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Purpose: To clarify the current use of unapproved and unproven cancer treatment (UUCT) among the bereaved families of patients with cancer who died in palliative care units, the financial burden and psychological experiences of the families, and the relationship between patients in palliative care who used UUCT and communication with their physicians’. Methods: This study was conducted as part of a cross-sectional, anonymous nationwide survey of the bereaved family members of cancer patients who died in palliative care unit in Japan. Results: Questionnaires were sent to 1,039 bereaved family members, and responses were received from 661 (64%). Of these, 558 were included in the study after excluding the 103 who did not complete the questionnaire. A total of 7.3% (41 of 558) of patients received UUCT. Of these, 34% (14 of 41) of patients were informed that the treatment was in the research phase, and 49% (20 of 41) were informed that the efficacy of the treatment was unknown. Regarding expectations for UUCT, 61% (25/41) expected to be cured, and 80% (33/41) expected it to slow disease progression. In multivariate logistic regression analysis, use of complementary and alternative medicine (CAM) was associated with receiving UUCT (p = 0.024), and patients who could discuss CAM with their doctors tended to receive UUCT (p = 0.054). Conclusion: Patients in palliative care unit who expect to cure tended to receive UUCT. These results highlight the challenge of telling patients that UUCT is ineffective and informing them of their prognosis and severe medical conditions. [ABSTRACT FROM AUTHOR]

To compare the difference between primary homoeopathic and conventional paediatric care in treating acute illnesses in children in their first 24 months of life. One hundred eight Indian singleton newborns delivered at 37 to 42 weeks gestation were randomised at birth (1:1) to receive either homoeopathic or conventional primary care for any acute illness over the study period. In the homoeopathic group, conventional medical treatment was added when medically indicated. Clinicians and parents were unblinded. Children in the homoeopathic group experienced significantly fewer sick days than those in the conventional group (RR: 0.37, 95% CI: 0.24–0.58; p < 0.001), with correspondingly fewer sickness episodes (RR: 0.53, 95% CI: 0.32–0.87; p =.013), as well as fewer respiratory illnesses over the 24-month period. They were taller (F (1, 97) = 8.92, p =.004, partial eta squared = 0.84) but not heavier than their conventionally treated counterparts. They required fewer antibiotics, and their treatment cost was lower. Conclusion: Homoeopathy, using conventional medicine as a safety backdrop, was more effective than conventional treatment in preventing sick days, sickness episodes, and respiratory illnesses in the first 24 months of life. It necessitated fewer antibiotics and its overall cost was lower. This study supports homoeopathy, using conventional medicine as a safety backdrop, as a safe and cost-effective primary care modality during the first 2 years of life. Trial registration: Clinical Trial Registry-India (2018/09/015641). https://ctri.nic.in/Clinicaltrials/login.php What is Known: • Due to their holistic nature, many Complementary and Alternative Medical (CAM) modalities are not readily amenable to assessment by head-to-head RCT for a given Indication. • We propose a pragmatic, RCT comparing homoeopathic with conventional medicine as a system. What is New: • Homoeopathic was apparently superior to conventional primary care in preventing sick days, sickness episodes, and respiratory illness episodes and was significantly associated with growth in height but not weight and required fewer antibiotics in children from birth to 24 months of age. [ABSTRACT FROM AUTHOR]

This article delves into the underexplored relationship between lay expertise and temporality by analysing semi-structured interviews with parents who treat their autistic children using complementary and alternative medicine (CAM). The analysis indicates that time and temporalities play a significant role in how parents construct and enact their expertise. Faced with uncertainty, urgency, and inadequate support from medical and educational systems, parents assumed crucial responsibilities in managing their children’s therapies. Over time, they acquired knowledge and skills, ultimately claiming expertise in caring for their children, making therapy decisions and administering treatments. Parents engaged in complex time work as they attempted to orchestrate everyday, developmental, therapeutic, and social rhythms, alternating their focus between future and present. They endeavoured to synchronise their children’s rhythms with those of peers by using CAM therapies not yet adopted into conventional medicine, which they perceived as slow and outdated. This study contributes novel insights into autism care, temporalities of care, and the under-examined nexus between lay expertise and temporality. [ABSTRACT FROM AUTHOR]

Abstract Background In health care, two in three users of complementary therapies (CT) stay silent about their CT use. Disclosure of CT use to physicians is important for patient safety, participation, and shared decision-making. Common reasons for CT nondisclosure include patients´ expectations of physicians’ unaccepting response to disclosure, physicians not asking, and patients believing it is unnecessary. This study aimed to increase understanding of patient silence. We investigated how the reasons for nondisclosure of CT use reported by CT users were associated with the frequency of CT disclosure and how these associations and reported justifications to keep silent reflect patient silence among the study participants. Methods This mixed-methods study used existing data from the non-probability-based online survey (n = 6802) targeted to CT users among the general population in Finland. A qualitative structured tabular thematic analysis was conducted for the selected 342 brief texts describing the reasons and justification for not telling physicians about CT use. The associations between the frequency of CT disclosure and the reasons for CT nondisclosure were analysed by crosstabulations and binary logistic regression analysis with SPSS (v28). Results Three types of patient silence were revealed. Avoidant silence illustrates the respondents coping with the fear of unwanted response from a physician and avoiding the expected negative consequences of CT disclosure. Precautionary silence exemplifies respondents striving to prevent the reoccurrence of previously experienced frustration of wishes to be seen and heard as CT users. Conditional silence portrays the self-confidence of respondents who assessed their need to disclose CT use to physicians on a case-by-case basis. Conclusions Silence, for some patients, may serve as a way of warding off past and possible future fears and frustrations related to CT disclosure. It is important to recognise different types of patient silence related to CT disclosure to enhance patient participation and shared decision-making in health care. Efforts are needed to provide health policy decision-makers with information about CT users’ lived experiences with CT communication in health care.

Background: In health care, two in three users of complementary therapies (CT) stay silent about their CT use. Disclosure of CT use to physicians is important for patient safety, participation, and shared decision-making. Common reasons for CT nondisclosure include patients´ expectations of physicians' unaccepting response to disclosure, physicians not asking, and patients believing it is unnecessary. This study aimed to increase understanding of patient silence. We investigated how the reasons for nondisclosure of CT use reported by CT users were associated with the frequency of CT disclosure and how these associations and reported justifications to keep silent reflect patient silence among the study participants. Methods: This mixed-methods study used existing data from the non-probability-based online survey (n = 6802) targeted to CT users among the general population in Finland. A qualitative structured tabular thematic analysis was conducted for the selected 342 brief texts describing the reasons and justification for not telling physicians about CT use. The associations between the frequency of CT disclosure and the reasons for CT nondisclosure were analysed by crosstabulations and binary logistic regression analysis with SPSS (v28). Results: Three types of patient silence were revealed. Avoidant silence illustrates the respondents coping with the fear of unwanted response from a physician and avoiding the expected negative consequences of CT disclosure. Precautionary silence exemplifies respondents striving to prevent the reoccurrence of previously experienced frustration of wishes to be seen and heard as CT users. Conditional silence portrays the self-confidence of respondents who assessed their need to disclose CT use to physicians on a case-by-case basis. Conclusions: Silence, for some patients, may serve as a way of warding off past and possible future fears and frustrations related to CT disclosure. It is important to recognise different types of patient silence related to CT disclosure to enhance patient participation and shared decision-making in health care. Efforts are needed to provide health policy decision-makers with information about CT users' lived experiences with CT communication in health care. [ABSTRACT FROM AUTHOR]

Having a healthy lifestyle is one of the main personal goals, and multiple behaviors can be used to achieve this goal. However, people do not always develop appropriate health behaviors. One of the consumption alternatives is the use of complementary and alternative medicine (CAM), which has been increasing significantly in recent years, although not always adequately. This study aimed to determine whether CAM use is associated with a healthy lifestyle in Spanish adults. To achieve these objectives, 2486 adults were interviewed as part of the 2018 Barometer of the Centro de Investigaciones Sociológicas about their lifestyle and CAM use. The findings show a relationship between healthy lifestyle and CAM use; our study shows that there are significant differences between people with healthier lifestyles and those with less healthy lifestyles in some of CAM use, such as herbal medicine, meditation, yoga, nutritional therapies, and acupuncture. [ABSTRACT FROM AUTHOR]

Vaccine hesitancy and its determinants have been previously widely researched. Vaccine hesitancy has been defined as a continuum of attitudes, ranging from accepting vaccines with doubts to rejecting them. The present study aims to explore the heterogeneity of a childhood-vaccine-hesitant group by using a person-oriented approach–latent profile analysis. A non-representative cross-sectional sample of vaccine-hesitant Slovenians (N = 421, Mage = 35.21, 82.9% women) was used to identify differences based on their reliance on personal research ("self" researching instead of relying on science), overconfidence in knowledge, endorsement of conspiracy theories, complementary and alternative medicine, and trust in the healthcare system. The analysis revealed three profiles of vaccine-hesitant individuals. The most hesitant profile—vaccine rejecting—expressed the greatest reliance on personal research, expressed the highest endorsement of conspiracy theories and complementary and alternative medicine, showed moderate overconfidence in their knowledge, and expressed the highest levels of distrust in the healthcare system. We further found differences in sociodemographic structure and that the identified profiles differed in their attitudes regarding MMR, HPV, and Seasonal Influenza vaccinations. The present study demonstrates the heterogeneity of the vaccine-hesitant community and offers insights into some of the traits, which are crucial for designing pro-vaccine campaigns. [ABSTRACT FROM AUTHOR]

Purpose: This article explored Licensed Clinical Social Workers (LCSWs) beliefs, attitudes, and knowledge of Complementary and Alternative Interventions (CAI). Method: We utilized a cross-sectional online survey among a sample of 193 LCSWs. Results: Approximately 60% of LCSWs assessed for and utilized CAI professionally, and 90% personally utilized CAI. LCSWs had moderately positive beliefs, neutral attitudes, and high baseline knowledge of CAI. Age and years of practice were the only significant correlates, and the only significant predictor for assessment and utilization of CAI was positive attitudes. Discussion: As the largest group of mental health providers, we found that it is vital for LCSWs to have a solid understanding of CAI to provide effective and safe services to the clients they serve. It is hoped that the results of this study will serve as a starting point for future research on CAI among social workers, with the goal of enhancing client-centered practice. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis is a parasitic skin disease prevalent in many parts of the world. Zinc has been investigated for its potential role in the immune response against Leishmania parasites. This study aimed to systematically review the literature and conduct meta-analyses to evaluate the serum zinc level and efficacy of zinc therapy in cutaneous leishmaniasis. A comprehensive search of electronic databases was performed to find studies reporting serum zinc levels and the efficacy of zinc therapy in cutaneous leishmaniasis. Meta-analyses were conducted using RevMan software (version 5.4), calculating the mean difference for serum zinc levels and risk ratio for the efficacy of zinc therapy. A total of 11 studies with 1009 participants were evaluated. Five of these studies, comprising 637 participants, examined serum zinc levels; the remaining six, involving 372 individuals, examined the effectiveness of zinc therapy in treating cutaneous leishmaniasis. The results showed that the serum zinc level was significantly lower in cutaneous leishmaniasis patients compared to controls (MD: − 26.65; 95% CI: [− 42.74, − 10.57]; p = 0.001). However, zinc therapy did not demonstrate a significant clinical improvement compared to standard treatment (RR: 0.96; 95% CI: [0.74, 1.23], p = 0.73). [ABSTRACT FROM AUTHOR]

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Background and aim: Pediatric high-grade gliomas (pedHGG) comprise a very poor prognosis. Thus, parents of affected children are increasingly resorting to complementary and alternative medicine (CAM), among those Boswellia extracts. However, nothing is known about the therapeutic effectiveness of their active substances, Boswellic acids (BA) in pedHGG. Thus, we aimed to investigate if the three main Boswellic acids (BA) present in Boswellia plants, alpha-boswellic acid (α-BA), beta-boswellic acid (β-BA) and 3-acetyl-11-keto-beta-boswellic acid (AKBA) hold any promising potential for treatment of affected pedHGG patients. Experimental procedure: Histone 3 (H3)-wildtype and H3.3K27M-mutant pedHGG cell lines were treated with BA, either alone or in combination with radio-chemotherapy with temozolomide. Cell viability, stemness properties, apoptosis, in ovo tumor growth and the transcriptome was investigated upon BA treatment. Results and conclusion: Interestingly, α-BA and β-BA treatment promoted certain tumor properties in both pedHGG cells. AKBA treatment reduced cell viability and colony growth accompanied by induction of slight anti-inflammatory effects especially in H3.3K27M-mutant pedHGG cells. However, no effects on apoptosis and in ovo tumor growth were found. In conclusion, besides positive anti-tumor effects of AKBA, tumor promoting effects were observed upon treatment with α-BA and β-BA. Thus, only pure AKBA formulations may be used to exploit any potential positive effects in pedHGG patients. In conclusion, the use of commercially available supplements with a mixture of different BA cannot be recommended due to detrimental effects of certain BA whereas pure AKBA formulations might hold some potential as therapeutic supplement for treatment of pedHGG patients.

Purpose: This cross-sectional study aimed to investigate the prevalence and characteristics of supplement usage among cancer patients and explore its potential associations with anxiety, excessive daytime sleepiness, and overall quality of life. Methods: Cancer patients receiving specific care at Hôtel Dieu de France University Hospital, Beirut, were enrolled between April and June 2023. In face-to-face interviews, participants were asked to complete a questionnaire consisting of sociodemographic information, supplement usage details, and cancer-related variables. Three validated surveys (Epworth Sleepiness Scale, GAD-7, and EORTC-QLQ-C15-PAL) were employed to assess excessive daytime sleepiness, anxiety, and overall quality of life. Statistical analyses, including chi-square tests, t-tests, and multiple regression models, were conducted to examine associations between supplement use and other variables. Results: A total of 202 participants were interviewed. Fifty-two percent reported regular use of supplements following their cancer diagnosis, with vitamin D being the most commonly used supplement. Using multivariate logistic regression, supplement use was associated with being female, having lower educational levels, having a longer duration since cancer diagnosis, and having a poor overall quality of life. The multivariate logistic regression showed no significant correlation between supplement use and excessive daytime sleepiness and anxiety. Conclusion: This study highlights a high prevalence of supplement usage among cancer patients in Lebanon, indicating a rising interest in alternative therapies aimed at enhancing quality of life. Larger prospective studies are needed to assess the relation between supplement intake and excessive daytime sleepiness and anxiety and establish clear guidelines pertaining to supplement use in cancer patients. [ABSTRACT FROM AUTHOR]

Background: In India, cancer of the cervix is the second most common cancer in women. Nowadays, various traditional herbal formulations can be used as adjuncts during conventional cancer therapies due to their anticancer activity. Habbe Musaffi Khoon (HMK), a Unani compound formulation, is traditionally used as a blood purifier and thus used to treat boils, scabies, acne, and pimples. It is also indicated in skin diseases, Habis-ud-Dam (styptic), and therapeutically used in Nafz-ud-Dam (hemorrhagic). Objectives: The main purpose of this work was to phytochemically characterize HMK aqueous extract (HMKaq) and determine its activity against cervical cancer cells. Materials and Methods: HMKaq was subjected to liquid chromatography-mass spectrometry (LC-MS) and evaluated for the presence of phytocompounds. HMKaq was evaluated for its effect on the viability of cervical cancer cells (HeLa, SiHa, and C33A) and was determined by MTT assay. Trypan blue dye exclusion was used to determine the outcome of HMKaq on the growth kinetics of cervical cancer cells. The role of HMK in regulating the cell cycle was analyzed by FACS and its effect on apoptosis was evaluated by checking mitochondrial membrane potential readings of JC-1 aggregates on a microplate reader and on the mRNA expression of caspase-3 and cytochrome C was evaluated by PCR. Results: LC-MS analysis revealed 3845 compounds, out of which 58 were the major compounds. These included phenolics, esters, fatty acids, furans, quinones, tannins, flavonoids, and terpenes. HMKaq reduced the viability and growth of the cells. It induced arrest in the cell cycle of HeLa and apoptosis in SiHa and C33A by depolarizing the membrane potential of the mitochondria and upregulation of mRNA expression of Cas3 and Cyt C. Conclusion: HMK exhibited anticancer activity against cervical cancer cells, thereby signifying its therapeutic potential. [ABSTRACT FROM AUTHOR]

This paper examines the predictors of belief in the efficacy of complementary and alternative medicine (CAM) and its use, including cognitive factors (scientific reasoning, health literacy, locus of control), beliefs (holistic and magical health beliefs pseudoscientific beliefs, and trust in doctors), sociodemographic factors, and cancer diagnosis. The sample consisted of 177 women (41.8% with a cancer diagnosis; Mage = 38.81, SD = 11.43). Beliefs in efficacy and use of CAM were the main outcome measures; preference for CAM over conventional treatment was a secondary outcome measure. Pseudoscientific/magical beliefs and external locus of control were the strongest predictors of positive attitudes toward CAM and its higher use, as well as preference for CAM instead of conventional treatment. Cancer diagnosis predicted only higher CAM use, but not more positive attitudes to CAM, nor preference for CAM instead of conventional medicine. Women with cancer had significantly more pseudoscientific beliefs than women without cancer and had a higher external locus of control over their health. Women with pseudoscientific/magical beliefs favor CAM treatments independently of the cancer diagnosis, although the diagnosis of cancer also contributes to their higher use of CAM. In other words, it seems improbable that women would turn toward CAM treatment only after being diagnosed with cancer. [ABSTRACT FROM AUTHOR]

Rationale & Objective: Complementary and alternative medicine (CAM) intake is widely prevalent in many parts of India. Heavy metals are known ingredients in some of these formulations. We studied the spectrum of glomerular diseases in patients using CAM. Study Design: Case series. Setting & Participants: Patients with proteinuria or unexplained acute kidney injury, who underwent a kidney biopsy between May 2021 and September 2022, and who provided a history of recent CAM intake were included in the study. For patients enrolled prospectively, blood and urine samples were analyzed using mass spectrometry for the presence of mercury, lead, arsenic and cadmium. The CAM formulation, when available, was analyzed using inductively coupled plasma-optical emission spectroscopy. Results: Twenty-eight patients were enrolled in the study, with a median duration of CAM intake of 4 months (interquartile range, 2-6 months). Heavy metal screening was performed in 17 patients, of whom 15 had elevated urine mercury levels, 10 had elevated blood mercury levels, and 1 had elevated blood and urine arsenic levels. Of the 6 CAM formulations that were analyzed, all had high levels of mercury. Kidney biopsy findings were membranous nephropathy (n = 19), minimal change disease (n = 8), and mesangial proliferative glomerulonephritis (n = 1). Of the 19 patients with membranous nephropathy, 14 were associated with neural epidermal growth factor-like protein 1 (NELL-1). With conservative management alone, 17 patients achieved complete remission. Limitations: Not all patients underwent blood and urine mercury testing, and only 6 patients provided the CAM samples for analysis. Furthermore, occupational and residential exposure to mercury could not be excluded. Conclusions: The most common kidney pathology noted in our study was membranous nephropathy, which was predominantly associated with neural epidermal growth factor-like protein 1. A significant proportion of the patients recovered completely after withdrawal of the offending agent and initiation of renin-angiotensin system blockade. Plain Language Summary: Complementary and alternative medicine (CAM) intake is widely prevalent in many parts of India, and heavy metals are known ingredients in some of these formulations. We describe the clinical spectrum of kidney disease, among patients who had recently ingested CAM. All patients underwent a kidney biopsy, and the most common finding was an entity called “NELL-1-associated membranous nephropathy,” which is known to be associated with heavy metal toxicity and CAM intake. Of 17 patients screened for such heavy metals, 15 had greater-than-permissible levels of mercury. Furthermore, 6 patients provided the CAM formulations that they had consumed for analysis: all contained high levels of mercury. Most such patients recovered following withdrawal of the offending CAM agent.

Abstract The effects of camel milk (CM) intake on lipid profile among patients with diabetes remain controversial. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to calculate the effect size of CM intake on blood lipids among patients with type 1 (T1D) and type 2 (T2D) diabetes. We searched nine databases from inception until December 31, 2022, to identify relevant RCTs. Effect sizes for total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), and high-density lipoprotein (HDL) were calculated and expressed using mean differences (MD) and confidence intervals (CI). Of 4,054 retrieved articles, 10 RCTs (a total of 347 participants aged 8–70 years, 60.5% male) were eligible for inclusion. The pooled results from a random-effects model showed statistically significant decreases in TC (MD − 21.69, 95% CI: 41.05, − 2.33; p = 0.03; I 2=99%), TG (MD − 19.79, 95% CI: −36.16, − 3.42; p=0.02, I 2=99%), and LDL (MD −11.92, CI: −20.57, −3.26; p = 0.007, I 2=88%), and a significant increase in HDL (MD 10.37, 95% CI, 1.90, 18.84; p=0.02, I 2=95%) in patients with diabetes supplemented with CM compared with usual care alone. Subgroup analysis revealed that only long-term interventions (> 6 months) elicited a significant reduction in TC levels and TG levels. Consumption of fresh CM by patients with diabetes resulted in significant reductions in TC, TG, and LDL levels, while showing a significant increase in HDL levels. Patients with T1D elicited a more beneficial effect in lowering TC, LDL, and TG levels and in increasing HDL levels than their corresponding partners with T2D. In conclusion, long-term consumption of CM for patients with diabetes, especially those with T1D, could be a useful adjuvant therapy to improve lipid profile alongside prescribed medications. However, the high heterogeneity in the included studies suggests that more RCTs with larger sample sizes and longer intervention durations are required to improve the robustness of the available evidence.

Vaccine hesitancy and its determinants have been previously widely researched. Vaccine hesitancy has been defined as a continuum of attitudes, ranging from accepting vaccines with doubts to rejecting them. The present study aims to explore the heterogeneity of a childhood-vaccine-hesitant group by using a person-oriented approach–latent profile analysis. A non-representative cross-sectional sample of vaccine-hesitant Slovenians (N = 421, Mage = 35.21, 82.9% women) was used to identify differences based on their reliance on personal research (“self” researching instead of relying on science), overconfidence in knowledge, endorsement of conspiracy theories, complementary and alternative medicine, and trust in the healthcare system. The analysis revealed three profiles of vaccine-hesitant individuals. The most hesitant profile—vaccine rejecting—expressed the greatest reliance on personal research, expressed the highest endorsement of conspiracy theories and complementary and alternative medicine, showed moderate overconfidence in their knowledge, and expressed the highest levels of distrust in the healthcare system. We further found differences in sociodemographic structure and that the identified profiles differed in their attitudes regarding MMR, HPV, and Seasonal Influenza vaccinations. The present study demonstrates the heterogeneity of the vaccine-hesitant community and offers insights into some of the traits, which are crucial for designing pro-vaccine campaigns.

Abstract Background Population based studies have shown large differences in the estimated prevalence of complementary and integrative health (CIH) usage between studies. This is in part due to there being no golden standard definition for CIH. In Finland, an updated and internationally comparable study on the prevalence of CIH usage is needed. In the present study, a modified Finnish version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-QFI) was utilised to examine prevalence of use of different CIH modalities and their experienced helpfulness in the general Finnish population. Methods Respondents aged 16 and above were invited to take part in this descriptive cross-sectional study through an online panel in December 2022. The usage of CIH and the experienced helpfulness were calculated with SPSS (v28) as the proportion of users per each modality. The data were weighted based on gender, age and place of residence. Results A total of 3244 respondents completed the survey. CIH was used by 51.1% (95%CI: 49.4–52.8) of the respondents in the 12 months prior to the survey. Self-help practices were the most used category of CIH (28.8%; 95%CI: 27.3–30.4). The prevalence of usage of CIH natural remedies excluding vitamins and minerals was 27.0% (95%CI: 25.5–28.6). CIH providers were visited by 20.4% of the respondents (95%CI: 19.0–21.8). Getting help for a long-term illness or improvement of well-being were often mentioned as the most important reason for the use of different CIH modalities. CIH was generally used more by women compared to men. The large majority found the modalities they used helpful. Conclusions The results increase current understanding on CIH usage in Finland. As the majority of users experience CIH as helpful, there is a need to study CIH in the context of public health policies. The estimates of CIH usage are highly dependent on what is considered as CIH, and this should be paid attention to in future studies.

The effects of camel milk (CM) intake on lipid profile among patients with diabetes remain controversial. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to calculate the effect size of CM intake on blood lipids among patients with type 1 (T1D) and type 2 (T2D) diabetes. We searched nine databases from inception until December 31, 2022, to identify relevant RCTs. Effect sizes for total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), and high-density lipoprotein (HDL) were calculated and expressed using mean differences (MD) and confidence intervals (CI). Of 4,054 retrieved articles, 10 RCTs (a total of 347 participants aged 8–70 years, 60.5% male) were eligible for inclusion. The pooled results from a random-effects model showed statistically significant decreases in TC (MD − 21.69, 95% CI: 41.05, − 2.33; p = 0.03; I2=99%), TG (MD − 19.79, 95% CI: −36.16, − 3.42; p=0.02, I2=99%), and LDL (MD −11.92, CI: −20.57, −3.26; p = 0.007, I2=88%), and a significant increase in HDL (MD 10.37, 95% CI, 1.90, 18.84; p=0.02, I2=95%) in patients with diabetes supplemented with CM compared with usual care alone. Subgroup analysis revealed that only long-term interventions (> 6 months) elicited a significant reduction in TC levels and TG levels. Consumption of fresh CM by patients with diabetes resulted in significant reductions in TC, TG, and LDL levels, while showing a significant increase in HDL levels. Patients with T1D elicited a more beneficial effect in lowering TC, LDL, and TG levels and in increasing HDL levels than their corresponding partners with T2D. In conclusion, long-term consumption of CM for patients with diabetes, especially those with T1D, could be a useful adjuvant therapy to improve lipid profile alongside prescribed medications. However, the high heterogeneity in the included studies suggests that more RCTs with larger sample sizes and longer intervention durations are required to improve the robustness of the available evidence. [ABSTRACT FROM AUTHOR]

The purpose of this evidence-based project (EBP) was to determine if an evidence-based sleep health and wellness intervention improved sleep in veterans self-reporting a history of insomnia. Insomnia can negatively affect an individual's physical and psychological well-being, as well as increase health-care costs and decrease the overall quality of life. The intervention utilized a combination of insomnia treatments, delivered to two American Legion veteran participant groups: an Alabama American Legion Retreat and individuals at an American Legion Post site. The holistic-focused modalities used in this intervention included Cognitive Behavioral Therapy for Insomnia (CBT-I) techniques, sleep hygiene principles, and Complementary and Alternative Medicine (CAM) methods. The measurement tool, the Insomnia Severity Index (ISI), indicated statistically significant changes in the severity of participants' self-reported insomnia. Based upon the research evidence and results of the pre- and post-test ISI, a more permanent, ongoing sleep health and wellness intervention is feasible and would have numerous beneficial effects for the veteran's management of insomnia symptoms. Future efforts include implementing sleep hygiene, CAM interventions, and holistic nursing-supported education interventions at other sites and venues within the Alabama American Legion, as well as maintaining long-term community partnerships with veteran groups such as the Alabama American Legion. [ABSTRACT FROM AUTHOR]

Traditional medicine has been practised for millennia in the Sámi population, based on a Sámi worldview and cosmology, which includes natural remedies, prayers, drums and yoik singing. During the Christianisation of the Sámi during the seventeenth and eighteenth centuries, these practices were condemned. In recent years, however, a revival of Sámi culture has occurred and so has the practice of Sámi traditional medicine (STM) and the use of complementary alternative medicine (CAM). The aim of this study is to map the prevalence and use of STM and CAM among Sámi in Sweden today. The study population consisted of 3641 Sámi from the whole of Sweden, who had participated in the population-based cross-sectional survey Sámi Health on Equal Terms (SámiHET) in 2021. Our results show that women are more prone to use both STM and CAM than men and that younger persons are more likely to use STM and CAM than elderly persons. STM is more often used in the northern parts of Sápmi compared to the southern parts as well as a lower use of CAM in the north. This might be due to the stronger Sámi identity and easier access to traditional Sámi healers/helpers in the north as well as limited access to CAM services [ABSTRACT FROM AUTHOR]

The increasing demand for fertility treatments has led to the rise of private clinics offering complementary and alternative medicine (CAM) treatments. The most frequently offered CAM infertility treatment is acupuncture. However, there is no good evidence to support the effectiveness of acupuncture in treating infertility. This study evaluates the scope of information provided by CAM fertility clinics in the UK. A content analysis was conducted on 200 websites of CAM fertility clinics in the UK that offer acupuncture as a treatment for infertility. Of the 48 clinics that met the eligibility criteria, the majority of the websites did not provide sufficient information on the efficacy, risks and success rates of acupuncture for infertility. This has the potential to infringe on patient autonomy, provide false hope and reduce the chances of pregnancy ever being achieved as fertility declines during the time course of ineffective acupuncture treatment. [ABSTRACT FROM AUTHOR]

ABSTRACTTraditional medicine has been practised for millennia in the Sámi population, based on a Sámi worldview and cosmology, which includes natural remedies, prayers, drums and yoik singing. During the Christianisation of the Sámi during the seventeenth and eighteenth centuries, these practices were condemned. In recent years, however, a revival of Sámi culture has occurred and so has the practice of Sámi traditional medicine (STM) and the use of complementary alternative medicine (CAM). The aim of this study is to map the prevalence and use of STM and CAM among Sámi in Sweden today. The study population consisted of 3641 Sámi from the whole of Sweden, who had participated in the population-based cross-sectional survey Sámi Health on Equal Terms (SámiHET) in 2021. Our results show that women are more prone to use both STM and CAM than men and that younger persons are more likely to use STM and CAM than elderly persons. STM is more often used in the northern parts of Sápmi compared to the southern parts as well as a lower use of CAM in the north. This might be due to the stronger Sámi identity and easier access to traditional Sámi healers/helpers in the north as well as limited access to CAM services

Background: Population based studies have shown large differences in the estimated prevalence of complementary and integrative health (CIH) usage between studies. This is in part due to there being no golden standard definition for CIH. In Finland, an updated and internationally comparable study on the prevalence of CIH usage is needed. In the present study, a modified Finnish version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-QFI) was utilised to examine prevalence of use of different CIH modalities and their experienced helpfulness in the general Finnish population. Methods: Respondents aged 16 and above were invited to take part in this descriptive cross-sectional study through an online panel in December 2022. The usage of CIH and the experienced helpfulness were calculated with SPSS (v28) as the proportion of users per each modality. The data were weighted based on gender, age and place of residence. Results: A total of 3244 respondents completed the survey. CIH was used by 51.1% (95%CI: 49.4–52.8) of the respondents in the 12 months prior to the survey. Self-help practices were the most used category of CIH (28.8%; 95%CI: 27.3–30.4). The prevalence of usage of CIH natural remedies excluding vitamins and minerals was 27.0% (95%CI: 25.5–28.6). CIH providers were visited by 20.4% of the respondents (95%CI: 19.0–21.8). Getting help for a long-term illness or improvement of well-being were often mentioned as the most important reason for the use of different CIH modalities. CIH was generally used more by women compared to men. The large majority found the modalities they used helpful. Conclusions: The results increase current understanding on CIH usage in Finland. As the majority of users experience CIH as helpful, there is a need to study CIH in the context of public health policies. The estimates of CIH usage are highly dependent on what is considered as CIH, and this should be paid attention to in future studies. [ABSTRACT FROM AUTHOR]

Purpose: Mistletoe treatment is discussed controversial as a complementary treatment for cancer patients. Aim of this systematic analysis is to assess the concept of mistletoe treatment in the clinical studies with respect to indication, type of mistletoe preparation, treatment schedule, aim of treatment, and assessment of treatment results. Methods: In the period from August to December 2020, the following databases were systematically searched: Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PsycINFO, CINAHL, and "Science Citation Index Expanded" (Web of Science). We assessed all studies for study types, methods, endpoints and mistletoe preparations including their ways of application, host trees and dosage schedules. Results: The search concerning mistletoe therapy revealed 3296 hits. Of these, 102 publications and at total of 19.441 patients were included. We included several study types investigating the application of mistletoe in different groups of participants (cancer patients of any type of cancer were included as well as studies conducted with healthy volunteers and pediatric patients). The most common types of cancer were breast cancer, pancreatic cancer, colorectal cancer and malignant melanoma. Randomized controlled studies, cohort studies and case reports make up most of the included studies. A huge variety was observed concerning type and composition of mistletoe extracts (differing pharmaceutical companies and host trees), ways of applications and dosage schedules. Administration varied e. g. between using mistletoe extract as sole treatment and as concomitant therapy to cancer treatment. As the analysis of all studies shows, there is no relationship between mistletoe preparation used, host tree and dosage, and cancer type. Conclusions: Our research was not able to deviate transparent rules or guidelines with respect to mistletoe treatment in cancer care. [ABSTRACT FROM AUTHOR]

Objective: The aim of this cohort study was to gain insight on influencing factors on the decision-making process in conventional medicine compared to complementary and alternative medicine (CAM). Methods: A standardized questionnaire was distributed among cancer patients who attended the counselling facility for CAM of a German university hospital in 2020. Results: Fifty patients (30.3%) returned the questionnaire. After counselling on CAM, most patients made a decision in CAM but also in conventional medicine. Thus, the focus on informed decision-making during counselling on CAM had a strong effect on the decision-making process in conventional medicine. Patients reporting good support also reported making decisions together with physicians and relatives. Moreover, after counselling on CAM, patients reported being more satisfied with their decision in both settings afterwards. Conclusion: Information on CAM which focuses on informed decision-making, supports patient's ability to understand and weigh risks and benefits of treatments, supports shared decision-making and enables patients to transfer these competences also to decisions on conventional medicine. So counselling on CAM may further decision-making competences in cancer patients. This encourages patients to engage in shared decision-making and increases patient's satisfaction with decisions. [ABSTRACT FROM AUTHOR]

Introduction: Noncommunicable diseases (NCDs) have emerged as a pandemic globally and the situation is worse for developing nations. The four major NCDs that are responsible for a major proportion of mortality across the globe are cardiovascular diseases, cancer, respiratory diseases, and diabetes. For a country with limited resources, an integrated approach toward the management of NCDs is of particular importance. Complementary and alternative medicines (CAMs) are those health-care and medical practices that are not currently an integral part of conventional medicine system. This study was undertaken to estimate the prevalence, pattern, and predictors of CAM use among patients with NCDs (diabetes, hypertension, or both). Materials and Methods: A health-facility-based cross-sectional study was conducted at different levels of government health-care facilities in Rishikesh, Uttarakhand. CAM categories included alternative medical systems, mind–body intervention, biologically based therapies, manipulative and body-based methods, and energy therapies. Additionally, jhaad phook/local healers were also included in our study. Results: The study showed that 41% of all the study participants were ever users of CAM. While most of the users were practicing more than one type of CAM, the most common type of CAM practiced was alternative medicine system (83.3%) followed by mind–body medicine (40.2%). Except religion and place of residence of the study participant, no other factor showed a significant association with ever usage of CAM. Conclusion: CAM use was popular among study participants as almost half of them were using/consuming it and alternative medicine system was the most common type of CAM practiced.

The present study investigated the use of complementary and alternative medicine (CAM) and its relationship with health-related quality of life (HRQOL) in patients with type 2 diabetes mellitus. A total of 421 patients with type 2 diabetes mellitus who completely met the inclusion criteria, aged 67.3 ± 12.8 years, among 622 outpatients were recruited in this cross-sectional study. We examined the use of CAM, such as supplements, Kampo, acupuncture, and yoga. HRQOL was assessed by EuroQOL. A total of 161 patients (38.2%) with type 2 diabetes mellitus used some type of CAM. The use of supplements and/or health foods was the highest among CAM users (112 subjects, 26.6%). HRQOL was significantly lower in patients who used some CAM (0.829 ± 0.221) than in those without any CAM use (0.881 ± 0.189), even after adjustments for confounding factors [F(1, 414) = 2.530, p = 0.014]. Proper information on CAM is needed for patients with type 2 diabetes mellitus.

Abstract Background Despite progress in haemodialysis and conventional medicine approaches, many patients still struggle to maintain an acceptable quality of life and turn to complementary and alternative medicine (CAM) to address their unmet needs. Objective This study aims to determine the prevalence, types, indications, and factors associated with CAM use by patients on maintenance haemodialysis (MHD) in Cameroon. Materials and methods This was a multicentric cross-sectional study involving MHD patients in Cameroon from February 2019 to May 2019. We included all consenting participants on MHD for at least 3 months and excluded participants with cognitive and behavioral problems. Face-to-face interviews were conducted. Results A total of 224 participants (145 males) with a mean age of 56.5 ± 14.2 years and a median haemodialysis vintage of 34.5 [IQR: 17.3–64.4] months were recruited. In all, 89.7% (n = 201) reported having used CAM before, while 71.6% (n = 144) were still using it. Biologically based therapies were the most popular (94%, n = 189), with herbal medicine (81.5%, n = 154) and Calabar chalk (52.4%, n = 99) being the most common. Physical well-being (57.2%), nausea (52%), and insomnia (42.7%) were the main indications for CAM use. Most respondents did not disclose their CAM use to their physicians (61.2%). Long haemodialysis vintage was associated with CAM use (AOR: 7.9; CI = 2.8–22.3; p

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 present study investigated the use of complementary and alternative medicine (CAM) and its relationship with health-related quality of life (HRQOL) in patients with type 2 diabetes mellitus. A total of 421 patients with type 2 diabetes mellitus who completely met the inclusion criteria, aged 67.3 ± 12.8 years, among 622 outpatients were recruited in this cross-sectional study. We examined the use of CAM, such as supplements, Kampo, acupuncture, and yoga. HRQOL was assessed by EuroQOL. A total of 161 patients (38.2%) with type 2 diabetes mellitus used some type of CAM. The use of supplements and/or health foods was the highest among CAM users (112 subjects, 26.6%). HRQOL was significantly lower in patients who used some CAM (0.829 ± 0.221) than in those without any CAM use (0.881 ± 0.189), even after adjustments for confounding factors [F(1, 414) = 2.530, p = 0.014]. Proper information on CAM is needed for patients with type 2 diabetes mellitus. [ABSTRACT FROM AUTHOR]

The study aimed to determine which factors affected a Thai general practitioner's (GP) intent to take integrative medicine and health (IMH) training. From the literature review, it was noted that IMH has other similar programs globally with names such as complementary and alternative medicine (CAM) and complementary and integrative medical procedures (CIM). Additionally, three latent variables were selected for the study and used in the confirmatory factor analysis (CFA) and structural equation model (SEM) LISREL 9.10 path analysis of the five hypotheses. The SEM results for each GP's training attendance intention (TAI) discovered that first in importance was each medical professional's learning ability (LA), then their perception of the innovative training course (ITC), and finally, their innovative attitude (IA). Final determination was then made that all the causal variables in the model had a positive influence on TAI, with the variability of factors influencing TAI (R2) at 41%. The three causal variables determined to affect TAI had total effect values of 0.64 (LA), 0.52 (ITC), and 0.43 (IA), respectively. [ABSTRACT FROM AUTHOR]

Abstract Background Dealing with the symptom burden of cancer diagnosis and treatment has led parents to seek different self-management strategies including Alternative and Complementary Medicine (CAM). The aim of this study was to perform a systematic review and meta-analysis about the use and effect of CAM modalities to treat adverse effects of conventional cancer treatment among children and young adults. Methods Six scientific research databases were used to identify randomized controlled trials (RCTs) from 1990 to September 2020. Included studies investigated the use of CAM to treat cancer treatment related adverse effects in children and young adults compared to controls. Results Twenty RCTs comprising 1,069 participants were included in this review. The included studies investigated acupuncture, mind–body therapies, supplements, and vitamins for chemotherapy-induced nausea and vomiting (CINV), oral mucositis, and anxiety among children and young adults who underwent conventional cancer treatment. Seven studies (315 participants) were included in the meta-analysis. The overall effect of CAM (including acupuncture and hypnosis only) on chemotherapy-induced nausea and/or vomiting and controls was statistically significant with a standard mean difference of -0.54, 95% CI [-0.77, -0.31] I2 = 0% (p

• The use of herbal medicine has been on the rise, especially in chronic disorders. • This study assesses herbal medicine use in patients with Inflammatory Bowel Disease. • The most frequently herb utilized in this study is Matricaria chamomilla. • Herbal usage significantly correlated with quality of life, and symptom severity. • The results may not be generalizable to all patients with Inflammatory Bowel Disease. The use of complementary and alternative medicine, particularly herbal medicine, is increasing, especially in chronic disorders. This study aims to identify common herbal medicines used by patients with inflammatory bowel disease, and to investigate their relationship with the quality of life, disease severity, and levels of anxiety, stress, and depression experienced by these patients. A total of 104 eligible patients with inflammatory bowel disease and in the middle years of life (20- 60 years old) participated in this cross-sectional study. Data collection was conducted using various assessment tools, i.e. a self-administered ethnomedicine questionnaire, Partial Mayo scoring index assessment, Crohn's disease activity index, Quality of Life Questionnaire, and Depression, Anxiety and Stress Scale. The findings of the present study revealed that 61.5% of the patients surveyed commonly used herbal medicine to alleviate their symptoms in the past year. Among the various herbs, Matricaria chamomilla L., Zataria multiflora Boiss., and Mentha Spicata L. were found to be most commonly used. Furthermore, a significant association was identified between herbal medicine use and age, Body Mass Index, marital status, level of education, alcohol consumption, Quality of Life, and severity disorder scores of the patients. Our results suggested a significant association between herbal medicine use and lower severity disorder scores and higher quality of life in patients with inflammatory bowel disease. However, these findings may not be generalizable to all patients with inflammatory bowel disease, or to patients in other geographical regions. [ABSTRACT FROM AUTHOR]

Background: Despite progress in haemodialysis and conventional medicine approaches, many patients still struggle to maintain an acceptable quality of life and turn to complementary and alternative medicine (CAM) to address their unmet needs. Objective: This study aims to determine the prevalence, types, indications, and factors associated with CAM use by patients on maintenance haemodialysis (MHD) in Cameroon. Materials and methods: This was a multicentric cross-sectional study involving MHD patients in Cameroon from February 2019 to May 2019. We included all consenting participants on MHD for at least 3 months and excluded participants with cognitive and behavioral problems. Face-to-face interviews were conducted. Results: A total of 224 participants (145 males) with a mean age of 56.5 ± 14.2 years and a median haemodialysis vintage of 34.5 [IQR: 17.3–64.4] months were recruited. In all, 89.7% (n = 201) reported having used CAM before, while 71.6% (n = 144) were still using it. Biologically based therapies were the most popular (94%, n = 189), with herbal medicine (81.5%, n = 154) and Calabar chalk (52.4%, n = 99) being the most common. Physical well-being (57.2%), nausea (52%), and insomnia (42.7%) were the main indications for CAM use. Most respondents did not disclose their CAM use to their physicians (61.2%). Long haemodialysis vintage was associated with CAM use (AOR: 7.9; CI = 2.8–22.3; p < 0.001). Conclusions: The use of CAM is common among Cameroon's haemodialysis population, with herbal medicines and Calabar chalk being the most frequent. The high symptom burden makes CAM attractive to them. Healthcare teams should be aware of these practices, initiate an open discussion, and appropriately advise patients about dangers, risks, and safety associated with their use. Trial registration: The institutional review board of the University of Bamenda. Reference: 2019/0038H/UBa/IRB UPM/TNCPI/RMC/1.4.18.2. [ABSTRACT FROM AUTHOR]

Complementary and alternative medicine (CAM) is used by many cancer patients by themselves. Therefore, we conducted a survey regarding the association between CAM, self-efficacy, and patient activation in adult cancer patients. A standardized questionnaire, consisted of the ASKU, the PAM 13-D, and a structured questionnaire on CAM usage from our own working group, was distributed to 880 potential participants. Six hundred and thirty-nine (639) patients (male 32.9%, female 63.2%; gynecological cancer 41%, gastrointestinal 19.2%, urogenital 15.6%) took part. 60% of all patients used CAM in the last 3 months (biological 73%, holistic 63%, mind-body methods 62%). Higher self-efficacy was associated with higher interest in CAM (p = 0.03), but not usage of CAM, compared to patients with lower self-efficacy (p = 0.099). Higher patient activation was associated with higher interest in CAM (p = 0.004) and usage of CAM (p = 0.012). Patients with higher activation significantly more often used homeopathy (p = 0.007), prayer (p = 0.002), yoga, etc. (p = 0.032), meditation (p = 0.002), low carb or ketogenic diets (p < 0.001) (but not vegan or other cancer diets). Higher patient activation is associated with higher usage of CAM. Focusing on patient activation as a goal in patient-physician relationship will help patients to adhere to a healthy lifestyle and to actively participate in the whole treatment process. [ABSTRACT FROM AUTHOR]

This article uses neo-Weberian social closure theory and Bourdieu's theory of symbolic violence to examine the epistemic tension between biomedicine and traditional Chinese medicine (TCM) in Aotearoa New Zealand (NZ), a country that aspires to a multicultural model of healthcare. Drawing on interviews with TCM practitioners and analysis of TCM practitioners' attempt to become a regulated profession, we argue that a multicultural health model remains a myth as biomedical stakeholders deploy material and symbolic forms of social closure that limit the scope of TCM practice. Discourses of the need for scientific evidence, public safety, qualification standards and English language fluency undermine the culturally distinctive but pragmatic forms of medicine that TCM practitioners utilise. This has implications for TCM as practitioners are denied public funding, their scope of practice is limited, and the expectations for TCM to conform to a biomedical model of healthcare have created tensions within the TCM community. [ABSTRACT FROM AUTHOR]