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Dotter C, Haug S, Schnell R, Scharf A, Altenbuchner A, Weber K. Analyzing factors determining vaccination willingness against COVID-19 in Germany 2020. Vaccine X 2023; 14:100342. [PMID: 37577261 PMCID: PMC10422663 DOI: 10.1016/j.jvacx.2023.100342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 06/28/2023] [Accepted: 06/29/2023] [Indexed: 08/15/2023] Open
Abstract
The study is based on a German single-topic population survey on vaccination willingness against COVID-19 (VWC) by the authors (2020, n = 2014). The single-topic survey allowed us to test several competing explanations for VWC, as discussed in the literature. The VWC in the sample was 67.3%. Logistic regression was used to identify factors affecting VWC. Being at high risk from COVID-19 and having received flu vaccination have a positive impact on VWC. Perceived VWC of friends has a strong positive effect on respondents' VWC. Bivariate relationships of gender, age, and level of education with VWC were no longer significant in a multivariate analysis. Trust in alternative medicine and belief in conspiracy theories have a negative effect on VWC.
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Affiliation(s)
- Caroline Dotter
- Institute for Social Sciences and Technology Assessment (IST), Regensburg Center of Health Sciences and Technology (RCHST), Ostbayerische Technische Hochschule (OTH) Regensburg, Seybothstraße 2, 93053 Regensburg, Germany
| | - Sonja Haug
- Institute for Social Sciences and Technology Assessment (IST), Regensburg Center of Health Sciences and Technology (RCHST), Ostbayerische Technische Hochschule (OTH) Regensburg, Seybothstraße 2, 93053 Regensburg, Germany
| | - Rainer Schnell
- Research Methodology Group, University of Duisburg-Essen, Forsthausweg 2, 47057 Duisburg, Germany
| | - Anna Scharf
- Institute for Social Sciences and Technology Assessment (IST), Regensburg Center of Health Sciences and Technology (RCHST), Ostbayerische Technische Hochschule (OTH) Regensburg, Seybothstraße 2, 93053 Regensburg, Germany
| | - Amelie Altenbuchner
- Institute for Social Sciences and Technology Assessment (IST), Regensburg Center of Health Sciences and Technology (RCHST), Ostbayerische Technische Hochschule (OTH) Regensburg, Seybothstraße 2, 93053 Regensburg, Germany
| | - Karsten Weber
- Institute for Social Sciences and Technology Assessment (IST), Regensburg Center of Health Sciences and Technology (RCHST), Ostbayerische Technische Hochschule (OTH) Regensburg, Seybothstraße 2, 93053 Regensburg, Germany
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Hijazi MA, Shatila H, Abu Qiyas S, Aboul-Ela M, El-Lakany A, Naja F. Complementary and alternative medicine use during the COVID-19 pandemic: Community pharmacists' knowledge, attitudes, and practices. Res Social Adm Pharm 2023; 19:502-509. [PMID: 36371308 PMCID: PMC9617642 DOI: 10.1016/j.sapharm.2022.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 10/17/2022] [Accepted: 10/23/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The challenges in COVID-19 treatment have driven patients to seek Complementary and Alternative Medicine (CAM) for the prevention and/or treatment of the disease. Pharmacists are uniquely positioned to promote the effective and safe use of CAM. OBJECTIVE Assess the beliefs, practices, and knowledge of community pharmacists in Lebanon about existing evidence for the use of CAM for the prevention and/or treatment of COVID-19. METHODS A national cross-sectional survey was conducted among community pharmacists during the COVID-19 pandemic in Lebanon (n = 310 respondents). Participants completed an online questionnaire addressing, in addition to the socio-demographic characteristics; the beliefs, practices, and knowledge of pharmacists regarding the existing evidence of CAM use for COVID-19 prevention and/or treatment. RESULTS Pharmacists (70%) received frequent inquiries about CAM for COVID-19 prevention or treatment. Only 25.5% of the pharmacists reported having enough time to get information about CAM and COVID-19. Almost all participants believed that pharmacists have a major role in the fight against COVID-19 (98%) and that they have enough information to counsel patients in that regard (75%). For practices, the majority of pharmacists reported counseling their patients on proper use (98%) and possible adverse reactions (93%) of CAM, but only 51% reported toxic or undesirable effects. Regarding knowledge, although most pharmacists answered correctly the questions on the role of CAM in preventing COVID-19, few knew about its role in treating the infection. Pharmacists who trust the WHO website as a credible source had a higher knowledge score (β = 0.52, 95%CI: 0.05-0.986). CONCLUSIONS The positive beliefs and practices of pharmacists towards CAM during the pandemic were coupled with a few gaps, especially in their knowledge about existing evidence for CAM use. Concerted efforts ought to be dedicated to supporting pharmacists in playing a more prominent role during health crises such as the COVID-19 pandemic.
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Affiliation(s)
- Mohamad Ali Hijazi
- Department of Pharmaceutical Sciences, Beirut Arab University, Beirut, Lebanon
| | - Hibeh Shatila
- Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Salma Abu Qiyas
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Maha Aboul-Ela
- Department of Pharmaceutical Sciences, Beirut Arab University, Beirut, Lebanon
| | - Abdalla El-Lakany
- Department of Pharmaceutical Sciences, Beirut Arab University, Beirut, Lebanon
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates,Research Institute of Medical and Health Sciences (RIHMS), University of Sharjah, Sharjah, United Arab Emirates,Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences American, University of Beirut, Beirut, Lebanon,Corresponding author. Department of Clinical Nutrition and Dietetics, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Al-Yousef HM, Alghadir AH, Iqbal A. Knowledge, attitude and dispensing practice of the pharmacists related to complementary alternative medicines in the Riyadh region of Saudi Arabia: a cross-sectional descriptive study. BMC Health Serv Res 2022; 22:1533. [PMID: 36527035 PMCID: PMC9758774 DOI: 10.1186/s12913-022-08932-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The use of complementary alternative medicines (CAMs) has risen globally in recent times. Such medications are exclusively and readily available in the Riyadh region of Saudi Arabia through community pharmacies and other retail outlets, exposing the consumers to various risks like harmful drug interactions. These situations take pharmacists to a responsible position where they should provide evidence-based information to help consumers make safe consumption. The consumption of CAMs can be ensured safe if pharmacists have appropriate knowledge and training about their use, dosing, side effects, etc. This study aimed to investigate and evaluate the pharmacist's factual knowledge, perception and dispensing practice related to various aspects of CAMs based on gender and experience. METHODS The study followed a structured self-administered questionnaire-based cross-sectional survey design. Out of 200, with a response rate of 89.5%, 179 pharmacists (115 males; 64 females) from the Riyadh region of Saudi Arabia participated in this study. The knowledge scores of male and female pharmacists were compared using an unpaired t-test. The correlation between pharmacists' knowledge and their work experience was determined using Pearson's correlation coefficient test, keeping the significance value at p < 0.05. RESULTS Almost all the respondents (99%) reported that they had never attended any lecture or course related to CAMs. Results show low knowledge scores, indicating poor respondents' knowledge concerning the use of CAMs. No significant difference was observed in knowledge scores based on gender, and no significant correlation between pharmacists' knowledge scores and their work experiences. CONCLUSION Therefore, the study concluded that both male and female pharmacists possess equal knowledge concerning the use of CAMs, and their work experience doesn't differentiate in their knowledge. Various factors like lack of time, etc., prevented respondents from interacting with patients. Regular organization of mandatory continuing education programs about the safe use of CAMs that can improve their knowledge is recommended. In addition, establishing a pharmacy connection network system can enhance patient monitoring and CAMs vigilance. This study lays a foundation for further work to assess pharmacists' knowledge and practice patterns in Saudi Arabia. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Hanan M. Al-Yousef
- grid.56302.320000 0004 1773 5396Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, 11433 Saudi Arabia
| | - Ahmad H. Alghadir
- grid.56302.320000 0004 1773 5396Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box. 10219, Riyadh, 11433 Saudi Arabia
| | - Amir Iqbal
- grid.56302.320000 0004 1773 5396Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box. 10219, Riyadh, 11433 Saudi Arabia
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Tracy TF, Young HJ, Lai B, Layton B, Stokes D, Fry M, Mehta T, Riser ES, Rimmer J. Supporting successful recruitment in a randomized control trial comparing clinic and home-based exercise among adults with multiple sclerosis. Res Involv Engagem 2022; 8:35. [PMID: 35906699 PMCID: PMC9336143 DOI: 10.1186/s40900-022-00366-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Tele- Exercise and Multiple Sclerosis (TEAMS) study, funded by the Patient Centered Outcome Research Institute (PCORI), is a pragmatic, cluster randomized controlled trial aimed at comparing the effectiveness of a 12-week complementary and alternative medicine (CAM) program for people with multiple sclerosis (MS) delivered by a therapist at a clinic and the same program initiated by the participant at home using a tablet and pre-recorded videos. The 20-session CAM program consists of yoga, Pilates and dual tasking exercises. The study aimed to enroll 820 participants with MS living in Alabama, Mississippi and Tennessee. MAIN BODY The information provided in this paper describes the strategies that led to the largest randomized controlled exercise trial ever conducted for people with multiple sclerosis. Specifically, the paper presents the result of incorporating stakeholder engagement, a novel participant recruitment method, to produce a successful recruitment outcome for a comparative effectiveness randomized controlled trial. This study used three tiers of engagement: panel members (9 members), clinical partners (88 occupational and physical therapists), and community organizations (6 non-profits). CONCLUSION Engagement of the stakeholder panel, clinical partners and community organizations led to interest of over 1700 people with MS across three states in the Deep South (final enrollment was n = 837). The diversity of our stakeholder groups and their extensive reach into various communities were a critical aspect for achieving our target sample size. The recruitment numbers reflect the importance of involving multiple stakeholder groups at project inception, developing relationships over time, utilizing member strengths, and monitoring their engagement on a regular basis to ensure a meaningful experience for all involved. TRIAL REGISTRATION NCT03117881. Registered 18 April 2017, https://clinicaltrials.gov/ct2/show/NCT03117881?term=tele+rehabilitation&cond=Multiple+Sclerosis&cntry=US&state=US%3AAL&draw=2&rank=1 .
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Affiliation(s)
| | - Hui-Ju Young
- UAB/Lakeshore Research Collaborative, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL 35233 USA
| | - Byron Lai
- UAB/Lakeshore Research Collaborative, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL 35233 USA
| | - Beverly Layton
- Patient Author, Expert By Experience, Birmingham, AL USA
| | - Dolly Stokes
- Patient Author, Expert By Experience, Fairhope, AL USA
| | - Mark Fry
- Patient Author, Expert By Experience, Nashville, TN USA
| | - Tapan Mehta
- UAB/Lakeshore Research Collaborative, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL 35233 USA
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL 35233 USA
| | - Emily S. Riser
- Tanner Center for Multiple Sclerosis, Birmingham, AL 35209 USA
| | - James Rimmer
- UAB/Lakeshore Research Collaborative, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL 35233 USA
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Wagenknecht A, Dörfler J, Freuding M, Josfeld L, Huebner J. Homeopathy effects in patients during oncological treatment: a systematic review. J Cancer Res Clin Oncol 2022. [PMID: 35731274 DOI: 10.1007/s00432-022-04054-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/02/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE In this systematic review we included clinical studies from 1800 until 2020 to evaluate evidence of the effectiveness of homeopathy on physical and mental conditions in patients during oncological treatment. METHOD In February 2021 a systematic search was conducted searching five electronic databases (Embase, Cochrane, PsychInfo, CINAHL and Medline) to find studies concerning use, effectiveness and potential harm of homeopathy in cancer patients. RESULTS From all 1352 search results, 18 studies with 2016 patients were included in this SR. The patients treated with homeopathy were mainly diagnosed with breast cancer. The therapy concepts include single and combination homeopathic remedies (used systemically or as mouth rinses) of various dilutions. Outcomes assessed were the influence on toxicity of cancer treatment (mostly hot flashes and menopausal symptoms), time to drain removal in breast cancer patients after mastectomy, survival, quality of life, global health and subjective well-being, anxiety and depression as well as safety and tolerance. The included studies reported heterogeneous results: some studies described significant differences in quality of life or toxicity of cancer treatment favouring homeopathy, whereas others did not find an effect or reported significant differences to the disadvantage of homeopathy or side effects caused by homeopathy. The majority of the studies have a low methodological quality. CONCLUSIONS For homeopathy, there is neither a scientifically based hypothesis of its mode of action nor conclusive evidence from clinical studies in cancer care.
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Ben-Arye E, Finkelstein A, Samuels N, Ben-Yehuda D, Schiff E, Reis S, Lesser L, Bergel M, Shaham D. From skepticism to openness: a qualitative narrative analysis of medical students' attitudes following an integrative medicine course. Support Care Cancer 2022; 30:4789-4795. [PMID: 35142910 PMCID: PMC9046550 DOI: 10.1007/s00520-022-06888-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/30/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The present study aimed to explore attitudes of medical students following a course in integrative medicine (IM) focused on palliative and supportive cancer. METHOD Attitudes to IM among pre-clerkship medical students were assessed following a 3-day required course, which included interviews with international experts in IM and "hands-on" workshops mentored by IM and non-IM healthcare professionals. Student reflections were analyzed qualitatively, and written narratives were examined thematically. RESULTS Of 161 students, 102 (63.4%) provided post-course reflections. The main narrative themes included pre-course attitudes, attitude changes and influencing factors, and insights on implementing IM in clinical practice. Pre-course attitudes were predominantly skeptical, with post-course attitudes more open and non-judgmental, addressing research on IM effectiveness and safety. Students looked favorably on the implementation of IM in clinical practice and felt the course enhanced communication with patients. CONCLUSIONS Student attitudes to IM shifted following the course, from a skeptical to a more non-judgmental and accepting approach. IM course may facilitate a better understanding of the limitations and risks of IM practices, particularly in the supportive cancer care setting, as well as implications regarding students' own resilience and professional growth.
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Affiliation(s)
- Eran Ben-Arye
- grid.6451.60000000121102151Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel ,grid.414553.20000 0004 0575 3597Integrative Oncology Program, Clalit Health Services, & Carmel Medical Centers, LinHaifa, Zebulun Israel
| | - Adi Finkelstein
- grid.419646.80000 0001 0040 8485Faculty of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel ,grid.9619.70000 0004 1937 0538Faculty of Medicine, Hadassah-Hebrew University Medical School, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Noah Samuels
- grid.414505.10000 0004 0631 3825Center for Integrative Complementary Medicine, Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dina Ben-Yehuda
- grid.9619.70000 0004 1937 0538Faculty of Medicine, Hadassah-Hebrew University Medical School, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Elad Schiff
- grid.6451.60000000121102151Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel ,grid.414529.fDepartment of Internal Medicine & Integrative Medicine Service, Bnai Zion Medical Center, Haifa, Israel
| | - Shmuel Reis
- grid.9619.70000 0004 1937 0538Faculty of Medicine, Hadassah-Hebrew University Medical School, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Lior Lesser
- grid.9619.70000 0004 1937 0538Faculty of Medicine, Hadassah-Hebrew University Medical School, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Michael Bergel
- grid.9619.70000 0004 1937 0538Faculty of Medicine, Hadassah-Hebrew University Medical School, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Dorith Shaham
- grid.9619.70000 0004 1937 0538Faculty of Medicine, Hadassah-Hebrew University Medical School, Hebrew University of Jerusalem, Jerusalem, Israel
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Mercadante S, Bellavia G, Cascio AL, Dabbene M, di Silvestre G, Casuccio A. The use of complementary alternative medicines in advanced cancer patients followed at home. Support Care Cancer 2021; 30:2003-2008. [PMID: 34636945 PMCID: PMC8505787 DOI: 10.1007/s00520-021-06580-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/15/2021] [Indexed: 11/04/2022]
Abstract
Objectives To assess the use of complementary alternative medicines (CAM) in advanced cancer patients followed at home. Methods A consecutive sample of advanced cancer patients admitted to a home palliative care program was invited to participate in the study in a period of two months. Demographic characteristics, religious belief, education level, diagnosis, and socio-economic condition were recorded. Patients were asked about the use of CAM, considered to be a health-related treatment practiced outside the established health services. Information about CAM indications and those who prescribed or suggested CAM were also collected. Results Two hundred and eighty-three advanced cancer patients followed at home were surveyed. Twelve patients (4.2%) were receiving CAM. The indication and type of CAM were variable, as well as the costs. Given the low number of patients taking CAM, no further analysis was performed. Conclusion A limited number of advanced cancer patients followed at home were using CAM. Further multicenter studies with a larger sample should be performed to provide information about such therapies, also including eventual benefits.
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Affiliation(s)
- Sebastiano Mercadante
- Main Regional Center for Cancer Pain and Supportive/Palliative Care, La Maddalena Cancer Center, Palermo, Italy. .,Regional Home Care Program, SAMOT, Palermo, Italy.
| | | | - Alessio Lo Cascio
- Main Regional Center for Cancer Pain and Supportive/Palliative Care, La Maddalena Cancer Center, Palermo, Italy
| | - Marcella Dabbene
- Main Regional Center for Cancer Pain and Supportive/Palliative Care, La Maddalena Cancer Center, Palermo, Italy
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Schmid GL, Kluge J, Deutsch T, Geier AK, Bleckwenn M, Unverzagt S, Frese T. Osteopathy in Germany: attitudes, beliefs and handling among general practitioners - results of a nationwide cross-sectional questionnaire survey. BMC Fam Pract 2021; 22:197. [PMID: 34620110 PMCID: PMC8499418 DOI: 10.1186/s12875-021-01545-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/17/2021] [Indexed: 11/23/2022]
Abstract
Background Osteopathy is a type of complementary medicine based on specific manual techniques. In many countries, including Germany, the profession is not officially regulated, and evidence for the effectiveness of osteopathy is insufficient for most diseases. Nevertheless, many health insurances in Germany offer reimbursement for therapy costs, if osteopathy is recommended by a physician. This cross-sectional survey of German general practitioners (GPs) explored beliefs and attitudes towards osteopathic medicine and described their daily interactions with it. Methods A random sample of 1000 GPs from all federal states was surveyed by mail using a self-designed questionnaire. We collected data on sociodemographics, personal experiences with osteopathy, and attitudes and expectations towards osteopathy. In particular, participants were asked about indications for osteopathic treatment and their beliefs about its effectiveness for different patient groups and diagnoses. A self-designed score was used to estimate general attitudes towards osteopathy and identify factors correlated with greater openness. Additionally, we performed logistic regression to reveal factors associated with the frequency of recommending osteopathy to patients. Results Response rate was 34.4%. 46.5% of participants were women, and the median age was 56.0 years. 91.3% of GPs had referred patients to an osteopath, and 88.0% had recommended osteopathy to their patients. However, 57.5% acknowledged having little or no knowledge about osteopathy. Most frequent reasons for a recommendation were spinal column disorders (46.2%), other complaints of the musculoskeletal system (18.2%) and headaches (9.8%). GPs estimated the highest benefit for chronically ill and middle-aged adults. Female gender (OR 2.09; 95%CI 1.29–3.38) and personal treatment experiences (OR 5.14; 95%CI 2.72–9.72) were independently positively associated with more frequent treatment recommendation. Conclusion GPs in Germany have frequent contact with osteopathy, and the vast majority have recommended osteopathic treatment to some extent in their practice, with foci and opinions comparable to other Western countries. The discrepancy between GPs making frequent referrals for osteopathic treatment while self-assessing to have little knowledge about it demonstrates need for intensified research on the collaboration with osteopaths and how to best integrate osteopathic treatments. Our results may help to focus future effectiveness studies on most relevant clinical conditions in general practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01545-2.
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Affiliation(s)
- Gordian L Schmid
- Department of General Practice, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany.
| | - Jeremias Kluge
- Department of General Practice, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Tobias Deutsch
- Department of General Practice, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Anne-Kathrin Geier
- Department of General Practice, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Markus Bleckwenn
- Department of General Practice, Medical Faculty, University of Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Susanne Unverzagt
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany
| | - Thomas Frese
- Institute of General Practice and Family Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany
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Zetzl T, Pittig A, Renner A, van Oorschot B, Jentschke E. Yoga therapy to reduce fatigue in cancer: effects of reminder e-mails and long-term efficacy. Support Care Cancer 2021. [PMID: 34155534 DOI: 10.1007/s00520-021-06345-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 06/06/2021] [Indexed: 11/30/2022]
Abstract
Objective To examine the efficacy of reminder e-mails to continue yoga therapy on practice frequency and fatigue in cancer patients and long-term effects of yoga on fatigue, depression, and quality of life. Methodology One hundred two cancer patients who completed an 8-week yoga therapy were randomly allocated to two groups: reminder (N = 51) vs. no-reminder group (N = 51). After completing yoga therapy, the reminder group received weekly e-mails for 24 weeks, which reminded them of practicing yoga, whereas the no-reminder group did not. Primary outcomes were fatigue and practice frequency, and long-term outcomes were fatigue, depression, and quality of life. Data were assessed using questionnaires after yoga therapy (T1) and 6 months after completing yoga therapy (T2). Result A significantly stronger reduction of general (p = 0.038, d = 0.42) and emotional fatigue (p = 0.004, d = 0.59) and a higher increase of practice frequency (p = 0.015, d = 0.52) between T1 and T2 were found for the reminder group compared to the no-reminder group. In the mediation model, practice frequency as a mediator partially explained the changes in emotional fatigue (indirect effect B = − 0.10). Long-term effects of yoga therapy regarding fatigue, depression, and quality of life were found (F > 7.46, p < 0.001, d > 0.54). Conclusion Weekly reminder e-mails after yoga therapy can positively affect general and emotional fatigue and help cancer patients with fatigue establish a regular yoga practice at home. However, higher practice frequency did not lead to higher physical or cognitive fatigue improvement, suggesting other factors that mediate efficacy on physical or cognitive fatigue, such as mindfulness or side effects of therapy.
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Hijazi MA, Shatila H, Omeich Z, El-Lakany A, Ela MA, Naja F. The role of pharmacists in complementary and alternative medicine in Lebanon: users' perspectives. BMC Complement Med Ther 2021; 21:81. [PMID: 33691698 PMCID: PMC7944898 DOI: 10.1186/s12906-021-03256-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/21/2021] [Indexed: 11/21/2022] Open
Abstract
Background Customers’ expectations and satisfaction are critical to ensure a more effective role of the community pharmacists in promoting the safe use of Complementary and Alternative Medicine (CAM). The aim of this study is to examine the perceptions and practices of customers buying their CAM products from pharmacies and explore their satisfaction with CAM-related services offered by the community pharmacists in Lebanon. Methods A national cross-sectional study was conducted among users of CAM (age > =18 years) who obtained their CAM from community pharmacies in Lebanon (n = 832). Within the proximity of the pharmacy, subjects were invited to complete a multi-component questionnaire. The latter consisted of four sections related to CAM: general beliefs, perception of pharmacists’ role, practices, satisfaction with services offered by the pharmacists. In addition, the questionnaire included questions about sociodemographic characteristics of participants. Results The majority of participants agreed to an active role of the pharmacists’ in guiding CAM use, however over half of the participants (61.3%) did not agree that the pharmacist is more knowledgeable in this field than other healthcare providers. As for practices, one in two surveyed customers (47%) did not always give feedback to their pharmacists about the outcomes after using CAM, 20% did not often ask the pharmacists about the safe and effective mode of use of the products and 28.1% did not discuss their medical history. For services offered by the pharmacist, the majority of participants reported receiving good education about the CAM product (87.1%), its side effects (87.1%) and mode of use (93.4%), while significant proportions of participants reported that pharmacists were not asking questions about their medical history before dispensing CAM products (22%) nor were they providing information on CAM-drug interactions (30%). Conclusions The results of this study highlighted important gaps between the perceptions of customers and the services they received from the pharmacists about CAM use. These findings could be used by concerned stakeholders, including public health authorities and educational bodies, to develop evidence-based interventions aimed at promoting the role of pharmacists in ensuring a safe and effective CAM use Lebanon. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03256-8.
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Affiliation(s)
- Mohamad Ali Hijazi
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Beirut Arab University, P.O. Box: 11 5020, Beirut, Lebanon
| | - Hibeh Shatila
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Zeina Omeich
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Beirut Arab University, P.O. Box: 11 5020, Beirut, Lebanon
| | - Abdalla El-Lakany
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Beirut Arab University, P.O. Box: 11 5020, Beirut, Lebanon
| | - Maha Aboul Ela
- Faculty of Pharmacy, Department of Pharmaceutical Sciences, Beirut Arab University, P.O. Box: 11 5020, Beirut, Lebanon
| | - Farah Naja
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical & Health Sciences (RIMHS), University of Sharjah, Sharjah, United Arab Emirates. .,Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon.
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Zetzl T, Renner A, Pittig A, Jentschke E, Roch C, van Oorschot B. Yoga effectively reduces fatigue and symptoms of depression in patients with different types of cancer. Support Care Cancer 2021; 29:2973-82. [PMID: 33026490 DOI: 10.1007/s00520-020-05794-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/18/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Examine the effects of an 8-week yoga therapy on fatigue in patients with different types of cancer. METHODS A total of 173 cancer patients suffering from mild to severe fatigue were randomly allocated to yoga intervention (n = 84) (IG) versus waitlist control group (CG) (n = 88). Yoga therapy consisted of eight weekly sessions with 60 min each. The primary outcome was self-reported fatigue symptoms. Secondary outcomes were symptoms of depression and quality of life (QoL). Data were assessed using questionnaires before (T0) and after yoga therapy for IG versus waiting period for CG (T1). RESULTS A stronger reduction of general fatigue (P = .033), physical fatigue (P = .048), and depression (P < .001) as well as a stronger increase in QoL (P = .002) was found for patients who attended 7 or 8 sessions compared with controls. Within the yoga group, both higher attendance rate and lower T0-fatigue were significant predictors of lower T1-fatigue (P ≤ .001). Exploratory results revealed that women with breast cancer report a higher reduction of fatigue than women with other types of cancer (P = .016) after yoga therapy. CONCLUSION The findings support the assumption that yoga therapy is useful to reduce cancer-related fatigue, especially for the physical aspects of fatigue. Women with breast cancer seem to benefit most, and higher attendance rate results in greater reduction of fatigue. TRIAL REGISTRATION German Clinical Trials Register DRKS00016034.
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Nik Yusof Fuad NF, Ching SM, Awg Dzulkarnain DH, Cheong AT, Zakaria ZA. Complementary alternative medicine use among postpartum mothers in a primary care setting: a cross-sectional study in Malaysia. BMC Complement Med Ther 2020; 20:197. [PMID: 32586306 PMCID: PMC7318471 DOI: 10.1186/s12906-020-02984-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 06/08/2020] [Indexed: 11/30/2022] Open
Abstract
Background Complementary alternative medicine (CAM) is widely used among postpartum mothers to maintain their well-being. This study aims to determine the prevalence and factors associated with CAM use among postpartum mothers in a primary-care clinic in Malaysia. Methods This is a cross-sectional study of 725 postpartum mothers, aged 18 and above, attending a primary-care clinic. The systematic sampling method was used to recruit patients through a structured, self-administered questionnaire. Data analysis was conducted using SPSS version 23. Multiple logistic regression was used to identify the predictors of CAM use among postpartum mothers. Results The prevalence of CAM use among postpartum mothers was 85.5%. Manipulative body therapies, including massage, reflexology, hot stone compression and body wrapping were the most widely used methods of CAM (84.1%) among postpartum mothers, followed by biological-based therapies (33.1%). More than half of the respondents (52.1%) opted to use CAM, as they had observed good results from other CAM users. However, our study showed that 57.1% of mothers who consumed herbal medicine reported neonatal jaundice in their newborn. The median of the expenditure on CAM usage was 250 Malaysian Ringgits, or USD 61.3 per month. According to multiple logistic regression analyses, being Muslim (OR = 5.258, 95% CI: 2.952–9.368), being Malay (OR = 4.414, 95% CI: 1.18–16.56), having a higher educational level (OR = 2.561, 95% CI: 1.587–4.133) and having delivered via spontaneous vaginal delivery (OR: 5.660, 95% CI: 3.454–9.276) had a significantly positive association with CAM use among postpartum mothers. Conclusions The prevalence of CAM use was high (8 out of 10) among postpartum mothers. Postpartum mothers who are Malay, Muslim, have a higher educational level and who have had spontaneous vaginal delivery tended to use CAM more. Manipulative body therapies, including massage, reflexology, hot stone compression and body wrapping, were the most widely used forms of CAM, followed by biological-based therapies. More than half of the mothers who consumed herbal medicine reported neonatal jaundice in their newborn. Thus, education to increase awareness regarding the consumption of herbs is urgently required in this country.
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Affiliation(s)
- Nik Farah Nik Yusof Fuad
- Klinik Kesihatan AU2 Keramat, Ministry of Health Malaysia, Taman Sri Keramat, Jalan AU2, Putrajaya, 54200, Selangor, Malaysia
| | - Siew Mooi Ching
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia. .,Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, 43400, Malaysia.
| | | | - Ai Theng Cheong
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Serdang, Malaysia
| | - Zainul Amiruddin Zakaria
- Department of Biomedical Science Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, 43400, Malaysia
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Rizeq B, Gupta I, Ilesanmi J, AlSafran M, Rahman MDM, Ouhtit A. The Power of Phytochemicals Combination in Cancer Chemoprevention. J Cancer 2020; 11:4521-4533. [PMID: 32489469 PMCID: PMC7255361 DOI: 10.7150/jca.34374] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 12/03/2019] [Indexed: 12/25/2022] Open
Abstract
Conventional therapies for cancer treatment have posed many challenges, including toxicity, multidrug resistance and economic expenses. In contrast, complementary alternative medicine (CAM), employing phytochemicals have recently received increased attention owing to their capability to modulate a myriad of molecular mechanisms with a less toxic effect. Increasing evidence from preclinical and clinical studies suggest that phytochemicals can favorably modulate several signaling pathways involved in cancer development and progression. Combinations of phytochemicals promote cell death, inhibit cell proliferation and invasion, sensitize cancerous cells, and boost the immune system, thus making them striking alternatives in cancer therapy. We previously investigated the effect of six phytochemicals (Indol-3-Carbinol, Resveratrol, C-phycocyanin, Isoflavone, Curcumin and Quercetin), at their bioavailable levels on breast cancer cell lines and were compared to primary cell lines over a period of 6 days. This study showed the compounds had a synergestic effect in inhibiting cell proliferation, reducing cellular migration and invasion, inducing both cell cycle arrest and apoptosis. Despite the vast number of basic science and preclinical cancer studies involving phytochemicals, the number of CAM clinical trials in cancer treatment still remains nascent. In this review, we summarize findings from preclinical and clinical studies, including our work involving use of phytochemicals, individually as well as in combination and further discuss the potential of these phytochemicals to pave way to integrate CAM in primary health care.
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Affiliation(s)
- Balsam Rizeq
- Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
- Biomedical Research Center, Qatar University, Doha, Qatar
| | - Ishita Gupta
- College of Medicine, Qatar University, Doha, Qatar
| | - Josephine Ilesanmi
- Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Mohammed AlSafran
- Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - MD Mizanur Rahman
- Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
| | - Allal Ouhtit
- Department of Biological and Environmental Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
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Cernasev A, Gomaa B, Hager K, Schommer JC, Brown LM. Use of National Consumer Survey Data to Explore Perceptions of Complementary and Alternative Medicine. Innov Pharm 2020; 11. [PMID: 34007606 PMCID: PMC8051915 DOI: 10.24926/iip.v11i2.2263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: Although Complementary and Alternative Medicine (CAM) has been the standard of therapy in Asia for centuries, it started receiving more attention in the U.S. in the last three decades. Objectives: The primary study objective was to explore individuals' perspectives of CAM. A secondary objective was to describe individuals' perceptions of pharmacists’ roles in facilitating their use of these services and products. Methods: Data were obtained from the 2015 and 2016 National Consumer Surveys on the Medication Experience and Pharmacist Roles. Data were collected from adults residing in the United States via on-line, self-administered surveys coordinated by Qualtrics Panels between April 28 and June 22, 2015 (n = 26,173) and between March 14 and 30, 2016 (n = 10,500). This study focused on written comments made in the surveys with Content Conventional Analysis applied to the text. Four researchers were trained to conduct coding to assess inter-judge reliability. The four judges had a high level of agreement which was greater than 0.95 for category type. Results: Out of a total of 36,673 respondents, 80% (29,426) submitted written comments at the end of the survey. Of these, 2,178 comments were about medications or health and 170 (8%) comments specifically about CAM, of which 136 (6%) were usable for analysis. Conventional Content Analysis revealed five themes:1)The role of pharmaceutical and insurance companies in CAM; 2) Overuse of medications; 3)Physicians can play a role in creating a balance between prescription use and CAM; 4) Individuals believe that CAM is more effective than Western medicines and prefer it; 5) Individuals want pharmacists to have a better understanding of CAM. Theresults of this study reveal individuals’ opinions regarding how they want CAM to be considered in their interactions with their healthcare team. Conclusion: Emergent themes suggest that individuals are interested in receiving more professionals’ healthcare to become more knowledgeable about CAM.
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Godley E, Smith MA. Efficacy of acupressure for chronic low back pain: A systematic review. Complement Ther Clin Pract 2020; 39:101146. [PMID: 32379678 DOI: 10.1016/j.ctcp.2020.101146] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/09/2020] [Accepted: 03/12/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Establish the utility of acupressure for chronic low back pain (CLBP). DESIGN A systematic review of English articles using PubMed and Embase was conducted from 01/2004-01/2020. Search terms included: "acupressure" and "chronic pain" or "low back pain". Articles included were randomized control trials evaluating acupressure in adult patients with CLBP. RESULTS 150 studies met initial criteria; 6 were included (n = 468). The average total treatment length was 4 weeks. The main treatment outcomes were changes in pain, disability, and sleep. All studies found a clinically significant reduction (, ≥30% decrease) in pain for the treatment groups. All studies found a clinically significant and/or statistically significant improvement in disability in at least one of the treatment groups. All studies found a statistically significant improvement in sleep. No study found significant adverse events. CONCLUSION Acupressure is a feasible, effective, safe, low cost nonpharmacologic method to treat CLBP.
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Affiliation(s)
- Erica Godley
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, MI, 48109, USA; University of Michigan College of Pharmacy, 428 Church St, Ann Arbor, MI, 48109, USA
| | - Michael A Smith
- Department of Clinical Pharmacy, College of Pharmacy, University of Michigan, Ann Arbor, MI, 48109, USA; University of Michigan College of Pharmacy, 428 Church St, Ann Arbor, MI, 48109, USA.
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Labidi S, Ennouri S, Rachdi H, El Benna H, Mejri N, Daoud N, Berrazaga Y, Boussen H. Use of complementary and alternative medicine in cancer: A Tunisian single-center experience. Bull Cancer 2020; 107:209-214. [PMID: 32000968 DOI: 10.1016/j.bulcan.2019.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 10/17/2019] [Accepted: 10/21/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION We aimed to explore the use of complementary and alternative medicine (CAM) and to identify their side effects, when used in cancer patients. We also assessed the communication of the patients and families with the oncologist about this issue. METHODS A cross-sectional survey of 120 adult patients treated for cancer in our medical oncology department between January and April 2019, using an anonymous questionnaire to assess complementary and alternative medicine use. RESULTS One hundred twenty patients participated in the survey, among them 102 used CAM (85%). A majority of users were female patients (n=72, 70.6%), and mean age was 52.4 years±11.6. Patients had breast cancer in 48% of cases. Wild herbs were the most commonly used alternative therapy (67.7%), particularly Ephedra foeminea (Alanda) in 52% of cases. Patients' families incited them to use CAM in 64.7% of cases. Internet and social network (Facebook) were the major sources of information on CAM (79.4%), followed by family and friends (72.5%). Fourteen patients (13.7%) reported nausea and vomiting secondary to CAM use. We reported disruption of liver function in 9.8% of cases, and renal failure in 1.96%, with fatal issue in one patient using Ephedra. Nineteen patients (18.6%) informed their oncologist about the alternative therapy they received. CONCLUSION The oncologist has to explore the use of alternative therapies with their patients. Communication about CAM should be a part of cancer care. It may protect patients from some dangerous side effects and improve efficacy of conventional therapy.
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Affiliation(s)
- Soumaya Labidi
- Abderrahmen Mami Hospital, Medical oncology department SOMA, Rue de l'hôpital, 2080 Ariana, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Sana Ennouri
- Abderrahmen Mami Hospital, Medical oncology department SOMA, Rue de l'hôpital, 2080 Ariana, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia.
| | - Haifa Rachdi
- Abderrahmen Mami Hospital, Medical oncology department SOMA, Rue de l'hôpital, 2080 Ariana, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Houda El Benna
- Abderrahmen Mami Hospital, Medical oncology department SOMA, Rue de l'hôpital, 2080 Ariana, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Nesrine Mejri
- Abderrahmen Mami Hospital, Medical oncology department SOMA, Rue de l'hôpital, 2080 Ariana, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Nouha Daoud
- Abderrahmen Mami Hospital, Medical oncology department SOMA, Rue de l'hôpital, 2080 Ariana, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Yosra Berrazaga
- Abderrahmen Mami Hospital, Medical oncology department SOMA, Rue de l'hôpital, 2080 Ariana, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
| | - Hamouda Boussen
- Abderrahmen Mami Hospital, Medical oncology department SOMA, Rue de l'hôpital, 2080 Ariana, Tunisia; University Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
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Hirata K, Nishiki Y, Goto R, Inagaki M, Oshima K, Shimazu Y, Takeda M. Resveratrol suppresses nociceptive jaw-opening reflex via 5HT 3 receptor-mediated GABAergic inhibition . Neurosci Res 2020; 160:25-31. [PMID: 31715199 DOI: 10.1016/j.neures.2019.10.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 10/28/2019] [Accepted: 10/31/2019] [Indexed: 11/20/2022]
Abstract
Systemic administration of the dietary constituent, resveratrol, was previously shown to inhibit the nociceptive jaw-opening reflex (JOR) via the endogenous opioid system. The present study investigated whether resveratrol could similarly affect the JOR under in vivo conditions via 5HT3 receptor-mediated GABAergic inhibition. We used electrical stimulation of the tongue in pentobarbital-anesthetized rats to evoke the JOR, which was recorded as the anterior belly of the digastric muscle electromyograms (dEMG). Intravenous administration of resveratrol (2 mg/kg) reduced the dEMG amplitude in response to three times the determined threshold electrical stimulation, with maximum inhibition reached within approximately 10 min. These inhibitory effects on the JOR were reversible to control levels after approximately 20 min. Pretreatment of rats with either 5HT3 receptor antagonist, ondansetron (0.25-1 mg/kg, i.p.), or GABAA receptor antagonist, bicuculline (0.5-1 mg/kg, i.p.), significantly and dose-dependently attenuated the inhibitory effects of resveratrol on dEMG amplitude compared with untreated controls. These findings suggest that resveratrol also attenuates the nociceptive JOR via 5HT3 receptor-mediated GABAergic inhibition. The present study therefore provides new insight into a possible mechanism underlying resveratrol-induced trigeminal antinociception via the descending pain control system and highlights a potential therapeutic agent for complementary alternative medicine.
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Liu X, Li M, Wang X, Dang Z, Yu L, Wang X, Jiang Y, Yang Z. Effects of adjuvant traditional Chinese medicine therapy on long-term survival in patients with hepatocellular carcinoma. Phytomedicine 2019; 62:152930. [PMID: 31128485 DOI: 10.1016/j.phymed.2019.152930] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/09/2019] [Accepted: 04/15/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Many patients with hepatocellular carcinoma (HCC) in Asian countries seek adjuvant therapy with traditional Chinese medicine (TCM). This study aims to explore the benefits of TCM therapy in the long-term survival of patients with hepatocellular carcinoma in China. PATIENTS AND METHODS In total, 3483 patients with HCC admitted to the Beijing Ditan Hospital of Capital Medical University were enrolled in this study. We used 1:1 frequency matching by sex, age, diagnosis time, Barcelona Clinic Liver Cancer staging, and type of treatments to compare the TCM users (n = 526) and non-TCM users (n = 526). A Cox multivariate regression model was employed to evaluate the effects of TCM therapy on the HR value and Kaplan-Meier survival curve for mortality risk in HCC patients. A log-rank test was performed to analyze the effect of TCM therapy on the survival time of HCC patients. RESULTS The Cox multivariate analysis indicated that TCM therapy was an independent protective factor for 5-year survival in patients with HCC (adjusted HR = 0.46, 95% CI 0.40-0.52, p < 0.0001). The Kaplan-Meier curve also showed that after PS matching, TCM users had a higher overall survival rate and a higher progression-free survival rate than non-TCM users. TCM users, regardless of the classification of etiology, tumor stage, liver function level, or type of treatment, all benefited significantly from TCM therapy. In addition, it was found that the most commonly used Chinese patent medications are Fufang Banmao Capsule, Huaier Granule, and Jinlong Capsule. CONCLUSION Using traditional Chinese medications as adjuvant therapy can probably prolong median survival time and improve the overall survival among patients with HCC. Further scientific studies and clinical trials are needed to examine the efficiency and safety.
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Affiliation(s)
- XiaoLi Liu
- Center of Integrative Medicine, Beijing Ditan Hospital, Affiliated to Capital Medical University, No. 8 Jing Shun East Street, Beijing 100015, China
| | - MengGe Li
- Department of hepatobiliary spleen and stomach, Henan Province of TCM, No. 6 Dongfeng Road, Zhengzhou, 420002, Henan Province, China
| | - Xinhui Wang
- Center of Integrative Medicine, Beijing Ditan Hospital, Affiliated to Capital Medical University, No. 8 Jing Shun East Street, Beijing 100015, China
| | - Zhibo Dang
- Center of Integrative Medicine, Beijing Ditan Hospital, Affiliated to Capital Medical University, No. 8 Jing Shun East Street, Beijing 100015, China
| | - Lihua Yu
- Center of Integrative Medicine, Beijing Ditan Hospital, Affiliated to Capital Medical University, No. 8 Jing Shun East Street, Beijing 100015, China
| | - XianBo Wang
- Center of Integrative Medicine, Beijing Ditan Hospital, Affiliated to Capital Medical University, No. 8 Jing Shun East Street, Beijing 100015, China
| | - YuYong Jiang
- Center of Integrative Medicine, Beijing Ditan Hospital, Affiliated to Capital Medical University, No. 8 Jing Shun East Street, Beijing 100015, China
| | - ZhiYun Yang
- Center of Integrative Medicine, Beijing Ditan Hospital, Affiliated to Capital Medical University, No. 8 Jing Shun East Street, Beijing 100015, China.
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Cai M, Yang EJ. Complementary and alternative medicine for treating amyotrophic lateral sclerosis: A narrative review. Integr Med Res 2019; 8:234-239. [PMID: 31692669 PMCID: PMC6806396 DOI: 10.1016/j.imr.2019.08.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/14/2019] [Accepted: 08/20/2019] [Indexed: 12/11/2022] Open
Abstract
Background Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disease that is characterized by selective motor neuron cell death in the motor cortex, brainstem, and spinal cord. Two drugs for ALS, riluzole and edaravone, have been approved by FDA for the treatment of ALS patients. However, they have many side effects, and riluzole extends the patient's life by only 2-3 months. Therefore, ALS patients seek an effective therapy for treating the symptoms or delaying the progression of ALS. Based on this, we review the effects of complementary and alternative medicine (CAM) in ALS animals or patients to verify the efficacy of CAM in incurable diseases. For this review, we searched published papers focusing on the effect of CAM in pre-clinical and clinical study in ALS. Methods The search keywords included amyotrophic lateral sclerosis, acupuncture, herbal medicine, Traditional Chinese medicine, CAM, animals, and clinical study through electronic databases PubMed and Google Scholar from their inception until March 2019. Results In the ALS animal model, CAM modulated the immune system to increase motor function by reducing the expression levels of neuroinflammatory proteins in the spinal cord. Besides this, ALS patients treated with herbal medicine showed improved disease symptoms, but clinical trials with larger sample sizes are needed to develop a treatment with this herbal medicine. Conclusion This review shows that CAM may be useful for ALS treatment, but more evidence regarding the efficacy and molecular mechanisms is required to establish CAM as a good therapy for the treatment of ALS patients.
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Affiliation(s)
- Mudan Cai
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, 34054, South Korea
| | - Eun Jin Yang
- Clinical Medicine Division, Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon, 34054, Republic of Korea
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Rudra RT, Farkas GJ, Haidar S, Slavoski KE, Lokey NE, Hudson TR. Complementary alternative medicine practices and beliefs in spinal cord injury and non-spinal cord injured individuals. J Spinal Cord Med 2018; 41:659-666. [PMID: 28782431 PMCID: PMC6217471 DOI: 10.1080/10790268.2017.1360831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CONTEXT/OBJECTIVE To compare the beliefs and practices of individuals with spinal cord injury (SCI), their friends and family members (F&F SCI), and healthcare professionals (HCP) regarding complementary alternative medicine (CAM). DESIGN A questionnaire regarding CAM practices and beliefs was administered to participants on paper or online. SETTING An academic rehabilitation hospital. PARTICIPANTS Ninety-six individuals voluntarily participated in the study. Participants included 28 patients with SCI, 36 F&F SCI, and 32 HCP. INTERVENTIONS Not applicable Outcome Measures: The questionnaire assessed participants' prior or current use of 14 CAM modalities, their willingness to use CAM in the future or recommend its use, and their beliefs and opinions of CAM. RESULTS Participants with SCI and their family and friends, were more likely than HCP to have used CAM (P ≤ 0.01 and P ≤ 0.03, respectively) and recommend its use (P ≤ 0.04 and P ≤ 0.03, respectively). All three groups showed statistical significance in their willingness to ever use certain CAM modalities (P ≤ 0.03 for SCI, P ≤ 0.04 for F&F SCI, and P ≤ 0.02 for HCP). SCI, F&F SCI, and HCP groups had similar beliefs and opinions regarding CAM. CONCLUSION Patients with SCI as well as their friends and family, have significantly more experience with CAM and are more likely to recommend its use than HCP, suggesting that they are interested and find benefit in alternative healthcare. This warrants further investigation of the integration of CAM into general health practices for those with SCI.
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Affiliation(s)
| | - Gary J. Farkas
- Department of Physical Medicine and Rehabilitation, Penn State Milton S. Hershey Medical Center and Penn State College of Medicine, Hershey, Pennsylvania, USA,Correspondence to: Gary J. Farkas, Department of Physical Medicine and Rehabilitation, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, 500 University Drive, P.O. Box 850, Mail Code R120, Hershey, Pennsylvania 17033-0850, USA; Ph: 717-531-0003, x284930, 717-531-0354.
| | - Shahd Haidar
- Department of Physical Medicine and Rehabilitation, Penn State Milton S. Hershey Medical Center and Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Kristin E. Slavoski
- Department of Physical Medicine and Rehabilitation, Penn State Milton S. Hershey Medical Center and Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Nancy E. Lokey
- Department of Physical Medicine and Rehabilitation, Penn State Milton S. Hershey Medical Center and Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Timothy R. Hudson
- Department of Physical Medicine and Rehabilitation, McGuire Veterans Medical Center, Richmond, Virginia, USA
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McKennon SA, Schauerhamer MB, Fudin HR, Babin JL, Shane-McWhorter L. Assessing pharmacy student confidence to answer patient questions regarding herbal medicines and natural product drugs. Curr Pharm Teach Learn 2018; 10:643-650. [PMID: 29986825 DOI: 10.1016/j.cptl.2018.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 11/16/2017] [Accepted: 02/03/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND PURPOSE To assess the change in confidence answering questions about herbal medicines and natural product drugs (HMNPD) in third year professional pharmacy students in an HMNPD course. EDUCATIONAL ACTIVITY AND SETTING A questionnaire was developed to query confidence in responding to patient questions, recommending specific products, and ability to retrieve resources regarding HMNPD. It was administered the first and last week of the semester; responses were evaluated using a Chi-squared test. FINDINGS At baseline, 46 students (84%) were "very hesitant", "hesitant", or "neither hesitant nor confident" in responding to HMNPD questions; after the course, most students were "confident" or "very confident" (n=30, 54%) (p < .001). Confidence in finding reliable resources increased from the first week (29 students [40%] were "confident" or "very confident") to the last week (51 students [91%] were "confident" or "very confident" [p < .001]). At baseline, five students (9%) were "confident" or "very confident" in ability to recommend a specific product; after the course, 26 students (46%) were "confident" or "very confident" (p < .001). Nine students (16%) felt "very confident" or "confident" in HMNPD safety/effectiveness at baseline; the same proportion felt this way at conclusion (p = .93). Four students (7%) were confident in HMNPD efficacy at baseline and nine (16%) felt the same way at the end (p = .12). DISCUSSION Significant increases in student confidence answering patient questions, responding to disease-specific queries, and using appropriate resources were found. There was no difference in confidence in HMNPD safety/efficacy. SUMMARY This study supported continued HMNPD education in the pharmacy program.
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Affiliation(s)
- Skye A McKennon
- University of Utah Department of Wellness and Integrative Health, LS Skaggs Patient Wellness Center, 530 Wakara Way, Salt Lake City, UT 84108, United States.
| | - Marisa B Schauerhamer
- University of Utah College of Pharmacy, Department of Pharmacotherapy, 30 S 2000 E, Salt Lake City, UT 84112, United States.
| | - Hannah R Fudin
- University of Utah College of Pharmacy, Department of Pharmacotherapy, 30 S 2000 E, Salt Lake City, UT 84112, United States.
| | - Jennifer L Babin
- University of Utah College of Pharmacy, Department of Pharmacotherapy, 30 S 2000 E, Salt Lake City, UT 84112, United States.
| | - Laura Shane-McWhorter
- University of Utah College of Pharmacy, Department of Pharmacotherapy, 30 S 2000 E, Salt Lake City, UT 84112, United States.
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Crow EM, Jeannot E. Premenstrual Syndrome: Symptomatic and Diagnosed Prevalence, Dualistic Treatment Approach - A Cross-Sectional Study in Ukraine. Int J Prev Med 2017; 8:66. [PMID: 28966755 PMCID: PMC5609352 DOI: 10.4103/ijpvm.ijpvm_18_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 06/23/2017] [Indexed: 11/17/2022] Open
Abstract
Background: Diagnosing and treatment of premenstrual syndrome (PMS) still pose a challenge in the routine medical practice which usually focuses on single pharmacological therapy. Recent research suggests that the combination of treatments including complementary alternative medicine (CAM) therapies may be more beneficial. The objective of this study was to assess the percentage of diagnosed and nondiagnosed PMS/premenstrual dysphoric disorder (PMDD) based on the presence of adequate symptoms and to compare population using hormonal or pharmaceutical agents versus CAM therapies. Methods: This is a cross-sectional study targeting sample population of 160 females of potentially reproductive age done in Ukraine between May 2014 and April 2015. Results: According to declared symptoms, 29% females versus 26% previously diagnosed by a medical professional qualify for “moderate/severe PMS,” P > 0.05. In 30% persons using pharmacological agents, major side effects, namely, nausea, insomnia, headache was caused by painkillers, contraceptives, and antidepressants. Only 37.5% of study population has been using CAM therapy methods to deal with the symptoms of PMS. Of these, 22% have achieved moderate degree in relief of the symptoms long term. Conclusions: We have concluded that when dealing with the burden of PMS/PMDD, the affected treatment-seeking women should have choice and access to the variety of therapies within integrative medicine (both conventional and nonconventional).
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Affiliation(s)
- Edith Meszaros Crow
- Researcher, University of Geneva, Faculty of Medicine, Institute of Global Health, Geneva, Switzerland
| | - Emilien Jeannot
- Researcher, University of Geneva, Faculty of Medicine, Institute of Global Health, Geneva, Switzerland.,University of Applied Sciences Western Switzerland, Haute Ecole de Santé, Delémont, Switzerland
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Villani V, Prosperini L, Palombini F, Orzi F, Sette G. Single-blind, randomized, pilot study combining shiatsu and amitriptyline in refractory primary headaches. Neurol Sci 2017; 38:999-1007. [PMID: 28283760 DOI: 10.1007/s10072-017-2888-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/03/2017] [Indexed: 01/03/2023]
Abstract
Complementary alternative medicine, such as shiatsu, can represent a suitable treatment for primary headaches. However, evidence-based data about the effect of combining shiatsu and pharmacological treatments are still not available. Therefore, we tested the efficacy and safety of combining shiatsu and amitriptyline to treat refractory primary headaches in a single-blind, randomized, pilot study. Subjects with a diagnosis of primary headache and who experienced lack of response to ≥2 different prophylactic drugs were randomized in a 1:1:1 ratio to receive shiatsu plus amitriptyline, shiatsu alone, or amitriptyline alone for 3 months. Primary endpoint was the proportion of patients experiencing ≥50%-reduction in headache days. Secondary endpoints were days with headache per month, visual analogue scale, and number of pain killers taken per month. After randomization, 37 subjects were allocated to shiatsu plus amitriptyline (n = 11), shiatsu alone (n = 13), and amitriptyline alone (n = 13). Randomization ensured well-balanced demographic and clinical characteristics at baseline. Although all the three groups improved in terms of headache frequency, visual analogue scale score, and number of pain killers (p < 0.05), there was no between-group difference in primary endpoint (p = ns). Shiatsu (alone or in combination) was superior to amitriptyline in reducing the number of pain killers taken per month (p < 0.05). Seven (19%) subjects reported adverse events, all attributable to amitriptyline, while no side effects were related with shiatsu treatment. Shiatsu is a safe and potentially useful alternative approach for refractory headache. However, there is no evidence of an additive or synergistic effect of combining shiatsu and amitriptyline. These findings are only preliminary and should be interpreted cautiously due to the small sample size of the population included in our study. Trial registration 81/2010 (Ethical Committee, S. Andrea Hospital, Sapienza University, Rome, Italy).
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Affiliation(s)
- Veronica Villani
- Neuro-Oncology Unit, Regina Elena National Cancer Institute, Via Elio Chianesi 30, 00144, Rome, Italy.
| | - Luca Prosperini
- Department of Neurology and Psychiatry, Sapienza University, Rome, Italy
| | | | - Francesco Orzi
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University, Rome, Italy
| | - Giuliano Sette
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Sapienza University, Rome, Italy
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Kokuba S, Takehana S, Oshima K, Shimazu Y, Takeda M. Systemic administration of the dietary constituent resveratrol inhibits the nociceptive jaw-opening reflex in rats via the endogenous opioid system. Neurosci Res 2017; 119:1-6. [PMID: 28153523 DOI: 10.1016/j.neures.2017.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 12/29/2016] [Accepted: 01/23/2017] [Indexed: 11/15/2022]
Abstract
The aim of the present study was to investigate whether, under in vivo conditions, systemic administration of resveratrol could attenuate the rat nociceptive jaw-opening reflex (JOR) via the endogenous opioid system. The JOR evoked by electrical stimulation of the tongue was recorded as digastric muscle electromyograms (dEMG) in pentobarbital-anesthetized rats. The amplitude of the dEMG increased significantly in proportion to the intensity of electrical stimulation (from 1× to 5 × threshold for the JOR). dEMG amplitude in response to 3× threshold electrical stimulation of the tongue was dose-dependently inhibited by intravenous administration of resveratrol (0.5-2mg/kg). Maximum inhibition of dEMG amplitude was seen within approximately 10min. These inhibitory effects were reversible, with dEMG responses returning to control levels after approximately 20min. Pretreatment of rats with naloxone resulted in significant, dose-dependent attenuation of the inhibitory effects of resveratrol on dEMG amplitude compared with control. These findings suggest that resveratrol inhibits the nociceptive JOR via the endogenous opioid system. Further, the findings of the present study strongly support the idea that resveratrol, which is not known to have any toxic side effects, combined with an opioid could be a potential therapeutic agent for the prevention of acute trigeminal nociception.
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Affiliation(s)
- Shota Kokuba
- Laboratory of Food and Physiological Sciences, Department of Life and Food Sciences, School of Life and Environmental Sciences, Azabu University, 1-17-71, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa 252-5201, Japan
| | - Shiori Takehana
- Laboratory of Food and Physiological Sciences, Department of Life and Food Sciences, School of Life and Environmental Sciences, Azabu University, 1-17-71, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa 252-5201, Japan
| | - Katsuo Oshima
- Department of Dental Technology, The Nippon Dental University College at Tokyo, 2-3-16, Fujimi-cho, Chiyoda-ku 102-007, Japan
| | - Yoshihito Shimazu
- Laboratory of Food and Physiological Sciences, Department of Life and Food Sciences, School of Life and Environmental Sciences, Azabu University, 1-17-71, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa 252-5201, Japan
| | - Mamoru Takeda
- Laboratory of Food and Physiological Sciences, Department of Life and Food Sciences, School of Life and Environmental Sciences, Azabu University, 1-17-71, Fuchinobe, Chuo-ku, Sagamihara, Kanagawa 252-5201, Japan.
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Nilsson J, Källman M, Östlund U, Holgersson G, Bergqvist M, Bergström S. The Use of Complementary and Alternative Medicine in Scandinavia. Anticancer Res 2016; 36:3243-3251. [PMID: 27354580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 05/31/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Complementary alternative medicine (CAM) is widely used among patients with cancer. This usage may have potentially harmful effects, especially when combined with anticancer drugs. However, some complementary methods may benefit patients. This review investigated the prevalence of CAM use among patients with cancer in Scandinavia and secondly studied the educational levels of CAM users compared to non-users. MATERIALS AND METHODS A systematic search of the PubMed library was carried out to locate articles published between January 2000 and October 2015 that investigated prevalence of CAM use among Scandinavian patients with cancer. RESULTS Twenty-two articles were found, of which nine were included in the review. The prevalence of CAM use was 7.9% to 53%, with an average of 36.0% across all studies. CONCLUSION Use of CAM is widespread among patients with cancer. Knowledge about CAM should be disseminated to both patients and staff in order to optimise discussions about CAM in clinical practice.
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Affiliation(s)
- Jonas Nilsson
- Centre for Research and Development, Gavle University Hospital, Gavle, Sweden Department of Radiation Sciences and Oncology, Umea University Hospital, Umea, Sweden Department of Radiology, Gavle University Hospital, Gavle, Sweden
| | - Mikael Källman
- Department of Oncology, Gavle University Hospital, Gavle, Sweden
| | - Ulrika Östlund
- Centre for Research and Development, Gavle University Hospital, Gavle, Sweden
| | - Georg Holgersson
- Centre for Research and Development, Gavle University Hospital, Gavle, Sweden Department of Oncology, Gavle University Hospital, Gavle, Sweden
| | - Michael Bergqvist
- Centre for Research and Development, Gavle University Hospital, Gavle, Sweden Department of Oncology, Gavle University Hospital, Gavle, Sweden Department of Radiation Sciences and Oncology, Umea University Hospital, Umea, Sweden
| | - Stefan Bergström
- Centre for Research and Development, Gavle University Hospital, Gavle, Sweden Department of Oncology, Gavle University Hospital, Gavle, Sweden
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Loraschi A, Bellantonio P, Bortolon F, Capra R, Cavalla P, Costantino G, Lugaresi A, Martinelli V, Marrosu MG, Patti F, Rottoli M, Salvetti M, Sola P, Solaro C, Klersy C, Marino F, Zaffaroni M, Cosentino M. Use of herbal remedies by multiple sclerosis patients: a nation-wide survey in Italy. Neurol Sci 2016; 37:613-22. [PMID: 26895323 DOI: 10.1007/s10072-016-2519-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 02/12/2016] [Indexed: 11/25/2022]
Abstract
Though recent progress in multiple sclerosis (MS) treatment is remarkable, numerous unmet needs remain to be addressed often inducing patients to look for complementary and alternative medicines (CAM), especially herbal remedies (HR). HR use, scarcely investigated in MS, may cause adverse reactions (AR) and interfere with conventional treatment. We performed a survey aimed at evaluating use and attitudes towards HR and factor associated to HR use. Other CAM use and attitudes have been investigated as well. Multiple-choice questionnaires were distributed to MS out patients attending 14 Italian referral Centers. Multivariable logistic regression was used to identify HR use determinants. Present/past HR use for either MS or other diseases was reported in 35.6 % of 2419 cases (95 % CI 36.0-40.0 %). CAM use was reported in 42.5 % of cases. Independent predictors of HR use were represented by higher education, geographic area, dissatisfaction with conventional treatment of diseases other than MS and benefit perception from CAM use. Both HR and CAM use were not always disclosed to the healthcare professional. In conclusion, HR and other CAM appear to be popular among MS patients. The involvement of the healthcare professionals appears to be scarce with potential risk of AR or interference with conventional treatments.
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Affiliation(s)
- A Loraschi
- Center for Research in Medical Pharmacology, University of Insubria, Via Ottorino Rossi n. 9, 21100, Varese, VA, Italy
| | - P Bellantonio
- Multiple Sclerosis Center, IRCCS Neuromed, Pozzilli, IS, Italy
| | - F Bortolon
- Multiple Sclerosis Centre, "San Bortolo" Hospital, Vicenza, Italy
| | - R Capra
- Multiple Sclerosis Center, Montichiari Hospital, Spedali Civili of Brescia, Brescia, Italy
| | - P Cavalla
- 1 Division of Neurology, Multiple Sclerosis Centre, A.O.U. City of Health and Science of Turin, Turin, Italy
| | - G Costantino
- Struttura Semplice "Sclerosi multipla" Az Ospedale-Università "Ospedali riuniti", Foggia, Italy
| | - A Lugaresi
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - V Martinelli
- Department of Neurology, San Raffaele Hospital, Milan, Italy
| | - M G Marrosu
- Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - F Patti
- Department of Medical and Surgical Science and Advanced Technologies, GF Ingrassia, Neurosciences Section, Multiple Sclerosis Center, University of Catania, Catania, Italy
| | - M Rottoli
- Multiple Sclerosis Center of Bergamo, USS Malattie Autoimmuni, Azienda Ospedaliera Papa Giovanni XXIII of Bergamo, Piazza OMS 1, 24127, Bergamo, Italy
| | - M Salvetti
- Neurology and Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Sapienza University of Rome, Rome, Italy
| | - P Sola
- Neurology Unit, Department of Neuroscience, University of Modena, Nuovo Ospedale Civile S. Agostino Estense, Estense, Italy
| | - C Solaro
- Neurology Unit, Department Head and Neck, ASL3 Genovese, Genoa, Italy
| | - C Klersy
- Biometry and Statistics Service, IRCCS Fondazione Policlinico S Matteo, Pavia, Italy
| | - F Marino
- Center for Research in Medical Pharmacology, University of Insubria, Via Ottorino Rossi n. 9, 21100, Varese, VA, Italy
| | - M Zaffaroni
- Multiple Sclerosis Center, Gallarate Hospital, Gallarate, Italy
| | - M Cosentino
- Center for Research in Medical Pharmacology, University of Insubria, Via Ottorino Rossi n. 9, 21100, Varese, VA, Italy.
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Walach H, Roberti di Sarsina P, Tassinari M. Data about (complementary and alternative) medicine are irrelevant, because we are all Bayesians. Eur J Intern Med 2015; 26:e10-1. [PMID: 25287698 DOI: 10.1016/j.ejim.2014.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 09/15/2014] [Accepted: 09/18/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Harald Walach
- Institute for Transcultural Health Studies, European University Viadrina, Frankfurt (Oder), Germany
| | - Paolo Roberti di Sarsina
- Observatory and Methods for Health, Department of Sociology and Social Research, University of Milano-Bicocca, Milan, Italy; Charity Association for Person Centred Medicine-Moral Entity, Bologna, Italy.
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Atwine F, Hultsjö S, Albin B, Hjelm K. Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda: a study of focus group interviews. Pan Afr Med J 2015; 20:76. [PMID: 26090034 PMCID: PMC4450037 DOI: 10.11604/pamj.2015.20.76.5497] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 01/14/2015] [Indexed: 11/11/2022] Open
Abstract
Introduction Health-care seeking behaviour is important as it determines acceptance of health care and outcomes of chronic conditions but it has been investigated to a limited extent among persons with diabetes in developing countries. The aim of the study was to explore health-care seeking behaviour among persons with type 2 diabetes to understand reasons for using therapies offered by traditional healers. Methods Descriptive study using focus-group interviews. Three purposive focus-groups were conducted in 2011 of 10 women and 7 men aged 39–72 years in Uganda. Data were collected through semi-structured interviews and qualitatively analysed according to a method described for focus-groups. Results Reasons for seeking help from traditional healers were symptoms related to diabetes such as polydipsia, fatigue and decreased sensitivity in lower limbs. Failure of effect from western medicine was also reported. Treatment was described to be unknown extracts, of locally made products taken as herbs or food, and participants had sought help from different health facilities with the help of relatives and friends. Conclusion The pattern of seeking care was inconsistent, with a switch between different health care providers under the influence of the popular and folk sectors. Despite beliefs in using different healthcare providers seeking complementary and alternative medicine, participants still experienced many physical health problems related to diabetes complications. Health professionals need to be aware of the risk of switches between different health care providers, and develop strategies to initiate health promotion interventions to include in the care actors of significance to the patient from the popular, folk and professional sectors, to maintain continuity of effective diabetes care.
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Affiliation(s)
- Fortunate Atwine
- School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden ; Department of Nursing, Mbarara University of Science and Technology (MUST), Mbarara, Uganda
| | - Sally Hultsjö
- School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Björn Albin
- School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Katarina Hjelm
- Department of Social and Welfare Studies, University of Linköping, Campus Norrköping, Sweden
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Chung SJ, Koh SB, Ju YS, Kim JW. Nationwide Survey of Patient Knowledge and Attitudes towards Human Experimentation Using Stem Cells or Bee Venom Acupuncture for Parkinson's Disease. J Mov Disord 2014; 7:84-91. [PMID: 25360232 PMCID: PMC4213536 DOI: 10.14802/jmd.14012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 08/26/2014] [Accepted: 09/08/2014] [Indexed: 11/24/2022] Open
Abstract
Objective Stem cell treatment is a well-recognized experimental treatment among patients with Parkinson’s disease (PD), for which there are high expectations of a positive impact. Acupuncture with bee venom is one of the most popular complementary and alternative treatments for PD. Patient knowledge and attitudes towards these experimental treatments are unknown. Methods Using a 12-item questionnaire, a nationwide survey was conducted of 963 PD patients and 267 caregivers in 44 Korean Movement Disorders Society member hospitals from April 2013 to June 2013. The survey was performed by trained interviewers using conventional methods. Results Regarding questions on experimental treatments using stem cells or bee venom acupuncture, 5.1–17.7% of PD patients answered questions on safety, efficacy, and evidence-based practice incorrectly; however, more than half responded that they did not know the correct answer. Although safety and efficacy have not been established, 55.5% of PD patients responded that they were willing to receive stem cell treatment. With regard to participating in experimental treatments, there was a strong correlation between stem cell treatment and bee venom acupuncture (p < 0.0001, odds ratio = 5.226, 95% confidence interval 3.919–6.969). Younger age, higher education, and a longer duration of PD were all associated with a correct understanding of experimental treatments. Conclusions Our data suggest that relatively few PD patients correctly understand the safety and efficacy of experimental treatments and that PD patients are greatly interested in new treatments. We hope that our data will be used to educate or to plan educational programs for PD patients and caregivers.
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Affiliation(s)
| | - Sun Ju Chung
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seong Beom Koh
- Department of Neurology, Korea University College of Medicine, Seoul, Korea
| | - Young-Su Ju
- Department of Occupational & Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jae Woo Kim
- Department of Neurology, Dong-A University School of Medicine, Busan, Korea
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Abstract
The authors illustrate the difficulties involved in obtaining a valid statistical significance in clinical studies especially when the prior probability of the hypothesis under scrutiny is low. Since the prior probability of a research hypothesis is directly related to its scientific plausibility, the commonly used frequentist statistics, which does not take into account this probability, is particularly unsuitable for studies exploring matters in various degree disconnected from science such as complementary alternative medicine (CAM) interventions. Any statistical significance obtained in this field should be considered with great caution and may be better applied to more plausible hypotheses (like placebo effect) than that examined - which usually is the specific efficacy of the intervention. Since achieving meaningful statistical significance is an essential step in the validation of medical interventions, CAM practices, producing only outcomes inherently resistant to statistical validation, appear not to belong to modern evidence-based medicine.
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Affiliation(s)
| | - Giulia Carreras
- Cancer Prevention and Research Institute (ISPO), via delle Oblate 2, 50139 Florence, Italy.
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de Souza Silva JE, Santos Souza CA, da Silva TB, Gomes IA, Brito GDC, de Souza Araújo AA, de Lyra-Júnior DP, da Silva WB, da Silva FA. Use of herbal medicines by elderly patients: A systematic review. Arch Gerontol Geriatr 2014; 59:227-33. [PMID: 25063588 DOI: 10.1016/j.archger.2014.06.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 06/05/2014] [Accepted: 06/08/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES We aimed to survey the published literature for articles that describe the use of herbal supplements by elderly patients and to summarize important aspects of selected studies, including most commonly used supplements, study type, study location, and potential hazards of herbal supplement use. METHODS Literature searches were conducted on three scientific/medical databases: Medline, Web of Science, and Scopus. Search results were examined for articles involving the use of herbal products in the elderly population that met selection criteria. RESULTS Initial searches yielded 1297 articles. Of these original results, only 16 met specific selection criteria. Twelve (75%) of studies identified were performed in North America. Nine studies (56.25%) were conducted in the United States. Seven of the studies were cross-sectional (43.8%). The most commonly reported were gingko biloba, garlic, ginseng, aloe vera, chamomile, spearmint, and ginger. Of these, gingko and garlic are the most commonly used among community-dwelling elderly. Both of these supplements have the potential to interact with anticoagulants and produce bruising or bleeding problems. CONCLUSIONS The use of herbal supplements is common among the elderly, a population that takes a disproportionate share of prescription medications compared to that taken by younger populations. Among the problems uncovered by these studies was a lack of dialog between medical professionals and patients about the use of herbal supplements. Prescribers need to consider the use of herbal supplements and discuss the matter with their elderly patients when making decisions about pharmacological treatments.
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Affiliation(s)
| | | | | | - Isla Alcântara Gomes
- Department of Physiology, Federal University of Sergipe, Aracaju 49100-000, Brazil
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Abstract
More than 11,000 articles lauding alternative medicine appear in the PubMed database, but there are only a few articles describing the complications of such care. Two patients suffering from complications of alternative medicine were treated in our hospital: one patient developed necrotizing fasciitis after acupuncture, and the second developed an epidural hematoma after chiropractic manipulation. These complications serve as a clarion call to the Israeli Health Ministry, as well as to health ministries around the world, to include complementary medicine under its inspection and legislative authority.
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Affiliation(s)
- Michael J. Bayme
- Surgery Ward A, Soroka University Medical Center, Beer Sheva, Israel
| | - Alex Geftler
- Orthopedic Ward, Soroka University Medical Center, Beer Sheva, Israel and
| | - Uri Netz
- Surgery Ward A, Soroka University Medical Center, Beer Sheva, Israel
| | - Boris Kirshtein
- Surgery Ward A, Soroka University Medical Center, Beer Sheva, Israel
| | - Yair Glazer
- Surgery Ward A, Soroka University Medical Center, Beer Sheva, Israel
| | - Shahar Atias
- Surgery Ward A, Soroka University Medical Center, Beer Sheva, Israel
| | - Zvi Perry
- Surgery Ward A, Soroka University Medical Center, Beer Sheva, Israel
- Center for Medical Education, Ben-Gurion University, Beer Sheva, Israel
- To whom correspondence should be addressed. E-mail:
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Coughlan BM, Thornton LM, Murphy N, Tait MA, Flanagan PC, Kenny-Walsh EE, O'Lorcain PP. The use of complementary and alternative medicine in an Irish cohort of people with an iatrogenic hepatitis C infection: results from a health and lifestyle survey. Complement Ther Med 2014; 22:683-9. [PMID: 25146073 DOI: 10.1016/j.ctim.2014.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 06/20/2014] [Accepted: 06/22/2014] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION A cohort of people with iatrogenic HCV infection, current or resolved, in Ireland have access to primary and secondary health care services, including specified complementary and alternative medicine (CAM) services, free of charge. OBJECTIVES Information about their pattern of CAM usage and its association with various demographic and lifestyle factors, and current HCV status, was sought as part of a health and lifestyle survey, in order to provide information for health service planning. DESIGN AND METHODS The survey was carried out by self-administered postal questionnaire. The level of CAM usage was compared to an age- and sex-matched sample of the general population. RESULTS The response was 48% (720/1485). Compared to the general population, the HCV population was significantly more likely to have attended a CAM practitioner (50.1% vs 23.9%, OR 3.2; 95% CI 2.7-3.9). Within the HCV population, multivariate analysis showed that females (OR 3.1; 95% CI 1.9-4.9), those who reported fibromyalgia (OR 2.7; 95% CI 1.8-3.9) and those who reported anxiety (OR 1.4; 95% CI 1.0-2.0) were significantly more likely to have used CAM, and smokers significantly less likely (OR 0.6; 95% CI 0.4-0.8). CAM attendance did not vary by current HCV status. Reflexology, acupuncture and massage were the most commonly used forms of CAM. CONCLUSIONS This study demonstrates that CAM services are used by a high proportion of people with iatrogenic chronic HCV. A more holistic approach to health care, using a biopsychosocial model framework, may better meet the physical and psychological health needs of this group.
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Affiliation(s)
- Barbara M Coughlan
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland.
| | - Lelia M Thornton
- Health Protection Surveillance Centre, Health Service Executive, Ireland
| | - Niamh Murphy
- Health Protection Surveillance Centre, Health Service Executive, Ireland
| | - Michele A Tait
- Hepatitis C National Office, Health Service Executive, Ireland
| | - Paula C Flanagan
- Health Protection Surveillance Centre, Health Service Executive, Ireland
| | | | - Piaras P O'Lorcain
- Health Protection Surveillance Centre, Health Service Executive, Ireland
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Abstract
Arthritis affects both the physical and psychological abilities of people in all walks of life. There are currently no recommended effective ‘disease-modifying’ remedies. Therapists and physicians are therefore exploring possible benefits from non-conventional therapeutic approaches. The purpose is to assess the changes in fitness and psychosocial outcomes of six doctor-referred patients as a result of participating in the I Can Move Again (ICMA) program. Six female participants diagnosed with arthritis were recruited from a local family practitioner. The subjects participated in a series of daily classes for 12 weeks including massage, mindfulness, bounce-back chairs, resistance chairs, aerobic and anaerobic training, rebounders, and whole body vibration platform Tai Chi. Demographic, psychosocial, and physical data were collected at the ICMA and at Y-Be-Fit (Provo, UT). Significant pre to post mean differences were found for sit-ups (F (1,8) =5.42 P =0.048), chair stand (F (1,10) =6.622 P =0.028), arm curl (F (1,10) =14.379 P =0.004), six-minute walk test distance (F (1,9)= 19.188 P=0.002), and speed (F,(1,8) =13.984 P =0.006), and rotation right (F (1,10) =8.921 P =0.014) and left (F (1,10) =11.373 P =0.007), in 27 of the 61-item questionnaire. The preliminary data on the six subjects lacked sufficient statistical power to detect the significant differences that could exist, thus committing a Type II error, but it is important to note an overall, substantial trend in improvement in the patients’ physical outcomes and psychosocial perceptions associated with improvements in activities of daily living.
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Affiliation(s)
- Krista Prusak
- 2365 Mountain Vista Lane Ste. 2, Provo, Utah 84606, 801-310-9987
| | - Keven Prusak
- 249 H SFH, Department of Teacher Education, Brigham Young University, Provo, Utah 84602, 801-422-1560, USA
| | - Jack Mahoney
- 2365 Mountain Vista Lane Ste. 2, Provo, Utah 84606, 801-310-9987
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Ben-Arye E, Silbermann M, Dagash J, Shulman B, Schiff E. Touching the other's suffering: cross-cultural challenges in palliative treatment along geopolitical crossroads. Oncologist 2014; 19:212-4. [PMID: 24436313 DOI: 10.1634/theoncologist.2013-0244] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service, Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel; Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Middle East Cancer Consortium, Haifa, Israel; Palliative Care-Home Care Hospice, Clalit Health Services, Haifa and Western Galilee District, Israel; Departments of Internal Medicine and Integrative Surgery Service, Bnai Zion Hospital, Haifa, Israel, and the International Center for Health, Law, and Ethics, Haifa, Israel
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