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Background and purpose Cannabinoids are widely used to alleviate intractable symptoms such as pain, nausea, and muscle spasticity. The purpose of this review was to ascertain the current state of the science regarding use of cannabinoids for cancer pain. Methods Four electronic databases were searched for randomized control trials of cannabinoids and cancer pain. Studies included examined the analgesic effects of cannabinoids for cancer pain. Methodological quality was assessed using the Jadad scale. Conclusions Eight randomized control trials met the inclusion criteria for review. Most trials found analgesic effects from cannabinoids when compared to placebo, although not all associations reached statistical significance. The analgesic effects of cannabinoids were also limited by dose-dependent side effects. Side effects most commonly reported were changes in cognition, sedation, and dizziness. Implications for practice There is evidence that cannabinoids are effective adjuvants for cancer pain not completely relieved by opioid therapy, but there is a dearth of high-quality studies to support a stronger conclusion. Cannabinoids appear to be safe in low and medium doses. Methodological limitations of the trials limited the ability to make sound conclusions. Further research is warranted before efficacy, safety, and utility of cannabinoids for cancer pain can be determined. [ABSTRACT FROM AUTHOR]

Purpose The study aims are to (a) describe nurse practitioners' (NPs') belief in effectiveness, knowledge, referral, and use of complementary/alternative therapies (C/ATs), (b) explore the initiation of C/AT dialogue between NPs and their patients, and (c) examine the relationships between demographic variables and NP C/AT knowledge, beliefs, use, referrals. Data sources A mixed-method cross-sectional online survey of licensed NPs ( N = 2874) from a Midwestern state was analyzed using descriptive statistics, thematic analysis, and content analysis. Conclusions NPs ( n = 410) report the most knowledge about prayer (40%) and mind-body practices (32%). Many NPs (84%) report using vitamins for personal use and 85% refer their patients for massage/bodywork. Most (95%) believe NPs should have knowledge of the most common C/AT and 81% believe C/AT have a legitimate use in allopathic medicine. NPs' knowledge, belief, use, and referral of C/AT are significantly correlated. NPs initiate C/AT dialogue with their patients 54% of the time. Factors that impact the NP and patient C/AT dialogue include patient/family openness, nature of the health problem, NP C/AT knowledge, time, and accessibility. Implications for practice Centralized C/AT sources could help expedite C/AT referrals. Implementing workplace C/AT clinics could help build knowledge, referral, personal use, and acceptance of C/AT. [ABSTRACT FROM AUTHOR]

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

Purpose To describe selected common health beliefs and practices among Mexican American immigrants with type II diabetes. Data sources Selected clinical trials, qualitative studies, and systematic reviews. Conclusions The Hispanic folk illness belief susto refers to an episode of severe fright, and Mexican American immigrants hold varying views on its relation to diabetes. Culturally and in the research, susto has also been linked with depression. Sabila (aloe vera) and nopal (prickly pear cactus) are herbal remedies that have had widespread, longstanding use in Mexican culture and while this is not the gold standard of research, it does provide ample evidence and a strong cultural belief that these therapies work. There is some evidence in the literature to support their efficacy as glucose-lowering agents, but lack of Food and Drug Administration (FDA) regulation, potential side effects, and a dearth of rigorous clinical trials preclude aloe vera and nopal from being recommended therapy. Implications for practice Awareness about susto beliefs, commonly used herbal remedies, and development of culturally sensitive communication skills are essential for nurse practitioners to effectively assist patients in this population achieve their glycemic goals. Research on the effects of nopal and aloe vera on diabetes is needed to guide clinical decisions. [ABSTRACT FROM AUTHOR]

Purpose This study described the use of complementary/alternative medicine (CAM) for arthritis management among community-dwelling older women in urban, suburban, and rural areas. Data sources A descriptive qualitative approach using focus group method was employed. A purposive sample of 50 women ages 66-101 who managed arthritis with CAM participated in eight semistructured focus groups: rural ( n = 22), suburban ( n = 17), and urban areas ( n = 11). Data were transcribed verbatim. Inductive analytic process and computer software were used for data analysis. Conclusions A wide variety of self-help CAM were reported. Supplements were the most commonly used CAM across all locations; rural participants reported the greatest variety of CAM use. Physical symptoms, dissatisfaction with conventional medicine, perceived safety and convenience of CAM, and a desire for personal control over one's health motivated CAM use. Most participants did not fully disclose their CAM use to their primary healthcare provider (HCP). Implications for practice Results suggest a strong need for primary HCP to purposely dialogue with their clients on CAM use when designing, organizing, and delivering arthritis care. Information on safe CAM use and greater options for effective arthritis management with CAM are needed. The value of group-based model for treating arthritis deserves further exploration. [ABSTRACT FROM AUTHOR]