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BACKGROUND AND PURPOSE: Naturopathy is a traditional medicine system originating from Europe and naturopathic practitioners provide care to 6.2% of Australians in a 12-month period. Australian naturopathic programs have undertaken a slow transition over the last 20 years from Advanced diploma to Bachelor degree as the minimum level of qualification for entry into the profession. This study aimed to understand and describe the experience of naturopathic graduates completing Bachelor degree and transitioning to provide naturopathic care in the community. MATERIALS AND METHODS: Qualitative semi-structured phone interviews were conducted with graduates of Bachelor's degree naturopathy programs, within five years of completing their studies. The data were analysed using Framework analysis methods. RESULTS: The analysis identified three related themes: (1) Love for looking after patients, but clinical practice is not easy, (2) Finding a place in the naturopathic profession and in the health system; and (3) Protecting the future of the profession and practice through registration. CONCLUSION: Graduates of Australian Bachelor's degree naturopathic programs face challenges as they attempt to find a place within their professional community. By identifying these challenges the profession's leaders may be able to develop initiatives to better support graduates and increase the success of new naturopaths.

BACKGROUND: The Canadian 24-hour movement behavior (24-HMB) guidelines recommend an adequate level of physical activity (PA), a limited amount of screen time (ST), and a sufficient sleep duration (SLP) to promote the healthy development of children. Although the positive effects of adhering to the 24-HMB guidelines have been established for several health parameters, less is known about how adherence to the 24-HMB guidelines relates to the myopia risk (i.e., inability to see distant objects properly). Thus, this study investigated associations between meeting 24-HMB guidelines and myopia risk in school-aged children. METHOD: Using a questionnaire survey, this cross-sectional study was conducted among parents of school-aged children (5-13 years) in China from 15th September to 15th October 2022, with a total of 1423 respondents with complete data for analysis. Parents reported their child's time spent in moderate-to-vigorous-intensity physical activity (MVPA), SLP, and ST. Multiple logistic regression analyses were performed to examine the associations between measures of PA, ST, and SLP alone and in combination, and the occurrence of myopia. RESULTS: A relatively low percentage of the children being included in the current study (4.92%) met all 24-HMB guidelines, while 32.46% had myopia. Girls had a significantly higher risk of myopia compared to boys (OR = 1.3, 1.002 to 1.68, p = 0.049). Children of parents without myopia had a lower risk of myopia (OR = 0.45, 0.34-0.59, p < 0.001). Children who lived in urban areas (OR = 1.83, 95% CI 1.33 to 2.52, p < 0.001) or towns (OR = 1.60, 1.03 to 2.47, p = 0.04) had a significantly higher risk of myopia compared to those living in rural areas. Meeting SLP guidelines (OR = 0.50, 95% CI 0.31 to 0.82, p < 0.01), meeting ST + SLP guidelines (OR = 0.47, 95% CI 0.32-0.69, <0.001), and meeting all three guidelines were associated with significantly lower risk of myopia (OR = 0.40, 95% CI 0.20-0.82, p = 0.01). Meeting more 24-HMB g

BACKGROUND: and purpose: Naturopathic practitioners (NPs) in the United States (US) and Australia are consulted for the prevention and management of a range of health conditions, including cardiovascular disease (CVD). Despite this, little is known about how NPs approach the management of CVD risk factors. The aim of this study was to explore NPs approach to the care of people with CVD risk factors. MATERIALS AND METHODS: In 2018, Australian and US NPs were recruited via professional representative organisations. A survey was developed containing four domains; naturopathic approaches to the clinical management of CVD risk factors, communication and sharing of information; professional-client relationship factors; and demographic information. The data analysis was conducted using the appropriate statistical tests. RESULTS: A total of 151 NPs completed the survey (Australia n = 75, US n = 76). NPs reported employing dietary, and multiple behavioural and natural product interventions to treat CVD risk factors. The most frequently recommended products by US and Australian NPs were fish oils (87%), magnesium (83%) and coenzyme Q10 (87%). Differences in what US and Australian NPs recommended were identified. NPs reported limited communication with medical doctors about their clients. NPs placed high importance on the relationship quality with their clients. CONCLUSION: US and Australian NPs represent an aspect of primary care and disease prevention that warrants further research that evaluates the potential risks and benefits of NP care, and challenges and opportunities associated with NPs integration into the healthcare systems, for populations with CVD risk factors.

BACKGROUND AND PURPOSE: Endometriosis is a painful female reproductive disease resulting in unmet health needs. Women with endometriosis frequently access different types of health care, yet little is known about naturopathic use. The purpose of this study is to explore the naturopathic utilisation by women with endometriosis in Australia. MATERIALS AND METHODS: This study reports a cross-sectional survey of Australian women with endometriosis. Participants were recruited through the not-for-profit organisations Endometriosis Australia and EndoActive social media platforms. Data was collected through a self-administered questionnaire by those eligible to participate. Participants were included if they self-reported a diagnosis of endometriosis via laparoscopic surgery and were an Australian resident. RESULTS: Of the recruited 303 women with endometriosis, 60 women reported consulting with a naturopath for endometriosis care. Women consulting with a naturopath, reported also consulting with a laparoscopic surgeon (66.7%, p = 0.01), acupuncturist (53.3%, p ≤ 0.01), physiotherapist (41.7%, p = 0.01), nutritionists/dietitians (n = 22, 36.7%, p = 0.01) or homeopath (15.0%, p ≤ 0.001), in addition to their naturopath in the previous 12 months for endometriosis management. Compared to non-naturopathic users, women reported frequently experiencing dyspareunia (OR 2.9, CI 1.4-5.9, p = 0.002) and reported a higher use of vitamin D supplementation for endometriosis management (OR 4.9, CI 2.5-9.9, p ≤ 0.001). CONCLUSION: Women who use naturopathy for endometriosis appear to be high users of health care services, both within complementary medicine and conventional medicine. The efficacy and role of naturopathic treatments and care for women with endometriosis requires further investigation.

Background and purpose Utilization of complementary medicines (CMs) amongst children with eosinophilic esophagitis (EoE) in Australia is high. Carers' beliefs, perceptions and use of CM can influence the decision to use CM in children in their care. This study explores the factors influencing the use of CM for a child's EoE when the carer also uses CM. Materials and methods Carers of children aged 0–18 years with EoE participated in a national cross-sectional online survey, conducted in Australia between September 2018 and February 2019. Data analysis included bivariate analysis, Cramer's V, backwards stepwise logistic regression and binomial logistic regression. Results Of the 181 total survey responses, 165 (91.2 %) respondents indicated they had utilized some form of CM for themselves. Children whose carer had used some form of CM for themselves were more likely to have used CM than children whose carer had not used CM (OR 4.6; p = 0.001). Of the CM self-using carers, 125 (75.8 %) had also chosen to utilize CM for their child's EoE. Use of CM in children was more likely amongst children who had used a pharmaceutical for their EoE (OR 7.51; p = 0.010), and those whose carer had consulted with “other health practitioners or health workers” for their child's EoE (OR 5.34; p < 0.001) or had consulted with a chiropractor for themselves (OR 2.70; p = 0.029). Conclusion High CM self-use amongst carers is associated with their decision to also use CM for their child's EoE, a concern given the absence of evidence for CM's safety and efficacy in this population. CM use in this population warrants further attention. Effective conventional medicines for EoE are limited and utilization of CM amongst children with EoE in Australia is high. The recommendation of CM for children with EoE warrants further attention given the substantial concomitant pharmaceutical care, and the absence of evidence for CM's safety and efficacy in this population. Further research into the role of C

Background and purpose: This study examined the effects of foot reflexology on agitation and extubation time of male patients following coronary artery bypass graft surgery. Materials and methods: In this randomized three-arm controlled clinical trial, participants (n = 120) were randomly assigned to the intervention, placebo, or control groups. The intervention group received foot reflexology massage for 15 min. Agitation was assessed using the Richmond Agitation- Sedation Scale before the intervention (Time 1) and immediately (Time 2) and 10 min after the intervention (Time 3). Extubation time was measured as the time from gaining full consciousness to endotracheal extubation. Results: Agitation reduced in all groups from Time 1 to Time 3 (p < 0.05); however, the intervention group showed a significantly higher reduction at Time 2 (p < 0.001) and Time 3 (p < 0.001). Also, extubation time was significantly shorter in the intervention group (p < 0.01). Conclusion: Foot reflexology may be introduced as a nursing intervention to facilitate the weaning process in the cardiac ICUs.

Asthma can be complex and difficult to manage. Patients often seek alternative treatment options, including Traditional Chinese Medicine (TCM). The paradigms that inform TCM treatments include a philosophy focusing on modifying the whole body status ('bian zheng') to treat the lungs. TCM practitioners use personalized treatment plans based on clusters of clinical patterns (eg. cold-related wheezing, kidney insufficiency/energy-deficiency-related wheezing). TCM includes herbal remedies and non-oral therapies such as cupping, acupuncture, and massage. The efficacy of TCM treatments of asthma is not well described as the majority of studies are published only in Chinese literature. We reviewed all available clinical trials in CNKI, Chaoxin, Wanfang, CQVIP, Springer-link, Science Direct, and Pubmed. Papers in Chinese were translated by dual lingual TCM and Western medicine doctors. Based on the identified studies, TCM is a safe additive treatment to Western medicine that can improve both symptoms and quality of life for patients with asthma.

© 2020 Elsevier Ltd Background and purpose: Massage is commonly used by the Australian public and is often sought by expectant mothers. Despite its popularity there is no regulatory body to enforce minimum educational standards, guidelines or evidence-based best practice for massage therapists. The aim of this paper is to critically examine the views and practices of massage therapists who offer preconception, antenatal or postnatal massage. Materials and methods: An online survey was administered to Australian massage therapists who provide massage in the preconception, antenatal or postnatal periods. Results: Ninety-nine therapists completed the survey. The majority of respondents had received training in pregnancy massage (n = 72; 72.7%) only. The most confident respondents were those that had both training and experience. Conclusion: There are potential gaps in training for massage therapists including up-to-date curriculum and a fragmentation around industry training requirements for pregnancy massage, which may impact on the safety and benefits of pregnancy massage.

© 2020 Elsevier Ltd Background: The complexity of chronic conditions challenges health systems and patients. Patients with chronic conditions often consult complementary medicine (CM) practitioners. Optimal care of chronic conditions requires understanding of the characteristics and consultation behaviours of these patients. Methods: Cross-sectional survey (n = 2025 adults), broadly representative of the Australian population. Measures included sociodemographics, health status and health service utilisation. Data from participants with chronic conditions were analysed. Results: Of the 1314 participants reporting chronic conditions, 38.4% consulted a CM practitioner. Significant differences were observed between participants who did/did not consult CM practitioners, across all sociodemographics and some health status items. The most reported reason for consultation was to support wellbeing. Predictors of consultation were younger age, employment, and private health insurance coverage for CM, however, predictors varied by profession consulted. Conclusion: CM consultations amongst those with chronic conditions appear to be influenced by sociodemographic and economic factors, and quality of life needs.

© 2020 Introduction: This study provides the most detailed empirical examination of the naturopathic profession and naturopathic practice in Australia. Methods: Naturopaths from the Practitioner Research And Collaboration Initiative (PRACI) were invited to participate in an online workforce survey. Results: The baseline survey was completed by 281 naturopaths and 155 (55.2%) completed the second survey. Respondents were predominantly female (86.7%), with a mean age of 45.5 years (SD 10.4). A diverse range of clinical interest topics were disclosed; most frequent were digestive (84.0%) and women's (79.4%) health. Diet/nutrition (91.1%), sleep (90.2%), stress management (85.3%) and physical activity/fitness (79.4%) were commonly discussed during consultation. Conclusion: Although respondents reported a varied scope of practice, there was a notable emphasis on lifestyle prescriptions. Given lifestyle diseases are the leading cause of death in Australia, a more in-depth examination of the preparedness of the naturopathy workforce to integrate into community-based health care teams is now warranted.

BACKGROUND:The use of natural health products (NHPs) is common in North America. In 2003, we found that 42% of NHP users had not disclosed this information to their primary care medical doctors (MDs). We repeated our survey in 2018/2019 to explore if the rate of NHP use disclosure had improved. METHODS:From November 2018-February 2019, a 21-item survey about NHP use and disclosure was administered to adult patients who visited the Robert Schad Naturopathic Clinic in Toronto, Canada. RESULTS:Almost all patients surveyed were using NHPs (99%), and 46% were using NHPs and prescription medication concurrently. Consistent with our 2003 findings, 42% of respondents who used NHPs did not disclose this information to their MD. CONCLUSION:Disclosure of NHP use to MDs by naturopathic patients is limited and remained unchanged over the past 15 years. Future research should explore primary care MDs' hesitancy to inquire about patient NHP use.

BACKGROUND:and Purpose: This study explores Ebola survivors' healthcare-seeking experiences within the context of Sierra Leone's free healthcare initiative (FHCI) and comprehensive package for Ebola survivors (CPES) program while also exploring the enablers and barriers to their use of informal healthcare. MATERIALS AND METHODS:We employed an inductive, exploratory qualitative approach using focus group discussion with 41 adults Ebola survivors in the four administrative regions of Sierra Leone. RESULTS:Biomedical care was the first choice of treatment option for most survivors immediately following post-ETC discharge. Survivors' healthcare-seeking experience varies before and after their inclusion into FHCI and the establishment of the CPES program. Personal and health system factors influenced survivors' decision to seek multiple healthcare approaches, especially T&CM. CONCLUSION:Our findings suggest the determinants of Ebola survivors' healthcare-seeking experiences should be considered when developing and implementing programs aimed at improving the current health status of Ebola survivors in Sierra Leone.

OBJECTIVES: To investigate the experiences of patients seeking osteopathy treatment in New Zealand; and to describe their perceptions of osteopathic treatment. DESIGN: Survey-based research design. SETTING: Private osteopathy practices. MAIN OUTCOME MEASURES: Demographic survey and the Patient Perception Measure-Osteopathy (PPM-O). RESULTS: Twelve osteopaths were recruited as practitioners. Responses from 107 patients were analysed. Approximately 75% of patients reported receiving a 'mostly cranial' treatment approach. The majority of patients (96.2%) indicated that osteopathic treatment helped their condition. The most frequently experienced sensation was 'relaxed'. A positive relationship was observed between the PPM-O and demographic variables. CONCLUSIONS: This is the first study to report on New Zealand osteopathy patient's experience of their treatment. The sensations and emotions experienced are largely consistent with previous Australian research. Predominantly positive perceptions of osteopathic treatment were reported. The current study provides some evidence of the construct validity of the PPM-O in a New Zealand patient population.

Adequate levels of health literacy (HL) are required for patients to access appropriate health services and develop an understanding of the options for managing their healthcare needs. There is limited literature on HL of patients seeking care for a musculoskeletal complaint. The present study sought to screen the HL of patients presenting to an Australian osteopathy student-led clinic using a single screening question 'Are you confident completing medical forms?'. Less than 10% of patients attending the clinic were considered to have below adequate levels of HL using this question, consistent with other work in Australian populations. Logistic regression analysis identified that the most significant demographic variables associated with lower HL were patients who did not speak English at home, those with lower education levels, and those who were less satisfied with their life. Evaluation of a patients' HL may assist practitioners to improve patient education and management strategies.