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Objectives New Zealand has experienced an increase in the use of traditional and complementary medicine treatment modalities, such as that of naturopathy. Limited research exists that has examined older aged New Zealanders utilisation of naturopathic treatment modalities. Therefore, the primary aim of this study was to provide a demographic profile of older adults who attended a student naturopathic clinic over a 2-year period. A secondary aim was to identity the symptoms or conditions for which treatment was sought. Methods De-identified data were collected for 76 older-aged (>65 years) clients, 28 male and 48 female clients aged between 65 and 88 years of age (71 ± 5.8). Results The majority of older aged clients who attended the clinic, were female, in the young-old age group (65–74 years of age) and identified as being New Zealand European. Treatment was predominately sought for chronic health conditions, such as constipation, chronic pain, and arthritis. Conclusions The older aged clients in our study were predominately seeking naturopathic treatment for the management of their chronic health conditions.

Background: The use of technologies continues to grow in healthcare provision, and learning technologies now dominate tertiary education. Meanwhile, complementary medicine (CM) constitutes a substantial component of contemporary healthcare, yet the education of existing and future CM practitioners has received little empirical attention. In direct response, our study examines the perceptions of CM students and faculty related specifically to health and learning technologies in clinical CM work and education. Methods: A cross-sectional online survey was administered to all current students (n = 4851) and tenured, contracted and adjunct academics (n =530) at two CM education institutions – in the US and in Australia. Results: Most student respondents (n = 134, 49%) reported that they either felt they were unsure if they would use telehealth in clinical practice or that they would use it (n = 116, 43%). The majority of all academic respondents did not believe it possible to conduct basic clinical processes online such as reading a patient's body language (M3.8, SD 1.0), conducting quality clinical training in CM settings (M3.2, SD 1.3) or learning rapport skills (M3.2, SD 1.2). Of those academics who were also in clinical practice, only a small number reported conducting virtual consultations in their CM work (n = 7,15.9%). Conclusion: Our findings highlight a potential disparity of perceptions between academics and students in these CM educational settings especially in relation to telehealth. Academics expressed hesitancy to fully rely on technologies to develop practitioners in a field where ‘formation of professional character’ is considered so important.

Now-a-days, different bioproducts are being used extensively for the welfare of mankind. However, for proper utility of any bioproduct, the exact biotechnological potential of that product should be explored. Honey is produced in almost every country on the planet. It has long been used as a medicinal agent in addition to its broader use as a popular food throughout the human history. It can be used to treat various diseases without causing any negative side effects. In the present study, the antibacterial potential of honey produced by A. dorsata was investigated at its variable concentrations (25, 50, 75 and 100 %) against four pathogenic bacterial species. The highest antimicrobial action was seen against E. coli at 100 % concentration of the honey while showing zone of inhibition of 37.5 ± 3.5 mm. However, the lowest antibacterial action was observed against E. faecalis. The overall order of growth inhibition by the honey at its 100 % concentration for the implicated bacterial species appeared as: E. coli ˃ P. aeruginosa ˃ S. aureus ˃ E. faecalis. The honey couldn’t show antibacterial action at its 25 % concentration. Our findings of the present study will be helpful for utility of the honey as an alternative medicine for curing different complications caused by microbial pathogens.

Summary Introduction Integrative health is the combined use of conventional medicine, complementary medicine and lifestyle medicine. It is the result of the coordination of patient-centred, science and evidence-based health practices, delivered by a multidisciplinary team. Its objective is to enable the return or the maintenance of health in an optimal well-being. Its originality lies in the inclusion of the patients and their own representations of care in the overall management of their health. Outlook As a result of a strong demand from patients but also from caregivers, this North American concept is gradually being established in France. Since December 2019, the Strasbourg Saint Vincent de Paul Hospital Group has opened an Outpatients unit for Integrative care. Initially created in Aix-en-Provence in 2010, there are now 7 Resource centres which offer Well Being care and a Personalised Therapeutic Accompaniment Program. In Dunkirk, the Flanders House of Supportive Care (Maison des Soins de Support des Flandres) has been in operation since 2017. In Paris, since 2018, the Rafael Institute offers 9000 integrated treatments per year. All these treatments are free of charge for the patient. Conclusion In treating the whole person, understanding the needs and values of each patient, by looking after the quality of life as much as seeking to cure, integrative health care makes it possible for caregivers to link the treatment goals with good and new practices for and with the patient.

Objective Coronavirus disease 2019 (COVID-19) caused a universal psychosocial impact and individuals exposed to threats prefer to try self-care interventions and adhere to non-conventional approaches such as traditional and complementary medicine (T&CM) for preventive purposes. This study was conducted to determine the use and belief about T&CM among the general population during the COVID-19 outbreak. Method A cross-sectional online survey was carried out among the general population (aged ≥ 18 years) of Adana, Turkey during the strict lockdown period (April 11 to April 30, 2020). The survey instrument included details about sociodemographic characteristics, general information, T&CM use and beliefs was distributed among eligible participants via social media channels (Instagram, WhatsApp and Facebook accounts). Results Out of the total 389 participants, almost 39.3% (n=153) of the participants were the T&CM user and 60.7% were non-T&CM user during COVID-19 in this study. Additionally, 61 (39.8%) participants reported the usage of more than one form of T&CM modalities. Most of them used herbal medicine (30.8%), followed by nutritional supplements/vitamins (23.8%). Around 33.9% (n=52 out of 153 T&CM user) of participants did not report T&CM use to their family physicians. A statistically significant difference was observed between T&CM users and non-T&CM users in gender, age, marital status, level of education, income, and prior use of T&CM (p

Summary Introduction Since the 1 st January 2021, homeopathy is no longer paid for by the French National Insurance system. Without drug interference and significant side effects, popular with two-thirds of French people, homeopathy is by far the most used complementary medicine, whatever the disease. What is its real merit and what are the risks for patients with chronic conditions of having to pay for the actual cost of their medicine without any help from the French National insurance system? Method Review of the literature concerning the use of homeopathy in cancer care support. Results Homeopathy is the most widely used complementary medicine in oncology (30.7% of patients) with a very high percentage of satisfaction. The improvement in the quality of life has been shown in several studies. Better compliance with conventional cancer treatments has also made it possible to demonstrate an improvement in survival rates. Prescribed in 75% of cases by doctors, the use of homeopathy does not lead to refusal of treatment and is more and more often accepted or even recommended by oncologists. The latter are informed of these treatments in 83% of cases. Discussion The average prescription, respecting the recommendations of the International Homeopathic Society for Supportive Care in Oncology, is around € 50 per month. This can represent a medico-social handicap in long-term illnesses. Stopping or reducing homeopathy for economic reasons not only endangers the quality of life of these patients but also puts at risk their observance of conventional treatments with its consequent loss of opportunity. Conclusion We believe it is essential and urgent for the French national insurance system to return to paying for homeopathy in the framework of supportive care for long-term illnesses.

espanolIntroduccion La publicacion cientifica es considerada el ultimo paso de la investigacion, siendo necesario involucrar cada vez mas al estudiante de medicina en este proceso. El objetivo del estudio fue determinar la accesibilidad de publicacion estudiantil en revistas medicas de Latinoamerica. Metodos Se realizo un estudio de cohorte retrospectivo. Se incluyeron todas las revistas medicas indizadas en Scimago Journal & Country Rank®. Se revisaron las instrucciones para los autores, se remitio un correo al contacto de correspondencia de la revista y se buscaron articulos en la base de datos de cada revista. Las categorias fueron: acepta publicacion estudiantil, acepta publicacion estudiantil con condicion, no acepta, no precisa. Los datos se analizaron en el programa estadistico Stata/MP® version 17, StataCorp LLC, Texas, EE. UU., para el analisis descriptivo se obtuvo porcentajes y medidas de frecuencia. Resultados Se incluyeron 188 revistas, de ellas el 52,65% permite la publicacion de articulos cientificos con estudiantes de medicina como autores con o sin condiciones. Los paises de Brasil, Mexico y Colombia son las que mas aceptan la publicacion de estudiantes libremente. Asimismo, las revistas de Q1 y de area tematica como Medicina complementaria, Anestesiologia y Medicina ocupacional, aceptaban en su mayoria la autoria estudiantil. Conclusion Mas de la mitad de las revistas analizadas permite la publicacion estudiantil, asimismo esta probabilidad se incrementa con el mejor posicionamiento de la revista, siendo un indicador alentador de la inclusion del estudiante de medicina como autor. EnglishIntroduction Scientific publication is considered the last step of research, being necessary to involve more and more the medical student in this process. The aim of this study was to determine the accessibility of student publication in Latin American medical journals. Methods A retrospective cohort study was conducted. All medical journals indexed in Scimago Journal & Country Rank™ were included. The instructions for the authors were reviewed, an email was sent to the journal's correspondence contact, and articles were searched in the database of each journal. The categories were: accepts student publication, accepts student publication with condition, does not accept, does not specify. The data were analyzed in the statistical program Stata/MP™ version 17, StataCorp LLC, Texas, USA, for descriptive analysis, percentages and frequency measures were obtained. Results 188 journals were included, of which 52.65% allow the publication of scientific articles with medical students as authors with or without conditions. The countries of Brazil, Mexico and Colombia are the ones that most accept the publication of students freely. Likewise, Q1 journals and journals of thematic areas such as Complementary medicine, Anesthesiology and Occupational medicine mostly accepted student authorship. Conclusion More than half of the journals analyzed allow student publication, and this probability increases with the better positioning of the journal, being an encouraging indicator of the inclusion of the medical student as an author.

Objective: Investigate the response of the Therapeutic Goods Administration's (TGA) new advertising complaint system to resubmitted complaints about complementary medicine weight loss products previously upheld by the Complaint Resolution Panel. Methods: Between July 2018 and July 2019, complaints about a convenience sample of 22 complementary medicines by eight sponsors, advertised on 140 different internet sites (cases), were resubmitted to the TGA. FatBlaster products featured. Follow‐up occurred in February 2021. Results: A search of the TGA advertising complaints database found ‘no result’ for 84% of the 140 cases submitted. Despite the TGA delisting three products and sponsors delisting ten others, all products complained about were still being advertised. Some products had minor changes in imagery but not claims. The sponsor (Cat Media, Naturopathica) had listed three new FatBlaster weight loss products. Conclusions: The TGA failed to protect consumers from ineffective weight loss medicines. Implications for public health: Weight loss medicines with misleading and deceptive claims are likely to divert users from evidence‐based weight loss activities. The TGA should ask for the evidence supporting promotional claims for these products and, if this is lacking, delist the entire class of products. For recalcitrant sponsors who repeatedly make egregious claims, civil and criminal penalties should be applied.

Background Online recruitment can be targeted efficiently to recruit specific samples for survey research. It has been shown to be a cost-effective method of recruitment, and useful for geographically dispersed populations. Objectives To describe the use of Facebook to recruit a targeted sample of expectant and breastfeeding mothers to a national online survey. Different techniques to assess response rates using data provided by Facebook are also described. Methods Participants accessed an anonymous online survey through a link included in posts from a Facebook page specifically set up for the research. Recruitment strategies were primarily of two types. Firstly, Facebook was paid to promote posts by displaying them on potential participants’ Facebook feeds. Secondly, by purposive and snowball recruitment through the sharing of posts on relevant Facebook pages. Post success was measured by the reach, impressions, link clicks, post clicks, and click through rates; and for boosted posts, the cost per day, and cost per engagement with the post as well. Traditional methods of calculating response rates, and response rates using post clicks and survey link clicks were calculated. Results After 10 weeks of recruitment, 1418 participants had enrolled in the study, and of these 810 (57.1%) completed the 20-minute (70 question) survey. Women participated from across Australia. Both paid and purposive approaches to promotion contributed to recruitment success. Paid promotions at higher costs for fewer days were the most successful. Total paid promotion costs were (Australian) $1147.97 (or $1.44 per completed survey). Purposive promotion was slower, but also contributed significantly to the number of people who saw the posts and clicked through to the survey. Traditional response rate calculations showed a response rate of 0.8%. Using post clicks and survey link clicks in calculations, resulted in response rates of 23.1% and 42.7%, respectively. Conclusions A combination of paid promotions and purposive and snowball recruitment on Facebook were used to successfully recruit 1418 participants resulting in 810 completed surveys over a 10-week period, at a low cost per participant. Use of additional methods to measure response rates may be useful in measuring the success of using Facebook posts in recruitment.

Seagrasses, one of the most threatened yet overlooked ecosystems on Earth, are the only flowering plants to recolonising the seabed. Apart from their critical ecological prominence on the life of many marine organisms, seagrasses are also used as an alternative or complementary medicine to manage an array of pathological disorders such as muscle aches, wounds, abdominal pain, indigestion, hangover, and mental disorders. However, a compilation of existing work on their ethnopharmacological uses, nutritional values, pharmacological propensities and bioactive compounds is lacking. Thus, this review aims at elaborating on the biochemical composition, phytochemical analysis, and biological properties including antioxidant, antimicrobial activities of various species of seagrasses. Seagrasses harbour several metabolites with multiple bioactivities. The phytochemical compounds isolated from Zostera marina L., Thalassia testudinum K. D. Koenig. and Thalassodendron ciliatum (Forssk.) exhibit a plethora of biological activities, including cytotoxicity against cancer cell lines, anti-human immunodeficiency virus (HIV), antimicrobial, and skin regenerating properties. This review also identifies vital lacuna in seagrass research. For instance, the mechanism and site of action of compounds displaying potent biological activities has not been adequately addressed together with optimisation of extraction methods to isolate minor metabolites and applying technological advancements in biological assays. In conclusion, this review provides a synthesis of current knowledge and highlights future work that needs to be undertaken for the biomedical application of such natural resources.

Vitamin B6, a cofactor in many biochemical reactions in the cells of living organisms, is an essential coenzyme for various catabolic and anabolic processes. Although vitamin B6 deficiency in young healthy women with a balanced diet is thought to be unusual, it can be seen with certain medications, health conditions, and dietary deficits, as well as aging. Vitamin B6 deficiency is associated with a variety of ill health effects, and correction of deficiency is considered beneficial. Women particularly are affected by unique health issues that are part of the array of disorders potentially alleviated through vitamin B6 supplementation.

Highlights • First study that directly compared Tai Ji Quan trials published in English and Chinese with meta-regression analysis in the largest sample to date • In trials published in English, Tai Ji Quan reduces systolic blood pressure by 10 mm Hg and diastolic blood pressure 4 mm Hg among adults with hypertension • In trials published in Chinese, Tai Ji Quan reduces systolic pressure by 19 mm Hg and diastolic pressure by 9 mm Hg among adults with hypertension • More confidence should be placed in Tai Ji Quan trials published in English due to their higher methodological quality compared to trials published in Chinese, Background Professional health organizations are not currently recommending Tai Ji Quan alongside aerobic exercise to treat hypertension. We aimed to examine the efficacy of Tai Ji Quan as antihypertensive lifestyle therapy. Methods Tai Ji Quan interventions published in English and Chinese were included when they involved healthy adults, reported pre- and post-intervention blood pressure (BP), and had a non-exercise/non-diet control group. We systematically searched 11 electronic databases for studies published through July 31, 2018, yielding 31 qualifying controlled trials. We (1) evaluated the risk of bias and methodological study quality, (2) performed meta-regression analyses following random-effects assumptions, and (3) generated additive models representing the largest possible clinically relevant BP reductions. Results Participants (n = 3223) were middle-aged (56.6 ± 15.1 years of age, mean ± SD) adults with prehypertension (systolic BP (SBP) = 136.9 ± 15.2 mmHg, diastolic BP (DBP) = 83.4 ± 8.7 mmHg). Tai Ji Quan was practiced 4.0 ± 1.4 sessions/week for 54.0 ± 10.6 min/session for 22.3 ± 20.2 weeks. Overall, Tai Ji Quan elicited significant reductions in SBP (–11.3 mmHg, 95%CI: –14.6 to –8.0; d+ = –0.75) and DBP (–4.8 mmHg, 95%CI: –6.4 to –3.1; d+ = –0.53) vs. control (p < 0.001). Controlling for publication bias among samples with hypertension, Tai Ji Quan trials published in English elicited SBP reductions of 10.4 mmHg and DBP reductions of 4.0 mmHg, which was half the magnitude of trials published in Chinese (SBP reductions of 18.6 mmHg and DBP reductions of 8.8 mmHg). Conclusion Our results indicate that Tai Ji Quan is a viable antihypertensive lifestyle therapy that produces clinically meaningful BP reductions (i.e., 10.4 mmHg and 4.0 mmHg of SBP and DBP reductions, respectively) among individuals with hypertension. Such magnitude of BP reductions can lower the incidence of cardiovascular disease by up to 40%., Graphical Abstract Image, graphical abstract

Objective To assess how the introduction of the Generalized Anxiety Disorder-7 (GAD-7) was utilised in consultations by students in complementary medicine undergraduate teaching clinic throughout Australia. This study also aims to evaluate the reported severity of anxiety in patients attending the clinic, the practitioner type consulted, and the treatment prescribed by the Complementary Medicine (CM) students for patients with anxiety during 2017-18. Design This is a longitudinal, observational study using data from the Endeavour Wellnation clinics across Australia. Methods Patients anxiety levels were measured with the GAD-7 at consultations with student practitioners during 2017–2018. Patients that completed the GAD-7 more than once had their subsequent GAD-7 scores compared to assess changes in outcome score. Information was taken from SurveyGizmo for patients who visited the student clinic making it a sub-group analysis. Results Three hundred and ninety (n = 390) GAD-7 surveys were completed from the 50, 896 consultations that occurred in 2017 and 2018 (0.7 % of consultations). Most patients (29.7 %, n = 116) reported moderate anxiety on several days. Thirty-nine patients (n = 39) completed the GAD-7 more than once. Nutrition patients were the most frequent to complete the GAD-7 more than once. Conclusions The introduction of the GAD-7 at Australian complementary medicine teaching clinics reported usage frequency of 0.7 % of consultations in the first two years. The reason for this usage frequency may be due to low encouragement of the use of Patient Reported Outcome Measurements (PROMs) by clinic supervisors and in pre-clinic subjects, students having low confidence in the use of the GAD-7 or other PROMs or lack of understanding of their benefits by either the student practitioner or the client. The lack of subsequent GAD-7 use in follow-up consultations may be contributing to a decreased substantiation of treatment outcomes for both the patient and the students. Consideration of more frequent use of the GAD-7 in regular clinical practice to enhance clinical outcomes and practitioner education is warranted.

More and more cancer patients around the world are using complementary and alternative medicine. They are mostly used as a complement to conventional care in decreasing the side effects of treatment and improving their quality of life. However, patients often use them without reporting it to their oncologists; the main reasons being the short duration of consultation and the fact that their oncologists do not support them due to a lack of scientific evidence. There are hundreds of them, some of which are now being used in French healthcare institutions as supportive care. The randomized controlled trial is the gold standard of evidence-based medicine, which is why we have carried out an overview of randomized controlled trials carried out around the world on alternative and complementary medicine.

Objective To systematically review evidence on the characteristics, experiences and impact of an open dialogue about complementary and alternative medicine (CAM) integrated in oncology care. Methods We searched MEDLINE, EMBASE, AMED, Scopus, ProQuest Dissertations and Thesis, Cochrane Central Register, clinicaltrials.gov, forskningsdatabase.dk and PROSPERO. Two reviewers screened title, abstract and full-text articles. Each study was appraised using the Critical Appraisal Skills Programme (CASP) and synthesized narratively. PROSPERO registration CRD42019112242. Results We retrieved 4736 articles and included 5; 3 received 9 ½, 1 received 9, and 1 received 5 points on the CASP score. Predominately, the open dialogue was one or two individual, patient-centered, face-to-face consultations led by oncology physicians. In one study, it was a tele-phone consultation and in another it was structured counseling led by pharmacists. Integrated information and recommendations about CAM contributed to high level of satisfaction and improvement in concerns, quality of life and well-being. Conclusion Integration of open dialogue about CAM in oncology care including acknowledging patients’ preferences, values, wishes and knowledge, and providing information about CAM expands the opportunities for improving patients’ health, quality of life and well-being. Practice Implications Open dialogue about CAM has potentials, but research on how it specifically helps patients, is needed.

Acupuncture, originally described as part of Chinese medical practice thousands of years ago, has become increasingly popular as a form of complementary medicine. This article highlights the current evidence for and against the use of acupuncture in the treatment of various rehabilitation diagnoses. This article also describes the historical aspects and basic principles of acupuncture.

Background: Hirudotherapy, also known as medicinal leech therapy, has been used to treat a wide range of disorders for thousands of years since Ancient Egypt. Leech therapy is also mentioned as a minimal invasive technique called Jalaukavacharana in the Sushruta Samhita, an ancient Sanskrit text of Ayurvedic medicine. Although hirudotherapy has become a popular component of complementary medicine in the last decade, scientometric studies investigating the articles published in this field, do not exist. Objective: In this study, we aimed to perform a detailed scientometric analysis of hirudotherapy literature. Materials and methods: We collected data by using four databases provided by Web of Science using the keywords hirudotherapy, leech therapy, medicinal leech and medicinal leech therapy. Results: A total of 834 articles were found of which 89.8% were original articles. USA was the leading country with 280 publications, followed by UK, Germany and France (128, 101 and 41 items, respectively). The most productive countries regarding hirudotherapy were the UK (1.93), Slovenia (1.44), and Israel (1.32). The peak publication year for hirudotherapy literature was 2011 with 41 papers. Conclusion: To the best of our knowledge, our study was the first bibliometric and scientometric analysis in this field and we believe that multicenter studies and further searches from developing and least developed countries are needed in hirudotherapy literature. (C) 2019 The Authors. Published by Elsevier B.V. on behalf of Institute of Transdisciplinary Health Sciences and Technology and World Ayurveda Foundation. WOS:000604619000025 2-s2.0-85068444333 PubMed: 31289001

Although the meaning of Integrative Medicine differs by individual patients, their demand for a more inclusive and integrative approach to care that utilizes both conventional and complementary medicine modalities has been increasing. Integrative medicine is an attempt to fulfill this growing demand for more holistic approaches to healthcare. The perspective and exemplar of a dually credentialed—board certified family medicine physician/acupuncturist led to two possible scenarios to fulfill this need: 1) encourage clinicians to receive training in both conventional and complementary medicine to create more multi-credentialed clinicians (MCPs) and/or 2) foster inter-professional collaboration among providers. One advantage of establishing a system that encourages more MCPs is that it allows patients to receive conventional and complementary medical care from one individual, but the time and expense of producing these MCPs poses a significant challenge in creating a pipeline of these individuals. If collaboration among clinicians was facilitated to provide patients with an integrative approach to their health care, this would allow the clinician to specialize in their area of focus; however, differing opinions and perspectives about how to care for the patient may pose significant communication challenges in the delivery of effective integrative care. Both of these approaches have the potential to create more access to integrative medicine for patients. Generous funding sources that create platforms for integrative medicine healthcare, such as The Bernard Osher Foundation’s support for Integrative Medicine, allow university–based community healthcare systems to generate research data that support evidence-based systemic change.

Objectives This systematic review aimed to evaluate the efficacy and safety of Tao-Hong Siwu Tang (TST) for the treatment of primary dysmenorrhea. Methods We searched four English databases (MEDLINE, EMBASE, Allied and Complementary Medicine Database, and Cochrane Central Register of Controlled Trials [CENTRAL, Cochrane Library]), three Chinese databases (China National Knowledge Infrastructure, Wanfang, and Chinese Science and Technology Periodical Database), two Korean databases (Oriental Medicine Advanced Searching Integrated System and Korean traditional Knowledge Portal), and one Japanese database (Citation Information by NII). All randomized controlled trials (RCTs) using TST or modified TST (MTST) were included. Three independent reviewers extracted the data, assessed the risk of bias according to the Cochrane criteria, and performed a meta-analysis. Results A total of 85 possibly relevant articles were identified, and five trials met our inclusion criteria. The meta-analysis showed a favorable effect of MTST compared to non-steroidal anti-inflammatory drugs (NSAIDs) (n = 486, risk ratio [RR] = 1.53, 95% confidence interval [95% CI] = 1.37–1.72, I2 = 39%). Among the included trials, one RCT showed superior effects of MTST on primary dysmenorrhea recurrence rate compared to NSAIDs (n = 246, RR = 0.31, 95% CI = 0.15–0.63, P = 0.001). Another RCT revealed a beneficial impact of oral contraceptives (OCs) used in combination with TST compared to OCs alone (n = 60, RR = 1.35, 95% CI = 1.02–1.79, P = 0.04). Conclusion This systematic review and meta-analysis provides moderate quality evidence for the superiority of MTST over NSAIDs as well as that of TST plus OCs over OCs in the treatment of primary dysmenorrhea.

In this study, a crude and purified polysaccharide from Cyclocarya paliurus (CPP, CPP0.05) were performed with chlorosulfonic acid-pyridine (CSA-Pyr) method to obtain sulfated derivatives (S-CPP, S-CPP0.05). After comparatively investigating, characterization results showed that the modifications were successful. Polysaccharides were used to culture mouse bone marrow-derived dendritic cells (BM-DCs) to evaluate their immunomodulatory activity and explore mechanism. The functional activity of CPP was significantly stronger than that of the purified polysaccharide CPP0.05. Meanwhile, S-CPP showed stronger immunomodulatory activity than CPP through determination of cytokine expression levels. We found that p-JNK, p-p38MAPK and NF-κB p65 proteins were significantly increased by stimulus of CPP and S-CPP, blocking TLR2/4 could significantly decreased proteins above which proved that immune regulation effect of CPP and S-CPP on DCs was performed via MAPK and NF-κB signaling pathways by triggering TLR2/4. S-CPP could serve as potential immunomodulatory agents used as complementary medicine or functional foods.

Background Diabetic retinopathy is a slow progressing complication of diabetes mellitus with multifactorial aetiology affecting approximately 80% of diabetics worldwide. Chronic hyperglycemic milieu of Diabetes induces biochemical changes which contribute to the pathogenesis of Diabetic retinopathy. Objective The present study examined the protective effect of Vasant Kusumakar Ras, an Ayurvedic herbo-mineral formulation, in diabetic retinopathy. Materials and Methods Diabetes was induced in rats by intraperitoneal injection of streptozotocin (45 mg/kg). Rats were kept without any treatment for period of three weeks for induction of Diabetic retinopathy followed by treatment with Vasant Kusumakar Ras (11.25 mg/kg, p.o) for further 5 weeks. Fasting blood glucose levels, lipid profile and HbA1c were determined. Eye tissue homogenates were subjected to biochemical analysis to determine the levels of oxidative stress parameters (superoxide dismutase, catalase, reduced glutathione, lipid peroxidation), vascular endothelial growth factor and aldose reductase activity. Histopathological analysis of retinal tissue was conducted using Hematoxylin and Eosin staining. Results Vasant Kusumakar Ras treatment restored serum lipid profile which was altered in diabetic rats. Treatment with Vasant Kusumakar Ras significantly ameliorated the oxidative stress in eye tissue resulting in decreased lipid peroxidation and increase in endogenous antioxidant levels. Levels of aldose reductase and vascular endothelial growth factor in eye tissue were significantly decreased in Vasant Kusumakar Ras treated rats. Hematoxylin and Eosin staining indicated that the Vasant Kusumakar Ras treatment significantly restored the normal architecture of the retinal tissue. Conclusion Vasant Kusumakar Ras exhibits protective effect and prevents the development of Diabetic retinopathy through its effects on multiple biochemical pathways implicated in pathogenesis of Diabetic retinopathy., Highlights • Diabetic retinopathy was induced by streptozotocin administration in adult male wistar rats. • Vasant Kusumakar Ras (VKR), an Ayurvedic herbo-mineral formulation, was administrated as treatment to diabetic rats. • Oxidative stress and vascular endothelial growth factor level were decreased by treatment with VKR. • Vasant Kusumakar Ras prevented diabetic retinopathy (DR) by its ability to act on multiple biochemical pathways implicated in pathogenesis of DR.

This first Special Issue collects fifteen original research and up-to-date review articles addressing the beneficial properties of herbal products, nutrient supplements, dietary regimens, and functional food for the complementary therapy of human pathologies. In these articles, renowned scholars present and discuss the curative effects and the molecular mechanisms of action of nutraceuticals, medicinal herbs, and dietary regimens that have been proven effective in the treatment of cancers, metabolic syndrome, fatty liver disease, hearth arrythmia and neurodegenerative disorders.

Objectives To report the prevalence and characteristics of complementary medicine use and product utilization by Australians living with sleep disorders. Design A cross-sectional study. Methods 2025 adults representative of the Australian population by age, gender and state/territory of residence completed a survey consisting of 50 items including demographic, health services and complementary product/service utilization and health status items. The sociodemographic characteristics, prevalence and frequency of complementary medicine (CM) use, and out of pocket CM expenses were compared between those reporting a sleep disorder to those without a sleep disorder. Results Of the 2019 respondents completing the online survey, 265 (13%) reported sleep disorders. Of these 265 respondents, the median age bracket was 40–50 years; 54.7% were females. The mean health-related quality of life score in this group was 44.8 ± 23.3; the group had a higher level of comorbid conditions compared to those without sleep disorders (p Conclusion Both complementary medicine and conventional services/medicines use is more prevalent in Australians with sleep disorders compared to those not reporting a sleep disorder. This raises a number of clinical and safety considerations including accommodating patient preferences.

ObjectiveChinese-American patients use CIH at high rates but disclosure of CIH use to clinicians is low. Further, the content of CIH talk between patients and their clinicians is not well described. We aimed to characterize CIH talk between Chinese-American patients and their primary care clinicians.MethodsDiscourse analysis of 70 audio-recordings of language concordant and discordant-interpreted visits.ResultsNearly half of all visits (48.6%) had some form of CIH communication. 'Simple CIH talk' focused on a single CIH topic resulting in a positive, neutral, or negative response by clinicians. 'CIH-furthering talk' was characterized by clinicians and patients addressing more than one CIH topic or including a combination of orientations to CIH by both clinicians and patients. CIH-furthering talk characterized by clinician humility could enhance rapport, cultural understanding, and open communication. CIH-furthering talk also led to miscommunication and retreat toward biomedicine.ConclusionCIH communication occurred frequently during language concordant and discordant-interpreted visits with Chinese-American patients. Both patients and clinicians used CIH-furthering talk as a conversational resource for managing care.InnovationThis discourse analysis of visits between Chinese-American patients and their clinicians advances understanding of CIH communication beyond disclosure, illustrating the complexity of linguistic and cultural nuances that affect patient care.

Higher plants have been used worldwide as natural medicine for long time to cure human diseases. About 80% of people globally use plants as safe sources of drugs to cure human diseases through different complementary medicine system. In Oman, there are plenty of plant sources with significant pharmacological activity. One of the available indigenous medicinal plants, Ficus sycomorus (FS), in Oman belongs to the Moraceae family. The plant contains different groups of biologically active compounds which are responsible for the biological activity. The selected Omani species showed different pharmacological activities and used traditionally to treat different diseases. Several research studies on biological, pharmacological and isolation of bioactive compounds have already been done on different species of Ficus worldwide . However, only a few such research studies have been conducted on the Omani Ficus species. Therefore, the aim of this present review is to evaluate the current biochemical and pharmacological status of the Omani FS species. Our intention in this study is to inform the third world generation regarding the toxicity, pharmacological activity and phytochemicals of the Omani FS species. The present brief review includes its taxonomy, pharmacological activity, phytochemicals and also its potential uses. In this context, the plant itself or extracts and isolated active compounds could be used as novel therapeutic medicine to treat different chemotherapy patients.

Purpose To measure the frequency, type, purpose of complementary medicine (CM) use among people with diabetes mellitus. Materials and methods The population of this descriptive study consisted of the patients hospitalized in the endocrine clinic of a university hospital in Eastern Turkey who were diagnosed with diabetes. Data were collected from 316 patients. Results 43.0% of the patients were using CM, and 97.0% of those using CM tried herbal methods. The patients who had variable glycated haemoglobin values (60.3%) and those who had DM-related complications (60.3%) used CM more. Conclusion It was determined that CM usage was prevalent among the patients. The most frequently used CM method was herbal therapy. We found that the use of CM was more common in patients with poor metabolic control. Therefore, healthcare professionals must be assess use of CM and provide suitable counseling.

Background The use of traditional and complementary medicine (T&CM) is increasing in both developed and developing countries. The school of Persian medicine (PM) in Iran is a comprehensive medical school that is rich in history and has its own special principles, elements, philosophy, and diagnostic and treatment options. Many complementary therapy modalities are also popular and in demand among patients and physicians. The aim of this paper is to provide logic for the policymakers in Iranian medical education to make changes in medical education curricula, particularly on integrating T&CM. Methods We reviewed the global experience in teaching T&CM to medical students, and highlighting the strengths of PM, described why it is necessary to integrate T&CM into general medicine curricula in Iran. Results PM is a traditional system of medicine that dates back about 7000 years. Although there are few studies about the safety and effectiveness of PM, research into it has recently been accelerated. There is a suitable opportunity for integrating T&CM with conventional medicine. Physicians should be familiar with T&CM to avoid any contraindications, interactions, and unwanted effects. Conclusion Traditional medicine is part of Iran’s heritage and, thus, needs special attention. Familiarization of physicians with T&CM can help them choose the best treatment options for their patients. To integrate T&CM into the medical education curricula of Iran, a two-credit course has been proposed for implementation across the country.

Summary Introduction There is a belief among vocalists that there are voice benefits from vitamin B12 treatment. Yet there are no previous reports regarding vitamin B12 effects on voice. Objectives To assess the prevalence of vitamin B12 use among singers and their beliefs regarding vitamin B12 therapy. Methods Anonymous online survey administered to singers, singing-teachers, speech-language pathologists, and laryngologists. Results A total of 192 participants completed the surveys; 128 singers (68 singing-teachers, 30 speech-language pathologists) and 64 laryngologists. Among singers, 12% have perceived voice benefits from vitamin B12 treatment taken for any reason. Four percent used vitamin B12 for voice benefits; all perceived voice benefits as a result. The leading voice benefits were improved stamina, reduced effort, confidence, and control. Nineteen percent of the singers would recommend vitamin B12 treatment to a friend; 15% of the singing-teachers would recommend it to a student. Among laryngologists, 33% been asked by a singer to prescribe vitamin B12 for voice benefits; 9% have prescribed it in the past. Yet only 3% would you recommend it to a patient. When asked “Do you believe vitamin B12 therapy improves vocal performance?” 31% of the singers responded “Yes,” compared with none in the laryngologists. When asked “Do you think the singing community believes vitamin B12 therapy improves vocal performance?” 26% of the singers responded “Yes,” compared with 53% of the laryngologists (P = 0.0002). Conclusions There is a discrepancy between the singers' and the laryngologists' beliefs regarding vocal benefits perceived by vitamin B12. Blinded randomized trials are required to verify or refute this belief.

Objective Examine the generational differences in complementary medicine (CM) utilisation between young women from the X and Millennial generations. Design Secondary analysis of two cross-sectional surveys from the Australian Longitudinal Study on Women’s Health (ALSWH). Setting Australia. Main outcome measures Differences between young Generation X women (surveyed 1996; aged 18–23 years), and Millennial women (surveyed 2014; aged 19–24 years) regarding consultations with CM practitioners, sociodemographic characteristics, and health. Predictors for CM consultations were analysed via logistic regression analyses. Results Of the 14,247 Generation X women, 19.4% reported consulting CM, compared to 26.8% of the 11,344 Millennial women. CM consultations was predicted in both cohorts by higher age, education beyond primary school, non-urban (vs. urban) residence, and frequent back pain or headaches. Obesity and regular smoking predicted non-use in both. Significant cohort differences were found in physical activity levels (moderate/high levels associated with increased CM consultations in Millennial, but not Generation X women), and health status (Generation X women reporting fair-poor health were more likely to consult CM practitioners, while Millennial women reporting good health were less likely to do so, compared to women with very good/excellent health). Conclusions The increase in CM utilization among young Australian women from Generation X compared to the Millennial generation could indicate different health consumer patterns for future middle-aged and older adult Australian women. Further increases in CM usage may be observed as current young women age into characteristics traditionally linked with higher CM use such as worsening health status and increased disposable income.

Background Pediatric use of complementary medicine (CM) is common and offers numerous research questions about diverse therapies and conditions. Although research priorities for pediatric CM have been identified, there was a need to update in light of the rapid evolution of the field. Methods Building on previous work, we conducted an international, consensus-based 4-step modified Delphi process to develop and refine a pediatric CM research agenda, including on-line questionnaires and an in-person meeting. Participants included health care professionals, researchers, and educators. Results We received 376 responses; participants included conventional and CM providers, researchers, educators, administrators, and policy-makers from 15 countries (Australia, Bangladesh, Belgium, Canada, China, Germany, India, Israel, Italy, New Zealand, Norway, Sri Lanka, The Netherlands, United Kingdom, and United States). While it was recognized that each region must set their own priorities based on use, access, and expertise, a “minimum set” for a pediatric CM research agenda was identified. After three rounds of surveys, participants identified the highest priorities for pediatric CM research as: (i) safety of CM therapies for infants, children, and adolescents; (ii) conditions for which CM use is highly prevalent and for which conventional medicine lacks safe, cost-effective therapies; iii) therapies/therapists to be examined for quality and reproducibility of interventions, comparative and cost effectiveness, dose, etc.; and iv) identification of relevant outcomes and outcome measurement tools. Conclusions The results of our study identify that “first do no harm” is the leading research priority for pediatric CM research, followed by more research on effectiveness of CM therapies for conditions not safely and effectively treated with conventional care. In order to improve pediatric health care, interdisciplinary collaborative approaches are needed between CM and conventional providers and researchers.

Background and purpose As many as one in two women consult with a complementary medicine (CM) practitioner for pregnancy-related health care, yet little is known about the reason for such a high rate of use. This paper presents the perceptions of CM practitioners regarding the role they play within the existing maternity care system. Materials and methods Semi-structured interviews with 23 CM practitioners were conducted and the transcripts analysed, using a Framework approach. Results Key themes pertaining to the perceived role of CM practitioners in maternity care emerged. (1) Becoming a maternity care provider: responding to a need and filling gaps in the system; (2) Characterising CM maternity care: Holistic, nurturing and addressing unmet health concerns and; (3) Treating health complaints neglected by conventional maternity care. Conclusion CM practitioners often acknowledge their specialist roles as part of a multidisciplinary team of practitioners rather than attempting to offer comprehensive pregnancy care.

Health misinformation can severely affect human behaviour, especially in controversial areas such as that of complementary medicine. A cross-sectional observational study was conducted on 16 web pages to identify different kinds of falsehoods, to estimate the risk of running into deceptive information, and to observe the differences among experts' and one layperson's assessments. Almost all analyzed claims were unfounded. Unexpectedly, the experts agreed more often on considering analyzed scientific statements to be correct rather than incorrect. However, half of the time, the experts did not agree, so that the correctness of some claims remained undefined. A statistically significant risk of running into unfounded information and incorrect or undefined claims was found. There was a low agreement between the expert and layperson evaluation. The results of this study can help consumer health librarians to interpret cues of potentially misleading information about controversial issues and thereby improve their information and communication services.

Aim To report the prevalence and sociodemographic characteristics of complementary medicine (CM) use by Australian and American adults living with gastrointestinal (GI) disorders. Method Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Medline, Pubmed, Scopus and Web of Science were searched for studies published in English language between 1st January 2008 and 8th April 2018. Additionally, a Google Scholar search and risk of bias assessment were conducted. Results Twelve (five American and seven Australian) studies, involving 53,991 adults were included. Data were extracted from studies reporting CM use by both specific populations with medically diagnosed GI disorders and the general population with self-reported GI disorders. CM use ranged from 23.6% to 44% (American) and 27.2% to 58% (Australian) by adults with medically diagnosed GI disorders. Whilst CM use was higher amongst females, with higher incomes and education levels. The prevalence of CM use by those with self-reported GI disorders varied from 0.31% to 80%. Herbal, probiotic supplements and mind-body practices were the most prevalent CMs used. The risk of bias assessment identified weaknesses in the external validity, principally related to poor study design. Conclusions There is a substantial use of CMs by American and Australian adults with GI disorders. Females with higher education and income are predominant users. There is a need to conduct up-to-date and well-designed prevalence and sociodemographic studies. Additionally, future studies should consider including health literacy and medicines disclosure scales in order to better understand CM use by this population.

The Department of Haematology/Oncology at the University Children's Hospital Bern (HONK), has adopted an integrative approach in addition to state of the art oncological care and implemented a collaboration with the Institute of Complementary Medicine IKOM, University of Bern, over the past 10 years. Stakeholder satisfaction with this service was high. We present descriptive data and report on 4 exemplary patients treated with additional individualized homeopathy (iHOM). Data concerning frequency of consultations, pathologies, follow-ups and clinical results were reviewed and summarized using descriptive statistics. 94 paediatric oncologic patients consulted for iHOM. Indications for the complementary treatment was wide-ranging. No interactions with conventional treatment and no adverse side-effects of iHOM were detected. We present four characteristic patient histories, in which iHOM was used in addition to standard treatment for mucositis, permissive tissue infection, insomnia and affective dysfunctions. All four patients clinically improved in an immediate temporal relationship to the additional treatment. CONCLUSION: The collaboration between HONK and IKOM established iHOM in paediatric oncology in Bern. In this setting, iHOM was a safe and supportive additional treatment for various indications during the conventional cancer care. However, no generalizable results can be deducted from these data. We emphasize future research on this topic.

Introduction Qigong encompasses a number of practice approaches, each with its own objectives, methods and benefits for the practitioner. With respect solely to its health-related aspects, Qigong has been categorised by the WHO within Traditional and Complementary Medicines. The purpose of this article is to outline our opinion on the advantages and limitations of the postures and static or dynamic dimensions of Qigong with respect to internal relaxation when using this activity under the heading of "traditional and complementary medicine". Methods The ideas set out in this article are based on the authors’ practical experience in this area and have been complemented with the contents of the articles selected and cited under the references. Results Healthy people could obtain more health benefits from dynamic practices than from static practices and from standing positions than from sitting or lying positions. In the case of people with physical and/or cognitive limitations or who suffer from some illness, it is necessary to investigate what posture, what practice time and what combination of static and dynamic activity is the most suitable for their needs. Conclusions An analysis of Qigong solely from the viewpoint of "traditional and complementary medicine" raises the question of how to take advantage of this activity as a "resource" and not as an "end in itself" and accordingly to compare, select, adapt and modify the postures and techniques to make them accessible to people of any age or with any physical or mental limitation or pathology who can take maximum advantage of its benefits.

Objectives: To explore the challenges regarding evidence and complementary medicine in Australia and identify potential future directions to develop leadership, action and debate.Design: Facilitated discussion among a roundtable of experts to identify and consider the relevant issues and potential actions. Methods: Purposive sampling of 17 expert stakeholders with a variety of experience in the traditional and complementary medicine (T&CM) arena. Thematic analysis of the half-day discussion transcript resulted in a framework for a broad agenda to support the development of appropriate evidence for T&CM. Results: Five key areas (with sub-themes) were identified, forming the backbone of an agenda-setting framework: focus areas; strategies; actions and outputs; barriers; and drivers of change. ‘Focus areas’ encapsulated the main themes and informed all key areas, these were: consumer perspectives and needs; hierarchies of evidence; safety of products, practitioners and practices; modernisation ofT &CM; regulation and policy; and evidence-based practice. Two recurring themes informed the framework at multiple levels: the complexity and varied understanding of what is ‘appropriate evidence’ for T&CM; and putting consumers at the centre – to ensure that their needs and safety are prioritised. Lack of resources for undertaking T&CM research necessitates the need to bring together information from multiple sources so that ‘totalities of evidence’ can be assessed to increase the T&CM evidence-base. Doing so requires reassessment of the relative value of traditional forms ofevidence and challenges current linear evidence hierarchies that prioritise clinical trials as the ‘gold standard’. Conclusions: This Australian agenda-setting framework for strengthening T&CM evidence requires an interdisciplinary leadership group (including consumer, clinician, academic and industry representatives) to build consensus, foster collaboration, and generate and disseminate information. Prioritising the perspectives and needs of consumers should be a primary focus in taking the ‘strengthening evidence forT&CM’ agenda forward. Refereed/Peer-reviewed

Graphical abstract, Many countries in the world face the new challenge of having human coronavirus infection to manage commendably - the large affliction of human health. Together, each country has modern drugs and a variety of medicinal products developed from their traditional medical practitioners to treat a common cold. In this review, we describe potentially synergistic therapeutics of traditional and complementary medicine available for common cold which might be useful for prevention or for the adjuvant treatment of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Further, we provide a phylogenetic overview of SARSCoV-2 based on a complete genome sequence of common cold viruses. We suggest modern and traditional medicine and preventive strategies which might control the disease to offer more suitable and acceptable common cold management including coronavirus. A substantial proportion of medicinal products developed by traditional medicine against common cold as well as modern medicine mainly focus on symptoms suppression. The recombinant interferon alpha-2b and lactoferrin derived from modern medicine in combination with herbal based products from traditional medicine may support the prevention of novel coronavirus infections. An integrated approach against common cold viruses to establish efficacy and safety through modern and traditional medicine and regular physical exercise along with preventive dietary sources is proposed.

Objectives: As well as associated cardiovascular diseases (CVD) like heart attacks, stroke, or others, arterial hypertension shows rising incidence throughout the last decades. The risk of developing an elevated blood pressure is mostly based on environmental and behavioral factors. Therefore, guidelines usually base a first-line therapy on lifestyle modifications. Complementary medicine (CM) offers a wide range of therapies to support such and CM utilization is common among CVD. We sought to analyze CM utilization among participants particularly suffering from arterial hypertension and aimed to distinguish utilization rates of different therapy approaches and predicting factors on this part of health behavior. Design and setting: This cross-sectional analysis was based on data of the 2017 National Health Interview survey (NHIS, n = 26,742; response rate 80,7%), performed among the US population. Main outcome measures and results: Within the last 12 months, 22.7% of participants reported to suffer from arterial hypertension and they were less likely to have used CM (26.8% with versus 32.5% without hypertension). Consulting a homeopath or using mind-body-medicine was more common among participants without the diagnosis, while equal proportions had consulted a chiropractor, a naturopath, a practitioner of traditional medicine, or a practitioner of chelation therapy. Regarding mind-body medicine (MBM), individuals with hypertension most often used spiritual meditation (10.6%), yoga (5.7%), mindfulness meditation (3.2%), progressive relaxation (3.1%), mantra meditation (2.4%), guided imagery (1.9%), tai chi (1.5%), and qi gong (0.4%). CM use in individuals with hypertension was associated with female sex, higher education, and/or living in the Western or Midwest USA. Conclusion: Participants with arterial hypertension were less likely to utilize CM therapies than those without. Regarding prevention and therapy of the disease, especially MBM therapies show promising results but further research and better information for the general population is needed. CA Kohl-Heckl

Background and purpose Current treatment strategies for ankylosing spondylitis (AS) include adalimumab and other biological drugs. However, treatment failures and side effects are commonly observed. This report documents the successful use of supplements and dietary changes to treat a patient with AS after cessation of adalimumab therapy. Patient presentation A 38-year-old human leukocyte antigen B27 positive female patient with AS showed no improvement when treated with a non-steroidal anti-inflammatory drug. The patient then began adalimumab therapy with some success; however, after nine months, she developed a disseminated and refractory Molluscum contagiosum infection. Adalimumab was withdrawn, and the patient started taking supplements, while adopting an anti-inflammatory diet (dairy-free, gluten-free, and sugar-free). Normalization of inflammatory markers was achieved after two months, and magnetic resonance imaging of the sacroiliac revealed a notable physical improvement.

Background and purpose This study examines the relationship between the use of complementary medicine (CM) interventions or consultations with CM practitioners and women's choice of contraceptive method. Materials and methods A secondary analysis of a cross-sectional survey of Australian Women aged 34–39 years from the Australian Longitudinal Study on Women's Health (ALSWH) was conducted. Associations between use of CM and contraception were analysed using Chi-squared tests and multivariate logistic regression. Results Based on the responses from the included women (n = 7299), women who consulted a naturopath/herbalist were less likely to use implant contraceptives (OR 0.56; 95% confidence interval (CI) 0.33; 0.95). Those consulting a chiropractor (OR 1.54; 95%CI 1.05; 2.25) or an osteopath (OR 2.16; 95% CI 1.32; 3.54) were more likely to use natural contraception. Conclusion There may be a link between women's choice of contraceptive method and their use of CM, in particular, with CM practitioner consultations.

Background and purpose Scant information exists about traditional, complementary and alternative medicine (TCAM) use in Indonesia, which prompted investigating its prevalence and correlates in Indonesia. Materials and methods Participants were 31,415 individuals 15 years and older that participated in the cross-sectional Indonesia Family Life Survey in 2014–15. Results In all, 24.4% had used a traditional practitioner and/or traditional medicine in the past four weeks, and 32.9% had used complementary medicine in the past four weeks. In adjusted logistic regression analysis, being of older age, being a Muslim, residing in an urban area or on Java, being unhealthy, having a chronic condition, having depression symptoms, experiencing sleep disturbance, and having high social support were associated with both current traditional practitioner and/or medicine use and complementary medicine use. Conclusion The study shows a high prevalence of TCAM use in Indonesia and several sociodemographic and health related factors of its use were identified.

Objectives Over time different systems were developed for the characterization of individuals according to their physical and psycho-vegetative traits which until today play a role in complementary medicine. This pilot study aimed at investigating if the concepts of polar constitutional types of anthroposophic medicine and according to Kretschmer can be further clarified using empirical method. Methods 96 participants, preselected by two polar body mass index (BMI) ranges (17–19.5 kg/m2 and 27–31 kg/m2), were categorized using both classification systems. Anthropometrical measurements were carried out and differences in the autonomic regulation were assessed using a questionnaire. From 12 participants showing a pronounced polar constitutional type, production of reactive oxygen species, proliferation, autophagy, and glucose uptake by lymphocytes, monocytes and granulocytes were measured in vitro. Results Correlations between the BMI and the strength of constitutional classification were found for both classification systems. Additionally, a strong correlation between the two systems themselves could be seen. Analysis of the overall questionnaire score of autonomic regulation did not yield significant correlations. However, using a modified 11 item score, reliability (Cronbach α = 0.656) and a differentiation of polar constitutional types was demonstrated (p Conclusion This study represents a first empirical approach toward the classification of anthroposophic constitutional types.

Objective: To identify communication patterns of Registered Nurses regarding patients’ use of complementary therapies. Methods: A cross-sectional online survey conducted in 2017 recruited Australian Registered Nurses working in any area of nursing. Results: Responses of 614 Registered Nurses were analysed. Patient-initiated discussion of complementary therapies were common for 77% of nurses; nurse-initiated discussions were perceived by 73% (sometimes/almost always/always). Nurses’ personal use of complementary therapies predicted discussion with patients and education-based, oncology, or aged care/rehabilitation nurses were most likely to initiate dialogue. Many (55%) did not ‘recommend’ a particular therapy, although 12% ‘almost always/always’ did so. Four out of five nurses (84%) documented patients’ use and communicated with medical/nursing colleagues about this use. Conversely, 61% ‘never’ or ‘almost never’ communicated with a complementary therapy practitioner. Conclusion: Nurses working in Australia often discuss complementary therapies, however they rarely specifically recommend their use. Their workplace environment and clinical context influenced nurses’ willingness to communicate about complementary therapy use. Practice implications evidence: suggests the need for policy development to promote communication between mainstream healthcare providers and complementary therapy practitioners to support the delivery of safe, high quality patient care. Refereed/Peer-reviewed

Background Use of complementary medicine in Australia is increasing. Despite documented high use, however, perspectives of complementary medicine teaching inclusion within health professions education are poorly documented and understood. Aim This paper explores medical students' perspectives of complementary medicine teaching from the curriculum of Australian medical programs. Methods A constructivist grounded theory methodological approach was used to generate, construct, and analyse data. Thirty second-year to final-year medical students from 10 medical school education faculties in Australian universities participated in semi-structured interviews over a five-month period in 2013. Findings Students from all represented medical schools highlighted perspectives of complementary medicine offerings in both the preclinical and clinical curriculum. Across the curriculum, a wide range of perspectives were related to both complementary medicine teaching and learning aspects incorporating social and ethical issues, evidence of clinical efficacy and safety, and evidence-based principles involving critical application and appraisal. Discussion The findings demonstrate diverse perspectives of complementary medicine teaching not necessarily synonymous with learning. While all students highlighted some form of complementary medicine teaching and/or learning, perspectives varied between schools and across jurisdictions in terms of context and content. Clinical exposure to informal complementary medicine learning in clerkship was extensive relative to formal didactic teaching in the preclinical curriculum. Educational exposure to complementary medicine was shown to positively affect medical student attitudes towards complementary medicine. Conclusion A coordinated policy towards integration of complementary medicine teaching in Australian medical curricula is recommended. Impetus for open debate regarding what level of complementary medicine teaching and/or learning is sufficient in medical and other health professions education is required.

Purpose Aim of this study was to determine the perceptions about and personal use of CAM by health care providers. Methods A cross-sectional survey was carried out on 320 health care providers, who were selected by census method. Results 86.6% of the subjects reported that they had used at least one or more CAM. The most commonly used CAM was prayer (65.6%). There was a significant relationship between sex and all the five factors of attitude. The highest mean score of attitude was related to Factor 1 (attitude toward the desirability of CAIM therapies). Based on the results of univariate logistic regression, there was a significant association between the use of complementary medicine and education level. Conclusion Based on the results it seems that this group can play an effective role in providing the appropriate information for the community and prevent the unnecessary use of CAM.

Objective The objective of the research was to explore attitudes of hospital nurses toward integrative medicine (IM). Design A special training program was developed in the Bnai-Zion medical center, a public hospital in Israel, where an innovative IM program was launched. Methods 65 nurses from 22 wards were asked at the beginning and the end of the program to complete an open-ended questionnaire concerning three major aspects: 1) their attitudes toward complementary medicine and its integration, 2) the importance and impact of the training program and 3) how they perceive their potential role in promoting IM in the wards. Results Nurses perceive themselves as boundary actors, who can play an important role in promoting IM within the wards. IM training programs for hospital nurses are recommended. This empowers nurses while restoring to clinical practice the essence of nursing as an integrative healing discipline.

Objective Traditional and Complementary Medicines (TCM) are widely used worldwide, and many of them have the potential to cause toxicity, interaction with conventional medications and non-adherence to prescribed medications due to patients' preference for the TCM use. However, information regarding their use among patients seeking care at emergency departments (ED) of a healthcare facility is limited. The study aimed to evaluate the TCM use among patients attending the ED of a teaching hospital in Malaysia. Study design A sub-analysis of data from a prevalence study of medication-related visits among patients at the ED of Hospital Universiti Sains Malaysia was conducted. The study took place over a period of six weeks from December 2014 to January 2015 involving 434 eligible patients. Data on demography, conventional medication, and TCM uses were collected from patient interview and the medical folders. Results Among this cohort, 66 patients (15.2%, 95%CI 12.0, 19.0) reported concurrent TCM use. Sixteen (24.2%) of the TCM users were using more than one (1) type of TCM, and 17 (25.8%) came to the ED for medication-related reasons. Traditional Malay Medicine (TMM) was the most frequently used TCM by the patients. Five patients (7.6%) sought treatment at the ED for medical problems related to use of TCM. Conclusion Patients seeking medical care at the ED may be currently using TCM. ED-physicians should be aware of these therapies and should always ask patients about the TCM use.