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This letter is to highlight errors made by Liu et al. in their 2020 paper in BMC Complementary Medicine and Therapies, "Complementary and alternative medicine—practice, attitudes, and knowledge among healthcare professionals in New Zealand: an integrative review". Substantial errors in their citation of the recent research and methodology by McDowell, Kohut & Betts (2019) pertaining to the practice of acupuncture in New Zealand by physiotherapists are presented. The actual results of McDowell et al.'s work and the true state of acupuncture use by their sample group is reported. [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]

Background: Complementary or alternative medicine (CAM) describes products/practices outside conventional medical care. CAM may be used to support or replace conventional/prescribed therapies. The aim of this study was to determine patterns of CAM use among children attending a tertiary care hospital in New Zealand (NZ) and measure parental opinion about CAM. Methods: Prospective survey-based study among children and their parents attending inpatient and outpatient clinical areas. Surveys collected demographic and health variables, current CAM use, and parental opinions on CAM. Results: Of the 236 children participating: 41% female, mean age 6.8 years (SD5), 76 (32%) with a chronic illness. CAM was used by 132 (56%) children, the most common being: oral supplements, body manipulation methods, or holistic practices. CAM use was associated with lower child health rating (p = 0.001), Māori ethnicity (p = 0.03), parent education level (p = 0.002), and family member CAM use (p < 0.001). Opinion survey results revealed CAM use was most strongly related to doctors recommending CAM, information on CAM, and CAM cost. There was a 31% CAM disclosure rate to the child's medical team. Conclusions: This study highlights cultural differences in CAM use not previously reported among children in NZ. Parental opinion regarding CAM influences use for their child and disclosure rates. [ABSTRACT FROM AUTHOR]

For the last two hundred years Maori in Aotearoa (New Zealand) have practiced a well-structured ethnomedical public health system which interlinked philosophies of spirituality, collective tribal values and ecology. Karakia occupies an important position in the traditional Maori healing system. The interdependent concept of self in Maoridom values Karakia as an insight oriented directive not only in distress but in the day to day life as well. The present paper aims to explore the therapeutic value of Karakia at the background of its psycho-cultural and social dynamics. Karakia is an effective therapeutic method of healing. Its emic quality is highly relevant in the context of modern treatment plan in mental health. [ABSTRACT FROM AUTHOR]

Background: The prevalence of CAM use is increasing. This integrative review investigated New Zealand healthcare professionals' practice of, attitudes toward, and knowledge about complementary and alternative medicine (CAM). Methods: Literature search was conducted in four databases from inception to April 2020. Studies were included if they reported results from primary data collection on practice of, attitudes toward, or knowledge about CAM amongst New Zealand healthcare professionals. Results: Eleven studies (two of 'high-quality', seven of 'moderate-quality', and two of 'low-quality') were identified with 2060 healthcare professionals including general practitioners (GPs), nurses, midwives, pharmacists, physiotherapists, and medical specialists. New Zealand healthcare professionals were generally positive regarding CAM use, but have concerns on the scientific evidence, regulation, safety, financial costs of CAM, and encourage an evidence-based CAM practice and stronger CAM regulation. Findings indicated that around 25% of GPs practise CAM, and 82.3% refer patients to CAM practitioners. When treating pregnant women, 48.4% of physiotherapists practise acupuncture, and 37.3% of midwives recommend CAM. GPs believe that acupuncture is the most helpful CAM modality, and most commonly practiced and referred patients to acupuncture. Up to 58% of GPs and Plunket nurses wanted to receive further education on CAM, and up to 66.7% GPs favour the idea CAM should be included in medical curriculums. Conclusions: Nine of the 11 included studies were of moderate to high quality, thus enhancing the reliability of the review findings. In order to better manage CAM in New Zealand New Zealand clinical settings, there is a need to invest in CAM research and education, and enhance CAM regulation. This review is a first step in developing an evidence base to offer insights for further development of effective CAM policies regarding safety, efficacy, regulation and integration in New Zealand. [ABSTRACT FROM AUTHOR]

Background Complementary medicines are a popular healthcare choice among patients/consumers, and most pharmacies sell these products. Pharmacists are well-placed to advise on complementary medicines, but their training and practices for these products are not optimal. Pharmacists' professional practices for complementary medicines ought to be influenced by professional codes of ethics and standards. Objective To examine community pharmacists' perspectives on complementary medicines in New Zealand, including motivations and justifications for selling these products, and professional and ethical issues complementary medicines raise for pharmacists. Setting Community pharmacists in New Zealand. Method Qualitative, semi-structured interviews with 27 New Zealand practising community pharmacists identified through purposive and convenience sampling. Main outcome measure Participants' views, experiences, and professional practices for complementary medicines. Results Participants struggled to clearly describe products they considered complementary medicines. Perspectives towards these products ranged from strongly supportive to somewhat sceptical; none was strongly opposed. Participants had several motivations for selling complementary medicines, particularly consumer demand and profits. Participants acknowledged ethical issues concerning complementary medicines, including lack of evidence of efficacy and pharmacists' limited training/knowledge. Few referred explicitly to complementary-medicines-related statements in the Pharmacy Council of New Zealand's Code of Ethics, or indicated these guided their practice. Conclusion Participants sold complementary medicines despite having limited knowledge on these products and concerns about efficacy; participants justified this as they believe they are providing an holistic option for patients, and/or ensuring complementary medicines do no harm. Participants were mindful of ethical/professional issues regarding complementary medicines, but were not necessarily aware of, or guided by, explicit statements in the Pharmacy Council of New Zealand's Code of Ethics. [ABSTRACT FROM AUTHOR]

Complementary and alternative medicine (CAM) products have existed in a regulatory vacuum for most of the past 30 years. With the national industry now worth more than $1.4 billion/year, and in widespread breach of the few regulations that apply to their products, it is no wonder that every attempt at new legislation over the past 15 years has ultimately failed. In the face of risks to public health from unsafe CAM products, false and misleading marketing of these products, and outdated and inappropriate legislation, new measures are desperately required. This article considers the history of CAM product regulation in New Zealand, through the mechanisms of the Food Acts 1981 and 2014, the Medicine Act 1981, and the Dietary Supplement Regulations 1985. It takes examples of risk-based regulation in the new Food Act 2014 and the Medicines Act 1981, and studies the nature of this regulatory device and the possibility of its application to CAM products. This leads on to a consideration of the attempts at updating the legislation around CAM products, and the problems encountered along the way. Finally, the article outlines a new proposal for the regulation of CAM products in New Zealand - the risk-based Complementary and Alternative Medicinal Products Bill. [ABSTRACT FROM AUTHOR]

Background: Low back pain is a common and costly condition internationally. There is high need to identify effective and economically efficient means for managing this problem. This study aimed to explore the cost-effectiveness of a novel motion-sensor biofeedback treatment approach in addition to guidelines-based care compared to guidelines-based care alone, from a societal perspective over a 12 month time horizon.Method: This was an incremental cost-effectiveness analysis conducted concurrently with a pilot, cluster randomized controlled trial. Health care resource use was collected using daily diaries and patient-self report at 3, 6 and 12 month follow-up assessments. Productivity was measured using industry classifications and participant self-reporting of ability to do their normal work with their present pain. Clinical effect was measured using the Patient Global Impression of Change measured at the 12 month follow-up assessment. Data were compared between groups using linear regression clustered by recruitment site. Bootstrap resampling was used to generate a visual representation of the 95% confidence interval for the incremental cost-effectiveness estimate. Two, one-way sensitivity analyses were undertaken to examine the robustness of findings to key assumptions.Result: There were n = 38 participants in the intervention group who completed the 12 month assessment and n = 45 in the control. The intervention group had greater use of trial-related medical and therapy resources [$477 per participant (95% CI: $447, $508)], but lower use of non-trial medical and therapy resources [$-53 per participant (95% CI: $-105, $-0)], and a greater improvement in productivity [$-5123 per participant (95% CI: $-10,174, $-72)]. Overall, the intervention dominated with a saving of $478,100 and an additional 41 participants self-rating as being very or much improved compared to the control. There was >99% confidence in this finding of dominance in both the primary and sensitivity analyses.Conclusions: The motion-sensor biofeedback treatment approach in addition to guidelines- based care appears to be both more clinically effective and economically efficient than guidelines- based care alone. This approach appears to be a viable means to manage low back pain and further research in this area should be a priority.Trial Registration: The randomised trial this research was based upon was prospectively registered on March 25th 2009 with the Australian New Zealand Clinical Trials Registry: ACTRN12609000157279 . [ABSTRACT FROM AUTHOR]

Objectives: To present the results of a systematic review of studies on acupuncture patients' health beliefs and treatment experiences. Search strategy: The search was conducted using CINAHL, PubMed, Ovid MEDLINE, ISI Web of Science, and PsychINFO for qualitative and mixed-methods studies expressing the voice of acupuncture patients. Reference lists of relevant articles were also searched. The review was restricted to studies published in English. Data collection and analysis: Study selection, quality appraisal, and data extraction were performed sequentially. Quality was appraised using the Joanna Briggs Institute Qualitative Assessment and Review Instrument, and the Dedoose mixed methods tool was used in data management and analysis. Results: Four overarching themes were identified: reasons for using acupuncture, treatment experiences, treatment outcomes, and therapeutic model. Conclusions: Patients' reasons for using acupuncture are diverse and include dissatisfaction with conventional medicine and attraction to holistic and empowering models of healthcare. Treatment is thought to relieve symptoms of the presenting concern and a range of other effects that improve well-being. This review highlights the need to improve understanding of patients' health-seeking behaviors and how individually meaningful treatment outcomes may be understood and assessed, particularly within complementary and alternative medicine. [ABSTRACT FROM AUTHOR]

South Australia releases national and international travel scholarships every year to the nursing and midwifery workforce to enable them to undertake observational site visits to inform the development of service models that can be introduced into care practices back in South Australia. Ten sites across New Zealand, Canada, and the UK agreed to host a site visit as part of a scholarship to look at day hospice (DH) programmes. The author undertook an observational study that included participation in DH programmes and discussions with staff and patients. There were many similarities across the three countries, in particular in the structure of the programmes, the staff makeup, and the support of the volunteer workforce. Two distinct models were observed: social and medical. Each has its value and both need to be incorporated to ensure services and participants have their needs met. Based on the site visits and other research, the author devised a proposal for South Australia to commence with a time-limited sessional group DH programme with a focus on maintenance of function for participants coupled with caregiver education and information provision. [ABSTRACT FROM AUTHOR]

A survey was distributed to parents at a conference organized by a dyspraxia support group, and mailed twice to the members with the support group's newsletters. Of 118 respondents, 84% reported that their children were diagnosed with dyspraxia, whereas 25% stated that their children's diagnosis was developmental coordination disorder. All respondents were using food supplements. Moreover, 69% of respondents sent their children to unconventional education or therapy, and 57% provided their children with some form of complementary and alternative medicine (CAM). In terms of perceived effectiveness of interventions, about half of the parents (53%) reported improvement of physical skills and attributed such progress to standard intervention in the mainstream health care and education systems in New Zealand. Despite popular use, effectiveness of unconventional education, therapy, or CAM was rarely considered. These findings have important implications for parents, health and educational service providers, policy makers, and funding bodies. [ABSTRACT FROM AUTHOR]