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Background: The World Health Organization and the Ministry of Health care about traditional and complementary medicine practices. Evaluating the attitudes of physiotherapy-rehabilitation students and nursing students toward conventional and complementary practices holds significant importance in healthcare education and practice. However, it is worth noting that a limited body of research focuses explicitly on these student groups. Methods: This cross-sectional study was conducted with 446 students in the departments of physiotherapy-rehabilitation and nursing in a university's faculty of health sciences. The data were collected using the Complementary, Alternative, and Conventional Medicine Attitude Scale (CACMAS) and the Complementary and Alternative Medicine Approaches Scale (CAMAS). The analyses used percentages, averages, standard deviation, Student's t, Mann-Whitney U, one-way ANOVA, Kruskal-Wallis analysis, the Scheffe post hoc test, and Pearson correlation. Results: 95.5 % of the students did not use complementary therapy previously; the education process of 89.7 % did not cover complementary treatment; 73.3 % stated that complementary therapy education should be given at schools; 74.2 % wanted to use complementary therapy. However, 94.2 % reported that the Ministry of Health did not know about complementary therapy regulations. The average total score was 25.44 ± 8.953 for the Complementary and Alternative Medicine Approaches Scale and 111.29 ± 16.092 for the Complementary, Alternative, and Conventional Medicine Attitude Scale. Conclusion: The students believed conventional and complementary therapy methods should be used for patients, and they expressed a keen interest in their professional practice after graduation.

Resumen: En el tratamiento de la ansiedad las medidas no farmacológicas han de estar presentes, tanto en monoterapia en el caso de la ansiedad leve o moderada, como en combinación con los tratamientos farmacológicos. Algunas de ellas cuentan con estudios suficientes como para avalar un alto grado de recomendación y otras, aun no estando respaldadas por estudios de alto nivel de evidencia, sí que son recomendables por la ausencia de efectos adversos en su uso. Entre estas medidas se encuentran la entrevista motivacional, psicoterapias, psicoeducativas, técnicas de relajación, mindfulness, yoga, aromaterapia, terapia a través de imágenes y uso de nuevas tecnologías, entre otras. El uso de ellas podrá ser aislado o constar de una combinación de varias técnicas y siempre adaptándolo a las características intrínsecas de la persona que padece la ansiedad y a su entorno. Abstract: In the treatment of anxiety, non-pharmacological measures must be present, both in monotherapy in the case of mild or moderate anxiety and in combination with pharmacological treatments. Some of them have sufficient studies to support a high degree of recommendation and others, although not supported by studies of high level of evidence, are recommended due to the absence of adverse effects in their use. Among these measures are motivational interviewing, psychotherapies, psychoeducational, relaxation techniques, mindfulness, yoga, aromatherapy, therapy through images and use of new technologies, among others. The use of them may be isolated or consist of a combination of several techniques and always adapting it to the intrinsic characteristics of the person suffering from anxiety and their environment.

Abstract Background Prostate cancer (PC) is a silent but potent killer among men. In 2018, PC accounted for more than 350, 000 death cases while more than 1.2 million cases were diagnosed. Docetaxel, a chemotherapeutic drug belonging to the taxane family of drugs, is one of the most potent drugs in combating advanced PC. However, PC cells often evolve resistance against the regimen. Hence, necessitating the search for complementary and alternative therapies. Quercetin, a ubiquitous phytocompound with numerous pharmacological properties, has been reported to reverse docetaxel resistance (DR) in docetaxel-resistant prostate cancer (DRPC). Therefore, this study aimed to explore the mechanism via which quercetin reverses DR in DRPC using an integrative functional network and exploratory cancer genomic data analyses. Results The putative targets of quercetin were retrieved from relevant databases, while the differentially expressed genes (DEGs) in docetaxel-resistant prostate cancer (DRPC) were identified by analysing microarray data retrieved from the Gene Expression Omnibus (GEO) database. Subsequently, the protein-protein interaction (PPI) network of the overlapping genes between the DEGs and quercetin targets was retrieved from STRING, while the hub genes, which represent the key interacting genes of the network, were identified using the CytoHubba plug-in of Cytoscape. The hub genes were further subjected to a comprehensive analysis aimed at identifying their contribution to the immune microenvironment and overall survival (OS) of PC patients, while their alterations in PC patients were also revealed. The biological roles played by the hub genes in chemotherapeutic resistance include the positive regulation of developmental process, positive regulation of gene expression, negative regulation of cell death, and epithelial cell differentiation among others. Conclusion Further analysis revealed epidermal growth factor receptor (EGFR) as the most pertinent target of quercetin in reversing DR in DRPC, while molecular docking simulation revealed an effective interaction between quercetin and EGFR. Ultimately, this study provides a scientific rationale for the further exploration of quercetin as a combinational therapy with docetaxel.

Objective: The study aimed to evaluate the effects of honey on the incidence of post-operative pain in patients undergoing tonsillectomy. Methods: This study is a double-blind and randomized controlled trial design. Twenty-four adult male patients underwent tonsillectomy surgery and were randomized assigned into three groups consist of honey group, placebo group, and control group. All subjects were given standard analgesia and antibiotics, also honey for the honey group and placebo for the placebo group, and only standard post-operative regimens for the control group. This study used silk-cotton tree or kapok tree honey (Ceiba pentandra). Honey was used by gargling every six hours for ten days. Likewise, the same method was applied in the placebo group. Pain scale was assessed for ten days using the Visual Analogue Scale questionnaire, and the frequency of analgesic drugs was recorded on days 1, 2, 4, 7, and 10. Result: Honey group showed significantly higher pain reduction when compared to placebo and control groups, with a significant reduction in the pain scale on day 1, 2, 4, 7 and 10 (p = 0.034; p = 0.003; p

Introduction: Hypertension is still a major global health problem and causes serious complications. Pharmacological therapy has been proven in lowering blood pressure, but non-compliance often occurs and causes side effects. A combination of non-pharmacological therapies, such as acupressure therapy, is important. This study aimed to describe and systematically assess the types of acupoints, benefits, and duration of acupressure therapy on the blood pressure in patients with hypertension. Methods: A systematic literature search was conducted on seven databases, namely, PubMed, DOAJ, Science Direct, ProQuest, CINAHL-EBSCO, Cochrane Library, and Garuda, to identify studies published based on the following inclusion criteria: articles published in English and Indonesian in the last 10 years (2012–2022), articles that employed a quantitative research design, i.e., RCTs and quasi-experimental, articles that mainly focus on acupressure and lowering blood pressure in patients with hypertension, and the study participants were 18 years old. Meanwhile, the exclusion criteria were as follows: the study population was composed of pediatric patients, articles not published in English and Indonesian, studies that were not intervention types, not in the objectives of the study, article in review form, study not full text. This systematic review uses the PRISMA guidelines by protocol registration number (PROSPERO) CRD42022368979, Critical Appraisal Skill Program (CASP) for randomized controlled trials, and Quasi-Experimental Checklist (JBI version) in assessing article quality. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Result: A total of 3.376 articles were screened, of which nine studies were eligible for analysis. Two articles recommended the application of acupoints, namely, the Taichong (LR3), Shenmen (HT7), and Taixi (KI3) acupoints, which are effective in lowering blood pressure. The duration of acupressure administration was reported to range from 3 to 40 min, and each duration can decrease blood pressure. The maximum result in lowering blood pressure in the physiological adaptation process can be achieved in 4 weeks. Conclusion: Acupressure therapy at Taichong (LR3), Shenmen (HT7), and Taixi (KI3) acupoints is a good non-pharmacological therapy option to help in lowering blood pressure in patients with hypertension.

Background and Purpose: Aromatherapy, a non-pharmacological intervention involving essential oils, has been suggested as a complementary therapy for perioperative discomfort. This study seeks to systematically examine the efficacy of aromatherapy in alleviating pain and other discomforts in mothers undergoing cesarean sections., Methods: A systematic search of PubMed, the Cochrane Library, and Embase was conducted from inception to September 2024. Inclusion criteria involved mothers undergoing cesarean section, aromatherapy as an intervention, and outcomes such as pain, anxiety, nausea and vomiting. Subgroup analyses explored the effects of distinct control groups, essential oil, dosage, number of sessions, and session length of aroma preparations. Statistical analysis was conducted using RevMan 5.3, with heterogeneity assessed using the Q test and I 2 statistic., Results: Seventeen studies involving 1490 participants were included. Aromatherapy significantly reduced post-cesarean pain (SMD = -1.19, 95 % CI [-1.93, -0.45], p = 0.002). Chamomile oil, low dosage (≤2 drops), single session and sessions lasting 20 min or less were more effective in relieving pain. Aromatherapy significantly decreased nausea incidence (RR = 0.52, 95 % CI [0.33, 0.81], p = 0.004), reduced analgesic requirements (RR = 0.60, 95 % CI [0.49, 0.73], p < 0.00001), and improved patient satisfaction (RR = 1.64, 95 % CI [1.26, 2.12], p = 0.0002)., Conclusion: Aromatherapy effectively reduces post-cesarean pain, nausea, analgesic use, and improves patient satisfaction. Chamomile oil, low doses (≤2 drops), single session and short length (≤20 min) seems to be the most effective method for alleviating post-cesarean pain., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Triple-negative breast cancer (TNBC) is the most aggressive breast cancer subtype due to its greater invasive capacity and non-response to hormone therapy. Several species of the Ficus genus have been used as an alternative to traditional medicine against malignant diseases. Previously, leaf extracts from Ficus crocata (Miq.) Mart. ex Miq. (F. crocata) showed antiproliferative activity in vitro against breast and cervical tumor cells without having a cytotoxic effect on non-tumor cell lines. The purpose of the study was to evaluate the effect of hexane (Hex-EFc), dichloromethane (Dic-EFc), and acetone (Ace-EFc) extracts from F. crocata on the proliferative and invasive capacity of breast cancer cells MCF-7 and MDA-MB-231. Materials and methods: The phytochemical profile was carried out by gas chromatography-mass spectrometry (GC-MS). Cell proliferation, migration, and invasion were determined by MTT, wound closure, and transwell assays, respectively. MMPs activity was analyzed using gelatin zymography, and fluorescence microscopy was used to visualize F-actin distribution. Results: Hex-EFc, Dic-EFc, and Ace-EFc showed cytotoxic activity on MDA-MB-231 tumor cells and, to a lesser extent, on MCF-7 cells, without presenting cytotoxicity at the same concentrations in MCF-10A non-tumor cells. Dic-EFc and Ace-EFc (5–10 μg/mL) reduced the migration capacity of MCF-7 and MDA-MB-231 cells. Interestingly, exposure to Dic-EFc and Ace-EFc (5–10 μg/mL) inhibited the invasive ability of MDA-MB-231 cells, reducing the secretion and activity of MMP-2 and MMP-9, as well as the F-actin distribution. Conclusions: Dic-EFc and Ace-EFc at low concentrations decreased breast cancer cell proliferation and invasiveness, mainly of MDA-MB-231 cells. The above supports the potential use of compounds from leaf extracts of F. crocata in neoadjuvant therapy to reduce the progression of breast cancer tumors, mainly triple-negative tumors.

Problem considered: The empirical evidence suggested the usage of ginger (zingiber officinale), complementary therapies and Non-steroidal anti-inflammatory drugs (NSAIDs) for dysmenorrhoea compared to self-administration of NSAIDs alone in alleviating the symptoms of dysmenorrhoea. However, there is a need for strong evidence to compare the effectiveness of ginger to that of complementary therapies like exercise, herbs (other than ginger) and NSAIDs. Thus, this systematic review aimed to compare the effectiveness of ginger with NSAIDs and other complementary therapies and suggests an effective dose of ginger in oral form that can be taken during dysmenorrhoea. Methods: A systematic literature search was conducted using electronic databases, namely MEDLINE via PubMed, Cochrane central, Scopus, CINHAL, EBSCOhost, ProQuest Central, and Google Scholar search engine. The search terms were combined keywords related to menstrual pain, complementary therapy, NSAIDs, and ginger. Randomized or quasi-randomized controlled trials that included ginger as a comparator to assess the effect on primary dysmenorrhea were included in this systematic review. Data were extracted, and the findings were narratively synthesised. Result: An initial search from the electronic database identified 394 studies, of which eleven studies met the eligibility criteria, where seven were randomised controlled trials, and four were quasi-experimental studies. There was no significant difference between ginger and NSAIDs in decreasing pain intensity during menstruation. Ginger and exercises like muscle relaxation techniques, stretching, and sub-maximal aerobic exercise effectively reduce pain when combined. Dill seeds (Anethum graveolens, an aromatic herb used for flavouring and medical purposes) and ginger alone were effective in dysmenorrhoea, but no effect of valerian, peppermint and cumin (spices) seeds were observed. The effect of ginger was inclusive compared to placebo. Conclusion: The usage of ginger up to two grams per day in divided doses of powder or dietary form for three days from the first day of the menstrual cycle can be used safely for primary dysmenorrhoea. Ginger can be combined with complementary therapies like exercise for increased effectiveness in relieving menstrual pain. The alternative therapy can reduce dependency on synthetic drugs for controlling dysmenorrhoea. However, there is a need to carry out rigorous randomized controlled trials of longer duration to evaluate the effectiveness of ginger and auxiliary therapies other than ginger in controlling menstrual pain.

Objective: This study aimed to investigate quality of life (QOL) improvement in long-term cancer survivors using complementary therapy (CT) as mind–body practice. Methods: A quasi-experimental study including intervention and control groups was conducted. Participants in the intervention group engaged in CTs, including music therapy, progressive muscle relaxation, and deep-breathing exercises for 8 weeks at home. QOL was evaluated in both the groups using Short Form-8 (SF-8) questionnaire before the experiment and at 4 and 8 weeks after starting the experiment. To examine QOL, we compared SF-8 subscale scores, the physical and mental component summaries of QOL. Results: Cancer survivors were assigned to the intervention and control groups, comprising 69 and 59 individuals. There were no significant differences in QOL between the two groups with low scores, but there was a significant difference in the mental aspect of QOL in 4 weeks, indicating that the intervention group was lower than the control group. Meanwhile, the intervention group tended to experience increased changes in the mental aspect of QOL in 8 weeks compared to 4 weeks, although there was no significant difference. Conclusions: CT did not exhibit an effect on QOL among cancer survivors, especially in 4 weeks. This might have been due to sample size, participants' potential low compliance resulting in an inability to confirm whether the CTs were performed accurately and continuously, and consideration of what CT suited them. Meanwhile, CT may require a longer time to increase QOL. We recommend further studies to address these factors when conducting CT as mind–body practice.

Background: The herbal drug (Fibrosin®) is often used as supportive therapy with intramuscular ceftriaxone injection for treatment of mastitis in field condition. Method: A single oral dose of Fibrosin® (1.9 g) was given 1 h prior to single intramuscular injection of ceftriaxone at 50 mg kg−1 in 3 apparently healthy male and 3 female goats. Plasma and urine samples were collected at predetermined time intervals and ceftriaxone/ceftizoxime was analyzed by HPLC. Ceftriaxone persisted for 3 h in plasma of Fibrosin® treated healthy goats. Results: Ceftriaxone showed a distinct reabsorption phase in its dispositional profile. Mean t½ K (distribution half-life) following absorption phase and t½ K′ (elimination half-life) following re-absorption phase were 0.091±0.01 and 0.43±0.03 h respectively with a reabsorption half-life (t½Ka′) of 0.18±0.003 h. Ceftriaxone at a lower concentration (67.91±9.42 μg mL−1) was recovered at 24 h post dosing from urine. The reabsorption rate constant was 3.86±0.10 h−1 that suggested rapid intestinal reabsorption. Conclusion: Rapid intestinal absorption of ceftriaxone indicated shorter persistence in the intestine and it also exhibited enhanced plasma persistence which may help to preserve beneficial intestinal bacteria as well as prevention of antimicrobial resistance development in the intestine for which the herbal drug may be used as a supportive therapy with intramuscular injection of ceftriaxone.

Based on their chemical composition, salus per aquam (spa) mineral waters (or medical mineral waters) can be classified as sulphurous, sulphate, bicarbonate etc. Sulphate mineral waters where the predominant element is sulphate anion SO42−, are frequently used in clinical therapy. In this review, we describe and analyze the current scientific knowledge concerning the therapeutic effect of sulphate mineral waters in the treatment of several disorders.Moreover, we underline how important is to integrate spa treatments with other therapeutic approaches to meet the various needs that can arise during a specific pathological state.

Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes significant disability and reduced quality of life. Scientific studies on yoga have revealed its various health benefits in chronic conditions, including autoimmune diseases. However, whether yoga is feasible for AS patients or not is not studied. Further, no validated yoga module is available for AS patients. Objective(s): This study intended to develop a yoga module for AS patients and investigated its feasibility of use. Materials and methods: The study was completed in three stages. In Stage I, six yoga experts prepared a list of 64 yoga practices based on the classical and contemporary yogic literature review. Of these practices, 41 were included in the designed yoga module. In Stage II, 41 experts with a minimum of five years of experience in yoga therapy were invited for yoga module validation. The usefulness of the practices was rated by experts on a 3-point scale (1: not at all useful, 2: moderately useful, and 3: very much useful). The Lawshe content validity ratio (CVR) method was used for the content validity of the yoga module. Practices with a CVR score of > 0.3 were retained in the final yoga module. In Stage III, a certified yoga instructor administered the validated yoga module to 19 AS patients (average age: 35.5 ± 10.7 years) thrice weekly for a month. Feasibility was assessed on the basis of the attrition rate, retention rate, attendance of the participants, and the subjective response on practical sessions using a structured checklist. Results: Of the 41 practices in the module, 31 had a CVR score of > 0.3 and were included in the final yoga module. Of the 25 participants, 19 (76%) completed the study while six dropped out (24%). Nineteen patients reported greater improvement in pain and flexibility. They found yoga relaxing and easy to practice. Most participants (65%) were able to practice a minimum of 30 min/day. Conclusion: The present study offers a validated yoga module consisting of 31 practices for AS patients. The results of the pilot suggested that the module is feasible, acceptable, and easy to practice for AS patients. We recommend that AS patients should practice this yoga module for a minimum of 30 min every day under the supervision of a yoga expert.

Introduction: Rice bran arabinoxylan compound (RBAC) is a nutraceutical for enhancing a depleted immune system during and after cancer treatment. This pilot feasibility trial aims to evaluate the effects of RBAC on cancer patients' quality of life during active treatment, compared to placebo, using a validated questionnaire. Other outcome measures include changes in inflammatory and nutritional status, cytokine profile, and gut microbiota. Methods/Design: The study will recruit 50 participants from a regional cancer center in Australia. Patients aged 18–70, diagnosed with solid organ cancers stage II and above, and currently undergoing active systemic therapies, are eligible. Random allocation of participants into two groups is stratified based on metastatic status and treatment type. The dosage is either 3 g/day of RBAC or placebo in identical packaging. The participants, study coordinator, and treating oncologists are blinded to the interventions. Data collections are at baseline and at four follow-up sessions, which are six weeks apart (24 weeks). Statistical analysis will involve a protected p-value with multiple dependent values and analyzed by ANOVA with repeated measures on the occasion of testing and with both a full Bonferroni or Sidak corrections applied to protect against Type I errors. Any observed significance warrants further analysis with pairwise comparisons. Analysis of covariance will also be performed to assess any influence of the demographic data, cancer diagnosis, as well as changes in physical activity, dietary habits, and complementary medicine usage. Comparisons of gut microbiota will be based on the analysis of the fecal microbiome using 16S ribosomal ribonucleic acid amplicon sequencing. The proposed research timeline is from October 2018 to May 2022. Trial registration: ANZCTR. Reg No: ACTRN12619000562178p.

Background: Complementary therapy and Alternative medicine (CAM) is used worldwide for many ailments and is a popular option amongst pregnant women for general wellbeing and managing symptoms. Many studies investigating the use of CAM in the antenatal and intrapartum period have been conducted however there is a lack of evidence regarding its effects on induction of labour and delivery. We established a post-dates clinic comprising of an antenatal check and CAM for low risk pregnant women to determine the impact of CAM on these outcomes. Methods: This was a cohort study with convenience sampling. A total of 1044 women were included. 397 received a combination of three CAM techniques (acupressure, reflexology and aromatherapy) and 647 women received standard clinical practice. The primary outcome was rate of induction of labour and secondary outcomes such as rates for epidural, length of labour, oxytocin use for induction or augmentation of labour, mode of delivery, blood loss during delivery, postpartum haemorrhage, significant perineal trauma, shoulder dystocia and admission of the baby to a special care unit were analysed. Findings: CAM did not have an effect on rates of induction of labour in nulliparous or multiparous women attending the post-dates clinic. However, we noted that nulliparous women who received CAM had shorter labours (mean 8.4 vs 10 h, p = 0.0002), less oxytocin augmentation (23% vs 35%, p = 0.0002), lower epidural rates (41% vs 50.5%, p = 0.02) and reduced blood loss regardless of mode of delivery (mean reduction 82ml, p = 0.03; 95%CI = -159 to -5). There were no significant differences in secondary outcomes when CAM was used in multiparous women apart from a 5.3 times increased risk of significant perineal trauma (6% vs 2%, p = 0.004) and those who had their labours induced after CAM had a higher risk of requiring an emergency caesarean section (5% vs 1%, p = 0.012). There was no difference on shoulder dystocia and neonatal admissions rates with CAM. Conclusion: There is no reduction in induction of labour rates with the use of CAM. The other effects of CAM on labour and delivery outcomes are varied and potentially only beneficial in a selected group of women. Further research must be carried out before making any clear recommendations on its use.

Objective: The number of cancer patients who survive more than 5 years after the completion of their initial treatment is increasing. Oncology nurses must consider the needs of long-term cancer survivors in addition to those of cancer patients undergoing treatment because cancer survivors experience anxiety over several issues, including the risk of recurrence and progression of cancer status and symptom management. Methods: We tried to examine the effect of complementary therapy (CT) to reduce anxiety. The experimental study compared an intervention group (5 males and 68 females) that underwent four CTs and a control group (5 males and 56 females) that received no intervention. The intervention group practiced the CTs in their home for 20 min/day, 2 days/week, for 8 weeks, for a total of 16 times, whereas the control group performed their usual routines. Stress response scale-18 (SRS-18) scores consisting of three subscales (depression-anxiety, temper-anger, and lethargy) were compared between the groups and across time within each group. Results: The intervention group reduced depression and anxiety significantly than the control group. Furthermore, the intervention group expressed the following positive feedback: "being able to relax," "being distracted from their worries and anxieties," "being able to sleep," "feeling more in-touch with reality," and "wanting to continue the practice." Conclusions: The study might accurately reflect the perspectives of women with cancer because the majority of the patients were women. Meanwhile, the result suggests that CTs might be useful for long-term cancer survivors who experience anxiety that influence their quality of life.

Objective: This study was to examine the effect of complementary therapy (CT) for nurses with high stress levels. It was taken before we employ this technique for cancer survivors because cancer patients are a heterogeneous group that requires substantial resources to investigate. Methods: A quasi-experimental design with five groups was employed for this study. The groups were examined whether there were effects for reducing the stress and the differences in effectiveness among four intervention groups and a nonintervention group. Stress relief was measured using pulse rate and blood pressure measurements and the short form of the profile of mood states (POMS-SF). The participants practiced the therapy for 20 min twice per week for 3 weeks. A two-way factorial analysis of variance was used to analyze the data. Results: The study enrolled 98 nurses (92 female and 6 male) with a mean age of 37.3 ± 10.5 years (range: 22–60 years). Fifty-nine nurses had 10 or more years of nursing experience. There were significant differences in pulse rate and the POMS-SF scores. All groups were effective for reducing the stress level of high-stress nurses, whereas four intervention CT groups were not more effective than nonintervention group. Conclusions: The complementary therapies were useful for nurses with high stress levels. Thus, they can be used as a self-management tool for such nurses. Afterward, we will use the CT for cancer survivors to determine whether it can improve the quality of life of cancer patients.

Objective: The purpose of this systematic review is to ascertain the impact of inhalation aromatherapy on stress and anxiety in clinical settings., Methods: A search strategy was developed using various databases. Randomised Controlled Trials (RCTs) as well as single and double-blind pilot clinical studies (non-RCT) using inhalation aromatherapy with an essential oil blend or a single essential oil were examined. All studies included a control intervention and use of a validated measurement tool. The time period under review was years 2000-2021. Due to the high level of heterogeneity and element of bias, a narrative synthesis was conducted., Results: The search strategy initially retrieved 628 studies and through application of the selection criteria and the removal of duplicates, 76 studies were selected for review with a total of 6539 patients. In 42% of the RCTs, physiological measures including vital signs and/or salivary cortisol were used in addition to questionnaires. Over 70% of the studies reported a positive effect on anxiety levels in the aromatherapy intervention groups compared with the control. However, in many cases this is limited by the absence of safety data, imprecise reporting of plant species and dosage of essential oil., Conclusion: Inhalation aromatherapy has the potential to reduce stress and anxiety with data emerging to further support this result across a wide modality of clinical treatments. However, there is a clear need for the development of standard protocols for research in this area, generating measurable results which will create the opportunity for more rigorous evidence-based outcomes., Competing Interests: Declaration of competing interest Fiona Hedigan is also employed by Fiona Hedigan & Associates Limited. She is conducting her postgraduate research as part of a collaboration agreement between the Enterprise Partner (Fiona Hedigan & Associates Limited) and Trinity College Dublin., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Cancer is one of the deadliest diseases against humans. To tackle this menace, humans have developed several high-technology therapies, such as chemotherapy, tomotherapy, targeted therapy, and antibody therapy. However, all these therapies have their own adverse side effects. Therefore, recent years have seen increased attention being given to the natural food for complementary therapy, which have less side effects. Garlic 大 蒜 Dà Suàn; Allium sativum), is one of most powerful food used in many of the civilizations for both culinary and medicinal purpose. In general, these foods induce cancer cell death by apoptosis, autophagy, or necrosis. Studies have discussed how natural food factors regulate cell survival or death by autophagy in cancer cells. From many literature reviews, garlic could not only induce apoptosis but also autophagy in cancer cells. Autophagy, which is called type-II programmed cell death, provides new strategy in cancer therapy. In conclusion, we wish that garlic could be the pioneer food of complementary therapy in clinical cancer treatment and increase the life quality of cancer patients.

Background: : During the coronavirus disease (COVID-19) pandemic, health care workers (HCWs) have faced a heightened risk of infection. Preventative measures are critical to mitigate the spread of COVID-19 and protect HCWs. Traditional Chinese medicine (TCM) has been recommended to prevent and treat COVID-19 in China. We conducted this survey to investigate the use of infection control behaviors, preventative and therapeutic interventions, and outcomes among HCWs during the surge of Omicron variant infections to explore the association of preventative measures with outcomes and to investigate the factors influencing the adoption of TCM as a preventative measure., Methods: : The questionnaire consisted of 23 sections with 154 questions intended for HCWs. The targeted respondents comprised all HCWs from Xiamen Hospital Affiliated of Beijing University of Chinese Medicine. The recruitment process was open between March 17 and June 1, 2022. Chi-square test was used to estimate the relationship between prevention and outcomes. Multivariable logistic regression was used to investigate factors influencing the use of TCM as a preventative measure., Results: : Among the 1122 participants who completed the questionnaire, 79.71% took preventative measures, including TCM (56.21%), physical activities (52.37%) and food supplements (26.99%). Xiamen preventative formula (a government-approved fixed prescription) (45.22%) and Lianhua Qingwen preparations (18.95%) were the most commonly used Chinese medicines. Thirty-six participants reported flu-like symptoms and three were diagnosed with COVID-19. Flu-like symptoms were not associated with prevention, vaccination, or TCM. Frontline working experience (OR = 0.61, 95% CI: 0.46-0.80), good knowledge of post-COVID-19 syndrome (OR = 0.57, 95% CI: 0.39-0.84), Western medicine qualifications (OR = 2.41, 95% CI: 1.51-3.86), nurses (OR = 1.70, 95% CI: 1.21-2.40), and medical technicians (OR = 2.27, 95% CI: 1.25-4.10) were associated with the willingness of using TCM as a preventative measure., Conclusion: : Complementary medicine, especially TCM, could be used for COVID-19 prevention. Knowledge of COVID-19 may prompt people to use TCM to prevent COVID-19. Multicenter studies and prospective cohort follow-up studies are needed to provide further insights into the use of TCM for COVID-19 management., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Xiaohua Pei reports article publishing charges was provided by Xiamen Municipal Bureau of Science and Technology. Co-responding author Jianping Liu is one of editorial board members of the European Journal of Integrative Medicine. Co-author Xiaoyang Hu is one of editorial board members of the European Journal of Integrative Medicine. Co-author Chun-li Lu is the managing editor of the European Journal of Integrative Medicine., (© 2023 Published by Elsevier GmbH.)

Background: Asthma is one of the most common non-communicable diseases. Yoga with physical postures, breathing exercises, meditation, and relaxation may play an essential role in the complementary management of lower respiratory diseases. The study aimed to evaluate the impact of yoga (posture, breathing exercises, and meditation) on pulmonary function tests, asthma control tests, and health-related quality of adult asthmatic patients., Methods: MEDLINE, PubMed, Embase, Cochrane, Scopus, Google Scholar, ResearchGate, Clinical Key, and Academia electronic search engines were explored to search the relevant literature. The present study included adult asthmatic patients (age -18 and 60 years) with mild to moderate asthma, per GINA (Global Initiative for Asthma) guidelines. The effect of yoga was assessed on the following outcomes; pulmonary function tests, including FeV1 (Forced expiratory volume 1 s), FVC (Forced vital capacity), FeV1/FVC, peak expiratory flow rate (PEFR), health-related quality of life, and asthma control test. A fixed-effect model was applied to compute significance for statistical heterogeneity. P-value <0.05 was considered for statistical significance., Results: Finally, fifteen articles were included for meta-analysis. The forest plot for overall effect of yoga intervention and usual care favors the yoga intervention for improvement in pulmonary function as FeV1 (SMD = 0.96, CI = 0.77-1.14, I 2  = 54%), FVC (SMD = 0.35, CI = 0.14-0.55, p = 0.11, I 2  = 50%), Fev1/FVC (SMD = 0.18, CI = -0.38-0.02, p = 0.02, I 2  = 50%), PEFR (SMD = 0.38, CI = 0.18-0.58, p = 0.0003, I 2  = 0%), asthma control test (SMD = 0.16, CI = 0.15-0.48, p = 0.31, I 2  = 86%) and health-related quality of life (SMD = 0.26, CI = 0.18-0.34, p = 0.02, I 2  = 51%) of asthmatic patients., Conclusion: This meta-analysis provides a moderate level of evidence regarding yoga as a complementary therapy in managing mild to moderate asthmatic patients. It also adds to the current knowledge of the same., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Complementary therapy in oncology aims to help patients better cope with the illness and side effects (SEs) of cancer treatments that affect their quality of life (QOL). This study aimed to assess the benefits of homeopathic treatment on the health-related QOL (HRQOL) of patients with non-metastatic breast cancer (BC) prescribed in postsurgical complementary therapy., Patients and Methods: An extraction from the French nationwide healthcare database targeted all patients who underwent mastectomy for newly diagnosed BC between 2012 and 2013. HRQOL was proxied by the quantity of medication used to palliate the SEs of cancer treatments., Results: A total of 98,009 patients were included (mean age: 61 ± 13 years). Homeopathy was used in 11%, 26%, and 22% of patients respectively during the 7 to 12 months before surgery, the 6 months before, and 6 months after. Thereafter, the use remained stable at 15% for 4 years. Six months after surgery, there was a significant overall decrease (RR = 0.88, confidence interval (CI) 95  = 0.87-0.89) in the dispensing of medication associated with SEs in patients treated with ≥ 3 dispensing of homeopathy compared to none. The decrease appeared to be greater for immunostimulants (RR = 0.79, (CI) 95  = 0.74-0.84), corticosteroids (RR = 0.82, (CI) 95  = 0.79-0.85), and antidiarrheals (RR = 0.83, (CI) 95  = 0.77-0.88)., Conclusion: The study showed an increasing use of homeopathy in patients with BC following diagnosis. This use was maintained after surgery and seemed to play a role in helping patients to better tolerate the SEs of cancer treatments., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Purpose: Mindfulness-based intervention (MBI) has been suggested as a method to alleviate mental health difficulties during the perinatal period. However, few studies have examined its use in improving maternal role adaptation. This study aimed to investigate the effectiveness of mindfulness in maternal role adaptation among first-time mothers., Materials and Methods: This randomized controlled trial study was performed on 40 first-time mothers who were randomly assigned into experimental (n = 20) and control (n = 20) groups. Research instruments included a demographic questionnaire and a validated Maternal Role Adaptation Questionnaire (MRAQ). In addition to receiving routine care, mothers in the experimental group attended eight 90-min sessions of mindfulness-based intervention. The control group, however, received only routine care. Both groups completed MRAQ before intervention, and immediately, one month, and two months after it., Results: After intervention, there was a significant increase in the mean scores of MRAQ and its seven domains in the experimental group at all three follow-up intervals (P < 0.001). These domains included "support and strengthening of the couples' relationships", "hardship and dissatisfaction", "mother-infant attachment", "stress and anxiety", "emotional growth", "functionality" and "social adaptation development"., Conclusion: The intervention implemented in this study could be effective in promoting maternal role adaptation., Competing Interests: Declaration of competing interest None declared., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: There is significant interest in the use of complementary therapies to control or reduce the severity of constipation., Aim: The aim of this study was to determine the effect of abdominal massage on the severity of constipation in elderly patients with fractures., Methods: In this randomized clinical trial, 60 elderly patients admitted to an Iranian orthopedic referral hospital who were suffering from constipation were randomly assigned to intervention and control groups. For the intervention group, abdominal massage was performed for 3 days, twice a day, for 15 minutes. Both groups were assessed using the Constipation Assessment Scale (CAS) and the Bristol Stool Scale (BSS)., Results: A statistically significant difference was observed between the two groups in BSS scores (p < 0.05). The mean CAS scores in the intervention group decreased from 10.74 to 4.51 after intervention and in the control group, it decreased from 10.20 to 7.37. There was a statistically significant difference in CAS scores between the two groups (p < 0.05)., Conclusion: The results of the study showed the positive effect of abdominal massage on stool consistency and reduction of severity constipation., Competing Interests: Declaration of competing interest The authors of this study declared no conflict of interest., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: The present study aimed to evaluate the safety and prophylactic efficacy of add-on Comprehensive Ayurveda and mindfulness-based Yoga (CAY) regimen to standard care among HealthCare Workers (HCWs) against COVID-19., Materials and Methods: This prospective single-blind (outcome assessor-blinded) RCT was conducted in tertiary care hospital in Delhi during July 2020-April 2021. HCWs of both sexes were randomized to add-on CAY intervention or control group. The primary outcomes were the incidence of confirmed COVID-19 positive cases and influenza-like illness events (ILI). Secondary outcomes were anxiety (GAD-7), depression (PHQ-9), and quality of life (SF-36) at the end of 12 weeks., Results: Three hundred fifty-six participants (181 in intervention and 175 in the control group) were randomized. With the modified intention to treat approach, we analyzed 309 participants. The mean age for the intervention and control group was 39.3 ± 10.1 and 36.6 ± 10 years, respectively. Incidence of COVID-19 event was higher in control group compared to CAY group (16 of 164 [9.8%] vs. 11 of 145 [7.6%]; P = 0.50). The incidence of ILI events was also higher in the control group as compared to the CAY group (14 of 164 [8.5%] vs 9 of 145 [6.2%]). The health change domain of the SF-36 questionnaire showed statistically significant improvement in the CAY group as compared to the control group (P < 0.01)., Conclusion: Incidence of COVID-19 and ILI events was lower in the CAY group compared with the contr ol group, though the difference is not statistically significant., (Copyright © 2022. Published by Elsevier Ltd.)

Children with Cerebral Palsy (CP) commonly experience unpleasant symptoms such as pain, anger, and sadness. The purpose of this quasi-experimental study, guided by the Theory of Unpleasant Symptoms (TOUS), was to examine the practicality and impact of delivering Reiki Therapy (RT) in homes over an 8-week intervention phase to children with CP. Thirteen pediatric participants were recruited, ranging in age from 5 to 16 years. Reiki Therapy was administered by a Level 3 Reiki Therapist in the home for 8 consecutive weeks. Parents completed on-line questionnaires addressing their children's unpleasant symptoms. Hair cortisol was measured as an indicator of stress. Nearly all study procedures were completed by the participants, indicating that the methods are feasible for a larger study. Reiki Therapy significantly decreased pain while lying down (3.09 vs. 2.00; p = .002) but not while sitting (2.55 vs. 2.09; p = .40). Anger symptoms showed a trend towards improvement in the participants. These preliminary findings demonstrate that Reiki is a therapeutic modality worthy of further investigation in the CP pediatric population., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes significant disability and reduced quality of life. Scientific studies on yoga have revealed its various health benefits in chronic conditions, including autoimmune diseases. However, whether yoga is feasible for AS patients or not is not studied. Further, no validated yoga module is available for AS patients., Objective(s): This study intended to develop a yoga module for AS patients and investigated its feasibility of use., Materials and Methods: The study was completed in three stages. In Stage I, six yoga experts prepared a list of 64 yoga practices based on the classical and contemporary yogic literature review. Of these practices, 41 were included in the designed yoga module. In Stage II, 41 experts with a minimum of five years of experience in yoga therapy were invited for yoga module validation. The usefulness of the practices was rated by experts on a 3-point scale (1: not at all useful, 2: moderately useful, and 3: very much useful). The Lawshe content validity ratio (CVR) method was used for the content validity of the yoga module. Practices with a CVR score of > 0.3 were retained in the final yoga module. In Stage III, a certified yoga instructor administered the validated yoga module to 19 AS patients (average age: 35.5 ± 10.7 years) thrice weekly for a month. Feasibility was assessed on the basis of the attrition rate, retention rate, attendance of the participants, and the subjective response on practical sessions using a structured checklist., Results: Of the 41 practices in the module, 31 had a CVR score of > 0.3 and were included in the final yoga module. Of the 25 participants, 19 (76%) completed the study while six dropped out (24%). Nineteen patients reported greater improvement in pain and flexibility. They found yoga relaxing and easy to practice. Most participants (65%) were able to practice a minimum of 30 min/day., Conclusion: The present study offers a validated yoga module consisting of 31 practices for AS patients. The results of the pilot suggested that the module is feasible, acceptable, and easy to practice for AS patients. We recommend that AS patients should practice this yoga module for a minimum of 30 min every day under the supervision of a yoga expert., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: This study aimed to investigate quality of life (QOL) improvement in long-term cancer survivors using complementary therapy (CT) as mind-body practice., Methods: A quasi-experimental study including intervention and control groups was conducted. Participants in the intervention group engaged in CTs, including music therapy, progressive muscle relaxation, and deep-breathing exercises for 8 weeks at home. QOL was evaluated in both the groups using Short Form-8 (SF-8) questionnaire before the experiment and at 4 and 8 weeks after starting the experiment. To examine QOL, we compared SF-8 subscale scores, the physical and mental component summaries of QOL., Results: Cancer survivors were assigned to the intervention and control groups, comprising 69 and 59 individuals. There were no significant differences in QOL between the two groups with low scores, but there was a significant difference in the mental aspect of QOL in 4 weeks, indicating that the intervention group was lower than the control group. Meanwhile, the intervention group tended to experience increased changes in the mental aspect of QOL in 8 weeks compared to 4 weeks, although there was no significant difference., Conclusions: CT did not exhibit an effect on QOL among cancer survivors, especially in 4 weeks. This might have been due to sample size, participants' potential low compliance resulting in an inability to confirm whether the CTs were performed accurately and continuously, and consideration of what CT suited them. Meanwhile, CT may require a longer time to increase QOL. We recommend further studies to address these factors when conducting CT as mind-body practice., Competing Interests: The corresponding author, Prof. Kazuko Onishi, is an editorial board member of Asia-Pacific Journal of Oncology Nursing. The article was subject to the journal's standard procedures, with peer review handled independently of Prof. Onishi and their research groups., (Copyright: © 2021 Ann & Joshua Medical Publishing Co. Ltd.)

Objective: Provide strategies for improving the care of perimenopausal and postmenopausal women based on the most recent published evidence., Target Population: Perimenopausal and postmenopausal women., Benefits, Harms, and Costs: Target population will benefit from the most recent published scientific evidence provided via the information from their health care provider. No harms or costs are involved with this information since women will have the opportunity to choose among the different therapeutic options for the management of the symptoms and morbidities associated with menopause, including the option to choose no treatment., Evidence: Databases consulted were PubMed, MEDLINE, and the Cochrane Library for the years 2002-2020, and MeSH search terms were specific for each topic developed through the 7 chapters., Validation Methods: The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and weak recommendations). INTENDED AUDIENCE: physicians, including gynaecologists, obstetricians, family physicians, internists, emergency medicine specialists; nurses, including registered nurses and nurse practitioners; pharmacists; medical trainees, including medical students, residents, fellows; and other providers of health care for the target population., Summary Statements: RECOMMENDATIONS., (Copyright © 2021 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.)

Background: and purpose: Preoperative anxiety is an important factor for postoperative complications, and many patients are using aromatherapy to relieve preoperative anxiety. This study aimed to evaluate the effect of aromatherapy on preoperative anxiety in adult patients., Methods: An electronic search of six databases (Cochrane Library, PubMed, Embase, CINAHL, CNKI, and WanFang Data) was conducted for full-text publications of trials published from the inception of the databases to February 20, 2020. All randomized controlled trials (RCTs) where aromatherapy was used for treatment of preoperative anxiety were included. Interventions included all types of aromatherapy compared to standard care or placebo. The primary outcome was self-rated anxiety and the secondary outcome was adverse effect. Two researchers independently screened and extracted relevant data. A random-effects model was utilized to calculate the effect size as mean difference (MD)., Results: Our search retrieved 347 records. Thirteen trials were included for qualitative analysis, of which ten RCTs with 750 patients were included for meta-analysis. Most studies had a high or unclear selection and performance bias. Overall, aromatherapy was found to decrease preoperative anxiety significantly compared to the control group (MD = -3.95, 95%CI [-6.36, -1.53], P = 0.001). According to subgroup analysis, most subgroups showed a significant effect of aromatherapy on preoperative anxiety, except for the no treatment subgroup (MD: 5.40, 95%CI: 7.76 to 0.71) and female subgroup (MD: 3.96, 95%CI: 9.19 to 1.27)., Conclusion: Aromatherapy may be an effective complementary treatment for preoperative anxiety. Nevertheless, due to methodological limitations of the included trials, further studies with strict control of the research design are required for firm recommendations., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background and Purpose: Migraine affects approximately 2% of the population of the UK with around 190,000 people experiencing a migraine daily. This study investigated the effectiveness of reflexology on migraine symptoms provided under pragmatic, personally funded conditions., Materials and Methods: Data was gathered on a case series of 20 reflexology clients with medically diagnosed migraine. All participants self-referred to a member of the Association of Reflexologists (AoR). The Measure Yourself Medical Outcome Profile (MYMOP) was completed at each appointment. All participants received six reflexology sessions., Results: In terms of an improvement in the overall MYMOP profile, 75% (n = 15) of clients had an improvement of two or more points. The minimal clinically important difference for the MYMOP change score is 1.0; this was achieved by 90% (n = 18) of participants. The mean difference in scores for each of the MYMOP aspects was calculated and the greatest improvement was found with symptom 1, their chosen primary symptom, which changed an average of 3.40 points (95% CI: 2.35, 4.45.) CONCLUSION: The results indicate the potential for reflexology to relieve the symptoms of migraine., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: This study was aimed to assess the effectiveness of auriculotherapy on managing nausea and vomiting during pregnancy., Methods: In this randomized clinical trial, 128 pregnant women suffering from nausea and vomiting were selected and assigned to study groups. The data were collected using demographic information and Rhodes' questionnaires and analyzed in SPSS v.22., Results: After intervention, the average nausea score of the Rhodes index declined significantly in patients in the intervention group (p < 0.001).However, there was no significant (p = 0.305) difference between the two groups regarding vomiting. The results of the repeated measures showed that interventions had a significant effect on the total score of the questionnaire and also the scores regarding nausea (p < 0.04)., Conclusion: The appropriate use of effective points on ears to control nausea and vomiting as a non-medicine and complementary treatment can alleviate nausea among pregnant women., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background and Purpose: Congenital muscular torticollis (CMT) is a musculoskeletal condition occurring in infants and children. This systematic review is conducted to summarize the current evidence on the effects and safety of TCM massage therapy for the treatment of CMT in infants and children., Methods: We searched for randomized controlled trials (RCTs) and quasi-RCTs on TCM massage for CMT in PubMed, Embase, CENTRAL, CINAHL, AMED, PsycINFO, Ovid MEDLINE, TCMLARS, ICTRP, CSTJ, CNKI, Wanfang Data, CBM, Taiwan Electronic Periodical Services, and the Index to Taiwan Periodical Literature System. Two reviewers conducted the data collection and analysis separately. Cochrane's collaboration tool was used to assess the risk of bias, and GRADEpro was used to assess the overall quality of the evidence. RevMan 5.3 software was used for data analysis with a random-effect model., Results: A systematic review of six RCTs and one quasi-RCT was conducted with a meta-analysis of two of the RCTs. Pooled analysis showed that TCM massage has similar effects to those of stretching therapy on CMT symptoms in terms of effective rate (risk ratio: 1.00, 95% CI: 0.94-1.06; I 2  = 0%; P = 0.99)., Conclusion: Evidence suggests that TCM massage therapy is beneficial for treating CMT in infants and children. Further clinical trials with high-quality methodologies need to be conducted., Competing Interests: Declaration of competing interest All authors declared there is no conflict of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Distal sensory peripheral neuropathy (HIV-DSP) affects upwards of 50% of people living with HIV. Causing often debilitating symptoms of tingling, numbness and burning, HIV-DSP can result in disability, unemployment and low quality of life. Comorbidities further complicate nursing care, heightening risk of polypharmacy and symptom exacerbation. Therefore, a neurological sensory assessment, combined with the patient's self-report of symptoms, can help nurse practitioners visualize, quantify and understand symptoms. Common pharmacological interventions include antiepileptics, antidepressants, analgesics and medical marijuana. The complexity of care for individuals with HIV-DSP merits a comprehensive approach. Implications for practice include interdisciplinary management with neurologists, podiatrists, mental health providers, and nurse-led counseling inclusive of patient safety teaching.

Background: There are numerous reports worldwide on the use of complementary therapy for female infertility. This paper presents an overview of the available systematic reviews (SRs) on the outcomes of complementary therapy for female infertility., Methods: Electronic databases, including Pubmed, the Cochrane Central Register of Controlled Trials (CENTRAL) and Google scholar, and six Korean medical databases (KoreaMed, KMBASE, OASIS, NDSL, KCI, and RISS) will be searched from their date of inception. Eligible SRs will be independently selected by two authors, according to the defined inclusion criteria. Methodological quality of the final selected SRs will then be evaluated using the 'Assessment of multiple systematic reviews 2 (AMSTAR2)'. Finally, we will report on the characteristics and outcomes of efficacy and safety of each individual SR., Discussion: This overview will apprise the overall quality and evidence of the outcomes of SRs of complementary therapy for female infertility., (© 2020 Korea Institute of Oriental Medicine. Publishing services by Elsevier B.V.)

Objective: The purpose of this study was to determine the effects of foot reflexology on depression during menopause., Design: Randomized controlled clinical trial., Setting: Gynecology outpatient clinic., Interventions: We enrolled 90 menopausal women with depression. Participants were assigned to the intervention (n = 45) and control (n = 45) groups by block randomization. Participants in the intervention group received 15 min of foot reflexology on each foot for a total of 30 min in evenings, twice a week for six weeks. Participants in the control group received only the routine care for menopause patients., Main Outcome Measures: The Beck Depression questionnaire was completed by all participants at the beginning of the trial and the end of the intervention and two months after completion of the intervention., Results: A total of 121 patients were assessed for eligibility to participate in the study. One-hundred patients met the criteria to participate, and 90 participants-45 participants in each group-completed the study. In the intervention group, the mean scores of depression before, immediately after, and two months after the study were 26.97 ± 4.47 (95% CI = 25.3-28.3), 22.55 ± 5.18 (95% CI = 20.9-24.1), and 21.20 ± 5.74 (95% CI = 19.4-22.9), respectively. In the control group, these scores were 26.15 ± 5.01 (95% CI = 24.6-27.6), 26.22 ± 5.14 (95% CI = 24.7-27.7), and 26.66 ± 3.87 (95%CI = 25.5-27.8), respectively. Using Repeated Measures ANOVA, the comparison of the mean scores of depression in the two groups indicated that the scores were decreased over time., Conclusion: The findings indicated that the foot reflexology technique can be effective for reducing women's depression during menopause. However, considering the study's limitations, including a small sample size and no intervention in the control group, more studies are needed to verify the findings., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objectives: This study:Healthy Active and in Control (HA1C), examined the feasibility and acceptability of yoga as a complementary therapy for adults with Type-2 Diabetes (T2DM)., Design: A 2-arm randomized clinical trial comparing Iyengar yoga with a supervised walking program., Setting: Hospital based gym-type facility and conference rooms., Interventions: Participants were randomized to a 12-week program of either; (1) a twice weekly Iyengar yoga, or (2) a twice-weekly program of standard exercise (SE)., Main Outcome Measures: Primary outcomes assessed feasibility and acceptability, including enrollment rates, attendance, study completion, and participant satisfaction. Secondary outcomes included HbA1c, physical activity, and measures of diabetes-related emotional distress, self-care and quality of life (QOL). Assessments were conducted at baseline, end of treatment, 6-months and 9-months post-enrollment., Results: Of 175 adults screened for eligibility, 48 (30 women, 18 men) were eligible and enrolled. The most common reasons for ineligibility were orthopedic restrictions, HbA1c levels <6.5 and BMI > 42. Session attendance was high (82% of sessions attended), as was follow-up completion rates (92%). Program satisfaction rated on a 5-point scale, was high among both Yoga (M = 4.63, SD = 0.57) and SE (M = 4.77, SD = 0.52) participants. Overall 44 adverse events (26 Yoga, 18 SE) were reported. Of these, six were deemed "possibly related" (e.g., neck strain, back pain), and 1 "probably related" (ankle pain after treadmill) to the study. Yoga produced significant reductions in HbA1c. Median HbA1c at 6 months was 1.25 units lower for Yoga compared to SE (95% CI: -2.54 -0.04). Greater improvements in diabetes self-care, quality of life, and emotional distress were seen among Yoga participants than among SE participants. Increases in mindfulness were seen in Yoga but not in SE., Conclusions: The yoga intervention was highly feasible and acceptable, and produced improvements in blood glucose and psychosocial measures of diabetes management., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Context: The aim of palliative care is to improve quality of life for patients with serious illnesses by treating their symptoms and adverse effects. Hospice care also aims for this for patients with a life expectancy of six months or less. When conventional therapies do not provide adequate symptom management or produce their own adverse effects, patients, families, and caregivers may prefer complementary or alternative approaches in their care., Objectives: The objectives of this study were to evaluate the available evidence on the use of complementary or alternative medicine (CAM) in hospice and palliative care and to summarize their potential benefits., Methods: A defined search strategy was used in reviewing literature from major databases. Searches were conducted using base terms and the symptom in question. Symptoms included anxiety, pain, dyspnea, cough, fatigue, insomnia, nausea, and vomiting. Studies were selected for further evaluation based on relevancy and study type. References of systematic reviews were also assessed. After evaluation using quality assessment tools, findings were summarized and the review was structured based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines., Results: Out of 4682 studies, 17 were identified for further evaluation. Therapies included acupressure, acupuncture, aromatherapy massage, breathing, hypnotherapy, massage, meditation, music therapy, reflexology, and reiki. Many studies demonstrated a short-term benefit in symptom improvement from baseline with CAM, although a significant benefit was not found between groups., Conclusion: CAM may provide a limited short-term benefit in patients with symptom burden. Additional studies are needed to clarify the potential value of CAM in the hospice or palliative setting., (Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Siddha system is a complementary system of medicine popular in South India. Information on common morbidities for which people seek care in Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) systems and especially in Siddha hospitals is very limited. This knowledge will help in prioritizing diseases and developing standard treatment guidelines., Objective(s): The present study was designed with the aim to describe the morbidity profile of the adult patients attending Siddha Out Patient Department (OPD) at Government Hospitals in Erode district of Tamil Nadu., Materials and Methods: A facility-based cross-sectional descriptive study was conducted among adult (15-59 years) patients, who attended Siddha Hospital OPDs during February, 2014. Two block level health facilities were randomly selected from ten block hospitals offering Siddha services in Erode district of Tamil Nadu. Information on socio-demographic characteristics like age, gender and education was captured using a pre-tested proforma. Diagnosis was done by treating Siddha practitioners as per reporting format. Data were single entered and analyzed using EpiData software., Results: Of the total 1786 patients who attended the Siddha OPD, 1720 (96%) completed the interviews. Mean (Standard Deviation) age of participants was 41 (11) years and 913 (53%) were females; 20% had no formal education. Of 1720 participants, arthritis (21%), neuritis (10%), fungal diseases (7%) were the top three morbidities, with arthritis and neuritis being most common morbidities in both males and females., Conclusion: Arthritis, neuritis and fungal diseases were the most common morbidities, for which patients sought care in Siddha hospitals. These morbidities can be considered for preparing standard treatment guidelines under the national programme., (Copyright © 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.)

Complementary therapies are being used more in the UK over the last two decades and yet very little evidence of their benefit is available. The aim of this study was to investigate, through face to face interviews with patients, using a phenomenological approach the perceived benefits of the different therapies in terms of their overall patient well-being. Eight patients; mean age 52.87years, range 40-64years presenting in the palliative care phase for life limiting conditions comprising one male and seven females agreed to participate in the study between March and September 2015. All eight participants reported perceived benefited from the therapies and that their identified concerns had been ameliorated. Participants reported feeling relaxed, calmer and being able to carry on with their daily lives and refocussing on themselves and what is important in life. Complementary therapies played a positive role, and therefore, an acceptable model of supporting palliative care patients., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objectives: This study aims to explore pregnant and postpartum women's understanding of the meaning of traditional and complementary medicine (T&CM) and how that may affect their T&CM use., Methods: A cross-sectional study was conducted using self-administered questionnaires. Data collected from 374 women were analysed and represented via descriptive statistics., Results: Out of the 374 participants, 285 (76.2%) reported using at least one type of T&CM to conceive, during pregnancy or in the postpartum period. The majority of the participants identified that T&CM is all about plants or natural products without chemicals or drugs (n = 267, 71.4%, p < .001). The category of T&CM with the highest usage was biological based therapies (n = 272, 95.4%), while the lowest was energy therapies (n = 8, 2.8%). The most commonly used T&CM was the traditional Malay massage (n = 170, 59.6%). The main sources of information and recommendations for using T&CM came from their family members or friends (n = 199, 69.8%). Almost half of the participants incurred minimum expenditures of MYR100 and below on the T&CM used (n = 137, 48.1%) and there was no significant difference between pregnant and postpartum women (p = .056)., Conclusion: This study reveals that many women are practising T&CM when trying to conceive and during pregnancy and the postpartum period even though they are aware that there is insufficient evidence on its safety and efficacy. Therefore, further studies are needed in order to gain sufficient clinical evidence that could be used to structure better guidelines for T&CM practices and services in Malaysia., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Background: The prevalence of insomnia increases with age. Chamomile is among the medicinal plants which are used as tranquilizer. Yet, there is inadequate experimental and clinical evidence regarding its hypnotic effects. This study sought to evaluate the effects of chamomile extract on sleep quality among elderly people., Design: A single-blind randomized controlled trial was performed., Setting: A convenient sample of sixty elderly people who aged sixty or more and lived in Kahrizak day care nursing home, Karaj, Iran, were randomly allocated to a control and a treatment group. The treatment group received chamomile extract capsules (200mg) twice a day for 28 consecutive days while the control group received wheat flour capsules (200mg) in the same manner. Using the Pittsburgh Sleep Quality Index, sleep quality was assessed immediately before, two weeks after beginning, immediately after the completion, and two weeks after the completion of the intervention. The data were analyzed via the independent-sample t, Chi-square, and Fisher's exact tests as well as the repeated measures analysis of variance., Results: The means of age in the control and the treatment groups were 70.73±6.44 and 69.36±4.99, respectively. Except for the habitual sleep efficiency component of the Sleep Quality Index, the study groups did not differ significantly from each other at baseline regarding the scores of the other components of the index. Moreover, at baseline, sleep quality in both groups was low, with no statistically significant between-group difference (P=0.639). However, after the intervention, sleep quality in the treatment group was significantly better than the control group (P<0.05)., Conclusion: The use of chamomile extract can significantly improve sleep quality among elderly people. Thus, it can be used as a safe modality for promoting elderly people's sleep., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Aims and Objectives: To analyze and clarify the concept of providing relief from anxiety using complementary therapies in the perioperative period utilizing the epistemological, pragmatic, linguistic and logical principles of a principle-based concept analysis to examine the state of the science., Background: The majority of patients scheduled for surgery experience anxiety in the perioperative period. Anxiety has the potential to limit a patient's ability to participate in his or her care throughout their hospitalization. Although medications are the conventional medical treatment for anxiety in the perioperative period, the addition of a complementary therapy could be an effective holistic approach to providing relief from anxiety., Design: Principle-based concept analysis., Methods: In 2015, strategic literature searches of CINHAL and PUBMED using keywords were performed. Fifty-six full text articles were assessed for eligibility., Results: Twelve studies were used in the final analysis to clarify the concept of relief from anxiety using complementary therapies in the perioperative period., Conclusion: This analysis has clarified the maturity and boundaries, within the four principles of a principle-based concept analysis, of the concept of relief from anxiety using complementary therapies in the perioperative period. A greater understanding of relief from anxiety using complimentary therapies in the perioperative period as an adjunct to conventional medicine will allow perioperative nurses and anesthesia providers to modify and specify the plan of care for their surgical patients. The use of complementary therapies for relief in the perioperative period appears to be an area of promising research and treatment for patients, families and providers., (Copyright © 2016 Elsevier Ltd. All rights reserved.)