Search

Complementary and alternative medicine (CAM) is a rapidly growing industry, with millions worldwide seeking these treatments for various ailments. While many CAM therapies have shown promise in improving health outcomes, there are also ethical challenges associated with them. In this article, we explore some of the most pressing ethical issues in CAM, including informed consent, justice in accessibility, and evidence-based therapies. This survey provides a comprehensive overview of the ethical issues in CAM and offers practical guidance for health-care providers navigating these complex issues. By understanding the ethical dilemmas in CAM, health-care providers can offer their patients safe and effective care while maintaining their professional and ethical obligations. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to identify how dietitians and other healthcare providers work to build trust in food systems in the course of providing dietary education. Methods: Qualitative semi‐structured interviews were conducted with 15 purposefully sampled dietitians (n = 5), general practitioners (n = 5), and complementary and alternative medicine practitioners (n = 5) within metropolitan South Australia. Interview data were then interpreted using an inductive thematic analysis approach, involving the construction of themes representing trust‐enhancing roles around which beliefs about professional roles, the 'patient', and food and health were clustered. Results: Healthcare providers communicate beliefs regarding (dis)trust in food systems through: (i) responding to patient queries and concerns following a food incident or scare; (ii) helping patients to identify (un)trustworthy elements of food supply systems; and (iii) encouraging consumption of locally produced and minimally processed food. Importantly, the expression of these roles differed according to participant beliefs about food and health (medico‐scientific versus alternative medicine) and their adoption of professional projects that sought to promote medico‐scientific ways of thinking about health and diet or manage the failures of Western medicine. Conclusion: The development and consolidation of trust‐enhancing roles amongst healthcare providers likely requires disciplinary reflection on professional values and the processes by which practitioners apply these values to understanding food systems. [ABSTRACT FROM AUTHOR]

An estimated 42% of Australians who consult complementary medicine (CM) practitioners have a mental health diagnosis. Preparedness of CM practitioners in managing such diagnoses is currently unknown. A cross-sectional survey of 257 CM practitioners who reported caring for people with a mental health diagnosis. Practitioners' mental health literacy, educational needs, and confidence in the assessment, management, and treatment of mental health—including suicide risk—were analysed. Most (59.1%) participants had no formal qualifications in mental health and 44.3% indicated they had not completed any training in psychological therapies. Only 20% were trained in mindfulness-based techniques or goal setting. Over 50% reported their undergraduate qualification contained insufficient mental health content to prepare them for clinical practice. Over one-half had attended continuing professional education on mental health. Practitioners reported greater confidence in assessing, managing, and treating mental wellbeing over complex mental health disorders and suicide risk. These findings uncovered a deficit in the CM practitioner's surveyed mental health education. As these CM practitioners are a primary point of contact for patients with mental health diagnoses, there is a critical need to expedite skills development in this workforce to support the delivery of safe and effective primary mental health care. [ABSTRACT FROM AUTHOR]

Protecting health-care provider (HCP) well-being is imperative to preserve health-care workforce capital, performance, and patient care quality. Limited evidence exists for the long-term effectiveness of HCP well-being programs, with less known about physiotherapists specifically. To review and synthesize qualitative research describing experiences of HCP, generate lessons learned from the greater population of HCP participating in workplace well-being programs, and then to inform programs and policies for optimizing psychological well-being in an understudied population of physiotherapists. This qualitative meta-synthesis included a systematic literature search conducted in September 2020; critical appraisal of results; and data reduction, re-categorizing, and thematic extraction (reciprocal translation) with interpretive triangulation. Twenty-five papers met the inclusion criteria. Participants included physicians, nurses, and allied health providers. All programs targeted the individual provider and included psychoeducational offerings, supervision groups, coaching, and complementary therapies. Four themes were constructed: 1) beneficial outcomes across a range of programs; 2) facilitators of program success; 3) barriers to program success; and 4) unmet needs driving recommendations. The findings enhance our understanding of diverse individual-level programs to address HCP well-being. Beneficial outcomes were achieved across program types with system-level support proving critical; however, HCP described barriers to program success (HCP characteristics, off-site programs, institutional culture) and remaining needs (resources, ethical dissonance) left unaddressed. Organizations should offer individual-level programs to support physiotherapists in the short term while pursuing long-term, system-level change to address drivers of well-being. [ABSTRACT FROM AUTHOR]

Background: Cancer patients often use complementary and alternative medicine (CAM), however, standardized assessment in clinical routine is missing. The aim of this study was to evaluate a screening questionnaire on CAM usage that was published in the S3 Guideline Complementary Medicine in the Treatment of Oncological Patients. Methods: We developed a survey questionnaire to assess the practicability of the guideline questionnaire and communication on CAM between health care providers (HCPs) and patients. We collected 258 guideline questionnaires and 116 survey questionnaires from ten clinics and held twelve semi-structured interviews with HCPs. Results: 85% used at least one of the listed CAM methods, 54 participants (N = 77) never disclosed usage to a physician. The most frequently used CAM methods were physical activity (76.4%) and vitamin D (46.4%). 25.2% used at least one method, that was labeled risky by the guideline. 53.4% did not know of CAM's risk of interactions and side effects. Introducing the guideline questionnaire in routine cancer care increased the rate of patients talking to an HCP regarding CAM significantly from 35.5 to 87.3%. The HCPs stated positive effects as an initiation of conversation, increased safety within CAM usage and patients feeling thankful and taken seriously. However, due to the limited amount of time available for discussions on CAM, generalized distribution to all patients was not feasible. Conclusion: Institutions should focus on implementing standard procedures and resources that help HCPs discuss CAM on a regular basis. HCPs should meet the patient's demands for CAM counseling and make sure they are equipped professionally. [ABSTRACT FROM AUTHOR]

Introduction: Over the last few decades, use of complementary and alternative medicine (CAM) has grown in popularity, changing health professionals' knowledge and attitude toward CAM, and the treatment recommended by them. The aim of the study was to evaluate the perception and practice of CAM among healthcare professionals. Methodology: A cross-sectional study was conducted among healthcare providers selected by multistage random sampling technique in two governmental hospitals and ten primary healthcare centers in two governorates in the Qassim region, Saudi Arabia. A web-based, self-administered questionnaire was distributed via social media platforms. Results: A total of 350 physicians responded to the survey. Good basic knowledge about CAM was reported by 48.6% of the respondents; a positive attitude was adopted by 53%; and CAM was actively practiced by 9.7%. Being a physician > 40 years and consultant affiliation were significantly associated with higher knowledge level about CAM (p = 0.006 and 0.03, respectively), as well as having a proactive practice (p = 0.007 and 0.04, respectively). Practicing CAM was prevalent among non-Saudi and married physicians (p = 0.02 for both). Knowledge about CAM and its practice were strongly correlated (p = 0.007). The most frequent constraints facing CAM practice were lack of knowledge and training on CAM (81.4%) and lack of studies supporting CAM (74.3%). Conclusions: The practices of health professionals in Qassim region need to be improved despite their expertise and favourable perception of CAM. Educational interventions could play greater roles in providing evidence-based CAM knowledge and enhancing training for physicians. [ABSTRACT FROM AUTHOR]

Introduction: Including traditional, complementary and integrative medicines in national health systems is a point of discussion worldwide. This article focuses on the theme within the scope of oncology in Latin America. Objective: To analyze the health care management dimensions included in scientific production in integrative oncology in Latin America. Materials and method: This is an integrative literature review carried out in the LILACS, Mosaico, IBECS, PubMed and Embase databases, whose guiding question was prepared according to The PRISMA 2020 Statement recommendations. The search occurred by the association of free terms related to the descriptors "Integrative Oncology," "Complementary Therapies," "Health Care," "Care Management," and "Countries That Make Up Latin America." Data were interpreted from the conceptual perspective of health care management dimensions. Results: The study selection process identified 206 studies. The final sample was made up of eight articles available online in full, published between 2017 and 2022 in Portuguese, Spanish or English. Articles were developed in Brazil (n = 4), Chile, Colombia, Peru, and Uruguay (n = 1, respectively). There was a predominance of the individual health care management dimension as the focus of analyzed studies. The "professional," "family," "societal," and "organizational" dimensions were presented in the discussion of results. Conclusions: Despite the insufficiency of studies, analysis of interdependence between dimensions indicates the complexity of the management process for integrating traditional, complementary and integrative medicine in oncological care in Latin America, which suggests an epistemology in the construction process. [ABSTRACT FROM AUTHOR]

Background: Understanding how patient-reported experiences of care and overall rating of care vary among patients with different characteristics is useful to help interpret results from patient experience surveys and design targeted improvement interventions. The primary objective of this paper was to identify the socio-demographic and health-related characteristics independently associated with overall rating of cancer care. The secondary objective was to explore if and how these characteristics were associated with specific experiences of cancer care. Methods: This cross-sectional multicenter study analyzed self-reported data collected from 2696 patients diagnosed with breast, prostate, lung, colorectal, skin, or hematological cancer from four large hospitals in French-speaking Switzerland. Multivariate logistic regressions with purposeful stepwise selection of independent variables were used to identify the socio-demographic and health-related characteristics independently associated with overall rating of cancer care in the primary analyses. In the secondary analyses, we ran the multivariate model from the primary analyses with specific experiences of care as outcomes to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) of the selected characteristics. Results: Respondents' mean rating of overall cancer care was 8.5 on a scale from 0 to 10, with 17% categorized as reporting a low rating (0–7 rating). Being a woman (OR 1.43, 95% CI 1.12–1.83), not being Swiss (OR 1.47, 95% CI 1.12–1.94), reporting lower health literacy (OR 1.95, 95% CI 1.54–2.47), preferring making medical decisions alone (OR 1.92, 95% CI 1.38–2.67), having forgone care due to cost (OR 1.72, 95% CI 1.29–2.29), having used complementary medicine (OR 1.55, 95% CI 1.22–1.97), and reporting poorer health (OR 3.12, 95% CI 2.17–4.50) were all independently associated with a low rating of overall cancer care. Poorer health, lower health literacy, and having forgone care were the three characteristics most often associated with problematic experiences of care. Conclusions: Our results identified several patient characteristics consistently associated with lower overall rating of care and specific experiences of cancer care. Among these determinants, health literacy and financial hardship emerged as key recurring factors shaping poor patient experiences that should be prioritized for attention by cancer care services. [ABSTRACT FROM AUTHOR]

Background: With the rapid increase in the prevalence of cancer worldwide, the utilization of complementary and alternative medicine (CAM) has increased among cancer patients. This review aimed to understand the perception, attitudes, and knowledge of healthcare professionals toward using CAM for cancer patients. Methods: A mixed‐methods systematic review was undertaken in four databases. Inclusion criteria were primary studies reporting perception, attitudes, and knowledge of healthcare professionals for using CAM for cancer patients were eligible. A mixed‐methods convergent synthesis was carried out, and the findings were subjected to a GRADE‐CERQual assessment of confidence. Results: Forty‐two studies were chosen. The majority of the studies were quantitative and had less than 100 participants. Most publications were from European countries, and oncology was the highest among the specialties. The review found the following themes: feasibility of having negative adverse effects, low expectations of using CAM among HCPs, potential positive effects of using CAM, specific CAM training may be helpful, no concrete regulations to promote CAM practice, and poor physician–patient communication. Conclusions: Nurses had more positive views than other professions; oncologists were concerned regarding herb–drug interactions; integration of CAM into the healthcare system was favorable; HCPs felt the need to participate in specific CAM training; and HCPs agreed that CAM education should be provided more regularly. Future studies should explore the studies views of cancer patients and details of in‐depth evidence of CAM in oncology settings. [ABSTRACT FROM AUTHOR]

The article discusses the author's experience with using a placebo-based approach to treat warts in a dermatology outpatient clinic. Topics discussed include the historical use of magic and remedies for various conditions, the role of placebos in medical practice, and the need for doctors and patients to work together as partners to achieve the best outcomes.

Increase in the morbidity of women during pregnancy and in the postnatal period, the known limitations using of modern synthetic drugs cause the search for ways of medical assistance, in particular use of phytotherapy. Aim: highlight the world and own experience of using phytotherapeutic agents during pregnancy and in the postnatal period, indications, limitations and threats. Materials and methods: used available monographic and journal sources in the electronic systems MED Line, EMBASE, Scopus, Web of Science using methods of analysis, comparison and generalization. Results. It has been established that scientists from the world's leading scientific centers state a growing interest in using of phytotherapy methods as one of the important approaches of medical pluralism in the pathology of pregnancy and in the postnatal period. depending on the level of economic development and the state of the medical industry of the state and the commonality and differences of the principles and forms of providing phytotherapeutic assistance. Commonality is that even ancient and simple methods and means of phytotherapy in this contingent of patients, along with modern ones in developed countries, are, albeit to varying degrees, effective and safe. In countries with a low socio-ecological level, simple methods according to ancient traditions are still forced to be used, mainly as a self-initiative or on the advice of friends, family, rarely - on the recommendations of specialists without clear recommendations regarding the duration and remote consequences of application, which is unfavorable. There are some difference between of using phytotherapy in the developed countries of Europe and USA is that various means, forms of plant factors are mainly manufactured in accordance with modern requirements of the Ministry of Health, are recommended on the basis of evidence-based medicine by properly trained obstetrics and gynecology personnel, modern sources of information are available for the improvement of medical personnel, training of pregnant women. The clear effectiveness and side effects of herbal preparations, their impact on the body of the mother, fetus and lactation processes are monitored. Various trainings and forms of improving using of herbal medicines are carried out and need for close contacts of obstetriciangynecologists with specialists in complementary and alternative medicine. Conclusions: Modern scientific studies testify to the effectiveness, safety and necessity of using herbal preparations in the pathology of pregnancy and the postnatal period as one of the important components of medical pluralism. The specifics of their use must comply with the requirements of the DMR and be recommended on the basis of evidence-based medicine. [ABSTRACT FROM AUTHOR]

Introduction Tinnitus is one of the most common otological complaints encountered. Patients often use the internet, especially YouTube videos, as a source of information regarding their health condition. There is a need to analyze the standard and quality of information in these videos so that the patients receive correct information. Objective The purpose of the present study was to evaluate the reliability and utility of YouTube videos on tinnitus. Methods The first 100 videos on YouTube using the search terms tinnitus and ringing in the ear were identified. Three subject experts assessed the reliability using the modified five-point DISCERN score and utility using a usefulness score. Various indices like view ratio, like ratio, video power index, and interaction index were also calculated. Results Out of the 100 videos selected, 34 were excluded; collectively the remaining 66 videos were viewed 12,797,730 times. The most common upload sources were hospital/physician (39%), paramedic health care providers (19%), and alternative medicine (19%). The discern score was the highest in hospital/physician group (mean 19.3) and lowest in patient experience group (mean 13.4). A negative correlation was observed between the number of views (correlation coefficient −0.214), number of likes (correlation coefficient −0.242), number of comments (correlation coefficient −0.242), and the usefulness score. Conclusion Although there are multiple videos on YouTube regarding tinnitus, the overall educational content and reliability of the videos are poor. Video popularity is not associated with usefulness. Healthcare providers should counsel patients regarding videos on YouTube and try to create more comprehensive videos. [ABSTRACT FROM AUTHOR]

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

The coronavirus disease 2019 (COVID-19) pandemic has impacted human lifestyles around the world, causing huge distress in terms of public health systems, emergency response capacity and economic development. The causative agent of COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is associated with respiratory involvement, cardiovascular-related diseases, and ultimately causes multiple organ failure and death in severely affected individuals. Thus, effective prevention or early treatment of COVID-19 is critical. An effective vaccine offers a way out of the pandemic for governments, the scientific community and people worldwide, but we still lack effective drug therapies, including treatments for the prevention and treatment of COVID-19. This had led to a high global demand for many complementary and alternative medicines (CAMs). Moreover, many healthcare providers are now requesting information about CAMs that prevent, relieve, or treat the symptoms of COVID-19 and even alleviate vaccine-related side effects. Experts and scholars must therefore become familiar with the use of CAMs in COVID-19, current research directions and effectiveness of CAMs for COVID-19. This narrative review updates the current status and research worldwide on the use of CAMs for COVID-19. The review provides reliable evidence on theoretical viewpoints and therapeutic efficacies of CAM combinations, and evidence in support of the therapeutic strategy of Taiwan Chingguan Erhau (NRICM102) against moderate-to-severe novel coronavirus infectious disease in Taiwan. [ABSTRACT FROM AUTHOR]

Complementary and alternative medicine (CAM) use in children with cancer has a high prevalence. If (parents of) patients bring up the topic of CAM, pediatric oncologists (POs) face considerable challenges regarding knowledge and professional behavior. In this study, we explore German POs' understanding of CAM and related attitudes as well as challenges and strategies related to CAM discussions by means of semi-structured interviews analyzed according to principles of qualitative thematic analysis with parents of children with cancer. We could conduct 14 interviews prior to theoretical saturation. The interviews had a duration of 15–82 min (M = 30.8, SD = 18.2). Professional experience in pediatric oncology was between 0.5 and 26 years (M = 13.8, SD = 7.6). Main themes identified were a heterogeneous understanding and evaluation of CAM, partly influenced by personal experiences and individual views on plausibility; the perception that CAM discussions are a possible tool for supporting parents and their children and acknowledgement of limitations regarding implementation of CAM discussions; and uncertainty and different views regarding professional duties and tasks when being confronted with CAM as a PO. Our interdisciplinary interpretation of findings with experts from (pediatric) oncology, psychology, and ethics suggests that there is need for development of a consensus on the minimal professional standards regarding addressing CAM in pediatric oncology. [ABSTRACT FROM AUTHOR]

This article discusses the impact of vascular medicine specialists on the utilization and management of inferior vena cava (IVC) filters in hospitalized patients. The study found that vascular medicine specialists recommended IVC filter placement in approximately one-third of consults, but also identified alternative strategies to filter placement in the majority of cases. Vascular medicine consultation contributed to lower IVC filter use at the institution, resulting in estimated cost savings. The study also highlighted the importance of vascular medicine follow-up in improving retrieval rates and individualizing patient evaluation. The authors suggest that future initiatives led by vascular medicine could further improve evaluation, tracking, and follow-up of IVC filters. [Extracted from the article]

Background: Women are known to use Complementary and Alternative Medicine (CAM) during pregnancy despite the subsequent potential unknown effects associated with its use. This study was performed to evaluate the use of CAM products and its related factors among pregnant women in Shiraz, Iran. Materials and Methods: This cross-sectional study of 365 pregnant women referred to obstetrics clinics affiliated to Shiraz University of Medical Sciences (Iran) was conducted in 2020. Sampling was performed in all three affiliated centers based on a probability, proportional to size protocol. Pregnant women were nominated using a systematic random sampling scheme using their health record numbers. A 20-item questionnaire was administered via in-person interviews and data on demographics, use of CAM products, reasons for use, and referral and information sources were collected. Binary logistic regression was applied and adjusted odds ratios were estimated. Results: CAM use was reported for recent pregnancies by 56.92% of participating women, with a significantly higher use in participants of low socioeconomic status (Chi2 1 = 5.12; p < 0.024). The main reason for CAM use was having faith in the efficacy of CAM (72.73%). Reported CAM use was restricted to herbal preparations. Most of the women who used CAM (73.0%) did not report their CAM use to their doctor. Conclusions: There is a high rate of CAM use among pregnant women. More maternal care services during current pregnancy, parity, and general and pregnancy-related history of CAM use were correlated with CAM use. Mother–healthcare provider relationship should be improved in the field of CAM. [ABSTRACT FROM AUTHOR]

Objectives: Immune enhancers are attracting attention day by day. Besides, during the coronavirus disease-2019 (COVID-19) pandemic, there has been an increasing demand for immune enhancers. Pharmacists are seen as trustable providers of complementary and alternative medicines, dietary and herbal supplements, immune-enhancers, and so on. This study aims to prioritization criteria that affect community pharmacists’ recommending behavior regarding immune enhancers. Materials and Methods: This paper adopts the analytic hierarchy process (AHP) to rank different criteria substantial for affecting community pharmacists’ recommending behavior regarding immune enhancers. In this direction, firstly seven criteria were identified through literature review and views of pharmacists who have community pharmacy experiences. These are; (i) ease of access, (ii) selling price, (iii) package, (iv) content (appropriateness to patient health status), (v) expectation of patient, (vi) quality, and (vii) trust in the manufacturer. Then, a questionnaire including criteria was prepared and delivered to community pharmacists. The data obtained from 93 participants were transferred to the Super Decisions software. The hierarchical structure of the AHP was established and pair-wise comparisons were made. Results: This study showed that the most important criterion was the ease of access (28%). Secondly, pharmacists give importance to the content of the product, while advising immune-enhancers (22%). Besides, it was determined that the least important criterion was the package of the product (4%). Conclusion: This study will contribute to the literature by facilitating the process of assessing factors that pharmacists pay attention to while recommending immune-enhancing products. Additionally, the present study results will shed light on firms producing such products, to shape their supply chain management strategies, especially for marketing and sales. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess the knowledge, attitudes, and practices of complementary and alternative medicine (CAM) among physicians and nurses at the American University of Beirut Medical Center (AUBMC) in Beirut, Lebanon. A web-based survey was emailed to 518 physicians and 423 registered nurses in all medical departments at AUBMC. Of the 94 physicians responding to the survey, 61% have never referred a patient to a CAM practitioner yet 33% reported that they would refer if available. Sixty-two percent of physicians believed that incorporating evidence-based CAM therapies will increase patient satisfaction and 66% thought that offering CAM would attract more patients. Of the 80 nurses who responded, 78.7% have never referred a patient to a CAM practitioner, yet half reported that they would likely refer if a CAM practitioner was available. Fifty-seven percent of nurses surveyed believed that offering CAM would attract more patients while 59% thought that it would increase patient satisfaction. Most nurses were uncomfortable counseling patients about CAM modalities. Favorable attitudes towards CAM were reflected by the physicians and nurses as signified by the above-average attitude means towards CAM (M = 4.01, SD =.16 and M = 3.25, SD =.59, respectively). The study findings demonstrate that despite the physicians' and nurses' limited knowledge and their discomfort in counseling on CAM, they expressed acceptability and willingness in using and incorporating CAM therapies into clinical practice at AUBMC. This is the first study conducted in Lebanon that assesses both nurses' and physicians' perspectives on the use of all CAM domains in general within the same healthcare setting. This study not only provides baseline data but also highlights the knowledge gap and learning needs among physicians and nurses with regards to CAM. [ABSTRACT FROM AUTHOR]

Professional development is a crucial aspect for further successful progression of an individual's skills and effective function in their role. It is also a compulsory part of registration for most professionals in the health care sector. This article reports on the evaluation of a monthly professional development program, specifically for spiritual care practitioners, offered over the period 2017–2019 by Spiritual Health Association (Victoria, Australia) and its partners. Many common themes such as motivation, culture, purpose and areas for improvement have been identified and are further examined. Recommendations such as greater emphasis on the professionalism in the sector, broader inclusions of sessions across culture and ethnicity and the development of cross disciplinary communication skills are made for the future of this program. [ABSTRACT FROM AUTHOR]

Background: Individuals with neck pain frequently turn to complementary and alternative medicine (CAM) to seek relief. However, conventional healthcare providers often lack adequate CAM therapy knowledge to deliver informed recommendations to patients. The purpose of this study was to identify mention of CAM in neck pain clinical practice guidelines (CPG) and assess the quality of CAM recommendations using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument.Methods: MEDLINE, EMBASE and CINAHL were systematically searched from 2009 to 2020 in addition to the Guidelines International Network and National Center for Complementary and Integrative Health websites. Eligible CPGs providing CAM recommendations were assessed twice with the AGREE II instrument, once to assess the overall CPG and then once to assess the CAM sections specifically.Results: From 643 unique search results, 15 CPGs on the treatment and/or management of neck pain were identified, and 8 made recommendations on CAM therapy. Regarding scaled domain percentages, the overall CPG scored higher than the CAM section for 5 of 6 domains (overall, CAM): (1) scope and purpose (93.4%, 93.1%), (2) stakeholder involvement (81.6%, 81.9%), (3) rigour of development (70.8%, 66.3%), (4) clarity of presentation (64.9%, 60.8%), (5) applicability (39.3%, 33.6%), and (6) editorial independence (47.9%, 45.3%).Conclusions: Most neck pain CPGs made CAM recommendations. The quality of CAM recommendations is lower than overall recommendations across all domains with the exception of stakeholder involvement. This disparity highlights the need for CAM recommendations quality improvement. Although many patients with neck pain seek CAM therapies, few CPGs are available for healthcare providers and patients. [ABSTRACT FROM AUTHOR]

This article discusses the issue of medical errors and how to navigate the challenges they present. It highlights the prevalence of adverse events in hospitals, estimating that around 10% of inpatients experience such events, with a significant number being preventable. The article also explores the legal perspective on medical errors in India, including criminal and civil liability, as well as disciplinary actions against doctors. It emphasizes the importance of effective communication, transparency, and trust between doctors and patients to prevent litigation. The author suggests that a checklist approach can help manage the complexity of modern medicine. [Extracted from the article]

Objectives: The main purpose of this study was to evaluate the subjective experience of Reiki in a large sample. Design: The study design was a single-arm pragmatic effectiveness trial with qualitative questions completed post-Reiki session. Setting: The study took place at private Reiki practices across the United States. Subjects: A total of 99 Reiki practitioners met the inclusion criteria and participated in the study. Reiki practitioners invited each of their Reiki clients to complete a survey before and after the Reiki session. Of the N = 1575 Reiki sessions recorded, N = 1284 qualitative responses were completed (82% of total) and included in the analysis. Interventions: Trained and experienced Reiki masters conducted Reiki sessions in person, with each session lasting between 45 and 90 min. Outcome measures: Participants were asked to describe their experience during the Reiki session. Results: Qualitative analysis revealed eight major themes: (1) deep relaxation and calm (68%), (2) body sensations/somatic experiences (53%), (3) emotions (29%), (4) spiritual or symbolic significance (18%), (5) changes in symptoms (17%), (6) changes in perception (11%), (7) sleep and drowsiness (10%), and (8) changes to breathing (4%). Significantly more males reported feeling relaxed and experiencing time perception changes, whereas more females reported body sensations, emotions, visual perceptions, and spiritual significance. Conclusions: The findings from this study suggest that Reiki can elicit the relaxation response and alter emotions and perception in such a way as to facilitate a transformative subjective healing experience. Future work will analyze these themes as they relate to changes in symptoms and compare the experience of Reiki with other biofield therapies. [ABSTRACT FROM AUTHOR]

There is a growing trend in complementary and alternative medicine (CAM) usage among the population with medical conditions. However, there is hesitancy for medical practitioners to integrate its application with the current treatment modality, despite governance by the authority. Hence, our objective is to systematically evaluate the healthcare perception towards integrating CAM in their practices. We systematically searched three large and renowned databases i.e., Scopus, Web of Science and PubMed, regarding "Perception on Integrating CAM Usage in Patient's Treatment among Healthcare Practitioners" from 2016 until 2020. At least two independent reviewers comprehensively screened and extracted the data from the accepted articles. A total of 15 studies were included in the final qualitative synthesis following a strict and rigorous assessment checked using MMAT 2018 checklist. The studies included providing the richness of information due to the qualitative nature of the study design. There were three main domains extracted i.e. knowledge, attitude, and perspective of the healthcare practitioner towards CAM integration. Limited knowledge of CAM among healthcare providers may be the possible main reason for nonsupportive attitude and negative perspective on CAM. However, those who showed an inclination towards CAM were found to be more open and ready to learn about CAM if it provides benefits to the patients. There is a heterogeneity of perception towards CAM integration from healthcare providers' point of view. A proactive and systematic CAM literacy awareness program may help to improve their understanding and possibly gain more trust in its application. [ABSTRACT FROM AUTHOR]

The paper presents a concept of application of electronic modeling in the development of e-Health systems for prevention in the diagnosis of problematic skin wounds, which include prevention and treatment, allowing uniformity in the assessment and increase the reliability of treatment tools to achieve a full life without pain, risk, and stress. Health and disease are two phases, changing smoothly or dramatically. It is to this uniqueness of the influences for their direct or indirect management that the research is directed - providing the practicing medical specialists with an opportunity for alternative and adequate diagnostics to ensure the subsequent normal life of the patient. The developed e-Health systems have been applied in the training of specialists in the specialties "Midwife" and "Nurse" and in the specialty "Electronics" at the University of Ruse. They are used in practical training of future doctors in UMHAT KANEV Ruse. [ABSTRACT FROM AUTHOR]

Art and music-based activities have played an important role in social work with groups since the origin of the profession. These activities continue to be used, yet less in known about how they are facilitated and led. This International Association for Social Work with Groups SPARC endorsed and funded study responds to this gap in the literature by examining the development and implementation of group-based music education residencies. Classically trained teaching artists (TAs) from a Chicago-based music ensemble led and facilitated a series of residencies at one agency with a drop-in center and a transitional living program for emerging adults experiencing homelessness and other forms of housing instability. Qualitative methods, including observation and focus group interviews, were used to explore the development and implementation of the residencies. Findings suggest TAs' adaptability, which is defined as flexibility, role adaptability, and capacity to meet residency participants where they were, played an important and integral role in the residencies. This study adds to the existing literature on music-based activities in social work with groups and extends our understanding of how these activities are facilitated and led. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic resulted in a rapid shift to remote consultations. The study aimed to explore the prevalence of telehealth consultations amongst allied health professional (AHP) services in the UK National Health Service (NHS), and the potential impact on health inequities and burden of treatment for patients. Methods: Cross-sectional online survey. Participants were practising UK registered AHP and/or AHP service manager in an NHS/social care/local authority service. Data was collected between May – June 2021. Results: 658 participants took part in this study, including 119 AHP service managers, managing a total of 168 AHP services, and 539 clinicians. 87.4% of clinicians and 89.4% of services represented were using telehealth consultations as a method of delivering healthcare, the majority reported their services were planning to continue using telehealth post COVID-19 restrictions. Participants reported a lack of technological skills for patients as the most prevalent barrier affecting the patient's ability to conduct a telehealth consultation, followed by a lack of technology for patients. These were also reported as the biggest disadvantages of telehealth for patients. The majority of clinicians reported a reduction in the cost of parking/transport to attend hospital appointments as a patient benefit of telehealth consultations. Reported benefits for clinicians included saving travel time/costs and allowing flexible working, while benefits to the AHP service included patient flexibility in how their appointments are conducted and reducing the potential exposure of staff to communicable diseases. Conclusions: The current large-scale implementation of telehealth in NHS AHP services may increase disparities in health care access for vulnerable populations with limited digital literacy or access. Consequently, there is a danger that telehealth will be considered inappropriate and thus, underutilised, negating the potential benefits of sustainability, patient empowerment and the reduction in the burden of treatment. [ABSTRACT FROM AUTHOR]

The atoms in all minerals are held together by electronic bonds, and, thus, all minerals contain chemical energy that can be extracted and measured. They derive from the amazing natural properties of minerals or of elements obtained from minerals. "The International Mineralogical Association [IMA] has declared 2022 the Year of Mineralogy. [Extracted from the article]

High-dose chemotherapy and autologous stem cell transplantation (ASCT) is used to treat some advanced malignancies. It is a traumatic procedure, with a high complication rate and significant mortality. ASCT patients and their carers draw on many sources of information as they seek to understand the procedure and its consequences. Some seek information from beyond orthodox medicine. Alternative beliefs and practices may conflict with conventional understanding of the theory and practice of ASCT, and 'contested understandings' might interfere with patient adherence to the strict and demanding protocols required for successful ASCT. The present study, conducted in Sydney, Australia, examines narrative-style interviews with 10 sequentially recruited ASCT patients and nine of their carers conducted at the time of transplant and three months later. Transcripts were read for instances of mention of alternative advice, and for instances of contested understanding of information relevant to the transplant. Patients and carer pairs expressed closely concordant views about alternative advice. Five pairs were consulting alternative practitioners. Contested understanding was expressed in four domains—understandings of the transplant itself and its underlying theory, of the relationship between the components of the 'transplant', of the nature and role of stem cells, and of beliefs about bodily function and life-style. Contested understandings of the transplant treatment were expressed as predominantly personal interpretations of orthodox information Patients and carers seemed to recognise that alternative and conventional systems were discordant, yet they were able to separate the two, and adhere to each practice without prejudicing their medical treatment. A single case of late, post-transplant repudiation of Western medicine is discussed to emphasise some of the possible determinants of dissonance when it does occur. [ABSTRACT FROM AUTHOR]

Comparing a textbook of internal medicine published in 1970 to one appearing in 2020 can be a fascinating experience. Appropriate system-related initiatives are needed, as well as changes in medical education, but physicians can already start by revitalizing their examination and communication skills, improving bonding with the patients, and attending to their own emotional needs. This evolution of patients' roles is generally desirable, but unavoidably adds to physicians' burden, having to provide more detailed explanations to more critical and better-informed patients. [Extracted from the article]

Introduction: To assist with the increasing orthopaedic workload, an allied health led hand therapy clinic was established to manage people having routine hand surgeries. The aim of this study was to evaluate patient and doctor satisfaction and safety of this alternative service delivery model. Methods: Prospective multimethod design evaluation was undertaken by occupational therapists and physiotherapists working in the field of hand therapy. Satisfaction surveys were completed by orthopaedic doctors and patients. Patient outcomes were assessed at 6 weeks post operatively using the Quick Disability of Arm, Shoulder and Hand questionnaire, total active range of motion, Crawford Classification, sensation using light touch and pain with activity utilising Wong Baker FACES® Pain Rating Scale. Quantitative satisfaction survey data were analysed and presented as frequencies and percentages with open question responses analysed using a qualitative description approach. All complications and readmissions within a 3‐month period were identified and recorded to assess safety of this model of care. Results: For the 6‐week post‐operative review, 81 patients were seen by an allied health professional rather than a doctor. Patient satisfaction was high with 90% of patients satisfied with post‐operative care provided by allied health; 2% of patients preferred to be seen by a doctor. Doctor satisfaction was also high with 95% of doctors being satisfied and confident with the quality of care provided. A high proportion of patients reported pain 2/10 or less with activity (82.72%), had full sensation (69.14%), excellent range of motion (82.72%), and Quick Disability Arm, Shoulder and Hand scores on average were below 25% indicating minimal functional deficits. Only five patients required doctor involvement post‐operatively. Conclusion: The allied heath led service delivery model was demonstrated to be safe and have high patient and doctor satisfaction, indicating an acceptable alternate pathway for management of people following routine hand surgery. [ABSTRACT FROM AUTHOR]

Previous evidence suggests that improvisational music therapy (IMT) can be effective at improving social skills of children on the autism spectrum (CoS). To date, no published research exists regarding the effectiveness of specific IMT techniques. Given the improvised nature of IMT such research is important to understand the effective ingredients of the method. The purpose of this study is to examine the effectiveness of three IMT techniques with minimally verbal CoS: (1) exact imitation, (2) imitation with elaboration, and (3) contingent response. Seven children aged 40 to 56 months (M = 50.1) participated in the study.Inclusion criteria included minimally verbal children (producing fewer than 10 spontaneous words or phrases) between three and five years of age diagnosed with autism spectrum disorder. Each child participated in nine 30-minute sessions designed toinclude one of the three treatment techniques. Hence, three therapy sessions targeted each therapy technique. Sessions were video-recorded, analyzed and coded for treatment fidelity and child engagement. Analysis revealed that there was a significant overall effect of therapist technique on engagement state of a child, Hotelling's Trace = 4.061, F(10, 14) = 2.843, p = 0.037. The overall pattern suggests that exact imitation and imitation with elaboration may result in better overall engagement than contingent response. Results suggest that using IMT imitation techniques may improve engagement. Since engagement is often a clinical goal, and is important in the process of social learning, music therapists are encouraged to consider employing imitation techniques during IMT sessions with CoS. [ABSTRACT FROM AUTHOR]

This article examines the relationships between biomedicine, complementary and alternative medicine (CAM) and parents' vaccination decision‐making in Switzerland. Our empirical evidence sheds light on an understudied phenomenon—parents switching from one doctor to another provider (often one offering CAM services) around issues that arise during vaccination consultations. This is important to understand since CAM is used by 25%–50% of the Swiss population and is integrated into the Swiss health‐care system when offered by biomedically trained medical doctors with additional CAM training. Qualitative data gathered from in‐depth semi‐structured interviews with parents (N = 30) and ethnographic observations of vaccination consultations (N = 16 biomedical consultations, N = 18 CAM consultations) demonstrate how there was not always a clear‐cut, direct relationship between (non)vaccination and parents' use of CAM and/or biomedicine. Borrowing from Hirschman (Exit, voice, and loyalty: Responses to decline in firms, organizations, and states, Harvard Univ. Press, 1970), we frame our analysis by using the concepts of exit, voice and loyalty to describe parents' provider selection and vaccination decision‐making process, although only four families in the sample described switching solely because of vaccination‐related issues. Findings add to vaccine decision‐making literature by describing and analysing the underdiscussed provider‐switching phenomenon and by demonstrating the importance of parents' experiences of trust, affect and choice in vaccination consultations as they pursue the best health outcomes for their children. [ABSTRACT FROM AUTHOR]

Background: Mental health disorders are a global health concern. In Australia, numerous national reports have found that the current mental healthcare system does not adequately meet the needs of Australians with mental illness. Consequently, a greater understanding of how people with a mental health disorder are using the broader healthcare system is needed. The aim of this paper is to explore conventional and complementary health care use and expenditure among Australian adults reporting a mental health disorder diagnosis.Methods: A cross-sectional online survey of 2,019 Australian adults examined socio-demographic characteristics, complementary and conventional health care use and the health status of participants.Results: 32 % (n = 641) of the total sample (N = 2019) reported a mental health disorder in the previous 3 years. Of these, 96 % reported consulting a general practitioner, 90.6 % reported using prescription medicines, 42.4 % consulted a complementary medicine practitioner, 56.9 % used a complementary medicine product and 23 % used a complementary medicine practice. The estimated 12-month out-of-pocket health care expenditure among Australians with a mental health disorder was AUD$ 4,568,267,421 (US$ 3,398,293,672) for conventional health care practitioners and medicines, and AUD$ 1,183,752,486 (US$ 880,729,891) for complementary medicine practitioners, products and practices. Older people (50-59 and 60 and over) were less likely to consult a CM practitioner (OR = 0.538, 95% CI [0.373, 0.775]; OR = 0.398, 95% CI [0.273, 0.581] respectively) or a psychologist/counsellor (OR = 0.394, 95% CI [0.243, 0.639]; OR = 0.267, 95% CI [0.160, 0.447] respectively). People either looking for work or not in the workforce were less likely to visit a CM practitioner (OR = 0.298, 95% CI [0.194, 0.458]; OR = 0.476, 95% CI [0.353, 0.642], respectively).Conclusions: A substantial proportion of Australian adults living with a mental health disorder pay for both complementary and conventional health care directly out-of-pocket. This finding suggests improved coordination of healthcare services is needed for individuals living with a mental health disorder. Research examining the redesign of primary health care provision should also consider whether complementary medicine practitioners and/or integrative health care service delivery models could play a role in addressing risks associated with complementary medicine use and the unmet needs of people living with a mental health disorder. [ABSTRACT FROM AUTHOR]

While immunisation rates were 94.63% for the whole Nepean Blue Mountains region of New South Wales in 2017, coverage for 1 year olds in the upper Blue Mountains was under 80%. There is a known relationship between vaccine‐hesitant parents and complementary and alternative medicine (CAM) use; however, little is known about how CAM practitioners fit within the information‐seeking pathway of parents. This exploratory study sought to address this knowledge gap. Qualitative semi‐structured interviews with vaccine‐hesitant and vaccine rejecting parents and CAM practitioners purposively sampled from the Blue Mountains area revealed three sets of themes: 1) Parents' search for further information about immunisation; 2) Parents' use of CAM practitioners as an immunisation information source; and 3) CAM practitioners' engagement with parents about immunisation. CAM practitioners form a definite, if complex, part of vaccine‐hesitant and vaccine‐rejecting parents decision‐making pathway in the Blue Mountains area. The notion of patient choice is crucial to vaccine discussions. Development of support materials, such as decision resources which give impartial and detailed information while acknowledging and supporting patient choice, are needed to support both CAM practitioners and parents in making informed vaccination decisions. [ABSTRACT FROM AUTHOR]

Objective Complementary and integrative medicine (CIM), including mind–body medicine (MBM), is a treatment option that has been proved to alleviate symptoms in patients with low back and neck pain. Methods Data from the National Center for Health Statistics' National Health Interview Survey 2017 were used to examine prevalence and predictors of MBM use and consultation of CIM practitioners among patients with low back and neck pain in the American adult population. Results A weighted total of 81,671,436 participants (33.1%) reported low back and neck pain. Of those, more participants used mantra meditation, mindfulness meditation, spiritual meditation, guided imagery, and progressive relaxation than did participants without low back and neck pain (all P  < 0.001). Spiritual meditation was the most popular (12.6%), followed by mindfulness meditation (6.9%) and progressive relaxation (5.4%). Participants with low back and neck pain consulted practitioners of CIM more often than did those without low back and neck pain (P  < 0.001). MBM use was predicted by being female, having a higher educational level, being employed, and living in the Western United States. Consultation of practitioners of CIM was predicted by younger age, being female, not being married or living with a partner, having a higher educational level, being employed, living in the Western United States, and being uninsured. Conclusions MBM is a popular treatment option for people with low back and neck pain. Practitioners of CIM are also being sought out by people with such complaints. Further research in this direction is relevant. [ABSTRACT FROM AUTHOR]

Background: Spirituality has become more prevalent in health professions other than complementary and alternative medicine (CAM). In CAM, spirituality appears to be part of a foundational component of the clinical practice, which is valued by many patients. Spirituality has gained popularity in healthcare education and practice; however, the contribution made by CAM remains minimal evidenced by the paucity of studies on the topic of spirituality in CAM. Therefore, there is need for a scoping review to: 1) to explore the focus and nature of research on spirituality in CAM; 2) to provide recommendations based on the relational aspects between spirituality and CAM. Methods: A scoping review was performed of all relevant articles found in Ebscohost (Academic Search Complete), Science Direct, and Scopus published between 2000 and 2019. This scoping review included two hundred and six studies, of these, twentytwo articles focussed on the role of spirituality in CAM. Results: These four themes were reported in the results: spirituality as a modality of CAM; patient perceptions of the role of spirituality and CAM; practitioner perceptions of the role of spirituality and CAM; and the role of spirituality and CAM in education and practice. Spirituality was considered an important component and was linked to culture, traditions and/or religious beliefs. The use of spirituality in CAM was especially linked to patients living with chronic disease such as diabetes, cardiac conditions and cancer. Spirituality seemingly facilitated health care and while patients expected spirituality healthcare advice from CAM practitioners most CAM practitioners felt ill equipped to deal with the topic appropriately. Conclusions: Overall, this scoping review highlights that the role of spirituality in CAM seem to be of value for both practitioners and clients within the CAM clinical setting. However, only a few practitioners include spiritual healthcare advice without clear guidelines. Consequently, this may compromise the holistic treatment, which so many patients expect within the CAM domain. Therefore, there is a need for the inclusion of spirituality in the CAM curriculum and guidelines for CAM practitioners. [ABSTRACT FROM AUTHOR]

The article presents the discussion on practicing togetherness and cooperation at eye level between the most diverse health care professions. Topics include nursing, physiotherapy, and midwifery being the only beginning for getting academicized, and other independent health professions being almost nonexistent; and naturopathic practitioners commonly recommending against following modern medical practices.

An interview with Denis Stewart, pioneer of Australian herbal medicine, is presented. Stewart talks about whether herbs have different actives and different attributes, the herbs that people lost touch with or forgotten, and origin of the herbal renaissance. He also mentions the start of the Naturopaths and Herbalist Association of Australia (NHAA) in Australia.

In this study, I employed interpretive ethnographic qualitative design to explore perceptions of and proposals from traditional healers, biomedical practitioners, and health care consumers regarding integrating traditional medicine and healing in Ghana. Data were gathered through focus groups, in-depth individual interviews, and qualitative questionnaires and analyzed thematically. The results revealed positive attitudes toward integrating traditional medicine in Ghana and a discursive discourse of power relations. The power imbalance between biomedical and traditional practitioners regarding what integrative models to adopt is sanctioned by formal education and institutional structure. As a result, multiple approaches for integration were made, including patient co-referrals, collaborations between biomedical and traditional medical practitioners, and creating a unit for traditional medicine and healers at the outpatients' department for patients to choose either biomedicine or traditional medicine. Incorporating aspects of traditional healing in the training of biomedical practitioners and creating a space for knowledge sharing were also proposed. These integrative models reflected the distinctive interests of healers and biomedical practitioners. Considering these findings, I recommended policy options for consideration toward achieving an integrative health care system in Ghana. [ABSTRACT FROM AUTHOR]

Context: Epilepsy is a condition characterized by abnormal and excessive electrical discharges of cortical neurons resulting sudden, repetitive, event-triggered seizures. Epilepsy is most common neurologic disorder during childhood and the second most common neurological disorder following cerebrovascular diseases in adults. Use of CAM in persons with epilepsy is high, even compared to individuals with other chronic health conditions.Objectives: We aimed to determine the prevalence, types, and factors influencing use of complementary and alternative medicine (CAM) in adults with epilepsy.Methods: The subjects of this descriptive study consisted of 96 patients with epilepsy in the outpatient neurology clinic of a hospital in Erzurum, Turkey. Frequency, percentage and other descriptive statistics were used to describe and summaries data.Results: While most patients preferred CAM use (76%) for treatment of epilepsy patients some did not (24%). Spiritual practices was the most commonly used therapy in 66.7 % of patients. Although 74% of the subjects reported that they were satisfied with their use of CAM, the majority (97%) did not discuss the use of these therapies with their primary physicians. It was determined that variables such as gender, education level, residential area, marital status, and level of income and affected the use of CAM (P < .05).Conclusion: Turkish patients with epilepsy frequently use CAM in addition to standard medical therapy. Nurses caring for patient with epilepsy should initiate a dialogue about usage of CAM, discussing the potential adverse effects of CAM and the patient's therapeutic goals. [ABSTRACT FROM AUTHOR]

There is a growing interest in the utility of complementary health approaches (CHAs) to promote wellness and health in the United States. Research from medical, allied health, and mental health fields reflect this expanding interest; however, very little research focuses on counselors and the integration of CHAs within practice or referral of counseling clients to Complementary Health Practitioners (CHPs). The current study expanded this research using transcendental phenomenology to explore the experiences, perspectives, and processes in use by current independently licensed professional counselors referring to complementary health practitioners (CHPs). The authors discuss and explore implications of these findings. [ABSTRACT FROM AUTHOR]

The article focuses on mainstreaming integrative medicine into modern healthcare. Topics discussed include the potential benefits of integrative medicine in treating chronic diseases, the need for evidence-based guidelines and regulation, and the integration of non-pharmacological interventions into clinical management.

The article reports on the Australian Traditional Medicine Society (ATMS) Members' Survey 2021 conducted in March 2021 and designed to guide the organization's next Strategic Plan. Topics covered include the membership types of those who participated in the survey, the most practiced modalities of practice of the respondents, such as Remedial Massage followed by Naturopathy, and the highest level of education in natural medicine completed by respondents.

Introduction: What does the analytical music therapy (AMT) approach have to offer the field of music therapy in terms of listening to manifestations of the unconscious, in both music and speech? Since Freud, dreams have been thought of as the royal road to our unconscious. Mary Priestley, the founder of AMT, integrated concepts from Freud, Klein and Jung in her work with her client's dreams. Method: This paper will explore the AMT techniques Priestley developed to work with dreams and situate them in Freudian theory, drawing on literature of AMT, other psychodynamic music therapy approaches, as well as the author's own training in AMT. The author will also examine what an analytical perspective on musical events during improvisation can teach us about how the unconscious may manifest in music. Results: Musical events such as sudden rhythmic shifts, polyrhythmic moments and rhythmic ruptures in a musical improvisation can indicate noteworthy moments in which the client encounters his or her unconscious. By recognizing and working with these moments, the music therapist may facilitate further exploration of unconscious content. Discussion: The implications of these shifts on how meaning can be generated within the frame of AMT will be discussed. The author argues that it is clinically useful to distinguish an understanding of the Freudian dynamic unconscious from a more general sense of the unconscious. [ABSTRACT FROM AUTHOR]

The term complementary and alternative medicine (CAM) describes a broad spectrum of health care practices that are not an integral part of the conventional health care system. Many patients worldwide use CAM on their own initiative, often in combination with their conventional medical therapy. CAM use is attractive especially to patients with primary immunodeficiency, since they suffer from frequent infections and autoimmunity. Those are frequently addressed by CAM providers. The aim of this multicentric study was to collect information on the use of CAM by these patients and to define characteristics that are associated with the use of CAM. A total of 101 patients with primary immunodeficiencies at German hospitals were surveyed on their CAM use (further 14 patients rejected to participate). Multiple psychological tests (MARS-D, WHO-5, PHQ9, EFQ) were conducted to investigate variations among personality traits associated with CAM use. Additionally, clinical and sociodemographic patient data was collected. A total of 72% of patients used CAM to treat their primary immunodeficiency. The three most frequently used methods were physical exercise or fitness training (65%), dietary supplements (58%), and homeopathy (49%). Most patients did not discuss CAM use with their doctors, mostly because they felt that there was no time for it. CAM plays an important role for patients with primary immunodeficiency in a high-resource health care setting such as Germany. In clinical practice, doctors should create a platform to discuss needs that go beyond conventional therapy. [ABSTRACT FROM AUTHOR]