Search

Purpose: To clarify the current use of unapproved and unproven cancer treatment (UUCT) among the bereaved families of patients with cancer who died in palliative care units, the financial burden and psychological experiences of the families, and the relationship between patients in palliative care who used UUCT and communication with their physicians’. Methods: This study was conducted as part of a cross-sectional, anonymous nationwide survey of the bereaved family members of cancer patients who died in palliative care unit in Japan. Results: Questionnaires were sent to 1,039 bereaved family members, and responses were received from 661 (64%). Of these, 558 were included in the study after excluding the 103 who did not complete the questionnaire. A total of 7.3% (41 of 558) of patients received UUCT. Of these, 34% (14 of 41) of patients were informed that the treatment was in the research phase, and 49% (20 of 41) were informed that the efficacy of the treatment was unknown. Regarding expectations for UUCT, 61% (25/41) expected to be cured, and 80% (33/41) expected it to slow disease progression. In multivariate logistic regression analysis, use of complementary and alternative medicine (CAM) was associated with receiving UUCT (p = 0.024), and patients who could discuss CAM with their doctors tended to receive UUCT (p = 0.054). Conclusion: Patients in palliative care unit who expect to cure tended to receive UUCT. These results highlight the challenge of telling patients that UUCT is ineffective and informing them of their prognosis and severe medical conditions. [ABSTRACT FROM AUTHOR]

Purpose: To clarify the current use of unapproved and unproven cancer treatment (UUCT) among the bereaved families of patients with cancer who died in palliative care units, the financial burden and psychological experiences of the families, and the relationship between patients in palliative care who used UUCT and communication with their physicians’. Methods: This study was conducted as part of a cross-sectional, anonymous nationwide survey of the bereaved family members of cancer patients who died in palliative care unit in Japan. Results: Questionnaires were sent to 1,039 bereaved family members, and responses were received from 661 (64%). Of these, 558 were included in the study after excluding the 103 who did not complete the questionnaire. A total of 7.3% (41 of 558) of patients received UUCT. Of these, 34% (14 of 41) of patients were informed that the treatment was in the research phase, and 49% (20 of 41) were informed that the efficacy of the treatment was unknown. Regarding expectations for UUCT, 61% (25/41) expected to be cured, and 80% (33/41) expected it to slow disease progression. In multivariate logistic regression analysis, use of complementary and alternative medicine (CAM) was associated with receiving UUCT (p = 0.024), and patients who could discuss CAM with their doctors tended to receive UUCT (p = 0.054). Conclusion: Patients in palliative care unit who expect to cure tended to receive UUCT. These results highlight the challenge of telling patients that UUCT is ineffective and informing them of their prognosis and severe medical conditions. [ABSTRACT FROM AUTHOR]

To compare the difference between primary homoeopathic and conventional paediatric care in treating acute illnesses in children in their first 24 months of life. One hundred eight Indian singleton newborns delivered at 37 to 42 weeks gestation were randomised at birth (1:1) to receive either homoeopathic or conventional primary care for any acute illness over the study period. In the homoeopathic group, conventional medical treatment was added when medically indicated. Clinicians and parents were unblinded. Children in the homoeopathic group experienced significantly fewer sick days than those in the conventional group (RR: 0.37, 95% CI: 0.24–0.58; p < 0.001), with correspondingly fewer sickness episodes (RR: 0.53, 95% CI: 0.32–0.87; p =.013), as well as fewer respiratory illnesses over the 24-month period. They were taller (F (1, 97) = 8.92, p =.004, partial eta squared = 0.84) but not heavier than their conventionally treated counterparts. They required fewer antibiotics, and their treatment cost was lower. Conclusion: Homoeopathy, using conventional medicine as a safety backdrop, was more effective than conventional treatment in preventing sick days, sickness episodes, and respiratory illnesses in the first 24 months of life. It necessitated fewer antibiotics and its overall cost was lower. This study supports homoeopathy, using conventional medicine as a safety backdrop, as a safe and cost-effective primary care modality during the first 2 years of life. Trial registration: Clinical Trial Registry-India (2018/09/015641). https://ctri.nic.in/Clinicaltrials/login.php What is Known: • Due to their holistic nature, many Complementary and Alternative Medical (CAM) modalities are not readily amenable to assessment by head-to-head RCT for a given Indication. • We propose a pragmatic, RCT comparing homoeopathic with conventional medicine as a system. What is New: • Homoeopathic was apparently superior to conventional primary care in preventing sick days, sickness episodes, and respiratory illness episodes and was significantly associated with growth in height but not weight and required fewer antibiotics in children from birth to 24 months of age. [ABSTRACT FROM AUTHOR]

This article delves into the underexplored relationship between lay expertise and temporality by analysing semi-structured interviews with parents who treat their autistic children using complementary and alternative medicine (CAM). The analysis indicates that time and temporalities play a significant role in how parents construct and enact their expertise. Faced with uncertainty, urgency, and inadequate support from medical and educational systems, parents assumed crucial responsibilities in managing their children’s therapies. Over time, they acquired knowledge and skills, ultimately claiming expertise in caring for their children, making therapy decisions and administering treatments. Parents engaged in complex time work as they attempted to orchestrate everyday, developmental, therapeutic, and social rhythms, alternating their focus between future and present. They endeavoured to synchronise their children’s rhythms with those of peers by using CAM therapies not yet adopted into conventional medicine, which they perceived as slow and outdated. This study contributes novel insights into autism care, temporalities of care, and the under-examined nexus between lay expertise and temporality. [ABSTRACT FROM AUTHOR]

Purpose: This article explored Licensed Clinical Social Workers (LCSWs) beliefs, attitudes, and knowledge of Complementary and Alternative Interventions (CAI). Method: We utilized a cross-sectional online survey among a sample of 193 LCSWs. Results: Approximately 60% of LCSWs assessed for and utilized CAI professionally, and 90% personally utilized CAI. LCSWs had moderately positive beliefs, neutral attitudes, and high baseline knowledge of CAI. Age and years of practice were the only significant correlates, and the only significant predictor for assessment and utilization of CAI was positive attitudes. Discussion: As the largest group of mental health providers, we found that it is vital for LCSWs to have a solid understanding of CAI to provide effective and safe services to the clients they serve. It is hoped that the results of this study will serve as a starting point for future research on CAI among social workers, with the goal of enhancing client-centered practice. [ABSTRACT FROM AUTHOR]

Purpose: This cross-sectional study aimed to investigate the prevalence and characteristics of supplement usage among cancer patients and explore its potential associations with anxiety, excessive daytime sleepiness, and overall quality of life. Methods: Cancer patients receiving specific care at Hôtel Dieu de France University Hospital, Beirut, were enrolled between April and June 2023. In face-to-face interviews, participants were asked to complete a questionnaire consisting of sociodemographic information, supplement usage details, and cancer-related variables. Three validated surveys (Epworth Sleepiness Scale, GAD-7, and EORTC-QLQ-C15-PAL) were employed to assess excessive daytime sleepiness, anxiety, and overall quality of life. Statistical analyses, including chi-square tests, t-tests, and multiple regression models, were conducted to examine associations between supplement use and other variables. Results: A total of 202 participants were interviewed. Fifty-two percent reported regular use of supplements following their cancer diagnosis, with vitamin D being the most commonly used supplement. Using multivariate logistic regression, supplement use was associated with being female, having lower educational levels, having a longer duration since cancer diagnosis, and having a poor overall quality of life. The multivariate logistic regression showed no significant correlation between supplement use and excessive daytime sleepiness and anxiety. Conclusion: This study highlights a high prevalence of supplement usage among cancer patients in Lebanon, indicating a rising interest in alternative therapies aimed at enhancing quality of life. Larger prospective studies are needed to assess the relation between supplement intake and excessive daytime sleepiness and anxiety and establish clear guidelines pertaining to supplement use in cancer patients. [ABSTRACT FROM AUTHOR]

Background: In India, cancer of the cervix is the second most common cancer in women. Nowadays, various traditional herbal formulations can be used as adjuncts during conventional cancer therapies due to their anticancer activity. Habbe Musaffi Khoon (HMK), a Unani compound formulation, is traditionally used as a blood purifier and thus used to treat boils, scabies, acne, and pimples. It is also indicated in skin diseases, Habis-ud-Dam (styptic), and therapeutically used in Nafz-ud-Dam (hemorrhagic). Objectives: The main purpose of this work was to phytochemically characterize HMK aqueous extract (HMKaq) and determine its activity against cervical cancer cells. Materials and Methods: HMKaq was subjected to liquid chromatography-mass spectrometry (LC-MS) and evaluated for the presence of phytocompounds. HMKaq was evaluated for its effect on the viability of cervical cancer cells (HeLa, SiHa, and C33A) and was determined by MTT assay. Trypan blue dye exclusion was used to determine the outcome of HMKaq on the growth kinetics of cervical cancer cells. The role of HMK in regulating the cell cycle was analyzed by FACS and its effect on apoptosis was evaluated by checking mitochondrial membrane potential readings of JC-1 aggregates on a microplate reader and on the mRNA expression of caspase-3 and cytochrome C was evaluated by PCR. Results: LC-MS analysis revealed 3845 compounds, out of which 58 were the major compounds. These included phenolics, esters, fatty acids, furans, quinones, tannins, flavonoids, and terpenes. HMKaq reduced the viability and growth of the cells. It induced arrest in the cell cycle of HeLa and apoptosis in SiHa and C33A by depolarizing the membrane potential of the mitochondria and upregulation of mRNA expression of Cas3 and Cyt C. Conclusion: HMK exhibited anticancer activity against cervical cancer cells, thereby signifying its therapeutic potential. [ABSTRACT FROM AUTHOR]

The increasing demand for fertility treatments has led to the rise of private clinics offering complementary and alternative medicine (CAM) treatments. The most frequently offered CAM infertility treatment is acupuncture. However, there is no good evidence to support the effectiveness of acupuncture in treating infertility. This study evaluates the scope of information provided by CAM fertility clinics in the UK. A content analysis was conducted on 200 websites of CAM fertility clinics in the UK that offer acupuncture as a treatment for infertility. Of the 48 clinics that met the eligibility criteria, the majority of the websites did not provide sufficient information on the efficacy, risks and success rates of acupuncture for infertility. This has the potential to infringe on patient autonomy, provide false hope and reduce the chances of pregnancy ever being achieved as fertility declines during the time course of ineffective acupuncture treatment. [ABSTRACT FROM AUTHOR]

Purpose: Mistletoe treatment is discussed controversial as a complementary treatment for cancer patients. Aim of this systematic analysis is to assess the concept of mistletoe treatment in the clinical studies with respect to indication, type of mistletoe preparation, treatment schedule, aim of treatment, and assessment of treatment results. Methods: In the period from August to December 2020, the following databases were systematically searched: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, CINAHL, and "Science Citation Index Expanded" (Web of Science). We assessed all studies for study types, methods, endpoints and mistletoe preparations including their ways of application, host trees and dosage schedules. Results: The search concerning mistletoe therapy revealed 3296 hits. Of these, 102 publications and at total of 19.441 patients were included. We included several study types investigating the application of mistletoe in different groups of participants (cancer patients of any type of cancer were included as well as studies conducted with healthy volunteers and pediatric patients). The most common types of cancer were breast cancer, pancreatic cancer, colorectal cancer and malignant melanoma. Randomized controlled studies, cohort studies and case reports make up most of the included studies. A huge variety was observed concerning type and composition of mistletoe extracts (differing pharmaceutical companies and host trees), ways of applications and dosage schedules. Administration varied e. g. between using mistletoe extract as sole treatment and as concomitant therapy to cancer treatment. As the analysis of all studies shows, there is no relationship between mistletoe preparation used, host tree and dosage, and cancer type. Conclusions: Our research was not able to deviate transparent rules or guidelines with respect to mistletoe treatment in cancer care. [ABSTRACT FROM AUTHOR]

Objective: The aim of this cohort study was to gain insight on influencing factors on the decision-making process in conventional medicine compared to complementary and alternative medicine (CAM). Methods: A standardized questionnaire was distributed among cancer patients who attended the counselling facility for CAM of a German university hospital in 2020. Results: Fifty patients (30.3%) returned the questionnaire. After counselling on CAM, most patients made a decision in CAM but also in conventional medicine. Thus, the focus on informed decision-making during counselling on CAM had a strong effect on the decision-making process in conventional medicine. Patients reporting good support also reported making decisions together with physicians and relatives. Moreover, after counselling on CAM, patients reported being more satisfied with their decision in both settings afterwards. Conclusion: Information on CAM which focuses on informed decision-making, supports patient's ability to understand and weigh risks and benefits of treatments, supports shared decision-making and enables patients to transfer these competences also to decisions on conventional medicine. So counselling on CAM may further decision-making competences in cancer patients. This encourages patients to engage in shared decision-making and increases patient's satisfaction with decisions. [ABSTRACT FROM AUTHOR]

Purpose: Nowadays, complementary and alternative medicine (CAM) is used by cancer patients all over the world. The aim of this study was to investigate the prevalence of CAM use in patients with cancer in Iran. Methods: This descriptive-analytical study was conducted on 320 cancer patients in Arak. For gathering information, a researcher-made questionnaire was used. This questionnaire was consisted of two parts: demographic and clinical information; and patient's attitude toward using complementary and alternative medicine treatments and their effectiveness, as well as how much they used different kinds of these treatments. The data were analyzed using SPSS software version 16. Results: Our findings showed that average age of participants was 55.11 ± 15.58. Most of them had leukemia (25.9%) and underwent chemotherapy (55%), and 141 (44.3%) of individuals were using CAM. Majority of patients (73.2%) were using CAM to improve physical conditions, 61.4% were using it simultaneously with conventional medical treatments, and 25% to reduce pain. Participants have reported visiting holy places, yoga, prayer therapy, and using medicinal plants and special diets, respectively. Conclusion: Considering the high number of patients using CAM treatments, proper planning and implementation to educate professional members of health team, especially doctors and nurses about CAM treatments is essential. The most important CAM treatments to be educated are spiritual therapies, yoga, medicinal plants, and diet therapy. Moreover, support and education about using these kinds of treatment should be considered in the supportive care program for patients with cancer. [ABSTRACT FROM AUTHOR]

Purpose: Curcumin, the active ingredient in turmeric, is employed by numerous cancer patients to support conventional cancer therapy. This systematic review aims to summarize the existing clinical evidence and to provide an overview of the potential benefits and risks associated with curcumin supplementation.In January 2024, we conducted a systematic search of five electronic databases (Embase, Cochrane, PsycInfo, CINAHL, and Medline) using a complex search strategy. We included randomized controlled trials on the use, effectiveness, and potential harm of additional curcumin therapy in adult patients under cancer treatment. The risk of bias was assessed using Cochrane revised Risk of Bias Tool 2.0.This systematic review included 34 randomized controlled trials involving 2580 patients out of 11143 search results. Included patients were primarily diagnosed with head and neck cancer, followed by breast, prostate, and colorectal cancer. Therapy concepts encompassed topical or systemic curcumin administration. The studies reported heterogeneous results concerning oral and skin symptoms, pain, weight alteration and changes in body composition, survival, and disease progression. Significant findings were reported for oral mucositis and weight loss. Considering risk of bias, all studies had moderate to high risk of bias. Regarding side effects, one study reported significantly more vomiting in the curcumin group.Although the results suggest promise in reducing mucositis and weight loss, a clear statement regarding the effectiveness of curcumin therapy on cancer patients cannot be made due to heterogeneous results and methodological limitations of the involved studies. Further investigations of higher quality are necessary to derive a definite recommendation for action.Methods: Curcumin, the active ingredient in turmeric, is employed by numerous cancer patients to support conventional cancer therapy. This systematic review aims to summarize the existing clinical evidence and to provide an overview of the potential benefits and risks associated with curcumin supplementation.In January 2024, we conducted a systematic search of five electronic databases (Embase, Cochrane, PsycInfo, CINAHL, and Medline) using a complex search strategy. We included randomized controlled trials on the use, effectiveness, and potential harm of additional curcumin therapy in adult patients under cancer treatment. The risk of bias was assessed using Cochrane revised Risk of Bias Tool 2.0.This systematic review included 34 randomized controlled trials involving 2580 patients out of 11143 search results. Included patients were primarily diagnosed with head and neck cancer, followed by breast, prostate, and colorectal cancer. Therapy concepts encompassed topical or systemic curcumin administration. The studies reported heterogeneous results concerning oral and skin symptoms, pain, weight alteration and changes in body composition, survival, and disease progression. Significant findings were reported for oral mucositis and weight loss. Considering risk of bias, all studies had moderate to high risk of bias. Regarding side effects, one study reported significantly more vomiting in the curcumin group.Although the results suggest promise in reducing mucositis and weight loss, a clear statement regarding the effectiveness of curcumin therapy on cancer patients cannot be made due to heterogeneous results and methodological limitations of the involved studies. Further investigations of higher quality are necessary to derive a definite recommendation for action.Results: Curcumin, the active ingredient in turmeric, is employed by numerous cancer patients to support conventional cancer therapy. This systematic review aims to summarize the existing clinical evidence and to provide an overview of the potential benefits and risks associated with curcumin supplementation.In January 2024, we conducted a systematic search of five electronic databases (Embase, Cochrane, PsycInfo, CINAHL, and Medline) using a complex search strategy. We included randomized controlled trials on the use, effectiveness, and potential harm of additional curcumin therapy in adult patients under cancer treatment. The risk of bias was assessed using Cochrane revised Risk of Bias Tool 2.0.This systematic review included 34 randomized controlled trials involving 2580 patients out of 11143 search results. Included patients were primarily diagnosed with head and neck cancer, followed by breast, prostate, and colorectal cancer. Therapy concepts encompassed topical or systemic curcumin administration. The studies reported heterogeneous results concerning oral and skin symptoms, pain, weight alteration and changes in body composition, survival, and disease progression. Significant findings were reported for oral mucositis and weight loss. Considering risk of bias, all studies had moderate to high risk of bias. Regarding side effects, one study reported significantly more vomiting in the curcumin group.Although the results suggest promise in reducing mucositis and weight loss, a clear statement regarding the effectiveness of curcumin therapy on cancer patients cannot be made due to heterogeneous results and methodological limitations of the involved studies. Further investigations of higher quality are necessary to derive a definite recommendation for action.Conclusion: Curcumin, the active ingredient in turmeric, is employed by numerous cancer patients to support conventional cancer therapy. This systematic review aims to summarize the existing clinical evidence and to provide an overview of the potential benefits and risks associated with curcumin supplementation.In January 2024, we conducted a systematic search of five electronic databases (Embase, Cochrane, PsycInfo, CINAHL, and Medline) using a complex search strategy. We included randomized controlled trials on the use, effectiveness, and potential harm of additional curcumin therapy in adult patients under cancer treatment. The risk of bias was assessed using Cochrane revised Risk of Bias Tool 2.0.This systematic review included 34 randomized controlled trials involving 2580 patients out of 11143 search results. Included patients were primarily diagnosed with head and neck cancer, followed by breast, prostate, and colorectal cancer. Therapy concepts encompassed topical or systemic curcumin administration. The studies reported heterogeneous results concerning oral and skin symptoms, pain, weight alteration and changes in body composition, survival, and disease progression. Significant findings were reported for oral mucositis and weight loss. Considering risk of bias, all studies had moderate to high risk of bias. Regarding side effects, one study reported significantly more vomiting in the curcumin group.Although the results suggest promise in reducing mucositis and weight loss, a clear statement regarding the effectiveness of curcumin therapy on cancer patients cannot be made due to heterogeneous results and methodological limitations of the involved studies. Further investigations of higher quality are necessary to derive a definite recommendation for action. [ABSTRACT FROM AUTHOR]

This article uses neo-Weberian social closure theory and Bourdieu's theory of symbolic violence to examine the epistemic tension between biomedicine and traditional Chinese medicine (TCM) in Aotearoa New Zealand (NZ), a country that aspires to a multicultural model of healthcare. Drawing on interviews with TCM practitioners and analysis of TCM practitioners' attempt to become a regulated profession, we argue that a multicultural health model remains a myth as biomedical stakeholders deploy material and symbolic forms of social closure that limit the scope of TCM practice. Discourses of the need for scientific evidence, public safety, qualification standards and English language fluency undermine the culturally distinctive but pragmatic forms of medicine that TCM practitioners utilise. This has implications for TCM as practitioners are denied public funding, their scope of practice is limited, and the expectations for TCM to conform to a biomedical model of healthcare have created tensions within the TCM community. [ABSTRACT FROM AUTHOR]

Ideal nutrition for all stages of pregnancy is so important, and the safety of consuming common foods, herbal products, complementary and alternative medicine (CAM), and nonnutritive substances is questionable. Despite the fact that herbs are entirely natural, not all of them are safe to ingest during pregnancy. Herbs such as ginger and peppermint are well known for being a powerful, safe, and effective remedy for vomiting and nausea during pregnancy. Pre-eclampsia and high blood pressure are among the important complications during pregnancy. Pre-eclampsia could be increased by drinking tea, while high blood pressure could be decreased with garlic consumption in pregnant women. During pregnancy blood glucose levels and glycogen storage are as important as blood pressure. Turmeric controls blood glucose levels, meanwhile red pepper enhances glycogen storage. Interacting with the cytochrome P450 system causes many food-drug interactions. St. John's Wort is one of the commonly used herbs that affects this system and should be taken cautiously in pregnancy. Chamomile should be consumed cautiously as well due to its effects on individuals suffering from coagulation disorders. As a safe herb during breastfeeding, fennel should be consumed wisely in pregnancy. Fennel contains estrogen-like features that affect fetal development and birth weight. As herbal products have varying and ambiguous effects, they should be consumed (as condiments, flavoring in foods or beverages) prudently. [ABSTRACT FROM AUTHOR]

Questions of legitimacy loom large in debates about the funding and regulation of complementary and alternative medicine (CAM) in contemporary health systems. CAM's growth in popularity is often portrayed as a potential clash between clinical, state and scientific legitimacies and legitimacy derived from the broader public. CAM's 'publics', however, are often backgrounded in studies of the legitimacy of CAM and present only as a barometer of the legitimating efforts of others. This article foregrounds the epistemic work of one public's effort to legitimate CAM within the UK's National Health Service: the campaign to 'save' Glasgow's Centre for Integrative Care (CIC). Campaigners skilfully intertwined 'experiential' knowledge of the value of CIC care with 'credentialed' knowledge regarding best clinical and managerial practice. They did so in ways that were pragmatic as well as purist, reformist as well as oppositional. We argue for legitimation as negotiated practice over legitimacy as a stable state, and as labour borne by various publics as they insert themselves into matrices of knowledge production and decision-making within wider health care governance. [ABSTRACT FROM AUTHOR]

Health and holistic quality of life, physical and emotional needs, somatic and spiritual aspects contain a comprehensive promise of healing. The aim of the current study is to measure the expectations of patients of medicine, alternative medicine and religion related to health and illness. The survey was carried out among 103 patients of a rural general practitioner from May to June 2013 and among 103 patients of the outpatient department for endocrinology and metabolic disease of the Jena University Hospital in 2013. All patients were asked by one interviewer (HM) on fears in relation to health/illness and expectations of help for its own life, medicine, alternative medicine and religion. The biggest fear of patients is "being in need of help of others." There is no significant difference between religious and non-religious patients. Overall, the expectations of medicine were significantly higher in all sectors than in alternative medicine or religion. Comparing alternative medicine and religion, the expectations of alternative medicine were significantly higher excluding consolation and inner peace. The expectations for medicine in general and for the physician are very high and comprehensive and go beyond diagnosis and realization of therapies. Patients expect hope, guidance, support, comfort, inner peace and advice most from medicine. This results in considerable challenges for the physician, especially in a healthcare system with limited resources and without suitable offers. There is an urgent need to integrate these requirements into daily routine. [ABSTRACT FROM AUTHOR]

Purpose: Complementary and alternative medicine (CAM) is often used by cancer patients and is concerning as concomitant oral CAM and chemotherapy use may result in adverse interactions and toxicities. We hypothesise that a decision aid (DA) may promote informed and rational use of oral CAM during chemotherapy, and increase patients' discussion with their oncologists on CAM use.Methods: We randomised 240 patients initiating chemotherapy to receive DA or none. Questionnaires were administered at randomisation (visit 1), 1 month (visit 2) and 3 months (visit 3). The primary endpoint was the decisional conflict score (DCS) for decision made on CAM use during chemotherapy. Secondary endpoints include patients' decision regret score (DRS) on CAM use, CAM uptake, discussion with oncologists on CAM usage, and difference in quality of life (QoL) score between CAM and non-CAM users at visit 3.Results: There was no difference in the mean DCS (mean difference 2.7 [95 CI - 2.9 to 8.3, p = 0.345]) and DRS (mean difference - 0.3 [95% CI - 6.3 to 5.8, p = 0.926]) between the two arms. There was a reduction in odds of CAM usage in the intervention arm compared to control arm (OR = 0.36, 95% CI 0.17 to 0.78, p = 0.009), but there was no difference in discussion with oncologists on CAM usage (OR = 0.46, 95% CI 0.07 to 3.01, p = 0.419), or in the QoL between CAM and non-CAM users.Conclusion: Our DA did not reduce DCS among cancer patients on chemotherapy. DA that provides more evidence-based information on CAM, and non-judgemental discussion initiated by oncologists to discuss CAM, may improve its effectiveness. [ABSTRACT FROM AUTHOR]

Introduction: Chronic disease has been known as a long-term disease requiring patients to adhere to continuous medication treatment. In a bid to treat and cure chronic diseases, there are patients that practices complementary and alternative treatment (CAM) without or alongside conventional medication as it is believed to have health benefits in treating this non-communicable disease. The purpose of this study is to review on the prevalence, types, and beliefs of CAM among Malaysians with chronic diseases. Methods: This study followed the guidelines set by the "Preferred Reporting Items guidelines for Systematic Reviews and Meta-Analysis" (PRISMA) group. Studies were identified using electronic databases that included Science Direct, Scopus, SAGE, Springer, CINAHL, MEDLINE, and Google Scholar. Results: 13 articles that met all the eligibility criteria were reviewed in this study. Among all types of chronic diseases, patients with hypertension recorded a high number of CAM usage, followed by diabetes with natural products or biological-based therapies as the most common CAM used type. Most patients with chronic diseases believed that CAM was effective and much safer than conventional medicine. Conclusion: CAM treatment is a common means of treatment among the Malaysian population with chronic diseases to treat their illness depending on the health problem. The patients' belief and conviction play a vital role in their decision to employ CAM as an alternative treatment. However, it is worth noting that the literature was limited to several types of common chronic diseases among the Malaysian population. [ABSTRACT FROM AUTHOR]

Biomedicine controls seizures for many children with epilepsy – but not all. In such cases, parents struggle in the wake of various structural, cultural, and corporeal ruptures. Continued use of ineffective medications can lead, iatrogenically, to frightening and serious symptoms and debilitations whose effects, along with those of uncontrolled seizures, ripple outward in challenging ways. Using data from 25 Californian (US) parents who favored providing cannabis to their ill children to meet the iatrogenic burdens of biomedical epilepsy treatments in 2015, well before cannabis's present destigmatization, this paper explores parental refiguration of the effects of clinical iatrogenesis as inevitable – and as productive of evidence necessary to finding better options. In attending to the generative dimensions of iatrogenesis, this paper strives to help clarify the dilemma for parents who critique biomedicine's isolating, materialist, and sometimes apparently haphazard approach to their children, but depend on biomedical and associated systems for their family's well-being nonetheless. Along the way, this paper underscores raced and gendered dimensions of their experiences. Rather than rejecting biomedicine, most hung on tightly, blaming the uncontrolled seizures and their aftermath on a lag in 'the science' and pointing to the cultural idea that every child is unique in explaining their own children's non-responsiveness to treatment thus far. Likewise, they worked to determine effective cannabis regimens with scientised rigour. However, in the end – and in keeping with a culture of (male) Whiteness – stigmatisation, fatigue from chronic care provision, faith in science, and a need for a biomedically-mediated form of social belonging underwrote a majority desire for cannabis's incorporation into the official biomedical pharmacopeia. [ABSTRACT FROM AUTHOR]

Background: The use of herbs and supplements (HS) is common among patients with cancer, yet limited information exists about potential medication interactions (PMIs) with HS use around chemotherapy. Methods: Patients with breast or prostate cancer who had recently finished chemotherapy at 2 academic medical centers were surveyed by telephone. Interviewers inquired about all medications, including HS, before, during, and after chemotherapy. Micromedex, Lexicomp, and Natural Medicines Comprehensive Database interaction software programs were used to determine PMIs. Results: A total of 67 subjects (age range, 39‐77 years) were evaluated in this study. Participants were primarily White patients (73%) with breast cancer (87%). The median number of medications was 11 (range, 2‐28) during the entire study and was highest during chemotherapy (7; range, 2‐22). Approximately four‐fifths (84%) used HS. A total of 1747 PMIs were identified, and they represented 635 unique PMIs across all 3 timeframes, with most occurring during chemotherapy. Prescription‐related PMIs (70%) were the most common type, and they were followed by HS‐related (56%) and anticancer treatment–related PMIs (22%). Approximately half of the PMIs (54%) were categorized as moderate interactions, and more than one‐third (38%) were categorized as major interactions. Patient use of HS increased from 51% during chemotherapy to 66% after chemotherapy, and this correlated with an increased prevalence of HS PMIs (46% to 60%). HS users were more likely to be at risk for a major PMI than non‐HS users (92% vs 70%; P =.038). Conclusions: The use of HS remains prevalent among patients with cancer and may place them at risk for PMIs both during chemotherapy and after the completion of treatment. Lay Summary: This study evaluates the risk of potential medication interactions for patients with breast or prostate cancer undergoing chemotherapy.The results show that patients often use herbs and supplements during treatment. Prescription medications are most often associated with medication interactions, which are followed by herb and supplement–related interactions. More than one‐third of potential medication interactions are considered major.Patients should be educated about the risk of herb and supplement–related medication interactions during treatment. Patients with cancer receiving chemotherapy commonly use herbs and supplements. Some of these products are associated with potential medication interactions. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this multicenter cross-sectional study was to analyze a cohort of breast (BC) and gynecological cancer (GC) patients regarding their interest in, perception of and demand for integrative therapeutic health approaches. Methods: BC and GC patients were surveyed at their first integrative clinic visit using validated standardized questionnaires. Treatment goals and potential differences between the two groups were evaluated. Results: 340 patients (272 BC, 68 GC) participated in the study. The overall interest in IM was 95.3% and correlated with older age, recent chemotherapy, and higher education. A total of 89.4% were using integrative methods at the time of enrolment, primarily exercise therapy (57.5%), and vitamin supplementation (51.4%). The major short-term goal of the BC patients was a side-effects reduction of conventional therapy (70.4%); the major long-term goal was the delay of a potential tumor progression (69.3%). In the GC group, major short-term and long-term goals were slowing tumor progression (73.1% and 79.1%) and prolonging survival (70.1% and 80.6%). GC patients were significantly more impaired by the side-effects of conventional treatment than BC patients [pain (p = 0.006), obstipation (< 0.005)]. Conclusion: Our data demonstrate a high overall interest in and use of IM in BC and GC patients. This supports the need for specialized IM counseling and the implementation of integrative treatments into conventional oncological treatment regimes in both patient groups. Primary tumor site, cancer diagnosis, treatment phase, and side effects had a relevant impact on the demand for IM in our study population. [ABSTRACT FROM AUTHOR]

We tested whether targeting the illusion of causality and/or misperceptions about health risks had the potential to reduce consumer demand for an ineffective health remedy (multivitamin supplements). We adopted a 2 (contingency information: no/yes) × 2 (fear appeal: no/yes) factorial design, with willingness-to-pay as the dependent variable. The contingency information specified, in table format, the number of people reporting a benefit vs. no benefit from both multivitamins and placebo, plus a causal explanation for lack of efficacy over placebo. The fear appeal involved a summary of clinical-trial results that indicated multivitamins can cause health harms. The control condition received only irrelevant information. Experimental auctions measured people's willingness-to-pay for multivitamins. Experiment 1 (N = 260) elicited hypothetical willingness-to-pay online. Experiment 2 (N = 207) elicited incentivised willingness-to-pay in the laboratory. Compared to a control group, we found independent effects of contingency information (-22%) and the fear appeal (-32%) on willingness-to-pay. The combination of both interventions had the greatest impact (-50%) on willingness-to-pay. We found evidence that consumer choices are influenced by both perceptions of efficacy and risk. The combination of both elements can provide additive effects that appear superior to either approach alone. [ABSTRACT FROM AUTHOR]

Drug-induced liver injury (DILI) is an important cause of acute liver failure with significant morbidity and mortality. The outcome of DILI varies widely according to the drug implicated and the type of liver injury. Owing to the heterogeneous nature of liver injury, knowledge on clinical course and prognosis of DILI is limited. We had undertaken this study to determine the clinical characteristics, outcomes, and predictors of mortality in patients with DILI. This prospective study was conducted from January 2015 through December 2018. We analyzed the drugs implicated, clinical course, and the outcome. Causality assessment was performed by using Roussel Uclaf Causality Assessment Method scoring. Patients were followed for 6 months until recovery/death or liver transplantation. There were 133 cases with DILI. The mean age was 47.6 years, and 51.9% of them were men. Drugs causing DILI were antitubercular drugs (37.5%) followed by neuropsychiatric drugs (16.5%), antibiotics/antifungals (12%), complementary and alternative medicine (10.5%), immunomodulatory/chemotherapeutic drugs (10.5%), and nonsteroidal antiinflammatory drugs (7.5%). Eighty-two (61.6%) patients were classified as hepatocellular, 30 (22.5%) as mixed and 21 (15.7%) as cholestatic type of injury. There was no significant difference in the mortality and morbidity between the three types of liver injury. There were 18 deaths (13.5%), of which antitubercular drugs constituted the majority (55.5%) followed by neuropsychiatric drugs (27.7%) and complementary and alternative medicine (16.6%). Based on receiver operating characteristic curve analysis, model for end-stage liver disease (MELD) score >28, mean international normalized ratio (INR) >1.97, mean bilirubin level >15.6 mg/dl, and creatinine level >1.35 mg/dl were associated with mortality. Although DILI is uncommon, it has significant morbidity and mortality. Antitubercular drugs were the most common cause for DILI and DILI-related mortality in our study. Variables such as MELD, INR, bilirubin, albumin, and creatinine help in predicting severity of liver injury and may help in triaging the patient for referral for liver transplantation. [ABSTRACT FROM AUTHOR]

Oral and topical zinc have been used for the treatment of acne, but there is a lack of definitive evidence for their efficacy. (a) To determine if mean serum zinc levels differ between acne patients and controls and (b) to determine the efficacy of zinc preparations in the treatment of acne. A systematic review and meta‐analysis was performed according to recommended PRISMA [Preferred Reporting Items for Systematic Reviews and Meta‐Analyses] guidelines. Subjects with acne had significantly lower serum zinc levels compared to controls. Patients who were treated with zinc had a significant improvement in mean inflammatory papule count compared to those who were not treated with zinc. There was no significant difference in the incidence of side effects in zinc supplementation vs comparators. Acne patients have decreased serum zinc levels. Zinc is effective for the treatment of acne, particularly at decreasing the number of inflammatory papules, when used as monotherapy or as an adjunctive treatment. [ABSTRACT FROM AUTHOR]

Objective: Laryngopharyngeal reflux (LPR) and associated symptoms can be refractory to treatment with acid suppressing medication. We investigated the role and evidence for complementary and alternative medicine (CAM) for LPR in this systematic review. Review Methods: Complementary and alternative treatment was defined in this systematic review as any non-acid suppressing medication, treatment, or therapy. A literature search was performed by two authors in consultation with a medical librarian using controlled vocabulary for "complementary and alternative medicine" and "laryngopharyngeal reflux" in the databases PubMed and EMBASE, with supplemental searches with Google Scholar. Results: Twenty articles were included in this review for the modalities: alginate, diet modification, prokinetics, respiratory retraining, voice therapy, rikkunshito (RKT), hypnotherapy, and sleep positioning. The studies were analyzed for bias based on the Cochrane criteria for RCTs and Methodological Index for non-RCT (MINORS) criteria for all other studies. For each modality a level of evidence was assigned to the current body of evidence using the GRADE approach. Conclusion: There is mixed evidence with a high degree of bias and heterogeneity between studies for the modalities presented in the paper. Based on this review, an anti-reflux diet is recommended for all patients and there is some low-quality evidence to support alkaline water. For patients with predominant vocal symptoms there is evidence that supports voice therapy. There is insufficient evidence to recommend prokinetics at this time. For patients with predominant globus symptoms, alginate, RKT, and relaxation strategies may be used in conjunction with acid suppressing medications for symptom relief. [ABSTRACT FROM AUTHOR]

Background: Complementary and alternative medicines (CAM) are associated with poor asthma medication adherence, a major risk factor for asthma exacerbation. However, previous studies showed inconsistent relationships between CAM use and asthma control due to small sample sizes, demographic differences across populations studied, and poor differentiation of CAM types. Methods: We examined associations between CAM use and asthma exacerbation using a cross-sectional analysis of the 2012 National Health Interview Survey. We included adults ≥18 years with current asthma (n = 2,736) to analyze racial/ethnic differences in CAM use as well as the association between CAM use and both asthma exacerbation and emergency department (ED) visit for asthma exacerbation across racial/ethnic groups. We ran descriptive statistics and multivariable logistic regressions. Result: Blacks (OR = 0.63 [0.49-0.81]) and Hispanics (OR = 0.66 [0.48–0.92]) had decreased odds of using CAM compared to Whites. Overall, there was no association between CAM use and asthma exacerbation (OR = 0.99 [0.79–1.25]) but the subgroup of 'other complementary approaches' was associated with increased odds of asthma exacerbation among all survey respondents (1.90 [1.21–2.97]), Whites (OR = 1.90 [1.21–2.97]), and Hispanics (OR = 1.43 [0.98–2.09). CAM use was associated with decreased odds of an ED visit for asthma exacerbation (OR = 0.65 [0.45–0.93]). These associations were different among racial/ethnic groups with decreased odds of ED visit among Whites (OR = 0.50 [0.32–0.78]) but no association among Blacks and Hispanics. Conclusion: We found that both CAM use and the association between CAM use and asthma exacerbation varied by racial/ethnic group. The different relationship may arise from how CAM is used to complement or to substitute for conventional asthma management. [ABSTRACT FROM AUTHOR]

Background: The use of complementary and alternative medicine (CAM) has increased in Western societies in recent years. In a national health survey conducted in 2006 in Iceland, 31.8% of the population had used CAM in the past 12 months; however, the trend of CAM use since then is unknown. This study's aim was to describe participants' use of CAM providers in Iceland in 2015 and compare it to the results of the previous survey. The current study explored the relationship between the participants' use of CAM and their background, religiosity, healthcare attitudes, mental and physical health, and physician visits. Methods : The study was based on a national health survey conducted in the Spring of 2015. The questionnaire was mailed to a random sample of Icelandic adults, aged 18–75. Altogether 1599 respondents returned valid questionnaires (response rate 58%). The standardized questions were developed and tested in previous health surveys. Results : Nearly 40% of respondents had used CAM in the past 12 months. This is an estimated 8.4% increase since 2006. Women and people with more education were more likely than other participants to use CAM. Repeated physician visits were related to increased likelihood of CAM use. Individuals with high anxiety were more likely than others to use CAM. Conclusions : Icelanders use CAM providers to a considerable degree, and CAM use has increased in recent years. Most CAM users appear to use CAM to complement care received in the general health system. [ABSTRACT FROM AUTHOR]

Keywords: médecine douce et complémentaire (MDC); analyse spatio-temporelle; SIG; complementary and alternative medicine (CAM); spatial-temporal analysis; GIS FR médecine douce et complémentaire (MDC) analyse spatio-temporelle SIG EN complementary and alternative medicine (CAM) spatial-temporal analysis GIS 323 335 13 06/04/20 20200601 NES 200601 Introduction Complementary and alternative medicine (CAM) consists of a wide range of therapies and procedures, but CAM practitioners (such as chiropractors, naturopaths, massage therapists, homeopaths, osteopaths, acupuncturists, and so on) are unified by a holistic approach to health care that embraces the "body, mind, and spirit" mantra to healing and/or to living with various pathologies. There is an important provision to this observation: the most outstanding growth in CAM offices and sales is unambiguously occurring in the smaller metropolitan areas (CAs); only for CAM employment change are the CMAs posting non-negative values. For instance, CAM office decline in a municipality with limited endowment of CAM offices will inevitably be more problematic from a CAM accessibility perspective than modest decrease in areas with an already high proportion of CAM practitioners. However, at the same time, much of the CMA is comprised of a continuous epicentre band of CAM employment gain, which means expanding CAM offices and/or the addition of newly established CAM offices. [Extracted from the article]

Pediatric autism spectrum disorder (ASD) consists of multisystem components that primary care providers (PCPs) must address. PCPs improve health outcomes associated with ASD when they administer developmental screening tools and thoroughly assess identifi ed concerns. Pursuing specialty health services early in childhood combined with managing comorbid conditions curtails symptom escalation and disease progression. [ABSTRACT FROM AUTHOR]

Objective: To assess prevalence and frequency of use of self-management strategies among female cancer survivors and to empirically identify categories of self-management.Methods: Female cancer survivors (N=673, mean age 51 years; >90% with breast cancer; M=5 years since diagnosis) completed an Internet survey indicating the frequency (never to very often) with which they had employed each strategy since diagnosis. The survey included commonly assessed self-management strategies, such as complementary and alternative medicine (CAM), religious practices, and exercise. Additionally we assessed the use of further strategies identified from recommendations of cancer survivors shared in Internet forums.Results: A principal component analysis yielded five categories: More Conscious Living, Turning to Family/Friends, CAM, Religious/Spiritual Practices, and Exercise. Prevalence rates of commonly measured strategies like CAM, Religious Practices, and Exercise were similar to previous studies. Considering frequency of use, however, revealed that only few participants reported frequent use of these strategies (<10%). In contrast, about half of the women (>50%) reported Turning to Family/Friends and engaging in More Conscious Living strategies (very) often.Conclusions: Relying on prevalence assessments of commonly investigated behaviors such as CAM or exercise may overestimate their use among cancer survivors. Cancer survivors engage in a wide range of self-management strategies. Encouraging living more consciously and cultivating social relations might be of greater relevance compared with CAM use or exercise. [ABSTRACT FROM AUTHOR]

Background: Biofeedback is increasingly used to treat clinical conditions in a wide range of settings; however, evidence supporting its use remains unclear. The purpose of this evidence map is to illustrate the conditions supported by controlled trials, those that are not, and those in need of more research.Methods: We searched multiple data sources (MEDLINE, PsycINFO, CINAHL, Epistemonikos, and EBM Reviews through September 2018) for good-quality systematic reviews examining biofeedback for clinical conditions. We included the highest quality, most recent review representing each condition and included only controlled trials from those reviews. We relied on quality ratings reported in included reviews. Outcomes of interest were condition-specific, secondary, and global health outcomes, and harms. For each review, we computed confidence ratings and categorized reported findings as no effect, unclear, or insufficient; evidence of a potential positive effect; or evidence of a positive effect. We present our findings in the form of evidence maps.Results: We included 16 good-quality systematic reviews examining biofeedback alone or as an adjunctive intervention. We found clear, consistent evidence across a large number of trials that biofeedback can reduce headache pain and can provide benefit as adjunctive therapy to men experiencing urinary incontinence after a prostatectomy. Consistent evidence across fewer trials suggests biofeedback may improve fecal incontinence and stroke recovery. There is insufficient evidence to draw conclusions about effects for most conditions including bruxism, labor pain, and Raynaud's. Biofeedback was not beneficial for urinary incontinence in women, nor for hypertension management, but these conclusions are limited by small sample sizes and methodologic limitations of these studies.Discussion: Available evidence suggests that biofeedback is effective for improving urinary incontinence after prostatectomy and headache, and may provide benefit for fecal incontinence and balance and stroke recovery. Further controlled trials across a wide range of conditions are indicated. [ABSTRACT FROM AUTHOR]

Despite the widespread view that complementary and alternative medicine (CAM) is a 'natural' and low-tech form of healthcare, by contrast with biomedicine, there are numerous devices used in the field of CAM that employ electricity as a diagnostic and therapeutic agent. These devices bring together different types and sources of knowledge, Western and Eastern theories, and expert and lay hands. They foreground complex psychosomatic, social, and environmental relations in which the patient's body and well-being are constituted. They are used to address biomedicine's iatrogenic effects and its indifference to specific bodily processes and entities (such as meridians or parasites). In effect they challenge, extend, and reinterpret biomedicine, thereby becoming one of the mediators between it and CAM. Although these devices are sought out by patients and used effectively by CAM practitioners, their ontological choreography and radius can become precarious in a healthcare system dominated by biomedicine. Different CAM devices then deal with the realities of biomedicine in different ways. While some modes of practising CAM devices are inclusive of biomedicine and carefully experiment with the realities it has inscribed in patients' bodies, others reject biomedicine altogether. [ABSTRACT FROM AUTHOR]

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder associated with altered bowel habits. IBS significantly impacts the quality of life of affected children and adolescents. Use of complementary and alternative medicine (CAM) is increasingly common among the gastrointestinal pediatric population. Peppermint oil, classified as an herbal remedy and one type of CAM, has demonstrated potential efficacy in treating abdominal pain associated with IBS. Despite limited pediatric studies establishing the effectiveness of peppermint oil capsules in the pediatric IBS population, the use of CAM and herbal remedies like peppermint oil are prevalent. It is essential for nurses and healthcare providers to be educated and aware of its impact in the pediatric IBS population to effectively guide care of these patients. [ABSTRACT FROM AUTHOR]

Highlights • The notion of Belief interval-valued soft set(BIVSS) is introduced. • Soft max-AND, min-OR, belief power, and recommend value are introduced. • MCDM is performed using Belief power and Belief recommend values. Abstract By combining belief interval-value (Dempster–Shafer Theory) and soft set then concept of belief interval-valued soft set (BIVSS) is introduced. The complement, soft max-AND, and soft min-OR operations are defined on BIVSS. Soft belief power and soft recommend value on BIVSS are introduced to solve MCDM problems as applications of the new concept. Numerical examples are provided to illustrate the new approach. [ABSTRACT FROM AUTHOR]

Objectives: We estimated prevalence of complementary and alternative medicine (CAM) use by reason for use (treatment, wellness, or both) among non-institutionalized adults with cancer in the United States. We also examined health-related quality of life (HRQOL) outcomes among adults with cancer who used CAM.Methods: We used data from the 2012 National Health Interview Survey (NHIS), which represents non-institutionalized adults with cancer (n = 2967 unweighted). Using a cross-sectional design with survey sampling techniques, we estimated past year prevalence of CAM use. We ran multivariable logistic regression analyses to investigate the odds of perceived benefits of CAM.Results: In the past 12 months, 35.1% of adults with cancer reported using some form of CAM. Among CAM users, 56.0% used CAM for both treatment and wellness, and 32.4% used CAM for wellness only. Only 11.6% used CAM for treatment only. Regardless of reason for use, the most commonly used CAM types in the past year were herbal therapies (56.8%), chiropractic (27.1%), and massage (24.9%). Among CAM users, those using CAM for wellness only and for a combination of treatment and wellness reported significantly higher odds of "a better sense of controlling health" and "improved overall health and feeling better" compared with treatment only users. Similar patterns were found in other HRQOL outcomes, but they were not statistically different.Conclusions: CAM is widely used among adults with cancer for wellness only or a combination of treatment and wellness. Given improved HRQOL outcomes, CAM may be a promising approach for enhancing health promotion and well-being among adults with cancer. [ABSTRACT FROM AUTHOR]

Purpose: One important goal of any cancer therapy is to improve or maintain quality of life. In this context, mistletoe treatment is discussed to be highly controversial. The aim of this systematic review is to give an extensive overview about the current state of evidence concerning mistletoe therapy of oncologic patients regarding quality of life and side effects of cancer treatments. Methods: In September and October 2017, Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, CINAHL and "Science Citation Index Expanded" (Web of Science) were systematically searched. Results: The search strategy identified 3647 articles and 28 publications with 2639 patients were finally included in this review. Mistletoe was used in bladder cancer, breast cancer, other gynecological cancers (cervical cancer, corpus uteri cancer, and ovarian cancer), colorectal cancer, other gastrointestinal cancer (gastric cancer and pancreatic cancer), glioma, head and neck cancer, lung cancer, melanoma and osteosarcoma. In nearly all studies, mistletoe was added to a conventional therapy. Regarding quality of life, 17 publications reported results. Studies with better methodological quality show less or no effects on quality of life. Conclusions: With respect to quality of life or reduction of treatment-associated side effects, a thorough review of the literature does not provide any indication to prescribe mistletoe to patients with cancer. [ABSTRACT FROM AUTHOR]

Purpose: Mistletoe treatment of cancer patients is discussed highly controversial in the scientific literature. Aim of this systematic review is to give an extensive overview about current state of research concerning mistletoe therapy of oncologic patients regarding survival, quality of life and safety.Methods: In September and October 2017 Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, CINAHL and "Science Citation Index Expanded" (Web of Science) were systematically searched.Results: The search strategy identified 3647 hits and 28 publications with 2639 patients were finally included in this review. Mistletoe was used in bladder cancer, breast cancer, other gynecological cancers (cervical cancer, corpus uteri cancer, and ovarian cancer), colorectal cancer, other gastrointestinal cancer (gastric cancer and pancreatic cancer), glioma, head and neck cancer, lung cancer, melanoma and osteosarcoma. In nearly all studies, mistletoe was added to a conventional therapy. Patient relevant endpoints were overall survival (14 studies, n = 1054), progression- or disease-free survival or tumor response (10 studies, n = 1091). Most studies did not show any effect of mistletoe on survival. Especially high quality studies do not show any benefit.Conclusions: With respect to survival, a thorough review of the literature does not provide any indication to prescribe mistletoe to patients with cancer. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance Traditional Chinese medicine (TCM) has been used for over two thousand years to treat motor impairments corresponding to the clinical manifestations of Parkinson's disease (PD). Aim of the study This study aimed to investigate the prescription of Chinese herbal medicine (CHM) for the management of PD and further determine whether CHM can improve motor function and decrease the risk of incident fracture. Materials and methods Patients older than 40 years newly diagnosed with PD between January 1997 and December 2010 were selected from the National Health Insurance Research Database (NHIRD) and followed up until the end of 2013. We used 1:1 frequency matching by age, sex, index year, and initial diagnostic year to compare the TCM users and non-TCM users. We used a Cox regression model and the Kaplan-Meier method to estimate the risk of developing fracture among the TCM and non-TCM users. Results In total, 7197 patients older than 40 years were newly diagnosed with PD between 1997 and 2010 in Taiwan. Among these patients, 3456 were TCM users, and 3730 were non-TCM users. We compared 2007 PD patients with comparable demographic characteristics and comorbidity profiles between the two cohorts. During the follow-up period, compared with the non-TCM cohort, fewer patients in the TCM cohort had incident fractures (adjusted hazard ratio: 0.5, 95% CI: 0.44–0.56). The cumulative incidence of fracture was lower in the TCM cohort (log-rank test, p < 0.0001). Shi-Chang-Pu ( Acorus gramineus Aiton), Yuan-Zhi ( Polygala tenuifolia Willd), Bei-Mu ( Fritillaria cirrhosa D. Don), Hai-Piao-Xiao ( Sepiella maindronide Rochebrune; Sepia esculenta Hoyle), and Tian-Ma ( Gastrodia elata Blume) constituted the core Chinese herbal medicine prescriptions used to treat PD patients. Conclusions The present study identified the core prescription pattern for the management of PD in Taiwan. Complementary CHM therapy was associated with a reduced risk of fracture in PD patients. [ABSTRACT FROM AUTHOR]

Background: The increasing attention and trend towards complementary and alternative medicine and the usage of such treatments in different nations has highlighted the need for their insertion into the medical curriculum from the basic and clinical sciences courses up to in Continued Medical Education (CME) programs. The familiarity of physicians with complementary therapies is of great importance. The aim of this study was to determine the topics required in the general medical curriculum in the field of complementary and alternative medicine so that they can be further applied by educational planers and administrators. Methods: This was a descriptive cross-sectional study. Regarding the importance of need assessment, at first the agreement-centric Delphi method was used by 15 faculty members and medical students (five faculty members of traditional medicine, five faculty members of clinical sciences and five students) in 3 rounds. With the distribution of openresponse questions, the necessary topics in the field of complementary and alternative medicine were covered and after finalization, a structured questionnaire was prepared. In the next step the validity and reliability of the structured questionnaire was studied, then it was completed by 169 cases of the study population and the results were disclosed. Results: The following results were obtained on the needs of the medical curriculum regarding the alternative and complementary medicine: acupuncture: 80.5%; chiropractic: 66.85%, homeopathy: 63.99%, yoga/ tai chi/ spiritual healing/ relaxation: 87.56%, reflexology: 63.35%, hypnotherapy: 63.89%, herbal therapy: 80.46%, damp and dry cupping: 46.73% and massage therapy: 25.50%. Accordingly, the first priority was yoga/ tai chi/ spiritual healing/ relaxation whereas the last priority was massage therapy. Conclusion: The ultimate goal of complementary and alternative medicine training for medical students is to prepare them for a logical and informed encounter with an important challenge in medicine. Therefore, a change in the training programs of medical faculties seems necessary based on the need assessments having been performed in this respect. [ABSTRACT FROM AUTHOR]

Recurrent urinary tract infection is more common in postmenopausal women, pregnant women, immunocompromised patients, and patients with catheters. Several complementary and alternative approaches in the prevention and treatment of urinary tract infection recurrence are evaluated in this review. [ABSTRACT FROM AUTHOR]

Although lots of great achievements have been gained in the battle against cancer during the past decades, cancer is still the leading cause of death in the world including in developing countries such as China. Traditional Chinese medicine (TCM) is popular in Chinese and East Asian societies as well as some other Western countries and plays an active role in the modern healthcare system including patients with cancer, which may act as a potential effective strategy in treating human cancers. In this review, we aimed to introduce the mechanisms of TCM compound, as an option of individualized therapy, in treating cancer patients from the perspective of both Chinese and Western medicine. In the view of traditional Chinese medicine theory, individualized treatment for human cancers based on syndrome type benefits the cancer patients with personalized conditions. Balancing Qi, Xue, Yin and Yang, eliminating phlegm and removing dampness is how TCM compound functions on cancer patients. While in the view of Western medicine, inhibiting cancer cell growth and metastasis as well as improving immune status is how herbal compounds act on cancer patients. We also summarized the applications of TCM compound in human cancers, which will shed light on the clinical application of TCM compound on patients with cancer. TCM compound could be used as a complementary and alternative medicine (CAM) in human cancers. It could be applied in cancer patients with cancer-related fatigue (CRF). In addition, it is a good method for alleviating the side effects of both radiotherapy and chemotherapy. Therefore, TCM compound plays a critical role in treating patients with cancer, which has a promising strategy in the field of cancer management. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Aims: The aim of this research was to study health-related and sociodemographic determinants of the use of different complementary and alternative medicine (CAM) treatments in Europe and differences in CAM use in various European countries. Methods: The study was based on a design-based logistic regression analysis of the European Social Survey (ESS), Round 7. We distinguished four CAM modalities: manual therapies, alternative medicinal systems, traditional Asian medical systems and mind-body therapies. Results: In total, 25.9% of the general population had used CAM during the last 12 months. Typically, only one CAM treatment had been used, and it was used more often as complementary rather than alternative treatment. The use of CAM varied greatly by country, from 10% in Hungary to almost 40% in Germany. Compared to those in good health, the use of CAM was two to fourfold greater among those with health problems. The health profiles of users of different CAM modalities varied. For example, back or neck pain was associated with all types of CAM, whereas depression was associated only with the use of mind-body therapies. Individuals with difficult to diagnose health conditions were more inclined to utilize CAM, and CAM use was more common among women and those with a higher education. Lower income was associated with the use of mind-body therapies, whereas the other three CAM modalities were associated with higher income. Conclusions: Help-seeking differed according to the health problem, something that should be acknowledged by clinical professionals to ensure safe care. The findings also point towards possible socioeconomic inequalities in health service use. [ABSTRACT FROM AUTHOR]

Abstract: Background: Although complementary and alternative medicine (CAM) is increasingly used, little is known about the reasons for CAM use (treatment, wellness, or both), or the self‐reported perceived benefits among US adults with diabetes. In this study we estimated prevalence rates of overall and specific types of CAM, as well as the perceived benefits of CAM, by reason for use among US diabetic adults. Methods: Cross‐sectional data from the 2012 National Health Interview Survey, which represents non‐institutionalized adults with diabetes (n = 3386 unweighted), were used to estimate prevalence rates of CAM use by reason. Multivariate logistic regression analyses were used to investigate the odds of perceived benefits of CAM by reason for use after controlling for covariates. Results: Of US diabetic adults, 26.2% reported using some form of CAM in the past year. Of these, 56.7% used CAM for both treatment and wellness, 28.3% used CAM for wellness only, and 15.0% used CAM for treatment only. Regardless of reasons for use, most commonly used CAM were herbal therapies (56.9%), followed by chiropractic (25.3%) and massage (20.2%). Those using CAM for a combination of both treatment and wellness had a higher likelihood of self‐reporting a “better sense of control over their health” (P = 0.011) and “improved overall health and feeling better” (P = 0.014) than those using CAM for treatment only. Conclusion: Although CAM may be a promising approach to improving health‐related quality of life, future research should address efficacy and patient safety. [ABSTRACT FROM AUTHOR]

Background: With healthcare costs steadily rising, cost-effective alternatives to traditional medical approaches are needed. Specifically, music therapy (MT), a form of complementary and alternative medicine (CAM), is shown to alleviate symptoms of an illness and improve overall well-being, as well as enhance allopathic treatment modalities, making it appropriate for use in various healthcare settings covered under many different payment schedules today. With interdisciplinary healthcare teams becoming the norm in practice, it is increasingly important that practitioners trained allopathically understand the importance of CAM and certain types of CAM practices such as MT that can provide important benefits for patients. Under the Patient Protection and Affordable Care Act of 2010 (PPACA), not only is wellness and well-being emphasized as part of overall healthcare goals, it is also reimbursable. Therefore, although some CAM practices such as MT require special licensure in order to serve clients specifically, any healthcare practitioner can understand and refer patients to MT services, as well as utilize aspects of MT within their own practice areas. Further, as the field of MT and appreciation for its benefits grows, evidence-based practice in MT is also essential. Therefore, research in CAM and MT furthers the overall acceptance over time by interdisciplinary teams, thereby increasing beneficial care approaches for patients. The purpose of this study was to identify and understand differences between physicians' (doctor of medicine [MD], doctor of osteopathic medicine [DO]) and non-physician practitioners' (nurse practitioners [NP], certified registered nurse anesthetists [CRNA], certified nurse midwives [CNM], physician assistants [PA], and clinical nurse specialists [CNS]) recommending practices, knowledge, and perspectives (attitudes, beliefs, and expectations) of MT as CAM. Clinically, understanding these differences is important to all practitioners so that they can better determine cost-effective means by which to enhance patient care within the confines of allopathic practice under the PPACA, Medicare, Medicaid, and private insurance payment structures today. Materials and Methods: A quantitative methodology with a descriptive, exploratory, cross-sectional, and correlational research design was used to measure recommending practices, knowledge, attitudes, beliefs, and expectations of physicians and non-physician practitioners utilizing a principal investigator-created valid and reliable tool entitled the Global Complementary/Alternative and Music Therapy Assessment (GCAMTA). A sample of 237 physician and 307 non-physician (total N = 544) practitioners participated. Data were continually collected electronically during a six-month period using various social media platforms: Facebook, Twitter, and LinkedIn. Additionally, access was provided to membership in several professional healthcare associations to recruit participants. Results: The GCAMTA revealed that 84.8% of physicians (MD/DO; n = 201/237) responded neutrally in their recommending practices, knowledge, attitudes, beliefs, and expectations toward MT as a CAM for their patients. Additionally, 86.6% of non-physician practitioners (NP, NA, CNM, CNS, PA; n = 266/307) responded more favorably toward MT as a CAM. For practitioners exhibiting higher knowledge of MT as a potential CAM (n = 207/307 [67.4%] non-physician practitioners vs. n = 36/237 [15.2%] MD/DO), favorability toward recommending MT as a CAM was also high. Results of the multivariate analysis of variance across all five dependent variables were statistically significant (p = 0.0001; α = 0.01). Conclusion: Educational curricula may contribute to the discrepancy in the views between physicians and non-physician practitioners. Traditional allopathic curricula may need to include teachings in holistic medicine in order to increase awareness of CAM such as MT. Additionally, further evidence-based research and longitudinal studies are needed for increased acceptance and eventual recommendation of these types of CAM approaches by healthcare practitioners in their practice. However, these types of revisions to curricula and practice take time. Recognizing this possible problem, practitioners need to become active healthcare providers and interdisciplinary healthcare team players by adopting evidence-based CAM approaches such as MT into their clinical practices, so that their patients have multiple cost-effective opportunities for care from which to select and achieve benefit. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Cannabis is an increasingly sought-after remedy for US children with intractable (biomedically uncontrollable) epilepsy. However, like other complementary-alternative medicine (CAM) modalities, and particularly as a federally illegal, stigmatized substance, it is unsanctioned by mainstream medicine. Parents are largely on their own when it comes to learning about, procuring, dispensing, and monitoring treatments. Exploring how they manage is crucial to better assist them. Moreover, it can illuminate how ‘research’ done on the ground by laypeople variously disrupts and reinforces lay–expert and science–non-science divides. To those ends, in 2016, 25 Southern California parents who used, had used, or sought to use cannabis pediatrically for epilepsy/seizures were interviewed regarding their evidentiary standards, research methods, and aims when trying the drug. Parents generally described their work as experimentation; they saw their efforts as adhering to authorized scientific practices and standards, and as contributing to the authorized medical cannabis knowledge base. Findings subverted assumptions, based on an outdated stereotype of CAM, that cannabis - using parents do not believe in biomedicine. Indeed, parents' desire for their children's biomedical demarginalization, combined with biomedical dependency and a high caregiver burden, fueled a collaborative stance. Implications for understanding the boundaries of science are explored, as are norms for parent agency as ill children's care managers, radicalization among people affected by contested illnesses, and the future of ‘medical marijuana.’ [ABSTRACT FROM AUTHOR]

It appears that complementary and alternative medicine ( CAM) is used increasingly often in horses for the assessment and treatment of suspected orthopaedic problems, especially back problems. The aim of this study was to determine the frequency of CAM use for the management of orthopaedic problems in a defined population of Swiss Warmblood horses. A total of 239 owners and caretakers of horses from a pre-defined database were called by a veterinarian to participate in the survey. A standardized questionnaire was designed to determine, for each orthopaedic case, where the localization of the problem was (limb or back) and if conventional medicine or CAM was used for consultation and treatment. When CAM was employed, the CAM discipline and administrator (veterinarian or alternative therapist) was defined. A total of 222 cases in 170 horses with orthopaedic problems were identified. Sixty-two horses were identified with a back problem, 96 horses with a lameness involving one or more limbs and 12 horses with a combined back problem and lameness. CAM was used commonly in this population (73.9%, 164 of 222) for both diagnostic workup and treatment of suspected orthopaedic problems, but was rarely administered by a veterinarian (12%, 27 of 222). In general, if a back problem was suspected by the owner, CAM was more frequently applied for diagnosis and treatment than in cases where a lameness was suspected; (91.9%, 68 of 74) vs. (64.9%, 96 of 148) ( P < 0.001), respectively. Osteopathy was the most frequently applied CAM discipline. CAM was frequently used for diagnostic and therapeutic purposes in Swiss Warmblood horses with suspected orthopaedic problems. CAM practitioners were consulted predominantly if a back problem was suspected, and the majority of CAM practitioners were not veterinarians. [ABSTRACT FROM AUTHOR]

Purpose: Integrative medicine (IM) has received increasing attention since the 1990s, but few studies have explored the key factors of the IM model in health care. This study aimed to describe the IM model in leading centers operating in the USA and Germany.Methods: A 28-item structured survey and semi-structured interviews were conducted in six centers providing integrative medicine in the USA and Germany, and were analyzed using a convergent mixed-method approach.Results: The elements in common across all six centers were the following: (1) involvement of general physicians (GP) in delivering complementary and alternative medicine (CAM) services; (2) requirement for GP or medical referral or recommendation to CAM services; (3) involvement of an integrative physician (IP) as a "gatekeeper"; (4) focus on research, education, and clinical practice; and (5) ongoing academic activities. The key elements differentiating the two countries were the following: (1) level of requirements for GP referral to CAM services; (2) differences in IM service delivery, including treatment modalities used; (3) accessibility of CAM services to patients; (4) interaction between team members and patients; (5) perception of CAM/IM; and (6) perception of patient-centered care. Themes underpinning these elements are the following: cultural aspects in conceptualizing IM health care; communication within IM programs; and resource availability for delivering IM services, which impacts patient engagement and team collaboration in the IM framework.Conclusions: Delivering IM health care requires a model of care that encourages interaction between all stakeholders. Developing a comprehensive conceptual framework to support IM practice is required to facilitate efficient and safe patient care. [ABSTRACT FROM AUTHOR]

Objectives: Health history questionnaires (HHQs) are a set of self-administered questions completed by patients prior to a clinical encounter. Despite widespread use, minimal research has evaluated the content of HHQs used in general internal medicine and family medicine (GIM/FM), integrative medicine, and complementary and alternative medicine (CAM; chiropractic, naturopathic, and Traditional Chinese Medicine [TCM]) clinics. Integrative medicine and CAM claim greater emphasis on well-being than does GIM/FM. This study investigated whether integrative medicine and CAM clinics' HHQs include more well-being content and otherwise differ from GIM/FM HHQs. Methods: HHQs were obtained from GIM/FM ( n = 9), integrative medicine ( n = 11), naturopathic medicine ( n = 5), chiropractic ( n = 4), and TCM ( n = 7) clinics in California. HHQs were coded for presence of medical history (chief complaint, past medical history, social history, family history, surgeries, hospitalizations, medications, allergies, review of systems), health maintenance procedures (immunization, screenings), and well-being components (nutrition, exercise, stress, sleep, spirituality). Results: In HHQs of GIM/FM clinics, the average number of well-being components was 1.4 (standard deviation [SD], 1.4) compared with 4.0 (SD, 1.1) for integrative medicine ( p < 0.01), 3.2 (SD, 2.1) for naturopathic medicine ( p = 0.04), 2.0 (SD, 1.4) for chiropractic ( p = 0.54), and 2.0 (SD, 1.5) for TCM ( p = 0.47). In HHQs of GIM/FM clinics, the average number of medical history components was 6.4 (SD, 1.9) compared with 8.3 (SD, 1.2) for integrative medicine ( p = 0.01), 9.0 (SD, 0) for naturopathic medicine ( p = 0.01), 7.1 (SD, 2.8) for chiropractic ( p = 0.58), and 7.1 (SD, 1.7) for TCM ( p = 0.41). Conclusions: Integrative and naturopathic medicine HHQs included significantly more well-being and medical history components than did GIM/FM HHQs. Further investigation is warranted to determine the optimal HHQ content to support the clinical and preventive health goals of general internal medicine, family medicine, integrative medicine, and CAM practices. [ABSTRACT FROM AUTHOR]