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Aim: This paper introduces the study on the European Union Project on complementary therapies and discusses project outputs and results. The goal of the European Union Project was to improve the professional knowledge and skills of women's health and oncology nurses regarding CT. Background: The increasing and widespread use of complementary therapies in the women's health and oncology population requires nurses to be educated about their suitable and safe use. Many nurses do not have proper training in complementary therapies and therefore should not inform their patients about them. Methods: The 'Improving the Nursing Care with Best Complementary Therapy Strategies Based on European Union Standards' (BestCARE) project was a strategic partnership within Erasmus plus for vocational education and training. The BestCARE project was coordinated by the Akdeniz University Nursing Faculty and was carried out with six partners from Turkey and Europe. Results: Fifteen nurses from Turkey and Italy were trained in complementary therapies in England. In addition, training courses and seminars were held in Turkey and Italy for women's health and oncology nurses. The BestCARE programme consisted of 14 work packages. The BestCARE programme was implemented via websites, an e‐learning training programme, training videos, reference and handbook, a curriculum proposal on complementary therapies and a simulation laboratory. Conclusion and implications for nursing and/or health policy: The BestCARE project allowed nurses to gain knowledge, experience and skills about complementary therapies and created a cultural awareness and sensitivity towards patients, caregivers and health professionals. [ABSTRACT FROM AUTHOR]

Background: During the past years, a number of studies have demonstrated the positive effect of apple on ageing and different diseases such as cancer, degenerative and cardiovascular diseases. The unicellular yeast Saccharomyces cerevisiae represents a simple eukaryotic model to study the effects of different compounds on lifespan. We previously demonstrated that apple extracts have anti-ageing effects in this organism because of their antioxidant properties. In particular, the effect is related to the presence in this fruit of polyphenols, which give a large contribution to the antioxidant activity of apples. Methods: We we used a clonogenic assay to assess the viability and the resistance to oxidative stress of S. cerevisiae cells in the presence of Annurca apple extracts. The production of ROS and the aberrant morphology of nuclei were detected by cell staining with the fluorescent dies Dihydrorhodamine 123 and DAPI, respectively. Mitochondrial morphology was analyzed by following the localization of the mito-GFP protein into the mitochondrial matrix. Results: In this study, we show that apple extracts can increase yeast lifespan, reduce the levels of reactive oxygen species and cell sensitivity to oxidative stress, and prevent nuclei and mitochondria fragmentation protecting cells from regulated cell death. Conclusions: In this paper, by using the yeast S. cerevisiae as a model, we have demonstrated that Annurca extracts possess antioxidant properties thanks to which the extracts can reduce the intracellular ROS levels and have anti-apoptotic functions thus prolonging cell lifespan. These results contribute to knowledge on the effects of natural compounds on ageing and support the use of yeast as a model organism for the development of simple tests to assess the effectiveness of bioactive substances from natural sources. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance This paper illustrates the results of an ethnobotanical study carried out in the Vesuvio National Park (VNP) (Campania, Southern Italy). It describes the medicinal uses of the plants in an ancient area rich in ethnobiodiversity investigated for the first time. Aim for the study The main aim of the study was to understand at what extent current knowledge on medicinal plant uses is still alive in VNP. Materials and methods The informations were collected using semi-structured and unstructured interviews performed on 136 persons living in the investigated area from March to November 2014 and from April to October 2015. The age of the informants ranged from 47 to 85 years old; more than half of the informants aged between 61 and 70. Local plant uses were listed and analyzed in a table and compared with uses in other localities in Italy and in other regions of the Mediterranean basin. Results In VNP were recorded a total number of 132 plant species, belonging to 110 genera and 51 families mentioned for medicinal purposes. Among the recorded 132 plant species, 70 are spontaneous or subspontaneous and 62 are cultivated above all in the kitchen gardens or in the apartments, as food or as ornamental. Herbs represent the majority, followed by trees and shrubs or subshrubs. The investigated plants were used to cure 116 different human health diseases and 4 veterinary problems. The majority of plants are used in the treatment of gastrointestinal, skin and respiratory problems. Conclusion The number of medicinal plants reported in this paper reflects a well-preserved traditional popular knowledge (TPK) of the elderly people living in the rural areas and in the small villages of VNP. The conservation of TPK is owed to the persistence of an oral tradition that safeguard the use of plants as herbal medicine. We realized that while the use of some wild plants is decreasing, people continue to gather some cultivated and invasive plants for preparing remedies. Researches like this are necessary to protect ancient memories, to promote the transfer of information to the younger generations, to preserve ethno-biodiversity and to provide a starting point fur further biochemical investigations on medicinal entities. [ABSTRACT FROM AUTHOR]

Abstract: Ethnopharmacological relevance: Many wild and cultivated plants are rich in mineral elements and bioactive compounds and are consumed for health purposes. Studies have demonstrated the curative properties of many of these food plants. In this paper, we discuss the properties of several plants with potential health benefits that have previously received little attention. Aim of the study: This review provides an overview and critical discussion of food plants perceived by informants (emic view) as healthy or used as ‘food medicine’ in Italy. Pharmacological activity of these plants is explored, based upon published scientific research (etic view). Preparation methods, taste perception, toxicity and various potentialities of some food plants are also discussed. Materials and methods: The present review includes literature available from 1877 to 2012. The information was collected from books, scientific papers, and abstracts that reported any plants used as food medicine in Italy. The perceived health properties were analyzed in the framework of recent international phytochemical and phytopharmacological literature. Results: A total of 67 edible wild plants and 18 cultivated vegetables, distributed into 20 families, were reported by informants (in literature). Several plants were highly cited (e.g., Taraxacum officinale Webb., Crepis vesicaria L., Allium cepa L., Allium sativum L.). The most frequent health properties attributed to edible plants by the informants were: laxative (22 species), diuretic (15), digestive (11), galactagogue (8), antitussive (cough) (8), hypotensive (7), tonic (7), sedative (7), hypoglycemic (6). Conclusions: Some edible plants are promising for their potential health properties, such as Crepis vesicaria L., Sanguisorba minor Scop. and Sonchus oleraceus L. Several wild species were perceived by informants to maintain health but have never been studied from a phytochemical or pharmacological point of view: e.g., Asparagus albus L., Crepis leontodontoides All., Hyoseris radiata L. subsp. radiata, Phyteuma spicatum L. [Copyright &y& Elsevier]

Background: This paper reports an ethnobotanical survey of the traditional uses of medicinal and useful plants in an area of the Pollino National Park, Basilicata, Southern Italy. The study, conducted between 2009 and 2010, gathered information on the medicinal plants traditionally used in the neighbourhood of town of Rotonda, in the Pollino National Park, that appears have very rich and interesting ethnopharmacological traditions. Methods: In all, we interviewed 120 key informants, whose age ranged between 50 and 95 years. Results: The research resulted to the identification of 78 medicinal plants belonging to 46 families. Among the species reported, 59 are used in human medicine, 18 for domestic use, 8 in veterinary medicine. Several plants have been reported in previous studies, but with different uses, or never reported. Conclusions: Data obtained showed that in the studied area the folk use of plants is alive and still derives from daily practice. [ABSTRACT FROM AUTHOR]

Background. Cancer patients are among the main consumers of traditional, complementary, integrative, and alternative medicine (TCIM) such as natural products (herbals, integrators, etc.) and mind and body practices (yoga, acupuncture, etc.). Methods. A questionnaire on TCIM was submitted to 415 Italian cancer patients. The questionnaire consisted of three sections: (i) biographical and clinical information; (ii) use of natural substances; and (iii) use of mind-body practices. Results. 406 patients completed the questionnaire. The prevalence of TCIM use was 72.3%. Of them, 75.6% started to use TCIM after a tumor diagnosis. The main reasons for using TCIM were to mitigate side effects (65.0%), to regain physical and mental balance (35.9%), to relieve pain (18.3%), and to improve the efficacy of cancer therapy (16.0%). 44.7% of patients taking natural products used them during conventional therapies (chemotherapy, radiotherapy, etc.), and in 67.5% of cases without consulting a doctor. As a consequence, only about 50% of patients taking natural substances used these compounds appropriately, and the most common errors were related with the purpose of reducing the side effects of the therapy (52.3%) and for boosting immune system (32.1%). Conclusions. There is an impelling need to provide patients with scientifically validated information to raise awareness about the benefits and risks of using TCIM. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance The area of the Nebrodi Regional Park (North-Eastern Sicily, Italy) has been quantitatively investigated in an ethnobotanical study for the first time. A total of 90 wild species are used for medicinal purposes and the uses of 5 species have not previously been reported in ethnobotanical studies in Italy (e.g., the use of Arisarum vulgare O. Targ. Tozz. for the treatment of rheumatic pains, the use of Silene vulgaris (Moench) Garcke for the treatment of liver diseases). The aim of this paper was to understand to what extent current knowledge on the medicinal use of plants is still an element of the culture within the rural populations of the Nebrodi Park. Materials and methods Semi-structured interviews were carried out in the local communities within the Nebrodi Regional Park with local people retained experts in rural traditions. A total of 226 people over the age of 60 were interviewed. Local plant uses were evaluated using ethnobotanical indices (e.g., cultural importance index, index of ethnobotanical diversity, informant consensus factor) and then compared with uses in other localities in Sicily, Italy and the Mediterranean area. Results Local communities use a total number of 90 wild species belonging to 44 plant families as medicinal remedies. The majority of the species are used as treatments against gastrointestinal system. The cultural importance index showed that Malva sylvestris (1.31) and Clinopodium nepeta (0.86) are the most important species to the Nebrodi area in terms of medicinal use. The use of Brassica rupestris Raf. for therapeutic purposes is limited to Sicily and it is an innovative finding of this study. Conclusions The research shows an ongoing process of cultural erosion in an advanced stage, but quantitative indices still highlight only for those species was a natural remedy deemed highly effective. [ABSTRACT FROM AUTHOR]

Ethnopharmacological relevance This paper illustrates the results of a study carried out in the Etna Regional Park (Eastern Sicily, Italy) concerning the traditional knowledge on medicinal use of wild plant species. It contains the results of a quantitative analysis carried out for the first time. A total of 71 wild species are used for medicinal purposes. Two species, Astracantha sicula (Biv.) Greuter and Trifolium phleoides Willd., are little known as medicinal in the Mediterranean area. The main aim of the study was to understand to what extent current knowledge on the medicinal use of plants is still an element of the culture within the elderly population of the Etna Regional Park. A further aim was to identify species not previously reported as medicinal in the Mediterranean area with a potential agricultural interest. Methodology The information was obtained using a semi-structured interview format performed on a sample of 196 people over the age of 60 who were considered experts in rural traditions. The plant uses were compared with other medical-ethnobotanical studies carried out in other areas of Sicily, Italy and various other Mediterranean countries. A number of quantitative indices were also used in order to verify the incidence of the species cited in the study within the culture and traditional medicine. Results Local communities currently use a total number of 71 wild species (34 families) as remedies for medicinal purposes. Most of the species were used as treatments against metabolic disorders and for general health. The leaves and the aerial parts of plants are the most-used parts of the plant and the most common preparation methods are decoction and direct application of plant parts. Astracantha sicula and Trifolium phleoides have never been documented as a species with medicinal properties in the Mediterranean literature. Conclusions Only very few medicinal uses are widely known by all the informants and, on many occasions, a specific medicinal use is cited by only very few people. The quantitative analysis shows that the level of traditional knowledge on medicinal use of plants in the study area is poor, highlighting a considerably advanced state of cultural erosion. [ABSTRACT FROM AUTHOR]

In this paper, the chemical composition and the antimicrobial activity of the essential oil of Angelica archangelica L. (Apiaceae) roots from central Italy were analyzed. The major constituents of the oil were α-pinene (21.3%), δ-3-carene (16.5%), limonene (16.4%) and α-phellandrene (8.7%). The oil shows a good antimicrobial activity against Clostridium difficile, Clostridium perfringens, Enterococcus faecalis, Eubacterium limosum, Peptostreptococcus anaerobius, and Candida albicans with minimum inhibitory concentration (MIC) values of 0.25, 0.25, 0.13, 0.25, 2.25, and 0.50% v/v, respectively. A weaker antimicrobial activity against bifidobacteria and lactobacilli-very useful in the intestinal microflora-has also been shown with MIC values >4.0% v/v. [ABSTRACT FROM AUTHOR]

Abstract: Ethnopharmacological relevance: The area of the “Monte Sicani Regional Park” (Central Western Sicily, southern Italy) has been quantitatively and extensively investigated in an ethnobotanical study for the first time. A total of 108 wild species are used for medicinal purposes, while, according to our study, the uses of 9 species have not previously been reported in ethnobotanical studies in Italy (e.g., the use of Kickxia elatine (L.) Dumort. for the treatment of hyperhydrosis of the feet, the use of Lavatera agrigentina Tineo for cough and bronchitis). Aim of the study: The aim of this paper is to analyze, through quantitative indicators, the extent of the current knowledge on medicinal uses of plants in the area, evaluating also the features of uniqueness and commonality of this knowledge in comparison with other Italian and Mediterranean areas. Methodology: Semi-structured interviews were carried out in the local communities between 2009 and 2010 within the Monti Sicani Regional Park with local people retained experts in rural traditions. A total of 230 people were interviewed about their knowledge on medicinal plant uses. Local plant uses were evaluated using ethnobotanical indices (e.g., cultural importance index, ethnobotanicity index, informant consensus factor) and then compared with uses in other localities in Sicily, Italy and the Mediterranean basin. Results: Local communities currently use a total number of 108 wild species (43 families) as remedies for human and livestock ailments. The majority of plants are used in the treatment of articular, skin and gastrointestinal problems. The use of some species is limited to Sicily (e.g., Rhus coriaria L., Athamanta sicula L., Senecio delphinifolius Vahl). Conclusions: The research shows an ongoing process of cultural erosion in an advanced stage, but results still highlight an interesting cultural identity as regards the local folk medicine. [Copyright &y& Elsevier]

Abstract: Ethnopharmacological relevance: This paper illustrates the results of an ethnobotanical study carried out in the Madonie Regional Park (Central Sicily, Italy). It specifies the medicinal uses of plants in the study area and contains the results of a quantitative analysis carried out for the first time in an area noted for its high degree of biodiversity. It also introduces 28 species not previously accounted for in the area of study for their medicinal uses, highlighting Silene flos-cuculi L. Greuter & Burdet, little known as medicinal in the Mediterranean area. Aim of the study: To understand to what extent current knowledge on medicinal-use plants is still an element of the culture within the elderly population of the Madonie Regional Park. Methodology: The information was obtained using a semi-structured interview format performed on 150 informants over the age of 60 who were considered experts in plants and rural traditions. The taxa were identified and the results were analysed also using a range of quantitative ethnobotanical indices. Results: A census was made of 174 wild plant species, 100 of which with medicinal and veterinary uses, belonging to 49 botanical families. Of the 170 endemic species found in the Madonie Regional Park, only 2 species were cited in this study for medicinal purposes. Most of the species were used against dermatological diseases, general health and metabolic disorders. The leaves were the most-used parts of the plant and the most common preparation methods were decoction and infusion. The level of knowledge on medicinal uses of the plants was not found to be high within the elderly population, demonstrating an ongoing process of cultural erosion. Conclusions: Only very few medicinal uses are widely known by all the informants and, on many occasions, a specific medicinal use was cited by only very few people. Further study is required in order to find out to what extent knowledge on the medicinal use of plants is still present in the younger generations in this area of Sicily, and what methods might be adopted in order to halt this gradual loss in knowledge. [Copyright &y& Elsevier]

Abstract: Epilepsy is a neurological disorder which has been recognized since antiquity. This paper evaluates the prophylactic and therapeutic remedies used by folk medicine to cure epilepsy in Italy. The data has been collected by reviewing written sources of physicians, ethnographers, folklorists between the late nineteenth and mid twentieth century. This approach leads to unearthing of 78 heterogeneous healing methods that have been divided into 16 (20%) magical, 20 (26%) religious and 42 (54%) natural remedies. The latter has been subdivided into 18 (43%) animal remedies, 17 (40%) plant remedies and 7 (17%) other remedies. Religious and magical remedies were used with the conviction that they would be able to provide recovery from epilepsy and to ward off evil spirits which had taken possession of the sick. Interestingly, the herbal remedies highlighted 12 (70%) plants that play or might play an important role with respect to the mechanisms that generate the epileptic seizures. This leads us to reconsider the historical significance of folk medicine, too often it is underestimated owing to its use of ineffective remedies, born of incompetence and superstition. [Copyright &y& Elsevier]

Abstract: Aim of study: This paper reports an ethobotanical survey of the traditional uses of medicinal and useful plants in an area of the National Park of Cilento and Vallo di Diano, Campania, Southern Italy. Materials and methods: This study conducted between 2009 and 2011, gathered information on the medicinal plants traditionally used in Southern Italy (Campania Region). In all, we interviewed 70 key informants, whose age ranged between 50 and 85 years. This people belonged to families which had strong links with traditional activities of the area. Results: The research resulted to the identification of 192 plants belonging to 64 families. Among the species reported, 86 are used in human medicine, 15 in veterinary medicine, 69 as human foods, 18 as animal feed, 61 for domestic and 8 for agricultural uses. Conclusion: A survey of the available literature on Southern Italy ethnobotany reveals that some species have been never reported and about 10% of cited uses are new. Data obtained show that in the studied area the folk use of plants is alive and still derives from daily practice. [Copyright &y& Elsevier]

Background. Previous surveys found CAM use during menopause to be popular. This paper compares the results from two surveys (Sydney and Bologna) to examine factors that determine the extent and pattern of CAM use to alleviate menopausal symptoms. Methods. Women, aged 45-65 years, who were symptomatic when transitioning through menopause or asymptomatic but taking menopause-specific treatments, were recruited in Sydney (n = 1,296) and Bologna (n = 1,106) to complete the same voluntary, anonymous, and self-administered questionnaire. The results were reanalysed using stratified analyses to determine similarities and differences. Results. Demographics of the two cohorts differed significantly. CAM was more popular in Sydney. The most significant determinants of CAM use were the use of CAM for other conditions besides menopause and the severity of vasomotor symptoms. Occupational status was a determinant of CAM use amongst Bologna respondents only. In order to relieve symptoms, Australian and Italian women used different CAM modalities whose effectiveness was generally perceived as good. Conclusion. CAM use is popular amongst menopausal women from Sydney and Bologna. Differences in the patterns of CAM use seem to depend on CAM availability and on the educational level and professional status of users. The complex interaction between market, social, and cultural factors of CAM use seems to be more influential on women's choice of CAM than the available evidence of their effectiveness. [ABSTRACT FROM AUTHOR]

Abstract: The aim of the European Society of Mastology (EUSOMA) Workshop, Florence, Italy, December 2004, was to produce guidelines on the use of complementary and alternative medicine (CAM) for breast cancer. The widespread use of CAM has to be acknowledged and the reasons for this understood. Deficiencies in the practice of conventional medicine that lead to the adoption of CAM need to be addressed. At the same time, CAM use for breast cancer should be quality controlled, avoiding double standards in evaluation, whilst recognising the problems of CAM research. These guidelines, which appear in an accompanying paper, aim to help oncologists and cancer patients alike. [Copyright &y& Elsevier]

Purpose: Complementary and Alternative Medicine (CAM) interventions are widely used by patients with chronic disorders, including cancer, and may interact with cancer treatment. Physicians are often unaware of this, probably due to poor patient-physician communication on CAM. The purpose of this study was to evaluate physicians' knowledge, attitudes and practice patterns regarding CAM in a survey conducted in Italy. Methods: A questionnaire was administered to 438 physicians (11 Italian hospitals) who predominantly treat patients with chronic disease, to collect personal and professional data and information on attitudes toward CAM and its possible role in Conventional Medicine (CM). Results: Of the 438 participants, most were specialists in oncology (18%), internal medicine (17%), surgery (15%), and radiotherapy (11%). Most worked at university (44%) or research hospitals (31%). Forty-two percent of participants believed that CAM could have an integrative role within CM. Oncologists were the physicians who were best informed on CAM (58%). Physicians working at research institutes or university hospitals had a greater knowledge of CAM than those employed at general hospitals (p < 0.0001), and those who were also involved in research activity had a greater knowledge of CAM than those who were not (p < 0.003). Length of work experience was significantly related to CAM knowledge. Moreover, 55% of participants suggest CAM interventions to their patients and 44% discuss CAM with them. The best-known interventions were acupuncture, Aloe vera and high-dose vitamin C. Conclusion: CAM use by patients with chronic disease and/or cancer has become a topical issue for the scientific community and for physicians. Knowing the reasons that prompt these patients to use CAM and guiding them in their decisions would improve treatment and outcomes and also benefit healthcare systems. Our findings contribute to a greater understanding of CAM knowledge, attitudes, and practice among Italian physicians. Further research is needed to identify the more effective CAM treatments and to work toward an integrated healthcare model. [ABSTRACT FROM AUTHOR]

A collaborative think tank involving panellists from immuno-oncology networks, clinical/translational investigators and the pharmaceutical industry was held in Siena, Italy, in October 2017 to discuss the evolving immune-oncology landscape, identify selected key challenges, and provide a perspective on the next steps required in the translation of current research and knowledge to clinical reality. While there is a trend of combining new agents (e.g., co-stimulator agonists) with a PD-1/PD-L1 treatment backbone, use of alternative combination therapy approaches should also be considered. While the rapid evolution in systems biology provides a deeper understanding of tumor and tumor microenvironment heterogeneity, there remains the need to identify and define genuinely predictive biomarkers to guide treatment and patient selection. Cross-specialty and cross-sector collaboration, along with a broader collective data-sharing approach are key to optimizing immuno-oncology therapy in clinical practice. Continued support of younger research-clinicians is essential for future success in clinical, translational and basic science investigations. [ABSTRACT FROM AUTHOR]

Background: To address the side effects of anticancer treatments, the Clinic for Complementary Medicine and Diet in Oncology was opened, in collaboration with the oncology department, at the Hospital of Lucca (Italy) in 2013. Aim: To present the results of complementary medicine treatment targeted toward reducing the adverse effects of anticancer therapy and cancer symptoms, and improving patient quality of life. Dietary advice was aimed at the reduction of foods that promote inflammation in favor of those with antioxidant and anti-inflammatory properties. Methods: This is a retrospective observational study on 357 patients consecutively visited from September 2013 to December 2017. The intensity of symptoms was evaluated according to a grading system from G0 (absent) to G1 (slight), G2 (moderate), and G3 (strong). The severity of radiodermatitis was evaluated with the Radiation Therapy Oncology Group (RTOG) scale. Almost all the patients (91.6%) were receiving or had just finished some form of conventional anticancer therapy. Results: The main types of cancer were breast (57.1%), colon (7.3%), lung (5.0%), ovary (3.9%), stomach (2.5%), prostate (2.2%), and uterus (2.5%). Comparison of clinical conditions before and after treatment showed a significant amelioration of nausea, insomnia, depression, anxiety, fatigue, mucositis, hot flashes, joint pain, dysgeusia, neuropathy, and all symptoms. Moreover, in a subgroup of 17 patients in radiotherapy undergoing integrative treatment, the level of toxicities and the severity of radiodermatitis were much lower than in the 13 patients without integrative treatment. Twenty-one cancer patients (6.2%) either refused (18) or discontinued (3) conventional anticancer treatment against the recommendation of their oncologist; after the integrative oncology (IO) visit, 7 (41.2%) out of 17 patients with follow-up decided to accept standard oncologic treatments. Conclusions: An IO clinic may contribute to reducing the adverse effects of anticancer therapy and improving the quality of life of cancer patients. [ABSTRACT FROM AUTHOR]

Objectives: The authors present a description of a theater workshop ('Metamorphosis Project'), developed at the Bologna Eating Disorders Center. Design: The workshops are aimed at young, hospitalized patients, and are largely based on the principles of drama therapy. In this article, this therapeutic modality is introduced by a discussion of the theoretical basis for the use of theater in psychiatry from the points of view of several preeminent psychiatrists, including Freud, Winnicott, Klein, and Moreno. Results: Three (3) clinical reports are presented. The satisfaction rate among the first groups of participants was 93%. Conclusions: It is suggested that theater can be useful in decreasing defense mechanisms, allowing a patient-focused approach, mitigating specific symptoms, and improving the quality of life during the hospital stay. [ABSTRACT FROM AUTHOR]

Purpose: To explore the use of CAM (Complementary/Alternative Medicine) in a population of cancer patients undergoing antineoplastic therapy, and to compare differences in sociodemographics, quality of life, and psychological features between CAM users and non-users. Methods: The study population was consecutive cancer patients undergoing antineoplastic treatment in three Piedmont cancer centers. Data were collected from anonymous questionnaires investigating CAM use or not, and what type if used, and sociodemographics, and through validated psychometric instruments to assess psychological features: Functional Assessment of Cancer Therapy-General, the Hospital Anxiety and Depression Scale, and the Mini Mental Adjustment to Cancer Scale. Results: Of the 288 evaluable patients, 52 (18.1%) reported using one or more types of CAM; the most often cited were herbs, special diets and body-based practices, such as plantar reflexology, chiropractic application, and massage. On quality of life assessment, CAM users scored lower than CAM non-users for physical wellbeing ( P = 0.006); no significant differences emerged for anxiety and depression and coping styles. Conclusions: CAM use is less prevalent in northern Italy than in most other European countries. CAM users were found to have a lower quality of life than CAM non-users. [ABSTRACT FROM AUTHOR]

Background: In the auricular maps introduced over the past 50 years by the French and Chinese schools, most organs and systems overlap consistently. One exception is the reproductive system, which shows a markedly different somatotopic representation--for example, for the uterus and the ovary. Objective: To identify the distribution of points with increased tenderness to pressure or with reduced electrical resistance, on the outer ear of a group of women undergoing hysteroscopy. Methods: For diagnostic purposes the auricles of 78 women were examined before and after hysteroscopy using a pain-pressure test and electrical skin resistance test. The points identified were transcribed onto a graphic system called Sectogram. Spatial cluster analysis was used to identify the statistically significant clusters of sectors with a higher concentration of points appearing after hysteroscopy. Results: The points identified after hysteroscopy tend to be concentrated in specific areas not previously recognised and which only partially overlap with the French and Chinese representation of the uterus. Conclusion: When auricular acupuncture is applied to reduce discomfort during hysteroscopy, particular attention must be paid when choosing the points/areas to be stimulated, which are not only those indicated in the Chinese or French maps. [ABSTRACT FROM AUTHOR]

Background: The present study describes Complementary and Alternative Medicine (CAM) use amongst Italian women transitioning through menopause. Popularity and perceived effectiveness of CAM treatments, use of pharmaceutical medications, characteristics of CAM users, the extent of communication between medical practitioners and women about their use of CAM, and variables associated with CAM use were also investigated. Methods: Women, aged 45-65 years attending Family Planning and Women's Health clinics or Menopause Centres in Bologna were invited to complete a voluntary, anonymous, self administered questionnaire, which was used in a previous study in Sydney. The questionnaire was translated and adapted for use amongst Italian women. Data on general demographic and health characteristics, menopause related symptoms and the use of CAM and pharmaceutical treatments during the previous 12 months were collected. Results: In total, 1,203 women completed the survey, of which 1,106 were included in the final sample. Of women who had symptoms linked with menopause and/or used remedies to alleviate symptoms, 33.5% reported to have used CAM. Among these, 23.5% had consulted one or more practitioners and 24% had used at least one CAM product. Approximately nine out of ten respondents reported medical practitioners did not seek information about their use of CAM; while one third of CAM users did not disclose the use of CAM to their physician. Nevertheless, medical practitioners were the most popular source of information. From the multivariate analysis, variables associated with CAM use were: professional employment, time since the last natural menses, use of CAM for conditions other than menopause, and presence of some severe symptoms. Conclusions: The relatively high prevalence of CAM use by women transitioning through menopause should encourage research initiatives into determining which CAM treatments are the safest and effective. The increasing and likely concomitant use of CAM with HRT and other pharmaceuticals underlines the need for the implementation of a surveillance system to report and monitor possible drug-herb adverse events. The discrepancy between women preferring to seek information about CAM from their medical doctor and the difficulties noted in communication between doctor and patient should encourage educational initiatives on CAM by health-care agencies and institutions. [ABSTRACT FROM AUTHOR]

Patients with cancer frequently use dietary supplementation and herbal therapies to control symptoms of disease and adverse effects of cancer therapy. Despite the widespread use of dietary supplementation and herbal therapies in oncology, robust scientific evidence in this area is lacking. Not only do these products need to be tested in large and well-designed observational or randomized studies, but their manufacturing process must be improved to achieve higher levels of standardization in product quality. Ginger is frequently used to counteract chemotherapy-induced nausea and vomiting (CINV), and some suggestions that it might be effective against CINV come from randomized and/or crossover clinical trials. However, several limitations in the methods of these studies limit their power and generalizability. The authors are conducting a randomized, double-blind study with a large sample size and homogeneous inclusion criteria in order to evaluate the efficacy of a wellstandardized ginger extract in reducing nausea in patients with cancer. The widespread use of standardized herbal therapies and natural components among patients requires that scientific and rigorous research strategies are applied in this field to guide the physicians and the patients in safer use. [ABSTRACT FROM AUTHOR]

Background: The growing popularity of CAM among the public is coupled with an ongoing debate on its effectiveness, safety, and its implications on the reimbursement system. This issue is critically important for GPs, who have a "gatekeeping" role with respect to health care expenditure. GPs must be aware of medications' uses, limitations and possible adverse effects. Our objective was to explore GPs' knowledge of CAM and patterns of recommendation and practice, as well as the relationship between such patterns and GPs' life-styles. Methods: A cross-sectional study was conducted in Tuscany, a region of central Italy. One hundred percent female GPs (498) and a 60% random sample of male GPs (1310) practising in the region were contacted through a self-administered postal questionnaire followed by a postal reminder and telephone interview. Results: Overall response rate was 82.1%. Most respondents (58%) recommended CAM but a far smaller fraction (13%) practised it; yet 36% of CAM practitioners had no certificated training. Being female, younger age, practising in larger communities, having had some training in CAM as well as following a vegetarian or macrobiotic diet and doing physical activity were independent predictors of CAM recommendation and practice. However, 42% of GPs did not recommend CAM to patients mostly because of the insufficient evidence of its effectiveness. Conclusion: CAM knowledge among GPs is not as widespread as the public demand seems to require, and the scarce evidence of CAM effectiveness hinders its professional use among a considerable number of GPs. Sound research on CAM effectiveness is needed to guide physicians' behaviour, to safeguard patients' safety, and to assist policy-makers in planning regulations for CAM usage. [ABSTRACT FROM AUTHOR]

Expanding on the introduction to the multinational study described in the first article, this article briefly reviews informants’ contexts of treatment across Italy, Norway, Sweden, and the United States, and provides a cursory description of each informant, organized according to her or his respective country. The informant descriptions are followed by illustrative third-person narratives drawn from interviews with two informants from Sweden. As a counterpoint to themes derived across informant narratives, such as the roles of home, significant others, and coping strategies, this article attempts to illustrate how such themes are interwoven within the context of individuals’ lives and personal journeys toward recovery. [ABSTRACT FROM AUTHOR]

Objective. To investigate the prevalence of use of unconventional therapies in Italy, the main health problems associated with and the motivations for use of these therapies. Methods. Questions about the use of unconventional therapies were inserted in a nation-wide survey conducted by face-to-face interviews with all members of sampled families by the National Institute of Statistics during four quarters of the years 1999–2000. Data presented here are based on the results of the first two quarters of the survey (September and December 1999) during which a representative sample of 30,000 Italian families (70,898 individuals) was interviewed. Results. Almost 9 million people (15.6% of the Italian population) used at least one unconventional therapy during the period 1997–1999. Homeopathy was the most frequently used (8.2% of the population), followed by manual treatments (7%), herbal medicine (4.8%) and acupuncture (2.9%). Homeopathy was also quite commonly used by children (7.7% of Italian children). The main reason for use was concern about potential toxicity of "conventional medicine". The health problem most frequently treated with all kinds of unconventional therapies was pain. Conclusions. Use of unconventional therapies has almost doubled since 1991. However, with 15.6% of the Italian population (9 million people) using at least one therapy, Italy ranks among the "light" users compared with other European countries. Homeopathy is the most frequently used therapy. The typical user is, as in other western countries, a highly educated woman aged 35–44 years and resident in the richest part of the country (north-eastern Italy). [ABSTRACT FROM AUTHOR]

Aim: To describe the epidemiological aspects of nocturnal enuresis (NE). In this study we identify the prevalence and the familial conditions in a large, representative sample of children with monosymptomatic NE (MNE) and nonmonosyptomatic NE (NMNE). Material and methods: In this descriptive-analytic study the Italian Society of Pediatrics (SIP) promoted a prevalence study of NE using a questionnaire involved 320 primary care Pediatricians from Northern, Central and Southern Italy, from January 2019 to July 2019, with a total of 130,000 children analyzed by questionnaire related to epidemiology and type of NE, familiarity, quality of sleep, eating and drinking habits, pharmacological and psychological/behavioural interventions and family involvement. Results: 270/320 (84.4%) Paediatrician replied to our questionnaire. We enrolled a total of 9307/130,000 (7.2%) children with NE, aged between 5 and 14 years: 2141 diagnosed with MNE and 7176 qualified as NMNE. Poor quality of sleep were reported in 7064 patients; 90% of children did not consider a dietary and drinking recommendation. Pediatrician reported a total of 54.1% of parents who declared to have a negative reaction to their children because of the bedwetting. A percentage of 71.4% of parents declared to use or to have used alternative therapies and not to prefer, at first, a pharmacological intervention. Conclusion: The choice of treatment should include psychological/behavioural interventions in all cases to improve the therapeutic outcome. All primary care Pediatricians should be aware of the all aspects of NE to choose the best way to treat every patient. [ABSTRACT FROM AUTHOR]

Nowadays, more and more consumers show a growing interest in healthy food products that may help to maintain or improve human health, such as honey. Honey has always represented a fundamental component of traditional medicine in many world cultures. However, only thanks to several studies carried out in the last years, its use is considered as an alternative and complementary medicine, namely apitherapy. In this way, honey is recognized increasingly by consumers not only as a natural alternative to refined sugar but as healthy food, as shown by determining an increase of its consumption worldwide. This study aims to explore the consumers' determinants of honey consumption, trying to understand whether, and how much, therapeutic properties of honey affect the Italian consumers' choices. The findings of this study, although exploratory, provide information on which quality characteristics influence honey consumption in Italy, revealing that, among quality attributes, the therapeutic properties of honey play an important role in affecting consumers' behavior, followed by income, variety and taste. This could have some implications for producers and marketers as this information could contribute to defining effective marketing strategies for communicating to consumers the quality attributes of honey and its therapeutic benefits. [ABSTRACT FROM AUTHOR]

Background: A growing use of complementary alternative medicine (CAM) has been found in Europe as well in Italy for chronic diseases, including the allergic rhinitis. The study aims at investigating the prevalence and the pattern of use of CAM amongst patient with allergic rhinitis. Methods: A 12-item questionnaire was developed by a panel of experts and administered to patients with moderate/severe allergic rhinitis consecutively referring during the study time-frame to seven allergy clinics placed all around Italy. The items covered several topics including reason for choosing CAM, its clinical efficacy, schedule of treatment, costs, type of therapy. Results: Overall 359 questionnaires were analysed. 20% of patients declared CAM use. A significant correlation between the use of CAM and female sex (p < 0.01) and with a higher level of education (p < 0.01) was observed. CAM users were adults (36% in the range between 20 and 40 years and 32% between 41 and 60 years). Youngsters (< 20 years) (7%) and elderly (> 60) (25%) less frequently used CAM.The most used type of CAM was homoeopathy (77% of patients). 60% of users would recommend CAM despite a poor clinical efficacy according to 67% of them. Conclusions: Although no evidence supports CAM efficacy and safety, the number of patients who relies on it is not negligible. As allergic rhinitis is not a trivial disease, the use of CAM as the only treatment for it should be discouraged at any level, but by general practitioner and specialist in particular. [ABSTRACT FROM AUTHOR]