies. However, results obtained are consistent from one study to another, allowing us to make certain recommendations. It is thus advisable to consider the introduction of hypnotherapy in pediatric oncology services. Based on the data collected, it is the complementary and alternative medicine with the most evidence in favor of effectiveness of the well-being of pediatric oncology patients, especially during painful procedures. It is also recommended to use art therapy and music therapy. Conversely, too little evidence is present to be able to recommend the use of acupuncture, chiropractic or osteopathy.

How Effective Are Spiritual Care and Body Manipulation Therapies in Pediatric Oncology? A Systematic Review of the Literature

PubMed Central

Poder, Thomas G.; Lemieux, Renald

2014-01-01

Background: The effects of cancer and associated treatments have a considerable impact on the well-being and quality of life of pediatric oncology patients. To support children and their families, complementary and alternative medicines are seen by nurses and doctors as practical to integrate to the services offered by hospitals. Objective: The purpose of this paper is to examine if the practice of complementary and alternative medicine, specifically spiritual care and treatments based on body manipulation, is likely to improve the health and well-being of children suffering from cancer. Method: This objective is achieved through a systematic review of the literature. The level of evidence associated with each practice of complementary and alternative medicine was assessed according to the methodological design used by the studies reviewed. Results and Conclusion: Studies reviewed are of a methodological quality that could be described as fair due to the small sample size of patients and the existence of a number of biases in the conduct and analysis of these studies. However, results obtained are consistent from one study to another, allowing us to make certain recommendations. It is thus advisable to consider the introduction of hypnotherapy in pediatric oncology services. Based on the data collected, it is the complementary and alternative medicine with the most evidence in favor of effectiveness of the well-being of pediatric oncology patients, especially during painful procedures. It is also recommended to use art therapy and music therapy. Conversely, too little evidence is present to be able to recommend the use of acupuncture, chiropractic or osteopathy. PMID:24576371

Unconventional Dentistry in India – An Insight into the Traditional Methods

PubMed Central

Boloor, Vinita Ashutosh; Hosadurga, Rajesh; Rao, Anupama; Jenifer, Haziel; Pratap, Sruthy

2014-01-01

Unconventional medicine (UM) has been known and practised since the recorded history of civilization. Some unconventional practices may be viewed as “the continuity of traditions, religious beliefs, and even quackery that non-specialists practice.” These practices have been associated with religious beliefs and the spiritual domain as well as with the physical domain. In ancient Old World civilizations, UM was performed by skilled experts or wise men; in today's Western civilization, practitioners may or may not be licensed, and some are charlatans. Dentistry, like medicine, is a traditional, science-based, highly regulated healthcare profession that serves increasingly sophisticated and demanding clients. Today, traditional dental practice is dealing with an array of challenges to the established professional system; these challenges are generally termed “alternative” (or complementary, unconventional, or integrative). Genuine alternatives are comparable methods of equal value that have met scientific and regulatory criteria for safety and effectiveness. Because “alternative care” has become politicized and is often a misnomer – referring to practices that are not alternative to, complementary to, or integrating with conventional health care – the more accurate term “unconventional” is used. PMID:25161919

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

PubMed

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

2016-09-08

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

Publishing scientifically sound papers in Traditional and Complementary Medicine.

PubMed

Isidoro, Ciro; Huang, Chia-Chi; Sheen, Lee-Yan

2016-01-01

Non-conventional medical practices that make use of dietary supplements, herbal extracts, physical manipulations, and other practices typically associated with folk and Traditional Medicine are increasingly becoming popular in Western Countries. These practices are commonly referred to by the generic, all-inclusive term "Complementary and Alternative Medicine." Scientists, practitioners, and medical institutions bear the responsibility of testing and proving the effectiveness of these non-conventional medical practices in the interest of patients. In this context, the number of peer-reviewed journals and published articles on this topic has greatly increased in the recent decades. In this editorial article, we illustrate the policy of the Journal of Traditional and Complementary Medicine for publishing solid and scientifically sound papers in the field of Traditional and Complementary Medicine.

Complementary feeding and the early origins of obesity risk: a study protocol

PubMed Central

Muniandy, Naleena Devi; Allotey, Pascale A; Soyiri, Ireneous N; Reidpath, Daniel D

2016-01-01

Introduction The rise in the prevalence of childhood obesity worldwide calls for an intervention earlier in the life cycle. Studies show that nutrition during early infancy may contribute to later obesity. Hence, this study is designed to determine if the variation in complementary feeding practices poses a risk for the development of obesity later in life. A mixed methods approach will be used in conducting this study. Methods and analysis The target participants are infants born from January to June 2015 in the South East Asia Community Observatory (SEACO) platform. The SEACO is a Health and Demographic Surveillance System (HDSS) that is established in the District of Segamat in the state of Johor, Malaysia. For the quantitative strand, the sociodemographic data, feeding practices, anthropometry measurement and total nutrient intake will be assessed. The assessment will occur around the time complementary feeding is expected to start (7 Months) and again at 12 months. A 24-hour diet recall and a 2-day food diary will be used to assess the food intake. For the qualitative strand, selected mothers will be interviewed to explore their infant feeding practices and factors that influence their practices and food choices in detail. Ethics and dissemination Ethical clearance for this study was sought through the Monash University Human Research and Ethics Committee (application number CF14/3850-2014002010). Subsequently, the findings of this study will be disseminated through peer-reviewed journals, national and international conferences. PMID:27852704

A focused ethnographic assessment of Middle Eastern mothers' infant feeding practices in Canada.

PubMed

Jessri, Mahsa; Farmer, Anna P; Olson, Karin

2015-10-01

The aim of this study was to examine the barriers to following complementary feeding guidelines among Middle Eastern mothers and the cultural considerations of practitioners from an emic perspective. This is a two-phase focused ethnographic assessment of infant feeding among 22 Middle Eastern mothers in Western Canada who had healthy infants aged <1 year. Data were collected through four focus groups conducted in Arabic/Farsi, and were further complemented by comprehensive survey data collected in the second phase of study. Mothers' main criterion for choosing infant foods was whether or not foods were Halal, while food allergens were not causes for concern. Vitamin D supplements were not fed to 18/22 of infants, and mashed dates (Halawi), rice pudding (Muhallabia/Ferni) and sugared water/tea were the first complementary foods commonly consumed. Through constant comparison of qualitative data, three layers of influence emerged, which described mothers' process of infant feeding: socio-cultural, health care system and personal factors. Culture was an umbrella theme influencing all aspects of infant feeding decisions. Mothers cited health care professionals' lack of cultural considerations and lack of relevance and practicality of infant feeding guidelines as the main reasons for ignoring infant feeding recommendations. Early introduction of pre-lacteal feeds and inappropriate types of foods fed to infants among immigrant/refugee Middle Eastern mothers in Canada is cause of concern. Involving trained language interpreters in health teams and educating health care staff on cultural competency may potentially increase maternal trust in the health care system and eventually lead to increased awareness of and adherence to best practices with infant feeding recommendations. © 2013 John Wiley & Sons Ltd.

Complementary and alternative medicine in women's health. Developing a research agenda.

PubMed

Murphy, P A; Kronenberg, F; Wade, C

1999-01-01

Complementary and alternative medicine is becoming an established intervention modality within the contemporary health care system. Various forms of complementary and alternative medicine are used by patients and practitioners alike, including chiropractic, massage, botanical medicine, homeopathy, and energy therapies. The National Center for Complementary and Alternative Medicine was established within the National Institutes of Health to facilitate evaluation of these alternative therapies, establish an information clearinghouse, and promote research in the field. This article discusses several aspects of complementary and alternative medicine, relates them to women's health, and describes the need for a research agenda to evaluate the impact of the complementary and alternative medicine modalities used for important conditions affecting women.

The health professional-patient-relationship in conventional versus complementary and alternative medicine. A qualitative study comparing the perceived use of medical shared decision-making between two different approaches of medicine.

PubMed

Berger, Stephanie; Braehler, Elmar; Ernst, Jochen

2012-07-01

To explore differences between conventional medicine (COM) and complementary and alternative medicine (CAM) regarding the attitude toward and the perceived use of shared decision-making (SDM) from the health professional perspective. Thirty guideline-based interviews with German GPs and nonmedical practitioners were conducted using qualitative analysis for interpretation. The health professional-patient-relationship in CAM differs from that in COM, as SDM is perceived more often. Reasons for this include external context variables (e.g., longer consultation time) and internal provider beliefs (e.g., attitude toward SDM). German health care policy was regarded as one of the most critical factors which affected the relationship between GPs and their patients and their practice of SDM. Differences between COM and CAM regarding the attitude toward and the perceived use of SDM are attributable to diverse concepts of medicine, practice context variables and internal provider factors. Therefore, the perceived feasibility of SDM depends on the complexity of different occupational socialization processes and thus, different value systems between COM and CAM. Implementation barriers such as insufficient communication skills, lacking SDM training or obedient patients should be reduced. Especially in COM, contextual variables such as political restrictions need to be eliminated to successfully implement SDM. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Transition in Infant and Young Child Feeding Practices in India.

PubMed

Puri, Seema

2017-01-01

Optimal infant and young child feeding, which includes initiation of breastfeeding within one hour of birth, exclusive breastfeeding for first six months, age appropriate complementary feeding after six months along with continued breastfeeding for 2 years and beyond, is a public health intervention to prevent child morbidity, mortality and malnutrition [1]. In India, even though institutional delivery rates are increasing, only 44% women are able to breastfeed their babies within one hour of delivery. While 65% children are exclusively breast fed for the first six months, the median duration of breastfeeding is 24.4 months and complementary feeding rates are 50%. To achieve optimal IYCF practices, each woman should have access to a community based IYCF counseling support system. Efforts are therefore needed to upgrade skill based training of health workers and revive and update the Baby Friendly Hospital Initiative (BFHI). To promote and sustain breastfeeding amongst working women, it is essential to ensure adequate maternity leave, crèches at work place, flexible working hours, and provision of physical space for breast feeding at work place. It is imperative to also create public awareness about the dangers of bottle and formula feeding and to provide accurate information on the appropriate complementary food to be given to infants. In conclusion, India needs to make serious efforts to overcome malnutrition with not only prioritized IYCF policies but also their effective implementation in place. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Barriers to the Entry of Biofield Healing Into “Mainstream” Healthcare

PubMed Central

Sprengel, Meredith; Ives, John A.; Jonas, Wayne

2015-01-01

In this article, we describe barriers to the entry of biofield healing into mainstream contemporary science and clinical practice. We focus on obstacles that arise from the social nature of the scientific enterprise, an aspect of science highlighted by the influential work of Thomas Kuhn (1922-1996), one of the most important— and controversial—philosophers of science in the 20th century. Kuhn analyzed science and its revolutionary changes in terms of the dynamics within scientific communities. Kuhn's approach helps us understand unconventional medical theories and practices such as biofield healing. For many years, these were called “complementary and alternative medicine” (CAM). However, because most people use nonmainstream approaches in conjunction with conventional treatments, the National Institutes of Health and many practitioners now prefer “Complementary and Integrative Medicine” (CIM) where integrative implies “bringing conventional and complementary approaches together in a coordinated way.”1 Biofield healing fits the integrative model well, provides a novel approach to therapeutic intervention, and is developing in a manner that can integrate with current medical science in simple ways. Yet, it still remains outside the conventional framework because of its conceptual bases, which contrast sharply with conventional assumptions regarding the nature of reality. PMID:26665046

Complementary and alternative medicine: the challenges of ethical justification. A philosophical analysis and evaluation of ethical reasons for the offer, use and promotion of complementary and alternative medicine.

PubMed

Mertz, Marcel

2007-09-01

With the prevalence of complementary and alternative medicine (CAM) increasing in western societies, questions of the ethical justification of these alternative health care approaches and practices have to be addressed. In order to evaluate philosophical reasoning on this subject, it is of paramount importance to identify and analyse possible arguments for the ethical justification of CAM considering contemporary biomedical ethics as well as more fundamental philosophical aspects. Moreover, it is vital to provide adequate analytical instruments for this task, such as separating 'CAM as belief system' and 'CAM as practice'. Findings show that beneficence and non-maleficence are central issues for an ethical justification of CAM as practice, while freedom of thought and religion are central to CAM as belief system. Many justification strategies have limitations and qualifications that have to be taken into account. Singularly descriptive premises in an argument often prove to be more problematic than universal ethical principles. Thus, non-ethical issues related to a general philosophical underpinning--e.g. epistemology, semantics, and ontology--are highly relevant for determining a justification strategy, especially when strong metaphysical assumptions are involved. Even if some values are shared with traditional biomedicine, axiological differences have to be considered as well. Further research should be done about specific CAM positions. These could be combined with applied qualitative social research methods.

Weaning practices among pastoralists: New evidence of infant feeding patterns from Bronze Age Eurasia.

PubMed

Ventresca Miller, Alicia; Hanks, Bryan K; Judd, Margaret; Epimakhov, Andrey; Razhev, Dmitry

2017-03-01

This paper investigates infant feeding practices through stable carbon (δ 13 C) and nitrogen (δ 15 N) isotopic analyses of human bone collagen from Kamennyi Ambar 5, a Middle Bronze Age cemetery located in central Eurasia. The results presented are unique for the time period and region, as few cemeteries have been excavated to reveal a demographic cross-section of the population. Studies of weaning among pastoral societies are infrequent and this research adds to our knowledge of the timing, potential supplementary foods, and cessation of breastfeeding practices. Samples were collected from 41 subadults (<15 years) and 27 adults (15+ years). Isotopic reference sets from adult humans as well as faunal remains were utilized as these form the primary and complementary foods fed to infants. Slight shifts in δ 13 C and δ 15 N values revealed that weaning was a multi-stage process (breastfeeding, weaning, and complete cessation of nursing) that began at 6 months of age, occurred over several years of early childhood, and was completed by 4 years of age. Our results indicate that weaning was a multi-stage process that was unique among late prehistoric pastoralist groups in Eurasia that were dependent on milk products as a supplementary food. Our discussion centers on supporting this hypothesis with modern information on central and east Eurasian herding societies including the age at which complementary foods are introduced, the types of complementary foods, and the timing of the cessation of breastfeeding. Integral to this work is the nature of pastoral economies and their dependence on animal products, the impact of complementary foods on nutrition and health, and how milk processing may have affected nutrition content and digestibility of foods. This research on Eurasian pastoralists provides insights into the complexities of weaning among prehistoric pastoral societies as well as the potential for different complementary foods to be incorporated into infant diets in the past. © 2016 Wiley Periodicals, Inc.

The experiences of persons living with HIV who participate in mind-body and energy therapies: a systematic review protocol of qualitative evidence.

PubMed

Bremner, Marie; Blake, Barbara; Stiles, Cheryl

2015-10-01

The purpose of this systematic review is to explore the experiences and perceptions of persons living with HIV who participate in mind-body and energy therapies. The review will focus on the use of mind-body medicine and energy therapies that include meditation, prayer, mental healing, Tai Chi, yoga, art therapy, music therapy, dance therapy, Qigong, reiki, therapeutic touch, healing touch and electromagnetic therapy. These mind-body and energy therapies are selected categories because they do not involve options that might be contraindicated to an individual's current treatment regime. More specifically, the review questions are: Complementary and alternative medicine (CAM) is a popular adjunct to conventional medicine across global populations. Complementary generally refers to a non-mainstream approach together with conventional medicine whereas alternative refers to a non-mainstream approach in place of conventional medicine. Most people use non-mainstream approaches along with conventional treatments. The World Health Organization [WHO] defines CAM as distinct health-care practices that have not been assimilated into a country's mainstream health care system.The USA's National Center for Complementary and Integrative Health (NCCIH), formerly National Center for Complementary and Alternative Medicine (NCCAM), organizes CAM into five medical system categories: whole medical systems, mind-body medicine, biologically based practices, manipulative and body-based practices, and energy therapies. Whole medical systems include homeopathy, naturopathy, traditional Chinese medicine and Ayurveda. Mind-body medicine includes meditation, prayer, mental healing, Tai Chi, yoga, art therapy, music therapy and dance therapy. Biologically based practices include dietary supplements, herbal supplements and a few scientifically unproven therapies. Manipulative and body-based practices include massage and spinal manipulation such as chiropractic and osteopathic. Energy therapies include Qigong, reiki, therapeutic touch, healing touch and electromagnetic therapy.The NCCAM, the Alternative Medicine's Strategic Plan for 2011-2015 and the Healthy People 2020 envision a society in which all people have the opportunity to live long, healthy lives. In most countries, life expectancy has increased, but unfortunately, the incidence of chronic illnesses such as cardiovascular disease, cancer, hypertension, diabetes and depression continues to increase. Research findings indicate that the use of CAM is often greater among people living with a chronic or life threatening illness compared with the general population,Until the development of highly active antiretroviral medications (ARVs) in 1996, a diagnosis of human immunodeficiency virus (HIV) was considered to be a death sentence. The human immunodeficiency virus attacks the immune system and weakens a person's ability to combat infections and some types of cancer. Currently, there is no cure for HIV but because of lifesaving medications, the mortality rate has declined significantly. The disease is now considered a chronic illness and highly manageable. Effective treatment has resulted in approximately 35 million people worldwide still living with HIV at the end of 2012.Because HIV is no longer a death sentence but a chronic illness, there is a need to evaluate the experiences and perceptions of people using CAM, considering the prevalence of CAM use within this population. In the United States and Canada, the rate of CAM use among HIV positive persons is approximately 50% to 70%, whereas in Africa, rates of CAM use range from 36% to 68%. Popular forms of CAM among persons living with HIV include herbal or nutritional supplements, mind and body practices, and spiritual or religious healing. Worldwide, only a small percentage of persons who have access to ARVs refuse to take them and utilize CAM exclusively to treat their HIV infection.People living with HIV often report using CAM because they believe that these therapies will improve their overall health and well-being and provides them an opportunity to take some responsibility in managing their personal health, which includes medication side effects. However, the effect of CAM on an individual's physical health often cannot be measured physiologically, but may be felt or experienced.Understanding CAM use is essential so that health professionals will have the most accurate information about which integrative therapies may or may not be helpful for people living with HIV. As recommended by the Institute of Medicine report entitled, 'Integrative Medicine and Patient Centered Care', health professionals have a moral commitment to find innovative ways of obtaining evidence and expanding knowledge about diverse interpretations of health and healing. Research aimed at exploring patients' experiences and perceptions of mind-body and energy therapies is imperative so asto offer comprehensive care and promote shared decision making regarding complementary therapeutic options.

Practice patterns in spine radiograph utilization among doctors of chiropractic enrolled in a provider network offering complementary care in the United States.

PubMed

Bussières, André E; Sales, Anne E; Ramsay, Timothy; Hilles, Steven; Grimshaw, Jeremy M

2013-01-01

Nonspecific back pain is associated with high use of diagnostic imaging in primary care, yet current evidence suggests that routine imaging of the spine is unnecessary. The objective of this study is to describe current practice patterns in spine radiograph utilization among doctors of chiropractic enrolled in an American provider network. A cross-sectional analysis of administrative claims data from one of the largest providers of complementary health care networks for health plans in the United States was performed. Survey data containing provider demographics were linked with routinely collected data on spine radiograph utilization and patient characteristics aggregated at the provider level. We calculated rates and variations of spine radiographs over 12 months. Negative binomial regression was performed to identify significant predictors of high radiograph utilization and to estimate the associated incidence risk ratio. Complete data for 6946 doctors of chiropractic and 249193 adult patients were available for analyses. In 2010, claims were paid for a total of 91542 new patient examinations and 23369 spine radiographs (including 17511 ordered within 5 days of initial patient examination). The rate of spine radiographs within 5 days of an initial patient visit was 204 per 1000 new patient examinations. Significant predictors of higher radiograph utilization rates included the following: practicing in the Midwest or South US census regions, practicing in an urban or suburban setting, chiropractic school attended, and being a male provider in full-time practice with more than 20 years of experience. Chiropractic school attended and practice location were the most influential predictors of spine radiograph utilization among network chiropractors. This information may help to inform the development and evaluation of a tailored intervention to address overuse of radiograph utilization. Copyright © 2013 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

An Analysis of News Media Coverage of Complementary and Alternative Medicine

PubMed Central

Bonevski, Billie; Wilson, Amanda; Henry, David A.

2008-01-01

Background To examine the accuracy and adequacy of lay media news stories about complementary and alternative medicines and therapies. Methodology/Principal Findings A descriptive analysis of news stories about complementary and alternative medicine (CAM) in the Australian media using a national medical news monitoring website, mediadoctor.org.au. Each story was rated against 10 criteria by two individuals. Consensus scores of 222 news articles reporting therapeutic claims about complementary medicines posted on mediadoctor.org.au between 1 January 2004 and 1 September 2007 were calculated. The overall rating score for 222 CAM articles was 50% (95% CI 47% to 53%). There was a statistically significant (F = 3.68, p = 0.006) difference in cumulative mean scores according to type of therapy: biologically based practices (54%, 95% CI 50% to 58%); manipulative body based practices (46%, 95% CI 39% to 54%), whole medical systems (45%, 95% CI 32% to 58%), mind body medicine (41%, 95% CI 31% to 50%) and energy medicine (33%, 95% CI 11% to 55%). There was a statistically significant difference in cumulative mean scores (F = 3.72, p = 0.0001) according to the clinical outcome of interest with stories about cancer treatments (62%, 95% CI 54% to 70%) scoring highest and stories about treatments for children's behavioural and mental health concerns scoring lowest (31%, 95% CI 19% to 43%). Significant differences were also found in scores between media outlets. Conclusions/Significance There is substantial variability in news reporting practices about CAM. Overall, although they may be improving, the scores remain generally low. It appears that much of the information the public receives about CAM is inaccurate or incomplete. PMID:18545688

Complementary Medicine and the Role of Oncology Nurses in an Acute Care Hospital: The Gap Between Attitudes and Practice.

PubMed

Admi, Hanna; Eilon-Moshe, Yael; Ben-Arye, Eran

2017-09-01

To describe hospital nurses' knowledge, attitudes, and practices regarding complementary medicine (CM); to compare the knowledge and attitudes of nurse managers to staff nurses with diverse oncology experience; and to assess attitudes toward integrating CM into the role of the hospital oncology nurse. 
. Descriptive, cross-sectional study.
. Rambam Health Care Campus in northern Israel.
. A convenience sample of 434 hospital nurses with varied oncology experience.
. Nurses completed a knowledge and attitude questionnaire developed for the current study. Data were analyzed using parametric and nonparametric statistical tests. 
. Hospital nurses' knowledge of and attitudes toward CM, and attitudes toward integrating CM into the role of the hospital oncology nurse.
. Nurses lack knowledge and are unaware of the risks associated with CM. However, they believe this approach can improve the quality of life of patients with cancer; 51% expressed an interest in receiving training. Oncology nurses were ambivalent about the feasibility of applying an integrative approach, whereas nurse managers expressed significantly more positive attitudes toward integrating CM within the scope of nursing practices.
. A large discrepancy remains between nurses' strong interest in CM and awareness of associated benefits, and their ambivalence toward its integration in their nursing practice. 
. Although improving nurses' knowledge should be mandatory, it remains insufficient; a shift in the approach to integrating CM into conventional health care is needed, from practitioners' responsibility to healthcare policymakers' responsibility. Legislations and policies are necessary, along with providing respectable infrastructures.

Assessment of Salient Beliefs Affecting Mothers’ Intention to Adherence to Dietary Diversity in their Children's Complementary Feeding

PubMed Central

Karimi-Shahanjarini, Akram; Rahmani, Fatemeh; Roshanei, Ghodratollah; Mahdi Hazavehei, Seyyed M.

2017-01-01

Background: Providing a variety of foods has been emphasized as one of the most important features of optimal complementary feeding. This study investigated key beliefs that guide mothers’ intention to adherence to dietary diversity in their 1–2-year-old children's complementary feeding. Methods: This was a cross-sectional study involving 290 mothers (mean age = 27, standard deviation = 5.32) with child 1–2-year-old attending maternal and child health section of health centers in Rasht, Iran. To represent the socioeconomic status of the participants, 6 centers out of 15 were selected from three different socioeconomic areas (low-, middle-, and high-income areas). Mothers completed a questionnaire assessing intention and belief-based items of theory of planned behavior. Correlations and multiple regression analyses were performed. Results: The mean age of mothers was 27 ± 5.33 (27–43 years). Regression analyses revealed that among behavioral beliefs, the perception that adherence to dietary diversity would lead to improve children's growth was the significant predictor of intention (β = 0.13, P = 0.04). Regarding normative beliefs, perceived social pressure from health-care professionals to adherence to dietary diversity significantly predicted intention (β = 0.15, P = 0.01). Among control beliefs, the perception that daily pressures made difficult adherence to dietary diversity was the key determinant (β = 0.19, P = 0.01). Conclusions: Findings of this study represent the important beliefs that can be addressed in development planning aimed at modifying mothers’ child complementary feeding practices. PMID:28479970

Undernutrition, poor feeding practices, and low coverage of key nutrition interventions.

PubMed

Lutter, Chessa K; Daelmans, Bernadette M E G; de Onis, Mercedes; Kothari, Monica T; Ruel, Marie T; Arimond, Mary; Deitchler, Megan; Dewey, Kathryn G; Blössner, Monika; Borghi, Elaine

2011-12-01

To estimate the global burden of malnutrition and highlight data on child feeding practices and coverage of key nutrition interventions. Linear mixed-effects modeling was used to estimate prevalence rates and numbers of underweight and stunted children according to United Nations region from 1990 to 2010 by using surveys from 147 countries. Indicators of infant and young child feeding practices and intervention coverage were calculated from Demographic and Health Survey data from 46 developing countries between 2002 and 2008. In 2010, globally, an estimated 27% (171 million) of children younger than 5 years were stunted and 16% (104 million) were underweight. Africa and Asia have more severe burdens of undernutrition, but the problem persists in some Latin American countries. Few children in the developing world benefit from optimal breastfeeding and complementary feeding practices. Fewer than half of infants were put to the breast within 1 hour of birth, and 36% of infants younger than 6 months were exclusively breastfed. Fewer than one-third of 6- to 23-month-old children met the minimum criteria for dietary diversity, and only ∼50% received the minimum number of meals. Although effective health-sector-based interventions for tackling childhood undernutrition are known, intervention-coverage data are available for only a small proportion of them and reveal mostly low coverage. Undernutrition continues to be high and progress toward reaching Millennium Development Goal 1 has been slow. Previously unrecognized extremely poor breastfeeding and complementary feeding practices and lack of comprehensive data on intervention coverage require urgent action to improve child nutrition.

Integrating Science and Engineering to Implement Evidence-Based Practices in Health Care Settings

PubMed Central

Wu, Shinyi; Duan, Naihua; Wisdom, Jennifer P.; Kravitz, Richard L.; Owen, Richard R.; Sullivan, Greer; Wu, Albert W.; Di Capua, Paul; Hoagwood, Kimberly Eaton

2015-01-01

Integrating two distinct and complementary paradigms, science and engineering, may produce more effective outcomes for the implementation of evidence-based practices in health care settings. Science formalizes and tests innovations, whereas engineering customizes and optimizes how the innovation is applied tailoring to accommodate local conditions. Together they may accelerate the creation of an evidence-based healthcare system that works effectively in specific health care settings. We give examples of applying engineering methods for better quality, more efficient, and safer implementation of clinical practices, medical devices, and health services systems. A specific example was applying systems engineering design that orchestrated people, process, data, decision-making, and communication through a technology application to implement evidence-based depression care among low-income patients with diabetes. We recommend that leading journals recognize the fundamental role of engineering in implementation research, to improve understanding of design elements that create a better fit between program elements and local context. PMID:25217100

The Impact of a Cultural Immersion Study Abroad Experience in Traditional Chinese Medicine.

PubMed

Conroy, Shelley F; Taggart, Helen M

2016-09-01

Study abroad programs have increased dramatically. Most programs are short-term and include a cultural immersion as well as classroom and/or service learning. In this article, the authors discuss a study abroad program to China that included cultural immersion and classroom learning specific to traditional Chinese medicine. Participants kept journals with specific writing assignments and reflections about their experiences during the trip. At the conclusion of the trip, a qualitative survey was administered to the participants. Outcomes included the benefits of cultural immersion and a greater appreciation of cultural diversity, complementary and alternative medicine and holistic health care. Participants were able to describe transformational experiences of living in and learning from the Chinese culture and peoples. They intended to incorporate their experiences and enhanced understanding of traditional Chinese medicine and complementary and alternative therapies to provide culturally competent holistic health care in their nursing practice. © The Author(s) 2015.

Mind-Body Therapies in Children and Youth.

PubMed

2016-09-01

Mind-body therapies are popular and are ranked among the top 10 complementary and integrative medicine practices reportedly used by adults and children in the 2007-2012 National Health Interview Survey. A growing body of evidence supports the effectiveness and safety of mind-body therapies in pediatrics. This clinical report outlines popular mind-body therapies for children and youth and examines the best-available evidence for a variety of mind-body therapies and practices, including biofeedback, clinical hypnosis, guided imagery, meditation, and yoga. The report is intended to help health care professionals guide their patients to nonpharmacologic approaches to improve concentration, help decrease pain, control discomfort, or ease anxiety. Copyright © 2016 by the American Academy of Pediatrics.

An analysis of sickness absence in chronically ill patients receiving Complementary and Alternative Medicine: A longterm prospective intermittent study

PubMed Central

Moebus, Susanne; Lehmann, Nils; Bödeker, Wolfgang; Jöckel, Karl-Heinz

2006-01-01

Background The popularity of complementary and alternative medicine (CAM) has led to a growing amount of research in this area. All the same little is known about the effects of these special treatments in every-day practice of primary care, delivered by general practitioners within the health insurance system. From 1994 to 2000 more than 20 German Company health insurances initiated the first model project on CAM according to the German social law. Aim of this contribution is to investigate the effectiveness of multi-modal CAM on chronic diseases within primary health care. Methods A long-term prospective intermittent study was conducted including 44 CAM practitioners and 1221 self-selected chronically ill patients (64% women) of whom 441 were employed. Main outcome measure is sick-leave, controlled for secular trends and regression-to-the mean and self-perceived health status. Results Sick-leave per year of 441 patients at work increased from 22 (SD ± 45.2) to 31 (± 61.0) days within three years prior to intervention, and decreased to 24 (± 55.6) in the second year of treatment, sustaining at this level in the following two years. Detailed statistical analysis show that this development exceeds secular trends and the regression-toward-the-mean effect. Sick-leave reduction was corroborated by data on self-reported improvement of patients' health status. Conclusion Results of this longterm observational study show a reduction of sick leave in chronically ill patients after a complex multimodal CAM intervention. However, as this is an uncontrolled observational study efficacy of any specific CAM treatment can not be proven. The results might indicate an general effectiveness of CAM in primary care, worthwhile further investigations. Future studies should identify the most suitable patients for CAM practices, the most appropriate and safe treatments, provide information on the magnitude of the effects to facilitate subsequent definitive randomised controlled studies that will help to position complementary and alternative medicine in health care. PMID:16472403

A systematic scoping review of complementary and alternative medicine mind and body practices to improve the health of veterans and military personnel.

PubMed

Elwy, A Rani; Johnston, Jennifer M; Bormann, Jill E; Hull, Amanda; Taylor, Stephanie L

2014-12-01

Meditation, imagery, acupuncture, and yoga are the most frequently offered mind and body practices in the Department of Veterans Affairs. Yet, the research on mind and body practices has been critiqued as being too limited in evidence and scope to inform clinical treatment. We conducted a systematic scoping review of mind and body practices used with veterans or active duty military personnel to identify gaps in the literature and make recommendations for future primary research. Following systematic literature review methodology, we searched 5 databases using 27 different National Center for Complementary and Alternative Medicine-defined mind and body practices as text words, keywords, and MeSH terms through June 30, 2014. We also conducted handsearches of 4 previous reviews. Active duty military members or veterans 18 years or older participating in mind and body practice interventions globally. Data were extracted from studies meeting 5 inclusion criteria. The quality of randomized controlled trials (RCTs) was assessed using an existing checklist. Of 1819 studies identified, 89 interventions (50 RCTs) published between 1976 and 2014, conducted in 9 countries, using 152 different measures to assess 65 health and well-being outcomes met our inclusion criteria. Most interventions took place in the United States (n=78). Meditation practices (n=25), relaxation techniques including imagery (n=20), spinal manipulation including physical therapy (n=16), and acupuncture (n=11) were the most frequently studied practices. Methodological quality of most RCTs was rated poorly. Meditation and acupuncture practices are among the most frequently offered and studied mind and body practices. Future research should include yoga as it is currently understudied among veterans and military personnel. A repository of mind and body intervention outcome measures may further future research efforts, as would conducting pragmatic trials and more robust RCTs.

Traditional Arabic & Islamic Medicine: A Conceptual Model for Clinicians and Researchers

PubMed Central

Al-Rawi, Sara; Fetters, Michael D

2012-01-01

Eighty percent of the population in the developing world relies on traditional medicine, and 70-80% of the population in developed countries utilizes complementary therapies. Though a vibrant healing tradition pervades modern life in the Arab and Muslim world, no clear definition or model exists to organize it’s multiple and intertwined elements. We define Traditional Arabic and Islamic Medicine (TAIM) as a system of healing practiced since antiquity in the Arab world within the context of religious influences of Islam and comprised of medicinal herbs, dietary practices, mind-body therapy, spiritual healing and applied therapy whereby many of these elements reflect an enduring interconnectivity between Islamic medical and prophetic influences as well as regional healing practices emerging from specific geographical and cultural origins. Our definition and conceptual model represents a novel addition to the literature on Arab and Muslim health practices, and presents an opportunity to address a global health concern. PMID:22980243

Traditional arabic & islamic medicine: a conceptual model for clinicians and researchers.

PubMed

Alrawi, Sara N; Fetters, Michael D

2012-04-28

Eighty percent of the population in the developing world relies on traditional medicine, and 70-80% of the population in developed countries utilized complementary therapies. Though a vibrant healing tradition pervades modern life in the Arab and Muslim world, no clear definition or model exists to organize it's multiple and intertwined elements . We define Traditional Arabic and Islamic Medicine (TAIM) as a system of healing practiced since antiquity in the Arab world within the context of religious influences of Islam and comprised of medicinal herbs, dietary practices, mind-body therapy, spiritual healing and applied therapy whereby many of these elements reflect an enduring interconnectivity between Islamic medical and prophetic influences as well as regional healing practices emerging from specific geographical and cultural origins. Our definition and conceptual model represents a novel addition to the literature on Arab and Muslim health practices, and presents an opportunity to address a global health concern.

Feeding practices for infants and young children during and after common illness. Evidence from South Asia

PubMed Central

Aguayo, Víctor M.

2016-01-01

Abstract Global evidence shows that children's growth deteriorates rapidly during/after illness if foods and feeding practices do not meet the additional nutrient requirements associated with illness/convalescence. To inform policies and programmes, we conducted a review of the literature published from 1990 to 2014 to document how children 0–23 months old are fed during/after common childhood illnesses. The review indicates that infant and young child feeding (IYCF) during common childhood illnesses is far from optimal. When sick, most children continue to be breastfed, but few are breastfed more frequently, as recommended. Restriction/withdrawal of complementary foods during illness is frequent because of children's anorexia (perceived/real), poor awareness of caregivers' about the feeding needs of sick children, traditional beliefs/behaviours and/or suboptimal counselling and support by health workers. As a result, many children are fed lower quantities of complementary foods and/or are fed less frequently when they are sick. Mothers/caregivers often turn to family/community elders and traditional/non‐qualified practitioners to seek advice on how to feed their sick children. Thus, traditional beliefs and behaviours guide the use of ‘special’ feeding practices, foods and diets for sick children. A significant proportion of mothers/caregivers turn to the primary health care system for support but receive little or no advice. Building the knowledge, skills and capacity of community health workers and primary health care practitioners to provide mothers/caregivers with accurate and timely information, counselling and support on IYCF during and after common childhood illnesses, combined with large‐scale communication programmes to address traditional beliefs and norms that may be harmful, is an urgent priority to reduce the high burden of child stunting in South Asia. PMID:26840205

Complementary Feeding: Review of Recommendations, Feeding Practices, and Adequacy of Homemade Complementary Food Preparations in Developing Countries – Lessons from Ethiopia

PubMed Central

Abeshu, Motuma Adimasu; Lelisa, Azeb; Geleta, Bekesho

2016-01-01

Breastfeeding provides the ideal food during the first 6 months of life. Complementary feeding starts when breast milk is no longer sufficient by itself, where the target age is for 6–23 months. The gap between nutritional requirement and amount obtained from breast milk increases with age. For energy, 200, 300, and 550 kcal per day is expected to be covered by complementary foods at 6–8, 9–11, and 12–23 months, respectively. In addition, the complementary foods must provide relatively large proportions of micronutrients such as iron, zinc, phosphorus, magnesium, calcium, and vitamin B6. In several parts of the developing world, complementary feeding continues as a challenge to good nutrition in children. In Ethiopia, only 4.2% of breastfed children of 6–23 months of age have a minimum acceptable diet. The gaps are mostly attributed to either poor dietary quality or poor feeding practices, if not both. Commercial fortified foods are often beyond the reach of the poor. Thus, homemade complementary foods remain commonly used. Even when based on an improved recipe, however, unfortified plant-based complementary foods provide insufficient key micronutrients (especially, iron, zinc, and calcium) during the age of 6–23 months. Thus, this review assessed complementary feeding practice and recommendation and reviewed the level of adequacy of homemade complementary foods. PMID:27800479

Complementary feeding and the early origins of obesity risk: a study protocol.

PubMed

Muniandy, Naleena Devi; Allotey, Pascale A; Soyiri, Ireneous N; Reidpath, Daniel D

2016-11-15

The rise in the prevalence of childhood obesity worldwide calls for an intervention earlier in the life cycle. Studies show that nutrition during early infancy may contribute to later obesity. Hence, this study is designed to determine if the variation in complementary feeding practices poses a risk for the development of obesity later in life. A mixed methods approach will be used in conducting this study. The target participants are infants born from January to June 2015 in the South East Asia Community Observatory (SEACO) platform. The SEACO is a Health and Demographic Surveillance System (HDSS) that is established in the District of Segamat in the state of Johor, Malaysia. For the quantitative strand, the sociodemographic data, feeding practices, anthropometry measurement and total nutrient intake will be assessed. The assessment will occur around the time complementary feeding is expected to start (7 Months) and again at 12 months. A 24-hour diet recall and a 2-day food diary will be used to assess the food intake. For the qualitative strand, selected mothers will be interviewed to explore their infant feeding practices and factors that influence their practices and food choices in detail. Ethical clearance for this study was sought through the Monash University Human Research and Ethics Committee (application number CF14/3850-2014002010). Subsequently, the findings of this study will be disseminated through peer-reviewed journals, national and international conferences. 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/.

Marketing complementary foods and supplements in Burkina Faso, Madagascar, and Vietnam: lessons learned from the Nutridev program.

PubMed

Bruyeron, Olivier; Denizeau, Mirrdyn; Berger, Jacques; Trèche, Serge

2010-06-01

Sustainable approaches to improving infant and young child feeding are needed. The Nutridev program worked in Vietnam, Madagascar, and Burkina Faso to test different strategies to improve complementary feeding using fortified products sold to families. To review the experiences of programs producing and marketing fortified complementary foods and to report on the feasibility of local production and marketing of fortified complementary foods to increase usage of high-quality foods among children of low-income families in a self-sustaining manner. Project documents, surveys of mothers, and production and sales reports were reviewed. Nutridev experience in Vietnam, Madagascar, and Burkina Faso demonstrates that it is possible to produce affordable, high-quality complementary foods and supplements locally in developing countries. Strategies to make products readily available to the targeted population and to convince this population to consume them yielded mixed results, varying greatly based on the strategy utilized and the context in which it was implemented. In several contexts, the optimal approach appears to be strengthening the existing food distribution network to sell complementary foods and supplements, with the implementation of a temporary promotion and nutrition education network in partnership with local authorities (e.g., health services) to increase awareness among families about the fortified complementary food product and optimal feeding practices. In urban areas, where the density of the population is high, design and implementation of specific networks very close to consumers seems to be a good way to combine economic sustainability and good consumption levels.

The Integrated Taxonomy of Health Care: Classifying Both Complementary and Biomedical Practices Using a Uniform Classification Protocol

PubMed Central

Porcino, Antony; MacDougall, Colleen

2009-01-01

Background: Since the late 1980s, several taxonomies have been developed to help map and describe the interrelationships of complementary and alternative medicine (CAM) modalities. In these taxonomies, several issues are often incompletely addressed: A simple categorization process that clearly isolates a modality to a single conceptual categoryClear delineation of verticality—that is, a differentiation of scale being observed from individually applied techniques, through modalities (therapies), to whole medical systemsRecognition of CAM as part of the general field of health care Methods: Development of the Integrated Taxonomy of Health Care (ITHC) involved three stages: Development of a precise, uniform health glossaryAnalysis of the extant taxonomiesUse of an iterative process of classifying modalities and medical systems into categories until a failure to singularly classify a modality occurred, requiring a return to the glossary and adjustment of the classifying protocol Results: A full vertical taxonomy was developed that includes and clearly differentiates between techniques, modalities, domains (clusters of similar modalities), systems of health care (coordinated care system involving multiple modalities), and integrative health care. Domains are the classical primary focus of taxonomies. The ITHC has eleven domains: chemical/substance-based work, device-based work, soft tissue–focused manipulation, skeletal manipulation, fitness/movement instruction, mind–body integration/classical somatics work, mental/emotional–based work, bio-energy work based on physical manipulation, bio-energy modulation, spiritual-based work, unique assessments. Modalities are assigned to the domains based on the primary mode of interaction with the client, according the literature of the practitioners. Conclusions: The ITHC has several strengths: little interpretation is used while successfully assigning modalities to single domains; the issue of taxonomic verticality is fully resolved; and the design fully integrates the complementary health care fields of biomedicine and CAM. PMID:21589735

US Spending On Complementary And Alternative Medicine During 2002–08 Plateaued, Suggesting Role In Reformed Health System

PubMed Central

Davis, Matthew A.; Martin, Brook I.; Coulter, Ian D.; Weeks, William B.

2013-01-01

Complementary and alternative medicine services in the United States are an approximately $9 billion market each year, equal to 3 percent of national ambulatory health care expenditures. Unlike conventional allopathic health care, complementary and alternative medicine is primarily paid for out of pocket, although some services are covered by most health insurance. Examining trends in demand for complementary and alternative medicine services in the United States reported in the Medical Expenditure Panel Survey during 2002–08, we found that use of and spending on these services, previously on the rise, have largely plateaued. The higher proportion of out-of-pocket responsibility for payment for services may explain the lack of growth. Our findings suggest that any attempt to reduce national health care spending by eliminating coverage for complementary and alternative medicine would have little impact at best. Should some forms of complementary and alternative medicine—for example, chiropractic care for back pain—be proven more efficient than allopathic and specialty medicine, the inclusion of complementary and alternative medicine providers in new delivery systems such as accountable care organizations could help slow growth in national health care spending. PMID:23297270

Dissemination and implementation of an educational tool for veterans on complementary and alternative medicine: a case study.

PubMed

Held, Rachel Forster; Santos, Susan; Marki, Michelle; Helmer, Drew

2016-09-02

We developed and disseminated an educational DVD to introduce U.S. Veterans to independently-practiced complementary and alternative medicine (CAM) techniques and encourage CAM experimentation. The project's goal was to determine optimal dissemination methods to facilitate implementation within the Veteran's Health Administration. In the first phase, the DVD was disseminated using four methods: passive, provider-mediated, active, and peer-mediated. In the second, implementation phase, "champion" providers who supported CAM integrated dissemination into clinical practice. Qualitative data came from Veteran focus groups and semi-structured provider interviews. Data from both phases was triangulated to identify common themes. Effective dissemination requires engaging patients. Providers who most successfully integrated the DVD into practice already had CAM knowledge, and worked in settings where CAM was accepted clinical practice, or with leadership or infrastructure that supported a culture of CAM use. Institutional buy-in allowed for provider networking and effective implementation of the tool. Providers were given autonomy to determine the most appropriate dissemination strategies, which increased enthusiasm and use. Many of the lessons learned from this project can be applied to dissemination of any new educational tool within a healthcare setting. Results reiterate the importance of utilizing best practices for introducing educational tools within the healthcare context and the need for thoughtful, multi-faceted dissemination strategies.

Complete coverage and covering completely: Breast feeding and complementary feeding: Knowledge, attitude, and practices of mothers.

PubMed

Jain, Sunil; Thapar, R K; Gupta, R K

2018-01-01

Knowing current trends for timely comprehensive action for health promotion practices is an important prerequisite for medical practitioners and policy makers. A survey of mothers at a Tertiary Care Hospital in central India. On the knowledge front >83.75% of the mothers studied showed good knowledge about breastfeeding and complementary feeding. Similar, but not as encouraging, were the results about attitude, with 76.25% of mothers having a positive attitude. The results of the practices part were varied. The WHO indicators assessed were 'early initiation of breastfeeding' (68.75%), 'exclusive breastfeeding under 6 months' (85%) (however exclusive breast feeding for first 6 months was carried out by only 36.25%), 'introduction of solid, semi-solid or soft foods' (48.75%), 'continued breastfeeding at 1 year' (63.75%) and 'continued breastfeeding at 2 years' (6.25%). There is a discrepancy between knowledge and practices. The exclusive breast feeding rates are far from the ideal and there is a decline of continued breast feeding beyond 15 months. This calls for sustained efforts with the aim - 'cover all and cover completely'. The ideal WHO indicator for exclusive breast feeding should be 'exclusive breastfeeding for first 6 months' which will provide information about the completeness of this ideal practice.

Predictors of College Students' Use of Complementary and Alternative Medicine

ERIC Educational Resources Information Center

Chng, Chwee Lye; Neill, Kweethai; Fogle, Peggy

2003-01-01

This study assessed the use of complementary and alternative medicine among college students (N=913), the relationships between health locus of control with use of complementary and alternative medicine, and health local of control with attitudes toward complementary and alternative medicine and what predicts their use. A majority (66%, n-913) of…

Education and the improvement of clinical ethics services

PubMed Central

2013-01-01

The proliferation of clinical ethics in health care institutions around the world has raised the question about the qualifications of those who serve on ethics committees and ethics consultation services. This paper discusses some of weaknesses associated with the most common educational responses to this concern and proposes a complementary approach. Since the majority of those involved in clinical ethics are practicing health professionals, the question of qualification is especially challenging as the role of ethics committees and, increasingly, ethics consultation services are becoming increasingly important to the functioning of health care institutions. Since the challenging nature of health care finances often leads institutions to rely on voluntary participation of committed health professional with only token administrative or clerical support to provide the needed ethics services, significant challenges are created for attaining competence and functional effectiveness. The article suggests that a complementary approach should be adopted for sustaining and building capacity in clinical ethics. Ethics committees and consultation services should systematically adopt quality improvement techniques to effect designed changes in clinical ethics performance and to build ethical capacity within targeted clinical units and services. Demonstrating improvements in functioning can go a long way to build confidence and capacity for clinical ethics and can help in justifying the need for support. To do so, however, requires that ethics committees and consultation services first shift attention to those areas that demonstrate weak or questionable ethical performance, including the established practices of the ethics committee and consultation service, and second seek collaboration with the involved health care providers to pursue demonstrable change. Such an approach has a much better chance of improving the capacity for clinical ethics in health care institutions than relying on educational approaches alone. PMID:23517735

Identifying priorities to improve maternal and child nutrition among the Khmu ethnic group, Laos: a formative study

PubMed Central

de Sa, Joia; Bouttasing, Namthipkesone; Sampson, Louise; Perks, Carol; Osrin, David; Prost, Audrey

2013-01-01

Chronic malnutrition in children remains highly prevalent in Laos, particularly among ethnic minority groups. There is limited knowledge of specific nutrition practices among these groups. We explored nutritional status, cultural beliefs and practices of Laos' Khmu ethnic group to inform interventions for undernutrition as part of a Primary Health Care (PHC) project. Mixed methods were used. For background, we disaggregated anthropometric and behavioural indicators from Laos' Multiple Indicator Cluster Survey. We then conducted eight focus group discussions and 33 semi-structured interviews with Khmu villagers and health care workers, exploring beliefs and practices related to nutrition. The setting was two rural districts in Luang Prabang province, in one of which the PHC project had been established for 3 years. There was a higher prevalence of stunting in the Khmu than in other groups. Disaggregation showed nutrition behaviours were associated with ethnicity, including exclusive breastfeeding. Villagers described strong adherence to post-partum food restrictions for women, while little change was described in intake during pregnancy. Most children were breastfed, although early introduction of pre-lacteal foods was noted in the non-PHC district. There was widespread variation in introduction and diversity of complementary foods. Guidance came predominantly from the community, with some input from health care workers. Interventions to address undernutrition in Khmu communities should deliver clear, consistent messages on optimum nutrition behaviours. Emphasis should be placed on dietary diversity for pregnant and post-partum mothers, encouraging exclusive breastfeeding and timely, appropriate complementary feeding. The impact of wider governmental policies on food security needs to be further assessed. PMID:22515273

Development and utilization of complementary communication channels for treatment decision making and survivorship issues among cancer patients: The CIS Research Consortium Experience.

PubMed

Fleisher, Linda; Wen, Kuang Yi; Miller, Suzanne M; Diefenbach, Michael; Stanton, Annette L; Ropka, Mary; Morra, Marion; Raich, Peter C

2015-11-01

Cancer patients and survivors are assuming active roles in decision-making and digital patient support tools are widely used to facilitate patient engagement. As part of Cancer Information Service Research Consortium's randomized controlled trials focused on the efficacy of eHealth interventions to promote informed treatment decision-making for newly diagnosed prostate and breast cancer patients, and post-treatment breast cancer, we conducted a rigorous process evaluation to examine the actual use of and perceived benefits of two complementary communication channels -- print and eHealth interventions. The three Virtual Cancer Information Service (V-CIS) interventions were developed through a rigorous developmental process, guided by self-regulatory theory, informed decision-making frameworks, and health communications best practices. Control arm participants received NCI print materials; experimental arm participants received the additional V-CIS patient support tool. Actual usage data from the web-based V-CIS was also obtained and reported. Print materials were highly used by all groups. About 60% of the experimental group reported using the V-CIS. Those who did use the V-CIS rated it highly on improvements in knowledge, patient-provider communication and decision-making. The findings show that how patients actually use eHealth interventions either singularly or within the context of other communication channels is complex. Integrating rigorous best practices and theoretical foundations is essential and multiple communication approaches should be considered to support patient preferences.

[Legislation and inspection for the health and safety of workers. Efficacy and limits].

PubMed

Tozzi, G A

2009-01-01

To provide information regarding Occupational Health and Safety (OHS) Inspections in Europe. The dynamics that are transforming regulatory subsystems and complementary inspection services are described. Simplification initiatives, the limits and difficulties of applying the different models of Health and Safety Management Systems are discussed. Examples are given on how to evaluate legislation and technical standards during planning and enforcement. Different approaches for studying characteristics, methodologies and efficacy in practice of OHS Inspection are provided. Targeted inspections need to respond to the needs of enterprises and workers. Impartiality must be guaranteed and workers' participation should be facilitated.

Animal Health and Welfare Issues Facing Organic Production Systems.

PubMed

Sutherland, Mhairi A; Webster, Jim; Sutherland, Ian

2013-10-31

The demand for organically-grown produce is increasing worldwide, with one of the drivers being an expectation among consumers that animals have been farmed to a high standard of animal welfare. This review evaluates whether this expectation is in fact being met, by describing the current level of science-based knowledge of animal health and welfare in organic systems. The primary welfare risk in organic production systems appears to be related to animal health. Organic farms use a combination of management practices, alternative and complementary remedies and convenional medicines to manage the health of their animals and in many cases these are at least as effective as management practices employed by non-organic producers. However, in contrast to non-organic systems, there is still a lack of scientifically evaluated, organically acceptable therapeutic treatments that organic animal producers can use when current management practices are not sufficient to maintain the health of their animals. The development of such treatments are necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare.

Use of complementary and alternative medicine by patients with hematological diseases experience at a university hospital in northeast Mexico.

PubMed

Jaime-Pérez, José Carlos; Chapa-Rodríguez, Adrián; Rodríguez-Martínez, Marisol; Colunga-Pedraza, Perla Rocío; Marfil-Rivera, Luis Javier; Gómez-Almaguer, David

2012-01-01

Complementary and alternative medicine includes a diverse group of medical and healthcare systems, practices and products not considered part of conventional medicine. Although there is information on unconventional practices in oncological diseases, specific data regarding the use of complementary and alternative medicine by hematology patients is scarce. The aim of this study is to document the prevalence of this modality of unconventional therapy in patients with malignant and benign hematological diseases, particularly children with acute lymphoblastic leukemia. An observational study of adult patients and guardians of children with malignant or benign hematological diseases was carried out by applying a structured questionnaire detailing the use and results of the most prevalent complementary and alternative medicine practices. One hundred and twenty patients were included; 104 had malignant and 16 had benign hematological diseases. The use of complementary and alternative medicine was greater in benign diseases but the difference was not statistically significant (64.7% versus 41.7%; p-value = 0.08). Patients and guardians with high school or college educations used these alternative practices more than patients with less schooling (60.7% versus 54.7%; p-value = 0.032). The use of folk remedies was most prevalent followed by herbal preparations and spiritual healing. Sixty-four percent of patients that used these unconventional practices reported improvement in their symptoms and increased capacity to perform daily activities. No significant difference was documented between patients with malignant or benign hematological diseases using these alternative practices. The majority of complementary and alternative medicine users reported improvement of the disease or chemotherapy-related symptoms.

Health Care Utilization Among Complementary and Alternative Medicine Users in a Large Military Cohort

DTIC Science & Technology

2011-01-01

Sources In addition to our longitudinal survey instrument , other data sources include the Standard Inpatient Data Record (SIDR), which is an...therapy, high-dose megavita- min therapy, homeopathic remedies, hypnosis , massage therapy, relaxation, and spiritual healing. For the pur- poses of these...analyses, acupuncture, biofeedback, chiro- practic care, energy healing, folk medicine, hypnosis , and massage therapy were grouped together as practi

Oncologists' and naturopaths' nutrition beliefs and practices.

PubMed

Novak, K L; Chapman, G E

2001-01-01

Despite the widespread use of complementary and alternative therapies by persons with cancer, little is known about how the understandings of complementary and alternative practitioners of these therapies compare with those of conventional physicians. The broad purpose of this research was, thus, to explore the beliefs of physicians and complementary and alternative health practitioners, their use of scientific and other types of evidence, and their counseling practices. The specific issue addressed was the beliefs and practices of oncologists and naturopaths regarding the role of diet in breast cancer prevention and treatment. A qualitative research design was used, involving in-depth semistructured interviews with 10 oncologists and 11 naturopaths. Interviews were tape-recorded, transcribed verbatim, and analyzed using qualitative methods. The oncologists believed that there is little evidence of a role for diet in breast cancer prevention and treatment, citing the lack of evidence from randomized controlled trials. They reported that they provide only general advice on healthy eating to patients. The naturopaths believed that diet is strongly implicated in breast cancer development, prevention, and treatment. They justified this belief by using scientific evidence from a variety of types of studies, logic or common sense, and their clinical experiences. Naturopaths reported that they provide patients with specific suggestions for foods to avoid or to emphasize in diets. The differences in the advice provided by oncologists and naturopaths are associated with different decision-making or knowledge construction systems. Educating patients about these differences will help patients to make more informed healthcare choices.

Health-care sector and complementary medicine: practitioners' experiences of delivering acupuncture in the public and private sectors.

PubMed

Bishop, Felicity L; Amos, Nicola; Yu, He; Lewith, George T

2012-07-01

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 other complementary therapies in addition to acupuncture. Future studies should examine the impact of these differences on patients' clinical outcomes.

Timing and Determinants of the Introduction of Complementary Foods in Kuwait: Results of a Prospective Cohort Study.

PubMed

Scott, Jane A; Dashti, Manal; Al-Sughayer, Mona; Edwards, Christine A

2015-08-01

The early introduction of complementary foods is common in Middle Eastern countries but little is known about the determinants of this practice in this region. This prospective cohort study conducted from October 2007 to October 2008 investigated the determinants of the very early (before 17 weeks) introduction of complementary foods in Kuwait and compared rates of this practice against rates reported in the mid-1990s. A total of 373 women were recruited from maternity hospitals in Kuwait City and followed to 26 weeks postpartum. Data on complementary feeding practices were available from 303 women. Multivariate logistic regression was used to estimate the association of very early introduction of complementary foods with infant sex and maternal characteristics including age, years of education, employment intentions at 6 months postpartum, parity, prepregnancy body mass index, and prepregnancy smoking status. All infants had received complementary foods by 26 weeks of age, with 30.4% receiving complementary foods before 17 weeks of age. Women born in other Arabic countries were less likely to introduce complementary foods before 17 weeks (adjusted odds ratio [adj OR] = 0.40; 95% confidence interval [CI], 0.22-0.73) than women born in Kuwait. Women who were exclusively formula feeding at 6 weeks postpartum were less likely to introduce complementary foods before 17 weeks (adj OR = 0.40; 95% CI, 0.23-0.71) than women who were still breastfeeding. Compared to the mid-1990s, fewer infants in Kuwait were receiving complementary foods before 17 weeks. Nevertheless, all infants had received complementary foods by 6 months of age. © The Author(s) 2015.

Integrating human health into environmental impact assessment: an unrealized opportunity for environmental health and justice.

PubMed

Bhatia, Rajiv; Wernham, Aaron

2008-08-01

The National Environmental Policy Act and related state laws require many public agencies to analyze and disclose potentially significant environmental effects of agency actions, including effects on human health. In this paper we review the purpose and procedures of environmental impact assessment (EIA), existing regulatory requirements for health effects analysis, and potential barriers to and opportunities for improving integration of human health concerns within the EIA process. We use statutes, regulations, guidelines, court opinions, and empirical research on EIA along with recent case examples of integrated health impact assessment (HIA)/EIA at both the state and federal level. We extract lessons and recommendations for integrated HIA/EIA practice from both existing practices as well as case studies. The case studies demonstrate the adequacy, scope, and power of existing statutory requirements for health analysis within EIA. The following support the success of integrated HIA/EIA: a proponent recognizing EIA as an available regulatory strategy for public health; the openness of the agency conducting the EIA; involvement of public health institutions; and complementary objectives among community stakeholders and health practitioners. We recommend greater collaboration among institutions responsible for EIA, public health institutions, and affected stakeholders along with guidance, resources, and training for integrated HIA/EIA practice.

Integrating Human Health into Environmental Impact Assessment: An Unrealized Opportunity for Environmental Health and Justice

PubMed Central

Bhatia, Rajiv; Wernham, Aaron

2008-01-01

Objectives The National Environmental Policy Act and related state laws require many public agencies to analyze and disclose potentially significant environmental effects of agency actions, including effects on human health. In this paper we review the purpose and procedures of environmental impact assessment (EIA), existing regulatory requirements for health effects analysis, and potential barriers to and opportunities for improving integration of human health concerns within the EIA process. Data sources We use statutes, regulations, guidelines, court opinions, and empirical research on EIA along with recent case examples of integrated health impact assessment (HIA)/EIA at both the state and federal level. Data synthesis We extract lessons and recommendations for integrated HIA/EIA practice from both existing practices as well as case studies. Conclusions The case studies demonstrate the adequacy, scope, and power of existing statutory requirements for health analysis within EIA. The following support the success of integrated HIA/EIA: a proponent recognizing EIA as an available regulatory strategy for public health; the openness of the agency conducting the EIA; involvement of public health institutions; and complementary objectives among community stakeholders and health practitioners. We recommend greater collaboration among institutions responsible for EIA, public health institutions, and affected stakeholders along with guidance, resources, and training for integrated HIA/EIA practice. PMID:18709140

Managing Safety and Operations: The Effect of Joint Management System Practices on Safety and Operational Outcomes.

PubMed

Tompa, Emile; Robson, Lynda; Sarnocinska-Hart, Anna; Klassen, Robert; Shevchenko, Anton; Sharma, Sharvani; Hogg-Johnson, Sheilah; Amick, Benjamin C; Johnston, David A; Veltri, Anthony; Pagell, Mark

2016-03-01

The aim of this study was to determine whether management system practices directed at both occupational health and safety (OHS) and operations (joint management system [JMS] practices) result in better outcomes in both areas than in alternative practices. Separate regressions were estimated for OHS and operational outcomes using data from a survey along with administrative records on injuries and illnesses. Organizations with JMS practices had better operational and safety outcomes than organizations without these practices. They had similar OHS outcomes as those with operations-weak practices, and in some cases, better outcomes than organizations with safety-weak practices. They had similar operational outcomes as those with safety-weak practices, and better outcomes than those with operations-weak practices. Safety and operations appear complementary in organizations with JMS practices in that there is no penalty for either safety or operational outcomes.

Praying until Death: Apostolicism, Delays and Maternal Mortality in Zimbabwe

PubMed Central

2016-01-01

Religion affects people’s daily lives by solving social problems, although it creates others. Female sexual and reproductive health are among the issues most affected by religion. Apostolic sect members in Zimbabwe have been associated with higher maternal mortality. We explored apostolic beliefs and practices on maternal health using 15 key informant interviews in 5 purposively selected districts of Zimbabwe. Results show that apostolicism promotes high fertility, early marriage, non-use of contraceptives and low or non-use of hospital care. It causes delays in recognizing danger signs, deciding to seek care, reaching and receiving appropriate health care. The existence of a customized spiritual maternal health system demonstrates a huge desire for positive maternal health outcomes among apostolics. We conclude that apostolic beliefs and practices exacerbate delays between onset of maternal complications and receiving help, thus increasing maternal risk. We recommend complementary and adaptive approaches that address the maternal health needs of apostolics in a religiously sensitive manner. PMID:27509018

Methodological Issues in Trials of Complementary and Alternative Medicine Interventions

PubMed Central

Sikorskii, Alla; Wyatt, Gwen; Victorson, David; Faulkner, Gwen; Rahbar, Mohammad Hossein

2010-01-01

Background Complementary and alternative medicine (CAM) use is widespread among cancer patients. Information on safety and efficacy of CAM therapies is needed for both patients and health care providers. Well-designed randomized clinical trials (RCTs) of CAM therapy interventions can inform both clinical research and practice. Objectives To review important issues that affect the design of RCTs for CAM interventions. Methods Using the methods component of the Consolidated Standards for Reporting Trials (CONSORT) as a guiding framework, and a National Cancer Institute-funded reflexology study as an exemplar, methodological issues related to participants, intervention, objectives, outcomes, sample size, randomization, blinding, and statistical methods were reviewed. Discussion Trials of CAM interventions designed and implemented according to appropriate methodological standards will facilitate the needed scientific rigor in CAM research. Interventions in CAM can be tested using proposed methodology, and the results of testing will inform nursing practice in providing safe and effective supportive care and improving the well-being of patients. PMID:19918155

The Vanguard Faculty program: research training for complementary and alternative medicine faculty.

PubMed

Connelly, Erin N; Elmer, Patricia J; Morris, Cynthia D; Zwickey, Heather

2010-10-01

The increasing use of complementary and alternative medicine (CAM) treatment is paralleled by a growing demand for an evidence-based approach to CAM practice. In 2007, the Helfgott Research Institute at the National College of Natural Medicine (NCNM), in partnership with Oregon Health & Science University (OHSU), both in Portland, OR, began a National Institutes of Health-funded initiative to increase the quality and quantity of evidence-based medicine (EBM) content in the curricula at NCNM. One key strategy of the Research in Complementary and Alternative Medicine Program (R-CAMP) initiative was to create a faculty development program that included four components: intensive training in EBM; professional skills enhancement; peer and mentored support; and, ultimately, utilization of these skills to incorporate EBM into the curricula. This initiative is centered on a core group of faculty at NCNM, called the Vanguard Faculty, who receives early, intensive training in EBM and works to incorporate this training into classes. Training consists of an intensive, week-long course, monthly group meetings, and periodic individualized meetings. Vanguard Faculty members also receive mentorship and access to resources to pursue individualized faculty development, research or scholarly activities. Early evaluations indicate that this effort has been successful in increasing EBM content in the curricula at NCNM. This article describes the Vanguard Faculty program in an effort to share the successes and challenges of implementing a wide-ranging faculty development and curricular initiative at a complementary and alternative medicine institution.

Current Understandings of the Research-Practice Gap From the Viewpoint of Complementary Medicine Academics: A Mixed-Method Investigation.

PubMed

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.

Effectiveness of Baby Friendly Community Initiative (BFCI) on complementary feeding in Koibatek, Kenya: a randomized control study.

PubMed

Maingi, Mildred; Kimiywe, Judith; Iron-Segev, Sharon

2018-05-08

Appropriate infant and young child nutrition is critical for proper growth and development. In order to promote optimal nutrition at an early age, the World Health Organization (WHO) and UNICEF have developed the Baby Friendly Hospital Initiative (BFHI) to address poor breastfeeding practices in maternity wards. However, impact is limited in less developed countries like Kenya, where more than half of all births are home deliveries. Therefore, Kenya has explored the adoption of Baby Friendly Community Initiative (BFCI) in its rural settings. In contrast to the BFHI, the BFCI supports breastfeeding and optimal infant feeding in community. BFCI has been implemented in Koibatek, in rural Kenya. This study aimed at assessing the effectiveness of BFCI on complementary feeding practices of children aged 6-23 months, by comparing intervention and control groups. This was a randomized control study design that included 270 mother-infant pairs enrolled in the Baby Friendly Community Initiative (BFCI) project in Koibatek. Evaluation was carried out using structured questionnaires. A statistically significantly higher proportion of children in the intervention group compared to the control group attained minimum dietary diversity (77% vs. 58%; p = 0.001), minimum meal frequency (96% vs. 89%; p = 0.046) and minimum acceptable diet (77% vs. 61%; p = 0.005). The odds of attaining minimum dietary diversity, minimum meal frequency and minimum acceptable diet were statistically significantly higher for the intervention group compared to control group (OR: 4.95; 95%CI 2.44-10.03, p = < 0.001; OR: 14.84; 95%CI 2.75-79.9, p = 0.002; OR: 4.61; 95%CI 2.17-9.78, p = < 0.001 respectively). The BFCI intervention was successful in improving complementary feeding practices. Strengthening and prioritizing BFCI interventions could have a significant impact on child health outcomes in rural Kenya. ISRCTN03467700 . Registration 24 September 2014. Retrospectively registered.

Military Report More Complementary and Alternative Medicine Use than Civilians

PubMed Central

Marriott, Bernadette P.; Finch, Michael D.; Bray, Robert M.; Williams, Thomas V.; Hourani, Laurel L.; Hadden, Louise S.; Colleran, Heather L.; Jonas, Wayne B.

2013-01-01

Abstract Objectives The study objective was to estimate complementary and alternative medicine (CAM) use among active duty military and compare data with civilian use. Design A global survey on CAM use in the 12 previous months was conducted. Final participants (16,146) were stratified by gender, service, region, and pay grade. Analysis included prevalence of CAM use, demographic and lifestyle characteristics. Results Approximately 45% of respondents reported using at least one type of CAM therapy. Most commonly used therapies were as follows: prayer for one's own health (24.4%), massage therapy (14.1%), and relaxation techniques (10.8%). After exclusion of prayer for one's own health, adjusting to the 2000 U.S. census, overall CAM use in the military (44.5%) was higher than that in comparable civilian surveys (36.0% and 38.3%). Conclusions Military personnel reported using three CAM stress-reduction therapies at 2.5–7 times the rate of civilians. Among the military, high utilization of CAM practices that reduce stress may serve as markers for practitioners assessing an individual's health and well-being. PMID:23323682

Being global in public health practice and research: complementary competencies are needed.

PubMed

Cole, Donald C; Davison, Colleen; Hanson, Lori; Jackson, Suzanne F; Page, Ashley; Lencuch, Raphael; Kakuma, Ritz

2011-01-01

Different sets of competencies in public health, global health and research have recently emerged, including the Core Competencies for Public Health in Canada (CCPHC). Within this context, we believe it is important to articulate competencies for globalhealth practitioners-educators and researchers that are in addition to those outlined in the CCPHC. In global health, we require knowledge and skills regarding: north-south power dynamics, linkages between local and global health problems, and the roles of international organizations. We must be able to work responsibly in low-resource settings, foster self-determination in a world rife with power differentials, and engage in dialogue with stakeholders globally. Skills in cross-cultural communication and the ability to critically self-reflect on one's own social location within the global context are essential. Those in global health must be committed to improving health equity through global systems changes and be willing to be mentored and to mentor others across borders. We call for dialogue on these competencies and for development of ways to assess both their demonstration in academic settings and their performance in global health practice and research.

Complementary feeding: a commentary by the ESPGHAN Committee on Nutrition.

PubMed

Agostoni, Carlo; Decsi, Tamas; Fewtrell, Mary; Goulet, Olivier; Kolacek, Sanja; Koletzko, Berthold; Michaelsen, Kim Fleischer; Moreno, Luis; Puntis, John; Rigo, Jacques; Shamir, Raanan; Szajewska, Hania; Turck, Dominique; van Goudoever, Johannes

2008-01-01

This position paper on complementary feeding summarizes evidence for health effects of complementary foods. It focuses on healthy infants in Europe. After reviewing current knowledge and practices, we have formulated these conclusions: Exclusive or full breast-feeding for about 6 months is a desirable goal. Complementary feeding (ie, solid foods and liquids other than breast milk or infant formula and follow-on formula) should not be introduced before 17 weeks and not later than 26 weeks. There is no convincing scientific evidence that avoidance or delayed introduction of potentially allergenic foods, such as fish and eggs, reduces allergies, either in infants considered at increased risk for the development of allergy or in those not considered to be at increased risk. During the complementary feeding period, >90% of the iron requirements of a breast-fed infant must be met by complementary foods, which should provide sufficient bioavailable iron. Cow's milk is a poor source of iron and should not be used as the main drink before 12 months, although small volumes may be added to complementary foods. It is prudent to avoid both early (<4 months) and late (>or=7 months) introduction of gluten, and to introduce gluten gradually while the infant is still breast-fed, inasmuch as this may reduce the risk of celiac disease, type 1 diabetes mellitus, and wheat allergy. Infants and young children receiving a vegetarian diet should receive a sufficient amount ( approximately 500 mL) of breast milk or formula and dairy products. Infants and young children should not be fed a vegan diet.

Use of complementary and alternative medicine by patients with hematological diseases experience at a university hospital in northeast Mexico

PubMed Central

Jaime-Pérez, José Carlos; Chapa-Rodríguez, Adrián; Rodríguez-Martínez, Marisol; Colunga-Pedraza, Perla Rocío; Marfil-Rivera, Luis Javier; Gómez-Almaguer, David

2012-01-01

Background Complementary and alternative medicine includes a diverse group of medical and healthcare systems, practices and products not considered part of conventional medicine. Although there is information on unconventional practices in oncological diseases, specific data regarding the use of complementary and alternative medicine by hematology patients is scarce. Objective The aim of this study is to document the prevalence of this modality of unconventional therapy in patients with malignant and benign hematological diseases, particularly children with acute lymphoblastic leukemia. Methods An observational study of adult patients and guardians of children with malignant or benign hematological diseases was carried out by applying a structured questionnaire detailing the use and results of the most prevalent complementary and alternative medicine practices. Results One hundred and twenty patients were included; 104 had malignant and 16 had benign hematological diseases. The use of complementary and alternative medicine was greater in benign diseases but the difference was not statistically significant (64.7% versus 41.7%; p-value = 0.08). Patients and guardians with high school or college educations used these alternative practices more than patients with less schooling (60.7% versus 54.7%; p-value = 0.032). The use of folk remedies was most prevalent followed by herbal preparations and spiritual healing. Sixty-four percent of patients that used these unconventional practices reported improvement in their symptoms and increased capacity to perform daily activities. Conclusion No significant difference was documented between patients with malignant or benign hematological diseases using these alternative practices. The majority of complementary and alternative medicine users reported improvement of the disease or chemotherapy-related symptoms. PMID:23049401

Improving Nutritional Health of the Public through Social Change: Finding Our Roles in Collective Action.

PubMed

Raine, Kim D

2014-09-01

Improving the nutritional health of the public continues to be a major challenge. Our mission of advancing health through food and nutrition has become increasingly complex, particularly as food environments shape the availability, affordability, and social acceptability of food and nutrition "choices". Promoting nutritional health requires that dietitians expand our knowledge in understanding the determinants of healthy eating and of social change strategies that advocates for and acts on improving food environments. While no single strategy can solve the challenges of public health nutrition, we can each identify unique strengths and opportunities. If we practice in complementary ways, using those strengths for collective action will make us stronger together toward social change supporting improved nutritional health of the public.

Israeli nurses' attitudes to the holistic approach to health and their use of complementary and alternative therapies.

PubMed

Orkaby, Brurya; Greenberger, Chaya

2015-03-01

To examine nurses' attitudes to holistic and biomedical approaches to health care and the correlation between the two and to explore the extent of recommending and using complementary and alternative medicine (CAM) by nurses and its correlation with attitudes toward the holistic approach to care. In this cross-sectional correlational study, a structured questionnaire was completed anonymously by 213 Israeli hospital-based nurses from various departments. Nurses perceived both approaches as critical to optimal health care: a positive correlation emerged of attitudes to the two approaches. Nurses recommended and used CAM extensively; most therapies were recommended and/or used by 70% or more of the respondents. Nurses with more positive attitudes toward holistic care tended to recommend and use CAM to a greater extent. Biomedical and holistic approaches are perceived by nurses to coexist within nursing professional boundaries and form a broad basis for optimal health care. Nurses' attitudes to the holistic approach appear to promote recommendation and/or use of CAM in practice. More training in CAM should be offered in nursing educational frameworks and research should continue to establish evidence for CAM's effectiveness. © The Author(s) 2014.

Diarrhoea and Suboptimal Feeding Practices in Nigeria: Evidence from the National Household Surveys.

PubMed

Ogbo, Felix A; Page, Andrew; Idoko, John; Claudio, Fernanda; Agho, Kingsley E

2016-07-01

Globally, Nigeria has the largest burden of infectious diseases (including diarrhoea). Optimal feeding practices have been well-documented to protect against diarrhoea in other contexts; but this benefit has not been broadly studied in Nigeria. The study aimed to examine the association between diarrhoea and childhood feeding practices to provide country-specific evidence. Data from the Nigeria Demographic and Health Survey for the period spanning 1999-2013 were used. Prevalence of diarrhoea by infant and young child feeding indicators was estimated, and the association between diarrhoea and childhood feeding indicators was examined using multilevel regression analyses. Prevalence of diarrhoea was higher among children whose mothers did not initiate breast feeding within the first hour of birth, infants who were not exclusively breastfed, and infants who were prematurely introduced to complementary foods. Early initiation of breast feeding was significantly associated with lower risk of diarrhoea (RR 0.68, 95% confidence interval (CI) 0.63, 0.74). Exclusively breastfed infants were less likely to develop diarrhoea compared to non-exclusively breastfed infants (RR 0.61, 95% CI 0.44, 0.86). Predominant breast feeding was significantly associated with a lower risk of diarrhoea (RR 0.66, 95% CI 0.54, 0.80). Bottle feeding and introduction of complementary foods were associated with a higher risk of diarrhoea. Early initiation of breast feeding as well as exclusive and predominant breast feeding protect against diarrhoea in Nigeria, while bottle feeding and introduction of complementary foods were risk factors for diarrhoea. Community- and facility-based initiatives are needed to improve feeding practices, and to reduce diarrhoea prevalence in Nigeria. © 2016 John Wiley & Sons Ltd.

[Aromatherapy and nursing: historical and theoretical conception].

PubMed

Gnatta, Juliana Rizzo; Kurebayashi, Leonice Fumiko Sato; Turrini, Ruth Natalia Teresa; Silva, Maria Júlia Paes da

2016-02-01

Aromatherapy is a Practical or Complementary Health Therapy that uses volatile concentrates extracted from plants called essential oils, in order to improve physical, mental and emotional well-being. Aromatherapy has been practiced historically and worldwide by nurses and, as in Brazil is supported by the Federal Nursing Council, it is relevant to discuss this practice in the context of Nursing through Theories of Nursing. This study of theoretical reflection, exploratory and descriptive, aims to discuss the pharmacognosy of essential oils, the historical trajectory of Aromatherapy in Nursing and the conceptions to support Aromatherapy in light of eight Nursing Theorists (Florence Nightingale, Myra Levine, Hildegard Peplau, Martha Rogers, Callista Roy, Wanda Horta, Jean Watson and Katharine Kolcaba), contributing to its inclusion as a nursing care practice.

Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers.

PubMed

Singer, Judy; Adams, Jon

2014-05-22

Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women's health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person within a health promotion model and focus on the relevance of diet and lifestyle factors as central to a CAM approach. From the perspectives of the health service managers, these findings contribute to our understanding around the rationale to include CAM within mainstream health services that deal with psychological trauma and chronic disease. The broader implications of this study can help assist in the development of health service policy on CAM integration in mainstream healthcare services.

A Configurational Approach to the Relationship between High-Performance Work Practices and Frontline Health Care Worker Outcomes

PubMed Central

Chuang, Emmeline; Dill, Janette; Morgan, Jennifer Craft; Konrad, Thomas R

2012-01-01

Objective To identify high-performance work practices (HPWP) associated with high frontline health care worker (FLW) job satisfaction and perceived quality of care. Methods Cross-sectional survey data from 661 FLWs in 13 large health care employers were collected between 2007 and 2008 and analyzed using both regression and fuzzy-set qualitative comparative analysis. Principal Findings Supervisor support and team-based work practices were identified as necessary for high job satisfaction and high quality of care but not sufficient to achieve these outcomes unless implemented in tandem with other HPWP. Several configurations of HPWP were associated with either high job satisfaction or high quality of care. However, only one configuration of HPWP was sufficient for both: the combination of supervisor support, performance-based incentives, team-based work, and flexible work. These findings were consistent even after controlling for FLW demographics and employer type. Additional research is needed to clarify whether HPWP have differential effects on quality of care in direct care versus administrative workers. Conclusions High-performance work practices that integrate FLWs in health care teams and provide FLWs with opportunities for participative decision making can positively influence job satisfaction and perceived quality of care, but only when implemented as bundles of complementary policies and practices. PMID:22224858

Integrative medicine in hematology/oncology: benefits, ethical considerations, and controversies.

PubMed

Rosenthal, David S; Dean-Clower, Elizabeth

2005-01-01

Integrative Medicine (IM), a newly emerging field, has evolved from Complementary and Alternative Medicine (CAM). CAM refers to diverse medical and health care systems, practices, and products that are not presently considered part of conventional medicine and generally have limited scientific evidence. In the US, CAM is a multi-billion dollar, unregulated industry with potential benefits and risks to consumers, including cancer patients, who are high utilizers of complementary therapies. Patients' CAM use often is unsupervised by physicians, yet patients need the advice and guidance of their hematologists/oncologists as part of total cancer care. Ethical and legal issues physicians need to address include inquiring about and educating patients regarding potential interactions (e.g., drug-herb, radiation-antioxidant) or product contaminants, while discussing other therapies that may alleviate symptoms and/or improve quality of life. Administratively, CAM offerings in medical settings require relevant policies and procedures, such as properly credentialing practitioners and providing financial assistance counseling for those who cannot afford fee-for-service. Unlike "Alternative Medicine," the goal of IM is to combine mainstream medical therapies and CAM therapies (e.g., acupuncture, meditation, music therapy) that have some high-quality scientific evidence of safety and effectiveness. The Society for Integrative Oncology (SIO), a new international organization of oncology professionals studying and integrating effective complementary therapies in cancer care, serves as a forum for presenting scientific data on these therapies while emphasizing the importance of developing infrastructure that promotes IM principles and practices. The ultimate goal is to develop multidisciplinary expertise and therapeutic synergy between conventional and complementary therapies.

Nutrition education and introduction of broad bean-based complementary food improves knowledge and dietary practices of caregivers and nutritional status of their young children in Hula, Ethiopia.

PubMed

Negash, Canaan; Belachew, Tefera; Henry, Carol J; Kebebu, Afework; Abegaz, Kebede; Whiting, Susan J

2014-12-01

Nutritious complementary foods are needed in countries where undernutrition and stunting are major problems, but mothers may be reluctant to change from traditional gruels. To test whether a recipe-based complementary feeding education intervention would improve knowledge and practice of mothers with young children in Hula, Ethiopia. A baseline survey of 200 eligible, randomly selected mother-child pairs gathered data on sociodemographic characteristics, food security status, knowledge and practices concerning complementary feeding, food group intakes of children aged 6 to 23 months by 24-hour recalls, and children's anthropometric measurements. Twice a month for 6 months, women in the intervention group received an education session consisting of eight specific messages using Alive and Thrive posters and a demonstration and tasting of a local barley and maize porridge recipe containing 30% broad beans. The control group lived in a different area and had no intervention. At 6 months, knowledge and practice scores regarding complementary feeding were significantly improved (p < .001) in the intervention group but not in the control group. The intervention resulted in improvement of children's dietary diversity, as well as mean intake of energy and selected nutrients, compared with children in the control group. Changes in height and weight did not differ between the two groups. Community-based nutrition education over 6 months that included demonstration of a local porridge recipe with broad beans added improved the complementary feeding practices of caregivers and the nutritional status of their young children.

[Bases for adequate complementary feeding in infants and young children].

PubMed

Gil Hernández, A; Uauy Dagach, R; Dalmau Serra, J

2006-11-01

Infants can be exclusively breast fed or formula fed for the first 6 months of life and their nutritional requirements are completely fulfilled. However, from 6 months onwards, human milk is not sufficient to supply all the nutrients necessary for infants and young children. Therefore, adequate supplementary feeding, in terms of both quantity and quality, should be provided. The present article aims to describe the scientific bases for practical recommendations on complementary feeding during infancy and early childhood, which may be useful to pediatricians and should serve to improve the health status of the infant population in Spain. In this sense, the new international recommendations for energy, protein and other nutrient requirements are reviewed. In Spain, the law applicable to manufacturing infant cereals and homogenized infant foods is that published by the European Union in specific directives. However, taking into consideration new advances in knowledge of nutritional requirements, we have considered a number of issues that could be relevant for the manufacture of these foods. Finally, we propose a series of basic principles that should serve as a guide for the complementary feeding of infants (whether breast fed, formula fed, or receiving mixed feeding) and young children. These recommendations are particularly addressed to pediatricians working in primary health services.

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MedlinePlus

... your health care providers about any complementary health approaches you use. Give them a full picture of ... information on NCCIH and complementary and integrative health approaches, including publications and searches of Federal databases of ...

Mapping the Health Care Policy Landscape for Complementary and Alternative Medicine Professions Using Expert Panels and Literature Analysis.

PubMed

Herman, Patricia M; Coulter, Ian D

2016-09-01

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.

Alternative approaches to epilepsy treatment.

PubMed

McElroy-Cox, Caitlin

2009-07-01

Complementary and alternative medicine (CAM) is a diverse group of health care practices and products that fall outside the realm of traditional Western medical theory and practice and that are used to complement or replace conventional medical therapies. The use of CAM has increased over the past two decades, and surveys have shown that up to 44% of patients with epilepsy are using some form of CAM treatment. This article reviews the CAM modalities of meditation, yoga, relaxation techniques, biofeedback, nutritional and herbal supplements, dietary measures, chiropractic care, acupuncture, Reiki, and homeopathy and what is known about their potential efficacy in patients with epilepsy.

Modernization is Associated with Intensive Breastfeeding Patterns in the Bolivian Amazon

PubMed Central

Veile, Amanda; Martin, Melanie; McAllister, Lisa

2014-01-01

For many traditional, non-industrialized populations, intensive and prolonged breastfeeding buffers infant health against poverty, poor sanitation, and limited health care. Due to novel influences on local economies, values, and beliefs, the traditional and largely beneficial breastfeeding patterns of such populations may be changing to the detriment of infant health. To assess if and why such changes are occurring in a traditional breastfeeding population, we document breastfeeding patterns in the Bolivian Tsimane, a forager-horticulturalist population in the early stages of modernization. Three predictions are developed and tested to evaluate the general hypothesis that modernizing influences encourage less intensive breastfeeding in the Tsimane: 1) Tsimane mothers in regions of higher infant mortality will practice more intensive BF; 2) Tsimane mothers who are located closer to a local market town will practice more intensive BF; and 3) Older Tsimane mothers will practice more intensive BF. Predictions were tested using a series of maternal interviews (from 2003-2011, n=215) and observations of mother-infant dyads (from 2002-2007, n=133). Tsimane breastfeeding patterns were generally intensive: 72% of mothers reported initiating BF within a few hours of birth, mean (± SD) age of CF introduction was 4.1±2.0 months, and mean (± SD) weaning age was 19.2±7.3 months. There was, however, intra-population variation in several dimensions of breastfeeding (initiation, frequency, duration, and complementary feeding). Contrary to our predictions, breastfeeding was most intensive in the most modernized Tsimane villages, and maternal age was not a significant predictor of breastfeeding patterns. Regional differences accounted for variation in most dimensions of breastfeeding (initiation, frequency, and complementary feeding). Future research should therefore identify constraints on breastfeeding in the less modernized Tsimane regions, and examine the formation of maternal beliefs regarding infant feeding. PMID:24444850

Tool to assess causality of direct and indirect adverse events associated with therapeutic interventions.

PubMed

Zorzela, Liliane; Mior, Silvano; Boon, Heather; Gross, Anita; Yager, Jeromy; Carter, Rose; Vohra, Sunita

2018-03-01

To develop and test a tool to assess the causality of direct and indirect adverse events associated with therapeutic interventions. The intervention was one or more drugs and/or natural health products, a device, or practice (professional delivering the intervention). Through the assessment of causality of adverse events, we can learn about factors contributing to the harm and consider what modification may prevent its reoccurrence. Existing scales (WHO-UMC, Naranjo and Horn) were adapted to develop a tool (algorithm and table) to evaluate cases of serious harmful events reported through a national surveillance study. We also incorporated a novel approach that assesses indirect harm (caused by the delay in diagnosis/treatment) and the health provider delivering the intervention (practice). The tool was tested, revised and then implemented to assess all reported cases of serious events resulting from use of complementary therapies. The use of complementary therapies was the trigger to report the event. Each case was evaluated by two assessors, out of a panel of five, representing different health care professionals. The tool was used in assessment of eight serious adverse events. Each event was independently evaluated by two assessors. The algorithm facilitated assessment of a serious direct or indirect harm. Assessors agreed in the final score on seven of eight cases (weighted kappa coefficient of 0.75). A tool to support the assessment of causality of adverse events was developed and tested. We propose a novel method to assess direct and indirect harms related to product(s), device(s), practice or a combination of the previous. Further research will probably help evaluate this approach across different settings and interventions.

Message to complementary and alternative medicine: evidence is a better friend than power

PubMed Central

Vickers, Andrew J

2001-01-01

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. PMID:11346455

The rise and fall of complementary medicine in National Health Service hospitals in England.

PubMed

Cant, Sarah; Watts, Peter; Ruston, Annmarie

2012-08-01

Whilst Complementary and Alternative Medicine (CAM) has never been systematically integrated into National Health Service (NHS) provision, there has been some limited evidence of a developing presence of CAM in NHS hospital based nursing and midwifery. This paper reports on a qualitative study that sought to document the nature and extent of such integrative practice in England, and the interpersonal and organisational factors that facilitated or impeded it. The data revealed a history in which attempts to integrate CAM had some initial success underpinned by the enthusiasm of individual practitioners and a relatively permissive organisational context. However, this was followed by a decline in service provision. The fact that the services were established by individuals left them vulnerable when more restrictive funding and governance regimes emerged. Whilst the data revealed a consistent story about CAM within the NHS, it must be recognised that the use of a snowball sample limits the generalizability of the findings. Copyright © 2012 Elsevier Ltd. All rights reserved.

Development of a Student Mentored Research Program between a Complementary and Alternative Medicine University and a Traditional, Research Intensive University

PubMed Central

Sullivan, Barbara M.; Furner, Sylvia E.; Cramer, Gregory D.

2014-01-01

The global need to develop clinician-scientists capable of using research in clinical practice, translating research knowledge into practice, and carrying out research that affects the quality, efficacy, and efficiency of health care is well-documented. The complementary and alternative medicine (CAM) professions embrace the call to develop physician-researchers to carry out translational and applied research for CAM modalities. CAM universities face unique challenges when implementing research training compared to traditional, research intensive (TRI) universities and medical centers where the majority of medical research is carried out. The authors present the development and outcomes of a mentored research program (MRP) between a CAM and a TRI institution, the National University of Health Sciences and the University of Illinois at Chicago School of Public Health, between 2006 and 2012. CAM pre-doctoral students engaged in a full-immersion semester at the TRI, including didactic courses and active research with a TRI faculty research mentor. Half of the participating doctor of chiropractic (DC) students continued on to PhD programs and half established integrative medicine, primary care clinical careers. Establishing rigorous criteria for mentors and mentees, communicating expectations, developing solid relationships between the mentor, mentee, and home school advisor, responding quickly to impediments, and providing adequate support from CAM and TRI investigators were key to the MRP success. To sustain research opportunities, coordinated degree programs for the DC and master of public health (DC/MPH) and master of clinical and translational research (DC/MS CTS) were established. PMID:24988423

AGREEing on Canadian cardiovascular clinical practice guidelines.

PubMed

Stone, James A; Austford, Leslie; Parker, John H; Gledhill, Norm; Tremblay, Guy; Arthur, Heather M

2008-10-01

The use of clinical practice guidelines (CPGs), particularly the routine implementation of evidence-based cardiovascular health maintenance and disease management recommendations, affords both expert and nonexpert practitioners the opportunity to achieve better, and at least theoretically similar, patient outcomes. However, health care practitioners are often stymied in their efforts to follow even well-researched and well-written CPGs as a consequence of contradictory information. The purposeful integration and harmonization of Canadian cardiovascular CPGs, regardless of their specific risk factor or clinical management focus, is critical to their widespread acceptance and implementation. This level of cooperation and coordination among CPG groups and organizations would help to ensure that their clinical practice roadmaps (ie, best practice recommendations) contain clear, concise and complementary, rather than contradictory, patient care information. Similarly, the application of specific tools intended to improve the quality of CPGs, such as the Appraisal of Guidelines for Research and Evaluation (AGREE) assessment tool, may also lead to improvements in CPG quality and potentially enhance their acceptance and implementation.

Complementary religious and spiritual interventions in physical health and quality of life: A systematic review of randomized controlled clinical trials

PubMed Central

Lucchetti, Giancarlo; Menezes, Paulo Rossi; Vallada, Homero

2017-01-01

Objective To examine whether religious and spiritual interventions (RSIs) can promote physical health and quality of life in individuals. Methods The following databases were used to conduct a systematic review: PubMed, Scopus, Web of Science, EMBASE, PsycINFO, Cochrane, and Scielo. Randomized controlled trials that evaluated RSIs regarding physical health outcomes and/or quality of life in English, Spanish or Portuguese were included. RSI protocols performed at a distance (i.e. intercessory prayer) or for psychiatric disorders were excluded. This study consisted of two phases: (a) reading titles and abstracts, and (b) assessing the full articles and their methodological quality using the Cochrane Back Review Group scale. Results In total, 7,070 articles were identified in the search, but 6884 were excluded in phase 1 because they were off topic or repeated in databases. Among the 186 articles included in phase 2, 140 were excluded because they did not fit the inclusion criteria and 16 did not have adequate randomization process. Thus, a final selection of 30 articles remained. The participants of the selected studies were classified in three groups: chronic patients (e.g., cancer, obesity, pain), healthy individuals and healthcare professionals. The outcomes assessed included quality of life, physical activity, pain, cardiac outcomes, promotion of health behaviors, clinical practice of healthcare professionals and satisfaction with protocols. The divergence concerning scales and protocols proposed did not allow a meta-analysis. RSIs as a psychotherapy approach were performed in 40% of the studies, and the control group was more likely to use an educational intervention (56.7%). The results revealed small effect sizes favoring RSIs in quality of life and pain outcomes and very small effects sizes in physical activity, promotion of health behaviors and clinical practice of health professionals compared with other complementary strategies. Other outcomes, such as cardiac measures and satisfaction with the protocols, revealed no evidence for RSIs. Regarding the quality of the selected articles according to the Cochrane Back Review Group Scale, the average score was 6.83 (SD = 9.08) on a scale of 11, demonstrating robustness in the studies. Conclusion Clinical trials on RSIs demonstrated that they had small benefits compared with other complementary health therapies by reducing pain and weight, improving quality of life and promoting health behaviors. The lack of clinical trials that included biological outcomes and the diversity of approaches indicate a need for more studies to understand the possible mechanisms of action of RSIs and their roles in health care. PMID:29049421

Massage Therapy for Health Purposes

MedlinePlus

... Web site: www.nih.gov/health/clinicaltrials/ Cochrane Database of Systematic Reviews The Cochrane Database of Systematic ... Licensed Complementary and Alternative Healthcare Professions. Seattle, WA: Academic Consortium for Complementary and Alternative Health Care; 2009. ...

78 FR 64963 - National Center for Complementary & Alternative Medicine; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Center for Complementary and Alternative Medicine Special Emphasis Panel, October...

77 FR 4052 - National Center for Complementary & Alternative Medicine; Amended Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Amended Notice of Meeting Notice is hereby given of a change in the meeting of the National Advisory Council for Complementary and Alternative Medicine, February 3, 2012, 8...

Complementary and Alternative Therapies: An Evidence-Based Framework

ERIC Educational Resources Information Center

Shaw, Steven R.

2008-01-01

Complementary and alternative medicine (CAM) has experienced a dramatic growth in use and acceptability over the last 20 years. CAM is a diverse collection of medical and healthcare systems, practices, and products that are not presently considered a component of conventional medicine. CAM traditionally has been practiced by informally educated…

Exploring Asian American attitudes regarding mental health treatment in primary care: A qualitative study.

PubMed

Hails, Katherine; Madu, Andrea; Kim, Daniel Ju Hyung; Hahm, Hyeouk Chris; Cook, Benjamin; Chen, Justin; Chang, Trina; Yeung, Albert; Trinh, Nhi-Ha

2018-05-01

In this exploratory study, we examined attitudes regarding mental health treatment among 10 Asian American patients in an urban primary care setting to better understand contextual barriers to care. Ten semi-structured telephone interviews were conducted with Asian Americans recruited from primary care practices in an urban medical center. The study's qualitative data suggest that focusing on specific cultural concerns is essential for increasing mental health access for Asian Americans. Although few participants initially expressed interest in a culturally focused mental health program themselves, when phrased as being part of their primary care practice, 8 expressed interest. Furthermore, most felt that the program could help family or friends. Many participants preferred to seek care initially from social systems and alternative and complementary medicine before seeking psychiatric care. Because Asian Americans face notable barriers to seeking mental health treatment, addressing cultural concerns by providing culturally sensitive care could help make mental health treatment more acceptable, particularly among less acculturated individuals. To our knowledge, this is the first qualitative study exploring barriers to Asian Americans accessing integrated mental health services in primary care.

Advancing the application of systems thinking in health: exploring dual practice and its management in Kampala, Uganda

PubMed Central

2014-01-01

Background Many full-time Ugandan government health providers take on additional jobs – a phenomenon called dual practice. We describe the complex patterns that characterize the evolution of dual practice in Uganda, and the local management practices that emerged in response, in five government facilities. An in-depth understanding of dual practice can contribute to policy discussions on improving public sector performance. Methods A multiple case study design with embedded units of analysis was supplemented by interviews with policy stakeholders and a review of historical and policy documents. Five facility case studies captured the perspective of doctors, nurses, and health managers through semi-structured in-depth interviews. A causal loop diagram illustrated interactions and feedback between old and new actors, as well as emerging roles and relationships. Results The causal loop diagram illustrated how feedback related to dual practice policy developed in Uganda. As opportunities for dual practice grew and the public health system declined over time, government providers increasingly coped through dual practice. Over time, government restrictions to dual practice triggered policy resistance and protest from government providers. Resulting feedback contributed to compromising the supply of government providers and, potentially, of service delivery outcomes. Informal government policies and restrictions replaced the formal restrictions identified in the early phases. In some instances, government health managers, particularly those in hospitals, developed their own practices to cope with dual practice and to maintain public sector performance. Management practices varied according to the health manager’s attitude towards dual practice and personal experience with dual practice. These practices were distinct in hospitals. Hospitals faced challenges managing internal dual practice opportunities, such as those created by externally-funded research projects based within the hospital. Private wings’ inefficiencies and strict fee schedule made them undesirable work locations for providers. Conclusions Dual practice prevails because public and private sector incentives, non-financial and financial, are complementary. Local management practices for dual practice have not been previously documented and provide learning opportunities to inform policy discussions. Understanding how dual practice evolves and how it is managed locally is essential for health workforce policy, planning, and performance discussions in Uganda and similar settings. PMID:25134522

The paradox of non-evidence based, publicly funded complementary alternative medicine in the English National Health Service: An explanation.

PubMed

Sheppard, Maria K

2015-10-01

Despite the unproven effectiveness of many practices that are under the umbrella term 'complementary alternative medicine' (CAM), there is provision of CAM within the English National Health Service (NHS). Moreover, although the National Institute for Health and Care Excellence was established to promote scientifically validated medicine in the NHS, the paradox of publicly funded, non-evidence based CAM can be explained as linked with government policy of patient choice and specifically patient treatment choice. Patient choice is useful in the political and policy discourse as it is open to different interpretations and can be justified by policy-makers who rely on the traditional NHS values of equity and universality. Treatment choice finds expression in the policy of personalised healthcare linked with patient responsibilisation which finds resonance in the emphasis CAM places on self-care and self-management. More importantly, however, policy-makers also use patient choice and treatment choice as a policy initiative with the objective of encouraging destabilisation of the entrenched healthcare institutions and practices considered resistant to change. This political strategy of system reform has the unintended, paradoxical consequence of allowing for the emergence of non-evidence based, publicly funded CAM in the NHS. The political and policy discourse of patient choice thus trumps evidence based medicine, with patients that demand access to CAM becoming the unwitting beneficiaries. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The evolution of a medical mystic: An interview with Christine Page, MD. Interview by Nancy Nachman-Hunt.

PubMed

Page, Christine

2008-01-01

Christine Page, MD, has been a physician and healer for more than 30 years. She received her medical degree at London University. Her medical specialties include obstetrics, gynecology, pediatrics, family practice, and homeopathy. She was raised in a family with rich spiritual traditions, and this background, in addition to her wide experience and expertise in traditional healthcare practices, enabled her to have an instrumental role in integrating complementary medicine into the British National Health Service. Dr Page is the author of 6 books: Frontiers of Health (Ebury Press; 1992); Mirror of Existence (Ebury Press; 1995); Beyond the Obvious (Ebury Press; 1998); Mind, Body, Spirit Workbook (Ebury Press; 2000); Spiritual Alchemy (Ebury Press; 2003); and the recently released 2012 and the Galactic Centre (Inner Traditions; 2008).

Out-of-Pocket Expenditures on Complementary Health Approaches Associated with Painful Health Conditions in a Nationally Representative Adult Sample

PubMed Central

Nahin, Richard L.; Stussman, Barbara J.; Herman, Patricia M.

2015-01-01

National surveys suggest that millions of adults in the United States use complementary health approaches such as acupuncture, chiropractic manipulation, and herbal medicines to manage painful conditions such as arthritis, back pain and fibromyalgia. Yet, national and per person out-of-pocket (OOP) costs attributable to this condition-specific use are unknown. In the 2007 National Health Interview Survey, use of complementary health approaches, reasons for this use, and associated OOP costs were captured in a nationally representative sample of 5,467 adults. Ordinary least square regression models that controlled for co-morbid conditions were used to estimate aggregate and per person OOP costs associated with 14 painful health conditions. Individuals using complementary approaches spent a total of $14.9 billion (S.E. $0.9 billion) OOP on these approaches to manage these painful conditions. Total OOP expenditures seen in those using complementary approaches for their back pain ($8.7 billion, S.E. $0.8 billion) far outstripped that of any other condition, with the majority of these costs ($4.7 billion, S.E. $0.4 billion) resulting from visits to complementary providers. Annual condition-specific per-person OOP costs varied from a low of $568 (SE $144) for regular headaches, to a high of $895 (SE $163) for fibromyalgia. PMID:26320946

Social Franchising and a Nationwide Mass Media Campaign Increased the Prevalence of Adequate Complementary Feeding in Vietnam: A Cluster-Randomized Program Evaluation123

PubMed Central

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

2017-01-01

Background: Rigorous evaluations of health system–based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). Objective: We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. Methods: A cluster-randomized, nonblinded evaluation design with cross-sectional surveys (n = ∼500 children aged 6–23.9 mo and ∼1000 children aged 24–59.9 mo/group) implemented at baseline (2010) and endline (2014) was used. Difference-in-difference estimates (DDEs) of impact were calculated for intent-to-treat (ITT) analyses and modified per-protocol analyses (MPAs; mothers who attended the social franchising at least once: 62%). Results: Groups were similar at baseline. In ITT analyses, there were no significant differences between groups in changes in CF practices over time. In the MPAs, greater improvements in the intensive than in the nonintensive group were seen for minimum dietary diversity [DDE: 6.4 percentage points (pps); P < 0.05] and minimum acceptable diet (8.0 pps; P < 0.05). Significant stunting declines occurred in both intensive (7.1 pps) and nonintensive (5.4 pps) groups among children aged 24–59.9 mo, with no differential decline. Conclusions: When combined with MM and CM, an at-scale social franchising approach to improve IPC, delivered through the existing health care system, significantly improved CF practices, but not child growth, among mothers who used counseling services at least once. A greater impact may be achieved with strategies designed to increase service utilization. This trial was registered at clinicaltrials.gov as NCT01676623. PMID:28179488

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

PubMed

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

2017-04-01

Background: Rigorous evaluations of health system-based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). Objective: We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. Methods: A cluster-randomized, nonblinded evaluation design with cross-sectional surveys ( n = ∼500 children aged 6-23.9 mo and ∼1000 children aged 24-59.9 mo/group) implemented at baseline (2010) and endline (2014) was used. Difference-in-difference estimates (DDEs) of impact were calculated for intent-to-treat (ITT) analyses and modified per-protocol analyses (MPAs; mothers who attended the social franchising at least once: 62%). Results: Groups were similar at baseline. In ITT analyses, there were no significant differences between groups in changes in CF practices over time. In the MPAs, greater improvements in the intensive than in the nonintensive group were seen for minimum dietary diversity [DDE: 6.4 percentage points (pps); P < 0.05] and minimum acceptable diet (8.0 pps; P < 0.05). Significant stunting declines occurred in both intensive (7.1 pps) and nonintensive (5.4 pps) groups among children aged 24-59.9 mo, with no differential decline. Conclusions: When combined with MM and CM, an at-scale social franchising approach to improve IPC, delivered through the existing health care system, significantly improved CF practices, but not child growth, among mothers who used counseling services at least once. A greater impact may be achieved with strategies designed to increase service utilization. This trial was registered at clinicaltrials.gov as NCT01676623.

Remarkable recoveries: research and practice from a patient's perspective.

PubMed

Barasch, Marc Ian

2008-08-01

Mind-body therapies are often portrayed in the literature as self-palliative, adjunctive, and complementary, but rarely as contributive to cure. Many physicians continue to view them as acceptable indulgences so long as they are harmless and the patient remains fully compliant with a standard treatment regimen. The possibility that such modalities might help drive the healing process itself is infrequently acknowledged. This article addresses the topic of such therapies, examining remarkable recoveries in cancer, and suggesting the need for a "Remarkable Recovery Registry" to expand the literature on these cases. The author discusses the importance of complementary alternative medicine, and emotional and pyschologic support in the treatment regimen, and the need for health care providers and patients to work together to provide the best emotional environment for the healing process.

Alternative Medicine and the Ethics Of Commerce.

PubMed

Macdonald, Chris; Gavura, Scott

2016-02-01

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.

Mindfulness-Based Stress Reduction in Advanced Nursing Practice: A Nonpharmacologic Approach to Health Promotion, Chronic Disease Management, and Symptom Control.

PubMed

Williams, Hants; Simmons, Leigh Ann; Tanabe, Paula

2015-09-01

The aim of this article is to discuss how advanced practice nurses (APNs) can incorporate mindfulness-based stress reduction (MBSR) as a nonpharmacologic clinical tool in their practice. Over the last 30 years, patients and providers have increasingly used complementary and holistic therapies for the nonpharmacologic management of acute and chronic diseases. Mindfulness-based interventions, specifically MBSR, have been tested and applied within a variety of patient populations. There is strong evidence to support that the use of MBSR can improve a range of biological and psychological outcomes in a variety of medical illnesses, including acute and chronic pain, hypertension, and disease prevention. This article will review the many ways APNs can incorporate MBSR approaches for health promotion and disease/symptom management into their practice. We conclude with a discussion of how nurses can obtain training and certification in MBSR. Given the significant and growing literature supporting the use of MBSR in the prevention and treatment of chronic disease, increased attention on how APNs can incorporate MBSR into clinical practice is necessary. © The Author(s) 2015.

An overview of CAM: components and clinical uses.

PubMed

Kiefer, David; Pitluk, Jessica; Klunk, Kathryn

2009-01-01

Complementary and alternative medicine (CAM), more recently known as integrative health or integrative medicine, is a diverse field comprising numerous treatments and practitioners of various levels of training. This review defines several of the main CAM modalities and reviews some of the research relevant to their clinical application. The goal is to provide healthcare providers with a basic understanding of CAM to start the incorporation of proven treatments into their clinical practice as well as guide them to working with CAM providers; ultimately, such knowledge is a fundamental part of a collaborative approach to optimal patient health and wellness.

Workplace psychological harassment in Canadian nurses: a descriptive study.

PubMed

Trépanier, Sarah-Geneviève; Fernet, Claude; Austin, Stéphanie

2013-03-01

This descriptive study investigated workplace psychological harassment in a sample of 1179 Canadian nurses. Two complementary types of assessment were used: exposure to negative behaviors and perceived victimization. Results revealed that exposure to negative behaviors was associated with certain sociodemographic variables (i.e. job status and the amount of overtime performed weekly), lower psychological health, and poorer functioning at work. Although many nurses reported being exposed to negative behaviors, few perceived these behaviors as psychological harassment per se. However, regardless of perceptions of victimization, exposure to negative behaviors was detrimental to nurses' psychological health and functioning at work. Practical implications are discussed.

Mixed Methods in Biomedical and Health Services Research

PubMed Central

Curry, Leslie A.; Krumholz, Harlan M.; O’Cathain, Alicia; Plano Clark, Vicki L.; Cherlin, Emily; Bradley, Elizabeth H.

2013-01-01

Mixed methods studies, in which qualitative and quantitative methods are combined in a single program of inquiry, can be valuable in biomedical and health services research, where the complementary strengths of each approach can yield greater insight into complex phenomena than either approach alone. Although interest in mixed methods is growing among science funders and investigators, written guidance on how to conduct and assess rigorous mixed methods studies is not readily accessible to the general readership of peer-reviewed biomedical and health services journals. Furthermore, existing guidelines for publishing mixed methods studies are not well known or applied by researchers and journal editors. Accordingly, this paper is intended to serve as a concise, practical resource for readers interested in core principles and practices of mixed methods research. We briefly describe mixed methods approaches and present illustrations from published biomedical and health services literature, including in cardiovascular care, summarize standards for the design and reporting of these studies, and highlight four central considerations for investigators interested in using these methods. PMID:23322807

Teaching Processes and Practices for an Australian Multicultural Classroom: Two Complementary Models

ERIC Educational Resources Information Center

Winch-Dummett, Carlene

2004-01-01

Which pedagogical processes and practices that target the recognition, value and sharing of world views in teaching and learning can be identified as strategies for learning to live together in an Australian multicultural classroom? The question is addressed by this paper, which presents two discrete but complementary pedagogical models that…

Performing 'pragmatic holism': Professionalisation and the holistic discourse of non-medically qualified acupuncturists and homeopaths in the United Kingdom.

PubMed

Givati, Assaf

2015-01-01

Complementary and alternative medicine practitioners have often utilised 'holism' as a key identification mark of their practice, distancing themselves from 'the reductionist biomedicine'. However, the past couple of decades have witnessed increased engagement of several complementary and alternative medicines in professionalisation, which includes a degree of biomedical alignment while 'reducing' holistic claims in order to provide practice with a 'credible outlook' and move closer to the mainstream, a development which challenges the role of holism in complementary and alternative medicine practices. This article explores the strategies by which two groups of complementary and alternative medicine practitioners, namely, non-medically qualified acupuncturists and homeopaths in the United Kingdom, pragmatically accommodate holistic notions as a professional resource, a process of negotiation between maintaining their holistic premise, on the one hand, and the drive to professionalise and enhance their societal status, on the other. Based on in-depth interviews with non-medically qualified acupuncture and homeopathy practitioners and school principals, textual analysis of practitioners' web sites and observation of practice, the findings demonstrate the dynamic approach to 'holism' in complementary and alternative medicine practice. This discourse, through which practitioners use a range of strategies in order to 'narrow' or 'expand' their holistic expression, can be described as 'pragmatic holism', by which they try to make gains from the formalisation/standardisation processes, without losing the therapies' holistic outlook and appeal. © The Author(s) 2014.

Patterns and determinants of breastfeeding and complementary feeding practices of Emirati Mothers in the United Arab Emirates

PubMed Central

2013-01-01

Background Breastfeeding is the preferred method of feeding for the infant. The present study aimed at investigating the different infant feeding practices and the influencing factors in the United Arab Emirates (UAE). Methods A convenient sample of 593 Emirati mothers who had infants up to 2 years of age was interviewed. The interviews included a detailed questionnaire and conducted in the Maternal and Child Health Centers (MCH) and Primary Health Centers (PHC) in three cities. Results Almost all the mothers in the study had initiated breastfeeding (98%). The mean duration of breastfeeding was 8.6 months. The initiation and duration of breastfeeding rates were influenced by mother’s age (P<0.034)and education(P<0.01), parity(OR=2.13; P<0.001), rooming in(OR=21.70; P<0.001), nipple problem(P<0.010) and use of contraception(P<0.034). As for the feeding patterns, the results of the multiple logistic analyses revealed that rooming in (OR=4.48; P<0.001), feeding on demand (OR=2.29; P<0.005) and feeding more frequently at night (P<0.001) emerged as significant factors associated with exclusive or predominantly breastfeeding practices. Among the 593 infants in the study, 24.1% had complementary feeding, 25% of the infants were exclusively breastfed, and 49.4% were predominantly breastfed since birth. About 30% of the infants were given nonmilk fluids such as: Anis seed drink (Yansun), grippe water and tea before 3 months of age. The majority of the infants (83.5%) in the three areas received solid food before the age of 6 months. A variety of reasons were reported as perceived by mothers for terminating breastfeeding. The most common reasons were: new pregnancy (32.5%), insufficient milk supply (24.4%) and infant weaned itself (24.4%). Conclusions In conclusion, infant and young child feeding practices in this study were suboptimal. There is a need for a national community-based breastfeeding intervention programme and for the promotion of exclusive breastfeeding as part of a primary public health strategy to decrease health risks and problems in the UAE. PMID:23442221

Discovering complementary colors from the perspective of steam education

NASA Astrophysics Data System (ADS)

Karabey, Burak; Yigit Koyunkaya, Melike; Enginoglu, Turan; Yurumezoglu, Kemal

2018-05-01

This study explored the theory and applications of complementary colors using a technology-based activity designed from the perspective of STEAM education. Complementary colors and their areas of use were examined from the perspective of physics, mathematics and art, respectively. The study, which benefits from technology, makes the theory of complementary colors accessible to all through practical applications and provides a multidisciplinary, integrated and innovative technique of teaching the subject of colors, which could be used to teach complementary colors.

[Effects of infant feeding practice on eczema during early childhood in Shanghai, Hohhot, and Fuzhou].

PubMed

Zheng, X Q; Zhu, G W; Zheng, Z Q; Yang, Y; Gong, C D; Deng, S S; Wu, Q L; Peng, Y M

2016-12-02

Objective: To estimate the prevalence of eczema in early childhood and effect of infant feeding practice on eczema by different regions of China with diverse climate and dietary patterns. Method: A questionnaire survey was conducted from June 2012 to October 2012 in Shanghai, Hohhot, and Fuzhou. The parent or guardian of the children aged between 2.5 to 3.5 years attending routine health visit in the chosen communities were invited to complete a modified questionnaire of the International Study of Asthma and Allergy in Childhood (ISAAC). Logistic regression model was used to analyze of the family history of allergy, duration of breastfeeding, timing of introduction of complementary foods and other potential confounders. Result: A total of 2 242 children were interviewed, 750 from Shanghai, 716 from Hohhot, and 776 from Fuzhou. The prevalence of eczema in early childhood was significantly different among Shanghai (16.9%, 95% CI 16.87-16.93), Hohhot (34.5%, 95% CI 34.46-34.54)and Fuzhou (44.3%, 95% CI 44.26-44.34). The difference was statistically significant between 3 groups (χ 2 =72.05, P <0.05). Introducing complementary food after the age of 6 months was associated with a decreased risk for eczema when compared to introduction between 4 to 6 months(odds ratio (OR) 0.58, 95% CI 0.41-0.81) in Fuzhou, while there was no significant association between timing of introduction of complementary foods and eczema in Shanghai and Hohhot. Conclusion: The prevalence of eczema during early childhood is various among three cities. The relationship between timing of introduction of complementary foods and eczema in Fuzhou is different from that in Shanghai and Hohhot. The role of climate and dietary patterns on prevalence of eczema needs further studies.

78 FR 51734 - National Center for Complementary and Alternative Medicine Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary and Alternative Medicine Notice of Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Advisory Council for Complementary and Alternative...

76 FR 79202 - National Center for Complementary & Alternative Medicine; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Advisory Council for Complementary and Alternative...

77 FR 43099 - National Center For Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-23

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center For Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Advisory Council for Complementary and Alternativ...

76 FR 55073 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-06

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the National Advisory Council for Complementary and Alternative Medicine ...

78 FR 19498 - National Center for Complementary and Alternative Medicine; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary and Alternative Medicine; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of a meeting of the National Advisory Council for Complementary and Alternative...

Art, dance, and music therapy.

PubMed

Pratt, Rosalie Rebollo

2004-11-01

Art, dance, and music therapy are a significant part of complementary medicine in the twenty-first century. These creative arts therapies contribute to all areas of health care and are present in treatments for most psychologic and physiologic illnesses. Although the current body of solid research is small compared with that of more traditional medical specialties, the arts therapies are now validating their research through more controlled experimental and descriptive studies. The arts therapies also contribute significantly to the humanization and comfort of modern health care institutions by relieving stress, anxiety, and pain of patients and caregivers. Arts therapies will greatly expand their role in the health care practices of this country in the twenty-first century.

Effectiveness of applying progressive muscle relaxation technique on quality of life of patients with multiple sclerosis.

PubMed

Ghafari, Somayeh; Ahmadi, Fazlolah; Nabavi, Masoud; Anoshirvan, Kazemnejad; Memarian, Robabe; Rafatbakhsh, Mohamad

2009-08-01

To identify the effects of applying Progressive Muscle Relaxation Technique on Quality of Life of patients with multiple Sclerosis. In view of the growing caring options in Multiple Sclerosis, improvement of quality of life has become increasingly relevant as a caring intervention. Complementary therapies are widely used by multiple sclerosis patients and Progressive Muscle Relaxation Technique is a form of complementary therapies. Quasi-experimental study. Multiple Sclerosis patients (n = 66) were selected with no probability sampling then assigned to experimental and control groups (33 patients in each group). Means of data collection included: Individual Information Questionnaire, SF-8 Health Survey, Self-reported checklist. PMRT performed for 63 sessions by experimental group during two months but no intervention was done for control group. Statistical analysis was done by SPSS software. Student t-test showed that there was no significant difference between two groups in mean scores of health-related quality of life before the study but this test showed a significant difference between two groups, one and two months after intervention (p < 0.05). anova test with repeated measurements showed that there is a significant difference in mean score of whole and dimensions of health-related quality of life between two groups in three times (p < 0.05). Although this study provides modest support for the effectiveness of Progressive Muscle Relaxation Technique on quality of life of multiple sclerosis patients, further research is required to determine better methods to promote quality of life of patients suffer multiple sclerosis and other chronic disease. Progressive Muscle Relaxation Technique is practically feasible and is associated with increase of life quality of multiple sclerosis patients; so that health professionals need to update their knowledge about complementary therapies.

Integrative intervention: a new perspective and brief review in aphasia.

PubMed

Marshall, Rebecca Shisler; Mohapatra, Bijoyaa

2017-09-01

While integrative treatment practices have become a popular treatment in different areas of study, its use in the field of aphasiology is still limited. The following paper is an attempt to address the different alternative practices that could potentially be used to remediate aphasia. A narrative review was completed regarding integrative intervention that could potentially apply to aphasia population. Through this article we have explored various treatment options for integrative health care in aphasiology. Integrative treatments including brain specific antioxidants, progesterone and estradiol therapy, nutrition, synbiotic treatment, exercise, yoga, meditation and positive mood states have demonstrated positive changes in health and behavior in healthy aging or disorders such as stroke and aphasia. Offering integrative treatment for people with aphasia allows potential for high impact gains when combined with current speech language therapeutic practices. This paper highlights the rehabilitation possibilities for aphasia therapy. Combining complementary and traditional treatment approaches could be viewed as one of the contemporary approaches to clinical practice and research for practitioners and health care systems. Implications for Rehabilitation There has been very little research that explores the potential of various types of integrative treatment for individuals with aphasia. An integrative approach to the treatment of aphasia has potential for future clinical application. Combining treatment approaches could be viewed as a viable approach to clinical practice and in the health care system.

The alliance in reflective supervision: a commentary on Tomlin, Weatherston, and Pavkov's critical components of reflective supervision.

PubMed

Watkins, C Edward

2015-01-01

What are the critical components of reflective supervision? In this commentary, I offer a complementary perspective on A.M. Tomlin, D.J. Weatherston, and T. Pavkov's (2014) seminal study about that very question. I consider their findings within the context of what we now know about the supervisory alliance-a highly robust, heuristic, and eminently practical construct that appears to capture the spirit of reflection, collaboration, and regularity at its best. Matters of alliance theory, practice, and research are briefly addressed, and effort is made to consider the implications of the supervisory alliance as fundamental, foundational, and quintessentially organizational for reflective supervision practice. © 2015 Michigan Association for Infant Mental Health.

An empirical definition of clinical supervision.

PubMed

Milne, Derek

2007-11-01

The growing recognition of clinical supervision as the basis for high-quality mental health services is apparent in policy, research and clinical practice, but an empirical definition is required to progress research and practice. A logical analysis was used to draft a working definition, and then a systematic review of 24 empirical studies of clinical supervision produced a best evidence synthesis, which was used to test and improve this definition. The logical analysis indicated that the most popular definition (Bernard & Goodyear, 1992) failed all four necessary tests of a good definition: precision, specification, operationalization and corroboration. The systematic review synthesis was then used to test the working definition, which passed these tests (with two amendments). These two complementary review approaches created a firmer basis for advancing research and practice.

Development of ethical rules for boundaries of touch in complementary medicine--outcomes of a Delphi process.

PubMed

Schiff, Elad; Ben-Arye, Eran; Shilo, Margalit; Levy, Moti; Schachter, Leora; Weitchner, Na'ama; Golan, Ofra; Stone, Julie

2010-11-01

The practice of complementary medicine (CAM) often involves touch. The unique philosophy of many CAM therapies, and the setting in which treatments are provided create a therapeutic space which may be less clearly defined than in conventional settings - a space in which the boundaries between professional touch and personal/intimate touch may become easily obscured. Thus, complementary therapists need clear definitions and firm boundaries in order to maintain therapeutic efficacy and commitment. The aim of the process described in this article, was to develop ethical guidelines for boundaries of touch that will promote the safety and protection of the public which use CAM. Through a modified Delphi process, a diverse group of CAM practitioners, physicians, ethicists, legal consultants, health policy specialists, and representatives from the public, developed Ethical Rules for Boundaries of Touch in CAM. These guidelines may be implemented in ethical codes of professional CAM organizations, and also serve as a foundation for curriculums in ethics in CAM schools. Copyright © 2010 Elsevier Ltd. All rights reserved.

Willingness to Pay for Complementary Health Care Insurance in Iran.

PubMed

Nosratnejad, Shirin; Rashidian, Arash; Akbari Sari, Ali; Moradi, Najme

2017-09-01

Complementary health insurance is increasingly used to remedy the limitations and shortcomings of the basic health insurance benefit packages. Hence, it is essential to gather reliable information about the amount of Willingness to Pay (WTP) for health insurance. We assessed the WTP for health insurance in Iran in order to suggest an affordable complementary health insurance. The study sample consisted of 300 household heads all over provinces of Iran in 2013. The method applied was double bounded dichotomous choice and open-ended question approach of contingent valuation. The average WTP for complementary health insurance per person per month by double bounded dichotomous choice and open-ended question method respectively was 199000 and 115300 Rials (8 and 4.6 USD, respectively). Household's heads with higher levels of income and those who worked had more WTP for the health insurance. Besides, the WTP increased in direct proportion to the number of insured members of each household and in inverse proportion to the family size. The WTP value can be used as a premium in a society. As an important finding, the study indicated that the households were willing to pay higher premiums than currently collected for the complementary health insurance coverage in Iran. This offers the policy makers the opportunity to increase the premium and provide good benefits package for insured people of country then better risk pooling.

Bench to Bedside: Understanding Symptom Response to Acupuncture Treatment and Designing a Successful Acupuncture Treatment Program

DTIC Science & Technology

2017-09-01

analysis. Along the way we learned that the Chinese Medicine information will be difficult to integrate into the main data set. At this point only a poster... psychological health, social context, physical function. We completed and submitted for review a simpler analysis of this relationship in The Importance and...the unfolding integration of complementary medical practices into regular medicine. It will assist acupuncturists and VA officials in determining if

Policy and public health recommendations to promote the initiation and duration of breast-feeding in developed country settings.

PubMed

Dyson, Lisa; Renfrew, Mary J; McFadden, Alison; McCormick, Felicia; Herbert, Gill; Thomas, James

2010-01-01

To develop policy and public health recommendations for implementation at all levels by individuals and organisations working in, or related to, the field of breast-feeding promotion in developed country settings, where breast-feeding rates remain low. Two research phases, comprising (i) an assessment of the formal evidence base in developed country settings and (ii) a consultation with UK-based practitioners, service managers and commissioners, and representatives of service users. The evidence base included three systematic reviews and an Evidence Briefing. One hundred and ten studies evaluating an intervention in developed country settings were assessed for quality and awarded an overall quality rating. Studies with a poor quality rating were excluded. The resulting seventy studies examined twenty-five types of intervention for breast-feeding promotion. These formed the basis of the second consultation phase to develop the evidence-based interventions into recommendations for practice, which comprised (i) pilot consultation, (ii) electronic consultation, (iii) fieldwork meetings and (iv) workshops. Draft findings were synthesised for two rounds of stakeholder review conducted by the National Institute for Health and Clinical Excellence. Twenty-five recommendations emerged within three complementary and necessary categories, i.e. public health policy, mainstream clinical practice and local interventions. The need for national policy directives was clearly identified as a priority to address many of the barriers experienced by practitioners when trying to work across sectors, organisations and professional groups. Routine implementation of the WHO/UNICEF Baby Friendly Initiative across hospital and community services was recommended as core to breast-feeding promotion in the UK. A local mix of complementary interventions is also required.

Improving communication skill training in patient centered medical practice for enhancing rational use of laboratory tests: The core of bioinformation for leveraging stakeholder engagement in regulatory science.

PubMed

Moura, Josemar de Almeida; Costa, Bruna Carvalho; de Faria, Rosa Malena Delbone; Soares, Taciana Figueiredo; Moura, Eliane Perlatto; Chiappelli, Francesco

2013-01-01

Requests for laboratory tests are among the most relevant additional tools used by physicians as part of patient's health problemsolving. However, the overestimation of complementary investigation may be linked to less reflective medical practice as a consequence of a poor physician-patient communication, and may impair patient-centered care. This scenario is likely to result from reduced consultation time, and a clinical model focused on the disease. We propose a new medical intervention program that specifically targets improving the patient-centered communication of laboratory tests results, the core of bioinformation in health care. Expectations are that medical students training in communication skills significantly improve physicians-patient relationship, reduce inappropriate use of laboratorial tests, and raise stakeholder engagement.

INFANT FEEDING IN THE FIRST TWO YEARS OF LIFE.

PubMed

Lopes, Wanessa Casteluber; Marques, Fúlvia Karine Santos; Oliveira, Camila Ferreira de; Rodrigues, Jéssica Alkmim; Silveira, Marise Fagundes; Caldeira, Antônio Prates; Pinho, Lucinéia de

2018-01-01

To analyze the prevalence of breastfeeding and the introduction of complementary food for zero to 24-month-old infants. This is a population-based cross-sectional study of children aged less than 24 months in Montes Claros, Minas Gerais, Brazil. Data were collected in 2015, by interviews with people in charge of infant care in the house. The questionnaire administered assessed the sociodemographic status of the family, maternal and infant characteristics and food consumption habits. Survival analysis was used to calculate median prevalence and duration of breastfeeding and the introduction of complementary feeding. With 180 days of life, 4.0% of the children were exclusively breastfed, 22.4% were mostly breastfed and 43.4% were fed breast milk as complementary food. In the third month of life, children were consuming water (56.8%), fruit juice or formula (15.5%) and cow's milk (10.6%). At the age of 12 months, 31.1% were consuming artificial juice and 50.0% were eating candies. Before the age of 1 year, 25.0% of them had already eaten instant noodles. The introduction of drinks, honey, sugar and candies as complementary food was found to be premature; and solid and semi-solid foods were almost appropriate. The habits described can directly affect the success of breastfeeding. Given that the inadequate eating practices identified can compromise the infant's health, actions that promote breastfeeding and provide guidance on the introduction of complementary foods are important.

Consensus Recommendations to NCCIH from Research Faculty in a Transdisciplinary Academic Consortium for Complementary and Integrative Health and Medicine

PubMed Central

Weeks, John; Anderson, Belinda; Meeker, William; Calabrese, Carlo; O'Bryon, David; Cramer, Greg D.

2015-01-01

Abstract Background: This commentary presents the most impactful, shared priorities for research investment across the licensed complementary and integrative health (CIH) disciplines according to the Academic Consortium for Complementary and Alternative Health Care (ACCAHC). These are (1) research on whole disciplines; (2) costs; and (3) building capacity within the disciplines' universities, colleges, and programs. The issue of research capacity is emphasized. Discussion: ACCAHC urges expansion of investment in the development of researchers who are graduates of CIH programs, particularly those with a continued association with accredited CIH schools. To increase capacity of CIH discipline researchers, we recommend National Center for Complementary and Integrative Health (NCCIH) to (1) continue and expand R25 grants for education in evidence-based healthcare and evidence-informed practice at CIH schools; (2) work to limit researcher attrition from CIH institutions by supporting career development grants for clinicians from licensed CIH fields who are affiliated with and dedicated to continuing to work in accredited CIH schools; (3) fund additional stand-alone grants to CIH institutions that already have a strong research foundation, and collaborate with appropriate National Institutes of Health (NIH) institutes and centers to create infrastructure in these institutions; (4) stimulate higher percentages of grants to conventional centers to require or strongly encourage partnership with CIH institutions or CIH researchers based at CIH institutions, or give priority to those that do; (5) fund research conferences, workshops, and symposia developed through accredited CIH schools, including those that explore best methods for studying the impact of whole disciplines; and (6) following the present NIH policy of giving priority to new researchers, we urge NCCIH to give a marginal benefit to grant applications from CIH clinician-researchers at CIH academic/research institutions, to acknowledge that CIH concepts require specialized expertise to translate to conventional perspectives. Summary: We commend NCCIH for its previous efforts to support high-quality research in the CIH disciplines. As NCCIH develops its 2016–2020 strategic plan, these recommendations to prioritize research based on whole disciplines, encourage collection of outcome data related to costs, and further support capacity-building within CIH institutions remain relevant and are a strategic use of funds that can benefit the nation's health. PMID:26133203

Exposure to Large-Scale Social and Behavior Change Communication Interventions Is Associated with Improvements in Infant and Young Child Feeding Practices in Ethiopia

PubMed Central

Rawat, Rahul; Mwangi, Edina M.; Tesfaye, Roman; Abebe, Yewelsew; Baker, Jean; Frongillo, Edward A.; Ruel, Marie T.; Menon, Purnima

2016-01-01

Optimal breastfeeding (BF) practices in Ethiopia are far below the government’s targets, and complementary feeding practices are poor. The Alive & Thrive initiative aimed to improve infant and young child feeding (IYCF) practices through large-scale implementation of social and behavior change communication interventions in four regions of Ethiopia. The study assessed the effects of the interventions on IYCF practices and anthropometry over time in two regions–Southern Nations, Nationalities and Peoples Region and Tigray. A pre- and post-intervention adequacy evaluation design was used; repeated cross-sectional surveys of households with children aged 0–23.9 mo (n = 1481 and n = 1494) and with children aged 24–59.9 mo (n = 1481 and n = 1475) were conducted at baseline (2010) and endline (2014), respectively. Differences in outcomes over time were estimated using regression models, accounting for clustering and covariates. Plausibility analyses included tracing recall of key messages and promoted foods and dose-response analyses. We observed improvements in most WHO-recommended IYCF indicators. Early BF initiation and exclusive BF increased by 13.7 and 9.4 percentage points (pp), respectively. Differences for timely introduction of complementary foods, minimum dietary diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD), and consumption of iron-rich foods were 22.2, 3.3, 26.2, 3.5, and 2.7 pp, respectively. Timely introduction and intake of foods promoted by the interventions improved significantly, but anthropometric outcomes did not. We also observed a dose-response association between health post visits and early initiation of BF (OR: 1.8); higher numbers of home visits by community volunteers and key messages recalled were associated with 1.8–4.4 times greater odds of achieving MDD, MMF, and MAD, and higher numbers of radio spots heard were associated with 3 times greater odds of achieving MDD and MAD. The interventions were associated with plausible improvements in IYCF practices, but large gaps in improving children’s diets in Ethiopia remain, particularly during complementary feeding. PMID:27755586

Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers

PubMed Central

2014-01-01

Background Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Methods Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women’s health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Results Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion of treating the whole person within a health promotion model and focus on the relevance of diet and lifestyle factors as central to a CAM approach. Conclusions From the perspectives of the health service managers, these findings contribute to our understanding around the rationale to include CAM within mainstream health services that deal with psychological trauma and chronic disease. The broader implications of this study can help assist in the development of health service policy on CAM integration in mainstream healthcare services. PMID:24885066

Exploring clinical wisdom in nursing education.

PubMed

McKie, Andrew; Baguley, Fiona; Guthrie, Caitrian; Jackson, Carol; Kirkpatrick, Pamela; Laing, Adele; O'Brien, Stephen; Taylor, Ruth; Wimpenny, Peter

2012-03-01

The recent interest in wisdom in professional health care practice is explored in this article. Key features of wisdom are identified via consideration of certain classical, ancient and modern sources. Common themes are discussed in terms of their contribution to 'clinical wisdom' itself and this is reviewed against the nature of contemporary nursing education. The distinctive features of wisdom (recognition of contextual factors, the place of the person and timeliness) may enable their significance for practice to be promoted in more coherent ways in nursing education. Wisdom as practical knowledge (phronesis) is offered as a complementary perspective within the educational preparation and practice of students of nursing. Certain limitations within contemporary UK nursing education are identified that may inhibit development of clinical wisdom. These are: the modularization of programmes in higher education institutions, the division of pastoral and academic support and the relationship between theory and practice.

Perspectives on urban conditions and population health.

PubMed

Vlahov, David; Galea, Sandro; Gibble, Emily; Freudenberg, Nicholas

2005-01-01

The majority of the world's population will live in cities in the next few years and the pace of urbanization worldwide will continue to accelerate over the coming decades. While the number of megacities is projected to increase, the largest population growth is expected to be in cities of less than one million people. Such a dramatic demographic shift can be expected to have an impact on population health. Although there has been historic interest in how city living affects health, a cogent framework that enables systematic study of urban health across time and place has yet to emerge. Four alternate but complementary approaches to the study of urban health today are presented (urban health penalty, urban health advantage, urban sprawl, and an integrative urban conditions model) followed by three key questions that may help guide the study and practice of urban health in coming decades.

Quality and cost improvement of healthcare via complementary measurement and diagnosis of patient general health outcome using electronic health record data: research rationale and design.

PubMed

Stusser, Rodolfo J; Dickey, Richard A

2013-12-01

In this evolving 'third era of health', one of the US Health Care Reform Act's goals is to effectively facilitate the primary care physician's ability to better diagnose and manage the health outcome of the outpatient. That goal must include research on the complementary quantitative-qualitative assessment and rating of the patient's health status. This paper proposes an overview of the rationale and design of a research program for a balanced measurement and diagnostic clinical decision support system (CDSS) of the changing general health status of the patient -including disease- using electronic health record (EHR) data. The rationale, objectives, health metric-diagnostic tools architecture, simulation-optimization, and clinical trials are outlined. Resources, time frames, costs, feasibility, healthcare benefits and data-integration of the project are delineated. The basis and components of the research program to achieve an automated-CDSS to complement physician's clinical judgment, calculating a mathematical 'health equation' from each patient's EHR database, assisting physician-patient collaboration to diagnose, and improve general health outcomes is described. Use of multiple dimensional index, ways of classification, and causal factors' assessments, to arrive at the EHR-based CDSS algorithm-software providing a general health level and state rating of the patient are proposed. Its application could provide a compass for the general practitioner's best choice and use of the myriad of healthcare educational and technological options available with lower costs for everyday clinical practice and research. It could advance the approaches and focus of the 'eras of diseases', to the promising 'era of health', in an integrated, general approach to 'health.'

Red Yeast Rice: An Introduction

MedlinePlus

... comprehensive survey of the use of complementary health approaches by Americans, 2.1 percent of respondents (an estimated 1.8 million Americans) had used complementary health approaches for cholesterol in the past year. Safety The ...

Breastfeeding in Mexico was stable, on average, but deteriorated among the poor, whereas complementary feeding improved: results from the 1999 to 2006 National Health and Nutrition Surveys.

PubMed

González de Cossío, Teresita; Escobar-Zaragoza, Leticia; González-Castell, Dinorah; Reyes-Vázquez, Horacio; Rivera-Dommarco, Juan A

2013-05-01

We present: 1) indicators of infant and young child feeding practices (IYCFP) and median age of introduction of foods analyzed by geographic and socioeconomic variables for the 2006 national probabilistic Health Nutrition Survey (ENSANUT-2006); and 2) changes in IYCFP indicators between the 1999 national probabilistic Nutrition Survey and ENSANUT-2006, analyzed by the same variables. Participants were women 12-49 y and their <2-y-old children (2953 in 2006 and 3191 in 1999). Indicators were estimated with the status quo method. The median age of introduction of foods was calculated by the Kaplan-Meier method using recall data. The national median duration of breastfeeding was similar in both surveys, 9.7 mo in 1999 and 10.4 mo in 2006, but decreased in the vulnerable population. In 1999 indigenous women breastfed 20.8 mo but did so for only 13.0 mo in 2006. The national percentage of those exclusively breastfeeding <6 mo also remained stable: 20% in 1999 and 22.3% in 2006. Nevertheless, exclusively breastfeeding <6 mo changed within the indigenous population, from 46% in 1999 to 34.5% in 2006. Between surveys, most breastfeeding indicators had lower values in vulnerable populations than in those better-off. Complementary feeding, however, improved overall. Complementary feeding was inadequately timed: median age of introduction of plain water was 3 mo, formula and non-human milk was 5 mo, and cereals, legumes, and animal foods was 5 mo. Late introduction of animal foods occurred among vulnerable indigenous population when 50% consumed these products at 8 mo. Mexican IYCFP indicate that public policy must protect breastfeeding while promoting the timely introduction of complementary feeding.

The timing of introduction of complementary foods and later health.

PubMed

Agostoni, Carlo; Przyrembel, Hildegard

2013-01-01

Complementary food is needed when human milk (or infant formula) alone is no longer sufficient for nutritional reasons. The timing of introduction needs to be determined on an individual basis although 6 months of exclusive breastfeeding can be recommended for most healthy term infants. Solid foods are intended to 'complement' ongoing breastfeeding with those dietary items whose intake has become marginal or insufficient. Both breastfeeding and complementary feeding can have direct or later consequences on health. Possible short-term health effects concern growth velocity and infections while possible long-term effects may relate to obesity, cardiovascular disease, autoimmunity (celiac disease and type 1 diabetes) and atopic disorders. For most of these it is impossible on the basis of the available evidence to conclude on the age when risks related to the start of complementary feeding are lowest or highest, with the possible exception of infections and early growth velocity. For undesirable health consequences, whilst potential mechanisms are recognized, the evidence from mostly observational studies is insufficient and requires more and prospective research. While the 6-month goal is desirable, introduction of suitable complementary food after 4 completed months with ongoing breastfeeding can be considered without adverse health consequences for infants living in affluent countries. Even less evidence on the consequences of the timing of complementary food introduction is available for formula-fed infants. Copyright © 2013 S. Karger AG, Basel.

European Mistletoe

MedlinePlus

... Audio) NCCIH Clinical Digest A monthly newsletter with evidence-based information on complementary and integrative practices and a ... and gemcitabine in patients with advanced solid tumors. Evidence-Based Complementary and Alternative Medicine. 2013;2013:964592. National ...

Butterbur

MedlinePlus

... Audio) NCCIH Clinical Digest A monthly newsletter with evidence-based information on complementary and integrative practices and a ... 495. Holland S, Silberstein SD, Freitag F, et al. Evidence-based guideline update: NSAIDs and other complementary treatments for ...

Complementary health insurance in France. Who pays? Why? Who will suffer from public disengagement?

PubMed

Saliba, Bérengère; Ventelou, Bruno

2007-05-01

The study is based on a rare database with information about health status, socioeconomic characteristics and the complementary health insurance choices of the French population. We intend to characterise a two-stage decision process: first, the decision to purchase complementary health insurance, and then the factors related to choice of policy quality. Our econometric study indicates that (i) income level has a strong and significant effect on the decision to purchase complementary insurance, whilst there is no evidence that health risk considerations affect this decision at all; (ii) the individual decision about quality is associated barely if at all with any rational explanatory variables. The population's concrete behaviour, revealed by the study, is consistent with an allocation of low-risk people to private insurance and high-risk people to public insurance. Complementary insurance is not especially relevant to patients with serious diseases, who depend much more on the public system. If the public insurance system were to disengage significantly from coverage of serious illness, a vacuum would be created that would leave people at high risk without full coverage. These results have broad implications for numerous national systems of social protection seeking a new mix between private and public insurance.

Healing relationships with nature.

PubMed

Burkhardt, M A

2000-02-01

Our health is intimately connected to the health of our environment. The contemporary world view which sees a radical distinction between humans as subjects and world as object can obscure our recognition of how much we rely on nature for health and survival. Indigenous traditions and contemporary scholars remind us that we live in a universe in which all things are connected, and in which nature continues to offer its gifts in co-creative partnership for the health and wellbeing of all. Living in awareness of our relationship with nature enables us to open more to the experience of nature's nurturing. Many complementary therapies derive from ancient practices that involve nature in healing partnership. As nurses and midwives we must learn to expand our boundaries to encompass the many ways that nature partners with us for healing.

Varieties of healing. 2: a taxonomy of unconventional healing practices.

PubMed

Kaptchuk, T J; Eisenberg, D M

2001-08-07

The first of two essays in this issue demonstrated that the United States has had a rich history of medical pluralism. This essay seeks to present an overview of contemporary unconventional medical practices in the United States. No clear definition of "alternative medicine" is offered because it is a residual category composed of heterogeneous healing methods. A descriptive taxonomy of contemporary unconventional healing could be more helpful. Two broad categories of unconventional medicine are described here: a more prominent, "mainstream" complementary and alternative medicine (CAM) and a more culture-bound, "parochial" unconventional medicine. The CAM component can be divided into professional groups, layperson-initiated popular health reform movements, New Age healing, alternative psychological therapies, and non-normative scientific enterprises. The parochial category can be divided into ethno-medicine, religious healing, and folk medicine. A topologic examination of U.S. health care can provide an important conceptual framework through which health care providers can understand the current situation in U.S. medical pluralism.

Modern postural yoga as a mental health promoting tool: A systematic review.

PubMed

Domingues, Rita B

2018-05-01

Yoga has been gaining popularity as a complementary therapy for mental health conditions, but research on the efficacy of yoga is still in its beginnings. The aim of this systematic review is to investigate the effects of modern postural yoga (strong focus on physical postures) on positive mental health (PMH) indicators in clinical and nonclinical populations. The most common PMH indicators were mindfulness, affect, resilience and well-being, followed by satisfaction with life, self-compassion, empathy and others. Diverse results were found across the 14 studies analysed, including significant positive effects of yoga practice on outcome variables, to no significant effects, both in relation to baseline levels and in relation to control groups. Nonetheless, most studies observed ameliorations in PMH indicators due to yoga practice. Given that yoga interventions pose serious methodological concerns, more research and better experimental designs are needed to properly assess the effects of yoga on PMH indicators. Copyright © 2018 Elsevier Ltd. All rights reserved.

Why health visiting? Examining the potential public health benefits from health visiting practice within a universal service: a narrative review of the literature.

PubMed

Cowley, Sarah; Whittaker, Karen; Malone, Mary; Donetto, Sara; Grigulis, Astrida; Maben, Jill

2015-01-01

There is increasing international interest in universal, health promoting services for pregnancy and the first three years of life and the concept of proportionate universalism. Drawing on a narrative review of literature, this paper explores mechanisms by which such services might contribute to health improvement and reducing health inequalities. Through a narrative review of empirical literature, to identify: (1) What are the key components of health visiting practice? (2) How are they reflected in implementing the universal service/provision envisaged in the English Health Visitor Implementation Plan (HVIP)? The paper draws upon a scoping study and narrative review. We used three complementary approaches to search the widely dispersed literature: (1) broad, general search, (2) structured search, using topic-specific search terms, (3) seminal paper search. Our key inclusion criterion was information about health visiting practice. We included empirical papers from United Kingdom (UK) from 2004 to February 2012 and older seminal papers identified in search (3), identifying a total of 348 papers for inclusion. A thematic content analysis compared the older (up to 2003) with more recent research (2004 onwards). The analysis revealed health visiting practice as potentially characterized by a particular 'orientation to practice.' This embodied the values, skills and attitudes needed to deliver universal health visiting services through salutogenesis (health creation), person-centredness (human valuing) and viewing the person in situation (human ecology). Research about health visiting actions focuses on home visiting, needs assessment and parent-health visitor relationships. The detailed description of health visitors' skills, attitudes, values, and their application in practice, provides an explanation of how universal provision can potentially help to promote health and shift the social gradient of health inequalities. Identification of needs across an undifferentiated, universal caseload, combined with an outreach style that enhances uptake of needed services and appropriate health or parenting information, creates opportunities for parents who may otherwise have remained unaware of, or unwilling to engage with such provision. There is a lack of evaluative research about health visiting practice, service organization or universal health visiting as potential mechanisms for promoting health and reducing health inequalities. This paper offers a potential foundation for such research in future. Copyright © 2014 Elsevier Ltd. All rights reserved.

Developing a research agenda for cardiovascular disease prevention in high-risk rural communities.

PubMed

Melvin, Cathy L; Corbie-Smith, Giselle; Kumanyika, Shiriki K; Pratt, Charlotte A; Nelson, Cheryl; Walker, Evelyn R; Ammerman, Alice; Ayala, Guadalupe X; Best, Lyle G; Cherrington, Andrea L; Economos, Christina D; Green, Lawrence W; Harman, Jane; Hooker, Steven P; Murray, David M; Perri, Michael G; Ricketts, Thomas C

2013-06-01

The National Institutes of Health convened a workshop to engage researchers and practitioners in dialogue on research issues viewed as either unique or of particular relevance to rural areas, key content areas needed to inform policy and practice in rural settings, and ways rural contexts may influence study design, implementation, assessment of outcomes, and dissemination. Our purpose was to develop a research agenda to address the disproportionate burden of cardiovascular disease (CVD) and related risk factors among populations living in rural areas. Complementary presentations used theoretical and methodological principles to describe research and practice examples from rural settings. Participants created a comprehensive CVD research agenda that identified themes and challenges, and provided 21 recommendations to guide research, practice, and programs in rural areas.

Patient-reported outcomes (PROs): the significance of using humanistic measures in clinical trial and clinical practice.

PubMed

Refolo, P; Minacori, R; Mele, V; Sacchini, D; Spagnolo, A G

2012-10-01

Patient-reported outcome (PRO) is an "umbrella term" that covers a whole range of potential types of measurement but it is used specifically to refer to all measures quantifying the state of health through the evaluation of outcomes reported by the patient himself/herself. PROs are increasingly seen as complementary to biomedical measures and they are being incorporated more frequently into clinical trials and clinical practice. After considering the cultural background of PROs - that is the well known patient-centered model of medicine -, their historical profile (since 1914, the year of the first outcome measure) and typologies, the paper aims at debating their methodological complexity and implementation into practice. Some clinical trials and therapeutic managements utilizing patient-centered measures will be also analyzed.

Developing a Research Agenda for Cardiovascular Disease Prevention in High-Risk Rural Communities

PubMed Central

Corbie-Smith, Giselle; Kumanyika, Shiriki K.; Pratt, Charlotte A.; Nelson, Cheryl; Walker, Evelyn R.; Ammerman, Alice; Ayala, Guadalupe X.; Best, Lyle G.; Cherrington, Andrea L.; Economos, Christina D.; Green, Lawrence W.; Harman, Jane; Hooker, Steven P.; Murray, David M.; Perri, Michael G.; Ricketts, Thomas C.

2013-01-01

The National Institutes of Health convened a workshop to engage researchers and practitioners in dialogue on research issues viewed as either unique or of particular relevance to rural areas, key content areas needed to inform policy and practice in rural settings, and ways rural contexts may influence study design, implementation, assessment of outcomes, and dissemination. Our purpose was to develop a research agenda to address the disproportionate burden of cardiovascular disease (CVD) and related risk factors among populations living in rural areas. Complementary presentations used theoretical and methodological principles to describe research and practice examples from rural settings. Participants created a comprehensive CVD research agenda that identified themes and challenges, and provided 21 recommendations to guide research, practice, and programs in rural areas. PMID:23597371

Complementary and Integrative Therapies

MedlinePlus

... itself. Types of complementary and integrative therapies Natural products use herbs, vitamins, minerals or microorganisms (such as the bacteria found in yogurt). Examples include black cohosh and probiotics. Mind and body practices are techniques given or ...

Gaps in international nutrition and child feeding guidelines: a look at the nutrition and young child feeding education of Ghanaian nurses.

PubMed

Davis, Jennie N; Brown, Helen; Ramsay, Samantha A

2017-08-01

To examine the nutrition and young child feeding (YCF) education and training of nurses in public health clinics of Ghana's Komenda-Edina-Eguafo-Abrem region (KEEA) in relation to global health guidelines, and how nurses served as educators for caregivers with children aged 0-5 years. A qualitative study of semi-structured one-on-one and group interviews (n 21) following a questionnaire of closed- and open-ended questions addressing child feeding, nutrition and global health recommendations. Interviews were conducted in English, audio-recorded, transcribed and coded. Descriptive data were tabulated. Content analysis identified themes from open-ended questions. KEEA public health clinics (n 12). Nurses (n 41) purposefully recruited from KEEA clinics. A model capturing nurses' nutrition and YCF education emerged with five major themes: (i) adequacy of nurses' basic knowledge in breast-feeding, complementary feeding, iron-deficiency anaemia, YCF and hygiene; (ii) nurses' delivery of nutrition and YCF information; (iii) nurses' evaluation of children's health status to measure education effectiveness; (iv) nurses' perceived barriers of caregivers' ability to implement nutrition and YCF education; and (v) a gap in global health recommendations on YCF practices for children aged 2-5 years. Nurses demonstrated adequate nutrition and YCF knowledge, but reported a lack of in-depth nutrition knowledge and YCF education for children 2-5 years of age, specifically education and knowledge of YCF beyond complementary feeding. To optimize child health outcomes, a greater depth of nutrition and YCF education is needed in international health guidelines.

Research methods in complementary and alternative medicine: an integrative review.

PubMed

de Almeida Andrade, Fabiana; Schlechta Portella, Caio Fabio

2018-01-01

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.

Timing of introduction of complementary food: short- and long-term health consequences.

PubMed

Przyrembel, Hildegard

2012-01-01

Complementary food is needed when breast milk (or infant formula) alone is no longer sufficient for both nutritional and developmental reasons. The timing of its introduction, therefore, is an individual decision, although 6 months of exclusive breastfeeding can be recommended for most healthy term infants. The new foods are intended to 'complement' ongoing breastfeeding with those dietary items whose intake has become marginal or insufficient. Both breastfeeding and complementary feeding can have direct or later consequences on health. The evaluation of consequences of both early and late introduction of complementary food can neither disregard the effect of breastfeeding compared to formula feeding nor the composition or quality of the complementary food. Possible short-term health effects concern growth velocity and infections, and possible long-term effects may relate to atopic diseases, type 1 and 2 diabetes, obesity and neuromuscular development. On the basis of the currently available evidence, it is impossible to exactly determine the age when risks related to the start of complementary feeding are lowest or highest for most of these effects, with the possible exception of infections and early growth velocity. The present knowledge on undesirable health effects, however, is mainly based on observational studies, and although some mechanisms have been proposed, further prospective studies have to clarify these unsolved issues. Even less evidence on the consequences of the timing of complementary food introduction is available for formula-fed infants. Copyright © 2012 S. Karger AG, Basel.

A Case Study of the Neti Pot's Rise, Americanization, and Rupture as Integrative Medicine in U.S. Media Discourse.

PubMed

Ho, Evelyn Y; Cady, Kathryn A; Robles, Jessica S

2016-10-01

In a period of only one decade in the United States, the neti pot shifted from obscure Ayurvedic health device to mainstream complementary and integrative medicine (CIM), touted by celebrities and sold widely in drug stores. We examine the neti pot as a case study for understanding how a foreign health practice became mainstreamed, and what that process reveals about more general discourses of health in the United States. Using discourse analysis of U.S. popular press and new media news (1999-2012) about the neti pot, we trace the development of discourses from neti's first introduction in mainstream news, through the hype following Dr. Oz's presentation on Oprah, to 2011 when two adults tragically died after using Naegleria fowleri amoeba-infested tap water in their neti pots. Neti pot discourses are an important site for communicative analysis because of the pot's complexity as an intercultural artifact: Neti pots and their use are enfolded into the biomedical practice of nasal irrigation and simultaneously Orientalized as exotic/magical and suspect/dangerous. This dual positioning as normal and exotic creates inequitable access for using the neti pot as a resource for increasing cultural health capital (CHC). This article contributes to work that critically theorizes the transnationalism of CIM, as the neti pot became successfully Americanized. These results have implications for understanding global health practices' incorporation or co-optation in new contexts, and the important role that popularly mediated health communication can play in framing what health care products and practices mean for consumers.

78 FR 21381 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-10

... Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Complementary and Alternative Medicine Special Emphasis Education Panel. Date: June 21, 2013. Time: 8:00 a.m. to... Complementary and Alternative Medicine, National Institutes of Health, HHS) Dated: April 4, 2013. Michelle Trout...

A Survey of Complementary and Alternative Medicine Knowledge among Health Educators in the United States

ERIC Educational Resources Information Center

Johnson, Ping; Priestley, Jennifer Lewis; Johnson, Roy D.

2008-01-01

Background: Complementary and alternative medicine (CAM) is popular among U.S. health care consumers, but no study has examined how much health educators know about CAM. Purpose: To examine the knowledge of basic CAM concepts and common CAM therapies among health educators in the U.S. Methods: An online survey was conducted among 1,299 health…

Modernization is associated with intensive breastfeeding patterns in the Bolivian Amazon.

PubMed

Veile, Amanda; Martin, Melanie; McAllister, Lisa; Gurven, Michael

2014-01-01

For many traditional, non-industrialized populations, intensive and prolonged breastfeeding buffers infant health against poverty, poor sanitation, and limited health care. Due to novel influences on local economies, values, and beliefs, the traditional and largely beneficial breastfeeding patterns of such populations may be changing to the detriment of infant health. To assess if and why such changes are occurring in a traditional breastfeeding population, we document breastfeeding patterns in the Bolivian Tsimane, a forager-horticulturalist population in the early stages of modernization. Three predictions are developed and tested to evaluate the general hypothesis that modernizing influences encourage less intensive breastfeeding in the Tsimane: 1) Tsimane mothers in regions of higher infant mortality will practice more intensive BF; 2) Tsimane mothers who are located closer to a local market town will practice more intensive BF; and 3) Older Tsimane mothers will practice more intensive BF. Predictions were tested using a series of maternal interviews (from 2003 to 2011, n = 215) and observations of mother-infant dyads (from 2002 to 2007, n = 133). Tsimane breastfeeding patterns were generally intensive: 72% of mothers reported initiating BF within a few hours of birth, mean (±SD) age of CF introduction was 4.1 ± 2.0 months, and mean (±SD) weaning age was 19.2 ± 7.3 months. There was, however, intra-population variation in several dimensions of breastfeeding (initiation, frequency, duration, and complementary feeding). Contrary to our predictions, breastfeeding was most intensive in the most modernized Tsimane villages, and maternal age was not a significant predictor of breastfeeding patterns. Regional differences accounted for variation in most dimensions of breastfeeding (initiation, frequency, and complementary feeding). Future research should therefore identify constraints on breastfeeding in the less modernized Tsimane regions, and examine the formation of maternal beliefs regarding infant feeding. Copyright © 2013 Elsevier Ltd. All rights reserved.

National Institutes of Health Pathways to Prevention Workshop: Advancing Research to Prevent Youth Suicide.

PubMed

Little, Todd D; Roche, Kathleen M; Chow, Sy-Miin; Schenck, Anna P; Byam, Leslie-Ann

2016-12-06

The National Institutes of Health (NIH) Pathways to Prevention Workshop "Advancing Research to Prevent Youth Suicide" was cosponsored by the NIH Office of Disease Prevention, National Institute of Mental Health, National Institute on Drug Abuse, and National Center for Complementary and Integrative Health. A multidisciplinary working group developed the agenda, and an evidence-based practice center prepared an evidence report that addressed data systems relevant to suicide prevention efforts through a contract with the Agency for Healthcare Research and Quality. During the workshop, experts discussed the evidence and participants commented during open forums. After considering the data from the evidence report, expert presentations, and public comments, an independent panel prepared a draft report that was posted on the NIH Office of Disease Prevention Web site for 5 weeks for public comment. This abridged version of the final report provides a road map for optimizing youth suicide prevention efforts by highlighting strategies for guiding the next decade of research in this area. These strategies include recommendations for improving data systems, enhancing data collection and analysis methods, and strengthening the research and practice community.

The Mind-Body Connection - Complementary and Alternative Approaches to Health

MedlinePlus

... Navigation Bar Home Current Issue Past Issues The Mind-Body Connection Complementary and Alternative Approaches to Health Past ... To Find Out More At medlineplus.gov , type "mind-body" or "emotions" into the Search box. There is ...

76 FR 30735 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alternative Medicine [[Page 30736

Use of complementary and alternative medicine by patients with arthritis.

PubMed

Unsal, Ayla; Gözüm, Sebahat

2010-04-01

The aims of this study were to determine the prevalence of complementary and alternative medicine use in patients with arthritis, the types of complementary and alternative medicine used, pertinent socio-demographic factors associated with complementary and alternative medicine use and its perceived efficacy. Arthritis is a major health issue, and the use of complementary and alternative medicine among patients with arthritis is common. This is a descriptive cross-sectional study. Data were obtained from 250 patients with arthritis at the physiotherapy and immunology clinics Atatürk University Hospital in eastern Turkey between May-July 2005 using a questionnaire developed specifically for this study. The instrument included questions on socio-demographic information, disease specifics and complementary and alternative medicine usage. Seventy-six per cent of participants reported use of at least one form of complementary and alternative medicine in the previous year. Complementary and alternative medicine users and non-users were not significantly different in most socio-demographic characteristics including age, gender, marital status and education level with the exception of economic status. We categorised treatment into six complementary and alternative medicine categories: 62.6% of patients used thermal therapies; 41.5% used oral herbal therapies; 40.5% used hot therapies; 32.6% used externally applied (skin) therapies; 28.4% used massage and 12.6% used cold therapies. All forms of complementary and alternative medicine except thermal and oral herbal therapies were perceived as very effective by more than half of study participants. Complementary and alternative medicine therapy is widely used by patients with arthritis and has perceived beneficial effects. It is important for nurses and other health care professionals to be knowledgeable about the use of complementary and alternative medicine therapies when providing care to patients with arthritis because of possible interactions with other treatments, delays in seeking care and the potential for poor quality products. It is also essential for health professionals to discuss treatment options with patients and to monitor treatment efficacy.

Integrating Complementary and Alternative Medicine into the Health Education Curriculum.

ERIC Educational Resources Information Center

Patterson, Sheila M.; Graf, Helen M.

2000-01-01

Reviews the popularity of complementary and alternative medicine (CAM) approaches in health education, suggesting a proposed CAM course for health education professional preparation and offering a course outline which can be used as a self- standing course or integrated into existing courses. It includes a proposed course description and goals,…

Complementary health care: a welcome addition to an employee benefits program.

PubMed

DeVries, George

2003-09-01

One up-and-coming approach to controlling health care costs is complementary health care, which does not rely on advances in high-tech, invasive technology or expensive new pharmaceuticals, but rather focuses much more on the high-touch, direct practitioner care. It often offers lower cost alternatives to traditional medicine.

Thyroid Disease and Complementary and Alternative Medicine (CAM)

MedlinePlus

... spirit; this combines standard medicine with CAM practices. TYPES OF COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) The NIH ... on stories from a handful of people) or qualitative evidence (based on feelings about the treatment) is ...

USE OF COMPLEMENTARY AND ALTERNATIVE MEDICINE IN GEORGIA.

PubMed

Nadareishvili, I; Lunze, K; Tabagari, N; Beraia, A; Pkhakadze, G

2017-11-01

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.

Medical students’ knowledge, attitude, and practice of complementary and alternative medicine: a pre-and post-exposure survey in Majmaah University, Saudi Arabia

PubMed Central

Al Mansour, Mohammed Abdullah; Al-Bedah, Abdullah MN; AlRukban, Mohammed Othman; Elsubai, Ibrahim S; Mohamed, Elsadiq Yousif; El Olemy, Ahmed Tawfik; Khalil, Asim AH; Khalil, Mohamed KM; Alqaed, Meshari Saleh; Almudaiheem, Abdullah; Mahmoud, Waqas Sami; Medani, Khalid Altohami; Qureshi, Naseem Akhtar

2015-01-01

Background Evidently, complementary and alternative medicine (CAM) is a recognized medical practice that efficiently uses multiple treatment therapies and techniques in the prevention and management of a variety of human disorders. Many medical schools have integrated CAM curriculum in medical education system worldwide. Research in knowledge, attitude, and practice (KAP) of diverse health professionals exposed to CAM courses is important from many perspectives including improvement in KAP and teaching skills of faculty, together with capacity building and curriculum development. Objective and setting This pre- and post-design cross-sectional study aimed to assess CAM-KAP of two intakes of medical students in Majmaah University, Saudi Arabia. Methods The second-year medical students of the first (year 2012–2013) and second (year 2013–2014) intake (n=26 and 39, respectively) were selected for this study. A reliable, 16-item self-administered questionnaire was distributed among all the students for answering before and after the 48-hour CAM course. The data were analyzed using appropriate statistical test of significance. Results Medical students’ knowledge and attitude toward CAM significantly improved across some subitems of CAM questionnaire with a positive trend in the rest of its items including their views on CAM practices. Conclusion CAM course tends to have a positive impact on KAP of medical students. The preliminary results of this study call for further research with a larger sample in academic settings across the nation. PMID:26082671

Complementary and conventional medicine: a concept map

PubMed Central

Baldwin, Carol M; Kroesen, Kendall; Trochim, William M; Bell, Iris R

2004-01-01

Background Despite the substantive literature from survey research that has accumulated on complementary and alternative medicine (CAM) in the United States and elsewhere, very little research has been done to assess conceptual domains that CAM and conventional providers would emphasize in CAM survey studies. The objective of this study is to describe and interpret the results of concept mapping with conventional and CAM practitioners from a variety of backgrounds on the topic of CAM. Methods Concept mapping, including free sorts, ratings, and multidimensional scaling was used to organize conceptual domains relevant to CAM into a visual "cluster map." The panel consisted of CAM providers, conventional providers, and university faculty, and was convened to help formulate conceptual domains to guide the development of a CAM survey for use with United States military veterans. Results Eight conceptual clusters were identified: 1) Self-assessment, Self-care, and Quality of Life; 2) Health Status, Health Behaviors; 3) Self-assessment of Health; 4) Practical/Economic/ Environmental Concerns; 5) Needs Assessment; 6) CAM vs. Conventional Medicine; 7) Knowledge of CAM; and 8) Experience with CAM. The clusters suggest panelists saw interactions between CAM and conventional medicine as a critical component of the current medical landscape. Conclusions Concept mapping provided insight into how CAM and conventional providers view the domain of health care, and was shown to be a useful tool in the formulation of CAM-related conceptual domains. PMID:15018623

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

PubMed

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

2017-06-08

Effective interdisciplinary communication is important to achieve better quality in health care. The aims of this study were to compare conventional and complementary providers' experience of communication about complementary therapies and conventional medicine with their cancer patients, and to investigate how they experience interdisciplinary communication and cooperation. This study analyzed data from a self-administrated questionnaire. A total of 606 different health care providers, from four counties in Norway, completed the questionnaire. The survey was developed to describe aspects of the communication pattern among oncology doctors, nurses, family physicians and complementary therapists (acupuncturists, massage therapists and reflexologists/zone-therapists). Between-group differences were analyzed using chi-square, ANOVA and Fisher's exact tests. Significance level was defined as p < 0.05 without adjustment for multiple comparisons. Conventional providers and complementary therapists had different patterns of communication with their cancer patients regarding complementary therapies. While complementary therapists advised their patients to apply both complementary and conventional modalities, medical doctors were less supportive of their patients' use of complementary therapies. Of conventional providers, nurses expressed more positive attitudes toward complementary therapies. Opportunities to improve communication between conventional and complementary providers were most strongly supported by complementary providers and nurses; medical doctors were less supportive of such attempts. A number of doctors showed lack of respect for complementary therapists, but asked for more research, guidelines for complementary modalities and training in conventional medicine for complementary therapists. For better quality of care, greater communication about complementary therapy use is needed between cancer patients and their conventional and complementary providers. In addition, more communication between conventional and complementary providers is needed. Nurses may have a crucial role in facilitating communication, as they are positive toward complementary therapies and they have more direct communication with patients about their treatment preferences.

Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Evidence Tool

PubMed Central

Albert, Dayna; Fortin, Rebecca; Herrera, Christine; Hanning, Rhona; Lessio, Anne; Rush, Brian

2013-01-01

In public health and chronic disease prevention there is increasing priority for effective use of evidence in practice. In Ontario, Canada, despite various models being advanced, public health practitioners are seeking ways to identify and apply evidence in their work in practical and meaningful ways. In a companion article, “Strengthening Chronic Disease Prevention Programming: The Toward Evidence-Informed Practice (TEIP) Program Assessment Tool,” we describe use of a tool to assess and strengthen program planning and implementation processes using 19 criteria derived from best and promising practices literature. In this article, we describe use of a complementary Program Evidence Tool to identify, synthesize, and apply a range of evidence sources to strengthen the content of chronic disease prevention programming. The Program Evidence Tool adapts tools of evidence-based medicine to the unique contexts of community-based health promotion and chronic disease prevention. Knowledge management tools and a guided dialogue process known as an Evidence Forum enable community stakeholders to make appropriate use of evidence in diverse social, political, and structural contexts. Practical guidelines and worksheets direct users through 5 steps: 1) define an evidence question, 2) develop a search strategy, 3) collect and synthesize evidence, 4) interpret and adapt evidence, and 5) implement and evaluate. We describe the Program Evidence Tool’s benefits, strengths, challenges, and what was learned from its application in 4 Ontario public health departments. The Program Evidence Tool contributes to the development and understanding of the complex use of evidence in community-based chronic disease prevention. PMID:23721788

Efficacy, Feasibility, and Acceptability of Perinatal Yoga on Women's Mental Health and Well-Being: A Systematic Literature Review.

PubMed

Sheffield, Karen M; Woods-Giscombé, Cheryl L

2016-03-01

Perinatal major depressive disorder affects 20% of women, while perinatal anxiety affects 10% of women. Although pharmacological treatment has shown effectiveness, many pregnant women are concerned about potential adverse effects on the fetus, maternal-infant bonding, and child development. Approximately 38% of American adults use complementary and alternative medicine, including yoga and other mind-body strategies. Although complementary and alternative medicine has been less studied in the perinatal population, it potentially offers women and their providers alternatives to traditional medication for treatment of perinatal depression and anxiety. Thus, the purpose of this systematic review was to examine existing empirical literature on yoga and its effects on women's health and well-being during the perinatal period. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systemic literature reviews, literature searches using relevant search terms were performed in four major electronic databases: CINAHL, PubMed, PsycINFO, and EMBASE. Thirteen publications met inclusion criteria. Results indicated that yoga interventions are generally effective in reducing anxiety and depression in pregnant women. The use of yoga in the perinatal period shows promise in improving mental health and well-being for women and infants. This review can inform future yoga intervention studies and clinical practice with the perinatal population. © The Author(s) 2015.

Knowledge, attitudes, and practices among health care providers regarding complementary and alternative medicine in Trinidad and Tobago.

PubMed

Bahall, Mandreker; Legall, George

2017-03-08

Health care providers are often ill prepared to interact about or make acceptable conclusions on complementary and alternative medicine (CAM) despite its widespread use. We explored the knowledge, attitudes, and practices of health care providers regarding CAM. This cross-sectional study was conducted between March 1 and July 31, 2015 among health care providers working mainly in the public sector in Trinidad and Tobago. A 34-item questionnaire was distributed and used for data collection. Questionnaire data were analysed using inferential and binary logistic regression models. Response rate was 60.3% (362/600). Responders were 172 nurses, 77 doctors, 30 pharmacists, and 83 other health care providers of unnamed categories (mainly nursing assistants). Responders were predominantly female (69.1%), Indo-Trinidadian (55.8%), Christian (47.5%), self-claimed "very religious" (48.3%), and had <5 years of working experience (40.6%). The prevalence of CAM use was 92.4% for nurses, 64.9% for doctors, 83.3% for pharmacists, and 77.1% for other health care providers. The majority (50-75%) reported fair knowledge of herbal, spiritual, alternative, and physical types of CAM, but had no knowledge of energy therapy and therapeutic methods. Sex, ethnicity, and type of health care provider were associated with both personal use and recommendation for the use of CAM. Predictors of CAM use were sex, religion, and type of health care provider; predictors of recommendation for the use of CAM were sex and type of health care provider. About half of health care providers (51.4%) and doctors (52%) were likely to ask their patients about CAM and <15% were likely to refer patients to a CAM practitioner. However, health care providers expressed interest in being educated on the subject. Doctors (51.9%) and pharmacists (63.3%) said that combination therapy is superior to conventional medicine alone. Less than 10% said conventional medicine should be used alone. Knowledge about CAM is low among health care providers. The majority engages in using CAM but is reluctant to recommend it. Predictors of CAM use were sex, religion, and profession; predictors of recommendation for the use of CAM were sex and profession. Health care providers feel the future lies in integrative medicine.

Use of Complementary Health Approaches for Musculoskeletal Pain Disorders Among Adults: United States, 2012.

PubMed

Clarke, Tainya C; Nahin, Richard L; Barnes, Patricia M; Stussman, Barbara J

2016-10-01

This report examines the use of complementary health approaches among U.S. adults aged 18 and over who had a musculoskeletal pain disorder. Prevalence of use among this population subgroup is compared with use by persons without a musculoskeletal disorder. Use for any reason, as well as specifically to treat musculoskeletal pain disorders, is examined. Using the 2012 National Health Interview Survey, estimates of the use of complementary health approaches for any reason, as well as use to treat musculoskeletal pain disorders, are presented. Statistical tests were performed to assess the significance of differences between groups of complementary health approaches used among persons with specific musculoskeletal pain disorders. Musculoskeletal pain disorders included lower back pain, sciatica, neck pain, joint pain or related conditions, arthritic conditions, and other musculoskeletal pain disorders not included in any of the previous categories. Respondents could report having more than one disorder. In 2012, 54.5% of U.S. adults had a musculoskeletal pain disorder. The use of any complementary health approach for any reason among persons with a musculoskeletal pain disorder (41.6%) was significantly higher than use among persons without a musculoskeletal pain disorder (24.1%). Among adults with any musculoskeletal pain disorder, the use of natural products for any reason (24.7%) was significantly higher than the use of mind and body approaches (15.3%), practitioner-based approaches (18.2%), or whole medical system approaches (5.3%). The pattern of use of the above-mentioned groups of complementary health approaches was similar for persons without a musculoskeletal disorder. However, prevalence of use among these persons was significantly lower compared with persons with a musculoskeletal disorder. For treatment, the use of practitioner-based approaches among persons with any musculoskeletal pain disorder (9.7%) was more than three times as high as the use of any other group of approaches (0.7%-3.1%). The patterns of use of specific groups of complementary health approaches also differed among specific musculoskeletal pain disorders. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

Pathways to Healing: Person-centered Responses to Complementary Services

PubMed Central

Bertrand, Sharon W.; Fermon, Barbara; Coleman, Julie Foley

2014-01-01

Objectives: This research study assessed perceived changes in quality-of-life measures related to participation in complementary services consisting of a variety of nontraditional therapies and/or programs at Pathways: A Health Crisis Resource Center in Minneapolis, Minnesota. Design: Survey data were used to assess perceived changes participants ascribed to their experience with complementary services at Pathways. Quantitative data analysis was conducted using participant demographics together with participant ratings of items from the “Self-Assessment of Change” (SAC) measure developed at the University of Arizona, Tucson. Qualitative data analysis was conducted on written responses to an additional survey question: “To what extent has your participation at Pathways influenced your healing process?” Setting/Location: Pathways offers a variety of services, including one-to-one sessions using nontraditional healing therapies, support groups, educational classes, and practice groups such as yoga and meditation for those facing serious health challenges. These services are offered free of charge through community financial support using volunteer practitioners. Participants: People (126) diagnosed with serious health challenges who used Pathways services from 2007 through 2009. Interventions: Participation in self-selected Pathways services. Measures: Responses to items on the SAC measure plus written responses to the question, “To what extent has your participation at Pathways influenced your healing process?” Results: Quantitative findings: Participants reported experiencing significant changes across all components of the SAC measure. Qualitative findings: Responses to the open-ended survey question identified perspectives on the culture of Pathways and a shift in participants' perceptions of well-being based on their experience of Pathways services. Conclusions: Participation in services provided by the Pathways organization improved perceptions of quality of life and well-being and led to more active involvement in the experience of a healing process. PMID:24753990

Special Section: Complementary and Alternative Medicine (CAM): Time to Talk

MedlinePlus

... with your health care providers any complementary and alternative medicines you take or are thinking about starting. Photo: ... and older use some form of complementary and alternative medicine (CAM). But less than one-third who use ...

Taiwanese adult cancer patients' reports of using complementary therapies.

PubMed

Lu, Jui-Hua; Tsay, Shiow-Luan; Sung, Su-Ching

2010-01-01

More information is needed by cancer clinicians regarding cancer patients' use of complementary and alternative medicine (CAM). In this qualitative study, in-depth interviews were used to obtain the reports of adult cancer patients regarding their use of CAM. Seven cancer patients (4 women, 3 men) who reported using CAM were recruited by snowball sampling. Content analysis was used to examine the interview transcriptions. Five themes and multiple categories were identified related to CAM use: (1) facing the challenges of cancer (I can't be defeated, need to cooperate with conventional medical treatment, rebuilding my confidence), (2) handling the physical and psychological distress of CAM use (extra loading due to the therapy, uncertainty and fear about the efficacy of CAM, being understood and supported, feeling guilty about being sick, (3) lifestyle disruption (altering social life, changing family living style), (4) having reasons for seeking other therapies (finding a way to cure the disease, boosting my immunity, improving my overall health status, and prolonging life and searching for peace of mind), and (5) unresolved practical concerns about CAM (finding an easy and effective way to practice CAM, needing CAM to be integrated into mainstream health care, and where to get the related information). Adult Taiwanese cancer patients who use CAM do experience burdens secondary to CAM use and prefer that oncology specialists be more informed about CAM. Oncology specialists who know where adult cancer patients could obtain helpful information about CAM would help to decrease the burdens that patients who use CAM experience.

Use of Complementary and Alternative Medicine (CAM) in cancer patients: An Italian multicenter survey.

PubMed

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

2017-04-11

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.

Health Education Careers in a Post-Health Reform Era.

PubMed

Auld, M Elaine

2017-09-01

Since enactment of the Patient Protection and Affordable Care Act in 2010, health education specialists (HES) have made important contributions in implementing the law's provisions at the individual, family, and population levels. Using their health education competencies and subcompetencies, HES are improving public understanding of health insurance literacy and enrollment options, conducting community health needs assessments required of nonprofit hospitals, modifying policies or systems to improve access to health screenings and preventive health services, strengthening clinical and community linkages, and working with employee benefit plans. In addition to educating stakeholders about their complementary training and roles with respect to clinical providers, HES must keep abreast of rapid changes catalyzed by the Affordable Care Act in terms of health standards, payment models, government regulations, statistics, and business practices. For continued career growth, HES must continually acquire new knowledge and skills, access and analyze data, and develop interprofessional partnerships that meet the evolving needs of employers as the nation pursues health for all.

What's cooking with garlic: is this complementary and alternative medicine for hypertension?

PubMed

Edwards, Quannetta T; Colquist, Stephanie; Maradiegue, Ann

2005-09-01

To define complementary and alternative medicine (CAM); describe one type of CAM, garlic (Allium sativum L); and discuss its effects on blood pressure as a treatment for hypertension. Literature review from professional journals, abstracts, natural therapy books, and the World Wide Web (Internet). Information from the following professional organizations and agencies: The World Health Organization, Agency of Healthcare Research and Quality, National Cancer Institute, National Center for Complementary and Alternative Medicine, American Botanical Council, and Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Garlic is widely used throughout the world as a CAM. It is one of the most popular herbal products sold in the United States. However, while some studies have shown small positive effects in reducing blood pressure, there are insufficient scientific data to draw conclusions regarding its efficacy on clinical blood pressure outcomes. Thus, healthcare providers should be cautious in recommending this herbal product as an antihypertensive CAM. CAMs may be used by clients for a variety of conditions including hypertension. Healthcare providers must be cognizant of the use, efficacy, adverse affects, and scientific evidence concerning CAM in order to provide safe and effective practice as well as appropriate and accurate information to their clients.

Complementary or competing climates? Examining the interactive effect of service and ethical climates on company-level financial performance.

PubMed

Myer, Adam T; Thoroughgood, Christian N; Mohammed, Susan

2016-08-01

By bending rules to please their customers, companies with high service climates may be less ethical but ultimately more profitable. In this article, we pose the question of whether being ethical comes at a cost to profits in customer-oriented firms. Despite the organizational reality that multiple climates coexist at a given time, research has largely ignored these types of questions, and the simultaneous analysis of multiple climate dimensions has received little empirical attention to date. Given their scientific and practical importance, this study tested complementary and conflicting perspectives regarding interactions between service (outcome-focused) and ethical (process-focused) climates on company-level financial performance. Drawing on a sample of 16,862 medical sales representatives spread across 77 subsidiary companies of a large multinational corporation in the health care product industry, we found support for a complementary view. More precisely, results revealed that profitability was enhanced, not diminished, in service-oriented firms that also stressed the importance of ethics. Results suggest studying the interactive effects of multiple climates is a more fruitful approach than examining main effects alone. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Contribution of inappropriate complementary foods to the salt intake of 8-month-old infants.

PubMed

Cribb, V L; Warren, J M; Emmett, P M

2012-01-01

Complementary feeding is a critical developmental time for establishing variety, and appropriate feeding practices are important. These include recommendations for a maximum intake of sodium (salt), because of the potential harmful effect of excessive intake on the developing kidneys and blood pressure in later life. Sodium intakes were examined to establish, if inappropriate complementary feeding practices were contributing to high intakes. Data were collected from a cohort of 1178 8-month-old infants born in 1991/92, participating in the Avon Longitudinal Study of Parents and Children, using a 3-day dietary records completed by their mothers. Sodium and energy intakes were calculated and infants were categorised into quartiles of sodium intake. Majority of infants were first introduced to solids around 3-4 months, with plain baby rice, rusks and other cereals being the first foods consumed during complementary feeding. In the whole sample, 70% consumed in excess, of 400 mg sodium per day, the maximum UK recommendation for children up to age 12 months. The mean sodium intake for the highest quartile was 1060 mg per day. Infants in this quartile were often consuming cows' milk as a main drink; eating three times the amount of bread compared with the lowest quartile and used salty flavourings such as yeast extract and gravy. Sodium intakes in this cohort of infants were higher than recommendations. Clear and practical education is needed on complementary feeding practice for mothers highlighting what foods to introduce and when. Manufacturers have a responsibility to reduce the sodium content of food products.

An energy-dense complementary food is associated with a modest increase in weight gain when compared with a fortified porridge in Malawian children aged 6-18 months

USDA-ARS?s Scientific Manuscript database

Poor complementary feeding practices are associated with stunting and growth faltering throughout the developing world. The objective was to compare the effect of using peanut-/soy-based fortified spread (FS) and corn porridge fortified with fish powder (FP) as complementary foods on growth in rural...

On-site comprehensive curriculum to teach reproductive health to female adolescents in Kenya.

PubMed

Gaughran, Margaret; Asgary, Ramin

2014-04-01

Rates of sexually transmitted infections (STIs) and unplanned pregnancy are high in Kenya, and limited reproductive health education exists in schools. We designed and implemented a 6-week reproductive health curriculum in Laikipia District, Kenya, in 2011, which included didactic sessions, educational games, and open discussions. We applied a mixed quantitative and qualitative methods to evaluate this curriculum including a comprehensive 35-item survey to assess pre- and post-training knowledge, attitudes, and practices of female teenagers regarding STIs/HIV and family planning using paired t-test as well as complementary focus groups (n=42) and individual interviews (n=20). Average age for 42 female teenagers was 16.5 (± 1.31) years. Pre-test questionnaires revealed lack of knowledge about different types of STIs, specifically chlamydia, but adequate knowledge of basic contraception including abstinence and condom use. By the conclusion of the study, we observed improvement in following educational domains: general knowledge of HIV/AIDS (85% ± 7.5% to 94% ± 5.6%) (p<0.001); general knowledge of teen pregnancy and STIs (57% ± 19% to 82% ± 13%) (p<0.001); and overall scores of knowledge, attitude, and self-efficacy (81% ± 6.6% to 90% ± 5%) (p<0.001). Focus group discussions, however, revealed persistent misconceptions and knowledge gaps with themes regarding HIV transmission risk factors, perceived difficulty negotiating condom use, masturbation and its perceived consequences, and issues surrounding female circumcision. Important misconceptions and gaps in reproductive practices were identified and addressed using a mixed methods approach. Despite prior basic knowledge and positive attitudes on STI prevention and family planning, complementary teaching approaches were instrumental in improving overall knowledge of STIs other than HIV as well as family planning. The curriculum was feasible, well received, and achieved its educational goals.

Feeding patterns and stunting during early childhood in rural communities of Sidama, South Ethiopia

PubMed Central

Tessema, Masresha; Belachew, Tefera; Ersino, Getahun

2013-01-01

Introduction The period from birth to two years of age is a “critical window” of opportunity for the promotion of optimal growth, health and behavioral development of children. Poor child feeding patterns combined with household food insecurity can lead to malnutrition which is a major public health problem in developing countries like Ethiopia. Methods A community based cross-sectional study that involved 575 participants from rural Sidama was conducted from February to March 2011. A two-stage stratified sampling procedure was employed to select the required households. Multivariable logistic regression analyses were performed to compare stunting by feeding patterns and other characteristics. Results Only 14.4% of mothers fed their children optimally. Prevalence of stunting was higher for infants aged 6 to 8 months (43%) than for those in 0-5 months (26.6%) or 9-23 months (39%) category. Women who did not receive antenatal care(ANC) during pregnancy were 1.5 times more likely to practice pre-lacteal feeding and 2.8 and 1.9 times more likely to feed their children below minimum dietary diversity and minimum meal frequency, respectively (P=0.01). Mothers older than 18 years during the birth of index child were 86% less likely to feed their child below minimum meal frequency than their younger counterparts (P=0.01). Children who started complementary food either before or after the recommended 6 months time, were more likely to be stunted (P=0.01). Conclusion The feeding practices of most mothers did not meet WHO recommendations. Behavior change communication about the importance of optimal complementary feeding and ANC attendance should be strengthened through extensive use of the Health Extension Workers to reduce the level of child stunting in the study area. PMID:23646211

Prevalence and patterns of use of mantra, mindfulness and spiritual meditation among adults in the United States.

PubMed

Burke, Adam; Lam, Chun Nok; Stussman, Barbara; Yang, Hui

2017-06-15

Despite a growing body of scientific literature exploring the nature of meditation there is limited information on the characteristics of individuals who use it. This is particularly true of comparative studies examining prevalence and predictors of use of various forms of meditation. A secondary analysis was conducted using data from the 2012 National Health Interview Survey (n = 34,525). Three popular forms of meditation were compared-mantra, mindfulness, and spiritual-to determine lifetime and 12-month use related to key sociodemographic, health behavior, health status, and healthcare access variables. The 12-month prevalence for meditation practice was 3.1% for spiritual meditation, 1.9% for mindfulness meditation, and 1.6% for mantra meditation. This represents approximately 7.0, 4.3, and 3.6 million adults respectively. A comparison across the three meditation practices found many similarities in user characteristics, suggesting interest in meditation may be more related to the type of person meditating than to the type of practice selected. Across meditation styles use was more prevalent among respondents who were female, non-Hispanic White, college educated, physically active; who used other complementary health practices; and who reported depression. Higher utilization of conventional healthcare services was one of the strongest predictors of use of all three styles. In addition to similarities, important distinctions were observed. For example, spiritual meditation practice was more prevalent among former drinkers. This may reflect use of spiritual meditation practices in support of alcohol treatment and sobriety. Reasons for use of meditation were examined using the sample of respondents who practiced mindfulness meditation. Wellness and prevention (74%) was a more common reason than use to treat a specific health condition (30%). Common reasons for use included stress management (92%) and emotional well-being (91%), and to support other health behaviors. Meditation was viewed positively because it was self-care oriented (81%) and focused on the whole person (79%). Meditation appears to provide an accessible, self-care resource that has potential value for mental health, behavioral self-regulation, and integrative medical care. Considering consumer preference for distinct types of meditation practices, understanding the underlying mechanisms, benefits, and applications of practice variations is important.

Time to Talk: 6 Things to Know When Selecting a Complementary Health Practitioner

MedlinePlus

... conditions. Choose a practitioner who understands how to work with people with your specific needs, even if general well-being is your goal. And, remember that health conditions can affect the safety of complementary approaches; for example, if ...

Traditional Chinese Medicine: An Introduction

MedlinePlus

... comprehensive survey on the use of complementary health approaches by Americans, an estimated 3.1 million U.S. adults had used acupuncture in the ... information on NCCIH and complementary and integrative health approaches, including ... the U.S.: 1-888-644-6226 TTY (for deaf and hard- ...

The Capabilities of Nurses for Complementary and Traditional Medicine Integration in Africa.

PubMed

Gyasi, Razak Mohammed; Abass, Kabila; Adu-Gyamfi, Samuel; Accam, Burnett Tetteh; Nyamadi, Victoria Mensah

2018-03-01

Despite the political commitment of national governments and collaborative efforts by the World Health Organization (WHO) toward the actualization of intercultural healthcare system over the past decades, sub-Saharan African countries feature medical cohabitation rather than a truly integrated medical system. This hospital-based cross-sectional study analyzed the capabilities of nurses for complementary and traditional medicine (CTM) integration in Africa. Practicing nurses (n = 210) were recruited to respond to the CTM Health Belief Questionnaire (CHBQ) in December 2016. Normality of data was evaluated using Kolmogorov-Smirnov statistic with a Lilliefors significance correction. The authors assessed the relationship among nurses' knowledge, personal use, and clinical practice of CTM, using Spearman's Rank Order Correlation (rho). The differences and associations in continuous and categorical baseline variables were determined with Mann-Whitney U test/Kruskal-Wallis H test and Pearson's Chi-square test, respectively, at p < 0.05 as statistically significant. The overall mean score of nurses' knowledge of CTM therapies was 38 (interquartile range [IQR] 16). This low CTM-related knowledge reflected in the poor mean performance score of 30 (IQR 17) and 22 (IQR 6) for personal use and clinical practice of CTM, respectively, among nurses. Nurses, therefore, lacked the confidence to recommend CTM therapies to patients. Yet, nurses exhibited a high positive attitude to CTM (72.7 ± 12.5). In addition to significant associations among CTM-related knowledge, education (p = 0.023), and religion (p < 0.001), the study found a positive and statistically significant correlation among CTM-related knowledge, personal use (r = 0.556, p < 0.001), and professional practice of CTM (r = 0.349, p < 0.001). Given their substantial role in the primary and public healthcare system, improving nurses' knowledge of CTM through evidence-based nursing education and training remains the surest way to achieve appropriate CTM integration in Africa as outlined in the WHO Traditional Medicine Strategy 2014-2023.

Rediscovering Recovery: Reconceptualizing Underlying Assumptions of Citizenship and Interrelated Notions of Care and Support

PubMed Central

Vandekinderen, Caroline; Roets, Griet; Roose, Rudi; Van Hove, Geert

2012-01-01

Over the last few decades, research, policy, and practice in the field of mental health care and a complementary variety of social work and social service delivery have internationally concentrated on recovery as a promising concept. In this paper, a conceptual distinction is made between an individual approach and a social approach to recovery, and underlying assumptions of citizenship and interrelated notions and features of care and support are identified. It is argued that the conditionality of the individual approach to recovery refers to a conceptualization of citizenship as normative, based on the existence of a norm that operates in every domain of our society. We argue that these assumptions place a burden of self-governance on citizens with mental health problems and risk producing people with mental health problems as nonrecyclable citizens. The social approach to recovery embraces a different conceptualization of citizenship as relational and inclusive and embodies the myriad ways in which the belonging of people with mental health problems can be constructed in practice. As such, we hope to enable social services and professionals in the field to balance their role in the provision of care and support to service users with mental health problems. PMID:23326216

[Transnational solidarity? Cross-border heath-care in the European Union].

PubMed

Schmucker, R

2010-03-01

The responsibilities of the European Union surrounding public health are concentrated on co-ordinating and complementary practices. A mandatory European harmonization of standards and policies is in effect in only a few areas such as pharmaceutical authorization and health protection at the workplace. The implementation of single market rights over the national health-care systems (negative integration) is growing at the European level. This has ambivalent repercussions. Whilst the rights of patients on the basis of the four fundamental freedoms in the context of cross-border health-care have got stronger, national governments see themselves confronted with a limitation of scope for their health-care policies. The basic principles of the integration project place European pressure on national governments. They are subject to sanctions if their policies are not directly in accordance with the single market concept. Georg Thieme Verlag KG Stuttgart. New York.

PUFA and LC-PUFA intake during the first year of life: can dietary practice achieve a guideline diet?

PubMed

Schwartz, J; Dube, K; Alexy, U; Kalhoff, H; Kersting, M

2010-02-01

An appropriate supply of n-3 long-chain polyunsaturated fatty acids (LC-PUFAs) during early childhood may enhance cognitive development. Little attention is paid to the fatty acid (FA) supply during the complementary feeding period. We examined the polyunsaturated fatty acids (PUFAs) and LC-PUFAs pattern in dietary practice of two study groups and evaluated the results against the present Dietary Guidelines in Germany. The food consumption and FA pattern of dietary practice in subjects from two prospective studies (n=102 and n=184, respectively) at the age of 3, 6 and 9 months was assessed by weighed diet records, and changes during the first year of life were compared with the food-based dietary guidelines for the first year of life. Dietary practice in the complementary feeding period was clearly dominated by commercial food products. The FA composition in dietary practice was different from the Guideline Diet and the ratio of n-6/n-3 PUFAs was less favorable. Consumption of breast milk or formula was still of major importance for the intake of LC-PUFAs in the complementary feeding period. LC-PUFAs are predominantly provided by breast milk and formula during the first year of life and consequently decrease when milk consumption decreases. For compensation, commercial complementary food might come closer to the Guideline Diet by lowering the n-6/n-3 PUFA ratio through appropriate vegetable oil along with an increase in total fat content up to the legal limit.

Complementary and alternative medicine: a survey of its use in pediatric cardiology.

PubMed

Adams, Denise; Whidden, Ashley; Honkanen, Meeri; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W James; Vohra, Sunita

2014-10-01

The use of complementary and alternative medicine is high among children and youth with chronic illnesses, including patients with cardiac conditions. Our goal was to assess the prevalence and patterns of such use among patients presenting to academic pediatric cardiology clinics in Canada. A survey instrument was developed to inquire about current or previous use of complementary and alternative medicine products and practices, including indications, beliefs, sources of information and whether this use was discussed with physicians. Between February and July 2007, the survey was administered to patients (or their parents/guardians) presenting to 2 hospital-based cardiology clinics: the Stollery Children's Hospital in Edmonton, Alberta, and the Children's Hospital of Eastern Ontario in Ottawa, Ontario. At the Stollery Children's Hospital, 64.1% of the 145 respondents had used complementary and alternative medicine compared with 35.5% of the 31 respondents at the Children's Hospital of Eastern Ontario (p = 0.003). Overall, the most common products in current use were multivitamins (70.6%), vitamin C (22.1%), calcium (13.2%), unspecified "cold remedies" (11.8%) and fish oil or omega-3 fatty acids (11.8%). The most common practices in current use were massage (37.5%), faith healing (25.0%), chiropractic (20.0%), aromatherapy (15.0%) and Aboriginal healing (7.5%). Many patients (44.9%) used complementary and alternative medicine products at the same time as conventional prescription drugs. Concurrent use was discussed with physicians or pharmacists by 64.3% and 31.3% of respondents, respectively. Use of complementary and alternative medicine products and practices was high among patients seen in the pediatric cardiology clinics in our study. Most respondents believed that the use of these products and practices was helpful; few reported harms and many did not discuss this use with their physicians, increasing the potential for interactions with prescribed medications.

Complementary and alternative medicine: a survey of its use in pediatric cardiology

PubMed Central

Adams, Denise; Whidden, Ashley; Honkanen, Meeri; Dagenais, Simon; Clifford, Tammy; Baydala, Lola; King, W. James

2014-01-01

Background The use of complementary and alternative medicine is high among children and youth with chronic illnesses, including patients with cardiac conditions. Our goal was to assess the prevalence and patterns of such use among patients presenting to academic pediatric cardiology clinics in Canada. Methods A survey instrument was developed to inquire about current or previous use of complementary and alternative medicine products and practices, including indications, beliefs, sources of information and whether this use was discussed with physicians. Between February and July 2007, the survey was administered to patients (or their parents/guardians) presenting to 2 hospital-based cardiology clinics: the Stollery Children’s Hospital in Edmonton, Alberta, and the Children’s Hospital of Eastern Ontario in Ottawa, Ontario. Results At the Stollery Children’s Hospital, 64.1% of the 145 respondents had used complementary and alternative medicine compared with 35.5% of the 31 respondents at the Children’s Hospital of Eastern Ontario (p = 0.003). Overall, the most common products in current use were multivitamins (70.6%), vitamin C (22.1%), calcium (13.2%), unspecified “cold remedies” (11.8%) and fish oil or omega-3 fatty acids (11.8%). The most common practices in current use were massage (37.5%), faith healing (25.0%), chiropractic (20.0%), aromatherapy (15.0%) and Aboriginal healing (7.5%). Many patients (44.9%) used complementary and alternative medicine products at the same time as conventional prescription drugs. Concurrent use was discussed with physicians or pharmacists by 64.3% and 31.3% of respondents, respectively. Interpretation Use of complementary and alternative medicine products and practices was high among patients seen in the pediatric cardiology clinics in our study. Most respondents believed that the use of these products and practices was helpful; few reported harms and many did not discuss this use with their physicians, increasing the potential for interactions with prescribed medications. PMID:25485246

Use of complementary and alternative medicine during pregnancy and the postpartum period: an analysis of the National Health Interview Survey.

PubMed

Birdee, Gurjeet S; Kemper, Kathi J; Rothman, Russell; Gardiner, Paula

2014-10-01

Complementary and alternative medicine (CAM) is commonly used among women, but few national data exist regarding CAM use during pregnancy or the postnatal period. Data from the 2007 National Health Interview Survey were analyzed for women ages between the ages of 18 and 49 years who were pregnant or had children less than 1 year old. CAM use was identified based on standard definitions of CAM from the National Institutes of Health's National Center for Complementary and Alternative Medicine. CAM use among women who were pregnant or with a child less than 1 year was compared with the other similarly aged female responders. CAM use was examined among these women stratified by sociodemographics, health conditions, and conventional medicine use through bivariable and multivariable logistic regression models. Among pregnant and postpartum women from the ages of 19 to 49 years in the United States, 37% of pregnant women and 28% of postpartum women reported using CAM in the last 12 months compared with 40% of nonpregnant/non-postpartum women. Mind-body practices were the most common CAM modality reported, with one out of four women reporting use. Biological therapies, excluding vitamins and minerals, during the postpartum period were used by only 8% of women. Using multivariable regression modeling, we report no significant difference in CAM use among pregnant compared with non-pregnant women (adjusted odds ratio [AOR], 0.88; [95% confidence interval 0.65-1.20]), but lower CAM use among postpartum women compared with non-pregnant women (AOR 0.67; [0.52-0.88]), while adjusting for sociodemographics. CAM use among pregnancy similar to women who are not pregnant, while postpartum CAM use decreases. Further evaluation of CAM therapies among pregnant and postpartum women is necessary to determine the costs and benefits of integrative CAM therapies in conventional care.

Complementary and Alternative Medicine (CAM) Treatments and Pediatric Psychopharmacology

ERIC Educational Resources Information Center

Rey, Joseph M.; Walter, Garry; Soh, Nerissa

2008-01-01

Children and adolescents often use complementary and alternative medicine (CAM) treatments outside their indications, particularly to lose weight. Some of the herbal remedies and dietary supplements that may of relevance for psychopharmacological practice are discussed with respect to CAM treatments.

Disclosure of complementary and alternative medicine use to health care providers among HIV-infected women.

PubMed

Liu, Chenglong; Yang, Yang; Gange, Stephen J; Weber, Kathleen; Sharp, Gerald B; Wilson, Tracey E; Levine, Alexandra; Robison, Esther; Goparaju, Lakshmi; Gandhi, Monica; Ganhdi, Monica; Merenstein, Dan

2009-11-01

To determine prevalence and predictors of complementary and alternative medicine (CAM) use disclosure to health care providers and whether CAM use disclosure is associated with highly active antiretroviral therapy (HAART) adherence among HIV-infected women, we analyzed longitudinal data collected between October 1994 and March 2002 from HIV-infected CAM-using women enrolled in the Women's Interagency HIV Study. Repeated measures Poisson regression models were constructed to evaluate associations of selected predictors with CAM use disclosure and association between CAM use disclosure and HAART adherence. A total of 1,377 HIV-infected women reported CAM use during study follow-up and contributed a total of 4,689 CAM-using person visits. The overall prevalence of CAM use disclosure to health care providers was 36% across study visits. Women over 45 years old, with a college education, or with health insurance coverage were more likely to disclose their CAM use to health care providers, whereas women identified as non-Hispanic Black or other ethnicities were less likely to communicate their CAM usage. More health care provider visits, more CAM domains used, and higher health care satisfaction scores had significant relationships with increased levels of CAM use disclosure. Restricting analysis to use of herbal or nonherbal medications only, similar results were obtained. Compared to other CAM domains, mind-body practice had the lowest prevalence of CAM use disclosure. Additionally, CAM use disclosure was significantly associated with higher HAART adherence. From this study, we showed that a high percentage of HIV-infected women did not discuss their CAM use with health care providers. Interventions targeted towards both physicians and patients may enhance communication of CAM use, avoid potential adverse events and drug interactions, and enhance HAART adherence.

Disclosure of Complementary and Alternative Medicine Use to Health Care Providers among HIV-Infected Women

PubMed Central

Yang, Yang; Gange, Stephen J.; Weber, Kathleen; Sharp, Gerald B.; Wilson, Tracey E.; Levine, Alexandra; Robison, Esther; Goparaju, Lakshmi; Gandhi, Monica; Merenstein, Dan

2009-01-01

Abstract To determine prevalence and predictors of complementary and alternative medicine (CAM) use disclosure to health care providers and whether CAM use disclosure is associated with highly active antiretroviral therapy (HAART) adherence among HIV-infected women, we analyzed longitudinal data collected between October 1994 and March 2002 from HIV-infected CAM-using women enrolled in the Women's Interagency HIV Study. Repeated measures Poisson regression models were constructed to evaluate associations of selected predictors with CAM use disclosure and association between CAM use disclosure and HAART adherence. A total of 1377 HIV-infected women reported CAM use during study follow-up and contributed a total of 4689 CAM-using person visits. The overall prevalence of CAM use disclosure to health care providers was 36% across study visits. Women over 45 years old, with a college education, or with health insurance coverage were more likely to disclose their CAM use to health care providers, whereas women identified as non-Hispanic Black or other ethnicities were less likely to communicate their CAM usage. More health care provider visits, more CAM domains used, and higher health care satisfaction scores had significant relationships with increased levels of CAM use disclosure. Restricting analysis to use of herbal or nonherbal medications only, similar results were obtained. Compared to other CAM domains, mind–body practice had the lowest prevalence of CAM use disclosure. Additionally, CAM use disclosure was significantly associated with higher HAART adherence. From this study, we showed that a high percentage of HIV-infected women did not discuss their CAM use with health care providers. Interventions targeted towards both physicians and patients may enhance communication of CAM use, avoid potential adverse events and drug interactions, and enhance HAART adherence. PMID:19821723

Four strategic pathways for the realization of the right to health through civil society actions: challenges and practical lessons learned in the Egyptian context.

PubMed

Sabae, Ayman

2014-12-11

This article examines four distinctly different, yet fully complementary, strategic pathways adopted by the Egyptian Initiative for Personal Rights (EIPR), an Egyptian independent human rights organization, in its practical efforts to protect and guarantee the realization of the right to health to all Egyptians. It reflects upon practical experiences, covering strategic options that include proposing new legislation to policy makers, participatory formulation of new laws from the ground up, public advocacy, coalition building, and litigation. It also examines several factors that affect the decision on which strategic pathway to follow. It reflects on the politico-economic settings, the presence of political will, the scope and extent of impacted stakeholders and the degree of complexity of the cause in question. Copyright © 2014 Sabae. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

[Agroecology and health promotion in Brazil].

PubMed

Azevedo, Elaine de; Pelicioni, Maria Cecília Focesi

2012-04-01

Research how specialists in health promotion and agroecology understand the concepts in those areas of common guidelines and how the relationship between such concepts is conceived. METHODS. Qualitative research. Fourteen specialists in the two areas were interviewed about the relationship between the agrofood system and health, concepts of agroecology and health promotion, and the relevance of including agroecology in public health training courses and vice-versa. There is little dialogue between the fields of study that were considered similar, food quality being the main interface between the areas. agroecology appeared to be a system of healthy food production, but the study showed other connections: agroecology and empowerment, a spur to autonomy and quality of life, and better socioeconomic conditions for the farmer; agroecology and environmental health; agroecology and community involvement; agroecology, territoriality, and cultural rescue [translator's note: this is a term for measures taken to revitalize or preserve imperiled indigenous cultures]; and agroecology, local foods, and low costs of production. Health promotion already was linked in effect to practices oriented to healthy lifestyles. The specialists appeared favorable toward including knowledge about public health in agroecology and vice-versa. Agroecology and health promotion contribute to one another and are complementary, and bringing them closer together can lead to an enriched discussion about rural health and the concept of public policies that focus on this theme, thereby stimulating actions for improvement and intersectoral practices.

Animal Health and Welfare Issues Facing Organic Production Systems

PubMed Central

Sutherland, Mhairi A.; Webster, Jim; Sutherland, Ian

2013-01-01

Simple Summary The demand for organically grown, animal derived produce is increasing due to a growing desire for consumer products that have minimal chemical inputs and high animal welfare standards. Evaluation of the scientific literature suggests that a major challenge facing organic animal production systems is the management and treatment of health-related issues. However, implementation of effective management practices can help organic animal producers achieve and maintain high standards of health and welfare, which is necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. Abstract The demand for organically-grown produce is increasing worldwide, with one of the drivers being an expectation among consumers that animals have been farmed to a high standard of animal welfare. This review evaluates whether this expectation is in fact being met, by describing the current level of science-based knowledge of animal health and welfare in organic systems. The primary welfare risk in organic production systems appears to be related to animal health. Organic farms use a combination of management practices, alternative and complementary remedies and convenional medicines to manage the health of their animals and in many cases these are at least as effective as management practices employed by non-organic producers. However, in contrast to non-organic systems, there is still a lack of scientifically evaluated, organically acceptable therapeutic treatments that organic animal producers can use when current management practices are not sufficient to maintain the health of their animals. The development of such treatments are necessary to assure consumers that organic animal-based food and fibre has not only been produced with minimal or no chemical input, but under high standards of animal welfare. PMID:26479750

Complementary, alternative, integrative, or unconventional medicine?

PubMed

Penson, R T; Castro, C M; Seiden, M V; Chabner, B A; Lynch, T J

2001-01-01

Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded the Kenneth B. Schwartz Center. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and sustenance to the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. Interest in complementary and alternative medicine (CAM) has grown exponentially in the past decade, fueled by Internet marketing, dissatisfaction with mainstream medicine, and a desire for patients to be actively involved in their health care. There is a large discordance between physician estimates and reported prevalence of CAM use. Many patients do not disclose their practices mainly because they believe CAM falls outside the rubric of conventional medicine or because physicians do not ask. Concern about drug interactions and adverse effects are compounded by a lack of Food and Drug Administration regulation. Physicians need to be informed about CAM and be attuned to the psychosocial needs of patients.

Development of the adult and child complementary medicine questionnaires fielded on the National Health Interview Survey

PubMed Central

2013-01-01

The 2002, 2007, and 2012 complementary medicine questionnaires fielded on the National Health Interview Survey provide the most comprehensive data on complementary medicine available for the United States. They filled the void for large-scale, nationally representative, publicly available datasets on the out-of-pocket costs, prevalence, and reasons for use of complementary medicine in the U.S. Despite their wide use, this is the first article describing the multi-faceted and largely qualitative processes undertaken to develop the surveys. We hope this in-depth description enables policy makers and researchers to better judge the content validity and utility of the questionnaires and their resultant publications. PMID:24267412

Development of the adult and child complementary medicine questionnaires fielded on the National Health Interview Survey.

PubMed

Stussman, Barbara J; Bethell, Christina D; Gray, Caroline; Nahin, Richard L

2013-11-23

The 2002, 2007, and 2012 complementary medicine questionnaires fielded on the National Health Interview Survey provide the most comprehensive data on complementary medicine available for the United States. They filled the void for large-scale, nationally representative, publicly available datasets on the out-of-pocket costs, prevalence, and reasons for use of complementary medicine in the U.S. Despite their wide use, this is the first article describing the multi-faceted and largely qualitative processes undertaken to develop the surveys. We hope this in-depth description enables policy makers and researchers to better judge the content validity and utility of the questionnaires and their resultant publications.

Training Psychologists for Rural Practice: Exploring Opportunities and Constraints.

PubMed

Domino, Marisa Elena; Lin, Ching-Ching Claire; Morrissey, Joseph P; Ellis, Alan R; Fraher, Erin; Richman, Erica L; Thomas, Kathleen C; Prinstein, Mitchell J

2018-04-17

To examine trends in the psychologist workforce and training opportunities, including factors that may influence the decision of clinical psychologists to practice in rural settings. We use a mixed-methods approach to examine the psychologist workforce nationally and in North Carolina (NC), including (1) an analysis of the location of programs awarding doctoral degrees; (2) an analysis of the practice, demographic, and educational characteristics of the psychologist workforce; and (3) interviews with directors of doctoral programs in clinical psychology to understand where current graduates are getting jobs and why they may or may not be choosing to practice in rural communities. Fewer than 1% of programs and institutions awarding doctoral degrees in psychology in the United States are located in rural areas. In NC, approximately 80% of practicing psychologists have out-of-state degrees and about 80% of recent NC graduates are not currently licensed in the state. This juxtaposition undermines the utility of adding more in-state degree programs. While expansion of training programs within rural areas could help alleviate the shortages of mental health providers, adding new degree-granting programs alone will not necessarily increase supply. We discuss complementary recruitment and retention strategies, including greater incentives for rural training and practice as well as training in emerging technologies that don't require providers to be physically located in underserved areas, such as telemedicine. Increasing the supply of psychologists practicing in rural areas will require a thoughtful, multipronged approach to training this critical part of the behavioral health workforce. © 2018 National Rural Health Association.

Attitudes and perceptions of Australian pharmacy students towards Complementary and Alternative Medicine – a pilot study

PubMed Central

Tiralongo, Evelin; Wallis, Marianne

2008-01-01

Background With the increased usage of CAM worldwide comes the demand for its integration into health professional education. However, the incorporation of CAM into health professional curricula is handled quite differently by different institutions and countries. Furthermore, the evaluation of CAM curricula is complicated because students' ability to learn about CAM may be influenced by factors such as student's prior knowledge and motivation, together with the perceptions and attitudes of clinical preceptors. The study aimed to describe the attitudes, perceptions and beliefs of second, third and fourth year pharmacy students towards complementary and alternative medicine (CAM) and to explore factors that might affect attitudes such as learning, preceptors and placements. Methods Pharmacy students from a University in South East Queensland, Australia participated in the study. The study consisted of a cross-sectional survey (n = 110) and semi-structured interviews (n = 9). Results The overall response rate for the survey was 75%, namely 50% (36/72) for second year, 77.3% (34/44) for third year and 97.6% (40/41) for fourth year students. Overall, 95.5% of pharmacy students believe that pharmacists should be able to advise patients about CAM and most (93.7%) have used CAM prior to course enrolment. Students' attitudes to CAM are influenced by the use of CAM by family, friends and self, CAM training, lecturers and to a lesser degree by preceptors. The majority of pharmacy students (89.2%) perceive education about CAM as a core and integral part of their professional degree and favour it over an additional postgraduate degree. However, they see a greater need for education in complementary medicines (such as herbal medicines, vitamins and minerals) than for education in complementary therapies (such as acupuncture, meditation and bio-magnetism). Knowledge and educational input rationalised rather than marginalised students' attitudes towards CAM. Conclusion Pharmacy students perceive education about CAM as a core and integral part of their professional degree. Students' attitudes towards CAM can be influenced by learning, lecturers, preceptors and practice experience. The content and focus of CAM education has to be further investigated and tailored to meet the professional needs of our future health professionals. PMID:18221569

What should be the basis for compulsory and optional health insurance premiums? Opinions of Swiss doctors.

PubMed

Jannot, Anne-Sophie; Perneger, Thomas V

2014-02-04

Little is known about doctors' opinions on how to finance health services. In Switzerland, mandatory basic health insurance currently uses regional flat fees that are unrelated to health and ability to pay, and optional complementary insurance uses risk-based premiums. Our objective was to assess Swiss physicians' opinions on what should determine health insurance premiums. We surveyed doctors in the canton of Geneva, Switzerland, about the desirable funding mechanism for mandatory health insurance and complementary health insurance. The proposed determinants of insurance premiums were current health and past medical history, lifestyle, healthcare costs in the previous year, genetic susceptibility to disease, regional average healthcare costs, household income, and wealth and demographic characteristics. Among the 1,516 respondents, only a few (<5%) believed that the mandatory health insurance premium should depend on health risk (health status, previous costs, genetics, and age and sex). More than 30% of respondents supported premiums based on lifestyle (34.6%), regional average health expenditures (31.2%), and household income and wealth (39.6%). For complementary health insurance, most respondents supported premiums based on lifestyle (74.6%) and on health risk (46.4%), but surprisingly also on household income and wealth (44.9%) and regional average health expenditures (39.4%). The characteristic most influencing the answers was the medical specialty. Doctors' opinions about healthcare financing mechanisms varied considerably, for both mandatory and complementary health insurance. Lifestyle was a surprisingly frequent choice, even though this criterion is not currently used in Switzerland. Ability to pay was not supported by the majority.

Use of Complementary Health Approaches Among Children Aged 4–17 Years in the United States: National Health Interview Survey, 2007–2012

PubMed Central

Black, Lindsey I.; Clarke, Tainya C.; Barnes, Patricia M.; Stussman, Barbara J.; Nahin, Richard L.

2015-01-01

Objective This report presents national estimates of the use of complementary health approaches among children aged 4–17 years in the United States. Selected modalities are compared for 2007 and 2012 to examine changes over time. Methods Data from the 2007 and 2012 National Health Interview Survey (NHIS) were analyzed for this report. The combined sample included 17,321 interviews with knowledgeable adults about children aged 4–17 years. Point estimates and estimates of their variances were calculated using SUDAAN software to account for the complex sampling design of NHIS. Differences between percentages were evaluated using two-sided significance tests at the 0.05 level. Results The use of complementary health approaches among children did not change significantly since 2007 (from 12.0% in 2007 to 11.6% in 2012). However, one approach, the use of traditional healers, showed a statistically significant decrease in use, from 1.1% in 2007 to 0.1% in 2012. No other significant decreases were identified. An increase in the use of yoga was observed during this period (from 2.3% in 2007 to 3.1% in 2012). Nonvitamin, nonmineral dietary supplements; chiropractic or osteopathic manipulation; and yoga, tai chi, or qi gong were the most commonly used complementary health approaches in both 2007 and 2012. Also consistent between 2007 and 2012 was that complementary health approaches were most frequently used for back or neck pain, head or chest cold, anxiety or stress, and other musculoskeletal conditions. PMID:25671583

A pilot study to assess students' perceptions, familiarity, and knowledge in the use of complementary and alternative herbal supplements in health promotion.

PubMed

Zimmerman, Caitlyn; Kandiah, Jay

2012-01-01

According to the National Center for Complementary and Alternative Medicine (NCCAM), use of herbal supplements is increasing and will continue to rise. With parents administering medicinal herbs to children as a preventive alternative to traditional drugs, the research team thought it would be interesting to assess the use of these products during the transition into adulthood through college life. This study examined participants' perceptions of, familiarity with, and knowledge of herbal supplements for health promotion. The research team invited participants to complete a 13-item Perception, Familiarity, and Knowledge Survey (PFKS). This online survey included questions regarding demographics, perceptions of complementary and alternative medicine, and familiarity with and knowledge of gingko, ginseng, St. John's wort, garlic, echinacea, and cinnamon. The study occurred at a Midwestern university. Two-hundred and eighty-six college students participated. The research team used the Chi-square test of association to examine the class rank (freshmen/sophomores, juniors/seniors, and graduate students) of students (frequency) and their gender in relation to their perceptions of, familiarity with, and knowledge of herbal supplements. Chi-square analysis showed that 80.8% of participants were familiar with complementary and alternative medicine (CAM) (P = .000). Of participants who were aware of the six herbs, a majority was familiar with ginkgo (82.4%), ginseng (96.1%), St. John's wort (78.4%), garlic (98.4%), echinacea (65.6%), and cinnamon (96.8%). Despite students' familiarity with the herbs, 45.1% to 74.1% of the participants were unsure of their effectiveness in preventing disease or promoting good health. Participants perceived the barriers to their CAM awareness as (1) insufficient education (26.0%), (2) a lack of scientific evidence (25.9%), and (3) a lack of trained professionals (17.5%). Many students (85.8%) desired educational courses on CAM therapies, with nutrition professors being ranked highest as the providers of this education by 88.0%. Over 60.0% of participants thought that conventional medicine could benefit from integration with CAM and that medical professionals should integrate CAM into health-care practices. College students appear to be highly familiar with CAM and herbal supplements but currently have little experience with and knowledge of herbal supplements.

Exploring Predictors of Health Sciences Students' Attitudes towards Complementary-Alternative Medicine

ERIC Educational Resources Information Center

Pettersen, Sverre; Olsen, Rolf V.

2007-01-01

This study demonstrated that a "less scientific worldview" predicted health science (HS) students' positive attitude towards "complementary-alternative medicine" (CAM), independently of important background characteristics as gender, pre-college science immersion, age, and type of HS education of the students. A total of 473 students in their…

We and they in the house of healing: debate among Arab complementary medicine practitioners on an integrative versus alternative approach to supportive cancer care.

PubMed

Popper-Giveon, Ariela; Schiff, Elad; Ben-Arye, Eran

2013-11-01

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.

Complementary health insurance, out- of- pocket expenditures, and health services utilization: A population- based survey.

PubMed

Homaie Rad, Enayatollah; Kavosi, Zahra; Moghadamnia, Mohammad Taghi; Arefnezhad, Masoud; Arefnezhad, Masoumeh; Felezi Nasiri, Banfashe

2017-01-01

Background: Studies have shown that people using complementary health insurances have more access to health services than others. In the present study, we aimed at finding the differences between out- of- pocket payments and health service utilizations in complementary health insurances (CHIs) users and nonusers. Methods: Propensity score matching was used to compare the 2 groups. First, confounder variables were identified, and then propensity score matching was used to compare out- of- pocket expenditures with dental, general physician, hospital inpatient, emergency services, nursing, midwifery, laboratory services, specialists and rehabilitation services utilization. Results: Our results revealed no significant differences between the 2 groups in out- of- pocket health expenditures. Also, the specialist visits, inpatient services at the hospital, and dental services were higher in people who used CHIs compared to nonusers. Conclusion: People did not change their budget share for health care services after using CHIs. The payments were equal for people who were not CHIs users due to the increase in the quantity of the services.

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

PubMed

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

2014-07-01

Complementary and alternative medicine is frequently used in the management of chronic pediatric diseases, but little is known about its use by those with Duchenne or Becker muscular dystrophy. Complementary and alternative medicine use by male patients with Duchenne or Becker muscular dystrophy and associations with characteristics of male patients and their caregivers were examined through interviews with 362 primary caregivers identified from the Muscular Dystrophy Surveillance, Tracking, and Research Network. Overall, 272 of the 362 (75.1%) primary caregivers reported that they had used any complementary and alternative medicine for the oldest Muscular Dystrophy Surveillance, Tracking, and Research Network male in their family. The most commonly reported therapies were from the mind-body medicine domain (61.0%) followed by those from the biologically based practice (39.2%), manipulative and body-based practice (29.3%), and whole medical system (6.9%) domains. Aquatherapy, prayer and/or blessing, special diet, and massage were the most frequently used therapies. Compared with nonusers, male patients who used any therapy were more likely to have an early onset of symptoms and use a wheel chair; their caregivers were more likely to be non-Hispanic white. Among domains, associations were observed with caregiver education and family income (mind-body medicines [excluding prayer and/or blessing only] and whole medical systems) and Muscular Dystrophy Surveillance, Tracking, and Research Network site (biologically based practices and mind-body medicines [excluding prayer and/or blessing only]). Complementary and alternative medicine use was common in the management of Duchenne and Becker muscular dystrophies among Muscular Dystrophy Surveillance, Tracking, and Research Network males. This widespread use suggests further study to evaluate the efficacy of integrating complementary and alternative medicine into treatment regimens for Duchenne and Becker muscular dystrophies. Copyright © 2014 Elsevier Inc. All rights reserved.

Bioethics and the Right to Health: Advancing a Complementary Agenda.

PubMed

Gibson, Jennifer L; Forman, Lisa; Nixon, Stephanie A

2015-06-11

This special section in Health and Human Rights Journal explores the relationship between bioethics and the right to health. Although bioethics scholars may argue for a right to health, particularly in the domains of universal health coverage and global health governance, and human rights scholars may advance ethical norms in their work, there has been little scholarly attention to the intersections, synergies, and contrasts between these two areas of study. At first glance, this is surprising given that bioethics and human rights share conceptual and normative terrain in articulating guidance for action on health-related issues and international policy and practice is explicitly interrelating human rights and ethics. Copyright 2015 Gibson, Forman, Nixon. This is an open access article distributed under the terms of Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licences/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.

The circle of the soul: the role of spirituality in health care.

PubMed

Moss, Donald

2002-12-01

This paper examines the critical attitude of behavioral professionals toward spiritual phenomena, and the current growing openness toward a scientific study of spirituality and its effects on health. Health care professionals work amidst sickness and suffering, and become immersed in the struggles of suffering persons for meaning and spiritual direction. Biofeedback and neurofeedback training can facilitate relaxation, mental stillness, and the emergence of spiritual experiences. A growing body of empirical studies documents largely positive effects of religious involvement on health. The effects of religion and spirituality on health are diverse, ranging from such tangible and easily understood phenomena as a reduction of health-risk behaviors in church-goers, to more elusive phenomena such as the distant effects of prayer on health and physiology. Psychophysiological methods may prove useful in identifying specific physiological mechanisms mediating such effects. Spirituality is also a dimension in much of complementary and alternative medicine (CAM), and the CAM arena may offer a window of opportunity for biofeedback practice.

Complementary physical therapies for movement disorders in Parkinson's disease: a systematic review.

PubMed

Alves Da Rocha, P; McClelland, J; Morris, M E

2015-12-01

The growth and popularity of complementary physical therapies for Parkinson's disease (PD) attempt to fill the gap left by conventional exercises, which does not always directly target wellbeing, enjoyment and social participation. To evaluate the effects of complementary physical therapies on motor performance, quality of life and falls in people living with PD. Systematic review with meta-analysis. Outpatients--adults diagnosed with idiopathic PD, male or female, modified Hoehn and Yahr scale I-IV, any duration of PD, any duration of physical treatment or exercise. Randomized controlled trials, non-randomized controlled trials and case series studies were identified by systematic searching of health and rehabilitation electronic databases. A standardized form was used to extract key data from studies by two independent researchers. 1210 participants from 20 randomized controlled trials, two non-randomized controlled trials and 13 case series studies were included. Most studies had moderately strong methodological quality. Dancing, water exercises and robotic gait training were an effective adjunct to medical management for some people living with PD. Virtual reality training, mental practice, aerobic training, boxing and Nordic walking training had a small amount of evidence supporting their use in PD. On balance, alternative physical therapies are worthy of consideration when selecting treatment options for people with this common chronic disease. Complementary physical therapies such as dancing, hydrotherapy and robotic gait training appear to afford therapeutic benefits, increasing mobility and quality of life, in some people living with PD.

People with insomnia: experiences with sedative hypnotics and risk perception.

PubMed

Cheung, Janet M Y; Bartlett, Delwyn J; Armour, Carol L; Ellis, Jason G; Saini, Bandana

2016-08-01

Sedative hypnotics form an important part of managing insomnia and are recommended for short-term use. It is standard practice for clinicians to inform the patient to use medications only 'when required', but the use of these medications is often chronic. Little is known about the impact of standard labelling/instructions on promoting appropriate medication use for managing insomnia. To explore patient medication-taking beliefs, experiences and behavioural practices relating to the use of pharmacological/complementary sleep aids for insomnia. Specialist sleep/psychology clinics and the general community in Sydney, Australia. Semi-structured interviews were conducted with 51 people with insomnia using a schedule of questions to gauge their experiences, beliefs and current practices relating to insomnia medication use. Interviews were audio-recorded, transcribed verbatim and subjected to Framework Analysis to identify emergent themes. Participants held distinctive views about the safety and efficacy of complementary and pharmacological agents but do not intuitively turn to medications to resolve their sleep complaint. Medication use was affirmed through tangible medication-taking cues due to the ambivalence in current instructions and labelling. Practices such as dosage modification, medication substitution and delaying medication use might be important drivers for psychological dependence. Current labelling and instructions do not necessarily promote the quality use of sedative hypnotics due to the variability in patient interpretations. Clarifying the timing, quantity and frequency of medication administration as well as insomnia symptom recognition would play a significant role in optimizing the role of pharmacotherapy in the management of insomnia. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

An international survey of nutritional practices in low- and middle-income countries: a report from the International Society of Pediatric Oncology (SIOP) PODC Nutrition Working Group.

PubMed

Murphy, A J; Mosby, T T; Rogers, P C; Cohen, J; Ladas, E J

2014-12-01

Optimal nutritional status is important in children with cancer, as it can influence clinical outcomes. To improve the nutritional health of children and adolescents receiving treatment for cancer residing in low income and middle-income countries (LMIC), we investigated nutrition practices among these nations' institutions providing treatment for childhood cancer. A cross-sectional survey of nutrition practice was administered to staff members at institutions providing treatment for children with cancer between 2011 and 2012. Countries classified as low income and middle income were divided by geographical region. Final analysis was performed with 96 surveys, which included 27 institutions from Asia, 27 institutions from Latin America and Caribbean, 27 institutions from Africa and 15 institutions from Europe. The study found that 55% of institutions had a dietician available on their service. Access to dieticians, lack of nutrition resources and lack of nutrition education of staff were the main barriers to providing nutrition care in LMIC. Half of the institutions performed nutritional assessment at diagnosis, and the methods used varied widely. Twenty-nine percent of all institutions used complementary and alternate therapies within their clinical practice, and 35% of institutions reported that nutrition education was provided to patients and families. Priority areas for improving the nutritional management in LMIC include the following: (1) improved nutrition education and assessment tools for doctors and nurses; (2) increased availability of nutrition education resources for families and patients; and (3) identification of the role of complementary and alternative therapies in closing gaps in symptom management in these institutions.

Expectations and responsibilities regarding the sale of complementary medicines in pharmacies: perspectives of consumers and pharmacy support staff.

PubMed

Iyer, Priya; McFarland, Reanna; La Caze, Adam

2017-08-01

Most sales of complementary medicines within pharmacies are conducted by pharmacy support staff. The absence of rigorous evidence for the effectiveness of many complementary medicines raises a number of ethical questions regarding the sale of complementary medicines in pharmacies. Explore (1) what consumers expect from pharmacists/pharmacies with regard to the sale of complementary medicines, and (2) how pharmacy support staff perceive their responsibilities when selling complementary medicines. One-on-one semi-structured interviews were conducted with a convenience sample of pharmacy support staff and consumers in pharmacies in Brisbane. Consumers were asked to describe their expectations when purchasing complementary medicines. Pharmacy support staff were asked to describe their responsibilities when selling complementary medicines. Interviews were conducted and analysed using the techniques developed within Grounded Theory. Thirty-three consumers were recruited from three pharmacies. Consumers described complementary medicine use as a personal health choice. Consumer expectations on the pharmacist included: select the right product for the right person, expert product knowledge and maintaining a wide range of good quality stock. Twenty pharmacy support staff were recruited from four pharmacies. Pharmacy support staff employed processes to ensure consumers receive the right product for the right person. Pharmacy support staff expressed a commitment to aiding consumers, but few evaluated the reliability of effectiveness claims regarding complementary medicines. Pharmacists need to respect the personal health choices of consumers while also putting procedures in place to ensure safe and appropriate use of complementary medicines. This includes providing appropriate support to pharmacy support staff. © 2016 Royal Pharmaceutical Society.

77 FR 28396 - National Center for Complementary & Alternative Medicine Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

... Complementary & Alternative Medicine Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alternative Medicine Special Emphasis Pane,l Clinical Research of Complementary Medical Care. Date: June 5..., and Alternative Medicine, National Institutes of Health, 6707 Democracy Boulevard, Suite 401, Bethesda...

Complementary filter implementation in the dynamic language Lua

NASA Astrophysics Data System (ADS)

Sadowski, Damian; Sawicki, Aleksander; Lukšys, Donatas; Slanina, Zdenek

2017-08-01

The article presents the complementary filter implementation, that is used for the estimation of the pitch angle, in Lua script language. Inertial sensors as accelerometer and gyroscope were used in the study. Methods of angles estimation using acceleration and angular velocity sensors were presented in the theoretical part of the article. The operating principle of complementary filter has been presented. The prototype of Butterworth's analogue filter and its digital equivalent have been designed. Practical implementation of the issue was performed with the use of PC and DISCOVERY evaluation board equipped with STM32F01 processor, L3GD20 gyroscope and LS303DLHC accelerometer. Measurement data was transmitted by UART serial interface, then processed with the use of Lua software and luaRS232 programming library. Practical implementation was divided into two stages. In the first part, measurement data has been recorded and then processed with help of a complementary filter. In the second step, coroutines mechanism was used to filter data in real time.

Herbal medications and plastic surgery: a hidden danger.

PubMed

Mohan, Arvind; Lahiri, Anindya

2014-04-01

Herbal medicine is a multibillion-pound industry, and surveys suggest that ~10% of the UK population uses herbal supplements concurrently with prescription medications. Patients and health care practitioners are often unaware of the adverse side effects of herbal medicines. In addition, because many of these herbal supplements are available over the counter, many patients do not disclose these when listing medications to health care providers. A 39-year-old nurse underwent an abdominoplasty with rectus sheath plication after weight loss surgery. Postoperatively, she experienced persistent drain output, and after discharge, a seroma developed requiring repeated drainage in the clinic. After scar revision 10 months later, the woman bled postoperatively, requiring suturing. Again, a seroma developed, requiring repeated drainage. It was discovered that the patient had been taking a herbal menopause supplement containing ingredients known to have anticoagulant effects. Complementary medicine is rarely taught in UK medical schools and generally not practiced in UK hospitals. Many supplements are known to have anticoagulant, cardiovascular, and sedative effects. Worryingly, questions about herbal medicines are not routinely asked in clinics, and patients do not often volunteer such information. With the number and awareness of complementary medications increasing, their usage among the population is likely to increase. The authors recommend specific questioning about the use of complementary medications and consideration of ceasing such medications before surgery. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

An Exploration of Edible Palm Weevil Larvae (Akokono) as a Source of Nutrition and Livelihood: Perspectives From Ghanaian Stakeholders.

PubMed

Laar, Amos; Kotoh, Agnes; Parker, Megan; Milani, Peiman; Tawiah, Charlotte; Soor, Shobhita; Anankware, Jacob P; Kalra, Nikhila; Manu, Grace; Tandoh, Akua; Zobrist, Stephanie; Engmann, Cyril; Pelto, Gretel

2017-12-01

Meeting the nutritive needs of infants and young children is a challenge in Ghana. Alternative animal source foods, including insects, could enhance infant and young child dietary quality while also improving livelihoods. To investigate the perspectives of Ghanaian stakeholders on the acceptability of the palm weevil larvae ( akokono) as a food source and the feasibility of micro-farming this local edible insect as a complementary food for infants and young children. We conducted an ethnographic study in the Brong-Ahafo Region of Ghana. First, 48 caregivers were asked questions about feeding and care practices, including attitudes toward production and consumption of akokono. Then, a selection of previously interviewed respondents joined 1 of 8 focus group discussions to provide further insight on key themes that emerged from earlier interviews. Concurrently, interviews with 25 other key local stakeholders were conducted. Respondents generally had favorable perceptions of akokono as a nutritious food. A small minority would not consume akokono for religious reasons. Key factors positively influencing the acceptability of akokono as a complementary food were familiarity with the consumption of akokono by the primary caregiver and health worker endorsement of akokono. Stakeholders consider the larvae farmable and were open to its domestication. Anticipated barriers to scaling up akokono micro-farming include a need for greater familiarity with and acceptance of the insect as food for infants and young children and creation of a sustainable market. Engagement with stakeholders, including health workers, will facilitate use of akokono as a complementary food.

Broadening our perspectives on complementary and alternative medicine for menopause: A narrative review.

PubMed

Tonob, Dunia; Melby, Melissa K

2017-05-01

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.

Impact of a collaborative interprofessional learning experience upon medical and social work students in geriatric health care.

PubMed

Gould, Paul Robert; Lee, Youjung; Berkowitz, Shawn; Bronstein, Laura

2015-01-01

Interprofessional collaborative practice is increasingly recognized as an essential model in health care. This study lends preliminary support to the notion that medical students (including residents) and social work students develop a broader understanding of one another's roles and contributions to enhancing community-dwelling geriatric patients' health, and develop a more thorough understanding of the inherent complexities and unique aspects of geriatric health care. Wilcoxon Signed Rank Tests of participants' scores on the Index of Interdisciplinary Collaboration (IIC) indicated the training made significant changes to the students' perception of interprofessional collaboration. Qualitative analysis of participants' statements illustrated (1) benefits of the IPE experience, including complementary roles in holistic interventions; and (2) challenges to collaboration. The findings suggest that interprofessional educational experiences have a positive impact upon students' learning and strategies for enhanced care of geriatric patients.

A critical narrative analysis of shared decision-making in acute inpatient mental health care.

PubMed

Stacey, Gemma; Felton, Anne; Morgan, Alastair; Stickley, Theo; Willis, Martin; Diamond, Bob; Houghton, Philip; Johnson, Beverley; Dumenya, John

2016-01-01

Shared decision-making (SDM) is a high priority in healthcare policy and is complementary to the recovery philosophy in mental health care. This agenda has been operationalised within the Values-Based Practice (VBP) framework, which offers a theoretical and practical model to promote democratic interprofessional approaches to decision-making. However, these are limited by a lack of recognition of the implications of power implicit within the mental health system. This study considers issues of power within the context of decision-making and examines to what extent decisions about patients' care on acute in-patient wards are perceived to be shared. Focus groups were conducted with 46 mental health professionals, service users, and carers. The data were analysed using the framework of critical narrative analysis (CNA). The findings of the study suggested each group constructed different identity positions, which placed them as inside or outside of the decision-making process. This reflected their view of themselves as best placed to influence a decision on behalf of the service user. In conclusion, the discourse of VBP and SDM needs to take account of how differentials of power and the positioning of speakers affect the context in which decisions take place.

Breast-feeding initiation and exclusive breast-feeding in rural Vietnam.

PubMed

Duong, Dat V; Binns, Colin W; Lee, Andy H

2004-09-01

To investigate the initiation of breast-feeding and exclusive breast-feeding within the first week after delivery for women in rural Vietnam. An interviewer-administered survey was conducted on a sample of rural women who gave birth during August-October 2002. Quang Xuong District, Thanh Hoa Province of Vietnam. Four hundred and sixty-three women participated in the study, of whom 181 delivered at the district hospital (39.1%), 229 at a commune health centre (49.5%) and 53 at home attended by a traditional birth attendant (11.4%). Although the initiation and exclusive breast-feeding rates were relatively high at 98.3% and 83.6% respectively, the premature introduction of complementary food was a great concern. Logistic regression analysis showed that, together with socio-cultural determinants such as feeding preferences of the husband and maternal grandmother, feeding practices of friends, factors relating to delivery methods, delivery locations and health problems could influence the initiation rate and breast-feeding patterns. To promote breast-feeding practices of rural mothers, health education on breast-feeding should take into account local socio-cultural features in addition to improving the counselling skills of health workers.

Petit bourgeois health care? The big small-business of private complementary medical practice.

PubMed

Andrews, Gavin J; Phillips, David R

2005-05-01

Although small business private complementary medicine (CAM) has grown to be a significant provider of health care in many Western societies, there has been relatively little research on the sector in business terms and on its wider socio-economic position and role. Using a combined questionnaire and interview survey, and the concept of small business petit bourgeoisie as a framework, this paper considers the character of therapists and their businesses in England and Wales. The findings suggest that typical of the core characteristics of both the petit bourgeoisie and therapists are the selling of goods with a considerable market viability, at the same time financial insecurity; the modest size of businesses; small amounts of direct employment generation and business owners undertaking everyday 'hands-on' work themselves. Certain of the therapists' and business characteristics depart from the stereotypical image of a small businesses class, such as the high incidence of part-time self-employment and incomes being supplemented often by unrelated waged employment. However, given the acknowledged diversity of the petit bourgeoisie between societies and over time, the framework is arguably appropriate in this context, and private CAM a latest guise. Indeed, just as the petit bourgeoisie have traditionally found market niches either neglected or rejected by bigger business, small business CAM has provided the forms of health care neglected and sometimes rejected by orthodox medicine.

RISK ASSESSMENT AND LIFE CYCLE IMPACT ASSESSMENT (LCIA) FOR HUMAN HEALTH CANCEROUS AND NONCANCEROUS EMISSIONS: INTEGRATED AND COMPLEMENTARY WITH CONSISTENCY WITHIN THE USEPA

EPA Science Inventory

The historical parallels, complementary roles, and potential for integration of human health risk assessment (RA) and Life-Cycle Impact Assessment (LCIA) are explored. Previous authors have considered the comparison of LCA and risk assessment recognizing the inherent differences ...

Health Promotion and Complementary Medicine: The Extent and Future of Professional Collaboration and Integration

ERIC Educational Resources Information Center

Hill, Faith

2006-01-01

Purpose: To explore the professional interface between health promotion (HP) and complementary and alternative medicine. Design/methodology/approach: A discussion paper, based on qualitative research involving in-depth interviews with 52 participants from either side of the interface. Findings: The current interface is predominantly limited to…

Use of Complementary and Alternative Medicine (CAM) in cancer patients: An Italian multicenter survey

PubMed Central

Berretta, Massimiliano; Pepa, Chiara Della; 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

2017-01-01

Introduction 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. Patients and method 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. RESULTS 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. Conclusion 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. PMID:28212560

Non-Pharmacological Treatments for ADHD in Youth

PubMed Central

Sharma, Anup; Gerbarg, Patricia L.; Brown, Richard P.

2016-01-01

Background Complementary and alternative medicine (CAM) in psychiatry or integrative psychiatry covers a wide range of biological, psychological and mind-body treatments that enhance standard medical practices and patient outcomes. While CAM approaches are popular amongst patients in their practice as well as in self-report because of their ease of use, health professionals have received limited education in these interventions and often are unaware of their patients’ use of CAM treatments. Method This overview highlights evidence-based CAM treatments for attention deficit hyperactivity disorder (ADHD) including dietary interventions, phytomedicines, mind-body practices and neurofeedback. Results While conventional treatments are the mainstays for ADHD, there are a large number of available treatments that can be used to enhance treatment response. Conclusion With improved education and further scientific and clinical research, validated integrative treatments will provide more effective, lower risk and lower cost care for patients with ADHD. PMID:27489754

Could yoga practice improve treatment-related side effects and quality of life for women with breast cancer? A systematic review and meta-analysis.

PubMed

Pan, Yuanqing; Yang, Kehu; Wang, Yuliang; Zhang, Laiping; Liang, Haiqing

2017-04-01

To determine if yoga as a complementary and alternative therapy was associated with enhanced health and treatment-related side effects in patients with breast cancer. This systematic review examines whether yoga practice provides any measurable benefit, both physically and psychologically, for women with breast cancer. PubMed, EMBASE and the Cochrane Library for randomized controlled trials (RCTs) throughout June 2013. We evaluated the quality of the included studies by the Cochrane Handbook 5.2 standards and analyzed the data using the Stata software, version 10.0. Meta-regression and subgroup analysis were also performed to identify additional predictors of outcome and to assess heterogeneity. Sixteen RCTs with a total of 930 participants were included. Comparing yoga groups to control groups, there was a statistically significant difference in overall health-related quality of life, depression, anxiety and gastrointestinal symptoms. Meta-regression analyses revealed that the duration of yoga practice and type of control group partly explained the heterogeneity. Subgroup analyses revealed that yoga had a positive effect on anxiety only when it had been practiced for longer than 3 months. Only the wait-list control group showed an effect of yoga on physical well-being. The current evidence demonstrates that yoga practice could be effective in enhancing health and managing some treatment-related side effects for patients recovering from breast cancer. In future clinical studies, clinicians should consider the patient's wishes along with the current best evidence of the effects of yoga practice in their clinical decision-making. © 2015 Wiley Publishing Asia Pty Ltd.

Complementary medicine for cancer patients in general practice: qualitative interviews with german general practitioners.

PubMed

Dahlhaus, Anne; Siebenhofer, Andrea; Guethlin, Corina

2015-01-01

The aim of this study was to investigate how general practitioners react when their cancer patients show interest in complementary medicine, and how their reaction is related to their knowledge in the field. We conducted semi-structured interviews with 10 German general practitioners. Interviewees came from 5 different federal states and varied in terms of urban/rural setting, single/joint practice, additional certifications, gender and length of professional experience. Interviews were electronically recorded, transcribed and then analysed using qualitative content analysis according to Mayring. General practitioners feel largely responsible for providing information on complementary medicine to their cancer patients. However, uncertainty and a lack of knowledge concerning CAM lead mainly to reactive responses to patients' needs, and the general practitioners base their recommendations on personal experiences and attitudes. They wish to support their cancer patients and thus, in order to keep their patients' hopes up and maintain a trusting relationship, sometimes support complementary medicine, regardless of their own convictions. Although general practitioners see themselves as an important source of information on complementary medicine for their cancer patients, they also speak of their uncertainties and lack of knowledge. General practitioners would profit from training in complementary medicine enabling them to discuss this topic with their cancer patients in a proactive, open and honest manner. © 2015 S. Karger GmbH, Freiburg

Practice-Based Knowledge Discovery for Comparative Effectiveness Research: An Organizing Framework

PubMed Central

Lucero, Robert J.; Bakken, Suzanne

2014-01-01

Electronic health information systems can increase the ability of health-care organizations to investigate the effects of clinical interventions. The authors present an organizing framework that integrates outcomes and informatics research paradigms to guide knowledge discovery in electronic clinical databases. They illustrate its application using the example of hospital acquired pressure ulcers (HAPU). The Knowledge Discovery through Informatics for Comparative Effectiveness Research (KDI-CER) framework was conceived as a heuristic to conceptualize study designs and address potential methodological limitations imposed by using a single research perspective. Advances in informatics research can play a complementary role in advancing the field of outcomes research including CER. The KDI-CER framework can be used to facilitate knowledge discovery from routinely collected electronic clinical data. PMID:25278645

A tale of two cultures: examining patient-centered care in a forensic mental health hospital

PubMed Central

Livingston, James D.; Nijdam-Jones, Alicia; Brink, Johann

2012-01-01

Several questions remain unanswered regarding the extent to which the principles and practices of patient-centered care are achievable in the context of a forensic mental health hospital. This study examined patient-centered care from the perspectives of patients and providers in a forensic mental health hospital. Patient-centered care was assessed using several measures of complementary constructs. Interviews were conducted with 30 patients and surveys were completed by 28 service providers in a forensic mental health hospital. Patients and providers shared similar views of the therapeutic milieu and recovery orientation of services; however, providers were more likely to perceive the hospital as being potentially unsafe. Overall, the findings indicated that characteristics of patient-centered care may be found within a forensic mental health hospital. The principles of patient-centered care can be integrated into service delivery in forensic mental health hospitals, though special attention to providers’ perceptions of safety is needed. PMID:22815648

Postnatal Prevention of Childhood Obesity in Offspring Prenatally Exposed to Gestational Diabetes mellitus: Where Are We Now?

PubMed Central

Dugas, Camille; Perron, Julie; Kearney, Michèle; Mercier, Roxanne; Tchernof, André; Marc, Isabelle; Weisnagel, S. John; Robitaille, Julie

2017-01-01

Children exposed to gestational diabetes mellitus (GDM) in utero are at high risk of developing many health problems such as obesity. There is an urgent need to find new strategies to prevent obesity development among high-risk populations such as those children. Accordingly, the aim of this review was to summarize current knowledge on the postnatal prevention of childhood obesity in offspring born from mothers with GDM. Specifically, this review addresses the impact of breastfeeding, complementary feeding practices as well as dietary intake and physical activity during childhood on obesity risk of children exposed to GDM in utero. Furthermore, breast milk composition of diabetic mothers and its potential impact on growth is discussed. According to the available literature, breastfeeding may reduce obesity risk in children exposed to GDM in utero but a longer duration seems necessary to achieve its protective effect against obesity. Detailed analysis of breast milk composition of mothers with GDM will be necessary to fully understand the relationship between breastfeeding and obesity in this specific population. This review highlights the need for more studies addressing the impact of complementary feeding practices and lifestyle habits during childhood on obesity risk of children exposed to GDM in utero. PMID:28848122

Postnatal Prevention of Childhood Obesity in Offspring Prenatally Exposed to Gestational Diabetes mellitus: Where Are We Now?

PubMed

Dugas, Camille; Perron, Julie; Kearney, Michèle; Mercier, Roxanne; Tchernof, André; Marc, Isabelle; Weisnagel, S John; Robitaille, Julie

2017-01-01

Children exposed to gestational diabetes mellitus (GDM) in utero are at high risk of developing many health problems such as obesity. There is an urgent need to find new strategies to prevent obesity development among high-risk populations such as those children. Accordingly, the aim of this review was to summarize current knowledge on the postnatal prevention of childhood obesity in offspring born from mothers with GDM. Specifically, this review addresses the impact of breastfeeding, complementary feeding practices as well as dietary intake and physical activity during childhood on obesity risk of children exposed to GDM in utero. Furthermore, breast milk composition of diabetic mothers and its potential impact on growth is discussed. According to the available literature, breastfeeding may reduce obesity risk in children exposed to GDM in utero but a longer duration seems necessary to achieve its protective effect against obesity. Detailed analysis of breast milk composition of mothers with GDM will be necessary to fully understand the relationship between breastfeeding and obesity in this specific population. This review highlights the need for more studies addressing the impact of complementary feeding practices and lifestyle habits during childhood on obesity risk of children exposed to GDM in utero. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

Prayer and health: review, meta-analysis, and research agenda.

PubMed

Masters, Kevin S; Spielmans, Glen I

2007-08-01

This article reviews the empirical research on prayer and health and offers a research agenda to guide future studies. Though many people practice prayer and believe it affects their health, scientific evidence is limited. In keeping with a general increase in interest in spirituality and complementary and alternative treatments, prayer has garnered attention among a growing number of behavioral scientists. The effects of distant intercessory prayer are examined by meta-analysis and it is concluded that no discernable effects can be found. The literature regarding frequency of prayer, content of prayer, and prayer as a coping strategy is subsequently reviewed. Suggestions for future research include the conduct of experimental studies based on conceptual models that include precise operationally defined constructs, longitudinal investigations with proper measure of control variables, and increased use of ecological momentary assessment techniques.

Untangling the nonrecyclable citizen: a critical reconceptualization of responsibility in recovery.

PubMed

Vandekinderen, Caroline; Roets, Griet; Van Hove, Geert

2014-10-01

Over the last decades, international research, policy, and practice in the field of mental health care and a complementary variety of social work and social service delivery methods have been focused on recovery as a dominant concept. Emphasizing the service user's responsibility appears to be a central component in the empowering process of recovery. Using a critical disability studies perspective, we aimed to untangle the relationship between the individual citizen with mental health problems and the society in which the recovery discourse operates in Belgium. In this article we explore the social dynamics in the unique life story of Jimmy Sax and analyze a diversity of discourses and practices that turned him into a nonrecyclable citizen. While exploring the different modes through which Jimmy's subjectivity was transformed throughout the course of his life, we expose the convoluted nature of the recovery paradigm, which leads to a reconceptualization of the notion of responsibility in recovery. © The Author(s) 2014.

An exploratory study of complementary and alternative medicine in hospital midwifery: models of care and professional struggle.

PubMed

Adams, Jon

2006-02-01

Complementary and alternative medicine (CAM) is increasingly popular amongst midwives in Australia. A growing number of hospital midwives are personally integrating one or a range of CAM within their midwifery practice. Despite this trend we still know little about CAM in midwifery, particularly at a grass-roots level. This paper reports findings from one section of a larger exploratory study examining grass-root practitioners' understandings and experiences of complementary therapies in nursing and midwifery. Thirteen in-depth interviews were conducted with midwives working in New South Wales public hospitals and currently integrating CAM within their general midwifery practice. Analysis illustrates how midwives' explanations of, and affinity claims regarding, CAM feed into wider ongoing issues relating to professional autonomy and the relationship between midwifery and obstetrics.

75 FR 26260 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-11

... Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alternative Medicine Special Emphasis Panel; Loan Repayment Program. Date: May 17, 2010. Time: 8 a.m. to 5 p.m..., Research and Training in Complementary and Alternative Medicine, National Institutes of Health, HHS) [[Page...

76 FR 29773 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-23

... Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alternative Medicine Special Emphasis Panel; NCCAM Education Panel. Date: June 23-24, 2011. Time: 8 a.m. to 12... Complementary and Alternative Medicine, National Institutes of Health, HHS) Dated: May 17, 2011. Jennifer S...

Racial and Ethnic Profiles of Complementary and Alternative Medicine Use Among Young Adults in the United States: Findings From the National Longitudinal Study of Adolescent Health.

PubMed

Upchurch, Dawn M; Wexler Rainisch, Bethany K

2012-10-01

This study describes complementary and alternative medicine use among a national sample of young adults, with an emphasis on characterizing racial and ethnic differences, highlighting variation across subgroups of Hispanics. The authors examined young adults ages 18 to 27 years (n = 14 128) from wave III (2001-2002) of the National Longitudinal Study of Adolescent Health. Prevalence estimates and logistic regression results were weighted and adjusted for complex sample design. The study examined recent complementary and alternative medicine use in the past 12 months, recent use for each of 15 specific complementary and alternative medicine modalities, and the 5 most commonly used modalities (herbs, massage, chiropractic, relaxation, and vitamins). Results showed that 29% of young adults aged 18 to 27 years recently used complementary and alternative medicine. Prevalence was highest among Cuban Americans (42%) and lowest among blacks (22%). Young adults used a diversity of complementary and alternative medicine modalities and there were substantial differences in use across racial and ethnic groups.

Racial and Ethnic Profiles of Complementary and Alternative Medicine Use Among Young Adults in the United States: Findings From the National Longitudinal Study of Adolescent Health

PubMed Central

Upchurch, Dawn M.; Wexler Rainisch, Bethany K.

2013-01-01

This study describes complementary and alternative medicine use among a national sample of young adults, with an emphasis on characterizing racial and ethnic differences, highlighting variation across subgroups of Hispanics. The authors examined young adults ages 18 to 27 years (n = 14 128) from wave III (2001–2002) of the National Longitudinal Study of Adolescent Health. Prevalence estimates and logistic regression results were weighted and adjusted for complex sample design. The study examined recent complementary and alternative medicine use in the past 12 months, recent use for each of 15 specific complementary and alternative medicine modalities, and the 5 most commonly used modalities (herbs, massage, chiropractic, relaxation, and vitamins). Results showed that 29% of young adults aged 18 to 27 years recently used complementary and alternative medicine. Prevalence was highest among Cuban Americans (42%) and lowest among blacks (22%). Young adults used a diversity of complementary and alternative medicine modalities and there were substantial differences in use across racial and ethnic groups. PMID:23869288

The role of the Internet in cancer patients' engagement with complementary and alternative treatments.

PubMed

Broom, Alex; Tovey, Philip

2008-04-01

This article draws on a study of 80 National Health Service cancer patients and their experiences of using the Internet within disease and treatment processes. It focuses on the role the Internet plays in the context of potential or actual engagement with complementary and alternative medicine (CAM). The results depart from previous conceptualizations of the Internet as a major source of CAM knowledge, and second, as a major pathway to patient CAM usage. Moreover, the results highlight significant anxiety as patients attempt to process vast amounts of complex biomedical diagnostic and prognostic information online. For patients attempting to embrace alternative therapeutic models of cancer care, exposure to prognostic data may pose considerable risks to individual well-being and engagement with healing practices. On the basis of these results we problematize social theorizations of the Internet as contributing to such things as: the democratization of knowledge; the deprofessionalization of medicine; and patient empowerment. We emphasize, instead, the potential role of the Internet in reinforcing biomedicine's paradigmatic dominance in cancer care.

Complementary therapy use by women's health clinic clients.

PubMed

Pettigrew, Amy C; King, Margaret O'Brien; McGee, Karen; Rudolph, Connie

2004-01-01

While it is known that more women than men use complementary and alternative therapies, it is important to look at women who are pregnant or possibly receiving hormonal therapy, as side effects and consequences of these therapies may have a significant effect on their health status. To assess women's knowledge, perceived effectiveness and use of 20 complementary and alternative therapies. Descriptive four-page questionnaire to obtain data on the use, reason for use, knowledge, perceived effectiveness, and sources of information of twenty complementary and alternative therapies. Women's Health Center at a large Midwestern hospital. A convenience sample of 250 women waiting to be seen by either a nurse midwife or obstetrician/gynecologist at an outpatient clinic. Sixty-nine percent of the participants used one or more complementary therapy. The most frequently used therapies included prayer, vitamins, massage, diet, and aromatherapy. The best predictor of use of each therapy was the participant's knowledge of the therapy. Participants generally rated the efficacy of the therapies higher than their knowledge level. Frequently cited sources of information were popular media and family. The least common information sources were nurse-midwives, drug stores, Internet, and other professional healthcare providers. Women in this setting use complementary therapies at a rate greater than the general population. The participants obtained a great deal of their information about the therapies from popular press, media, friends, and family members rather than from licensed healthcare providers.

Chapter 5 mantram repetition: an evidence-based complementary practice for military personnel and veterans in the 21st century.

PubMed

Bormann, Jill E; Weinrich, Sally; Allard, Carolyn B; Beck, Danielle; Johnson, Brian D; Holt, Lindsay Cosco

2014-01-01

Today in the digital age, with our advances in modern technology and communication, there are additional stressors for our military personnel and Veterans. Constant dangers exist both on and off the battlefield, unlike prior wars that had clearly-defined war zones. In addition, medical advances have assisted in saving the lives of many more gravely injured troops than ever previously possible. As the wars in Iraq and Afghanistan come to an end, large numbers of service men and women are returning home with multiple injuries. This group of Veterans has significantly higher rates of posttraumatic stress disorder (PTSD) and traumatic brain injury than ever before reported. Although existing PTSD therapies have been found to be highly effective for many Veterans, there is a substantial minority unsatisfactorily treated. Mantram repetition, an innovative, complementary, evidence-based treatment, is proving to be successful for these new Veterans. When used regularly it helps with "road rage, impatience, anger, frustration, and being out of control." A mantram is a brief, sacred word or phrase that embodies divine power or the greatest positive energy one can imagine (Easwaran, 2008a). Mantram repetition is a simple, quick, personal, portable, and private complementary practice that may be used as an adjunct to current treatments for PTSD. Growing research evidence supports mantram repetition's value for dissemination and adoption in the 21st century. This chapter summarizes Mantram Program research conducted from 2003 to 2014. It describes the health-related benefits of the Mantram Program in various populations. The current research focuses on benefits for managing psychological distress and promoting quality of life in Veterans. Future areas for research are suggested.

Household Food Security Is Associated with Infant Feeding Practices in Rural Bangladesh1,2

PubMed Central

Saha, Kuntal K.; Frongillo, Edward A.; Alam, Dewan S.; Arifeen, Shams E.; Persson, Lars Åke; Rasmussen, Kathleen M.

2008-01-01

Although household food security (HHFS) has been shown to affect diet, nutrition, and health of adults and also learning in children, no study has examined associations with infant feeding practices (IFP). We studied 1343 infants born between May 2002 and December 2003 in the Maternal and Infant Nutrition Intervention in Matlab study to investigate the effect of HHFS on IFP in rural Bangladesh. We measured HHFS using a previously developed 11-item scale. Cumulative and current infant feeding scales were created from monthly infant feeding data for the age groups of 1–3, 1–6, 1–9, and 1–12 mo based on comparison to infant feeding recommendations. We used lagged, dynamic, and difference longitudinal regression models adjusting for various infant and maternal variables to examine the association between HHFS and changes in IFP, and Cox proportional hazards models to examine the influence of HHFS on the duration of breast-feeding and the time of introduction of complementary foods. Better HHFS status was associated with poor IFP during 3–6 mo but was associated with better IFP during 6–9 and 9–12 mo of age. Although better HHFS was not associated with the time of introduction of complementary foods, it was associated with the type of complementary foods given to the infants. Intervention programs to support proper IFP should target mothers in food-secure households when their babies are 3–6 mo old and also mothers in food-insecure households during the 2nd half of infancy. Our results provide strong evidence that HHFS influences IFP in rural Bangladesh. PMID:18567765

Discussion of "Representation of People's Decisions in Health Information Systems: A Complementary Approach for Understanding Health Care Systems and Population Health".

PubMed

Al-Shorbaji, Najeeb; Borycki, Elizabeth M; Kimura, Michio; Lehmann, Christoph U; Lorenzi, Nancy M; Moura, Lincoln A; Winter, Alfred

2017-02-01

This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Representation of People's Decisions in Health Information Systems: A Complementary Approach for Understanding Health Care Systems and Population Health" written by Fernan Gonzalez Bernaldo de Quiros, Adriana Ruth Dawidowski, and Silvana Figar. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the paper of de Quiros, Dawidowski, and Figar. In subsequent issues the discussion can continue through letters to the editor.

Effectiveness of facility-based personalized maternal nutrition counseling in improving child growth and morbidity up to 18 months: A cluster-randomized controlled trial in rural Burkina Faso

PubMed Central

Huybregts, Lieven; Martin-Prevel, Yves; Donnen, Philippe; Lanou, Hermann; Grosemans, Joep; Offoh, Priscilla; Dramaix-Wilmet, Michèle; Sondo, Blaise; Roberfroid, Dominique; Kolsteren, Patrick

2017-01-01

The period from conception to 24 months of age is a crucial window for nutrition interventions. Personalized maternal counseling may improve childbirth outcomes, growth, and health. We assessed the effectiveness of facility-based personalized maternal nutrition counseling (from pregnancy to 18 months after birth) in improving child growth and health in rural Burkina Faso. We conducted a paired cluster randomized controlled trial in a rural district of Burkina Faso with 12 primary health centers (clusters). Healthcare providers in the intervention centers received patient-centered communication and nutrition counseling training. Pregnant women in the third trimester living in the center catchment areas and intending to stay for the next 2 years were prospectively included. We followed 2253 mother-child pairs quarterly until the child was aged 18 months. Women were interviewed about counseling experiences, dietary practices during pregnancy, and their child’s feeding practices and morbidity history. Anthropometric measurements were taken at each visit using standardized methods. The primary outcomes were the cumulative incidence of wasting, and changes in child weight-for-height z-score (WHZ). Secondary outcomes were the women’s prenatal dietary practices, early breastfeeding practices, exclusive breastfeeding, timely introduction of complementary food, child’s feeding frequency and dietary diversity, children’s mean birth weight, endpoint prevalence of stunting, and cumulative incidence of diarrhea, fever, and acute respiratory infection. All analyses were by intention-to-treat using mixed effects models. The intervention and control arms each included six health centers. Mothers in the intervention arm had a significantly higher exposure to counseling with 11.2% for breastfeeding techniques to 75.7% for counseling on exclusive breastfeeding. Mothers of infants below 6 months of age in the intervention arm were more likely to exclusively breastfeed (54.3% vs 42.3%; Difference of Proportion (DP) 12.8%; 95% CI: 2.1, 23.6; p = 0.020) as compared to the control arm. Between 6 and 18 months of age, more children in the intervention arm benefited from the required feeding frequency (68.8% vs 53.4%; DP 14.1%; 95% CI: 9.0, 19.2; p<0.001) and a larger proportion had a minimum dietary diversity (28.6% vs 22.0%; DP 5.9%; 95% CI: 2.7, 9.2; p<0.001). Birth weight of newborns in the intervention arm was on average 84.8 g (p = 0.037) larger compared to the control arm. However, we found no significant differences in child anthropometry or morbidity between study arms. Facility-based personalized maternal nutrition counseling was associated with an improved prenatal dietary practices, Infant and Young Child Feeding practices, and child birth weight. Complementary strategies are warranted to obtain meaningful impact on child growth and morbidity. This includes strategies to ensure good coverage of facility-based services and effective nutrition/care practices in early childhood. PMID:28542391

Use of complementary and alternative medicines during the third trimester.

PubMed

Pallivalapila, Abdul Rouf; Stewart, Derek; Shetty, Ashalatha; Pande, Binita; Singh, Rajvir; McLay, James S

2015-01-01

To estimate the prevalence, indications, and associated factors for complementary and alternative medicine use during the last trimester of pregnancy. A questionnaire survey was conducted of women with a live birth (N=700) admitted to the postnatal unit at the Royal Aberdeen Maternity Hospital, northeast Scotland. Outcome measures included: complementary and alternative medicine used; vitamins and minerals used; reasons for complementary and alternative medicine use; independent associated factors for use; views; and experiences. Descriptive and inferential statistical analysis was performed. The response rate was 79.6% of eligible women. Two thirds of respondents (61.4%) reported using complementary and alternative medicine, excluding vitamins and minerals, during the third trimester. Respondents reported using a total of 30 different complementary and alternative medicine modalities, of which oral herbal products were the most common (38% of respondents, 40 different products). The independent associated factors for complementary and alternative medicine use identified were: complementary and alternative medicine use before pregnancy (odds ratio [OR] 4.36, 95% confidence interval [CI] 2.39-7.95, P<.001); a university education (OR 2.41, 95% CI 1.46-4.0, P=.001), and complementary and alternative medicine use by family or friends (OR 2.36, 95% CI 1.61-3.47, P<.001). There was no association with health care professional recommendations. Users were significantly more likely than nonusers to agree that complementary and alternative medicines were safer than prescribed medicines (P=.006), less likely to be associated with side effects (P≤.001), and could interfere with conventional medicines (P≤.001). Despite the majority of respondents, and notably users, being uncertain about their safety and effectiveness, complementary and alternative medicine modalities and complementary and alternative medicine products are widely used during the third trimester of pregnancy in this study population. Although prior use was the most significant independent associated factor, the role of family and friends, rather than health professionals, in the decision to use complementary and alternative medicine may be of concern. III.

Intergrative health care method based on combined complementary medical practices: rehabilitative acupuncture, homeopathy and chiropractic.

PubMed

Rodríguez-van Lier, María Esperanza; Simón, Luis Manuel Hernández; Gómez, Rosa Estela López; Escalante, Ignacio Peón

2014-01-01

There are various models of health care, such as the epidemiological, psychosocial, sociological, economic, systemic of Neuman, cognitive medicine or ecological, ayurvedic, supraparadigmatic among others. All of them are seeking to combine one or more elements to integrate a model of health care. The article presents a systemic approach to health care with complementary medicines such as rehabilitative acupuncture, homeopathy and chiropractic through the application of a method of holistic care and integrated approach. There was a participatory action research in January 2012 to January 2013, with a comprehensive approach in 64 patients using the clinical method. We included the environmental aspects, biological, emotional, and behavioral to identify, recognize and integrate the form of manifestation of the disease. Later, it was ordered in a coherent way the etiologic factors, precipitating factors and identified the vulnerability of the patients as well as the structural alterations, classifying them in immediate, mediate and late. Referred to the three disciplines: rehabilitative acupuncture, homeopathy and chiropractic to be seen doing references and against-references between them, evaluating the current state of health and each meeting by noting the clinical and behavioral changes submitted and thus the area of attention to which would be forwarded to continue their treatment. 64 patients rotated by the 3 areas taking an average of 30 meetings with rehabilitative acupuncture, 12 with homeopathy and 10 with chiropractic. The changes were submitted clinical attitudinal, behavioral, clinical and organic. The model of care was multifaceted and interdisciplinary with a therapeutic approach of individualization and a holistic view to carry out a comprehensive diagnosis and provide quality health care to the population.

Use of concurrent mixed methods combining concept mapping and focus groups to adapt a health equity tool in Canada.

PubMed

Guichard, Anne; Tardieu, Émilie; Dagenais, Christian; Nour, Kareen; Lafontaine, Ginette; Ridde, Valéry

2017-04-01

The aim of this project was to identify and prioritize a set of conditions to be considered for incorporating a health equity tool into public health practice. Concept mapping and focus groups were implemented as complementary methods to investigate the conditions of use of a health equity tool by public health organizations in Quebec. Using a hybrid integrated research design is a richer way to address the complexity of questions emerging from intervention and planning settings. This approach provides a deeper, operational, and contextualized understanding of research results involving different professional and organizational cultures, and thereby supports the decision-making process. Concept mapping served to identify and prioritize in a limited timeframe the conditions to be considered for incorporation into a health equity tool into public health practices. Focus groups then provided a more refined understanding of the barriers, issues, and facilitating factors surrounding the tools adoption, helped distinguish among participants' perspectives based on functional roles and organizational contexts, and clarified some apparently contradictory results from the concept map. The combined use of these two techniques brought the strengths of each approach to bear, thereby overcoming some of the respective limitations of concept mapping and focus groups. This design is appropriate for investigating targets with multiple levels of complexity. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Quality Model to Select Patients in Cupping Therapy Clinics: A New Tool for Ensuring Safety in Clinical Practice.

PubMed

Aboushanab, Tamer; AlSanad, Saud

2018-06-08

Cupping therapy is a popular treatment in various countries and regions, including Saudi Arabia. Cupping therapy is regulated in Saudi Arabia by the National Center for Complementary and Alternative Medicine (NCCAM), Ministry of Health. The authors recommend that this quality model for selecting patients in cupping clinics - first version (QMSPCC-1) - be used routinely as part of clinical practice and quality management in cupping clinics. The aim of the quality model is to ensure the safety of patients and to introduce and facilitate quality and auditing processes in cupping therapy clinics. Clinical evaluation of this tool is recommended. Continued development, re-evaluation and reassessment of this tool are important. Copyright © 2018. Published by Elsevier B.V.

Health psychology as a context for massage therapy: a conceptual model with CAM as mediator.

PubMed

Hymel, Glenn M; Rich, Grant J

2014-04-01

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.

[Feeding practices in 6-to-24-month-old children in Yaoundé, Cameroon: relationship with their nutritional status].

PubMed

Ngo Um-Sap, S; Mbassi Awa, H; Hott, O; Tchendjou, P; Womga, A; Tanya, A; Koki Ndombo, P

2014-01-01

Shifting from breastfeeding to solid food is known as the complementary feeding period. When complementary feeding is inadequate, malnutrition results in most cases. These practices differ depending on cultural and religious backgrounds as well as geographical location. Ruel and Menon studied the relationship between feeding practices during diversification and nutritional status of children at 6 and 36 months, using a score called the Infant and Child Feeding Index (ICFI). This ICFI scored feeding practices such as breastfeeding, bottle-feeding, food diversity, and meal frequency, which has never been studied in Cameroon. The aim of this study was to describe actual feeding practices in children in our context as well as to investigate their relationship with children's nutritional status. We carried out a cross-sectional study throughout the month of January 2011 at the Chantal-Biya Foundation. Mothers completed a questionnaire on how their infants were fed at birth, the initiation of complementary food, and feeding practices for the 3 days before the survey. The children's anthropometric parameters were noted. All mothers coming for vaccination or vitamin A supplementation for their children aged between 6 and 24 months were enrolled in the study. We enrolled 197 mothers and their infants. Breastfeeding was the main feeding method at birth, but was exclusive until 6 months for only 15 % of the infants. Three-quarter of nursing mothers started adding complementary food at age 4-6 months, using pap. Half of the children did not receive animal products, fruits, or vegetables. When applying the ICFI to these practices, it appeared that the various diversification practices scored less than 8 for 50% of the population. A positive association was noted between the ICFI and nutritional status, as expressed by height-of-age Z-score (HAZ) and the weight-for-age Z-score (WAZ). We concluded that the codified feeding practices with respect to Ruel and Menon's ICFI are associated with the nutritional status of children between 6 and 24 months in Yaounde, Cameroon. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

75 FR 6041 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-05

... Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alternative Medicine Special Emphasis Panel; Basic Science R21s, Ks. Date: March 8-9, 2010. Time: 8 a.m. to 5... Training in Complementary and Alternative Medicine, National Institutes of Health, HHS) Dated: January 27...

75 FR 65498 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-25

... Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Alternative Medicine Special Emphasis Panel, Type 3 P01s. Date: November 16, 2010. Time: 2 p.m. to 3:30 p.m..., Research and Training in Complementary and Alternative Medicine, National Institutes of Health, HHS) Dated...

Behavioral Change Strategies for Improving Complementary Feeding and Breastfeeding.

PubMed

Osendarp, Saskia J M; Roche, Marion L

2016-01-01

Improving infant and young child feeding (IYCF) practices, including breastfeeding and complementary feeding, has been identified as one of the most effective interventions to improve child survival, stunting and wasting. Evidence from randomized controlled trials suggests that effective promotion of breastfeeding and complementary feeding, with or without food provision, has the potential to improve IYCF practices and child nutrition. However, in many countries, breastfeeding practices and complementary feeding practices are still far from optimal. The lack of implementation of available, effective, affordable interventions in scale-up programs is in part attributed to a lack of innovative, creative and effective behavioral change strategies that enable and encourage caregivers. Successful behavioral change strategies should be based on a rigorous situational analysis and formative research, and the findings and insights of formative research should be used to further design interventions that address the identified barriers and enablers, to select delivery channels, and to formulate appropriate and effective messages. In addition, successful behavioral change interventions should a priori define and investigate the program impact pathway to target behavioral change and should assess intermediary behavioral changes and indicators to learn why the expected outcome was achieved or not achieved by testing the program theory. The design of behavioral change communication must be flexible and responsive to shifts in societies and contexts. Performance of adequate IYCF also requires investments to generate community demand through social mobilization, relevant media and existing support systems. Applying these principles has been shown to be effective in improving IYCF practices in Vietnam, Bangladesh and Ethiopia and is recommended to be adopted by other programs and countries in order to accelerate progress in improving child nutrition. © 2016 S. Karger AG, Basel.

Factors affecting pharmacists’ recommendation of complementary medicines – a qualitative pilot study of Australian pharmacists

PubMed Central

2012-01-01

Background Complementary medicines (CMs) are widely used by the Australian public, and pharmacies are major suppliers of these medicines. The integration of CMs into pharmacy practice is well documented, but the behaviours of pharmacists in recommending CMs to customers are less well studied. This study reports on factors that influence whether or not pharmacists in Australia recommend CMs to their customers. Methods Data were collected from semi-structured interviews with twelve practicing pharmacists based in Brisbane, Australia. The qualitative data were analysed by thematic analysis. Results The primary driver of the recommendation of CMs was a desire to provide a health benefit to the customer. Other important drivers were an awareness of evidence of efficacy, customer feedback and pharmacy protocols to recommend a CM alongside a particular pharmaceutical medication. The primary barrier to the recommendation of CMs was safety concerns around patients on multiple medications or with complex health issues. Also, a lack of knowledge of CMs, a perceived lack of evidence or a lack of time to counsel patients were identified as barriers. There was a desire to see a greater integration of CM into formal pharmacy education. Additionally, the provision of good quality educational materials was seen as important to allow pharmacists to assess levels of evidence for CMs and educate them on their safe and appropriate use. Conclusions Pharmacists who frequently recommend CMs identify many potential benefits for patients and see it as an important part of providing a ‘healthcare solution’. To encourage the informed use of CMs in pharmacy there is a need for the development of accessible, quality resources on CMs. In addition, incorporation of CM education into pharmacy curricula would better prepare graduate pharmacists for community practice. Ultimately, such moves would contribute to the safe and effective use of CMs to the benefit of consumers. PMID:23051066

Complementary feeding patterns among ethnic groups in rural western China.

PubMed

Qu, Peng-Fei; Zhang, Ya; Li, Jia-Mei; Zhang, Ruo; Yang, Jiao-Mei; Lei, Fang-Liang; Li, Shan-Shan; Liu, Dan-Meng; Dang, Shao-Nong; Yan, Hong

This study investigated complementary feeding practices among four ethnic groups (Han, Uygur, Tibetan, and Zhuang) based on a cross-sectional survey in rural western China. In 2005, a stratified multistage cluster random sampling method was used to recruit 9712 children (7411 Han, 1032 Uygur, 678 Tibetan, and 591 Zhuang) between 6 and 35 months of age and their mothers from 45 counties in 10 provinces (autonomous regions, municipalities) in western China. The rates of early introduction (before 6 months) of complementary foods in four ethnic groups (Han, Uygur, Tibetan, and Zhuang) were 71.30%, 95.95%, 82.40%, and 72.30%, respectively. The Infant and Child Feeding Index (ICFI) for Uygur and Tibetan children was lower than that for Han children at all age groups. Uygur children were more likely to have unqualified ICFI compared with Han children in a multivariate logistic regression (odds ratio (OR)=5.138, 95% confidence interval (CI): 4.340-6.084). A higher level of maternal education, greater family wealth, and the availability of complementary feeding educational materials decreased the likelihood of an unqualified ICFI. The nutritional status of children (Han, Tibetan, and Zhuang) with qualified ICFI was better than that for children with unqualified ICFI. Appropriate interventions are required to improve complementary feeding practices in rural western China.

The meaning of complementary, alternative and traditional medicine among the Indonesian psychology community: a pilot study.

PubMed

Liem, Andrian; Rahmawati, Kuncoro Dewi

2017-07-01

Complementary, alternative and traditional medicine (CATM) is a new field, as well as a promising area of study and practice in psychology. It is important to research the cultural context and meaning of CATM, including its definitions and examples, among different communities of psychology because CATM's use is dependent on how it is understood by the members. The aim of this pilot study is to provide an interpretation of the Indonesian psychology community's understanding of CATM through a qualitative approach. Online interviews with open-ended questions and purposive sampling were used. Participants were dominantly psychologists or lecturers in clinical psychology area. Ten males and 12 females with an average age of 28.0 ± 2.5 years voluntarily participated in this study. Interviews were audio-recorded, transcribed verbatim, and reviewed and analysed by the two authors to ensure accuracy of interpretation. It was found that there was no single meaning of CATM among the Indonesian community of psychology. Participants were not familiar enough with the terms and tended to use them with overlap. It can be suggested that "complementary medicine" and "alternative medicine" or "complementary-alternative medicine" combined provides more suitable terminology for use among Indonesian psychology community when communicating with other health care professionals. The understanding of the terms and examples of CATM were diverse and were often used interchangeably in the projects/interviews. It was also found that Indonesian psychologists required more education regarding CATM. In addition, future studies with more participants from various aspects of the psychology community should be conducted to capture a more representative sample.

Pharmacokinetic interactions of herbal medicines for the treatment of chronic hepatitis.

PubMed

Hsueh, Tun-Pin; Lin, Wan-Ling; Tsai, Tung-Hu

2017-04-01

Chronic liver disease is a serious global health problem, and an increasing number of patients are seeking alternative medicines or complementary treatment. Herbal medicines account for 16.8% of patients with chronic liver disease who use complementary and alternative therapies. A survey of the National Health Insurance Research Database in Taiwan reported that Long-Dan-Xie-Gan-Tang, Jia-Wei-Xia-Yao-San, and Xiao-Chai-Hu-Tang (Sho-saiko-to) were the most frequent formula prescriptions for chronic hepatitis used by traditional Chinese medicine physicians. Bioanalytical methods of herbal medicines for the treatment of chronic hepatitis were developed to investigate pharmacokinetics properties, but multicomponent herbal formulas have been seldom discussed. The pharmacokinetics of herbal formulas is closely related to efficacy, efficiency, and patient safety of traditional herbal medicines. Potential herbal formula-drug interactions are another essential issue during herbal formula administration in chronic hepatitis patients. In a survey with the PubMed database, this review article evaluates the existing evidence-based data associated with the documented pharmacokinetics profiles and potential herbal-drug interactions of herbal formulas for the treatment of chronic hepatitis. In addition, the existing pharmacokinetic profiles were further linked with clinical practice to provide insight for the safety and specific use of traditional herbal medicines. Copyright © 2016. Published by Elsevier B.V.

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

PubMed

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

2017-08-01

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

Complementary and Alternative Medicine: Attitudes and Use among Health Educators in the United States

ERIC Educational Resources Information Center

Johnson, Ping; Priestley, Jennifer; Porter, Kandice Johnson; Petrillo, Jane

2010-01-01

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…

Parents' Use of Complementary Health Approaches for Young Children with Autism Spectrum Disorder

ERIC Educational Resources Information Center

Lindly, Olivia J.; Thorburn, Sheryl; Heisler, Karen; Reyes, Nuri M.; Zuckerman, Katharine E.

2018-01-01

Knowledge of why parents use complementary health approaches (CHA) for children with autism spectrum disorder (ASD) is limited. We conducted a mixed methods study to better understand factors influencing parents' decision to use CHA for ASD. Parent-reported data about CHA use were collected on a probability sample of 352 young children with ASD in…

78 FR 56238 - National Center for Complementary and Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary and Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meeting. The meeting will be closed to the public in...

78 FR 37836 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-24

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meeting. The meeting will be closed to the public in...

76 FR 17140 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meeting. The meeting will be closed to the public in...

77 FR 52751 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meeting. The meeting will be closed to the public in...

76 FR 79201 - National Center for Complementary & Alternative Medicine; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meetings. The meetings will be closed to the public in...

77 FR 1940 - National Center for Complementary and Alternative Medicine; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary and Alternative Medicine; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meetings. The meetings will be closed to the public in...

76 FR 12744 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meeting. The meeting will be closed to the public in...

76 FR 6806 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meeting. The meeting will be closed to the public in...

76 FR 27651 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-12

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meeting. The meeting will be closed to the public in...

78 FR 34664 - National Center for Complementary and Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-10

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary and Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meeting. The meeting will be closed to the public in...

77 FR 69869 - National Center for Complementary and Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary and Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meeting. The meeting will be closed to the public in...

78 FR 10184 - National Center For Complementary & Alternative Medicine; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center For Complementary & Alternative Medicine; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meetings. The meetings will be closed to the public in...

77 FR 58402 - National Center for Complementary & Alternative Medicine; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-20

... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Center for Complementary & Alternative Medicine; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. App.), notice is hereby given of the following meeting. The meeting will be closed to the public in...

Prevalence and Predictors of Complementary and Alternative Medicine (CAM) Use among Ivy League College Students: Implications for Student Health Services

ERIC Educational Resources Information Center

Versnik Nowak, Amy L.; DeGise, Joe; Daugherty, Amanda; O'Keefe, Richard; Seward, Samuel, Jr.; Setty, Suma; Tang, Fanny

2015-01-01

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,…

Functions of Turkish Complementary Schools in the UK: Official vs. Insider Discourses

ERIC Educational Resources Information Center

Çavusoglu, Çise

2014-01-01

Complementary schools in the United Kingdom (UK) are community organised schools with the general aim of teaching younger generations their "native" languages and cultures. However, the aims and practices of these schools are predominantly dependent on changes in the social and political contexts both in the host country (in this case…

Puncturing the myths of acupuncture.

PubMed

Mallory, Molly J; Do, Alexander; Bublitz, Sara E; Veleber, Susan J; Bauer, Brent A; Bhagra, Anjali

2016-09-01

Acupuncture is a widely practiced system of medicine that has been in place for thousands of years. Consumer interest and use of acupuncture are becoming increasingly popular in the United States, as it is used to treat a multitude of symptoms and disease processes as well as to maintain health and prevent illness. A growing body of evidence increasingly validates the practice of acupuncture. Further developing scientific data will play an important role in the future of acupuncture and other complementary and alternative medicines in public health. Acupuncture is commonly used concurrently with conventional medicine. Although acupuncture is embraced by consumers and medical professionals, misconceptions abound. We have explored and dispelled ten misconceptions common to the practice of acupuncture, utilizing an evidence-based approach. As the trend of merging conventional medical care with acupuncture treatment grows, it is important to develop a conceptual model of integrative medicine. Using a scientific evidence approach will create a structure from which to begin and grow confidence among conventional medical providers. Acupuncture is a safe and effective modality when performed properly by trained professionals. Educating both the consumer and medical community is important to enable appropriate and evidence-based applications of acupuncture and integration with conventional medicine for high-quality patient care.

Improving the intake of nutritious food in children aged 6-23 months in Wuyi County, China – a multi-method approach

PubMed Central

Wu, Qiong; van Velthoven, Michelle H.M.M.T.; Chen, Li; Car, Josip; Rudan, Diana; Saftić, Vanja; Zhang, Yanfeng; Li, Ye; Scherpbier, Robert W.

2013-01-01

Aim To develop affordable, appropriate, and nutritious recipes based on local food resources and dietary practices that have the potential to improve infant feeding practices. Methods We carried out a mixed methods study following the World Health Organization’s evaluation guidelines on the promotion of child feeding. We recruited caregivers with children aged 6-23 months in Wuyi County, Hebei Province, China. The study included a 24-hour dietary recall survey, local food market survey, and development of a key local food list, food combinations, and recipes. Mothers tested selected recipes at their homes for two weeks. We interviewed mothers to obtain their perceptions on the recipes. Results The 24-hour dietary recall survey included 110 mothers. Dietary diversity was poor; approximately 10% of children consumed meat and only 2% consumed vitamin A-rich vegetables. The main reason for not giving meat was the mothers’ belief that their children could not chew and digest meat. With the help of mothers, we developed six improved nutritious recipes with locally available and affordable foods. Overall, mothers liked the recipes and were willing to continue using them. Conclusions This is the first study using a systematic evidence-based method to develop infant complementary recipes that can address complementary feeding problems in China. We developed recipes based on local foods and preparation practices and identified the barriers that mothers faced toward feeding their children with nutritious food. To improve nutrition practices, it is important to both give mothers correct feeding knowledge and assist them in cooking nutritious foods for their children based on locally available products. Further research is needed to assess long-term effects of those recipes on the nutritional status of children. PMID:23630143

Integrative Medicine Selects Best Practice from Public Health and Biomedicine

PubMed Central

Ryan, Terence J

2013-01-01

The meaning of terms Integrated and Integrative are described variously by an amalgam of latest scientific advances with ancient healing systems, of complementary medicine and biomedicine, and sexually transmitted infections and HIV/AIDS. It means seamless good quality care between hospital and primary care. They provoke approval mostly from patients and disapproval mostly from advocates of science and evidence-based medicine. The Institute of Applied Dermatology in Kasaragod, Kerala, India has championed a mix of Biomedicine, Yoga and herbals from Ayurvedic medicine, partly based on publications from the Department of Dermatology of the University of Oxford. In Oxford dermatology, acceptance of value of integrative medicine (IM) is demonstrated, especially in wound healing and the skin's blood supply. This has long featured in the university's research program. A variety of approaches to the practice of medicine are illustrated with reference to Osler, Garrod, and Doll. IM is believed to underlie contemporarily best practice. Particular emphasis is given to the control of heat, pain, redness, and swelling, all manifestations of inflammation, and the importance of emotion as a stimulus or inhibitor carried by neural pathways. These may explain some unbelievable Asian practices and one of the many roles of Yoga. The concept of Integrative is expanded to include care of the earth and nutrition, the hazards of climate change, Gardens for Health, do (k) no (w) harm as a key to good practice. PMID:23716803

Complementary Self-Care Strategies for Healthy Aging.

ERIC Educational Resources Information Center

Barrett, Sondra

1993-01-01

Focuses on alternative self-care practices in terms of collaboration with the primary care physician and individual exploration of self-care practices such as acupuncture, meditation, and nutrition counseling. (JOW)

Introduction of new food textures during complementary feeding: Observations in France.

PubMed

Marduel Boulanger, A; Vernet, M

2018-01-01

Complementary feeding plays a crucial role in the development of infants and toddlers and studies suggest benefits specific to the introduction of food textures. Evaluate the recommendations given to parents, their practices, and their attitudes towards the introduction of food textures during complementary feeding in France. This was a cross-sectional pilot study conducted in 2013. One hundred and eighty-one parents with at least one child aged 6-36 months living in France completed an ad hoc questionnaire. Eighty-eight percent of the parents surveyed received oral information on complementary feeding, but only 46% received such information on the introduction of food textures. Pediatricians were the most frequently listed source of oral information on complementary feeding. More than half the parents also looked for additional information in books and on the internet. While oral recommendations matched parents' practices, they seemed to occur at a later age compared to infants' physiological ability to handle new textures. The quality of information on food texture advice available in paper and electronic formats evaluated using a 4-point scale was found to be limited. Introducing new food texture was spontaneously reported as the most common difficulty in complementary feeding (16%). Fear of choking when first introducing food pieces was reported by 54% of the parents. The parents' lack of information on the introduction of food textures, as well as their fear that their child may choke, should encourage providing new recommendations in France. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Children and Complementary Health Approaches

MedlinePlus

... were natural products 2 (fish oil, melatonin, and probiotics), and chiropractic or osteopathic manipulation. For children, complementary ... nih.gov E-mail: ods@nih.gov U.S. Food and Drug Administration (FDA) The FDA oversees the ...

Acupuncture (PDQ®)—Health Professional Version

Cancer.gov

Acupuncture is a complementary therapy used by cancer patients to manage cancer and treatment-related symptoms. Get detailed information about acupuncture and its use as a complementary therapy in cancer in this summary for clinicians.

A Delivery Model for Home Fortification of Complementary Foods with Micronutrient Powders: Innovation in the Context of Vietnamese Health System Strengthening.

PubMed

Nguyen, Marie; Poonawala, Alia; Leyvraz, Magali; Berger, Jacques; Schofield, Dominic; Nga, Tran Thuy; Van, Tran Khan; Hoa, Do Thi Bao; Wieringa, Frank Tammo

2016-04-29

Adding micronutrient powders (MNP) to complementary foods at the point of preparation (home fortification) can improve micronutrient status of young children. Ensuring sustained access to MNPs at scale, however, remains challenging in many countries. The Global Alliance for Improved Nutrition (GAIN) partnered with the National Institute of Nutrition (NIN) in Vietnam to pioneer the distribution of a locally-produced MNP, provided for sale through the public health system with counseling on optimal infant and young child feeding practices by trained health workers. Different packaging options were available to adapt to caregivers' disposable income. During the six-month pilot, 1.5 million sachets were sold through 337 health centers across four provinces, targeting children 6-59 months of age. Sales were routinely monitored, and a cross-sectional survey in 32 communes for caregivers (n = 962) and health staff (n = 120) assessed MNP coverage and compliance, five months after the start of distribution. A total of 404 caregivers among the 962 caregivers surveyed (i.e., 42%) had visited the health center in the past year. Among them, 290 caregivers had heard about the product and a total of 217caregivers had given the MNP to their child at least once, representing a conversion rate from product awareness to product trial of 74.8%. The effective coverage (i.e., consumption of ≥3 sachets/child/week) was 11.5% among the total surveyed caregivers and reached 27.3% amongst caregivers who visited health centers in the previous month. The MNP purchase trends showed that the number of sachets bought by caregivers was positively correlated with the wealth index. The pilot showed that providing MNPs for sale in packs of various quantities, combined with infant and young child feeding (IYCF) counseling at the health center, is effective for groups accessing the health system.

A Delivery Model for Home Fortification of Complementary Foods with Micronutrient Powders: Innovation in the Context of Vietnamese Health System Strengthening

PubMed Central

Nguyen, Marie; Poonawala, Alia; Leyvraz, Magali; Berger, Jacques; Schofield, Dominic; Nga, Tran Thuy; Van, Tran Khan; Hoa, Do Thi Bao; Wieringa, Frank Tammo

2016-01-01

Adding micronutrient powders (MNP) to complementary foods at the point of preparation (home fortification) can improve micronutrient status of young children. Ensuring sustained access to MNPs at scale, however, remains challenging in many countries. The Global Alliance for Improved Nutrition (GAIN) partnered with the National Institute of Nutrition (NIN) in Vietnam to pioneer the distribution of a locally-produced MNP, provided for sale through the public health system with counseling on optimal infant and young child feeding practices by trained health workers. Different packaging options were available to adapt to caregivers’ disposable income. During the six-month pilot, 1.5 million sachets were sold through 337 health centers across four provinces, targeting children 6–59 months of age. Sales were routinely monitored, and a cross-sectional survey in 32 communes for caregivers (n = 962) and health staff (n = 120) assessed MNP coverage and compliance, five months after the start of distribution. A total of 404 caregivers among the 962 caregivers surveyed (i.e., 42%) had visited the health center in the past year. Among them, 290 caregivers had heard about the product and a total of 217caregivers had given the MNP to their child at least once, representing a conversion rate from product awareness to product trial of 74.8%. The effective coverage (i.e., consumption of ≥3 sachets/child/week) was 11.5% among the total surveyed caregivers and reached 27.3% amongst caregivers who visited health centers in the previous month. The MNP purchase trends showed that the number of sachets bought by caregivers was positively correlated with the wealth index. The pilot showed that providing MNPs for sale in packs of various quantities, combined with infant and young child feeding (IYCF) counseling at the health center, is effective for groups accessing the health system. PMID:27136585

Complementary and Alternative Therapies

PubMed Central

Moore, Mary Lou

2002-01-01

Complementary and alternative therapies are increasingly used by many pregnant women in the United States; however, limited research is available on many therapies. The number of studies should increase with the establishment of the National Center for Complementary and Alternative Medicine by the National Institutes of Health. This column reviews recent studies of both herbal medicines and alternative therapies used in pregnancy. PMID:17273285

Community Based Maternal and Child Health Nutrition Project, Uttar Pradesh: An Innovative Strategy Focusing on “At Risk” Families

PubMed Central

Vir, Sheila C

2013-01-01

Research Question: Use of community based volunteers, frequently reaching and counseling a selected group of prioritized families, can make a substantial difference in improving maternal and child care practices and in reducing child undernutrition. Setting: Program Rural Uttar Pradesh, India. Study Design: A comparison of baseline and endline surveys following 4 years of community based project intervention Participants: “At risk” undernutrition families comprising mothers of under twos, newlyweds, and severely undernourished children below 6 years. Intervention: Mapping and counseling of “at risk” families. Measuring impact on maternal-child care practices, underweight status. Results: Trained community mobilizers identified and counseled selected “at risk” families. Following 4 years of implementation in 907 villages of 8 blocks of four districts, significant improvement was noted in practices of early initiation of breastfeeding, feeding colostrum, timely introduction of complementary feeding, and washing the hands after defecation. Percentage of mothers exclusively breastfeeding at 6 months was only 2.1% with 78% receiving prelacteal feeds. A small increase in normal and mild malnutrition and a significant reduction of 43% in severe malnutrition was noted. Conclusion: Frequently counseling by accredited social health activists by focusing on selected defined “at risk” families of under twos and those with severe malnourished children could result in increasing acceptability of correct child health, feeding, and care practices and in contributing to improving nutritional status scenario. PMID:24302825

Complementary school garden, nutrition, water, sanitation and hygiene interventions to improve children's nutrition and health status in Burkina Faso and Nepal: a study protocol.

PubMed

Erismann, Séverine; Shrestha, Akina; Diagbouga, Serge; Knoblauch, Astrid; Gerold, Jana; Herz, Ramona; Sharma, Subodh; Schindler, Christian; Odermatt, Peter; Drescher, Axel; Yang, Ray-Yu; Utzinger, Jürg; Cissé, Guéladio

2016-03-09

Malnutrition and intestinal parasitic infections are common among children in Burkina Faso and Nepal. However, specific health-related data in school-aged children in these two countries are scarce. In the frame of a larger multi-stakeholder project entitled "Vegetables go to School: Improving Nutrition through Agricultural Diversification" (VgtS), a study has been designed with the objectives to: (i) describe schoolchildren's health status in Burkina Faso and Nepal; and to (ii) provide an evidence-base for programme decisions on the relevance of complementary school garden, nutrition, water, sanitation and hygiene (WASH) interventions. The studies will be conducted in the Centre Ouest and the Plateau Central regions of Burkina Faso and the Dolakha and Ramechhap districts of Nepal. Data will be collected and combined at the level of schools, children and their households. A range of indicators will be used to examine nutritional status, intestinal parasitic infections and WASH conditions in 24 schools among 1144 children aged 8-14 years at baseline and a 1-year follow-up. The studies are designed as cluster randomised trials and the schools will be assigned to two core study arms: (i) the 'complementary school garden, nutrition and WASH intervention' arm; and the (ii) 'control' arm with no interventions. Children will be subjected to parasitological examinations using stool and urine samples and to quality-controlled anthropometric and haemoglobin measurements. Drinking water will be assessed for contamination with coliform bacteria and faecal streptococci. A questionnaire survey on nutritional and health knowledge, attitudes and practices (KAP) will be administered to children and their caregivers, also assessing socioeconomic, food-security and WASH conditions at household level. Focus group and key-informant interviews on children's nutrition and hygiene perceptions and behaviours will be conducted with their caregivers and school personnel. The studies will contribute to fill a data gap on school-aged children in Burkina Faso and Nepal. The data collected will also serve to inform the design of school-based interventions and will contribute to deepen the understanding of potential effects of these interventions to improve schoolchildren's health in resource-constrained settings. Key findings will be used to provide guidance for the implementation of health policies at the school level in Burkina Faso and Nepal. ISRCTN30840 (date assigned: 17 July 2015).

From monocausality to systems thinking: a complementary and alternative conceptual approach for better understanding the development and prevention of sports injury.

PubMed

Hulme, Adam; Finch, Caroline F

The science of sports injury control, including both its cause and prevention, has largely been informed by a biomedical and mechanistic model of health. Traditional scientific practice in sports injury research has routinely involved collapsing the broader socioecological landscape down in order to analyse individual-level determinants of injury - whether biomechanical and/or behavioural. This approach has made key gains for sports injury prevention research and should be further encouraged and allowed to evolve naturally. However, the public health, Applied Human Factors and Ergonomics, and injury epidemiological literature more broadly, has accepted the value of a socioecological paradigm for better understanding disease and injury processes, and sports injury research will fall further behind unless it does the same. A complementary and alternative conceptual approach towards injury control known as systems thinking that builds on socioecological science, both methodologically and analytically, is readily available and fast developing in other research areas. This review outlines the historical progression of causal concepts in the field of epidemiology over the course of the modern scientific era. From here, causal concepts in injury epidemiology, and models of aetiology as found in the context of sports injury research are presented. The paper finishes by proposing a new research agenda that considers the potential for a systems thinking approach to further enhance sports injury aetiological understanding. A complementary systems paradigm, however, will require that sports injury epidemiologists bring their knowledge and skillsets forwards in an attempt to use, adapt, and even refine existing systems-based approaches. Alongside the natural development of conventional scientific methodologies and analyses in sports injury research, progressing forwards to a systems paradigm is now required.

Core and Complementary Chiropractic: Lowering Barriers to Patient Utilization of Services.

PubMed

Triano, John J; McGregor, Marion

2016-12-01

The use of chiropractic services has stalled while interest in accessing manipulation services is rising. The purpose of this paper is to consider this dilemma in the context of the dynamics of professional socialization, surveys of public attitudes, and a potential strategic action. This is a reflection work grounded in the literature on professional socialization and the attitudes held regarding chiropractic in modern society, to include its members, and in original data on training programs. Data were interpreted on the background of the authors' cross-cultural experiences spanning patient care, research, education, and interprofessional collaboration. Recommendation on a strategic action to counter barriers in patient referrals was synthesized. Professional socialization is the process by which society enables professional privilege. Illustration of typical and divergent professional socialization models emerged that explain cognitive dissonance toward the profession. Questions of trust are commensurate with the experiences during patient encounters rather than with a common identity for the profession. Diversity among encounters perpetuates the uncertainty that affects referral sources. Commonality as an anchor for consistent professional identity and socialization through the content of core chiropractic, defined by training and practice, offers a means to offset uncertainty. Complementary chiropractic, analogous to complementary medicine, provides an outlet under professional socialization for the interests to explore additional methods of care. The practice workplace is an effective lever for altering barriers to the use of services. Clarifying rhetoric through conceptualization of core and complementary practices simplifies the socialization dynamic. Further, it takes advantage of accepted cultural semantics in meaningful analogy while continuing to empower practical diversity in care delivery in response to evolving scientific evidence.

Making sense of "alternative", "complementary", "unconventional" and "integrative" medicine: exploring the terms and meanings through a textual analysis.

PubMed

Ng, Jeremy Y; Boon, Heather S; Thompson, Alison K; Whitehead, Cynthia R

2016-05-20

Medical pluralism has flourished throughout the Western world in spite of efforts to legitimize Western biomedical healthcare as "conventional medicine" and thereby relegate all non-physician-related forms of healthcare to an "other" category. These "other" practitioners have been referred to as "unconventional", "alternative" and "complementary", among other terms throughout the past half century. This study investigates the discourses surrounding the changes in the terms, and their meanings, used to describe unconventional medicine in North America. Terms identified by the literature as synonymous to unconventional medicine were searched using the Scopus database. A textual analysis following the method described by Kripendorff 2013 was subsequently performed on the five most highly-cited unconventional medicine-related peer-reviewed literature published between 1970 and 2013. Five commonly-used, unconventional medicine-related terms were identified. Authors using "complementary and alternative", "complementary", "alternative", or "unconventional" tended to define them by what they are not (e.g., therapies not taught/used in conventional medicine, therapy demands not met by conventional medicine, and therapies that lack research on safety, efficacy and effectiveness). Authors defined "integrated/integrative" medicine by what it is (e.g., a new model of healthcare, the combining of both conventional and unconventional therapies, accounting for the whole person, and preventative maintenance of health). Authors who defined terms by "what is not" stressed that the purpose of conducting research in this area was solely to create knowledge. Comparatively, authors who defined terms by "what is" sought to advocate for the evidence-based combination of unconventional and conventional medicines. Both author groups used scientific rhetoric to define unconventional medical practices. This emergence of two groups of authors who used two different sets of terms to refer to the concept of "unconventional medicine" may explain why some journals, practitioner associations and research/practice centres may choose to use both "what is not" and "what is" terms in their discourse to attract interest from both groups. Since each of the two groups of terms (and authors who use them) has different meanings and goals, the evolution of this discourse will continue to be an interesting phenomenon to explore in the future.

Complementary approaches to palliative oncological care.

PubMed

Zappa, Simone B; Cassileth, Barrie R

2003-01-01

The popularity of complementary and alternative medicine (CAM) has increased tremendously in recent years. Thus, it is imperative to distinguish between alternative therapies that can be dangerous and complementary therapies that are primarily palliative and augment conventional treatment. Memorial Sloan-Kettering Cancer Center's Integrative Medicine Service offers complementary therapies to patients in an attempt to improve quality of life and provide symptom management. In addition to clinical services, it also provides education to health care professionals and the public and performs clinical and laboratory research on complementary modalities and the antitumor properties of botanicals. If CAM is to be accepted by mainstream medicine, research must be done usingstandard research methodologies.

["I swear on Apollus Medicus...": the birth of medical deontology].

PubMed

Ceccobelli, Sandro

2011-01-01

In the Oath, Hippocrates does not cite Dionisus at all. In Greek mythology, Apollus and Dionisus are, in some way, absolutely conflicting gods, nonetheless complementary each to the other; both are devoted to healing practices, one through his téchne founded on scientific knowledge, the other throught collective cathartic processes. The author conjectures that the exclusion of Dionisus from the medical Hippocratic scene means the birth of a medical deontology founded on the contrast between profecy and extasis, knowledge and happiness, order and change, health and disease. Balancing these cultural different aspects of therapy and cure, Bioethics could reunify the concepts of health, sickness and disease in the idea of Life, continuosly changing and developing. The curing process needs synthesis--invoking Apollus to rescover Dionisus mask.

[The National Database of the Regional Collaborative Rheumatic Centers as a tool for clinical epidemiology and quality assessment in rheumatology].

PubMed

Zink, Angela; Huscher, Dörte; Listing, Joachim

2003-01-01

The national database of the German Collaborative Arthritis Centres is a well-established tool for the observation and assessment of health care delivery to patients with rheumatic diseases in Germany. The discussion of variations in treatment practices contributes to the internal quality assessment in the participating arthritis centres. This documentation has shown deficits in primary health care including late referral to a rheumatologist, undertreatment with disease-modifying drugs and complementary therapies. In rheumatology, there is a trend towards early, intensive medical treatment including combination therapy. The frequency and length of inpatient hospital and rehabilitation treatments is decreasing, while active physiotherapy in outpatient care has been increased. Specific deficits have been identified concerning the provision of occupational therapy services and patient education.

Massage, a complementary therapy effectively promoting the health and well-being of older people in residential care settings: a review of the literature.

PubMed

McFeeters, Sarah; Pront, Leeanne; Cuthbertson, Lesley; King, Lindy

2016-12-01

To explore the potential benefits of massage within daily routine care of the older person in residential care settings. Globally, the proportion of people over 65 years is rapidly rising. Increased longevity means older people may experience a rise in physiological and psychological health problems. These issues potentially place an increased demand for quality long-term care for the older person. Complementary approaches such as massage appear to be needed in quality residential care. A critical literature review was undertaken. A literature review pertaining to massage in the older resident was conducted using a range of online databases. Fourteen studies dated 1993-2012 met the inclusion criteria and were critically evaluated as suitable resources for this review. Evidence suggests massage may be advantageous from client and nursing perspectives. Clients' perceive massage to positively influence factors such as pain, sleep, emotional status and psychosocial health. Evidence also demonstrates massage to benefit the client and organisation by reducing the necessity for restraint and pharmacological intervention. Massage may be incorporated into care provision and adopted by care providers and family members as an additional strategy to enhance quality of life for older people. Massage offers a practical activity that can be used to enhance the health and well-being of the older person in residential care. Massage offers benefit for promoting health and well-being of the older person along with potential increased engagement of family in care provision. Integration of massage into daily care activities of the older person requires ongoing promotion and implementation. © 2016 John Wiley & Sons Ltd.

The Study of Health Coaching: The Ithaca Coaching Project, Research Design, and Future Directions

PubMed Central

2013-01-01

Health coaching (HC) is a process holding tremendous potential as a complementary medical intervention to shape healthy behavior change and affect rates of chronic lifestyle diseases. Empirical knowledge of effectiveness for the HC process, however, is lacking. The purposes of this paper are to present the study protocol for the Ithaca Coaching Project while also addressing research design, methodological issues, and directions for HC research. This is one of the first large-scale, randomized control trials of HC for primary prevention examining impact on physical and emotional health status in an employee population. An additional intent for the project is to investigate self-determination theory as a theoretical framework for the coaching process. Participants (n=300) are recruited as part of a campus-wide wellness initiative and randomly assigned to one of three levels of client-centered HC or a control with standard wellness program care. Repeated measures analyses of covariance will be used to examine coaching effectiveness while path analyses will be used to examine relationships between coaching processes, self-determination variables, and health outcomes. There is a great need for well-designed HC studies that define coaching best practices, examine intervention effectiveness, provide cost:benefit analysis, and address scope of practice. This information will allow a clearer definition of HC to emerge and determination of if, and how, HC fits in modern-day healthcare. This is an exciting but critical time for HC research and for the practice of HC. PMID:24416673

The study of health coaching: the ithaca coaching project, research design, and future directions.

PubMed

Sforzo, Gary A

2013-05-01

Health coaching (HC) is a process holding tremendous potential as a complementary medical intervention to shape healthy behavior change and affect rates of chronic lifestyle diseases. Empirical knowledge of effectiveness for the HC process, however, is lacking. The purposes of this paper are to present the study protocol for the Ithaca Coaching Project while also addressing research design, methodological issues, and directions for HC research. This is one of the first large-scale, randomized control trials of HC for primary prevention examining impact on physical and emotional health status in an employee population. An additional intent for the project is to investigate self-determination theory as a theoretical framework for the coaching process. Participants (n=300) are recruited as part of a campus-wide wellness initiative and randomly assigned to one of three levels of client-centered HC or a control with standard wellness program care. Repeated measures analyses of covariance will be used to examine coaching effectiveness while path analyses will be used to examine relationships between coaching processes, self-determination variables, and health outcomes. There is a great need for well-designed HC studies that define coaching best practices, examine intervention effectiveness, provide cost:benefit analysis, and address scope of practice. This information will allow a clearer definition of HC to emerge and determination of if, and how, HC fits in modern-day healthcare. This is an exciting but critical time for HC research and for the practice of HC.

Research scholars program: a faculty development initiative at the Oregon College of Oriental Medicine.

PubMed

Hammerschlag, Richard; Lasater, Kathie; Salanti, Sonya; Fleishman, Susan

2008-05-01

The Research Scholars Program (RSP) was created at the Oregon College of Oriental Medicine (OCOM) to provide faculty development in research literacy, research-informed clinical practice, and research participation skills. The RSP is part of a broad effort, funded by a National Institutes of Health/National Center for Complementary and Alternative Medicine R25 education grant, to infuse an evidence-based perspective into the curriculum at schools of complementary and alternative medicine. The RSP arose from the realization that this curriculum reform would first necessitate faculty training in both research appreciation and pedagogy. OCOM's grant, Acupuncture Practitioner Research Education Enhancement, is a partnership with the Oregon Health & Science University School of Nursing (OHSU SON). The RSP was developed initially as a collaborative effort among the OCOM Dean of Research (R.H.), OCOM Director of Research Education (S.F.), and an OHSU SON education specialist (K.L.). The 9-month, 8 hours per month seminar-style RSP provides the opportunity for a cohort of OCOM faculty and staff to explore research-related concepts and content as well as pedagogical practices that emphasize interactive, learner-centered teaching. The RSP adheres to a competency-based approach as developed by the Education Committee of the grant. As a tangible outcome, each Research Scholar designs a sustainable learning activity that infuses a research perspective into their courses, clinic supervision, or other sphere of influence at the college. In this paper, we describe the creative process and the lessons learned during the planning and initial implementation of the RSP. We view the early successes of the RSP as encouraging signs that research literacy and an evidence-based perspective are becoming increasingly accepted as needed skill sets for present-day practitioners of acupuncture and Oriental medicine.

Associations of land, cattle and food security with infant feeding practices among a rural population living in Manyara, Tanzania.

PubMed

Hanselman, Bailey; Ambikapathi, Ramya; Mduma, Estomih; Svensen, Erling; Caulfield, Laura E; Patil, Crystal L

2018-01-19

Livelihoods strategies and food security experiences can positively and negatively affect infant and young child feeding (IYCF) practices. This study contributes to this literature by exploring how variation in household economics among rural farmers in Tanzania relates to IYCF patterns over the first 8 months of an infant's life. These data were produced from a longitudinal study in which a cohort of mother-infant dyads was followed from birth to 24 months. In addition to baseline maternal, infant, and household characteristics, mothers were queried twice weekly and monthly about infant feeding practices and diet. Weekly and monthly datasets were merged and analyzed to assess infant feeding patterns through the first 8 months. Standard statistical methods including survival and logistic regression analyses were used. Aside from breastfeeding initiation, all other IYCF practices were suboptimal in this cohort. Land and cattle ownership were associated with the early introduction of non-breastmilk food items. Food insecurity also played a role in patterning and inadequate complementary feeding was commonplace. Health promotion programs are needed to delay the introduction of animal milks and grain-based porridge, and to achieve a minimum acceptable diet after 6 months of age among smallholder farmers in rural Tanzania. Results highlight that livelihoods-based health promotion interventions, built from a flexible and integrated design, may be an important strategy to address community-level variation in infant feeding practices and promote optimal IYCF practices.

Assessment of corporate compliance with guidance and regulations on labels of commercially produced complementary foods sold in Cambodia, Nepal, Senegal and Tanzania.

PubMed

Sweet, Lara; Pereira, Catherine; Ford, Rosalyn; Feeley, Alison B; Badham, Jane; Mengkheang, Khin; Adhikary, Indu; Sy Gueye, Ndèye Yaga; Coly, Aminata Ndiaye; Makafu, Cecilia; Zehner, Elizabeth

2016-04-01

National legislation and global guidance address labelling of complementary foods to ensure that labels support optimal infant and young child feeding practices. This cross-sectional study assessed the labels of commercially produced complementary foods (CPCF) sold in Phnom Penh (n = 70), Cambodia; Kathmandu Valley (n = 22), Nepal; Dakar Department (n = 84), Senegal; and Dar es Salaam (n = 26), Tanzania. Between 3.6% and 30% of products did not provide any age recommendation and 8.6-20.2% of products, from all sites, recommended an age of introduction of <6 months. Few CPCF products provided a daily ration (0.0-8.6%) and 14.5-55.6% of those that did exceeded the daily energy recommendation for complementary foods for a breastfed child from 6 to 8.9 months of age. Only 3.6-27.3% of labels provided accurate and complete messages in the required language encouraging exclusive breastfeeding, and almost none (0.0-2.9%) provided accurate and complete messages regarding the appropriate introduction of complementary foods together with continued breastfeeding. Between 34.3% and 70.2% of CPCF manufacturers also produced breastmilk substitutes and 41.7-78.0% of relevant CPCF products cross-promoted their breastmilk substitutes products. Labelling practices of CPCF included in this study do not fully comply with international guidance on their promotion and selected aspects of national legislation, and there is a need for more detailed normative guidance on certain promotion practices in order to protect and promote optimal infant and young child feeding. © 2016 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.

Assessment of corporate compliance with guidance and regulations on labels of commercially produced complementary foods sold in Cambodia, Nepal, Senegal and Tanzania

PubMed Central

Sweet, Lara; Pereira, Catherine; Ford, Rosalyn; Feeley, Alison B; Mengkheang, Khin; Adhikary, Indu; Gueye, Ndèye Yaga Sy; Coly, Aminata Ndiaye; Makafu, Cecilia; Zehner, Elizabeth

2016-01-01

Abstract National legislation and global guidance address labelling of complementary foods to ensure that labels support optimal infant and young child feeding practices. This cross‐sectional study assessed the labels of commercially produced complementary foods (CPCF) sold in Phnom Penh (n = 70), Cambodia; Kathmandu Valley (n = 22), Nepal; Dakar Department (n = 84), Senegal; and Dar es Salaam (n = 26), Tanzania. Between 3.6% and 30% of products did not provide any age recommendation and 8.6−20.2% of products, from all sites, recommended an age of introduction of <6 months. Few CPCF products provided a daily ration (0.0−8.6%) and 14.5−55.6% of those that did exceeded the daily energy recommendation for complementary foods for a breastfed child from 6 to 8.9 months of age. Only 3.6−27.3% of labels provided accurate and complete messages in the required language encouraging exclusive breastfeeding, and almost none (0.0−2.9%) provided accurate and complete messages regarding the appropriate introduction of complementary foods together with continued breastfeeding. Between 34.3% and 70.2% of CPCF manufacturers also produced breastmilk substitutes and 41.7−78.0% of relevant CPCF products cross‐promoted their breastmilk substitutes products. Labelling practices of CPCF included in this study do not fully comply with international guidance on their promotion and selected aspects of national legislation, and there is a need for more detailed normative guidance on certain promotion practices in order to protect and promote optimal infant and young child feeding. PMID:27061960

Complementary and Alternative Medicine Use in Modern Obstetrics: A Survey of the Central Association of Obstetricians & Gynecologists Members.

PubMed

Babbar, Shilpa; Williams, Karen B; Maulik, Dev

2016-10-05

The use of complementary and alternative medicine during pregnancy is currently on the rise. A validated survey was conducted at the Central Association of Obstetrician and Gynecologists annual meeting to evaluate the knowledge, attitude, and practice of general obstetricians and gynecologists and maternal-fetal medicine specialists in America. We obtained 128 responses: 73 electronically (57%) and 55 via the paper survey (43%). Forty-five percent reported personally using complementary and alternative medicine and 9% of women respondents used complementary and alternative medicine during pregnancy. Overall, 62% had advised their patients to utilize some form of complementary and alternative medicine in pregnancy. Biofeedback, massage therapy, meditation, and yoga were considered the most effective modalities in pregnancy (median [semi-interquartile range] = 2 [0.5]). Maternal-fetal medicine specialists were significantly more likely to disagree on the use of complementary and alternative medicine for risk reduction of preterm birth compared to obstetricians and gynecologists (P = .03). As the use of complementary and alternative medicine continues to rise in reproductive-age women, obstetricians will play an integral role in incorporating complementary and alternative medicine use with conventional medicine. © The Author(s) 2016.

Complementary and Alternative Medicine Use in Modern Obstetrics: A Survey of the Central Association of Obstetricians & Gynecologists Members

PubMed Central

Babbar, Shilpa; Williams, Karen B.; Maulik, Dev

2016-01-01

The use of complementary and alternative medicine during pregnancy is currently on the rise. A validated survey was conducted at the Central Association of Obstetrician and Gynecologists annual meeting to evaluate the knowledge, attitude, and practice of general obstetricians and gynecologists and maternal-fetal medicine specialists in America. We obtained 128 responses: 73 electronically (57%) and 55 via the paper survey (43%). Forty-five percent reported personally using complementary and alternative medicine and 9% of women respondents used complementary and alternative medicine during pregnancy. Overall, 62% had advised their patients to utilize some form of complementary and alternative medicine in pregnancy. Biofeedback, massage therapy, meditation, and yoga were considered the most effective modalities in pregnancy (median [semi-interquartile range] = 2 [0.5]). Maternal-fetal medicine specialists were significantly more likely to disagree on the use of complementary and alternative medicine for risk reduction of preterm birth compared to obstetricians and gynecologists (P = .03). As the use of complementary and alternative medicine continues to rise in reproductive-age women, obstetricians will play an integral role in incorporating complementary and alternative medicine use with conventional medicine. PMID:27707901

Toward a humanistic model in health communication.

PubMed

Werder, Olaf

2017-03-01

Since the key to effective health communication lies in its ability to communicate well, some of its core problems are those that relate to the sharing of meaning between communicators. In elaborating on these problems, this paper offers two key propositions: one, health communication has to pass through the filter of a particular world view that creates a discrepancy between expected and actual message reception and response. Two, the assumption of a rational human actor made implicitly by most health psychological models is a contestable issue, as many times message recipients do not follow a cognitive judgment process. The phenomenon of resisting health messages by reasonable people asks the question whether we ought to rethink our adherence to a particular vision of human health as many times the adverse reaction to behaviour modification occurs as the result of a particular dialogical or discursive situation. At the same time, most motivational decisions in people's daily routines are automatic and use a concept known as self-identity to give stability to their behaviour patterns. Finally, health communication as part of organised government practices adheres to predominant value perspectives within health promotion practice that affect the manner in which health issues become problematised. This paper proposes a humanistic model that aims to pay attention to the intricacies of human communication by addressing all of the above problems in turn. It interprets the sharing of meaning element in human communication and addresses the question of how the idea of health is created through discourse. As such, it offers a complementary and constructive paradigm and set of approaches to understand health, its meanings and communication.

Cultural consonance, constructions of science and co-existence: a review of the integration of traditional, complementary and alternative medicine in low- and middle-income countries

PubMed Central

Lakshmi, Josyula K; Nambiar, Devaki; Narayan, Venkatesh; Sathyanarayana, Tamysetty N; Porter, John; Sheikh, Kabir

2015-01-01

This review examined the determinants, patterns and imports of official recognition, and incorporation of different traditional, complementary and alternative systems of medicine (TCAM) in the public health establishment of low- and middle-income countries, with a particular focus on India. Public health systems in most countries have tended to establish health facilities centred on allopathy, and then to recognize or derecognize different TCAM based on evidence or judgement, to arrive at health-care configurations that include several systems of medicine with disparate levels of authority, jurisdiction and government support. The rationale for the inclusion of TCAM providers in the public health workforce ranges from the need for personnel to address the disease burden borne by the public health system, to the desirability of providing patients with a choice of therapeutic modalities, and the nurturing of local culture. Integration, mostly described as a juxtaposition of different systems of medical practice, is often implemented as a system of establishing personnel with certification in different medical systems, in predominantly allopathic health-care facilities, to practise allopathic medicine. A hierarchy of systems of medicine, often unacknowledged, is exercised in most societies, with allopathy at the top, certain TCAM systems next and local healing traditions last. The tools employed by TCAM practitioners in diagnosis, research, pharmacy, marketing and education and training, which are seen to increasingly emulate those of allopathy, are sometimes inappropriate for use in therapeutic systems with widely divergent epistemologies, which call for distinct research paradigms. The coexistence of numerous systems of medicine, while offering the population greater choice, and presumably enhancing geographical access to health care as well, is often fraught with tensions related to the coexistence of philosophically disparate, even opposed, disciplines, with distinct and unaligned notions of evidence and efficacy, and ethical and operational challenges of the administration of a plural workforce. PMID:25171821

Impact of flooding on feeding practices of infants and young children in Dhaka, Bangladesh Slums: what are the coping strategies?

PubMed

Goudet, Sophie M; Griffiths, Paula L; Bogin, Barry A; Selim, Nasima

2011-04-01

Previous research has shown that urban slums are hostile environments for the growth of infants and young children (IYC). Flooding is a hazard commonly found in Dhaka slums (Bangladesh) which negatively impacts IYC's nutritional and health status. This paper aims 1) to identify the impact of flooding on IYC's feeding practices, and 2) to explore the coping strategies developed by caregivers. Qualitative data (participant observation and semi-structured interviews) and quantitative data (household questionnaire and anthropometric measurements) collected in slums in Dhaka (n=18 mothers, n=5 community health workers, and n=55 children) were analysed. The subjects of the interviews were mothers and Bangladesh Rural Advancement Committee (BRAC) community health workers living and working in the slums. Research findings showed that breastfeeding and complementary feeding practices for IYC were poor and inappropriate due to lack of knowledge, time, and resources in normal times and worse during flooding. One coping strategy developed by mothers purposely to protect their IYC's nutritional status was to decrease their personal food intake. Our research findings suggest that mothers perceived the negative impact of flooding on their IYC's nutritional health but did not have the means to prevent it. They could only maintain their health through coping strategies which had other negative consequences. The results suggests a holistic approach combining 1) provision of relief for nutritionally vulnerable groups during flooding, 2) support to mothers in their working role, 3) breastfeeding counseling and support to lactating mothers with difficulties, and 4) preventing malnutrition in under 2 year old children. © 2010 Blackwell Publishing Ltd.

Timely initiation of complementary feeding and associated factors among children aged 6 to 12 months in Northern Ethiopia: an institution-based cross-sectional study

PubMed Central

2013-01-01

Background Exclusive breastfeeding (EBF) for the first six months of life is critical for the wellbeing of the child. In the mean while, timely initiation and starting nutritionally-adequate, safe, age-appropriate complementary feeding at six months is recommended for the better health and development of infants. According to the Ethiopian Demographic and Health Survey 2011, timely initiation of complementary feeding in Ethiopia at the 6th month was only 51%. The purpose of this study is to determine the magnitude of timely initiation of complementary feeding and associated factors in Mekelle town, Northern Ethiopia. Methods An institutional based cross-sectional study design was conducted among 422 mothers of infants aged from six months to one year selected from six public health facilities. Sample size proportional to the patient flow rate of each institution was allocated and systematic random sampling method was used to get the study participant. An exit interview using structured questionnaire was conducted about their experience on complementary feeding and related experience. The questionnaire was pretested among 21 mothers. Data were entered with EPI info version 3.5.1 and cleaning and analysis was done by using SPSS version 16. Frequencies distribution, binary and multiple logistic regressions were done. OR and 95% confidence interval was computed. Result The prevalence of timely initiation of complementary feeding at sixth month was 62.8% (265/422, 95% C.I: 58.1, 67.31%). Educational level, occupation of mother, parity, having ANC follow up, and birth preparedness were found to be independent predictor of timely initiation of complementary feeding. Conclusions Almost two-third of mothers initiated complementary feeding at six month of child’ age as recommended. This was relatively higher prevalence than most developing countries. However, significant proportion of mothers still did not initiate complementary feeding timely. Mothers who are illiterate and completed only primary school need more attention. All mothers must be encouraged to make antenatal care follow up. PMID:24195592

Complementary and Alternative Medicine Use Among Allergy Practices: Results of a Nationwide Survey of Allergists.

PubMed

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.

Unproven diagnostic procedures in IgE-mediated allergic diseases.

PubMed

Niggemann, B; Grüber, C

2004-08-01

A considerable body of literature on therapeutic aspects of complementary and alternative medicine has been published in recent years, but little is known on diagnostic procedures. This short review lists complementary and alternative diagnostic procedures for the diagnosis of allergic diseases and presents an assessment of their usefulness for the daily practice. The review of the literature revealed that neither the determination of specific immunoglobulin G-antibodies in serum, the hair-analysis, the cytotoxic test, kinesiology, iridology, or electrodermal testing represent useful tests for the daily practice. To date, no complementary or alternative diagnostic procedure can be recommended as a meaningful element in the diagnostic work-up of allergic diseases. This is especially true for food allergy: properly performed oral food challenges still represent the gold standard for implementing specific diets in food allergic individuals. Ineffective diagnostic approaches may be costly for the consumer and delay appropriate therapy.

The Use of Intuition in Homeopathic Clinical Decision Making: An Interpretative Phenomenological Study

PubMed Central

Brien, Sarah; Dibb, Bridget; Burch, Alex

2011-01-01

While intuition plays a role in clinical decision making within conventional medicine, little is understood about its use in complementary and alternative medicine (CAM). The aim of this qualitative study was to investigate intuition from the perspective of homeopathic practitioners; its' manifestation, how it was recognized, its origins and when it was used within daily clinical practice. Semi-structured interviews were carried out with clinically experienced non-National Health Service (NHS) UK homeopathic practitioners. Interpretative phenomenological analysis was used to analyze the data. Homeopaths reported many similarities with conventional medical practitioner regarding the nature, perceived origin and manifestation of their intuitions in clinical practice. Intuition was used in two key aspects of the consultation: (i) to enhance the practitioner-patient relationship, these were generally trusted; and (ii) intuitions relating to the prescribing decision. Homeopaths were cautious about these latter intuitions, testing any intuitive thoughts through deductive reasoning before accepting them. Their reluctance is not surprising given the consequences for patient care, but we propose this also reflects homeopaths' sensitivity to the academic and medical mistrust of both homeopathy and intuition. This study is the first to explore the use of intuition in decision making in any form of complementary medicine. The similarities with conventional practitioners may provide confidence in validating intuition as a legitimate part of the decision making process for these specific practitioners. Further work is needed to elucidate if these findings reflect intuitive use in clinical practice of other CAM practitioners in both private and NHS (i.e., time limited) settings. PMID:19773389

Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context.

PubMed

London, Leslie; Tangwa, Godfrey; Matchaba-Hove, Reginald; Mkhize, Nhlanhla; Nwabueze, Remi; Nyika, Aceme; Westerholm, Peter

2014-06-23

International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address workplace hazards demand that actions for occupational health extend beyond just the workplace. A stronger articulation of occupational health practice with advocacy for prevention should be an ethical norm. Ethical codes should ideally harmonize and balance individual and community needs so as to provide stronger moral authority guidelines. There is a need to consider an African Charter on Bioethics as complementary and strengthening of existing codes for the region.

Ethics in occupational health: deliberations of an international workgroup addressing challenges in an African context

PubMed Central

2014-01-01

Background International codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance and cogency of an ethical code in occupational health for an African context through an iterative consultative process. Discussion Firstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address workplace hazards demand that actions for occupational health extend beyond just the workplace. Summary A stronger articulation of occupational health practice with advocacy for prevention should be an ethical norm. Ethical codes should ideally harmonize and balance individual and community needs so as to provide stronger moral authority guidelines. There is a need to consider an African Charter on Bioethics as complementary and strengthening of existing codes for the region. PMID:24957477

Compulsory private complementary health insurance offered by employers in France: implications and current debate.

PubMed

Franc, Carine; Pierre, Aurélie

2015-02-01

In January 2013, within the framework of a National Inter-professional Agreement (NIA), the French government required all employers (irrespective of the size of their business) to offer private complementary health insurance to their employees from January 2016. The generalization of group complementary health insurance to all employees will directly affect insurers, employers and employees, as well as individuals not directly concerned (students, retirees, unemployed and civil servants). In this paper, we present the issues raised by this regulation, the expected consequences and the current debate around this reform. In particular, we argue that this reform may have adverse effects on equity of access to complementary health insurance in France, since the risk structure of the market for individual health insurance will change, potentially increasing inequalities between wage-earners and others. Moreover, tax exemptions given to group contracts are problematic because public funds used to support these contracts can be higher at individual level for high-salary individuals than those allocated to improve access for the poorest. In response to the criticism and with the aim of ensuring equity in the system, the government decided to reconsider some of the fiscal advantages given to group contracts, to enhance programs and aids dedicated to the poorest and to redefine an overall context of incentives. Copyright © 2015. Published by Elsevier Ireland Ltd.

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

PubMed

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

2016-09-01

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

The Challenge of Complementary and Alternative Medicine After Austerity: A Response to Recent Commentaries.

PubMed

Tavares, Aida Isabel

2015-10-26

Complementary and Alternative Medicine (CAM) is frequently used in Portugal and it contributes to the improvement of people's health. CAM and Western Medicine (WM) are taken as complements both in the diagnosis and the treatment stage. The Portuguese health system is able to generate certified CAM professionals but the provision of CAM care and services is not included in the national health system. In times of austerity, this is not expected to change and access to CAM care continues to be out-of-pocket health expenditure. But the future for health in Portugal may well involve including CAM therapies in an integrated health system. © 2016 by Kerman University of Medical Sciences.

The Challenge of Complementary and Alternative Medicine After Austerity: A Response to Recent Commentaries

PubMed Central

Tavares, Aida Isabel

2016-01-01

Complementary and Alternative Medicine (CAM) is frequently used in Portugal and it contributes to the improvement of people’s health. CAM and Western Medicine (WM) are taken as complements both in the diagnosis and the treatment stage. The Portuguese health system is able to generate certified CAM professionals but the provision of CAM care and services is not included in the national health system. In times of austerity, this is not expected to change and access to CAM care continues to be out-of-pocket health expenditure. But the future for health in Portugal may well involve including CAM therapies in an integrated health system. PMID:26673657

Open data models for smart health interconnected applications: the example of openEHR.

PubMed

Demski, Hans; Garde, Sebastian; Hildebrand, Claudia

2016-10-22

Smart Health is known as a concept that enhances networking, intelligent data processing and combining patient data with other parameters. Open data models can play an important role in creating a framework for providing interoperable data services that support the development of innovative Smart Health applications profiting from data fusion and sharing. This article describes a model-driven engineering approach based on standardized clinical information models and explores its application for the development of interoperable electronic health record systems. The following possible model-driven procedures were considered: provision of data schemes for data exchange, automated generation of artefacts for application development and native platforms that directly execute the models. The applicability of the approach in practice was examined using the openEHR framework as an example. A comprehensive infrastructure for model-driven engineering of electronic health records is presented using the example of the openEHR framework. It is shown that data schema definitions to be used in common practice software development processes can be derived from domain models. The capabilities for automatic creation of implementation artefacts (e.g., data entry forms) are demonstrated. Complementary programming libraries and frameworks that foster the use of open data models are introduced. Several compatible health data platforms are listed. They provide standard based interfaces for interconnecting with further applications. Open data models help build a framework for interoperable data services that support the development of innovative Smart Health applications. Related tools for model-driven application development foster semantic interoperability and interconnected innovative applications.

Midwives' support for Complementary and Alternative Medicine: a literature review.

PubMed

Hall, Helen G; McKenna, Lisa G; Griffiths, Debra L

2012-03-01

There is evidence that the use of Complementary and Alternative Medicine by childbearing women is becoming increasingly popular in industrialised countries. The aim of this is paper is to review the research literature investigating the midwives' support for the use of these therapies. A search for relevant research published from 2000 to 2009 was undertaken using a range of databases and by examining relevant bibliographies. A total of thirteen studies were selected for inclusion in this review. The findings indicate that the use of Complementary and Alternative Medicine is widespread in midwifery practice. Common indications for use include; labour induction and augmentation, nausea and vomiting, relaxation, back pain, anaemia, mal-presentation, perineal discomfort, postnatal depression and lactation problems. The most popular therapies recommended by midwives are massage therapy, herbal medicines, relaxation techniques, nutritional supplements, aromatherapy, homeopathy and acupuncture. Midwives support the use Complementary and Alternative Medicine because they believe it is philosophically congruent; it provides safe alternatives to medical interventions; it supports the woman's autonomy, and; incorporating Complementary and Alternative Medicine can enhance their own professional autonomy. There is considerable support by midwives for the use of Complementary and Alternative Medicine by expectant women. Despite this enthusiasm, currently there are few educational opportunities and only limited research evidence regarding CAM use in midwifery practice. These shortfalls need to be addressed by the profession. Midwives are encouraged to have an open dialogue with childbearing women, to document use and to base any advice on the best available evidence. Copyright © 2010 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

A survey of Canadian regulated complementary and alternative medicine schools about research, evidence-based health care and interprofessional training, as well as continuing education

PubMed Central

2013-01-01

Background While some effort has been made to integrate complementary and alternative medicine (CAM) information in conventional biomedical training, it is unclear whether regulated Canadian CAM schools’ students are exposed to research activities and continuing education, or whether topics such as evidence-based health care and interprofessional collaboration (IPC) are covered during their training. Since these areas are valued by the biomedical training field, this may help to bridge the attitudinal and communication gaps between these different practices. The aim of this study was to describe the training offered in these areas and gather the perceptions of curriculum/program directors in regulated Canadian CAM schools. Methods A two-phase study consisting of an electronic survey and subsequent semi-structured telephone interviews was conducted with curriculum/program (C/P) directors in regulated Canadian CAM schools. Questions assessed the extent of the research, evidence-based health care, IPC training and continuing education, as well as the C/P directors’ perceptions about the training. Descriptive statistics were used to describe the schools’, curriculum’s and the C/P directors’ characteristics. Content analysis was conducted on the interview material. Results Twenty-eight C/P directors replied to the electronic survey and 11 participated in the interviews, representing chiropractic, naturopathy, acupuncture and massage therapy schools. Canadian regulated CAM schools offered research and evidence-based health care training as well as opportunities for collaboration with biomedical peers and continuing education to a various extent (58% to 91%). Although directors were generally satisfied with the training offered at their school, they expressed a desire for improvements. They felt future CAM providers should understand research findings and be able to rely on high quality research and to communicate with conventional care providers as well as to engage in continuing education. Limited length of the curriculum was one of the barriers to such improvements. Conclusions These findings seem to reinforce the directors’ interest and the importance of integrating these topics in order to ensure best CAM practices and improve communication between CAM and conventional providers. PMID:24373181

The principles of disease elimination and eradication.

PubMed Central

Dowdle, W. R.

1998-01-01

The Dahlem Workshop discussed the hierarchy of possible public health interventions in dealing with infectious diseases, which were defined as control, elimination of disease, elimination of infections, eradication, and extinction. The indicators of eradicability were the availability of effective interventions and practical diagnostic tools and the essential need for humans in the life-cycle of the agent. Since health resources are limited, decisions have to be made as to whether their use for an elimination or eradication programme is preferable to their use elsewhere. The costs and benefits of global eradication programmes concern direct effects on morbidity and mortality and consequent effects on the health care system. The success of any disease eradication initiative depends strongly on the level of societal and political commitment, with a key role for the World Health Assembly. Eradication and ongoing programmes constitute potentially complementary approaches to public health. Elimination and eradication are the ultimate goals of public health, evolving naturally from disease control. The basic question is whether these goals are to be achieved in the present or some future generation. PMID:10063669

Factors influencing first-time mothers' introduction of complementary foods: a qualitative exploration.

PubMed

Walsh, Anne; Kearney, Lauren; Dennis, Nicole

2015-09-22

Optimal infant nutrition comprises exclusive breastfeeding, with complementary foods introduced from six months of age. How parents make decisions regarding this is poorly studied. This study begins to address the dearth of research into the decision-making processes used by first-time mothers relating to the introduction of complementary foods. This qualitative explorative study was conducted using interviews (13) and focus groups (3). A semi-structured interview guide based on the Theory of Planned Behaviour (TPB). The TPB, a well-validated decision-making model, identifies the key determinants of a behaviour through behavioural beliefs, subjective norms, and perceived behavioural control over the behaviour. It is purported that these beliefs predict behavioural intention to perform the behaviour, and performing the behaviour. A purposive, convenience, sample of 21 metropolitan parents recruited through advertising at local playgroups and childcare centres, and electronically through the University community email list self-selected to participate. Data were analysed thematically within the theoretical constructs: behavioural beliefs, subjective norms and perceived behavioural control. Data relating to sources of information about the introduction of complementary foods were also collected. Overall, first-time mothers found that waiting until six months was challenging despite knowledge of the WHO recommendations and an initial desire to comply with this guideline. Beliefs that complementary foods would assist the infants' weight gain, sleeping patterns and enjoyment at meal times were identified. Barriers preventing parents complying with the recommendations included subjective and group norms, peer influences, infant cues indicating early readiness and food labelling inconsistencies. The most valued information source was from peers who had recently introduced complementary foods. First-time mothers in this study did not demonstrate a good understanding of the rationale behind the WHO recommendations, nor did they understand fully the signs of readiness of infants to commence solid foods. Factors that assisted waiting until six months were a trusting relationship with a health professional whose practice and advice was consistent with the recommendations and/or when their infant was developmentally ready for complementary foods at six months and accepted them with ease and enthusiasm. Barriers preventing parents complying with the recommendations included subjective and group norms, peer influences, infant cues indicating early readiness and food labelling inconsistencies.

History and Experience: A Survey of Traditional Chinese Medicine Treatment for Alzheimer's Disease

PubMed Central

Liu, Ping; Kong, Mingwang; Yuan, Shihe; Liu, Junfeng; Wang, Ping

2014-01-01

Traditional Chinese medicine (TCM) is practiced in the Chinese health care system for more than 2,000 years. In recent years, herbal medicines, which are used to treat Alzheimer's disease (AD) in China based on TCM or modern pharmacological theories have attracted considerable attention. In this paper, we discuss etiology and pathogenesis of AD, TCM therapy, and herbal extracts for the treatment of AD. There is evidence to suggest that TCM therapy may offer certain complementary cognitive benefits for the treatment of AD. Chinese herb may have advantages with multiple target regulation compared with the single-target antagonist in view of TCM. PMID:24624220

EHR Learning - It's about Nursing, Leadership and Long-Term Commitments.

PubMed

Furlong, Karen E

2016-01-01

Despite a global commitment to the adoption of technologies, such as electronic health records (EHRs), to support the delivery of health services, there is little empirical guidance to support effective planning for the integration of these tools into practice settings (Suter et al. 2009). In particular, although EHR learning is known to positively influence integration (Byrne 2012), individual perspectives are often overlooked because of investigative designs that devalue such viewpoints by exploring the utility of technologies rather than the lived experiences of individual users of the technology. Therefore, this qualitative study offered nurse participants opportunities to make sense of EHR learning through talking about their experiences. This narrative inquiry was a collaborative interpretive method of discovery: stories and thematic analysis were the two separate yet complementary frames used to support data analysis. Finally, several practice implications and recommendations about EHR learning are presented with an emphasis placed upon patient safety as a way to impart accountability on behalf of learners, educators and those charged with governing responsibilities during times of EHR integration. Copyright © 2016 Longwoods Publishing.

The protection of the patient's private life: the computer challenge. Second part.

PubMed

Van Overstraeten, M; Michel, Luc

2002-12-01

Today, medical practice is invaded by a growing number of technologies of all kinds, among which computer techniques have an important place. Although they have significant advantages, for instance in terms of medical record management, they give rise to several problems, particularly concerning the confidentiality of the patient's data with regards to third party. A great number of specific provisions, complementary to the general texts protecting private life (examined in the first part of this two parts article), endeavour to solve these problems. It is true that these provisions are recent, have various origins and often appear as rules difficult to understand. Yet, they are partially inspired by a common logic. Relying on these common features, the authors make two suggestions for the future, in order to avoid that the growing computerisation of medical practice eventually destabilises the health care relationship: a) Any dictatorship of confidentiality must be rejected b) Stimulating a sense of professionalism is most likely the way to avoid an anarchic and unrealistic development of rules aimed at regulating the health care relationship.

The Complementary Health Approaches for Pain Survey (CHAPS): Validity testing and characteristics of a rural population with pain

PubMed Central

2018-01-01

Objectives Little is known about patterns and correlates of Complementary Health Approaches (CHAs) in chronic pain populations, particularly in rural, underserved communities. This article details the development and implementation of a new survey instrument designed to address this gap, the Complementary Health Approaches for Pain Survey (CHAPS). Design Following pilot-testing using pre-specified criteria to assess quality and comprehension in our target population, and after feedback regarding face-validity from content experts and stakeholders, the final cross-sectional self-report survey required 10–12 minutes to complete. It contained 69 demographic, lifestyle and health-related factors, and utilized a Transtheoretical Model (TTM) underpinning to assess short- and long-term use of 12 CHAs for pain management. Twenty additional items on pain severity, feelings, clinical outcomes, and activities were assessed using the Short-Form Global Pain Scale (SF-GPS); Internal reliability was assessed using Cronbach’s alpha. Settings/location Investigators conducted consecutive sampling in four West Virginia pain management and rheumatology practices. Participants 301 Appalachian adult patients seeking conventional care for pain management. Results Response rates were high (88% ± 4.1%). High quality and comprehension deemed the CHAPS an appropriate measurement tool in a rural population with pain. Missing data were unrelated to patient characteristics. Participants predominantly experienced chronic pain (93%), had five or more health conditions (56%, Mean = 5.4±3.1), were white (92%), female (57%), and middle-aged (Mean = 55.6 (SD = 13.6) years). Over 40% were disabled (43%) and/or obese (44%, Mean BMI = 33.4±31.5). Additionally, 44% used opioids, 31% used other prescription medications, and 66% used at least one CHA for pain, with 48% using CHAs for greater than 6 months. There was high internal reliability of the SF-GPS (alpha = .93) and satisfactory internal reliability for each of the five TTM stages across (all) twelve CHAs: precontemplation (0.89), contemplation (0.72), preparation (0.75), action (0.70), and maintenance (0.70). Conclusions The CHAPS is the first comprehensive measurement tool to assess CHA use specifically for pain management. Ease of administration in a population with pain support further use in population- and clinic-based studies in similar populations. PMID:29718951

Effects of Reiki With Music Compared to Music Only Among People Living With HIV.

PubMed

Bremner, Marie N; Blake, Barbara J; Wagner, V Doreen; Pearcey, Sharon M

2016-01-01

Persons living with HIV (PLWH) often seek complementary treatments to improve their overall health and well-being. Reiki, an ancient healing practice, has been found to be effective in reducing symptoms of stress, anxiety, pain, and depression. The purpose of this pilot study was to evaluate the effectiveness of Reiki as a complementary treatment for PLWH. Using a two-group mixed-methods experimental design, 37 participants were randomized to either a 6-week Reiki with Music Group or a Music Only Group. Self-reported and physiologic measures were obtained at baseline, 6 weeks, and 10 weeks. Significant improvements in relief of pain and stress in those receiving RMG were found. At the 6-week assessment, semi-structured interviews were conducted with all participants. Qualitative findings indicated that Reiki and music therapy helped reduce stress, anxiety, and depression. Evidence-based data regarding the effectiveness of Reiki will help nurses help patients better manage HIV-related symptoms. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Mobile-Based Nutrition and Child Health Monitoring to Inform Program Development: An Experience From Liberia.

PubMed

Guyon, Agnes; Bock, Ariella; Buback, Laura; Knittel, Barbara

2016-12-23

Implementing complex nutrition and other public health projects and tracking nutrition interventions, such as women's diet and supplementation and infant and young child feeding practices, requires reliable routine data to identify potential program gaps and to monitor trends in behaviors in real time. However, current monitoring and evaluation practices generally do not create an environment for this real-time tracking. This article describes the development and application of a mobile-based nutrition and health monitoring system, which collected monitoring data on project activities, women's nutrition, and infant and young child feeding practices in real time. The Liberia Agricultural Upgrading Nutrition and Child Health (LAUNCH) project implemented a nutrition and health monitoring system between April 2012 and June 2014. The LAUNCH project analyzed project monitoring and outcome data from the system and shared selected behavioral and programmatic indicators with program managers through a short report, which later evolved into a visual data dashboard, during program-update meetings. The project designed protocols to ensure representativeness of program participants. LAUNCH made programmatic adjustments in response to findings from the monitoring system; these changes were then reflected in subsequent quarterly trends, indicating that the availability of timely data allowed for the project to react quickly to issues and adapt the program appropriately. Such issues included lack of participation in community groups and insufficient numbers of food distribution points. Likewise, the system captured trends in key outcome indicators such as breastfeeding and complementary feeding practices, linking them to project activities and external factors including seasonal changes and national health campaigns. Digital data collection platforms can play a vital role in improving routine programmatic functions. Fixed gathering locations such as food distribution points represent an opportunity to easily access program participants and enable managers to identify strengths and weaknesses in project implementation. For programs that track individuals over time, a mobile tool combined with a strong database can greatly improve efficiency and data visibility and reduce resource leakages. © Guyon et al.

Guidance on How to Move from Current Practice to Recommended Practice in Life Cycle Impact Assessment (UNEP/SETAC Life Cycle Initiative Publication)

EPA Science Inventory

The report provides guidance on how to move from current practice to recommended practice in Life Cycle Impact Assessment. It is composed of three complementary parts elaborated in the first task force (TFI) of the LCIA programme, with contribution of the other three task forces:

Responding to GPs' information resource needs: implementation and evaluation of a complementary medicines information resource in Queensland general practice

PubMed Central

2011-01-01

Background Australian General Practitioners (GPs) are in the forefront of primary health care and in an excellent position to communicate with their patients and educate them about Complementary Medicines (CMs) use. However previous studies have demonstrated that GPs lack the knowledge required about CMs to effectively communicate with patients about their CMs use and they perceive a need for information resources on CMs to use in their clinical practice. This study aimed to develop, implement, and evaluate a CMs information resource in Queensland (Qld) general practice. Methods The results of the needs assessment survey of Qld general practitioners (GPs) informed the development of a CMs information resource which was then put through an implementation and evaluation cycle in Qld general practice. The CMs information resource was a set of evidence-based herbal medicine fact sheets. This resource was utilised by 100 Qld GPs in their clinical practice for four weeks and was then evaluated. The evaluation assessed GPs' (1) utilisation of the resource (2) perceived quality, usefulness and satisfaction with the resource and (3) perceived impact of the resource on their knowledge, attitudes, and practice of CMs. Results Ninety two out of the 100 GPs completed the four week evaluation of the fact sheets and returned the post-intervention survey. The herbal medicine fact sheets produced by this study were well accepted and utilised by Qld GPs. The majority of GPs perceived that the fact sheets were a useful resource for their clinical practice. The fact sheets improved GPs' attitudes towards CMs, increased their knowledge of those herbal medicines and improved their communication with their patients about those specific herbs. Eighty-six percent of GPs agreed that if they had adequate resources on CMs, like the herbal medicine fact sheets, then they would communicate more to their patients about their use of CMs. Conclusion Further educational interventions on CMs need to be provided to GPs to increase their knowledge of CMs and to improve their communication with patients about their CMs use. PMID:21933434

Infants and young children feeding practices and nutritional status in two districts of Zambia.

PubMed

Katepa-Bwalya, Mary; Mukonka, Victor; Kankasa, Chipepo; Masaninga, Freddie; Babaniyi, Olusegun; Siziya, Seter

2015-01-01

Appropriate feeding is important in improving nutrition and child survival. Documentation of knowledge of caregiver on infant feeding is scanty in Zambia. The aim of this study was to describe feeding practices and nutritional status among infants and young children (IYC) in two districts in Zambia: Kafue and Mazabuka. A cross-sectional study was conducted between January and March 2006 using both quantitative and qualitative methods. A questionnaire was administered to caregiver of children aged under24 months. Lengths and weights of all children were measured. Focused group discussions were conducted in selected communities to assess parents or guardian knowledge, attitude and practice related to infant feeding. A total of 634 caregivers (361 from Kafue and 273 from Mazabuka) participated in the study. About 311/618 (54.0%) of the caregiver knew the definition and recommended duration of exclusive breastfeeding (EBF) and when to introduce complementary feeds. Two hundred and fifty-one (81.2%) out of 310 respondents had acquired this knowledge from the health workers. Only 145/481 (30.1%) of the respondents practiced exclusive breastfeeding up to six months with 56/626 (8.9%) of the mothers giving prelacteal feeds. Although 596/629 (94.8%) of the respondents reported that the child does not need anything other than breast milk in the first three days of life, only 318/630 (50.5%) of them considered colostrum to be good. Complementary feeds were introduced early before six months of age and were usually not of adequate quality and quantity. Three hundred and ninety-one (64%) out of 603 caregivers knew that there would be no harm to the child if exclusively breastfed up to six months. Most of the children's nutritional status was normal with 25/594 (4.2%) severely stunted, 10/596 (1.7%) severely underweight and 3/594 (0.5%) severely wasted. The caregiver in the communities knew about the recommended feeding practices, but this knowledge did not translate into good practice. Knowing that most of the mothers will breastfeed and have heard about appropriate breastfeeding, is important in the development of sustainable strategies required to improve feeding practices and, thus, nutritional status of children.

Integrative, Alternative, and Complementary Therapies (PDQ®)—Health Professional Version

Cancer.gov

Topics in Integrative, Alternative, and Complementary Therapies gives a brief description of some of these therapies used by people with cancer. Links to additional information, references, and resources on the NCI website are provided in this summary for clinicians.

Health workforce governance: Processes, tools and actors towards a competent workforce for integrated health services delivery.

PubMed

Barbazza, Erica; Langins, Margrieta; Kluge, Hans; Tello, Juan

2015-12-01

A competent health workforce is a vital resource for health services delivery, dictating the extent to which services are capable of responding to health needs. In the context of the changing health landscape, an integrated approach to service provision has taken precedence. For this, strengthening health workforce competencies is an imperative, and doing so in practice hinges on the oversight and steering function of governance. To aid health system stewards in their governing role, this review seeks to provide an overview of processes, tools and actors for strengthening health workforce competencies. It draws from a purposive and multidisciplinary review of literature, expert opinion and country initiatives across the WHO European Region's 53 Member States. Through our analysis, we observe distinct yet complementary roles can be differentiated between health services delivery and the health system. This understanding is a necessary prerequisite to gain deeper insight into the specificities for strengthening health workforce competencies in order for governance to rightly create the institutional environment called for to foster alignment. Differentiating between the contribution of health services and the health system in the strengthening of health workforce competencies is an important distinction for achieving and sustaining health improvement goals. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Complementary feeding adequacy in relation to nutritional status among early weaned breastfed children who are born to HIV-infected mothers: ANRS 1201/1202 Ditrame Plus, Abidjan, Cote d'Ivoire.

PubMed

Becquet, Renaud; Leroy, Valériane; Ekouevi, Didier K; Viho, Ida; Castetbon, Katia; Fassinou, Patricia; Dabis, François; Timite-Konan, Marguerite

2006-04-01

In high HIV prevalence resource-constrained settings, exclusive breastfeeding with early cessation is one of the conceivable interventions aimed at the prevention of HIV through breast milk. Nevertheless, this intervention has potential adverse effects, such as the inappropriateness of complementary feeding to take over breast milk. The purpose of our study first was to describe the nature and the ages of introduction of complementary feeding among early weaned breastfed infants up to their first birthday and second was to assess the nutritional adequacy of these complementary foods by creating a child feeding index and to investigate its association with child nutritional status. A prospective cohort study in Abidjan, Côte d'Ivoire, was conducted in HIV-infected pregnant women who were willing to breastfeed and had received a perinatal antiretroviral prophylaxis. They were requested to practice exclusive breastfeeding and initiate early cessation of breastfeeding from the fourth month to reduce breast milk HIV transmission. Nature and ages of introductory complementary feeding were described in infants up to their first birthday by longitudinal compilation of 24-hour and 7-day recall histories. These recalls were done weekly until 6 weeks of age, monthly until 9 months of age, and then quarterly. We created an index to synthesize the nutritional adequacy of infant feeding practices (in terms of quality of the source of milk, dietary diversity, food, and meal frequencies) ranging from 0 to 12. The association of this feeding index with growth outcomes in children was investigated. Among the 262 breastfed children included, complete cessation of breastfeeding occurred in 77% by their first birthday, with a median duration of 4 months. Most of the complementary foods were introduced within the seventh month of life, except for infant food and infant formula that were introduced at age 4 months. The feeding index was relatively low (5 of 12) at age 6 months, mainly as a result of insufficient dietary diversity, but was improved in the next 6 months (8.5 of 12 at 12 months of age). Inadequate complementary feeding at age 6 months was associated with impaired growth during the next 12 months, with a 37% increased probability of stunting. Adequate feeding practices around the weaning period are crucial to achieving optimal child growth. HIV-infected women should turn to early cessation of breastfeeding only when they are counseled properly to provide adequate complementary feeding to take over breast milk. Our child feeding index could contribute to the assessment of the nutritional adequacy of complementary feeding around the weaning period and therefore help to detect children who are at risk for malnutrition.

Consumption of highly processed snacks, sugar-sweetened beverages and child feeding practices in a rural area of Nicaragua.

PubMed

Contreras, Mariela; Zelaya Blandón, Elmer; Persson, Lars-Åke; Ekström, Eva-Charlotte

2016-01-01

Appropriate feeding behaviours are important for child growth and development. In societies undergoing nutrition transition, new food items are introduced that may be unfavourable for child health. Set in rural Nicaragua, the aim of this study was to describe the infant and young child feeding (IYCF) practices as well as the consumption of highly processed snack foods (HP snacks) and sugar-sweetened beverages (SSBs). All households with at least one child 0- to 35-month-old (n = 1371) were visited to collect information on current IYCF practices in the youngest child as well as consumption of SSBs and HP snacks. Breastfeeding was dominant (98%) among 0- to 1-month-olds and continued to be prevalent (60%) in the second year, while only 34% of the 0- to 5-month-olds were exclusively breastfed. Complementary feeding practices were deemed acceptable for only 59% of the 6- to 11-month-old infants, with low dietary diversity reported for 50% and inadequate meal frequency reported for 30%. Consumption of HP snacks and SSBs was frequent and started early; among 6- to 8-month-olds, 42% and 32% had consumed HP snacks and SSBs, respectively. The difference between the observed IYCF behaviours and World Health Organization recommendations raises concern of increased risk of infections and insufficient intake of micronutrients that may impair linear growth. The concurrent high consumption of SSBs and HP snacks may increase the risk of displacing the recommended feeding behaviours. To promote immediate and long-term health, growth and development, there is a need to both promote recommended IYCF practices as well as discourage unfavourable feeding behaviours. © 2014 John Wiley & Sons Ltd.

Feeding in the first year of life - emerging benefits of introducing complementary solids from 4 months.

PubMed

Symon, Brian; Bammann, Michael

2012-04-01

Current World Health Organization guidelines recommend exclusive breastfeeding for the first 6 months of life. Breastfeeding conveys clear benefits to both mother and child. These benefits are likely to be amplified by prolonged feeding. This article outlines the emerging evidence that suggests possible benefits from introducing complementary solids from 4 months of age in developed countries. The human gut may have a critical early window during which it has an opportunity to develop immunological tolerance. Introducing complementary solids from 4 months of age may decrease the risk of food allergy and coeliac disease - immunological illnesses that have become a public health priority. The new draft National Health and Medical Research Council guidelines recommend introducing solids at around 6 months (22-26 weeks). However, given recent evidence, it may be appropriate to recommend the introduction of solids from 4 months of age in the Australian context.

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

PubMed

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

2008-12-01

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

Infant and Young Child Feeding Behaviors among Working Mothers in India: Implications for Global Health Policy and Practice

PubMed Central

Kumar, Vinay; Arora, Gunjan; Midha, Ish Kumar; Gupta, Yogender Pal

2015-01-01

Background: The National Guidelines on Infant and Young Child Feeding introduced in 2006 recommended the initiation of breastfeeding immediately after birth, preferably within one hour; exclusive breastfeeding for the first six months; appropriate and adequate complementary feeding from six months of age while continuing breastfeeding; and continued breastfeeding up to the age of two years or beyond. Working women in India constitute a dominant and expanding pool of mothers. There is paucity of research focused on feeding behavior within this group. Method: One hundred and fifty working women answered a structured questionnaire about their demographics, birth history, levels of awareness and practice of feeding guidelines, and perceptions about breastfeeding and counseling. Data analysis was carried out using Microsoft Excel and the Statistical Package for the Social Sciences. Results: Majority of participants belonged to 21-39 years age group, had nuclear families, received college education, and delivered in institutional setups. Gaps were observed between the mother’s levels of awareness and practice for different tenets of national guidelines. Higher education, longer maternity leave, higher income, and utilization of counseling services facilitated adoption of optimal feeding behavior. Most women perceived breast milk to be superior to any alternative and favored provision of counseling during last trimester. Conclusions and Global Health Implications: Counseling women on optimal feeding behavior is a potential intervention to convert its awareness into actual practice. The lessons learned from this study can help refine both national and global Mother and Child Health policies and programs. PMID:27621981

Bidirectional transfer between joint and individual actions in a task of discrete force production.

PubMed

Masumoto, Junya; Inui, Nobuyuki

2017-07-01

The present study examined bidirectional learning transfer between joint and individual actions involving discrete isometric force production with the right index finger. To examine the effects of practice of joint action on performance of the individual action, participants performed a pre-test (individual condition), practice blocks (joint condition), and a post-test (individual condition) (IJI task). To examine the effects of practice of the individual action on performance during the joint action, the participants performed a pre-test (joint condition), practice blocks (individual condition), and a post-test (joint condition) (JIJ task). Whereas one participant made pressing movements with a target peak force of 10% maximum voluntary contraction (MVC) in the individual condition, two participants produced the target force of the sum of 10% MVC produced by each of them in the joint condition. In both the IJI and JIJ tasks, absolute errors and standard deviations of peak force were smaller post-test than pre-test, indicating bidirectional transfer between individual and joint conditions for force accuracy and variability. Although the negative correlation between forces produced by two participants (complementary force production) became stronger with practice blocks in the IJI task, there was no difference between the pre- and post-tests for the negative correlation in the JIJ task. In the JIJ task, the decrease in force accuracy and variability during the individual action did not facilitate complementary force production during the joint action. This indicates that practice performed by two people is essential for complementary force production in joint action.

Chapter 29: Unproved and controversial methods and theories in allergy-immunology.

PubMed

Shah, Rachna; Greenberger, Paul A

2012-01-01

Unproved methods and controversial theories in the diagnosis and management of allergy-immunology are those that lack scientific credibility. Some definitions are provided for perspective because in chronic medical conditions, frequently, nonscientifically based treatments are developed that can have a very positive psychological effect on the patients in the absence of objective physical benefit. Standard practice can be described as "the methods of diagnosis and treatment used by reputable physicians in a particular subspecialty or primary care practice" with the understanding that diagnosis and treatment options are consistent with established mechanisms of conditions or diseases.(3) Conventional medicine (Western or allopathic medicine) is that which is practiced by the majority of MDs, DOs, psychologists, RNs, and physical therapists. Complementary medicine uses the practice of conventional medicine with complementary and alternative medicine such as using acupuncture for pain relief in addition to opioids. Alternative medicine implies use of complementary and alternative practices in place of conventional medicine. Unproved and controversial methods and theories do not have supporting data, validation, and sufficient scientific scrutiny, and they should not be used in the practice of allergy-immunology. Some examples of unproven theories about allergic immunologic conditions include allergic toxemia, idiopathic environmental intolerance, association with childhood vaccinations, and adrenal fatigue. Unconventional (unproved) diagnostic methods for allergic-immunologic conditions include cytotoxic tests, provocation-neutralization, electrodermal diagnosis, applied kinesiology assessments, and serum IgG or IgG(4) testing. Unproven treatments and intervention methods for allergic-immunologic conditions include acupuncture, homeopathy ("likes cure likes"), halotherapy, and autologous urine injections.

Discussion of “Representation of People’s Decisions in Health Information Systems: A Complementary Approach for Understanding Health Care Systems and Population Health”

PubMed Central

2017-01-01

Summary This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper “Representation of People’s Decisions in Health Information Systems: A Complementary Approach for Understanding Health Care Systems and Population Health” written by Fernan Gonzalez Bernaldo de Quiros, Adriana Ruth Dawidowski, and Silvana Figar. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the paper of de Quiros, Dawidowski, and Figar. In subsequent issues the discussion can continue through letters to the editor. PMID:28144678

Qualitative evaluation: A critical and interpretative complementary approach to improve health programs and services

PubMed Central

Tayabas, Luz María Tejada; León, Teresita Castillo; ESPINO, JOEL MONARREZ

2014-01-01

This short essay aims at commenting on the origin, development, rationale, and main characteristics of qualitative evaluation (QE), emphasizing the value of this methodological tool to evaluate health programs and services. During the past decades, different approaches have come to light proposing complementary alternatives to appraise the performance of public health programs, mainly focusing on the implementation process involved rather than on measuring the impact of such actions. QE is an alternative tool that can be used to illustrate and understand the process faced when executing health programs. It can also lead to useful suggestions to modify its implementation from the stakeholders’ perspectives, as it uses a qualitative approach that considers participants as reflective subjects, generators of meanings. This implies that beneficiaries become involved in an active manner in the evaluated phenomena with the aim of improving the health programs or services that they receive. With this work we want to encourage evaluators in the field of public health to consider the use of QE as a complementary tool for program evaluation to be able to identify areas of opportunity to improve programs’ implementation processes from the perspective of intended beneficiaries. PMID:25152220

Development of a strategic model for integrating complementary medicines into professional pharmacy practice.

PubMed

Ung, Carolina Oi Lam; Harnett, Joanna; Hu, Hao

2017-08-03

Traditional medicine (TM) and complementary medicine (CM) products have played an increasingly important role in the business of pharmacy for over two decades in a number of countries. With a focus on the quality use of all medicines including complementary medicines, there have been a number of initiatives to encourage the integration of TM/CM products into professional practice. Recent studies report that many of the barriers that prevent such integration remain. To explore the pharmacists' perspective regarding how barriers to the integration of TM/CM products into the professional practice of pharmacy could be resolved. Purposive sampling and snowballing were used to recruit 11 registered pharmacists who had worked in community pharmacy for a minimum of 6 months to participate in one of 3 focus groups. Focus group questions informed by previous studies, explored participants' perspectives on the actions required to support professional services related to TM/CM products. Pharmacists proposed that five key stakeholders (professional pharmacy organizations, universities, government, pharmacy owners, and pharmacists) enact 4 developments that require a collaborative effort ("education and training", "building the evidence base", "developing reliable and accessible information resources", and "workplace support for best practice"). Manufacturers of TM/CM products were not identified by pharmacists as collaborators in these developments. Collectively, the findings from this study support a strategic model to guide the integration of TM/CM products into the professional practice of pharmacy. Copyright © 2017 Elsevier Inc. All rights reserved.

A comparison of complementary and alternative medicine users and use across geographical areas: A national survey of 1,427 women

PubMed Central

2011-01-01

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

Use of traditional complementary and alternative medicine for HIV patients in KwaZulu-Natal, South Africa.

PubMed

Peltzer, Karl; Preez, Natalie Friend-du; Ramlagan, Shandir; Fomundam, Henry

2008-07-24

Traditional medicine use has been reported is common among individuals with moderate and advanced HIV disease. The aim of this cross-sectional study was to assess the use of Traditional Complementary and Alternative Medicine (TCAM) for HIV patients prior to initiating antiretroviral therapy in three public hospitals in KwaZulu-Natal, South Africa. Using systematic sampling, 618 HIV-positive patients were selected from outpatient departments from three hospitals and interviewed with a questionnaire. TCAM was commonly used for HIV in the past six months by study participants (317, 51.3%) and herbal therapies alone (183, 29.6%). The use of micronutrients (42.9%) was excluded from TCAM since mostly vitamins were provided by the health facility. Herbal therapies were the most expensive, costing on average 128 Rand (US$16) per patient per month. Most participants (90%) indicated that their health care provider was not aware that they were taking herbal therapies for HIV (90%). Herbal therapies were mainly used for pain relief (87.1%) and spiritual practices or prayer for stress relief (77.6%). Multivariate logistic regression with use of herbs for HIV as the dependent variable identified being on a disability grant and fewer clinic visits to be associated with use of herbs, and TCAM use for HIV identified being on a disability grant, number of HIV symptoms and family members not contributing to main source of household income to be associated with TCAM use. Traditional herbal therapies and TCAM are commonly used by HIV treatment naïve outpatients of public health facilities in South Africa. Health care providers should routinely screen patients on TCAM use when initiating ART and also during follow-up and monitoring keeping in mind that these patients may not fully disclose other therapies.

Talking about Complementary and Alternative Medicine with Health Care Providers: A Workbook and Tips

Cancer.gov

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.

Talking about Complementary and Alternative Medicine with Health Care Provider: A Workbook and Tips

Cancer.gov

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.

The initiation of complementary feeding among Qom indigenous people.

PubMed

Olmedo, Sofia Irene; Valeggia, Claudia

2014-06-01

As of six months of life, breastfeeding no longer covers an infant's energy or micronutrient needs, so appropriate complementary feeding should be provided. The objective of this study was to assess the time and adequacy for introducing complementary feeding in a Qom/Toba population and analyze the sociocultural concepts of families regarding complementary feeding. Quantitative and qualitative data were collected by participant observation and semistructured surveys administered to mothers of 0-2 year old infants. Qom breastfeed their infants long term and on demand. Most infants have an adequate nutritional status and start complementary feeding at around 6 months old as per the local health center and international standards. However, mostly due to socioeconomic factors, foods chosen to complement breastfeeding have a relatively scarce nutritional value.

Building on a YMCA's health and physical activity promotion capacities: A case study of a researcher-organization partnership to optimize adolescent programming_.

PubMed

Bush, Paula Louise; García Bengoechea, Enrique

2016-08-01

School-based physical activity programs are only effective for increasing adolescents' school-based physical activity. To increase out-of-school-time physical activity, complementary community programs are warranted. Partnerships between universities and community organizations may help build the capacity of these organizations to provide sustainable programs. To understand capacity building processes and outcomes, we partnered with a YMCA to build on their adolescent physical activity promotion capacity. Together, we designed and implemented means to evaluate the YMCA teen program to inform program planning. For this qualitative case study, emails and interviews and meetings transcripts were collected over 2.5 years and analyzed using inductive and deductive thematic analysis. Findings illustrate that the YMCA's workforce and organizational development capacities (e.g., evaluation and health promotion capacity and competence) were increased through our partnership, resource allocation, and leadership. We responded to YMCA partners' perceived needs, yet guided them beyond those needs, successfully combining our complementary objectives, knowledge, and skills to generate an integrated program vision, rationale, and evaluation results. This provided YMCA partners with validation, reminders, and awareness. In turn, this contributed to programming and evaluation practice changes. In light of extant capacity building literature, we discuss how our partnership increased the YMCA's capacity to promote healthy adolescent programs. Copyright © 2016 Elsevier Ltd. All rights reserved.

I will always be with you: traditional and complementary therapists' perspectives on patient-therapist-doctor communication regarding treatment of Arab patients with cancer in Israel.

PubMed

Popper-Giveon, Ariela; Schiff, Elad; Ben-Arye, Eran

2012-12-01

In 2008, an Integrative Oncology Program was implemented at the Clalit Oncology Service in Haifa, Israel, to promote patients' well-being during chemotherapy and advanced stages of disease. We hypothesized that studying the perceptions of Arab complementary and alternative medicine (CAM) therapists would facilitate development of a cross-culturally integrative oncology approach. Semi-structured interviews were held with 27 Arab therapists who use medicinal herbs, the Quran and various CAM modalities, with the aim of characterizing their treatment practices and learning about their perspectives regarding conventional cancer care. Thematic analysis revealed that therapists act as go-betweens, mediating between patients and conventional physicians. Therapists translate diagnoses into Arabic and elucidate key concepts. They tend to perceive their role as gatekeepers accompanying patients through the conventional health system, referring them for further examinations, and providing CAM-based supportive care consultation. CAM therapists have an essential role in supportive care of Arab patients with cancer. Triangular patient-therapist-oncologist communication may have an impact on patients' experience and treatment quality. Recognition of CAM therapists as mediators between patients' health beliefs and conventional perceptions of care may improve doctor-patient dialogue and facilitate supportive care provision in a cross-cultural context. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Disclosure of Complementary and Alternative Medicine to Conventional Medical Providers: Variation by Race/Ethnicity and Type of CAM

PubMed Central

Chao, Maria T.; Wade, Christine; Kronenberg, Fredi

2009-01-01

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

Mind-Body Medicine Practices in Complementary and Alternative Medicine

MedlinePlus

... interactions among the brain, the rest of the body, the mind, and behavior The ways in which emotional, mental, ... alternative medicine (CAM). Within CAM, some examples of mind-body medicine practices are meditation, hypnosis, tai chi, and ...

Medical Pluralism among American Women: Results of a National Survey

PubMed Central

Chao, Maria; Kronenberg, Fredi; Cushman, Linda; Kalmuss, Debra

2008-01-01

Abstract Background Medical pluralism can be defined as the employment of more than one medical system or the use of both conventional and complementary and alternative medicine (CAM) for health and illness. American women use a variety of health services and practices for women's health conditions, yet no national study has specifically characterized women's medical pluralism. Our objective was to describe medical pluralism among American women. Methods A nationally representative telephone survey of 808 women ≥18 years of age was conducted in 2001. Cross-sectional observations of the use of 11 CAM domains and the use of an additional domain—spirituality, religion, or prayer for health—during the past year are reported. Women's health conditions, treatments used, reasons for use, and disclosure to conventional physicians are described, along with predictors of CAM use. Results Over half (53%) of respondents used CAM for health conditions, especially for those involving chronic pain. The majority of women disclosed such practices at clinical encounters with conventional providers. Biologically based CAM therapies, such as nutritional supplements and herbs, were commonly used with prescription and over-the-counter (OTC) pharmaceuticals for health conditions. Conclusions Medical pluralism is common among women and should be accepted as a cultural norm. Although disclosure rates of CAM use to conventional providers were higher than in previous population-based studies, disclosure should be increased, especially for women who are pregnant and those with heart disease and cancer. The health risks and benefits of polypharmacy should be addressed at multiple levels of the public health system. PMID:18537484

A study into the effectiveness of unqualified GP assistants.

PubMed

Philip, Marilyn; Turnbull, Betty

This article aims to address the potential shortfall in care provision offered by general practitioners (GPs) resulting from pending retirement and the retention and recruitment crisis. An educational module was developed that offered both theory and practise to unqualified general practice assistants. The module content was determined following discussion with local GPs. A small qualitative study of six students was carried out to review efficacy of participants in their new role. Using a grounded theory approach, participant and supervisor views of course content and delivery, role preparation diversity were analysed and compared. Tape-recorded interviews were conducted and analysis carried out employing the constant comparative method. Data were coded and emergent themes categorized. Overall, participants agreed that the module had strengthened their knowledge, added new skills, heightened their job satisfaction, added significant diversity to their role and enhanced their employability potential. Five participants communicated that they were more confident in performing clinical skills and advising health improvement techniques. Supervisors also reported that participants displayed a more competent and professional approach to health care, which was complementary to the role of the GP and practice nurse. Ultimately this allowed both GP and practice nurse to focus on dealing with chronic illness targets, as required in the new directive (Scottish Executive, 2004).

An Advanced Pharmacy Practice Framework for Australia

PubMed Central

Jackson, Shane; Martin, Grant; Bergin, Jennifer; Clark, Bronwyn; Stupans, Ieva; Yeates, Gilbert; Nissen, Lisa; Marty, Stephen; Gysslink, Paul; Matthews, Andrew; Kirsa, Sue; Deans, Kerry; Sorimachi, Kay

2015-01-01

The need to develop An Advanced Pharmacy Practice Framework for Australia (the “APPF”) was identified during the 2010 review of the competency standards for Australian pharmacists. The Advanced Pharmacy Practice Framework Steering Committee, a collaborative profession-wide committee comprised of representatives of ten pharmacy organisations, examined and adapted existing advanced practice frameworks, all of which were found to have been based on the Competency Development and Evaluation Group (CoDEG) Advanced and Consultant Level Framework (the “CoDEG Framework”) from the United Kingdom. Its competency standards were also found to align well with the Domains of the National Competency Standards Framework for Pharmacists in Australia (the “National Framework”). Adaptation of the CoDEG Framework created an APPF that is complementary to the National Framework, sufficiently flexible to customise for recognising advanced practice in any area of professional practice and has been approved by the boards/councils of all participating organisations. The primary purpose of the APPF is to assist the development of the profession to meet the changing health care needs of the community. However, it is also a valuable tool for assuring members of the public of the competence of an advanced practice pharmacist and the quality and safety of the services they deliver. PMID:28975900

Health-system strengthening and tuberculosis control.

PubMed

Atun, Rifat; Weil, Diana E C; Eang, Mao Tan; Mwakyusa, David

2010-06-19

Weak health systems are hindering global efforts for tuberculosis care and control, but little evidence is available on effective interventions to address system bottlenecks. This report examines published evidence, programme reviews, and case studies to identify innovations in system design and tuberculosis control to resolve these bottlenecks. We outline system bottlenecks in relation to governance, financing, supply chain management, human resources, health-information systems, and service delivery; and adverse effects from rapid introduction of suboptimum system designs. This report also documents innovative solutions for disease control and system design. Solutions pursued in individual countries are specific to the nature of the tuberculosis epidemic, the underlying national health system, and the contributors engaged: no one size fits all. Findings from countries, including Bangladesh, Cambodia, India, Tanzania, Thailand, and Vietnam, suggest that advances in disease control and system strengthening are complementary. Tuberculosis care and control are essential elements of health systems, and simultaneous efforts to innovate systems and disease response are mutually reinforcing. Highly varied and context-specific responses to tuberculosis show that solutions need to be documented and compared to develop evidence-based policies and practice. Copyright 2010 Elsevier Ltd. All rights reserved.

Determinants of inappropriate timing of introducing solid, semi-solid or soft food to infants in Pakistan: secondary data analysis of Demographic and Health Survey 2006-2007.

PubMed

Hazir, Tabish; Senarath, Upul; Agho, Kingsley; Akram, Dure-Samin; Kazmi, Narjis; Abbasi, Saleem; Dibley, Michael J

2012-01-01

Inappropriate timing of introducing complementary food deprives the infant of optimum nutrition, leading to undernutrition, and increased mortality and morbidity. The aim of this analysis was to identify determinants of inappropriate timing of introduction of solid, semi-solid and soft foods in Pakistan. Data on 941 infants 3.00 to 8.99 months were obtained from the Pakistan Demographic and Health Survey 2006-2007. The prevalence of introduction of foods among infants aged 3.00-5.99 months and 6.00-8.99 months was examined against a set of individual, household and community level variables using univariate analysis. Adjusted odds ratio (AOR) for early introduction in age 3.00-5.99 months and non-introduction in 6.00-8.99 months of age were calculated using backward stepwise logistic regression models. The prevalence of early introduction of complementary foods among 3.00- to 5.99-month-old and timely introduction among 6.00- to 8.99-month-old infants were 10.6% and 39.2%, respectively. Multivariate analyses revealed that mothers who had four or more antenatal clinic visits (AOR=2.68) and who lived in the provinces of Sindh (AOR=2.89) and Baluchistan (AOR=6.75) were more likely to introduce complementary foods early. Mothers from middle-level households (AOR=7.82), poorer households (AOR=4.84) and poorest households (AOR=5.72) were significantly more likely to delay introduction of complementary foods. In conclusion more than half (60.8%) of Pakistani infants do not receive complementary foods at recommended time. Public health interventions to improve the timing of introduction of complementary food are needed at national level with special focus on high risk groups. © 2011 Blackwell Publishing Ltd.

The role of the Therapeutic Goods Administration and the Medicine and Medical Devices Safety Authority in evaluating complementary and alternative medicines in Australia and New Zealand.

PubMed

Ghosh, Dilip; Skinner, Margot; Ferguson, Lynnette R

2006-04-03

Currently, the regulation of complementary and alternative medicines and related health claims in Australia and New Zealand is managed in a number of ways. Complementary medicines, including herbal, minerals, nutritional/dietary supplements, aromatherapy oils and homeopathic medicines are regulated under therapeutic goods/products legislation. The Therapeutic Goods Administration (TGA), a division of the Commonwealth Department of Health and Ageing is responsible for administering the provisions of the legislation in Australia. The New Zealand Medicines and Medical Devices Safety Authority (Medsafe) administers the provision of legislation in New Zealand. In December 2003 the Australian and New Zealand governments signed a Treaty to establish a single, bi-national agency to regulate therapeutic products, including medical devices prescription, over-the-counter and complementary medicines. A single agency will replace the Australian TGA and the New Zealand Medsafe. The role of the new agency will be to safeguard public health through regulation of the quality, safety and efficacy or performance of therapeutic products in both Australia and New Zealand. The major activities of the new joint Australia New Zealand therapeutic products agency are in product licensing, specifying labelling standards and setting the advertising scheme, together with determining the risk classes of medicines and creating an expanded list of ingredients permitted in Class I medicines. A new, expanded definition of complementary medicines is proposed and this definition is currently under consultation. Related Australian and New Zealand legislation is being developed to implement the joint scheme. Once this legislation is passed, the Treaty will come into force and the new joint regulatory scheme will begin. The agency is expected to commence operation no later than 1 July 2006 and will result in a single agency to regulate complementary and alternative medicines.

Hypertension: What are the self-care and health-care-seeking behaviours in women over time?

PubMed

Sibbritt, D; Davidson, P; Peng, W B; Adams, J; Hickman, L

2016-12-01

The aim of this study was to estimate the prevalence and incidence of hypertension in women, and describe their self-care and health-seeking behaviours. This research was conducted as part of the Australian Longitudinal Study on Women's Health, a study comprising a nationally representative sample of Australian women in three age groups. The focus of this research is 14 099 women born in 1946-1951, who have been surveyed six times (1996-2010). Student t-tests were used to compare women who did or did not have hypertension by their health-care utilization. Longitudinal analyses were conducted using a Poisson generalized estimating equation model. The incidence of hypertension among this cohort during 1996 to 2010 ranged from 400 to 597 participants per survey, resulting in an increase in prevalence of hypertension from 20.9% in 1996 to 41.3% in 2010. For all survey periods, women with hypertension had a significantly higher average number of visits to doctors and allied health practitioners compared with women without hypertension (P<0.005). The use of complementary medicine (practitioners and self-prescribed treatments) by women with hypertension was significantly lower compared to women without hypertension (P<0.005). Over time, conventional health-care utilization was higher for women with hypertension compared with women without hypertension (adjusted RR=1.18; 95% CI: 1.14, 1.22; P<0.0001). Our findings show that women with hypertension are using a range of conventional and complementary and alternative medicine: with hypertensive women using more conventional medicine and less complementary and alternative medicine than non-hypertensive women. As such, health-care providers should communicate with their patients regarding their use of complementary and alternative medicine in their efforts to provide safe, effective and coordinate care.

The outcomes of complementary and alternative medicine use among pregnant and birthing women: current trends and future directions.

PubMed

Steel, Amie; Adams, Jon; Sibbritt, David; Broom, Alex

2015-06-01

Complementary and alternative medicine is used by a substantial number of pregnant women and maternity care providers are often faced with the task of ensuring women are using safe and effective treatments while respecting a woman's right to autonomous decision-making. In the era of evidence-based medicine maternity health professionals are expected to draw upon the best available evidence when making clinical decisions and providing health advice. This review will outline the current trends in research evidence associated with the outcomes of complementary and alternative medicine use amongst pregnant and birthing women as well as highlight some potential directions for future development in this important yet largely unknown topic in contemporary maternity care.

Determinants of infant and young child feeding practices in Bangladesh: secondary data analysis of Demographic and Health Survey 2004.

PubMed

Mihrshahi, Seema; Kabir, Iqbal; Roy, S K; Agho, Kingsley E; Senarath, Upul; Dibley, Michael J

2010-06-01

In Bangladesh, poor infant and young child feeding practices are contributing to the burden of infectious diseases and malnutrition. Objective. To estimate the determinants of selected feeding practices and key indicators of breastfeeding and complementary feeding in Bangladesh. The sample included 2482 children aged 0 to 23 months from the Bangladesh Demographic and Health Survey of 2004. The World Health Organization (WHO)-recommended infant and young child feeding indicators were estimated, and selected feeding indicators were examined against a set of individual-, household-, and community-level variables using univariate and multivariate analyses. Only 27.5% of mothers initiated breastfeeding within the first hour after birth, 99.9% had ever breastfed their infants, 97.3% were currently breastfeeding, and 22.4% were currently bottle-feeding. Among infants under 6 months of age, 42.5% were exclusively breastfed, and among those aged 6 to 9 months, 62.3% received complementary foods in addition to breastmilk. Among the risk factors for an infant not being exclusively breastfed were higher socioeconomic status, higher maternal education, and living in the Dhaka region. Higher birth order and female sex were associated with increased rates of exclusive breastfeeding of infants under 6 months of age. The risk factors for bottle-feeding were similar and included having a partner with a higher educational level (OR = 2.17), older maternal age (OR for age > or = 35 years = 2.32), and being in the upper wealth quintiles (OR for the richest = 3.43). Urban mothers were at higher risk for not initiating breastfeeding within the first hour after birth (OR = 1.61). Those who made three to six visits to the antenatal clinic were at lower risk for not initiating breastfeeding within the first hour (OR = 0.61). The rate of initiating breastfeeding within the first hour was higher in mothers from richer households (OR = 0.37). Most breastfeeding indicators in Bangladesh were below acceptable levels. Breastfeeding promotion programs in Bangladesh need nationwide application because of the low rates of appropriate infant feeding indicators, but they should also target women who have the main risk factors, i.e., working mothers living in urban areas (particularly in Dhaka).

Characterization of Complementary and Alternative Medicine-Related Consultations in an Academic Drug Information Service.

PubMed

Gregory, Philip J; Jalloh, Mohamed A; Abe, Andrew M; Hu, James; Hein, Darren J

2016-12-01

To characterize requests received through an academic drug information consultation service related to complementary and alternative medicines. A retrospective review and descriptive analysis of drug information consultations was conducted. A total of 195 consultations related to complementary and alternative medicine were evaluated. All consultation requests involved questions about dietary supplements. The most common request types were related to safety and tolerability (39%), effectiveness (38%), and therapeutic use (34%). Sixty-eight percent of the requests were from pharmacists. The most frequent consultation requests from pharmacists were questions related to drug interactions (37%), therapeutic use (37%), or stability/compatibility/storage (34%). Nearly 60% of complementary and alternative medicine-related consultation requests were able to be completely addressed using available resources. Among review sources, Natural Medicines Comprehensive Database, Clinical Pharmacology, Micromedex, and Pharmacist's Letter were the most common resources used to address consultations. Utilization of a drug information service may be a viable option for health care professionals to help answer a complementary and alternative medicine-related question. Additionally, pharmacists and other health care professionals may consider acquiring resources identified to consistently answering these questions. © The Author(s) 2015.

National Cultures, Performance Appraisal Practices, and Organizational Absenteeism and Turnover: A Study across 21 Countries

ERIC Educational Resources Information Center

Peretz, Hilla; Fried, Yitzhak

2012-01-01

Performance appraisal (PA) is a key human resource activity in organizations. However, in this global economy, we know little about how societal cultures affect PA practices. In this study, we address this gap by focusing on 2 complementary issues: (a) the influence of societal (national) cultural practices on PA practices adopted by organizations…

[Phenomenology and phenomenological method: their usefulness for nursing knowledge and practice].

PubMed

Vellone, E; Sinapi, N; Rastelli, D

2000-01-01

Phenomenology is a thought movement the main aim of which is to study human fenomena as they are experienced and lived. Key concepts of phenomenology are: the study of lived experience and subjectivity of human beings, the intentionality of consciousness, perception and interpretation. Phenomenological research method has nine steps: definition of the research topic; superficial literature searching; sample selection; gathering of lived experiences; analysis of lived experiences; written synthesis of lived experiences; validation of written synthesis; deep literature searching; writing of the scientific document. Phenomenology and phenomenological method are useful for nursing either to develop knowledge or to guide practice. Qualitative-phenomenological and quantitative-positivistic research are complementary: the first one guides clinicians towards a person-centered approach, the second one allows the manipulation of phenomena which can damage health, worsen illness or decrease the quality of life of people who rely on nursing care.

The Problem of Dualism in Modern Western Medicine

PubMed Central

Gendle, Mathew H.

2016-01-01

Dualism is historically important in that it allowed the medical practice to be divorced from church oversight. The reductionist approaches of modern Western medicine facilitate a dispassionate and mechanistic approach to patient care, and dualist views promoted by complementary and alternative medicine are also problematic. Behavioural disorders are multifactorally realizable and emerge apparently chaotically from interactions between internal physiological systems and the patient's environment and experiential history. Conceptualizations of behavioural disorders that are based on dualism deny the primacy of individual physiology in the generation of pathology and distract from therapies that are most likely to produce positive outcomes. Behavioural health professionals should adopt holistic models of patient care, but these models must be based on methodologies that emphasize radical emergence over the artificial separation of the “physical” and “mental.” This will allow for the humanistic practice of medicine while simultaneously maximizing the likelihood of treatment success. PMID:28031628

[Palliative care: between humanization and medicalization at the end of life].

PubMed

Alonso, Juan Pedro

2013-09-01

This paper analyzes the palliative care of terminal patients, examining the tensions between the humanization of care and the progressive medicalization at the end-of-life situation. The research upon which the article is based adopts a qualitative methodological approach derived from interviews with professionals and patients and ethnographic observations in a palliative care unit in the City of Buenos Aires, Argentina. The article describes the configuration of personalized and comprehensive health care based on the core values of more humanized end-of-life care promoted by palliative care supporters. Similarly, the paper analyzes how these practices are assisted by progress in the medicalization process in which the dimension of care is considered less an unprofessional area of medical practice than an area of care in which specific technical skills and know-how are employed. The articles explores how instead of being divergent, the logic of care and medicalization work in a complementary fashion.

The Prevalence of Complementary and Alternative Medicine Use Among Dermatology Outpatients in Shiraz, Iran

PubMed Central

Dastgheib, Ladan; Farahangiz, Saman; Adelpour, Zeinab; Salehi, Alireza

2017-01-01

The objective of this study was to assess complementary and alternative medicine use and its related factors among Iranian dermatology outpatients. In this cross-sectional study, a self-structured questionnaire was administered to 600 dermatology outpatients. Mann-Whitney U test, chi-square test, and binary logistic regression test were used. A total of 188 (31.3%) patients had used one of complementary and alternative medicine methods. The most frequent method used was herbal medicine (89.9%). The mean years of duration of the skin condition were significantly higher in complementary and alternative medicine users compared with nonusers (P = .037). Patients with acne and alopecia significantly used more complementary and alternative medicine (odds ratio: 2.48 and 3.19, respectively). There was a significant relationship between education and using complementary and alternative medicine (P < .001). Complementary and alternative medicine use is prevalent among our patients and we should think of ways of educating general population about complementary and alternative medicine methods and their potential risks and benefits and encourage our health care workers to communicate these materials with their patients. PMID:28446027

The Prevalence of Complementary and Alternative Medicine Use Among Dermatology Outpatients in Shiraz, Iran.

PubMed

Dastgheib, Ladan; Farahangiz, Saman; Adelpour, Zeinab; Salehi, Alireza

2017-10-01

The objective of this study was to assess complementary and alternative medicine use and its related factors among Iranian dermatology outpatients. In this cross-sectional study, a self-structured questionnaire was administered to 600 dermatology outpatients. Mann-Whitney U test, chi-square test, and binary logistic regression test were used. A total of 188 (31.3%) patients had used one of complementary and alternative medicine methods. The most frequent method used was herbal medicine (89.9%). The mean years of duration of the skin condition were significantly higher in complementary and alternative medicine users compared with nonusers ( P = .037). Patients with acne and alopecia significantly used more complementary and alternative medicine (odds ratio: 2.48 and 3.19, respectively). There was a significant relationship between education and using complementary and alternative medicine ( P < .001). Complementary and alternative medicine use is prevalent among our patients and we should think of ways of educating general population about complementary and alternative medicine methods and their potential risks and benefits and encourage our health care workers to communicate these materials with their patients.

A Mathematics Teacher's Practice in a Technological Environment: A Case Study Analysis Using Two Complementary Theories

ERIC Educational Resources Information Center

Tabach, Michal

2011-01-01

Integrating technology in school mathematics has become more and more common. The teacher is a key person in integrating technology into everyday practice. To understand teacher practice in a technological environment, this study proposes using two theoretical perspectives: the theory of technological pedagogical content knowledge to analyze…

Talking about Complementary and Alternative Medicine with your Health Care Provider: A workbook and tips

Cancer.gov

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.

Talking about complementary and alternative medicine with your health care provider: A workbook and Tips

Cancer.gov

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.

The coexistence of traditional medicine and biomedicine: A study with local health experts in two Brazilian regions.

PubMed

Zank, Sofia; Hanazaki, Natalia

2017-01-01

This study investigated the combined use of traditional medicine and biomedicine by local experts in Chapada do Araripe communities (Ceará State) and maroon communities (Santa Catarina State), Brazil. The objective was to understand the perception of local health specialists regarding the number of healers, demand for healers and use of medicinal plants, and the dependence of different environments to obtain such plants. We also aimed to understand the role of medicinal plants to treat different categories of diseases and if there is a complementary use of medicinal plants and allopathic biomedicine, according to the context of each group. The research was conducted with local health specialists that answered structured interviews, created free lists and participated in guided tours to collect cited plants. Sixty-six local health specialists were identified in the Araripe communities and 22 specialists in the maroon communities. In the maroon communities, a greater number of specialists thought there was a decrease in the number and demand for healers, as well as the use of medicinal plants, due to changes in traditional livelihoods, since they are located in a region where the effects of the modernization were more intense. In the Chapada do Araripe communities the specialists knew more plants extracted from native vegetation, whereas in the maroon communities cultivated plants were better known, which may reflect the environmental conditions and the history of each region. Medicinal plants are preferred to treat simpler health problems that do not require medical care, such as gastrointestinal problems, general pain, flues and colds. The biomedicine is used principally for problems with blood pressure, general pains and endocrine and nutritional diseases. Even with the particularities of each region, in general the use of medicinal plants and biomedicines occurred in a complementary form in both regions; however, this coexistence may result from these different contexts. This study also found that there was knowledge and appreciation for traditional health practices in both regions.

The coexistence of traditional medicine and biomedicine: A study with local health experts in two Brazilian regions

PubMed Central

Zank, Sofia; Hanazaki, Natalia

2017-01-01

This study investigated the combined use of traditional medicine and biomedicine by local experts in Chapada do Araripe communities (Ceará State) and maroon communities (Santa Catarina State), Brazil. The objective was to understand the perception of local health specialists regarding the number of healers, demand for healers and use of medicinal plants, and the dependence of different environments to obtain such plants. We also aimed to understand the role of medicinal plants to treat different categories of diseases and if there is a complementary use of medicinal plants and allopathic biomedicine, according to the context of each group. The research was conducted with local health specialists that answered structured interviews, created free lists and participated in guided tours to collect cited plants. Sixty-six local health specialists were identified in the Araripe communities and 22 specialists in the maroon communities. In the maroon communities, a greater number of specialists thought there was a decrease in the number and demand for healers, as well as the use of medicinal plants, due to changes in traditional livelihoods, since they are located in a region where the effects of the modernization were more intense. In the Chapada do Araripe communities the specialists knew more plants extracted from native vegetation, whereas in the maroon communities cultivated plants were better known, which may reflect the environmental conditions and the history of each region. Medicinal plants are preferred to treat simpler health problems that do not require medical care, such as gastrointestinal problems, general pain, flues and colds. The biomedicine is used principally for problems with blood pressure, general pains and endocrine and nutritional diseases. Even with the particularities of each region, in general the use of medicinal plants and biomedicines occurred in a complementary form in both regions; however, this coexistence may result from these different contexts. This study also found that there was knowledge and appreciation for traditional health practices in both regions. PMID:28414735

Special Section: Complementary and Alternative Medicine (CAM): Acupuncture From Ancient Practice to Modern Science

MedlinePlus

... Home Current Issue Past Issues Special Section CAM Acupuncture From Ancient Practice to Modern Science Past Issues / ... percent of U.S. adults use acupuncture. What Is Acupuncture? Dr. Adeline Ge adjusts placement of acupuncture needles ...

The effect of hospital-physician integration on health information technology adoption.

PubMed

Lammers, Eric

2013-10-01

The US federal government has recently made a substantial investment to enhance the US health information technology (IT) infrastructure. Previous literature on the impact of IT on firm performance across multiple industries has emphasized the importance of a process of co-invention whereby organizations develop complementary practices to achieve greater benefit from their IT investments. In health care, employment of physicians by hospitals can confer greater administrative control to hospitals over physicians' actions and resources and thus enable the implementation of new technology and initiatives aimed at maximizing benefit from use of the technology. In this study, I tested for the relationship between hospital employment of physicians and hospitals' propensity to use health IT. I used state laws that prohibit hospital employment of physicians as an instrument to account for the endogenous relationship with hospital IT use. Hospital employment of physicians is associated with significant increases in the probability of hospital health IT use. Therefore, subsidization of health IT among hospitals not employing physicians may be less efficient. Furthermore, state laws prohibiting hospitals from employing physicians may inhibit adoption of health IT, thus working against policy initiatives aimed at promoting use of the technology. Copyright © 2012 John Wiley & Sons, Ltd.

Integration for coexistence? Implementation of intercultural health care policy in Ghana from the perspective of service users and providers.

PubMed

Gyasi, Razak Mohammed; Poku, Adjoa Afriyie; Boateng, Simon; Amoah, Padmore Adusei; Mumin, Alhassan Abdul; Obodai, Jacob; Agyemang-Duah, Williams

2017-01-01

In spite of the World Health Organization's recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary medicine into the national health care delivery system need to account for individual-level involvement and cultural acceptability of care rendered by health care providers. Studies in Ghana, however, have glossed over the standpoint of the persons of the illness episode about the intercultural health care policy framework. This paper explores the health care users, and providers' experiences and attitudes towards the implementation of intercultural health care policy in Ghana. In-depth interviews, augmented with informal conversations, were conducted with 16 health service users, 7 traditional healers and 6 health professionals in the Sekyere South District and Kumasi Metropolis in the Ashanti Region of Ghana. Data were thematically analysed and presented based on the a posteriori inductive reduction approach. Findings reveal a widespread positive attitude to, and support for integrative medical care in Ghana. However, inter-provider communication in a form of cross-referrals and collaborative mechanisms between healers and health professionals seldom occurs and remains unofficially sanctioned. Traditional healers and health care professionals are skeptical about intercultural health care policy mainly due to inadequate political commitment for provider education. The medical practitioners have limited opportunity to undergo training for integrative medical practice. We also find a serious mistrust between the practitioners due to the "diversity of healing approaches and techniques." Weak institutional support, lack of training to meet standards of practice, poor registration and regulatory measures as well as negative perception of the integrative medical policy inhibit its implementation in Ghana. In order to advance any useful intercultural health care policy in Ghana, the government's total commitment in informed training and provider education, enforcement of regulatory instrument and improved community engagement is needed. Evidence-based incorporation of traditional medical therapies into clinical practice will provide safer, faster and more effective health care for the underserved and resource-poor, particularly in the rural areas.

Implicit and explicit attitudes towards conventional and complementary and alternative medicine treatments: Introduction of an Implicit Association Test.

PubMed

Green, James A; Hohmann, Cynthia; Lister, Kelsi; Albertyn, Riani; Bradshaw, Renee; Johnson, Christine

2016-06-01

This study examined associations between anticipated future health behaviour and participants' attitudes. Three Implicit Association Tests were developed to assess safety, efficacy and overall attitude. They were used to examine preference associations between conventional versus complementary and alternative medicine among 186 participants. A structural equation model suggested only a single implicit association, rather than three separate domains. However, this single implicit association predicted additional variance in anticipated future use of complementary and alternative medicine beyond explicit. Implicit measures should give further insight into motivation for complementary and alternative medicine use. © The Author(s) 2014.