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Song YP, Liu JL, Zong CZ, Zhang FS, Ren YF, Ching YL, Wang YX, Li WX, Zhao H, Huang YR, Gao K. A bibliometric study on trends in chiropractic research from 1920 to 2023. Complement Ther Med 2024; 82:103038. [PMID: 38582375 DOI: 10.1016/j.ctim.2024.103038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/25/2024] [Accepted: 04/03/2024] [Indexed: 04/08/2024] Open
Abstract
OBJECTIVE An increasing body of evidence suggests a positive role of chiropractic in the treatment of neuro-musculoskeletal disorders. This study aims to explore current research hotspots and trends, providing insights into the broad prospects of this field. METHODS A bibliometric review was conducted on all chiropractic articles included in the Web of Science Core Collection before December 31, 2023. RESULTS Over the past century, the volume of research in the field of chiropractic has been fluctuating annually, with four peaks observed in total. The United States, Canada, Australia, and the United Kingdom are leading countries. Chu, Eric Chun-Pu is the author with the most publications, while Bronfort, Gert has the highest total citation count. The University of Southern Denmark has produced the most publications, while Queens University - Canada is the most central institution. The Journal of Manipulative and Physiological Therapeutics is the journal with the most publications and citations, while the Journal of the American Medical Association is the most central journal. The two most-cited articles were both authored by Eisenberg DM. Emerging keywords include "chronic pain" and "skills". The theoretical mechanisms and scientific basis of chiropractic, its clinical practice and safety, education and training, integration with other disciplines, and patient experiences and satisfaction are the frontiers and hotspots of research. CONCLUSION This study integrates bibliometric analysis to summarize the current state of research and global network centers in the field of chiropractic, further highlighting the hotspots and trends in this field. However, Individual and national rankings should be interpreted with caution due to our focus on Web of Science rather than PubMed.
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Affiliation(s)
- Yi-Ping Song
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jia-Li Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Chen-Zhong Zong
- The Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Fang-Shuo Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yan-Feng Ren
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yuen-Lim Ching
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yi-Xiao Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Wen-Xun Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - He Zhao
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
| | - Yi-Ran Huang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China.
| | - Kuo Gao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
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Alnafia A, Binyousef FH, Algwaiz A, Almazyed A, Alduaylij T, Alolaiwi O, Alajlan A, Alsuhaibani M, Alenazi KA. Attitudes Towards Complementary and Alternative Medicine Among Pediatricians in Saudi Arabia. Cureus 2021; 13:e20486. [PMID: 35070536 PMCID: PMC8761483 DOI: 10.7759/cureus.20486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background Complementary and Alternative Medicine (CAM) refers to a variety of healthcare practices outside the domain of conventional medicine, which may be integrated with conventional medicine by many physicians. Objectives This study aims to assess the attitudes and beliefs of pediatricians toward the use of CAM on children and to evaluate their knowledge and experience regarding CAM therapies and their desire for additional CAM training courses. Methods This is a cross-sectional study that was conducted in Saudi Arabia. A self-administered electronic questionnaire consisting of 27 questions was distributed among pediatricians to assess the demographics, beliefs, experiences, and attitudes of pediatricians related to the use of CAM for children. Non-probability convenience sampling was used in selecting the sample of pediatricians. Data analysis was performed using SPSS version 21 (IBM Corp., Armonk, NY). Results In this study, 140 participants completed the questionnaires. Most of the participants were of the male gender (83, 59.3%) and Saudi nationals (127, 90.7%). With regards to questions related to the experiences and opinions of participants regarding the use of CAM, 101 (72.1%) subjects reported the use of CAM among family members. Pediatricians cited affirmative encounters of use of CAM in 94 (67.1%) by parents. Pediatricians were not in favor of the use of CAM for end-stage (114, 81.4%) and chronic disease (108, 77.1%). The overall median self-reported CAM knowledge score was statistically higher for males in comparison with females [3 (IQR 1-5)] versus 2 (IQR 2-4), P = 0.030]. Also for nationality, median scores were significantly greater for the Riyadh region in contrast to other regions [[3 (IQR 2-5)] versus 2 (IQR 1-4), P = 0.041]. There was a significant difference in median scores for qualification of participants (P = 0.002). A multiple pairwise comparison revealed a statistically significant (P = 0.012) difference between participants with the qualification of residents and specialization. No differences in median CAM scores were found for responses related to the experiences, opinions, and attitudes of pediatricians towards the use of CAM therapies. Conclusion Most of the pediatricians in Saudi Arabia don't recommend the use of CAM treatment in their practice, but they acknowledge that learning more about CAM and imparting appropriate knowledge regarding it may incorporate its use in their routine clinical practices in a safe way.
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Affiliation(s)
- Alwaleed Alnafia
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | | | | | - Anas Almazyed
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Tariq Alduaylij
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Osama Alolaiwi
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Abdullah Alajlan
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | | | - Kamel A Alenazi
- Pediatrics, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
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Sathiyan J, Faeyza N, Ramasamy K, Ng WS, Ganapathy S. Complementary and Alternative Medicine Use Among Pediatric Emergency Department Patients in Singapore. Pediatr Emerg Care 2021; 37:e1566-e1570. [PMID: 32530833 DOI: 10.1097/pec.0000000000002117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to determine the prevalence and types of complementary and alternative medicine (CAM) use among pediatric emergency department (ED) patients and perceptions of CAM among the caregivers who administer CAM in Singapore. METHODS A survey was administered in a Singapore ED (June 2016-June 2017). A convenience sample of parents/carers accompanying pediatric patients completed a self-administered questionnaire. The primary outcome measures were prevalence of CAM use and perceptions of CAM. RESULTS Parents/carers of 610 patients participated. Four hundred seventy-five (78.0%, 95% confidence interval, 74.5-81.0) had taken a CAM within the previous 12 months and 110 (18.1%; 95% confidence interval, 14.8-21.0) had taken a CAM on the day of presentation. There were no sex differences between CAM users and nonusers (P = 0.691). The use of CAM was more common among preschool children and younger (62.9%). There was no difference in CAM use among those with and without chronic disease (P = 0.878). Vitamins/supplements, cod liver oil, and probiotics were the most commonly used CAM. A total of 0.7% of CAM use was reported to the ED doctor. There were no adverse effects reported. The perception that CAMs are safe was more common among parents or caregivers who had administered CAM (P = 0.008). CONCLUSIONS Complementary and alternative medicine use is very common among pediatric ED patients in Singapore and is more prevalent than in Australia and the United Kingdom. However, it is not always reported to the doctor. Parents or caregivers who administer CAM are more likely to perceive CAMs to be safe.
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Zisman CR, Patti MA, Kalb LG, Stapp EK, Van Eck K, Volk H, Holingue C. Complementary and Alternative Medicine Use in Children with a Developmental Disability and Co-occurring Medical Conditions. Complement Ther Med 2020; 53:102527. [PMID: 33066848 DOI: 10.1016/j.ctim.2020.102527] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The primary aim of this study was to evaluate differences in the prevalence of complementary and alternative medicine (CAM) usage among children with and without developmental disabilities (DD). Secondarily, the association between CAM usage and comorbid chronic medical conditions was explored among children with DD. DESIGN Data come from the 2012 Child Complementary and Alternative Medicine Supplement of the National Health Interview Survey, a nationally representative sample of children in the United States between the ages of 4 and 17 (n = 10,218).Main outcome measures Multiple logistical regression models provided insight into the relationships between parent-report CAM usage, DD, and chronic medical conditions. RESULTS Children with developmental disabilities were more likely to use CAMs compared to their typically developing peers (21% vs 16%). Children with DDs and comorbid chronic medical conditions used CAMs at even higher rates (23% vs 18%). CONCLUSIONS Results indicated that children with DD, especially those with a co-occurring chronic medical condition, use CAMs more often that typically developing children. Given scarcity of information on safety and effectiveness, clinical providers need to be alert to which children may be more likely to be exposed to CAMs. Communication between parents and providers needs to include discussion of CAM treatments.
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Affiliation(s)
- Corina R Zisman
- Section on the Neurobiology of Fear and Anxiety, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, MD, 20892, United States.
| | - Marisa A Patti
- Department of Epidemiology, Brown University School of Public Health, 121 S Main St, Providence, RI 02903, United States
| | - Luther G Kalb
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Baltimore, MD, 21205, United States; Wendy Klag Center for Autism and Developmental Disabilities, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, United States; Department of Neuropsychology, Kennedy Krieger Institute, 1750 E Fairmount Ave, Baltimore, MD, 21231, United States
| | - Emma K Stapp
- Genetic Epidemiology Branch, Intramural Research Program, National Institute of Mental Health, 35 Convent Drive MSC 3720, Bldg. 35A, Bethesda, MD 20892-3720, United States
| | - Kathryn Van Eck
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, United States; Department of Psychiatry, Kennedy Krieger Institute, 1741 Ashland Ave, Baltimore, MD, 21205, United States
| | - Heather Volk
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Baltimore, MD, 21205, United States; Wendy Klag Center for Autism and Developmental Disabilities, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, United States
| | - Calliope Holingue
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, 624 N Broadway, Baltimore, MD, 21205, United States; Wendy Klag Center for Autism and Developmental Disabilities, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD, 21205, United States; Department of Neuropsychology, Kennedy Krieger Institute, 1750 E Fairmount Ave, Baltimore, MD, 21231, United States
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Fetz K, Längler A, Schwermer M, Carvalho-Hilje C, Vagedes J, Zuzak TJ, Ostermann T. Comparative analysis of resource utilization in integrative anthroposophic and all German pediatric inpatient departments. BMC Health Serv Res 2020; 20:939. [PMID: 33046108 PMCID: PMC7552368 DOI: 10.1186/s12913-020-05782-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 09/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Integrative Medicine (IM) combines conventional and complementary therapies. It aims to address biological, psychological, social, spiritual and environmental aspects of patients' health. During the past 20 years, the use and request of IM in children and adults has grown. Anthroposophic Medicine (AM) is an IM approach frequently used in children in Germany. From both public health and health economic perspectives, it is relevant to investigate whether there are differences in the resource utilization between integrative pediatric departments (IPD) and the entirety of all pediatric departments. METHODS Standard ward documentation data from all German integrative anthroposophic pediatric departments (2005-2016; N = 29,956) is investigated and systematically compared to data of the entirety of all pediatric departments in Germany derived from the Institute for the Hospital Reimbursement System (2005-2016, N = 8,645,173). The analyses focus on: length of stay, Diagnosis Related Groups (DRG), Major Diagnosis Categories (MDC), and effective Case Mix Index (CMI). RESULTS The length of stay in the IPD (M = 5.38 ± 7.31) was significantly shorter than the DRG defined length of stay (M = 5.8 ± 4.71; p < .001; d = - 0.07) and did not exceed or undercut the DRG covered length of stay. Compared to the entirety of all pediatric departments (M = 4.74 ± 6.23) the length of stay was significantly longer in the in the IPD (p <. 001; d = 0.12). The effective CMI in IPD and all pediatric departments were identical (M = 0.76). The frequencies of DRG and MDC differed between IPD and all pediatric departments, with higher frequencies of DRGs and MDCs associated with chronic and severe illnesses in the IPD. CONCLUSIONS Treatment within integrative anthroposophic pediatric departments fits well in terms of the DRG defined conditions concerning length of stay, even though integrative pediatric patients has an increased length of stay of averagely 1 day, which is most likely associated to time consuming, complex integrative treatment approaches and to a certain extend to higher amount of chronic and severe diseases.
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Affiliation(s)
- Katharina Fetz
- Department of Psychology, Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany.
| | - Alfred Längler
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany.,Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany
| | - Melanie Schwermer
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany
| | - Clara Carvalho-Hilje
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany.,Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany
| | - Jan Vagedes
- ARCIM Academic Research in Complementary and Integrative Medicine, Filderstadt, Germany.,Department of Neonatology, University Hospital Tuebingen, Calwerstraße 7, 72076, Tübingen, Germany
| | - Tycho Jan Zuzak
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany.,Department of Pediatric Oncology and Hematology, University Hospital Essen, Hufelandstr.55, 45147, Essen, Germany
| | - Thomas Ostermann
- Department of Psychology, Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany
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Fetz K, Ostermann T, Schwermer M, Appelbaum S, Vagedes J, Zuzak TJ, Längler A. Do patients of integrative anthroposophic pediatric inpatient departments differ? Comparative analysis to all pediatric inpatients in Germany considering demographic and clinical characteristics. BMC Public Health 2019; 19:1623. [PMID: 31795983 PMCID: PMC6889203 DOI: 10.1186/s12889-019-7972-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 11/19/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Integrative medicine (IM) is a patient-centered, evidence-based, therapeutic paradigm which combines conventional and complementary approaches. The use of IM in pediatrics has increased in the past two decades and parents' demand for it is growing. An IM whole systems approach is anthroposophic medicine. Considering the growing demand for integrative approaches in children, it is relevant from a public health perspective to find out which kind of children use IM in Germany and whether they differ from the entirety of pediatric inpatients in Germany. Moreover, it would be interesting to known, whether these patients are willing to travel a longer distance to gain integrative treatment. METHODS The present study investigates the standard ward documentation datasets of 29,956 patients of all German integrative anthroposophic pediatric inpatient wards from 2005 to 2016 and compares them systematically to collect data of the entirety of all pediatric inpatient wards in Germany. Apart from patients' age and gender, and the ICD-10 admission diagnoses, the geographical catchment area of the hospitals were analyzed. RESULTS Sociodemographic characteristics of pediatric inpatients in the integrative anthroposophic departments (IAH) did not differ from the entirety of all pediatric inpatients. Regarding clinical characteristics, higher frequencies were found for endocrine, nutritional and metabolic diseases (IAH: 7.24% vs. 2.98%); mental, behavioral, and neurodevelopmental disorders (IAH: 9.83% vs. 3.78%) and nervous diseases (IAH: 8.82% vs. 5.16%) and lower frequencies for general pediatric diseases such as respiratory diseases (IAH: 17.06% vs. 19.83%), digestive diseases (IAH: 3.90% vs. 6.25%), and infectious and parasitic diseases (IAH: 12.88% vs. 14.82%) in comparison to the entirety of all pediatric inpatients in Germany. The IAH showed a broad catchment area, with most patients being from former, Western federal republic of Germany. Large catchment areas (> 100 km) for the IAH are merely covered by severe and chronic diseases. CONCLUSION Pediatric inpatients of IAH do not differ from the entirety of pediatric inpatients in Germany regarding sociodemographic characteristics but show differences regarding clinical characteristics. Parents are willing to travel further distance to get specialized integrative anthroposophic medical care for children with severe and chronic diseases.
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Affiliation(s)
- Katharina Fetz
- Department of Psychology and Psychotherapy, Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany
| | - Thomas Ostermann
- Department of Psychology and Psychotherapy, Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany
| | - Melanie Schwermer
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany
| | - Sebastian Appelbaum
- Department of Psychology and Psychotherapy, Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany
| | - Jan Vagedes
- ARCIM Institute Academic Research in Complementary and Integrative Medicine, Filderstadt, Germany
- Department of Neonatology, University Hospital Tuebingen, Calwerstraße 7, 72076 Tübingen, Germany
| | - Tycho Jan Zuzak
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany
- Department of Pediatric Oncology and Hematology, University Hospital Essen, Hufelandstr.55, 45147 Essen, Germany
| | - Alfred Längler
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313 Herdecke, Germany
- Professorship for Integrative Pediatrics, Institute for Integrative Medicine, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany
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Mayan M, Alvadj T, Punja S, Jou H, Wildgen S, Vohra S. Parents' experiences of an inpatient pediatric integrative medicine service for symptom management. Explore (NY) 2019; 15:415-418. [PMID: 31377302 DOI: 10.1016/j.explore.2019.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/18/2019] [Accepted: 07/21/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Pediatric integrative medicine (PIM) refers to the combination of treatments from conventional medicine and complementary therapies for which there is evidence of safety and effectiveness. As pediatric use of complementary therapies increases, it is important to determine parental views on the use of these therapies by their children. OBJECTIVE To describe parental experiences with a PIM service for management of pain, nausea/vomiting and anxiety in the context of an inpatient pediatric cardiology unit. DESIGN Telephone interviews were carried out with the parents of pediatric cardiology inpatients. The interviews focused on their and their child's experiences with the PIM service while in the hospital. Interviews were transcribed, and analyzed using qualitative content analysis. RESULTS Data saturation was reached after nine interviews conducted during the period between June 2015 and January 2016. Parents self-reported that the PIM service was particularly helpful at alleviating symptoms of anxiety in their children. Moreover, because their children were more at ease, parents also felt less anxiety. CONCLUSION Pediatric integrative medicine as an adjunct to conventional care is seen as beneficial by parents of children admitted to a pediatric cardiology unit.
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Affiliation(s)
- Maria Mayan
- Community University Partnership for the Study of Children, Youth and Families, Faculty of Extension, University of Alberta, Edmonton, Canada
| | - Tatjana Alvadj
- Community University Partnership for the Study of Children, Youth and Families, Faculty of Extension, University of Alberta, Edmonton, Canada; Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Salima Punja
- Women and Children's Health Research Institute, University of Alberta, 1702 College Plaza, 8215 - 112 Street NW, Edmonton, T6G 2C8 Alberta, Canada
| | - Hsing Jou
- Women and Children's Health Research Institute, University of Alberta, 1702 College Plaza, 8215 - 112 Street NW, Edmonton, T6G 2C8 Alberta, Canada
| | - Sarah Wildgen
- Community University Partnership for the Study of Children, Youth and Families, Faculty of Extension, University of Alberta, Edmonton, Canada
| | - Sunita Vohra
- Women and Children's Health Research Institute, University of Alberta, 1702 College Plaza, 8215 - 112 Street NW, Edmonton, T6G 2C8 Alberta, Canada.
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Ramesh G, Gerstbacher D, Arruda J, Golianu B, Mark J, Yeh AM. Pediatric Integrative Medicine in Academia: Stanford Children's Experience. CHILDREN (BASEL, SWITZERLAND) 2018; 5:E168. [PMID: 30545081 PMCID: PMC6306866 DOI: 10.3390/children5120168] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 02/07/2023]
Abstract
Pediatric integrative medicine is an emerging field which, to date, has not been described in detail in academic medical centers in the United States. Early research of pediatric integrative medicine modalities shows promise for the treatment of common pediatric conditions such as irritable bowel syndrome, acute and chronic pain, headache, and allergy, among others. In light of the growing prevalence of pediatric illnesses and patient complexity, it is crucial to emphasize the patient's overall well-being. As academic centers around the world start to develop pediatric integrative medicine programs, the aim of this manuscript is to briefly highlight evidence of effective integrative treatments in pediatric subspecialties, to describe the establishment of our integrative medicine program, to summarize its early efforts, and to discuss potential barriers and keys to success.
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Affiliation(s)
- Gautam Ramesh
- School of Medicine, University of California, San Diego, La Jolla, CA 92093, USA.
| | - Dana Gerstbacher
- Division of Rheumatology, Department of Pediatrics, School of Medicine, Stanford University, Palo Alto, CA 94304, USA.
| | - Jenna Arruda
- Department of Pediatrics, School of Medicine, Stanford University, Palo Alto, CA 94304, USA.
| | - Brenda Golianu
- Division of Pediatric Anesthesia and Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA 94304, USA.
| | - John Mark
- Division of Pulmonary Medicine, Department of Pediatrics, School of Medicine, Stanford University, Palo Alto, CA 94304, USA.
| | - Ann Ming Yeh
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, School of Medicine, Stanford University, Palo Alto, CA 94304, USA.
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Beliveau PJH, Wong JJ, Sutton DA, Simon NB, Bussières AE, Mior SA, French SD. The chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided. Chiropr Man Therap 2017; 25:35. [PMID: 29201346 PMCID: PMC5698931 DOI: 10.1186/s12998-017-0165-8] [Citation(s) in RCA: 147] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/31/2017] [Indexed: 12/31/2022] Open
Abstract
Background Previous research has investigated utilization rates, who sees chiropractors, for what reasons, and the type of care that chiropractors provide. However, these studies have not been comprehensively synthesized. We aimed to give a global overview by summarizing the current literature on the utilization of chiropractic services, reasons for seeking care, patient profiles, and assessment and treatment provided. Methods Systematic searches were conducted in MEDLINE, CINAHL, and Index to Chiropractic Literature using keywords and subject headings (MeSH or ChiroSH terms) from database inception to January 2016. Eligible studies: 1) were published in English or French; 2) were case series, descriptive, cross-sectional, or cohort studies; 3) described patients receiving chiropractic services; and 4) reported on the following theme(s): utilization rates of chiropractic services; reasons for attending chiropractic care; profiles of chiropractic patients; or, types of chiropractic services provided. Paired reviewers independently screened all citations and data were extracted from eligible studies. We provided descriptive numerical analysis, e.g. identifying the median rate and interquartile range (e.g., chiropractic utilization rate) stratified by study population or condition. Results The literature search retrieved 14,149 articles; 328 studies (reported in 337 articles) were relevant and reported on chiropractic utilization (245 studies), reason for attending chiropractic care (85 studies), patient demographics (130 studies), and assessment and treatment provided (34 studies). Globally, the median 12-month utilization of chiropractic services was 9.1% (interquartile range (IQR): 6.7%-13.1%) and remained stable between 1980 and 2015. Most patients consulting chiropractors were female (57.0%, IQR: 53.2%-60.0%) with a median age of 43.4 years (IQR: 39.6-48.0), and were employed (median: 77.3%, IQR: 70.3%-85.0%). The most common reported reasons for people attending chiropractic care were (median) low back pain (49.7%, IQR: 43.0%-60.2%), neck pain (22.5%, IQR: 16.3%-24.5%), and extremity problems (10.0%, IQR: 4.3%-22.0%). The most common treatment provided by chiropractors included (median) spinal manipulation (79.3%, IQR: 55.4%-91.3%), soft-tissue therapy (35.1%, IQR: 16.5%-52.0%), and formal patient education (31.3%, IQR: 22.6%-65.0%). Conclusions This comprehensive overview on the world-wide state of the chiropractic profession documented trends in the literature over the last four decades. The findings support the diverse nature of chiropractic practice, although common trends emerged.
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Affiliation(s)
| | - Jessica J. Wong
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Canada
- Department of Research, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON M2H 3J1 Canada
| | - Deborah A. Sutton
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Canada
| | - Nir Ben Simon
- Department of Research, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON M2H 3J1 Canada
| | - André E. Bussières
- School of Physical and Occupational Therapy, McGill University, Montréal, Canada
- Département chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Centre de recherche interdisciplinaire en réadaptation (CRIR), Montréal, Canada
| | - Silvano A. Mior
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT) and Canadian Memorial Chiropractic College (CMCC), Toronto, Canada
- Department of Research, Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON M2H 3J1 Canada
| | - Simon D. French
- Department of Public Health Sciences, Queen’s University, Kingston, Canada
- School of Rehabilitation Therapy, Queen’s University, Kingston, Canada
- Department of Chiropractic, Macquarie University, Sydney, Australia
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10
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Ding JL, Taylor DM, Lee M, Johnson OG, Ashok A, Griffiths M, Simma L, Craig SS, Cheek JA, Babl FE. Observational study of alternative therapies among paediatric emergency department patients. Emerg Med Australas 2017; 29:136-142. [PMID: 28244266 DOI: 10.1111/1742-6723.12744] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/22/2017] [Accepted: 01/24/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE While complementary medicine use among ED paediatric patients is common, the use of alternative therapies (ATs; physical or spiritual therapies) is unknown. We aimed to determine the 12 month period prevalence and nature of AT use among paediatric patients and parent perceptions of AT use. METHODS We undertook a cross-sectional survey of a convenience sample of parents of paediatric patients in three EDs in metropolitan Melbourne, Australia (January-June, 2015). Parents were invited to complete a validated, anonymous, self-administered questionnaire. The main outcomes were AT use by the patient and parent perceptions of ATs. RESULTS A total of 806 parents were enrolled. In the previous 12 months, 393 (48.8%) patients had received at least one AT. There were no gender or ethnicity differences between AT users and non-users. AT use was more common among older patients (P < 0.05). Patients with chronic illness tended to use more ATs (P = 0.12). A total of 1091 courses of 43 different ATs had been provided. The most common were massage (16% of patients), chiropractic therapy (9.8%), relaxation (7.2%), meditation (6.2%) and aromatherapy (6.1%). ATs were generally used for musculoskeletal problems, health maintenance, stress and anxiety. Parents who arranged the ATs were significantly more likely to report that ATs are safe, prevent and treat illness, assist prescription medicines and offer a more holistic approach to healthcare (P < 0.001). CONCLUSION AT use is common among paediatric ED patients. Parents who arrange AT have differing perceptions of AT usefulness and safety from those who do not.
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Affiliation(s)
- Juen-Li Ding
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - David McD Taylor
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.,Emergency Department, Austin Health, Melbourne, Victoria, Australia
| | - Marina Lee
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.,Emergency Department, Austin Health, Melbourne, Victoria, Australia
| | - Olivia G Johnson
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Aadith Ashok
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Meg Griffiths
- Paediatric Emergency Department, Monash Medical Centre, Emergency Program, Monash Health, Melbourne, Victoria, Australia.,Monash Emergency Research Collaborative, Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Leopold Simma
- Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Simon S Craig
- Paediatric Emergency Department, Monash Medical Centre, Emergency Program, Monash Health, Melbourne, Victoria, Australia.,Monash Emergency Research Collaborative, Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - John A Cheek
- Paediatric Emergency Department, Monash Medical Centre, Emergency Program, Monash Health, Melbourne, Victoria, Australia.,Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Franz E Babl
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia.,Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia.,Murdoch Children's Research Institute, Melbourne, Victoria, Australia
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11
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Datta M, Vitolins MZ. Food Fortification and Supplement Use-Are There Health Implications? Crit Rev Food Sci Nutr 2017; 56:2149-59. [PMID: 25036360 DOI: 10.1080/10408398.2013.818527] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
UNLABELLED Dietary supplements are a multi-billion dollar industry in the U.S., and their use is increasing exponentially. Additionally, many foods and beverages are increasingly being fortified with single or multiple vitamins and minerals. Consequently, nutrient intakes are exceeding the safe limits established by the Institute of Medicine. In this paper, we examine the benefits and drawbacks of vitamin and mineral supplements and increasing consumption of fortified foods (in addition to dietary intake) in the U.S. POPULATION The pros and cons are illustrated using population estimates of folic acid, calcium, and vitamin D intake, highlighting concerns related to overconsumption of nutrients that should be addressed by regulatory agencies.
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Affiliation(s)
- Mridul Datta
- a Department of Nutrition Science , Purdue University , West Lafayette , Indiana , USA
| | - Mara Z Vitolins
- b Wake Forest School of Medicine , Department of Epidemiology and Prevention , Winston-Salem , North Carolina , USA
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12
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Keim SA, Tchaconas A, Adesman A. Comparison of Support for Breastfeeding Beyond 12 Months of Age from Conventional and Alternative Pediatric Primary Care Providers. Breastfeed Med 2017; 12:345-350. [PMID: 28557563 DOI: 10.1089/bfm.2017.0032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Conventional medicine pediatric care providers (e.g., pediatricians) have been shown to be influential in women's decisions to initiate and sustain breastfeeding. Alternative pediatric care providers (e.g., naturopaths and chiropractors) may also provide breastfeeding support, but this has not been the subject of prior research. Our objective was to compare breastfeeding mothers' perceptions of support from these two provider types in a large sample of women who breastfed for more than 12 months. METHODS We conducted a cross-sectional study of 49,091 U.S. women through online questionnaire distributed through peer breastfeeding groups. We used log-binomial regression to compare those who used an alternative pediatric healthcare provider to care for their child to those who used a conventional provider on perceptions of support and key factors influencing the decision to breastfeed for more than 12 months. RESULTS Those who used an alternative provider were more likely to discuss breastfeeding (Adj RR = 1.25, 95% CI 1.17-1.33), feel comfortable discussing breastfeeding (Adj RR = 1.17; 95% CI 1.15-1.19), and feel supported by the provider (Adj RR = 1.25; 95% CI 1.23-1.28). However, providers' recommendations were not important factors in these women's decision to breastfeed beyond 12 months of age. CONCLUSIONS Mothers who used an alternative care provider as their child's primary source of healthcare rated the provider's breastfeeding support more favorable than those who used a conventional provider (usually a pediatrician). Improving breastfeeding support may be one way to retain families in conventional pediatric primary care, and thereby, ensure children receive comprehensive, evidence-based care.
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Affiliation(s)
- Sarah A Keim
- 1 Center for Biobehavioral Health, The Research Institute , Nationwide Children's Hospital, Columbus, Ohio.,2 Department of Pediatrics, College of Medicine, The Ohio State University , Columbus, Ohio.,3 Division of Epidemiology, College of Public Health, The Ohio State University , Columbus, Ohio
| | | | - Andrew Adesman
- 4 Hofstra Northwell School of Medicine , Hempstead, New York.,5 Cohen Children's Medical Center of New York , New Hyde Park, New York
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13
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McLellan MC, Highfield ES, Woolf AD. Pediatric Health Care Providers’ Attitudes and Referral Predictors for Therapeutic Massage and Acupuncture. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/1533210105280645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this study was to assess pediatric health providers’ attitudes, experience, and referral patterns with respect to therapeutic massage and acupuncture (TM&A). A written survey of experience with and attitudes about TM&A was distributed to a convenience sample of pediatric health care providers attending a regional postgraduate course in April 2002. Bivariate analyses were performed using Fisher’s exact test and the chisquare statistic. Pediatric care providers’ practices of referring patients to TM&A were associated with their own familiarity with and prior use of TM&A as well as their professed comfort level in discussing these modalities. There were no significant differences by professional status, gender, or years in practice in 42% of the respondents who reported making TM&A referrals. Pediatric health care providers’practices in referring patients for TM&A are positively associated with their familiarity with and personal use of TM&A.
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Affiliation(s)
| | | | - Alan D. Woolf
- Harvard Medical School, Academy at Harvard Medical School, Program in Environmental Medicine, Children's Hospital, Boston
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14
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Quimby EL. The Use of Herbal Therapies in Pediatric Oncology Patients: Treating Symptoms of Cancer and Side Effects of Standard Therapies. J Pediatr Oncol Nurs 2016; 24:35-40. [PMID: 17185400 DOI: 10.1177/1043454206296027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Complementary and alternative medicine is increasing in use in the pediatric oncology population. Although there is a multitude of herbal therapies used, the focus of this article is a review of the literature addressing some herbal therapies used to treat the symptoms of cancer and side effects of traditional methods of treatment. Ginger is used in the treatment of nausea and vomiting. St. John's wort is successful in treating depression and anxiety. Echinacea is used as an immunostimulant. Herbal therapies in the pediatric oncology population are usually initiated and managed by parents. Many herbal therapies are beneficial, but some potential herb-drug interactions should be considered. This poses a challenge to the oncology nurse because herbal treatments are managed by the parents and pharmaceuticals are managed by the practitioner. Educating the patient, family, and practitioner is important in ensuring a thorough health history assessment and, subsequently, safe and effective herbal and pharmacological therapies.
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Affiliation(s)
- Erin L Quimby
- Oncology/BMT Unit at Children's Hospital of Philadelphia, USA.
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15
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Italia S, Brüske I, Heinrich J, Berdel D, von Berg A, Lehmann I, Standl M, Wolfenstetter SB. Complementary and Alternative Medicine Use Among Chronically Ill Adolescents from 2 German Birth Cohorts. ACTA ACUST UNITED AC 2016; 23:246-52. [PMID: 27607464 DOI: 10.1159/000448444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Pediatric use of complementary and alternative medicine (CAM) is popular in Europe, and utilization may be even more prevalent in chronically ill children/adolescents. This study's aim is to assess CAM use among adolescents with chronic conditions. METHODS Data on drug utilization (past 4 weeks) and consultation with CAM providers (past year) were collected using a self-administered questionnaire from 4,677 adolescents from the German GINIplus/LISAplus birth cohorts. All reported drugs were classified into therapeutic categories (conventional drugs, homeopathy, herbal drugs, etc.). Additionally, participants were asked to list any chronic diseases (that were parent-reported, physician-verified diagnoses such as allergies, atopic dermatitis, asthma, or other chronic diseases) that they had had over the previous 5 years. RESULTS Compared with the total sample, drug utilization in general (60.1% vs. 41.1%), homeopathy use (11.1% vs. 8.1%), and consultation with CAM providers (16.9% vs. 10.9%) was significantly more prevalent among chronically ill adolescents. However, chronically ill adolescents used relatively (proportion of the defined therapeutic category among all drugs used) more conventional drugs than healthy adolescents. CONCLUSION Compared with healthy adolescents, CAM use is more prevalent among adolescents with chronic conditions. Nevertheless, CAM may predominantly be used as a complementary treatment option rather than substituting conventional drugs.
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Affiliation(s)
- Salvatore Italia
- Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Survey of parental acceptance of massage therapy, energy therapy and acupuncture for their children in the acute pediatric inpatient rehabilitation setting. Complement Ther Med 2016; 27:102-7. [DOI: 10.1016/j.ctim.2016.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 06/06/2016] [Accepted: 06/14/2016] [Indexed: 12/23/2022] Open
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Ralston-Wilson J, Artola E, Lynn AM, Doorenbos AZ. The Feasibility of Developing an Inpatient Acupuncture Program at a Tertiary Care Pediatric Hospital. J Altern Complement Med 2016; 22:458-64. [PMID: 27203737 DOI: 10.1089/acm.2015.0347] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Use of complementary and integrative health approaches has increased significantly in recent decades, with hospital-based acupuncture programs becoming more common. This article presents the feasibility of developing an inpatient acupuncture program at a pediatric hospital. DESIGN AND SETTING In January 2014, Seattle Children's Hospital, a tertiary care pediatric hospital serving patients from a five-state region, began a 6-month pilot project offering inpatient acupuncture. During the pilot, inpatient acupuncture and related manual therapies were provided to pediatric patients age 0-23 years who were admitted to Seattle Children's Hospital or were seen for an outpatient surgical procedure. MEASURES The following data were collected: the reason for the acupuncture consult, type and number of treatments provided, any reported response to treatment, and any reported adverse events. Patients and referring providers gave feedback via questionnaires. RESULTS During the pilot program, 338 treatments were provided to 87 patients. High interest, demand, and positive feedback from hospital providers, patients, and families led to the development of a full-time inpatient acupuncture program. CONCLUSIONS The positive response to Seattle Children's inpatient acupuncture program with feasibility and acceptability demonstrated by increasing consults and patient and provider questionnaire data suggest that similar programs may be of interest to other pediatric hospitals.
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Affiliation(s)
- Jaime Ralston-Wilson
- 1 Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital , Seattle, WA
| | - Elizabeth Artola
- 1 Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital , Seattle, WA
| | - Anne M Lynn
- 1 Department of Anesthesiology and Pain Medicine, Seattle Children's Hospital , Seattle, WA.,2 Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington , Seattle, WA
| | - Ardith Z Doorenbos
- 2 Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington , Seattle, WA.,3 Department of Biobehavioral Nursing and Health Systems, School of Nursing, University of Washington , Seattle, WA
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18
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Schlefman A, Rappaport DI, Adams-Gerdts W, Stubblefield SC. Brief Report: Healing Touch Consults at a Tertiary Care Children's Hospital. Hosp Pediatr 2016; 6:114-8. [PMID: 26822561 DOI: 10.1542/hpeds.2015-0203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Components of complementary and alternative medicine are increasingly being implemented at academic medical centers. These approaches include therapeutic touch or healing touch (HT), an energy-based therapy using light touch on or near the body. Limited data exist regarding complementary and alternative medicine use at children's hospitals. The aim of this study was to evaluate patterns and clinical characteristics of HT consultations among children hospitalized at Nemours/A.I. duPont Hospital for Children. METHODS We conducted a retrospective chart review of all patients hospitalized from January 2012 through December 2013, comparing patients who received HT consultations with those who did not. RESULTS There were 25,396 admissions during the study period; 882 (4%) of these, representing 593 individual patients, received an HT consultation. As compared with those without an HT consultation, patients receiving HT were older (median 12 years vs 5 years, P<.001), female (58% vs 46%, P<.001), and more likely to be admitted to the hematology/oncology or blood/bone marrow transplant units (P<.001). Patients with HT consultations had longer hospitalizations (median 121 hours vs 38 hours, P<.001) and more medical problems (median 12 vs 4, P<.001). Six attending physicians were responsible for placing the majority of HT consultations. Of the 593 patients receiving an HT consultation, 21% received ≥2 consultations during the study period. CONCLUSIONS Certain patients, such as those with longer hospitalizations and more medical problems, were more likely to receive HT consultations. Many patients received multiple consultations, suggesting that HT may be an important aspect of ongoing care for hospitalized children.
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Jatau AI, Aung MMT, Kamauzaman THT, Chedi BAZ, Sha'aban A, Rahman AFA. Use and toxicity of complementary and alternative medicines among patients visiting emergency department: Systematic review. JOURNAL OF COMPLEMENTARY MEDICINE RESEARCH 2016; 5:191-7. [PMID: 27104042 PMCID: PMC4835996 DOI: 10.5455/jice.20160223105521] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/09/2016] [Indexed: 11/23/2022]
Abstract
Many studies have been conducted in health-care settings with regards to complementary and alternative medicine (CAM) use among patients. However, information regarding CAM use among patients in the emergency department (ED) is scarce. The aim of this article was to conduct a systematic review of published studies with regards to CAM use among the ED patients. A literature search of published studies from inception to September 2015 was conducted using PubMed, Scopus, and manual search of the reference list. 18 studies that met the inclusion criteria were reviewed. The prevalence rate of CAM use among ED patients across the studies ranged of 1.4-68.1%. Herbal therapy was the sub-modality of CAM most commonly used and frequently implicated in CAM-related ED visits. Higher education, age, female gender, religious affiliation, and chronic diseases were the most frequent factors associated with CAM use among the ED patients. Over 80% of the ED physicians did not ask the patients about the CAM therapy. Similarly, 80% of the ED patients were ready to disclose CAM therapy to the ED physician. The prevalence rate of CAM use among patients at ED is high and is growing with the current increasing popularity, and it has been a reason for some of the ED visits. There is a need for the health-care professionals to receive training and always ask patients about CAM therapy to enable them provide appropriate medical care and prevent CAM-related adverse events.
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Affiliation(s)
- Abubakar Ibrahim Jatau
- Department of Health Sciences, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak, Kuala Terengganu, Malaysia
| | - Myat Moe Thwe Aung
- Department of Community Medicine, Faculty of Medicine, Universiti Sultan Zainal Abidin, Kampus Kota, Kuala Terengganu, Malaysia
| | | | - Basheer A Z Chedi
- Department of Pharmacology, College of Health Sciences, Bayero University Kano, Kano, Nigeria
| | - Abubakar Sha'aban
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Ab Fatah Ab Rahman
- Department of Health Sciences, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak, Kuala Terengganu, Malaysia
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Complementary and Alternative Medicine use in Pediatric Attention-Deficit Hyperactivity Disorder (ADHD): Reviewing the Safety and Efficacy of Herbal Medicines. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2016. [DOI: 10.1007/s40474-016-0074-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Mustafa G, Bashir N, Aslam M. Parental beliefs and practice of spiritual methods for their sick children at a tertiary care hospital of Pakistan- a cross sectional questionnaire study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:14. [PMID: 26758383 PMCID: PMC4710972 DOI: 10.1186/s12906-016-0986-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 01/05/2016] [Indexed: 01/09/2023]
Abstract
Background Complementary and alternative medicine (CAM) comprises a variety of health care systems, practices, and products that are not usually thought to be part of allopathic medicine. This study investigated the parental beliefs and practices for use of spiritual methods in the treatment and early recovery of their children. Methods We performed a cross-sectional, descriptive study with convenience sampling of parents/caregivers of sick children who were admitted to the Children’s Hospital in Multan. A trained interviewer collected the data. Results A total of 1280 forms were analyzed. The majority of respondents were mothers (1053, 82.4 %), they resided in Multan (817, 63.8 %), and were not educated (754, 58.9 %). A total of 420 (32.8 %) respondents had a low socioeconomic background, 601 (47 %) were middle class, and 259 (20.2 %) were upper class. Grandmothers/mothers advised spiritual methods in the majority of respondents (605, 85.9 %). The parents used a variety of spiritual methods in 704 (55 %) children. Economic status and education showed an inverse relation with the use of CAM. A total of 809 (63.2 %) respondents believed that only a drug would heal the disease, while 575 (44.9 %) believed that spiritual methods have a 25 %–50 % role in healing. A total of 1269 (99.1 %) respondents believed that allopathic drugs are needed for healing, while only 0.9 % considered otherwise. Conclusion The majority of people believe that CAM is a contributory factor towards healing and does not interfere with allopathic treatment. Electronic supplementary material The online version of this article (doi:10.1186/s12906-016-0986-3) contains supplementary material, which is available to authorized users.
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Neri CM, Beeson T, Mead H, Darbari DS, Meier ER. Provider Perspective on Integrative Medicine for Pediatric Sickle Cell Disease-related Pain. Glob Adv Health Med 2016; 5:44-50. [PMID: 26937313 PMCID: PMC4756782 DOI: 10.7453/gahmj.2015.101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Integrative medicine (IM) approaches are sometimes used to manage sickle cell disease (SCD)-related pain. The purpose of this research is to (1) understand provider perspective towards the use of IM for pain in children with SCD at a large urban children's hospital and (2) provide recommendations on how to better promote IM for children and adolescents with SCD. METHODS After approval from the institutional review board, a qualitative case study approach was used with criterion-type purposeful sampling to select providers from the division of hematology to adequately inform the study. Semistructured interviews were completed using audiotape to facilitate transcription. NVivo 10 analytic software (QSR International Pty Ltd, Doncaster, Victoria, Australia) was used to organize data into themes to answer the study questions. RESULTS Ten provider interviews were completed. Attitudes were generally positive, and most providers felt that IM is generally helpful. All providers reported that they do not optimally use integrative therapies for children with SCD. The barriers uncovered focused on lack of process for integration of IM, specifically that IM resources seem transient and based on short-term funding. Provider attitude towards CAM is generally positive, but provider comfort level is highly variable. No providers are completely comfortable with their knowledge base about IM, and increased knowledge is desired. CONCLUSIONS Creation of protocols and processes to incorporate IM into management plans for patients with SCD could help to promote its use. Education of providers about utility and efficacy of IM for SCD-related pain and about existing resources would aid in promotion of IM for children with SCD.
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Affiliation(s)
- Caitlin M Neri
- Division of Pediatric Hematology, Boston Medical Center, Massachusetts; Department of Pediatrics, Boston University School of Medicine (Dr Neri), United States
| | - Tishra Beeson
- Department of Physical Education, School & Public Health, Central Washington University, Ellensburg (Dr Beeson), United States
| | - Holly Mead
- The George Washington University Milken Institute School of Public Health, Washington, DC (Dr Mead), United States
| | - Deepika S Darbari
- Division of Hematology, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; The George Washington University School of Medicine and Health Sciences (Dr Darbari), United States
| | - Emily Riehm Meier
- Division of Hematology, Center for Cancer and Blood Disorders, Children's National Medical Center, Washington, DC; The George Washington University School of Medicine and Health Sciences (Dr Meier), United States
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23
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Defining integrative medicine in narrative and systematic reviews: A suggested checklist for reporting. Eur J Integr Med 2015. [DOI: 10.1016/j.eujim.2014.11.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Italia S, Wolfenstetter SB, Teuner CM. Patterns of complementary and alternative medicine (CAM) use in children: a systematic review. Eur J Pediatr 2014; 173:1413-28. [PMID: 24782030 DOI: 10.1007/s00431-014-2300-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Revised: 02/15/2014] [Accepted: 03/24/2014] [Indexed: 10/25/2022]
Abstract
UNLABELLED Utilization of complementary and alternative medicine (CAM) among children/adolescents is popular. This review summarizes the international findings for prevalence and predictors of CAM use among children/adolescents. We therefore systematically searched four electronic databases (PubMed, Embase, PsycINFO, AMED; last update in 07/2013) and reference lists of existing reviews and all included studies. Publications without language restriction reporting patterns of CAM utilization among children/adolescents without chronic conditions were selected for inclusion. The prevalence rates for overall CAM use, homeopathy, and herbal drug use were extracted with a focus on country and recall period (lifetime, 1 year, current use). As predictors, we extracted socioeconomic factors, child's age, and gender. The database search and citation tracking yielded 58 eligible studies from 19 countries. There was strong variation regarding study quality. Prevalence rates for overall CAM use ranged from 10.9-87.6 % for lifetime use and from 8-48.5 % for current use. The respective percentages for homeopathy (highest in Germany, United Kingdom, and Canada) ranged from 0.8-39 % (lifetime) and from 1-14.3 % (current). Herbal drug use (highest in Germany, Turkey, and Brazil) was reported for 0.8-85.5 % (lifetime) and 2.2-8.9 % (current) of the children/adolescents. Studies provided a relatively uniform picture of the predictors of overall CAM use (higher parental income and education, older children), but only a few studies analyzed predictors for single CAM modalities. CONCLUSION CAM use is widespread among children/adolescents. Prevalence rates vary widely regarding CAM modality, country, and reported recall period.
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Affiliation(s)
- Salvatore Italia
- Department of International Health, School for Public Health and Primary Care (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands,
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Işler A, Turan FD, Gözüm S, Oncel S. Complementary and alternative approaches used by parents of children with epilepsy on epilepsy management. Epilepsy Behav 2014; 32:156-61. [PMID: 24462737 DOI: 10.1016/j.yebeh.2013.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 11/26/2013] [Accepted: 12/15/2013] [Indexed: 11/15/2022]
Abstract
The aim of this study was to determine the complementary and alternative approaches used by parents of children with epilepsy on epilepsy management. This descriptive study included a total of 304 parents of children with epilepsy aged between 0 and 18years evaluated at the Pediatric Neurology Clinic of Akdeniz University Hospital in Turkey between January and May 2013. Data were collected by using a questionnaire developed by the researchers. It was determined that all the parents use complementary and alternative approaches for their children with epilepsy, and the most common approaches are praying (99.3%); keeping their children away from the effects of smoking (79.8%); feeding their children walnuts (79.6%), butter (59.2%), and bone marrow (58.6%); providing their children with good quality sleep (58.6%); and enabling their children to play games (51%). The approaches commonly applied during seizures include praying (96.2%), comforting their children in their arms and showing affection (55.6%), waiting for seizures to finish at home (45.7%), and laying children on their side (41.1%). Of parents, 98% stated that alternative approaches enable them to control their child's seizures, 100% said that alternative approaches have no adverse effect, and 98.4% stated that they will continue to use these approaches. The children's approaches to cope with epilepsy included looking after pets (72.7%), listening to music (70.1%), watching television (64.5%), playing games (55.3%), praying (51%), and spending time with friends (48.7%). Most of the approaches used by parents and children with epilepsy for the management of illness are determined to consist of complementary approaches that may contribute to management of epilepsy. Knowing the approaches of parents and children with epilepsy that could adversely affect disease management is important for educating parents and children to avoid these potentially harmful interventions.
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Affiliation(s)
- Ayşegül Işler
- Akdeniz University, Nursing Faculty, Pediatric Nursing Department, Antalya, Turkey.
| | - Fatma Dilek Turan
- Akdeniz University, Nursing Faculty, Pediatric Nursing Department, Antalya, Turkey.
| | - Sebahat Gözüm
- Akdeniz University, Nursing Faculty, Public Health Nursing Department, Antalya, Turkey.
| | - Selma Oncel
- Akdeniz University, Nursing Faculty, Public Health Nursing Department, Antalya, Turkey.
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Gorodzinsky AY, Davies WH, Drendel AL. Parents' treatment of their children's pain at home: pharmacological and nonpharmacological approaches. J Pediatr Health Care 2014; 28:136-47. [PMID: 23419506 DOI: 10.1016/j.pedhc.2012.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 11/17/2012] [Accepted: 12/17/2012] [Indexed: 11/30/2022]
Abstract
INTRODUCTION During childhood, pain often is experienced on a nearly daily basis. This study focuses on pain alleviation techniques provided by parents, because children's painful experiences are most often treated at home. Hypotheses addressed various factors that can influence use of pain alleviation techniques, including parents' level of catastrophizing about their children's pain, children's age, and conversations with health care professionals. METHOD A total of 756 parents of children ages 6 to 17 years completed an online survey regarding pain alleviation including use and effectiveness of pharmacological and nonpharmacological techniques, pain catastrophizing, and questions regarding dialogue with health care professionals. RESULTS Parents with increased pain catastrophizing used more pharmacological techniques, and child self-administration of pain alleviation techniques increased with the child's age. Parents were more likely to have spoken with their health care professional about pharmacological techniques. DISCUSSION This study provides information that can help health care professionals initiate conversations regarding treatment options and align recommendations with techniques that parents are likely to use, and it can help health care professionals provide supportive alternative recommendations.
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Abstract
Complementary and alternative medicine (CAM) defies simple definition, because the distinction between CAM and conventional medicine is largely arbitrary and fluid. Despite inconclusive data on the efficacy and safety of many CAM treatments in child and adolescent psychiatry, there are enough data on certain treatments to provide guidance to clinicians and researchers. CAM treatments, as adjunctive therapy or monotherapy, can be clinically beneficial and sensible. The low stigma and cost-competitiveness of many CAM psychiatric treatments are highly attractive to children and parents. Physicians need to be knowledgeable about CAM treatments to provide clinically valid informed consent for some conventional treatments.
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Mood disorders in youth: exercise, light therapy, and pharmacologic complementary and integrative approaches. Child Adolesc Psychiatr Clin N Am 2013; 22:403-41, v. [PMID: 23806312 DOI: 10.1016/j.chc.2013.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The therapeutic value of physical exercise, bright light therapy and dawn simulation, and several pharmacologic treatments, including hypericum (St. John's wort), S-adenosylmethionine, and 5-hydroxytryptophan, are reviewed, with a focus on their use for treating major depressive disorder in children and adolescents and also for alleviating depressed mood in the general (nonclinical) population of youth. For each treatment discussed, all published randomized, double-blind, placebo-controlled trials are summarized, along with some additional selected studies. Nutritional psychopharmacology and several other approaches to treating depression will be presented in an upcoming volume in the Child and Adolescent Psychiatric Clinics of North America.
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Lorenc A, Crichton N, Robinson N. Traditional and complementary approaches to health for children: Modelling the parental decision-making process using Andersen's Sociobehavioural Model. Complement Ther Med 2013; 21:277-85. [PMID: 23876557 DOI: 10.1016/j.ctim.2013.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 05/17/2013] [Accepted: 05/22/2013] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Traditional and complementary approaches to health (TCA) are common for children. Andersen's Sociobehavioural Model (SBM) is often used to explain healthcare decision-making. This study aimed to identify the prevalence and determinants of traditional and complementary approaches to health (TCA) in a multi-ethnic child population, and to explore whether the SBM explained TCA health care decision-making in this population. DESIGN Cross-sectional questionnaire survey. NHS ethical approval was given. SETTING GP waiting rooms, Northwest London. MAIN OUTCOME MEASURE AND ANALYSIS All carers/parents (with children under 16), attending GP appointments on specific days, were asked to complete a questionnaire about TCA use; primary outcome 12-month child TCA use. Forward stepwise logistic regression tested appropriateness of the SBM. RESULTS A total of 394 questionnaires were returned, representing 737 children; a quarter White British. Prevalence of 12-month TCA use was 45.4%, mainly food-based herbs/spices for minor illnesses which were used prior to GP consultation. Over half identified that TCA was part of their ethnic/cultural background. Only 29% had discussed TCA with their GP. The strongest predictor of child TCA use in the SBM was carer TCA use, itself influenced by carer gender and ethnicity, and GP advice. Need factors were not influential. CONCLUSIONS Child TCA use was common in this multi-ethnic community, particularly the use of food-based remedies for minor illnesses, and carers' experience and background are central in deciding to use TCA for a child. TCA appears practiced as part of cultural background, with implications for GPs to be aware of their role in guiding patients to ensure safe practice.
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Affiliation(s)
- Ava Lorenc
- Department of Allied Health Sciences, London South Bank University, United Kingdom.
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Benjamins LJ, Gourishankar A, Yataco-Marquez V, Cardona EH, de Ybarrondo L. Honey pacifier use among an indigent pediatric population. Pediatrics 2013; 131:e1838-41. [PMID: 23650307 DOI: 10.1542/peds.2012-3835] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Use of honey pacifiers by infants presenting to a pediatric clinic at a county hospital in Houston, Texas, was observed by several of our staff members. Although we could not find any published studies linking the use of honey pacifiers to infant botulism, we also could not find any studies assessing the prevalence of honey pacifier use in general. METHODS We conducted a cross-sectional, descriptive study using a novel survey that had 19 items. The survey was administered to the parents of children up to age 12 months presenting to a county hospital pediatric clinic for well-child care in Houston, Texas, from February 2010 to April 2011. RESULTS There were 397 respondents. Approximately 11% of the respondents reported using honey pacifiers with their infant children. Reasons for use included tradition, infant preference, and perceived health benefits (eg, helps with constipation or colic). Approximately 20% of the honey pacifier users and 23% of the entire group reported knowledge of honey potentially causing an illness in children <12 months of age. Nearly 40% of all respondents also reported using herbal or folk remedies. CONCLUSIONS Honey pacifier use was relatively common among this population, seen in ∼1 out of 10 respondents. A majority of the mothers surveyed (∼80%) were unaware of the potential dangers of giving honey to infants under age 12 months. Herbal medicine use was also common.
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Affiliation(s)
- Laura J Benjamins
- Department of Pediatrics, University of Texas-Houston Medical School, Houston, TX 77030, USA.
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The prevalence of herb and dietary supplement use among children and adolescents in the United States: Results from the 2007 National Health Interview Survey. Complement Ther Med 2013; 21:358-63. [PMID: 23876567 DOI: 10.1016/j.ctim.2013.05.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 01/11/2013] [Accepted: 05/02/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The purpose of this study is to examine the national prevalence of herb and dietary supplement usage among children and adolescents age 4-17 in the United States, and to identify population factors associated with usage. METHODS Weighted population estimates are derived from the 2007 National Health Interview Child Complementary and Alternative Medicine Supplement (sample n=9417). Wald chi-square tests are used to compare factors associated with herb and dietary supplement use. RESULTS An estimated 2.9 million children and adolescents used herbs or dietary supplements in 2007. Pediatric herb and supplement use was more common among adolescents and non-Hispanic whites, and positively associated with parental education and household income. Children with activity limitations due to chronic health conditions, long-term prescription use, or relatively heavy use of physician services were also more likely to use herbal supplements. Echinacea and fish oil were most commonly used herbs and supplements. CONCLUSIONS Children in the US appear to use herbs or dietary supplements at a much lower rate than adults. This analysis shows a pattern of moderate and appropriate herb and supplement use in the pediatric population.
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Herbal medicinal products in the paediatric population--status quo and perspectives. Wien Med Wochenschr 2013; 163:46-51. [PMID: 23377951 DOI: 10.1007/s10354-013-0175-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 01/03/2013] [Indexed: 11/27/2022]
Abstract
The limited extent of data available for herbal medicinal products (HMPs) in the paediatric population is related to missing documentation of their use in practice and in literature. Therefore, information for properly evaluating indications, posology, length of treatment and safety in children is often lacking. Frequently, these documentation gaps are reflected in the product information of HMPs as final result of regulatory decisions. On the other hand, there is long-term experience of HMPs as well established and traditionally used medicinal products, which also covers the use in the paediatric population, as applied by parents themselves, and the recommendations of physicians, other health practitioners and pharmacists. The methodology of pharmaco-epidemiologic studies is a valuable tool to evaluate data of the practical use of HMPs in children. The documentation gap may be closed by such methodologies, and HMPs may be applied prospectively on the basis of well-documented empirical knowledge.
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Lemay JF, Amin A, Pacaud D. Complementary and alternative medicine use in children and adolescents with type 1 diabetes. Paediatr Child Health 2012; 16:468-72. [PMID: 23024584 DOI: 10.1093/pch/16.8.468] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2010] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) in paediatric patients varies between 11% and 68%. There are limited reports of its use in children with type 1 diabetes mellitus (T1DM). OBJECTIVE To describe the use of CAM in children with T1DM, and the perceptions of both users and nonusers regarding the effect of CAM on diabetes management. DESIGN/METHODS A cross-sectional, anonymous questionnaire survey was mailed to a randomly selected subgroup of patients with T1DM. Each patient's main caregiver was asked to complete the questionnaire. RESULTS Of 403 questionnaires mailed, 195 (48%) were completed. The mean (± SD) age of the children was 12.2±4.0 years (56% boys). Use of CAM was reported in 110 children (56%) (vitamins/minerals [n=99], herbal medicine [n=22], dietary supplement [n=13]). When excluding the use of vitamins/minerals, the CAM number dropped to 47 children (24%). Only the current age of the child was significantly different between users and nonusers of CAM. In users, reasons cited for using CAM were to minimize symptoms, improve control, prevent complications and add benefits to insulin. Only 30% of CAM users stated that CAM improved diabetes control. Nonusers cited satisfaction with current diabetes treatment and lack of knowledge as reasons for not using CAM. CONCLUSIONS CAM use in children with T1DM was frequent, and appeared to be an attempt to improve control or prevent diabetes complications. However, improved control was not reported as a benefit. Diabetes care teams should assess the use of CAM in children with T1DM, and monitor for any potential positive or negative effects.
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Affiliation(s)
- Jean-François Lemay
- Department of Paediatrics, Alberta Children's Hospital, University of Calgary, Calgary, Alberta
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Efe E, Işler A, Sarvan S, Başer H, Yeşilipek A. Complementary and alternative medicine use in children with thalassaemia. J Clin Nurs 2012; 22:760-9. [PMID: 22906056 DOI: 10.1111/j.1365-2702.2012.04210.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The aims of this study were to: (1) determine the types of complementary and alternative medicine use among children with thalassaemia as reported by parents and (2) describe sociodemographic and medical factors associated with the use of such treatments in families residing in southern Turkey. BACKGROUND Thalassaemia is one of the most common human genetic diseases. Despite the therapeutic efforts, patients will encounter a variety of physical and psychological problems. Therefore, the use of complementary and alternative medicines among children thalassaemia is becoming increasingly popular. DESIGN This is a descriptive study of complementary and alternative medicine. METHODS This study was conducted in the Hematology Outpatient Clinic at Akdeniz University Hospital and in the Thalassemia Centre at Ministry of Health Antalya Education and Research Hospital, Antalya, Turkey, between January 2010-December 2010. Parents of 97 paediatric patients, among 125 parents who applied to the haematology outpatient clinic and thalassaemia centre between these dates, agreed to take part in the study with whom contact could be made were included. Data were collected by using a questionnaire. RESULTS The proportion of parents who reported using one or more of the complementary and alternative medicine methods was 82·5%. Of these parents, 61·8% were using prayer/spiritual practice, 47·4% were using nutritional supplements and 35·1% were using animal materials. CONCLUSION It was determined that a significant portion of the parents using complementary and alternative medicine use it to treat their children's health problems, they were informed about complementary and alternative medicine by their paediatricians and family elders, and they have discussed the use of complementary and alternative medicine with healthcare professionals. RELEVANCE TO CLINICAL PRACTICE To sustain medical treatment and prognosis of thalassaemia, it is important for nurses to consult with their patients and parents regarding the use and potential risks of some complementary and alternative medicine.
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Affiliation(s)
- Emine Efe
- Child Health Nursing Department, School of Health, Akdeniz University, Antalya, Turkey.
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Shih CC, Liao CC, Su YC, Yeh TF, Lin JG. The association between socioeconomic status and traditional chinese medicine use among children in Taiwan. BMC Health Serv Res 2012; 12:27. [PMID: 22293135 PMCID: PMC3359156 DOI: 10.1186/1472-6963-12-27] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2011] [Accepted: 02/01/2012] [Indexed: 11/10/2022] Open
Abstract
Background Traditional Chinese medicine (TCM) utilization is common in Asian countries. Limited studies are available on the socioeconomic status (SES) associated with TCM use among the pediatric population. We report on the association between SES and TCM use among children and adolescents in Taiwan. Methods A National Health Interview Survey was conducted in Taiwan in 2001 that included 5,971 children and adolescents. We assessed the children's SES using the head of household's education, occupation and income. This information was used to calculate pediatric SES scores, which in turn were divided into quartiles. Children and adolescents who visited TCM in the past month were defined as TCM users. Results Compared to children in the second SES quartile, children in the fourth SES quartile had a higher average number of TCM visits (0.12 vs. 0.06 visits, p = 0.027) and higher TCM use prevalence (5.0% vs. 3.6%, p = 0.024) within the past month. The adjusted odds ratio (OR) for TCM use was higher for children in the fourth SES quartile than for those in the first SES quartile (OR 1.49; 95% confidence interval [CI] 1.02-2.17). The corresponding OR was 2.17 for girls (95% CI 1.24-3.78). The highest-SES girls (aged 10-18 years) were most likely to visit TCM practices (OR 2.47; 95% CI 1.25-4.90). Conclusions Children and adolescents with high SES were more likely to use TCM and especially girls aged 10-18 years. Our findings point to the high use of complementary and alternative medicine among children and adolescents.
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Affiliation(s)
- Chun-Chuan Shih
- 1The School of Chinese Medicine for Post-Baccalaureate, I-Shou University,Kaohsiung County 82445, Taiwan
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Epidemiology: spinal manipulation utilization. J Electromyogr Kinesiol 2012; 22:648-54. [PMID: 22289432 DOI: 10.1016/j.jelekin.2012.01.006] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 11/13/2011] [Accepted: 01/06/2012] [Indexed: 01/08/2023] Open
Abstract
The objectives of this article are to (1) describe spinal manipulation use by time, place, and person, and (2) identify predictors of the use of spinal manipulation. We conducted a systematic review of the English-language literature published from January 1, 1980 through June 30, 2011. Of 822 citations identified, 213 were deemed potentially relevant; 75 were included after further consideration. Twenty-one additional articles were identified from reference lists. The literature is heavily weighted toward North America, Europe, and Australia and thus largely precludes inferences about spinal manipulation use in other parts of the world. In the regions covered by the literature, chiropractors, osteopaths, and physical therapists are most likely to deliver spinal manipulation, often in conjunction with other conservative therapies. Back and neck pain are the most frequent indications for receiving spinal manipulation; non-musculoskeletal conditions comprise a very small percentage of indications. Although spinal manipulation is more commonly used in adults than children, evidence suggests that spinal manipulation may be more likely used for non-musculoskeletal ailments in children than in adults. Patient satisfaction with spinal manipulation is very high.
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Huillet A, Erdie-Lalena C, Norvell D, Davis BE. Complementary and alternative medicine used by children in military pediatric clinics. J Altern Complement Med 2011; 17:531-7. [PMID: 21649519 DOI: 10.1089/acm.2010.0339] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES The objective of this study was to evaluate the prevalence, types, perceived effects, and factors that influence the use of complementary and alternative medicine (CAM) by military children. DESIGN A parent survey was administered in two military general pediatric clinics from June to September 2009. Parents completed surveys about their children including the following items: demographic information, a list of specific CAM therapies, family CAM use, and child health status. RESULTS Caregivers completed 278 surveys. The overall use of CAM was 23%. The most common type of CAM used was herbal therapy (34%). The CAM therapies most commonly reported to be very helpful were special diets (67%), melatonin (57%), vitamins and minerals used at doses higher than the recommended daily allowance (50%), and massage therapy (50%). The majority of users reported no side-effects (96%). Among CAM users, 53% had discussed their CAM use with a physician and 47% had seen a CAM practitioner. Factors associated with CAM use in multiple regression analysis included chronic conditions (p = 0.001), parent/sibling use of CAM (p < 0.001), and parent age over 30 years (p = 0.02). Primary sources of CAM information were friends and family (68%) and doctors (44%). Common reasons for using CAM were to promote general health (70%), to relieve symptoms (56%), and to improve quality of life (48%). Eighty percent (80%) of all respondents indicated they would use CAM if recommended by a physician. CONCLUSIONS In this military population with access to universal health care, CAM use is higher than the U.S. national average and nearly double that of the 2007 National Health Interview Survey study. Patients with chronic conditions, family members using CAM, and parental age over 30 years are more likely to use CAM. CAM is perceived as helpful with minimal to no side-effects. Pediatricians should inquire about CAM use and be prepared to provide guidance on this topic.
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Affiliation(s)
- Adam Huillet
- Developmental and Behavioral Pediatrics, Madigan Army Medical Center, Fort Lewis, WA, USA.
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Haliloglu B, İşgüven P, Yıldız M, Arslanoğlu İ, Ergüven M. Complementary and alternative medicine in children with type 1 diabetes mellitus. J Clin Res Pediatr Endocrinol 2011; 3:139-43. [PMID: 21911327 PMCID: PMC3184515 DOI: 10.4274/jcrpe.v3i3.27] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE Complementary and alternative medicine (CAM) is increasingly utilized in adults and children for treatment of various conditions. Studies on CAM in diabetes have mainly focused on the adult population and its application in children has not been well established. The aim of this study was to examine the prevalence and characteristics of CAM use in Turkish children with type 1 diabetes mellitus (T1DM). METHODS The information was acquired by a questionnaire completed by a face-to-face interview with the parents of children with T1DM. RESULTS A total of 195 subjects (mean age: 14.02±4.7 years; F/M: 103/92) were included in this survey. Use of CAM was reported in 85 subjects (43.6%). Herbal medicines were used in 64 subjects (75.3%). Sixty-nine subjects (81.2%) did not inform the diabetes specialist about CAM use. Thirty-eight subjects (44.7%) evaluated CAM as efficacious. Only 3 subjects (3.5%) interrupted the insulin injections to use CAM. No relationships were found between CAM use and parental education or insulin dose. There were significant correlations between CAM use and higher family income (p=0.027), urban residence (p=0.05), presence of complications (p=0.03), dissatisfaction with medical therapy (p=0.034) and prior CAM use among parents (p=0.001). CONCLUSION CAM use is a frequent practice among diabetic children, which is usually not shared with their physicians and sometimes leads to cessation of medical treatment.
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Affiliation(s)
- Belma Haliloglu
- Marmara University Faculty of Medicine, Department of Pediatric, Division of Pediatric Endocrinology, Istanbul, Turkey
| | - Pınar İşgüven
- Göztepe Education and Research Hospital, Department of Pediatric Endocrinology, Istanbul, Turkey
| | - Metin Yıldız
- Göztepe Education and Research Hospital, Department of Pediatric Endocrinology, Istanbul, Turkey
| | - İlknur Arslanoğlu
- Düzce University Faculty of Medicine, Department of Pediatric, Division of Pediatric Endocrinology, Duzce, Turkey
| | - Müferet Ergüven
- Göztepe Education and Research Hospital, Department of Pediatric, Istanbul, Turkey
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Marchisio P, Bianchini S, Galeone C, Baggi E, Rossi E, Albertario G, Torretta S, Pignataro L, Esposito S, Principi N. Use of complementary and alternative medicine in children with recurrent acute otitis media in Italy. Int J Immunopathol Pharmacol 2011; 24:441-9. [PMID: 21658318 DOI: 10.1177/039463201102400217] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Controlling environmental factors, chemoprophylaxis, immunoprophylaxis and surgery are considered possible means of preventing recurrent acute otitis media (RAOM), but there are no available data concerning the paediatric use of complementary and alternative medicine (CAM). We evaluated the uses of CAM (homeopathy and/or herbal medicine) as means of preventing AOM in children with a history of RAOM. Eight hundred and forty Italian children with RAOM (≥3 episodes in six months) aged 1-7 years were surveyed in 2009 using a face-to-face questionnaire, filled by parents or caregivers, that explored the prevalence, determinants, reasons, cost, and perceived safety and efficacy of CAM. About one-half (46%) of the children used CAM, significantly more than the number who used immunoprophylaxis (influenza vaccine 15%; p<0.05), PCV-7 34%; p<0.05) or chemoprophylaxis (2%; p<0.001). Use of CAM in the family was the only important factor positively associated with the use of CAM in children (adjusted OR 7.94; 95% CI: 5.26-11.99). The main reasons for using CAM were a fear of the adverse effects of conventional medicine (40%) and to increase host defences (20%). CAM was widely seen as safe (95%) and highly effective (68%). CAM prescribers were paediatricians in 50.7% of cases; self-initiation was reported by 23% of respondents. CAM expenditure was between Euro 25 and Euro 50/month in 27.6% of cases and ≥ Euro 50/month in 16%. Children with RAOM should be considered among the categories of subjects likely to be using CAM. Together with the fact that paediatricians are the main prescribers, this is worrying because of the current lack of evidence regarding the efficacy, safety and cost-effectiveness of CAM in the prevention of RAOM.
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Affiliation(s)
- P Marchisio
- Department of Maternal and Paediatric Sciences, Università degli Studi di Milano and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Rubin D. Triage and case presentations in a chiropractic pediatric clinic. J Chiropr Med 2011; 6:94-8. [PMID: 19674702 DOI: 10.1016/j.jcme.2007.05.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2007] [Revised: 04/15/2007] [Accepted: 05/27/2007] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE The use of triage in a chiropractic practice is to determine whether or not a patient who has presented to an office is in need of a referral to another health care provider. The objective of this article is to illustrate the use of triage skills in a primary care, chiropractic pediatric practice. This is examined both in the new patient setting and during visit-to-visit protocol. METHOD An analysis of the number of chiropractic triage visits during a 1-year period was performed on 48 new children or pregnant women and 1634 existing pediatric and pregnancy visits. RESULTS The average level of chiropractic triage for a new patient, whether pediatric or pregnant, was a limited level of concern (P3, green flag), with more than 85% of new patients falling into that category. Fifteen percent were at a cautionary (P2, yellow flag) level, and none were at the emergency (P1, red flag) level. Between 12% and 15% of the total of existing pediatric or pregnancy visits were at a P1 or P2 level of triage, and 11% of the total of pediatric triage visits were at the P1 level. CONCLUSION New patients rarely come to a chiropractic pediatric office in a P1-level crisis, whereas existing patients have a much higher likelihood of presenting during a P1 challenge. P2 triage levels are somewhat common, whereas P3 triage levels are the most frequent. Triage methods are a way to help place a patient in a category that can ensure an optimum, safe, and effective level of care.
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Affiliation(s)
- Drew Rubin
- Adjunct Faculty, Life University, College of Chiropractic, Marietta, GA 30060; Private Practice, Marietta, GA
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Tsao JCI, Meldrum M, Kim SC, Jacob MC, Zeltzer LK. Treatment Preferences for CAM in children with chronic pain. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 4:367-74. [PMID: 17965769 PMCID: PMC1978240 DOI: 10.1093/ecam/nel084] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2006] [Accepted: 09/25/2006] [Indexed: 12/15/2022]
Abstract
CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls) (mean age = 14.5 years ± 2.4; range = 8–18 years) presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examine the relationships between CAM treatment preferences and patient's sociodemographic and clinical characteristics, as well as their self-reported level of functioning. Over 60% of patients elected to try at least one CAM approach for pain. The most popular CAM therapies were biofeedback, yoga and hypnosis; the least popular were art therapy and energy healing, with craniosacral, acupuncture and massage being intermediate. Patients with a diagnosis of fibromyalgia (80%) were the most likely to try CAM versus those with other pain diagnoses. In multivariate analyses, pain duration emerged as a significant predictor of CAM preferences. For mind-based approaches (i.e. hypnosis, biofeedback and art therapy), pain duration and limitations in family activities were both significant predictors. When given a choice of CAM therapies, this sample of children with chronic pain, irrespective of pain diagnosis, preferred non-invasive approaches that enhanced relaxation and increased somatic control. Longer duration of pain and greater impairment in functioning, particularly during family activities increased the likelihood that such patients agreed to engage in CAM treatments, especially those that were categorized as mind-based modalities.
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Affiliation(s)
- Jennie C I Tsao
- Pediatric Pain Program, Department of Pediatrics, David Geffen School of Medicine at UCLA, USA.
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Downey L, Tyree PT, Huebner CE, Lafferty WE. Pediatric vaccination and vaccine-preventable disease acquisition: associations with care by complementary and alternative medicine providers. Matern Child Health J 2011; 14:922-30. [PMID: 19760163 DOI: 10.1007/s10995-009-0519-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study investigated provider-based complementary/alternative medicine use and its association with receipt of recommended vaccinations by children aged 1-2 years and with acquisition of vaccine-preventable disease by children aged 1-17 years. Results were based on logistic regression analysis of insurance claims for pediatric enrollees covered by two insurance companies in Washington State during 2000-2003. Primary exposures were use of chiropractic, naturopathy, acupuncture, or massage practitioner services by pediatric enrollees or members of their immediate families. Outcomes included receipt by children aged 1-2 years of four vaccine combinations (or their component vaccines) covering seven diseases, and acquisition of vaccine-preventable diseases by enrollees aged 1-17 years. Children were significantly less likely to receive each of the four recommended vaccinations if they saw a naturopathic physician. Children who saw chiropractors were significantly less likely to receive each of three of the recommended vaccinations. Children aged 1-17 years were significantly more likely to be diagnosed with a vaccine-preventable disease if they received naturopathic care. Use of provider-based complementary/alternative medicine by other family members was not independently associated with early childhood vaccination status or disease acquisition. Pediatric use of complementary/alternative medicine in Washington State was significantly associated with reduced adherence to recommended pediatric vaccination schedules and with acquisition of vaccine-preventable disease. Interventions enlisting the participation of complementary/alternative medicine providers in immunization awareness and promotional activities could improve adherence rates and assist in efforts to improve public health.
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Affiliation(s)
- Lois Downey
- Harborview Medical Center, Division of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of Washington, Box 359765, 325 Ninth Avenue, Seattle, WA 98104, USA.
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Toliver-Sokol M, Murray CB, Wilson AC, Lewandowski A, Palermo TM. Patterns and predictors of health service utilization in adolescents with pain: comparison between a community and a clinical pain sample. THE JOURNAL OF PAIN 2011; 12:747-55. [PMID: 21481647 DOI: 10.1016/j.jpain.2010.12.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2010] [Revised: 12/07/2010] [Accepted: 12/28/2010] [Indexed: 11/24/2022]
Abstract
UNLABELLED There is limited research describing the patterns of healthcare utilization in adolescents with chronic pain. This study describes healthcare utilization in a clinical chronic pain sample, and compares the patterns of service use of this group to a community sample with intermittent pain complaints. We also investigated demographic and clinical factors that predicted healthcare visits and medication use in the clinical sample. Data on 117 adolescents (aged 12-18; n = 59 clinical pain sample, n = 58 community) were collected. Caregivers and adolescents reported on sociodemographics, medical visits, current medications, pain, activity limitations, and depression. As hypothesized, the clinical pain sample had higher rates of healthcare consultation on all types of medical visits (general, specialty care, complementary medicine, mental health, OT/PT), and higher medication use compared to the community sample. Regression analyses revealed that higher annual income, greater pain frequency, and higher levels of caregiver-reported activity limitations were associated with a greater number of healthcare visits for the total sample. Within the clinical pain sample, higher pain frequency and greater activity limitations (caregiver report) predicted more specialty care visits. Additionally, higher income and greater levels of depressive symptoms predicted a higher number of prescribed medications. PERSPECTIVE This study contributes to the limited available data on health service and medication use in a clinical chronic pain sample versus a community sample of adolescents. We also identify clinical factors (pain frequency, parent-reported activity limitations, depressive symptoms) and demographic factors (gender, income) associated with healthcare utilization.
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Affiliation(s)
- Cora Collette Breuner
- Department of Pediatrics, Division of Adolescent Medicine, University of Washington, Seattle Children's Hospital, Seattle, WA, USA
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McCarty RL, Weber WJ, Loots B, Breuner CC, Vander Stoep A, Manhart L, Pihoker C. Complementary and alternative medicine use and quality of life in pediatric diabetes. J Altern Complement Med 2010; 16:165-73. [PMID: 20180689 DOI: 10.1089/acm.2008.0566] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The objectives of this study were to explore the association between complementary and alternative medicine (CAM) use as reported by youth, and parents' and children's reported quality of life in youth with diabetes. DESIGN The study design was a cross-sectional survey. SETTING Youth in Washington State participated in the SEARCH for Diabetes in Youth study, a national, multisite epidemiological study designed to assess the prevalence and incidence of diabetes in U.S. youth. Surveys assessing CAM utilization were mailed in January and April 2006. PARTICIPANTS One thousand four hundred and thirty-nine (1439) youth were mailed a CAM survey. The final sample consisted of 467 youth with both CAM survey results and quality-of-life data. OUTCOME MEASURES Difference in mean scores on Pediatric Quality of Life Inventory (PedsQL) between CAM users and nonusers overall, and specific CAM therapies were the outcome measures. RESULTS Of the 1439 participants approached, 587 (40.8%) returned the CAM survey. In adjusted analyses, children reported any CAM use as associated with more barriers to treatment (difference in mean scores -3.48, 95% confidence interval [CI] -6.65, -0.31). Children following a CAM diet reported higher quality of life (PedsQL Core Total difference 4.01, 95% CI [0.10-7.91]; Core Psychosocial difference was 6.45, 95% CI [1.95 to 10.95]), but those using stress-reduction activities reported poorer quality of life (Diabetes Total difference -4.19, 95% CI [-8.35 to -0.04]). Parent-reported quality of life was lower for children who used "other supplements" (Core Total difference -6.26, 95% CI [-11.29 to -1.24]; Core Psychosocial difference was -5.92, 95% CI [-11.65 to -0.19]). CONCLUSIONS CAM diets were associated with increased quality of life in youth with diabetes, whereas supplement use and stress-reduction activities were associated with decreased quality of life. The temporal sequence between CAM use and quality of life requires further study.
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Karpouzis F, Bonello R, Pollard H. Chiropractic care for paediatric and adolescent Attention-Deficit/Hyperactivity Disorder: A systematic review. CHIROPRACTIC & OSTEOPATHY 2010; 18:13. [PMID: 20525195 PMCID: PMC2891800 DOI: 10.1186/1746-1340-18-13] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Accepted: 06/02/2010] [Indexed: 11/18/2022]
Abstract
BACKGROUND Psychostimulants are first line of therapy for paediatric and adolescent AD/HD. The evidence suggests that up to 30% of those prescribed stimulant medications do not show clinically significant outcomes. In addition, many children and adolescents experience side-effects from these medications. As a result, parents are seeking alternate interventions for their children. Complementary and alternative medicine therapies for behavioural disorders such as AD/HD are increasing with as many as 68% of parents having sought help from alternative practitioners, including chiropractors. OBJECTIVE The review seeks to answer the question of whether chiropractic care can reduce symptoms of inattention, impulsivity and hyperactivity for paediatric and adolescent AD/HD. METHODS Electronic databases (Cochrane CENTRAL register of Controlled Trials, Cochrane Database of Systematic reviews, MEDLINE, PsycINFO, CINAHL, Scopus, ISI Web of Science, Index to Chiropractic Literature) were searched from inception until July 2009 for English language studies for chiropractic care and AD/HD. Inclusion and exclusion criteria were applied to select studies. All randomised controlled trials were evaluated using the Jadad score and a checklist developed from the CONSORT (Consolidated Standards of Reporting Trials) guidelines. RESULTS The search yielded 58 citations of which 22 were intervention studies. Of these, only three studies were identified for paediatric and adolescent AD/HD cohorts. The methodological quality was poor and none of the studies qualified using inclusion criteria. CONCLUSIONS To date there is insufficient evidence to evaluate the efficacy of chiropractic care for paediatric and adolescent AD/HD. The claim that chiropractic care improves paediatric and adolescent AD/HD, is only supported by low levels of scientific evidence. In the interest of paediatric and adolescent health, if chiropractic care for AD/HD is to continue, more rigorous scientific research needs to be undertaken to examine the efficacy and effectiveness of chiropractic treatment. Adequately-sized RCTs using clinically relevant outcomes and standardised measures to examine the effectiveness of chiropractic care verses no-treatment/placebo control or standard care (pharmacological and psychosocial care) are needed to determine whether chiropractic care is an effective alternative intervention for paediatric and adolescent AD/HD.
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Affiliation(s)
- Fay Karpouzis
- Department of Chiropractic, Faculty of Science, Macquarie University, Sydney, NSW 2109, Australia
- Macquarie Injury Management Group, Macquarie University, Sydney, NSW 2109, Australia
| | - Rod Bonello
- Department of Chiropractic, Faculty of Science, Macquarie University, Sydney, NSW 2109, Australia
- Macquarie Injury Management Group, Macquarie University, Sydney, NSW 2109, Australia
| | - Henry Pollard
- Department of Chiropractic, Faculty of Science, Macquarie University, Sydney, NSW 2109, Australia
- Macquarie Injury Management Group, Macquarie University, Sydney, NSW 2109, Australia
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Abstract
OBJECTIVE The objective of this study was to characterize the practice of pediatric chiropractic. DESIGN The study design was a cross-sectional descriptive survey. SETTINGS/LOCATION The settings were private practices throughout the United States, Canada, and Europe. PARTICIPANTS The participants were 548 chiropractors, the majority of whom are practicing in the United States, Canada, and Europe. MAIN OUTCOME MEASURES Practitioner demographics (i.e., gender, years in practice, and chiropractic alma mater), practice characteristics (i.e., patient visits per week, practice income reimbursement), and chiropractic technique were surveyed. The practitioners were also asked to indicate common indicators for pediatric presentation, their practice activities (i.e., use of herbal remedies, exercise and rehabilitation, prayer healing, etc.), and referral patterns. RESULTS A majority of the responders were female with an average practice experience of 8 years. They attended an average of 133 patient visits per week, with 21% devoted to the care of children (<18 years of age). Practice income was derived primarily from out-of-pocket reimbursement with charges of an average of $127 and $42 for the first and subsequent visits, respectively. These visits were reimbursed to address common conditions of childhood (i.e., asthma, ear infections, etc.). Approach to patient care was spinal manipulative therapy (SMT) augmented with herbal remedies, exercises, rehabilitation, and so on. Wellness care also figured prominently as a motivator for chiropractic care. Fifty-eight percent (58%) indicated an established relationship with an osteopathic or medical physician. Eighty percent (80%) of the responders indicated referring patients to medical practitioners while only 29% indicated receiving a referral from a medical/osteopathic physician. CONCLUSIONS The chiropractic care of children is a significant aspect of the practice of chiropractic. Further research is warranted to examine the safety and effectiveness of this popular nonallopathic approach to children's health.
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Affiliation(s)
- Joel Alcantara
- International Chiropractic Pediatric Association, Media, PA 19063, USA.
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Gentil LB, Robles ACC, Grosseman S. Uso de terapias complementares por mães em seus filhos: estudo em um hospital universitário. CIENCIA & SAUDE COLETIVA 2010; 15 Suppl 1:1293-9. [DOI: 10.1590/s1413-81232010000700038] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2007] [Accepted: 12/14/2007] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo é avaliar a utilização de terapias complementares (TC) por mães em seus filhos. Trata-se de um estudo transversal, descritivo. Foram entrevistadas 202 mães de crianças assistidas em um hospital universitário. As variáveis analisadas foram: uso de terapias complementares/motivos para tal, tipos de terapias utilizadas, sua finalidade, seus efeitos, revelação ao médico/motivos para tal e reação do médico. A prevalência de uso de terapias complementares foi 87,6%. De 177 mães que utilizavam TC, muitas mencionaram mais de um tipo, sendo: chás (72,8%), benzimento (41%), simpatias (12,9%), remédios/xaropes caseiros (8,4%), oração/promessa (7,4%), homeopatia (4,0%), tratamento espiritual/parapsicológico (4,0%), mistura de substâncias desconhecidas/garrafada (3%), massagem (2%) e reiki/florais (1,5%). As ervas mais utilizadas foram erva-doce (16,7%), camomila (14,8%) e hortelã (10,9%); 57,6% das mães não informaram o uso ao médico. Dos 499 tratamentos empregados, houve percepção de melhora em 429 (86%) e relato de dois casos de efeitos adversos. A prevalência do uso de terapias complementares foi alta, sendo os chás a terapia mais utilizada e erva-doce, camomila e hortelã as ervas mais usadas. Houve percepção de melhora na maioria das terapias usadas.
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O'Keefe M, Coat S. Increasing health-care options: the perspectives of parents who use complementary and alternative medicines. J Paediatr Child Health 2010; 46:296-300. [PMID: 20367764 DOI: 10.1111/j.1440-1754.2010.01711.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To explore the relationship between conventional medicine and complementary and alternative medicine (CAM) with parents who use CAM, and to consider factors that may contribute to parent non-disclosure of CAM usage to their doctor. METHODS Thirty-three parents participated in one of seven focus groups. Transcripts were analysed using an iterative process of theme identification and testing against transcript data. RESULTS The participants believed they should trust their instincts as parents in caring for their child. It was important also to the participants that they understood why their child was ill, and a range of theories of health and illness were discussed. The use of CAM was attractive as it offered more options in health care than just relying on conventional medicine alone. The use of additional therapies was seen as a means to increase the likelihood that something would work. Many of the participants described bad experiences with doctors when they discussed CAM use previously so they had become more circumspect in mentioning it. The participants were most satisfied with medical care for their child when they felt the doctor respected their point of view and listened to them. CONCLUSIONS Doctors caring for children and their families should expect that many parents are using CAM to increase health-care options. Inquiries about CAM usage should be made in a non-judgmental and encouraging manner so parents feel comfortable in providing an honest answer. Advice to parents about CAM may need to be backed up with evidence to address differing parent understanding of illness.
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Affiliation(s)
- Maree O'Keefe
- University of Adelaide School of Paediatrics and Reproductive Health, Women's and Children's Hospital, North Adelaide, Australia.
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