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Complementary and alternative medicine (CAM) degrees in Australian and British universities have come under attack from sceptics who argue that such courses teach only 'pseudoscience'. Moreover, CAM academics have themselves been publicly labelled 'quacks'. Comparatively little is known about this group of health professionals who span the two worlds of CAM practice and academia. How do they navigate between these domains, and how are their collective and individual professional identities constructed? Drawing on 47 semi-structured interviews, this paper explores the professional identities of academics working in three university-based CAM disciplines in Australia and the UK: osteopathy, chiropractic and Chinese medicine. By analysing these individuals' accounts, and building on prior research on health professions in the academy, the paper contributes to understanding how contests about professionalism and professional knowledge take place against the academic-practice divide. By focussing on a domain where knowledge claims are conspicuously contested, it highlights the salience of navigating 'epistemic stress' for both group and individual professional identity. [ABSTRACT FROM AUTHOR]

Objectives: The study is an exploratory study of a media event in Australia based on the publication of two separate systematic analyses of complementary medicine (CM) therapies. The objective of the study was to measure the scientific quality of Australian newspaper media reports about two international peer-reviewed research papers reporting results on complementary medicines published in biomedical journals during Feb/March 2007. For purposes of clarity, we refer to the papers as the ‘Antioxidant Study’ (Bjelakovic et al 2007) and the ‘Prenatal Multivitamin Study’ (Goh et al 2007). Methods: We sourced articles that were published about the two research papers in mainstream metropolitan and national Australian newspapers during February and March 2007. We then applied a model of analysis called the Index of Scientific Quality (ISQ) to measure the scientific quality of the news reports. Results: We identified 14 newspaper articles and one newswire article about the Antioxidant Study and two newspaper articles about the Prenatal Multivitamin Study. Of the seven ISQ criteria, ‘validity’ and ‘precision’ were rated the least adequate, ‘important consequences’ of the research were reported partially in the Antioxidant Study and wholly in the Prenatal Multivitamin Study, and ‘opinion from fact’ was adequate in the majority of articles. Conclusion: This exploratory study conveyed an overall inadequacy in the scientific quality of the newspaper reporting about the two CM studies in major metropolitan and national Australian newspapers. Whilst we found that journalists were careful to attribute opinions to their sources, their reports conveyed a very limited understanding of biomedical research methodologies and a subsequent incapacity to scrutinise these methodologies with rigour. [ABSTRACT FROM AUTHOR]

There is increasing pressure on complementary and alternative medicine (CAM) to follow the evidence-based approach promoted in allied health and medicine, in which the randomised control trial represents the evidence gold standard. However, many CAM advocates see these methods as undermining the holism of CAM practice. This paper explores how such tensions are managed in CAM university departments – settings in which particular forms of knowledge and evidence are given 'official' imprimatur by CAM educators and researchers. By comparing two types of CAM, the paper also unpacks differences within this broad category, asking whether CAM academic disciplines comprise different 'epistemic cultures' (Knorr-Cetina, K. (1999). Epistemic cultures: How the sciences make knowledge. Cambridge, MA: Harvard University Press). Interviews were conducted with 20 lecturers in Chinese medicine and osteopathy, across five Australian universities, and augmented with observation in two degree programs. Findings reveal contrasting ontological and epistemological perspectives between the two academic fields. Chinese medicine lecturers had largely adopted bioscientific models of research, typically conducting laboratory work and trials, although teaching included traditional theories. Osteopathy academics were more critical of dominant approaches and were focused on reframing notions of evidence to account for experiences, with some advocating qualitative research. The study illustrates CAM's 'epistemic disunity' while also highlighting the particular challenges facing academic CAM. [ABSTRACT FROM AUTHOR]

This paper examines the differential incorporation of acupuncture and homeopathy into the medical establishment in Portugal. While the former has been incorporated into the medical establishment, the latter is still banned by the Medical Council, yet remains in practice by medical doctors in the country. Drawing on the insider viewpoints of medical doctors committed to these two therapies, the findings of this paper suggest that the rhetoric of insufficient scientific evidence of homeopathy still prevails within the medical establishment. However, two other factors were emphasised: the medical prejudice or 'resistance to innovation' of the Portuguese Medical Council and the idiosyncrasies of acupuncture and homeopathy, which have made them amendable to biomedicine (or not). This paper argues that the differential responses of the Portuguese medical establishment to acupuncture and homeopathy are due to reasons beyond that given of the medical rhetoric of insufficient scientific evidence for homeopathy, and which extend to issues of professional status and power. This paper suggests that the emerging commercial interest of the pharmaceutical industry in homeopathy's pharmacopeia worldwide could enhance homeopathy's status in the country and could therefore pressurise the medical orthodoxy to redress its position towards this therapy. [ABSTRACT FROM AUTHOR]

This paper explores the contemporary relevance of sociological theorisations centred on medical power, including the medical dominance and deprofessionalisation theses. To achieve this it examines two issues that have been tentatively linked to the relative decline of the power and autonomy of biomedicine - complementary and alternative medicine (CAM) and the Internet-informed patient. Drawing on these two different but interconnected social phenomena, this paper reflects on the potential limitations of power-based theorisations of the medical profession and its relationship to patients and other non-biomedically situated professional groups. It is argued that power-based conceptual schemas may not adequately reflect the non-linear and complex strategic adaptations that are occurring among professional groups. [ABSTRACT FROM AUTHOR]

The concept of placebo has had a long history in medicine, and has evolved over time with the introduction of randomised controlled trials for testing health treatment, the increasing research done around the psychotherapies, the development of complementary and alternative medicine approaches to health, as well as the conceptual contributions from academic disciplines like psychology and anthropology. In recent years, discourses about placebo have pursued a number of key directions, and the current review paper explores these developments. For example, psychology has looked at placebo in terms of classical conditioning and the role of anxiety. Anthropology on the other hand has focused on the role of meaning and ritual in the placebo effect and psychotherapy research has encouraged an examination of the effects of the therapeutic relationship. Our review paper concludes by outlining directions ahead for future scholarship and research. [ABSTRACT FROM AUTHOR]

In this analytic review, the authors consider the 'boom' in demand for the services of practitioners of modalities of complementary and alternative medicine (CAM). The evidence for the increase in demand for these services is reviewed and explanations for this phenomenon considered and evaluated. Two particular explanations are considered: the postmodern thesis and the gendered spirituality thesis, as well as more general changes in society. Finally the paper considers the role of the social sciences in the legitimation and increasing use of CAM. The paper concludes that the trend is likely to continue, as will the role of social scientists in observing and documenting CAM. [ABSTRACT FROM AUTHOR]

This paper examines the primarily sociological and anthropological literature that discusses the current challenges posed by the 'modernisation' of herbal knowledge through its co-option by biomedicine. Through this examination we identify evidence for a trend which suggests this co-option is a tactical strategy to preserve biomedical dominance through control of the knowledge base of 'other' medicines. Having identified such a trend, we examine the invention of the term 'complementary and alternative medicine' (CAM), suggesting that the universalising of non-orthodox health care practices under this construct is a problematic symptom of biomedical co-option. We then go on to argue that a possible outcome of biomedical co-option is an epistemological bifurcation between 'traditionally' orientated and 'biomedically' informed herbal knowledge and practice, a phenomenon whose implications demand serious recognition and analysis, not only in the academic literature, but also in wider public debates. [ABSTRACT FROM AUTHOR]

The call for increased integration of complementary and alternative medicine (CAM) with biomedicine implies an acceptance and compatibility of the theories, practices and research of these medicines, as well as recognition of consumer demand. CAMs slow integration into hospital systems, medical practices and research institutes can be argued to provide greater choice and autonomy to the medical consumer. As this mainstreaming of CAM continues it not only produces these potential 'goods' but also negative unintended consequences for the various practices that CAM encompasses, which in turn impacts on the consumer. CAM is often reflected poorly using the standard tools of evidence-based medicine (EBM) assessment which is demanded by not only medical institutions but also funding bodies. This paper examines the complex interactions generated by this process giving attention to the consequences for CAM practitioners and the subsequent impact on practice and accordingly on the consumer. [ABSTRACT FROM AUTHOR]

Through interviews with users and providers of anti-ageing medicine in Australia as well as the analysis of various internet sites, anti-ageing clinics, journals and magazines dealing with anti-ageing medicine, this paper will argue that the anti-ageing industry in Australia is an example of how ‘mediascapes’ operate, seeking in this case to replicate the American model while developing a more localized practice meeting local needs, cultural orientations and regulatory frameworks. The products being studied here include some which have been on the market for many years in the Complementary and Alternative Medicine (CAM) industry, but have only recently been rebranded as ‘anti-ageing’. These include vitamins, anti-oxidants, supplements such as beta-carotene, selenium and coenzyme Q10, homeopathic products, exercise and diet programs. Other products that have been recently labelled as ‘anti-ageing’ and are included in this study are hormone therapies, testosterone, melatonin, Human Growth Hormone (HGH), and Dehydroepiandrosterone (DHEA). These products have been previously trialled and used in the treatment of medical problems such as heart disease, sexual dysfunction, cognitive and memory loss problems, and hormonal deficiency. Current medical research on stem cells, particularly embryonic stem cells, has also fallen within the realm of anti-ageing treatments developed from this research area and available primarily in countries with limited regulation and control over the use and availability of embryonic stem cells in the context of the private anti-ageing clinic. The differences and similarities between the practice of anti-ageing medicine in Australia and in America highlight current tensions and correspondences in the manner in which ageing is being constructed, managed and experienced. They are indicative of the impact that social policy directions, regulatory frameworks and economic policies have on the way in which ageing individuals and society at large approach the experience of old age. [ABSTRACT FROM AUTHOR]

This paper discusses the perspectives of 18 people who were living with HIV/AIDS in Melbourne, Australia, and who were using complementary and alternative medicine (CAM) alongside biomedicine. I argue that although people may perceive the holistic focus of CAM to be more desirable than the more pathogenic focus of biomedicine, a holistic approach is also associated with limitations. In this study, participants were motivated to use CAM because of the perceived limitations of biomedicine and also because of a desire to have control over how their illness was managed. However the majority of participants were not interested in the philosophical principles of CAM, rather in whether these therapies were effective and manageable. These findings suggest that although people may hold different beliefs about CAM as compared with biomedicine, an approach to healthcare that has a practical focus on both clinical outcomes and patient wellbeing may be acceptable to most people. [ABSTRACT FROM AUTHOR]

New Zealand research suggests that CAM use by GPs has decreased, while referral to CAM practitioners by GPs has increased, and that patients often do not tell their health practitioners when they are using CAM. The New Zealand Medical Council has developed guidelines for GPs who use CAM. However, there is no research in New Zealand that looks at how patients and GPs respond to CAM issues in the consultation. This paper uses data collected for two research projects on doctor-patient interaction. For this research, consultations between 105 patients and nine GPs were video-recorded. In this data set, all doctors but one were 'orthodox' and to some degree reserved judgement on CAM, albeit remaining cautious in how they made this evident. Patients on the other hand demonstrated a variety of strategies to get CAM on the agenda, and GPs were careful to couch any criticism in such a way as to protect the 'face' of patients. [ABSTRACT FROM AUTHOR]

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Book prescription schemes and healthy reading schemes are public mental health initiatives that are inspired by the bibliotherapeutic principle of 'the guided use of reading, always with a therapeutic outcome in mind' (Katz & Watz, 1992). These initiatives were originally developed in the UK as an example of care in the community for the treatment of mild to moderate mental health problems. This involves the creation of a collection of self-help books in a local library which members of the public can access free of charge to help with their recovery from mental illness. Ireland's first Book Prescription Scheme was established in Dublin City in 2007. This article presents a critical assessment of the contribution that these reading schemes offer the treatment of mental illness in Ireland. While advocates commend this new service, a critical discourse analysis of Irish self-help reading schemes reveals that offering guided reading for the treatment of mental illness provides an individualistic and neo-liberal construction of mental illness and well-being. [ABSTRACT FROM AUTHOR]

While anti-ageing medicine may be defined by efforts to control human aging, individual motivation to utilise anti-ageing medicine proves to be multifaceted. Qualitative, in-depth interviews with 15 people who have used anti-ageing medicine reveal that the turn to anti-ageing medicine may be more about disillusionment with allopathic medicine than it is about controlling bodily aging. By contextualising people's use of anti-ageing medicine within their lifelong body regimen ‘careers’, and looking closely at the first career sequence, which is characterised by a questioning of tradition – the tradition of allopathic medicine – new perspectives behind the rise of anti-ageing medicine are offered. Shared grievances with mainstream medicine tend to be situated around both the medical delivery and the medical treatment. Rather than reject the values associated with biomedicine, as is often the case with alternative health enthusiasts (Siahpush 1998), those using anti-ageing medicine seek out an ‘alternative’ biomedicine that they perceive to offer more satisfactory solutions to their problems. [ABSTRACT FROM AUTHOR]

The integration of complementary and alternative medicine into cancer care is widely debated. Advocates of integration frequently cite the popularity of such therapies amongst patients in support of their case. However, little specific empirical attention has been given to how integration is actually regarded by these patients. Based on semi structured interviews with 80 cancer patients in the UK, this article examines the assumption of a link between use and support for integration. On the basis of this study we argue that: 1. A characterisation of unequivocal cancer patients' support for integration (even amongst those who use CAM) is an over-simplification and distortion of the situation 2. It is inappropriate to conflate 'use' with 'advocacy' 3. Patients' engagement with the idea of integration is complex and multi-layered; and 4. This complexity can be explicated by looking at key dimensions of an integrative process: evidence and risk, cost, and provider legitimacy. [ABSTRACT FROM AUTHOR]