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Background: Palliative care, a cornerstone of comprehensive healthcare, prioritizes quality of life for individuals with life-threatening illnesses. Aromatherapy, with its holistic approach and patient-reported benefits, emerges as a promising complementary therapy for managing symptoms and enhancing well-being in palliative care. Objective: The objective of this systematic review is to assess the efficacy of aromatherapy interventions in symptom management, with a focus on pain, anxiety, nausea, and sleep disturbances among palliative care patients. Design: A comprehensive search was conducted across various databases to identify relevant studies. Eligibility criteria were applied, resulting in the inclusion of eight studies for analysis. The review assessed the efficacy of aromatherapy interventions, primarily through massage, in symptom management. Variations in intervention procedures and outcome measures were noted, necessitating a critical examination of the findings. Results: The review's findings suggest promising outcomes associated with aromatherapy in palliative care. Aromatherapy interventions demonstrated significant efficacy in reducing pain, anxiety, nausea, and improving sleep quality among patients. However, considerable heterogeneity was observed across studies, highlighting the need for standardized methodologies and larger-scale trials. Conclusion: This systematic review underscores the potential of aromatherapy as a complementary intervention in palliative care. While the findings support its efficacy in symptom management, methodological inconsistencies across studies warrant further research. Standardized approaches and larger trials are essential to validate the tailored effectiveness of aromatherapy for different symptoms encountered in palliative care, ultimately enhancing its clinical utility and integration into therapeutic practices. [ABSTRACT FROM AUTHOR]

Background: Many clinical practice guidelines for management of pain disorders now favor first-line use of nonpharmacological therapies (NPT). However, Medicare coverage of NPT is limited. Methods: Using a serial cross-sectional design, we examined temporal trends in the utilization and cost of NPT procedures commonly used to treat pain under Medicare. Results: Utilization and costs for physical therapy increased while those for spinal and osteopathic manipulation declined. Discussion: Future research on NPT under Medicare should focus on equity of patient access and comparative outcomes. [ABSTRACT FROM AUTHOR]

Objective: The study aims to determine the vaccination status of children and evaluate the relationship between vaccination rates, vaccine attitudes, and some parental health practices. Design and Methods: This cross‐sectional study was conducted with 674 mothers. Data were collected using a survey evaluating vaccine characteristics, some infant health practices, and The Public Attitude Toward Vaccination Scale—Health Belief Model. Chi‐square test, independent samples t‐test, and logistic regression analysis were used. Results: 80.2% of children were fully vaccinated. The rate of non or under‐vaccination was higher in the group that did not regularly undergo follow‐up for 0–2‐year‐old children, did not fully have health screenings, did not use vitamin D and iron supplements, and used alternative medicine. Moreover, the duration of breast milk feeding, the transition to supplementary food, and the duration of vitamin D use in the non‐fully vaccinated group were lower than in the fully vaccinated group (p <.05). The increase in maternal education period and severity and benefit attitude scores of vaccine attitude were the factors that decreased the rate of non‐fully vaccination. The increase in barrier scores toward vaccines increased the rate of non or under‐vaccination. Conclusion: Mothers who have negative attitudes toward vaccination have negative behaviors in health practices and screenings on infant/child health. [ABSTRACT FROM AUTHOR]

Background: Since its academic inception in the 1960s, Germany's general practice has seen numerous dissertations, many of which are housed in the 'Archive of German language General Practice' (ADAM). Aim: This study aims to provide the first comprehensive overview of dissertation topics from the discipline of general- and family medicine in Germany, establishing a foundation for advancing research. Method: We employed a systematic review approach, examining 801 dissertations from both ADAM and online sources. Each topic was identified, categorized, and finalized through consensus by two independent reviewers. Results: Our analysis encompassed 486 dissertations from ADAM, 176 from the German national library, and 139 from university libraries. A total of 167 unique research topics were identified. The predominant themes included medical education (n = 49), medication orders (n = 39), frequent consultation issues (n = 33), complementary medicine (n = 32), and screening measures (n = 29). The use of qualitative methods was constantly rising, from no qualitative methods used from 1965–1974, up to 22% of dissertations in recent years. Conclusion: The diversity of 167 research topics underscores the vastness and complexity of general practice in Germany. This structured overview is pivotal for facilitating focused and interconnected research endeavors in the field. [ABSTRACT FROM AUTHOR]

Objective Long-term follow-ups of prehabilitation programs for lumbar spine surgery are lacking, and more comprehensive evaluations are needed. In the current study, we evaluated the long-term effects of a prehabilitation program compared with conventional care in relation to lumbar fusion surgery in patients with degenerative disc disease. Methods Patients (n = 118) receiving lumbar fusion surgery were included in a multicenter randomized controlled trial, involving 1 university hospital and 2 spine clinics. The intervention was a person-centered prehabilitation program based on cognitive-behavioral physical therapy that targeted psychological presurgical risk factors, physical activity, and overall health. The control group received conventional preoperative care. Patient-reported outcome measures (PROMs) included assessments at 8 time-points: low back disability (primary outcome), back pain intensity, leg pain intensity, pain catastrophizing, fear of movement, anxiety and depressive mood, health-related quality of life, and patient-specific functioning. Physical activity and physical capacity were assessed at 5 time points. Linear mixed models were used to analyze the effects of the intervention. Results There were no significant differences between groups at the 12- and 24-month follow-ups for any outcome, except for the One Leg Stand test 1 year following surgery, in favor of the control group. There were significant improvements for both groups, from baseline to the 12- and 24-month follow-ups for all physical capacity test and patient-reported outcome measures, except for leg pain and self-efficacy for exercise. Conclusion No long-term effects were found for the prehabilitation program compared to conventional care. Physical activity did not improve over time, despite significantly improved self-reported functioning and physical capacity measurements. Impact These findings have implications for the current understanding of the long-term effects of prehabilitation and suggest that future research should focus on programs promoting physical activity both before and after lumbar spine surgery to decrease the risk of long-term adverse health outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This study conducted a systematic literature review and meta-analysis on the effectiveness of aromatherapy in reducing restless legs syndrome (RLS) in hemodialysis patients. Methods: Using the population, intervention, comparison, outcome, study design framework, a search was conducted of eight electronic databases: PubMed, Cochrane, Embase-Ovid, CINAHL, Web of science, Scopus, PQDT, and RISS. The population was hemodialysis patients, and the intervention included aromatherapy aiming at RLS, compared to control groups receiving placebo or usual care. The outcome measured was RLS, and the study design was randomized controlled trials. Results: The analysis included seven articles presenting results from 10 studies, and the pooled overall effect of aromatherapy on RLS in hemodialysis patients was shown by a Hedge’s g of −1.84 (95% confidence interval: −2.45 to −1.23). Meta-regression analysis revealed greater effectiveness in studies that received funding. Age over 60, lavender oil use, intervention duration of less than 4 weeks, sessions longer than 30 minutes, a routine care control group, and quality assessment score of 10 or less were associated with RLS reduction. Conclusion: The study concluded that aromatherapy is effective for managing RLS in hemodialysis patients. [ABSTRACT FROM AUTHOR]

Cancer is one of the most important societal challenges in the world, with over 23 million new cases/year and 10 million deaths/year, that will only be properly tackled with a stronger focus on prevention. This calls for an informed population, aware of risk factors and willing to adopt preventive behaviors and early cancer screenings. For that purpose, 2' Life-changing minutes was created, the first ever televised Entertainment-Education series on cancer prevention. This study aims to evaluate the impact of 2' Life-changing minutes , a novel E-E format for cancer prevention, on knowledge gains and behavior changes. Two complementary studies were performed involving a total of 1314 participants: a test-screening (TS) study targeting potential viewers of the series, and a natural-screening (NS) study targeting those that spontaneously watched the series on television. We found (i) very high levels of appreciation and narrative engagement, and also willingness to see more episodes; (ii) statistically significant knowledge gains, ranging from 17% to 44%, on all four topics tested; (iii) evidence of effective behavior change. Regression analysis showed that narrative engagement was the best predictor of behavior change [NS: odds ratio (OR) = 3.38, 95% confidence interval (CI) = 1.70–6.74, p  = 0.001; TS: OR = 2.05, 95% CI = 1.13–0.371, p  = 0.018]. This study demonstrates the series' real impact and serves as a proof-of-concept for a novel strategy of cancer prevention that is based around compelling health narratives, rather than information or data, to engage viewers, increase knowledge and induce behavior change. [ABSTRACT FROM AUTHOR]

The recognition of complementary and alternative medicine (CAM) is increasingly growing worldwide. Positive attitudes toward using CAM may reflect an evidence-based understanding and awareness of its common uses and potential abuses, facilitating its sound integration into the society for positive results. This study aimed to identify the level of knowledge, practices, and barriers associated with the use of CAM among medical and nonmedical students. A cross-sectional study was conducted between April 2023 and July 2023 involving a sample group of medical and nonmedical students from King Khalid University, Abha, Saudi Arabia. A total of 341 students completed the survey. Approximately 53.4% of the participants were medical and 46.6% were nonmedical students. Herbal medicine was the most used among medical students (21%) followed by aromatherapy (12%) and chiropractic (11%), while the most used CAM among nonmedical students was spiritual healing/Quran (19%). The prevalence of good knowledge is higher in medical students compared to nonmedical students in some CAM modalities. In addition, the results show that there are no significant differences in attitudes toward CAM among medical and nonmedical students. Respondents from both groups were keen on gaining more knowledge about all the CAM modalities. It is important to utilize the data from this study for enhancing curricula in university programs and promoting education and practice related to CAM. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to review the literature on complementary and alternative therapies, utilizing text mining and trend analysis in nursing research. As CAM becomes increasingly prevalent in healthcare settings, a comprehensive understanding of the current research landscape is essential to guide evidence-based practice, inform clinical decision-making, and ultimately enhance patient outcomes. Method: This study aimed to identify CAM-related literature published from 2018 to 2023. Using the search terms 'complementary therap*', 'complementary medicine', 'alternative therap*', and 'alternative medicine', we performed a comprehensive search in eight databases, including EMBASE, Cochrane Central, PubMed Central, Korea Education and Research Information Service (RISS), Web of Science, KMbase, KISS, and CINAHL. From the text network and topic modeling analysis of 66,490 documents, 15 topics were identified. These topics were classified into two nursing-related topics through an academic classification process involving three doctors with doctoral degrees, three nurses, and three pharmacists. Based on the classified topics, research trends were comparatively analyzed by re-searching the database for 12 nursing and 22 non-nursing literature. Result: This study found that in nursing literature, yoga is used to improve mental symptoms such as stress and anxiety. In non-nursing literature, most of the experimental studies on complementary and alternative therapies were conducted in a randomized manner, confirming that a variety of physiological and objective indicators were used. Additionally, it was discovered that there were differences in the diversity of research subjects and research design methods for the same intervention method. Therefore, future research should focus on broadening the scope of subjects and measurement tools in nursing studies. Additionally, such studies should be conducted with randomization and generalizability in the experimental design in mind. Conclusion: This study employed text network analysis and text mining to identify domestic and international CAM research trends. Our novel approach combined big data-derived keywords with a systematic classification method, proposing a new methodological strategy for trend analysis. Future nursing research should focus on broadening the scope of subjects, diversifying measurement tools, and emphasizing randomization and generalizability in experimental designs. [ABSTRACT FROM AUTHOR]

Background: Women with diminished ovarian reserve (DOR) have fewer eggs than would be expected at their age. It is estimated that 10% of women seeking fertility treatment are diagnosed with DOR. However, the success rate of medically assisted reproduction (MAR) is significantly lower in women with DOR, thus many seek additional approaches. Aim: To explore the health needs of women with DOR, treatment options and experience of treatment including traditional complementary integrative medicine (TCIM). Methods: Anyone with a diagnosis of DOR, living in Australia or New Zealand, aged over 18 were invited to complete an online survey distributed via fertility support networks and social media platforms from April to December 2021. Results: Data from 67 respondents were included. The main aspects of health that were impacted by DOR were fertility (91.0%) and mental health (52.2%). The main treatment recommended was MAR with most women either currently using MAR (38.8%) or having previously used MAR (37.3%). TCIM was widely used with 88.1% of women utilising supplements, 74.6% consulting with TCIM practitioners, and 65.7% adopting self‐care practices. The main reasons for using TCIM were to improve fertility or support pregnancy, and to support general health and well‐being. Conclusions: Women with DOR have additional health needs apart from infertility, most notably mental health support. The main form of treatment utilised is MAR, despite DOR being challenging for fertility clinicians. TCIM was widely used, and respondents perceived benefits related to improving fertility, supporting pregnancy, or improving well‐being through use of acupuncture, meditation, naturopathy, massage, yoga. [ABSTRACT FROM AUTHOR]

This systematic review aims to critically evaluate and synthesize the economic outcomes of various therapeutic strategies employed to manage cachexia patients. A comprehensive search for randomized controlled trials and observational studies was conducted from January 1, 2000 to December 31, 2023, using PubMed, Google Scholar, Clinical Trials Registry, Cochrane Central Register of Controlled Trials, British Medical Journal, National Health Service Economic Evaluation Database, and ScienceDirect, following PRISMA guidelines. We assessed the quality of the included studies using the Consolidated Health Economic Evaluation Reporting Standards reporting guidelines. We identified six high to medium quality economic evaluations in four countries, focusing on cancer, chronic obstructive pulmonary disease, and HIV/AIDS-associated cachexia. The results indicate that combination management strategies, specifically the use of nutritional supplements and exercise, are more cost-effective than usual care for cachexia syndrome. Additionally, two studies showed that dietary supplements alone were more cost-effective than usual care, and pharmacotherapy alone was more cost-effective than a placebo. Combining several strategies, such as nutritional supplements and exercise, may be the most economically efficient method for managing cachexia compared to usual care or single treatment approaches. However, the restricted and diverse characteristics of the current research hinder the definitive conclusions. [ABSTRACT FROM AUTHOR]

Objectives: Mastitis is mainly caused by Gram-positive bacteria and usually involves treatment with beta-lactam antibiotics and clindamycin. Oxazolidinones show good results in the treatment of skin and soft tissue infections (SSTIs) due to its pharmacokinetic characteristics. We aimed to describe clinical characteristics and outcomes of patients who received oxazolidinones for the treatment of SSTIs of the mammary tissue. Methods: Retrospective single-centre study of patients with a diagnosis of breast infection who received treatment with oxazolidinones as initial or salvage therapy between September 2016 and November 2022. Patients were identified through the pharmacy database. The primary outcome was clinical cure. Results: Twenty-nine patients received oxazolidinones: 27 received linezolid and 2 tedizolid. Median age was 41 years (IQR 31.0–56.5) and 28 patients were female. Ten patients (35%) had a history of breast cancer, while three (10%) had an immunosuppressive condition. Microbiological isolation was obtained in 24 individuals (83%). Predominant isolations were methicillin-resistant Staphylococcus aureus (8, 28%) and methicillin-susceptible S. aureus (7, 24%). Twenty-four patients (83%) received oxazolidinones as a salvage therapy, with a median duration of 14 days (IQR 10–17). Clinical cure was achieved in 24 patients (83%), while 4 relapsed after a median of 15 days (IQR 4–34). One was lost to follow-up. Three patients (10%) were taking selective serotonin reuptake inhibitors, and one of them concurrently received linezolid for 4 days with no adverse events recorded. Cytopenia during treatment was observed in 2/12 individuals. Oxazolidinones allowed hospital discharge in 11/13 hospitalized patients. Conclusions: Oxazolidinones could be considered as an alternative for treating breast infections. [ABSTRACT FROM AUTHOR]

In robotic total hip arthroplasty (THA), virtual range of motion (VROM) modeling allows the surgeon to account for spinopelvic motion and create an impingement-free range of motion that is patient-specific. The primary purpose of this study was to evaluate the risk of dislocation in patients undergoing direct anterior THA using VROM rather than manual ROM trialing. Prospectively collected data was reviewed retrospectively of all consecutive anterior THAs performed by a single fellowship-trained surgeon. No patients were excluded from the study. VROM identified bone and implant impingement, which was recorded in degrees of hip external rotation(ER) at 0° of hip extension (standing), and in degrees of hip internal rotation(IR) at 90° of hip flexion (sitting). No patients had manual ROM trialing performed. Dislocation events were recorded during the first 3 months of follow-up. 362 patients, with a mean age of 67 and mean BMI of 28.8, were included. This cohort, including 154 patients (42.5%) with abnormal spinopelvic motion, demonstrated zero dislocations using VROM. The average ER impingement occurred at 60.9° ER (range 20-90°), and 50.8° IR (range 25-90°). Patients with ER impingement <55° had significantly less acetabular anteversion (16.4° ±3.3°, p < 0.001). Compared to the entire cohort, anteversion of the acetabulum was also decreased in the stuck-sitting subgroup (17.4° ±3.3°, p < 0.001) and increased in the stuck standing subgroup (20.5° ±3.6°, p < 0.001). ER impingement was a stronger predictor of acetabular anteversion than spinopelvic motion category (r = 0.458). Patients with ER impingement <45° (6.4%) or IR impingement <35° (6.6%) were "early impingers". In this cohort of anterior THA patients with a high proportion of abnormal spinopelvic motion, a technique utilizing only VROM produced no dislocations. An impingement-free zone of 45° ER standing and 35° IR sitting is recommended. [ABSTRACT FROM AUTHOR]

BACKGROUND: Increasing levels of distress and barriers to healthcare have coincided with increasing use of Complementary and Alternative Medicine (CAM). While mindfulness and movement interventions may improve wellbeing, little research has compared the effectiveness of these two approaches. OBJECTIVE: This single intervention study aimed to (1) explore the effects of two brief, online, self-administered mindfulness and movement interventions on affect and vitality, and (2) establish whether changes in affect and vitality could be predicted by age, gender, general distress, previous CAM experience and enjoyment of the intervention. METHODS: Participants (n = 62) were randomly allocated to follow a brief online mindfulness or movement intervention. Levels of affect (using PANAS) and subjective vitality (using the Subjective Vitality Scale) were measured pre and post intervention. Demographics, experience with CAM and general distress (using the DASS-21) were collected pre intervention, while level of enjoyment (using the ENJOY scale) was measured post intervention. Open-text responses gathered qualitative data on participant experience. RESULTS: Participants completing the mindfulness intervention reported increased vitality and decreased positive and negative affect. Those completing the movement intervention reported increased vitality and positive affect and decreased negative affect. Higher DASS-21 levels were predictive of greater reductions in negative affect. Higher levels of enjoyment were predictive of greater increases in positive affect and vitality. CONCLUSIONS: Differences between mindfulness and movement interventions may indicate that they could have targeted applications. While further research is necessary, these brief, online interventions may provide a sustainable, accessible self-management and wellbeing intervention. [ABSTRACT FROM AUTHOR]

BACKGROUND: Complementary and alternative medicines (CAM) are being uses more often with cancer patients. OBJECTIVE: This study aimed to investigate attitudes, use and influencing factors of CAM among cancer patients during the COVID-19 pandemic. METHODS: This descriptive, cross-sectional study was conducted on 407 cancer patients in Turkey. The study was conducted during July-September 2021 using a Questionnaire that included a Complementary, Alternative and Conventional Medicine Attitude Scale (CACMAS). Pearson's Chi-Squared Test, Mann-Whitney U, Kruskal Wallis, and logistic regression were all utilized. RESULTS: The findings revealed that 76.2% of the participants stated that they used CAM methods while undergoing cancer treatment, and 65.2% of those who did so kept from sharing this information to medical professionals. Phytotherapy was the most common CAM method used by patients. The use of CAM was found to be significantly higher among those who were 55–64 years of age, married, secondary school graduates, non-smokers, CAM users before their cancer diagnosis, and who had a family history of cancer (p < 0.05). The participants' average CACMAS scores were 112.20±16.53. Among those who used CAM during treatment, non-smoking, overweight-obese participants had higher CACMAS scores (p < 0.05). CONCLUSION: Due to the high prevalence of CAM usage among cancer patients and possible interaction effects with chemotherapy medications, it is important for healthcare professionals to assess and educate cancer patients regarding CAM use. Additional research is needed to determine potential interactions, as well as pros and cons of CAM use during cancer treatment. [ABSTRACT FROM AUTHOR]

Background: Acupuncture is a promising treatment for common symptoms after traumatic brain injury (TBI). Our objectives were to explore knowledge, attitudes and beliefs about acupuncture, identify health service needs and assess the perceived feasibility of weekly acupuncture visits among individuals with TBI. Methods: We surveyed adults 18 years of age and older with TBI who received care at the University of Washington. Respondents were asked to complete 143 questions regarding acupuncture knowledge, attitudes and beliefs, injury-related symptoms and comorbidities, and to describe their interest in weekly acupuncture. Results: Respondents (n = 136) reported a high degree of knowledge about acupuncture as a component of Traditional Chinese Medicine, needle use and safety, but were less knowledgeable regarding that the fact that most conditions require multiple acupuncture treatments to achieve optimal therapeutic benefit. Respondents were comfortable talking with healthcare providers about acupuncture (63.4%), open to acupuncture concurrent with conventional treatments (80.6%) and identified lack of insurance coverage as a barrier (50.8%). Beliefs varied, but respondents were generally receptive to using acupuncture as therapy. Unsurprisingly, respondents with a history of acupuncture (n = 60) had more acupuncture knowledge than those without such a history (n = 66) and were more likely to pursue acupuncture without insurance (60%), for serious health conditions (63.3%) or alongside conventional medical therapy (85.0%). Half of all respondents expressed interest in participating in weekly acupuncture for up to 12 months and would expect almost a 50% improvement in symptoms by participating. Conclusion: Adults with TBI were receptive and interested in participating in weekly acupuncture to address health concerns. These results provide support for exploring the integration of acupuncture into the care of individuals with TBI. [ABSTRACT FROM AUTHOR]

Background: A significant number of women experience labour without effective pain management and thus suffer from unbearable labour pain to the extent they term labour as the most agonizing event in their lives. Unresolved labour pain can lead to stress, fear, and confusion, which may compromise placental perfusion and lead to birth asphyxia. Although various pharmacological and non-pharmacological labour pain management methods exist, the use of non-pharmacological methods (NPMs) to manage labour pain has remained low in low-resource settings. This paper explored the barriers for using NPMs to manage labour pain by nurse-midwives in eastern Tanzania. Methods: We conducted an exploratory qualitative study with 18 nurse-midwives purposefully recruited from the labour wards of two selected district hospitals in eastern Tanzania. Qualitative content analysis guided the data analysis. Results: Two categories illustrating barriers to using NPMs were generated: individual-level and institutional-level barriers. Individual-level barriers include (i) limited competencies of nurse-midwives on the use of NPMs for managing labour pain, (ii) inadequate exposure to labour pain management practices, (iii) misconceptions about labour pain relief, and (iv) a lack of opportunities for knowledge acquisition. The institutional barriers include (i) a critical staff shortage amidst many clients and (ii) an unfavourable healthcare facility environment. Conclusion: The implementation of NPMs for labour pain management by nurse-midwives in eastern Tanzania faces several institutional and individual barriers. We recommend addressing both supply- and demand-side barriers. Strengthening nurse midwives' competencies in NPMs adoption and use and improving the facility environment to ensure privacy during labour can be a starting point for addressing supply-side issues. We recommend dispelling myths and misconceptions through health promotion education to address demand-side barriers. [ABSTRACT FROM AUTHOR]

Background: Half of all patients with cancer use complementary medicine. Given the benefits and risks associated with complementary medicine use, contact between complementary medicine practitioners and conventional healthcare providers (oncologists, nurses) is important for monitoring the health and well-being of mutual patients with cancer. Research on occurrence of such interprofessional contact is scarce. This study aims to describe complementary medicine practitioners' experiences with contact with conventional healthcare providers about mutual patients with cancer and the importance they attach to patient disclosure of complementary medicine use to their conventional healthcare provider. Predictors for interprofessional contact are explored. Methods: An online survey was administered among complementary medicine practitioners who treat patients with cancer or cancer survivors and who are member of a professional association in the Netherlands. Results: The survey was completed by 1481 complementary medicine practitioners. 40% of the participants reported to have contact with conventional healthcare providers of patients with cancer. Only 13% of the complementary medicine practitioners experienced conventional healthcare providers as open to communication with them. An explorative logistic regression showed that openness of conventional healthcare providers as experienced by complementary medicine practitioners was the most important predictor for the occurrence of interprofessional contact (OR = 8.12, 95% CI 5.12–12.86, p <.001). Most complementary medicine practitioners (82%) considered it important that patients disclose complementary medicine use to their conventional healthcare provider and 49% of the participants always motivates their patients to do so. Conclusions: Interprofessional contact with conventional healthcare providers in oncology occurs but is not routine for most complementary medicine practitioners. More than one-third of the surveyed complementary medicine practitioners experienced conventional healthcare providers as not open to communication with them. The openness of conventional healthcare providers as experienced by complementary practitioners is an important predictor for interprofessional contact to take place. Most complementary practitioners acknowledge the importance of patient disclosure of complementary medicine use to their conventional healthcare provider. Open communication about the topic of complementary medicine use between complementary practitioners, conventional healthcare providers and patients prevents overlooking relevant medical information and facilitates optimal monitoring of health and safety of patients with cancer. [ABSTRACT FROM AUTHOR]

Real-world evidence on the association between natural medicinal products and the recurrence of sleep disorders is currently limited, particularly when compared to the evidence reported for prescription hypnotics. In a retrospective cohort analysis, we investigated patients with sleep disorders prescribed either the natural medicinal product Neurexan (Nx4), benzodiazepines, or nonbenzodiazepines (Z-drugs) using the IQVIA Disease Analyzer database, which encompasses electronic medical records nationwide in Germany. A 1:1 matching procedure based on age, sex, prevalent depression, anxiety or adjustment disorder, and the number of medical consultations in the past 12 months resulted in four cohorts: patients prescribed Nx4 were matched with those prescribed Z-drugs (two cohorts with 8594 matched patients each), and another cohort of patients prescribed Nx4 were matched with those prescribed benzodiazepines (7779 matched pairs). Results from multivariable-adjusted Cox regression models demonstrated that Nx4 was associated with a significantly lower risk of recurrent sleep disorder diagnosis within 30–365 days after prescription compared to both Z-drugs (HR = 0.65, 95%CI = 0.60–0.70, p < 0.001) and benzodiazepines (HR = 0.85, 95%CI = 0.79–0.93, p < 0.001). Additionally, Nx4 was associated with a lower prevalence of depression compared to Z-drugs (HR = 0.90, 95%CI = 0.83–0.98, p = 0.020) and benzodiazepines (HR = 0.89, 95%CI = 0.82–0.97, p = 0.009). These findings suggest an association between Nx4 and improved sleep and mental health outcomes. However, due to inherent limitations in the study design, the causality of this relationship cannot be stated. [ABSTRACT FROM AUTHOR]

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

Background: Ayush (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) system of medicine has been extensively used in India for the prevention and management of coronavirus disease 2019 (COVID-19). The present report is the second update of a living systematic review and meta-analysis and has been intended to assess the preventive potential and safety of Ayush drugs against COVID-19. Methods: A search of databases such as PubMed, the Cochrane central register of controlled trials, the World Health Organization (WHO) COVID-19 database, the clinical trial registry-India, the AYUSH research portal, and preprint repositories was performed till March 1, 2023. Randomized controlled trials or analytical observational studies were included. Incidences of COVID-19 infections and mortality were taken as primary outcome measures; and symptomatic severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection, incidences of hospital admissions, and adverse events were taken as secondary outcomes. The risk of bias was evaluated by version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB-2) and the Risk of Bias in Non-Randomized Studies-of Interventions (ROBINS-I) tool. Data were synthesized through the RevMan 5.4 tool, and the certainty of the evidence was ranked through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: Out of 2350 articles, 15 studies were included in the review. The pooled estimate of Guduchi [Tinospora cordifolia (Thunb.) Miers], Chyawanprasha, and Ayuraksha kit was obtained. Meta-analysis of the data suggested that Guduchi may reduce the incidences of COVID-19 infections (risk ratio [RR]: 0.67 [95% confidence interval, CI: 0.48–0.95]) and the symptom development among the infected (RR: 0.88 [95% CI: 0.73–1.08]), however, no change was observed in hospital admissions (RR: 0.96 [95% CI: 0.20–4.53]). It is uncertain that Chyawanprasha reduces the incidence of COVID-19 infection (RR: 0.28; [95% CI: 0.07–1.08]). Ayuraksha kit as chemoprophylaxis may reduce the incidences of COVID-19 infections (RR: 0.49; [95% CI: 0.32–0.77]). The certainty of the evidence was low to moderate mainly due to the serious risk of bias. Conclusion: Prophylactic use of Ayush medicines for populations at risk may help to prevent COVID-19 infection by reducing incidence and severity. However, considering the certainty and fewer studies, high-quality studies are still desired to confirm the efficacy and safety of Ayush chemoprophylaxis for COVID-19. Nevertheless, this update will serve as a torchbearer for policymakers, physicians, and other stakeholders for their decision-making through evidence-based medicine. [ABSTRACT FROM AUTHOR]

Introduction: Recent years have seen rapid changes to traditional, complementary, and integrative medicine (TCIM) practices in Australia associated with increased interest in TCIM during the COVID-19 pandemic and reorganization of practice delivery methods. This study aimed to update the understanding of the current TCIM workforce in Australia. Methods: Representatives of six TCIM professional organizations developed a survey for e-mail distribution to members. The anonymous online Qualtrics survey was based on previous surveys to identify workforce trends over time. Survey data were analyzed descriptively using Qualtrics and STATA statistical software (version 16). Results: Responses were recorded from 1921 participants. Respondents were predominantly female (79.7%); 71.8% were aged over 45 years. Remedial massage therapists represented 32.1% and naturopaths represented 23.7% of respondents. Highest qualifications were diplomas (37.7%), bachelor's degrees (28.9%), and advanced diplomas (21.8%). Metropolitan locations accounted for 68.1% of practices. Solo private practice was the main practice setting (59.8%); 13.8% practiced in group private practice with TCIM practitioners; and 10.6% practiced with allied health practitioners. Approximately three quarters of respondents (73.9%) saw 0–5 new clients per week; 42.2% had 0–5 follow-up consultations per week. Collaboration rates with TCIM practitioners, other non-TCIM practitioners, and general medical practitioners (GPs) were 68.7%, 24.4%, and 9.2%, respectively. A total of 93% did not suspect an adverse event from their treatment in the past year. Businesses of 75.9% of respondents were reportedly affected by the pandemic. Discussion: Comparisons with previous surveys show ongoing predominance of female practitioners, an aging workforce, a high proportion of remedial massage and naturopathy practitioners, and an increasingly qualified TCIM workforce. There was little change in the very low number of adverse events suspected by practitioners, number of consultations per week, and low levels of income of most TCIM practitioners compared with the average income in Australia. Respondents collaborated at similar rates as in the past; however, more with TCIM practitioners than with GPs. [ABSTRACT FROM AUTHOR]

Objective Vulvodynia is a chronic clinical condition characterized by provoked or non-provoked vulvar pain for at least 3 months of unknown etiology. The onset of vulvodynia involves a complex interplay of peripheral and central pain mechanisms, such as pelvic floor muscle and autonomic dysfunction, and interpersonal factors. A stepwise approach of pelvic floor physical therapy as medical management is suggested. In this scenario, by this meta-analysis of randomized controlled trials, we aimed to evaluate the efficacy of rehabilitation interventions in patients with vulvodynia. Methods On October 13, 2022, PubMed, Scopus, and Web of Science were systematically searched for randomized controlled trials that assessed the efficacy of the rehabilitative approach to pain during intercourse in patients with vulvodynia. The quality assessment was performed with the Cochrane risk-of-bias tool for randomized trials. The trial registration number is CRD42021257449. At the end of the search, 9 studies were included for a total of 332 patients. A pairwise meta-analysis was performed to highlight the efficacy of rehabilitative approaches for reducing pain during intercourse, as measured with a visual analog scale or a numerical rating scale. Results Meta-analysis showed that all these rehabilitative approaches had an overall effect size of −1.43 (95% CI = −2.69 to −0.17) in decreasing vulvodynia pain in terms of the visual analog scale. In the subgroup analysis, a significant effect size in acupuncture (effect size = −2.36; 95% CI = −3.83 to −0.89) and extracorporeal shockwave therapy (effect size = −2.94; 95% CI = −4.31 to −1.57; I2 = 58%) was observed. According to the Cochrane risk-of-bias tool, a low risk of bias for outcome selection in 89% of studies. Conclusion Findings from this meta-analysis suggested that the physical agent modalities and complementary medicine techniques in people with vulvodynia appear to be more effective than placebo, sham, or waiting list. Further evidence on physical agent modalities and complementary therapies are warranted in the future. Impact This was the first systematic review and meta-analysis of randomized controlled trials to provide evidence on the efficacy of rehabilitation interventions in patients with vulvodynia. [ABSTRACT FROM AUTHOR]

Fatigue, a common problem following a stroke, can have negative effects on a person's daily life. There are no good interventions thus far for alleviating fatigue among those affected. This review aimed to evaluate the effects of non-pharmacological interventions on fatigue among people with stroke. A search was conducted for articles in seven databases, clinical trial registry, and backward and forward citations of included publications. Randomized controlled trials, including feasibility and pilot trials, of non-pharmacological interventions for managing fatigue or promoting sleep or both in people with stroke were included. The standardized mean difference in scores for fatigue was analyzed using random effects models. Ten studies, with 806 participants, were analyzed. The identified interventions included physical interventions, cognitive interventions, a combination of physical and cognitive interventions, oxygen therapy, and complementary interventions. Non-pharmacological interventions had no significant immediate, short-term and medium-term effects on fatigue. The adverse effects of falls and arrhythmia were each found in one participant in circuit training. The risk of bias was high in all studies. The certainty of the evidence ranged from very low to low. The evidence in support of any non-pharmacological interventions for alleviating fatigue is still inconclusive in people with stroke. In view of the inadequacies of existing interventions and study designs, addressing the multidimensional characteristics of fatigue may be a possible direction in developing interventions. A robust study design with a larger sample size of people with stroke experiencing fatigue is required to evaluate the effects of interventions. [ABSTRACT FROM AUTHOR]

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is an underaddressed and distressing common side effect of cancer treatment. Effective management of CIPN merits a comprehensive team approach. Nurse navigators are in a unique position to provide education and support to people with CIPN and to advocate for treatment options. Objectives: To report on our experience in development and patient feedback of a CIPN clinical pathway with embedded patient education. We also report on the role of the nurse navigator in developing and implementing this project. Methods: We reviewed patient-reported outcome data to identify the incidence of CIPN in our gynecologic oncology patient population and developed a clinical pathway for management of CIPN. We also developed CIPN patient education materials and developed a process to deliver them to patients. We surveyed patients about their experience with CIPN and their satisfaction with their CIPN-related education. Results: Ten patients completed the satisfaction survey on CIPN education. Eight of 10 patients (80%) answered "Agree" or "Strongly agree" that the education was given in a timely manner. Eight of 10 patients (80%) answered that the education was easy to understand. Conclusion: Earlier identification of symptoms and awareness of resources, such as utilization of the CIPN pathway, can provide relief for people with CIPN and can minimize the effects of CIPN, leading to improved quality of life. The nurse navigator is uniquely positioned to impact the patient experience of CIPN. Next steps include evaluation of provider use of the pathway and continued tracking of patient-reported outcomes. [ABSTRACT FROM AUTHOR]

Objective: To assess the efficacy and safety of Bufei Jiedu (BFJD) ranules as adjuvant therapy for patients with multidrug-resistant pulmonary tuberculosis (MDR-PTB). Methods: A large-scale, multi-center, double-blinded, and randomized controlled trial was conducted in 18 sentinel hospitals in China from December 2012 to December 2016. A total of 312 MDR-PTB patients were randomly assigned to BFJD Granules or placebo groups (1:1) using a stratified randomization method, which both received the long-course chemotherapy regimen for 18 months (6 Am-Lfx-P-Z-Pto, 12 Lfx-P-Z-Pto). Meanwhile, patients in both groups also received BFJD Granules or placebo twice a day for a total of 18 months, respectively. The primary outcome was cure rate. The secondary outcomes included time to sputum-culture conversion, changes in lung cavities and quality of life (QoL) of patients. Adverse reactions were monitored during and after the trial. Results: A total of 216 cases completed the trial, 111 in the BFJD Granules group and 105 in the placebo group. BFJD Granules, as an adjuvant treatment, increased the cure rate by 13.6% at the end of treatment, compared with the placebo (58.4% vs. 44.8%, P=0.02), and accelerated the median time to sputum-culture conversion (5 months vs. 11 months). The cavity closure rate of the BFJD Granules group (50.6%, 43/85) was higher than that of the placebo group (32.1%, 26/81; P=0.02) in patients who completed the treatment. At the end of the intensive treatment, according to the 36-item Short Form, the BFJD Granules significantly improved physical functioning, general health, and vitality of patients relative to the placebo group (all P<0.01). Overall, the death rates in the two groups were not significantly different; 5.1% (8/156) in the BFJD Granules group and 2.6% (4/156) in the placebo group. Conclusions: Supplementing BFJD Granules with the long-course chemotherapy regimen significantly increased the cure rate and cavity closure rates, and rapidly improved QoL of patients with MDR-PTB (Registration No. ChiCTR-TRC-12002850) [ABSTRACT FROM AUTHOR]

This narrative review aims to summarize the use of alternative treatments (e.g., relaxation training, meditation, written intervention) for emotional expression, processing, control, or management in patients with migraine and tension-type headaches, which the previous literature has shown to be related to migraine pain perception and headache symptoms. Online databases including PubMed, Scopus, Web of Science, PsycINFO, and Medline were searched to identify studies published between 2000 and 2023. A descriptive synthesis of the included studies was conducted. We included seven articles after screening 1.173 records. A total of 610 patients with a diagnosis of migraine or tension-type headache, and an average age of 19–45.5 years (68–90.4% females) were recruited in the selected studies. Overall, the results show that alternative approaches to headache treatment contribute to the management, reduction, or control of negative emotions and at the same time have a positive impact on pain perception and headache symptoms. However, in some cases, the effects are more promising than others, depending on the peculiarities or limitations of each approach considered. This review provides useful insights from a methodological point of view for future studies on the management or control of negative emotions in patients with migraine and tension-type headache. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the role of psychological variables in medication adherence in OCD. Methods: This descriptive and correlational study was carried out at Tehran Institute of Psychiatry in Tehran. The statistical population of the present study includes all OCD patients referred to the Tehran Institute of Psychiatry. The participants were selected by available sampling method. The patients completed the demographic questionnaire, Yale Brown Obsessive-Compulsive Disorder Scale-Second Edition (Y-BOCS-II), Vancouver Obsessional Compulsive Inventory (VOCI), Medication Adherence Rating Scale (MARS), Drug Attitude Questionnaire (DAI-10), Multidimensional Scale of Perceived Special Support (MSPSS), Coping strategies scale of Lazarus and Folkman (WOCQ), and Temperament and Character Inventory (TCI). Multiple Linear Regression (MLR) was used to analyze the data. Results: The variable of education status (r=0.18) had a positive relationship and the variable of hospitalization history (r=-0.26) had a negative relationship with medication adherence. Medication adherence is only negatively associated with obsessive thoughts (r=-0.18, r=-0.20). Duration of drug use (r=0.27), attitude to treatment (r=0.25) and social support (r=0.54) had a positive relationship with medication adherence. Among the various dimensions of temperament and character, four dimensions of harm avoidance (r=-0.29), reward dependence (r=-0.44), persistence (r=-0.20) and self-transcendence (r=0.32) had a significant correlation with medication adherence. Variables of social support, reward dependence, persistence, harm avoidance and education status had the highest regression effect on medication adherence. Conclusion: Medication adherence is one of the behaviors that predicts successful treatment and reduces the negative side effects and severity of the OCD. [ABSTRACT FROM AUTHOR]

Individuals living with cancer and survivors of cancer who self-identify as Hispanic experience higher pain burden and greater barriers to pain management compared with their non-Hispanic counterparts. The Society for Integrative Oncology-ASCO guideline recommends acupuncture and massage for cancer pain management. However, Hispanic individuals' expectations about these modalities remain under-studied and highlight a potential barrier to treatment utilization in this population. We conducted a subgroup analysis of baseline data from two randomized clinical trials to evaluate ethnic differences in treatment expectations about integrative pain treatment modalities among Hispanic and non-Hispanic cancer patients and survivors of cancer. The Mao Expectancy of Treatment Effects (METE) instrument was used to measure treatment expectancy for electro-acupuncture, auricular acupuncture, and massage therapy. Results of this study demonstrated that Hispanic participants reported greater expectation of benefit from electroacupuncture, auricular acupuncture, and massage (all P < 0.01). After controlling for age, gender, race, and education, Hispanic ethnicity remained significantly associated with greater expectation of benefit from integrative therapies for pain (coef.=1.47, 95% CI, 0.67–2.27). Non-white race (coef.=1.04, 95% CI, 0.42–1.65), no college education (coef.=1.16, 95% CI, 0.59–1.74), and female gender (coef.=0.94, 95% CI, 0.38–1.50) were also associated with a greater expectation of benefit from integrative therapies. Pain management should be informed by a shared decision-making approach that aligns treatment expectancy with treatment selections to optimize outcomes. Compared with non-Hispanic participants, Hispanic individuals reported higher expectation of benefit from acupuncture and massage, highlighting the potential role for integrative therapies in addressing ethnic pain disparities. Trial Registration NCT02979574 NCT04095234. [ABSTRACT FROM AUTHOR]

This study focuses on the subjective well-being (SWB) of a sample of military veterans before and after their engagement with a nonclinical, alternative mental health therapies residential retreat in the United Kingdom. The study findings have relevance for trauma-exposed individuals globally. Military veterans will actively avoid seeking traditional mental health treatments due to factors such as stigma and life-long labels, as well as a reluctance to engage in talk therapies. This is despite the widespread occurrence of diagnosed and undiagnosed chronic mental health conditions such as posttraumatic stress disorder following periods of service. Moving beyond trauma-informed practice and embracing a healing-centered approach involving holistic therapies delivered during a retreat-type format has a positive impact on the SWB of service users. Positive changes in SWB were recorded using the Warwick–Edinburgh Mental Well-Being Scale and the lived experiences of the participants. A shared military identity contributes immeasurably to a veteran-centered approach to holistic therapy, healing, and recovery. [ABSTRACT FROM AUTHOR]

Background: Traditional medicine (TM) interventions are plausible therapeutic alternatives to conventional medical interventions against emerging and endemic zoonotic diseases, particularly in low-and middle-income countries that may lack resources and infrastructure. Despite the growing popularity in the usage of TM interventions, their clinical safety and effectiveness are still contested within conventional healthcare in many countries. Methods: We conducted a scoping review of the peer-reviewed literature that synthesises and maps the evidence on TM interventions for the treatment and prevention of zoonoses on the Indian subcontinent. The region, a global hotspot of biodiversity and emerging infections, is characterised by high prevalence of TM use. Based on the scientific literature (mostly case study research, n=l06 studies), our review (1) maps the scope of the literature, (2) synthesises the evidence on the application of TM interventions for zoonoses, and (3) critically reflects on the state of TM and identifies areas for future research focus. Results: The evidence synthesis confirmed widespread usage of TM interventions for zoonoses on the subcontinent, with the majority of research reported from India (n=99 studies, 93.4%), followed by Pakistan (n=3 studies, 2.8%), Bangladesh (n=2 studies, 1.9%), and Sri Lanka (n=1, 0.9%). Most of the reviewed studies reported on ethno-medicinal uses of plant species, primarily for treating dengue (n=20 studies), tuberculosis (n=18 studies), Escherichia coli infection (n=16 studies), lymphatic filariasis and cholera (n=9 apiece). However, the evidence on the safety and effectiveness of these reported TM interventions is limited, indicating that these data are rarely collected and/or shared within the peer-reviewed literature. Conclusion: This review thus highlights that, whilst TMs are already being used and could offer more widely accessible interventions against emerging and endemic zoonoses and ectoparasites, there is an urgent need for rigorous clinical testing and validation of the safety and effectiveness of these interventions. [ABSTRACT FROM AUTHOR]

We evaluated the long-term risks of overall cancer and all-cause mortality associated with five types of phytopharmaceuticals and the most commonly used estrogen-progestogen medications for the treatment of postmenopausal syndrome in women. Using data from Taiwan's National Health Insurance Research Database (NHIRD) from 1 January 2000 to 31 December 2018, we conducted a 1:2 matched cohort study with 12,087 eligible patients. We compared phytopharmaceuticals -only users (n = 4029, phytopharmaceuticals group) with HRT-only users (n = 8058, HRT group) with a washout period of ≥6 months. The phytopharmaceuticals group had significantly lower risks of overall cancer and all-cause mortality than the HRT group (adjusted hazard ratio [95% confidence interval]: 0.60 [0.40–0.9] and 0.40 [0.16–0.99], respectively) after over 180 days of use. Bupleurum and Peony Formula were associated with lower risks of overall cancer and all-cause mortality (aHR: 0.57 [0.36–0.92] and 0.33 [0.11–1.05], respectively). In conclusion, phytopharmaceuticals may serve as an alternative therapy to HRT for alleviating menopausal symptoms and reducing health risks, leading to more favorable long-term health outcomes. Further randomized control trials are necessary to validate the findings of this study. [ABSTRACT FROM AUTHOR]

Objective: The Integrative Health and Wellness Clinic (IHWC), established in 2019 at the San Francisco VA Health Care System, is an interdisciplinary clinic consisting of a medical provider, dietician, physical therapist, and psychologist trained in complementary and integrative health (CIH) following the VA Whole Health model of care. Veterans with complex chronic conditions seeking CIH and nonpharmacologic approaches are referred to the IHWC. This study evaluated the clinic's acceptability and feasibility among veteran patients and its preliminary impact on health and wellbeing, health-related goals, and use of CIH approaches. Methods: Mixed methods were used to assess patient-reported outcomes and experiences with the IHWC. Participants completed surveys administered at baseline and 6-months and a subset completed a qualitative interview. Pre- and post-scores were compared using t-tests and chi-square tests. Results: Thirty-five veterans completed baseline and 6-month follow up surveys. Of these, 13% were women; 24% < 50 years of age, and 44% identified as racial/ethnic minorities. Compared to baseline, at 6 months, there were significant (P <.05) improvements in overall health, physical health, perceived stress, and perceived helpfulness of clinicians in assisting with goal attainment; there was a trend toward improved mental health (P =.057). Interviews (n = 25) indicated satisfaction with the interdisciplinary clinical model, support of IHWC providers in goal attainment, and positive impact on physical and mental health. Areas for improvement included logistics related to scheduling of multiple IHWC providers and referrals to other CIH services. Conclusion: Results revealed significant improvement in important clinical domains and satisfaction with interprofessional IHWC clinic providers, but also opportunities to improve clinic processes and care coordination. An interdisciplinary clinic focused on CIH and Whole Health is a feasible and acceptable model of care for veterans with complex chronic health conditions in the VA healthcare system. [ABSTRACT FROM AUTHOR]

Background: Any illness places a significant burden on patients, including deterioration in quality of life. Animal assisted therapy may be helpful in the rehabilitation process and in the treatment of patients to alleviate this phenomenon. Methods: A randomized, controlled research was conducted in 2019 and 2020 in a rehabilitation center in Budapest. In our study, the control and experimental groups received the same therapy, but the rehabilitation treatment of the intervention group was complemented by dog therapy. Patients were evaluated by means of the short form Beck Depression Inventory, State-Trait Anxiety Inventory, Illness Intrusiveness Ratings Scale, Visual Analog Scale for pain and the WHO-5 Well-being Index. For statistical analysis paired T-test and ANCOVA was performed. Results: 58 participants in both groups took part in the research. Results confirm that both groups showed statistically significant improvement in all outcome measures, except for depression symptoms in dog therapy group. Quality of life of the participants improved significantly, their pain and anxiety levels were significantly reduced, they felt significantly less burdened by the disease in their daily lives. Therapeutic-dog sessions had a large effect on patients' quality of life and anxiety. Conclusions: There is a strong case for animal assisted therapy as a complementary therapy in the rehabilitation program, and it is proposed that consideration should be given to the application of this method on a larger scale within health care. The study was retrospectively registered at ISRCTN Registry (registration number: ISRCTN10208787) on 15/03/2022. [ABSTRACT FROM AUTHOR]

Background. A timely diagnosis of cancer is important for patient outcomes. The delay in the patient interval (time from symptom interpretation to seeking help) is often the longest throughout the cancer patient pathway. Factors extending this interval include vague symptom profiles increasing the difficulty of symptom appraisal and individual demographics influencing help‐seeking behaviours. An underexplored and potential source of delay in cancer diagnosis is associated with managing symptoms using self‐care activities prior to presentation to healthcare. Methods. This study aimed to characterise the use of self‐care activities in the context of managing nonspecific symptoms, prior to cancer diagnosis and their effect on the length of the patient interval. Eligible publications were identified using a rapid systematic review, and their qualitative self‐care data were extracted and analysed using thematic synthesis. Results. Forty‐five qualitative research papers between 2009 and 2024 were included in the final review. Self‐care was used as part of an iterative process, often resulting in delayed presentation to healthcare, if methods were effective in managing nonspecific symptoms. Across the literature, varying types of self‐care activities were reported across all cancers with nonspecific symptoms, including the use of over‐the‐counter or alternative medications, lifestyle changes, and watchful waiting. The individual's decision to self‐care was either prompted externally by a healthcare professional (HCP) (e.g., community pharmacists) or prompted by the individual depending on the availability of home remedies and medication. Patients used self‐care when there was a low perceived need to seek healthcare, to determine whether healthcare was required, or to avoid the use of healthcare. However, across the literature, there is limited evidence to understand the variation by cancer type, symptoms, and individual characteristics. Conclusions. The findings of this rapid review demonstrate that self‐care activities could hinder prompt help‐seeking and delay cancer diagnosis among people who are experiencing nonspecific cancer symptoms. However, more evidence is needed to understand which individual factors facilitate the adoption of self‐care behaviours over prompt help‐seeking for nonspecific cancer symptoms. [ABSTRACT FROM AUTHOR]

Objective: Patients with cancer often use complementary and alternative medication (CAM). This research aims to study the current attitude of healthcare professionals toward the use of CAM to improve current care. Methods: A questionnaire on both the current practice and opinions about CAM use was sent to healthcare professionals in Amsterdam UMC, who work for the department of hematology or oncology. Oncologists, hematologists, residents, (specialized) nurses, dieticians, (hospital)pharmacists, and pharmacy technicians were asked to participate in this study. Results: Among eligible healthcare professionals, 77 responded to the questionnaire (34%). Overall, 87% of healthcare professionals indicate it is important to be aware of their patient's CAM use, and all find the potential of drug–herb interactions important. However, more than half of the healthcare professionals inquire about the patient's CAM use infrequently. In addition, only 15% of the healthcare professionals stated they had sufficient knowledge of CAM to advise patients on their use of CAM. Conclusions: Healthcare professionals are aware of the potential risks of CAM use in combination with anti-cancer treatment. However, CAM use is not yet discussed with every patient. This may be due to healthcare professionals' lack of knowledge about CAM. [ABSTRACT FROM AUTHOR]

Simple Summary: The recent approval of [177Lu]Lu-prostate-specific membrane antigen (PSMA) for managing metastatic castration-resistant prostate cancer (mCRPC) has catalyzed the innovation of various PSMA-targeted radiopharmaceuticals. In our retrospective study, we explored both safety and efficacy of two beta-emitting PSMA radioligands, [177Lu]Lu and [161Tb]Tb, for mCRPC therapy. Our study included 53 patients and reinforced prior evidence validating the clinical safety and efficacy of these radioligands. Our research suggested that these treatments are characterized by a favorable safety profile with negligible toxicity. Moreover, [161Tb]Tb-PSMA recipients, though trialed in a smaller patient sample, yielded concordant outcomes on par with those receiving [177Lu]Lu-PSMA, highlighting its promise as an alternative therapy and warrants additional investigation. The objective of this retrospective study is to assess the effectiveness and safety of two beta-emitting prostate-specific membrane antigen (PSMA) radioligands, [177Lu]Lu and [161Tb]Tb, in heavily treated patients with metastatic castration-resistant prostate cancer (mCRPC). A total of 148 cycles of beta-emitting PSMA radioligand therapy were given to 53 patients at a specialized cancer care center in Amman, Jordan. This treatment was offered following the exhaustion of all prior treatment modalities. Approximately half of the cases (n = 26) demonstrated an initial partial response to PSMA radioligand therapy. Moreover, roughly one-fourth of the patients (n = 13) exhibited a sustained satisfactory biochemical response, which qualified them to receive a total of six PSMA radioligand therapy cycles and maintain continued follow-up for additional treatment cycles. This was reflected by an adequate prostate-specific antigen (PSA) decline and a concomitant partial response evident on [68Ga]Ga-PSMA positron emission tomography/computed tomography imaging. A minority of patients (n= 18; 34%) experienced side effects. Generally, these were low-grade and self-limiting toxicities. This study endorses previous research evidence about PSMA radioligand therapy's safety and efficacy. It also provides the first clinical insight from patients of Arab ethnicity. This should facilitate and promote further evidence, both regionally and internationally. [ABSTRACT FROM AUTHOR]

Background: Sleep disturbance is highly prevalent among post‐operative cardiac patients, with negative impacts on surgical recovery and rehabilitation. Post‐operative pain and anxiety commonly seen in cardiac surgery patients are associated with poor sleep. Sleep medications commonly used are not ideal with prolonged usage, and non‐pharmacological interventions can be good alternatives or complements. Aim: To examine effectiveness of non‐pharmacological interventions in post‐operative cardiac settings on sleep quality, pain intensity and anxiety. Design: Systematic review and meta‐analysis. Methods: PubMed, CENTRAL, Embase, CINAHL, Scopus, CNKI and ProQuest Dissertations and Theses were searched on 12 October 2022. Randomised controlled trials of non‐pharmacological interventions examining sleep quality for adult post‐operative cardiac patients were included. Included studies were appraised using Cochrane Risk of Bias tool version 1. Meta‐analysis was conducted using RevMan version 5.4.1, and heterogeneity was assessed using I2 statistics and Cochran Q's test. Results: Eighteen studies involving 1701 participants were identified. Coronary artery bypass graft was most common. Non‐pharmacological interventions varied in types and duration. All intervention groups were compared to usual care, placebo, no interventions or active comparators. Statistically significant improvement in sleep quality (SMD = −.91, 95% CI = −1.17 to −.65) was found among intervention groups that explored cognitive behavioural therapy, relaxation techniques, exercise, massage, acupressure, aromatherapy, music, eye mask and earplugs. Pain intensity was reduced (SMD = −.63, 95% CI = −1.05 to −.20) with cognitive behavioural therapy, relaxation techniques, massage, music and eye mask. Anxiety was improved (SMD = −.21, 95% CI = −.38 to −.04) with exercise and music. Conclusion: The overall use of non‐pharmacological interventions can optimise sleep after cardiac surgery. Further research with greater methodological rigour is needed to investigate different intervention‐related characteristics while considering potential confounders. Relevance to Clinical Practice: Post‐operative cardiac settings can consider incorporating non‐pharmacological interventions. Patients and healthcare providers can be better informed about the use of such interventions to improve sleep. Registration: PROSPERO CRD42022384991. [ABSTRACT FROM AUTHOR]

Objective: The relationship between chronic pain and complementary and alternative medicine (CAM) use is poorly understood, and the situation in rural Australia is particularly unclear. The objective here was to determine the socio‐demographic factors associated with the use of CAM for the treatment of chronic pain in a region of rural Australia. Methods: This secondary analysis used data from a population health survey, Crossroads‐II, to assess the relationships of various socio‐demographic factors with the use of CAM by those suffering from chronic pain. Design: Face‐to‐face surveys at households randomly selected from residential address lists. Setting: A large regional centre and three nearby rural towns in northern Victoria, Australia. Participants: Sixteen years of age and older. Main Outcome Measures: Use of a CAM service to treat chronic pain. Results: Being female (2.40 [1.47, 3.93], p < 0.001) and having a bachelorʼs degree (OR 2.24 [1.20, 4.20], p < 0.001) had a significant positive relationship with the use of CAM overall to redress chronic pain and those 50 years and older had greater odds of using manipulation therapies relative to those below 50 years (50–64: OR 0.52 [0.32, 0.86], p = 0.010; 65+: 0.37 [0.18, 0.75], p = 0.005). Conclusion: In the studied region, females and those with university education have the greatest odds of using CAM to treat chronic pain. This study needs to be complemented with more mechanistic investigations into the reasons people make the decisions they make about using CAM for the management of chronic pain. [ABSTRACT FROM AUTHOR]

The primary goal of holistic nursing research is to develop and expand the knowledge base of holism and healing for nursing praxis. This article provides an overview of the process used to identify the research priorities for holistic nursing research over the next 3 to 5 years. A mixed method design using Appreciative Inquiry and surveys revealed five research priorities and the holistic philosophical foundation for these priorities. Additionally, new challenges in the environment, person, health, and nursing will undoubtedly emerge, requiring nurses to discern the research needs beyond 2026. This work seeks to inspire holistic nurses to consider research related to the American Holistic Nurses Association's five key research priorities. [ABSTRACT FROM AUTHOR]

Chronic diseases such as type 2 diabetes mellitus (T2DM), arterial hypertension (HTN), and obesity are significant global health challenges, contributing to millions of premature deaths. In Mexico, these pose major challenges due to limited access to healthcare and inadequate primary care quality. Complementary medicine presents itself as an adjuvant in this context, offering minimally invasive techniques to enhance physical, mental, and spiritual well-being. However, effective treatment adherence is crucial for positive outcomes, influenced by self-efficacy, resulting in persistently low adherence rates—a pressing public health concern. This observational study aimed to explore how perceptions of complementary medicine and treatment adherence predict self-efficacy among individuals with chronic diseases in Mexico. Data were collected from 113 participants with chronic conditions, including T2DM, HTN, and obesity. Participants completed surveys assessing perception of complementary medicine, treatment adherence, and self-efficacy. Statistical analyses, including correlations and regression, were conducted to examine the relationships between variables. The study revealed significant correlations between the perception of complementary medicine, treatment adherence, and self-efficacy. Treatment adherence was positively associated with self-efficacy, while perception of holistic medicine was negatively correlated with self-efficacy. Perception of complementary medicine and adherence to treatment were found to predict 41.9% (p = 0.001) self-efficacy. These findings underscore the potential of complementary therapies in enhancing self-efficacy levels, and highlight the importance of holistic healthcare approaches in managing chronic conditions. Further research is needed to better understand these relationships and their implications for healthcare outcomes in Mexico and beyond. [ABSTRACT FROM AUTHOR]

Background: Previous researches conducted in both developed and developing countries have demonstrated a rising trend in the utilization of complementary and alternative medicine. The World Health Organization has underscored the importance of studying the prevalence and determinants of such alternative practices. This study delves into the knowledge, attitudes, and practices of Iranian adults towards Persian medicine, a distinct form of complementary and alternative medicine, through a national survey for the first time. Methods: A total of 2882 Iranian adults (aged ≥ 15 years) were randomly chosen from all regions. Data were gathered through structured door-to-door interviews using a survey questionnaire, wherein cases were selected randomly based on postal codes, and interviewers completed the forms at the participants' residences. Results: Approximately 46% of the subjects exhibited familiarity with Persian Medicine. The study revealed that the primary sources of knowledge about Persian Medicine were family, relatives, and friends, with only 2.9% indicating medical staff as their source of information. Furthermore, the study indicated that 21% of participants expressed a strong interest in using Persian Medicine, while 30.3% did not. When comparing Persian medicine to modern medicine, respondents indicated that Persian medicine is more cost-effective and has fewer side effects, yet modern medicine is more widely used globally; although, the majority responded "I don't know" to other questions. The results also demonstrated that approximately 37% of the participants had a history of Persian Medicine utilization in their lifetime. Conclusion: This study revealed that Iranian adults have low reliable knowledge (from medical staff, Persian medicine books and other publications) and limited familiarity with Persian medicine, with about one third of the participants expressing disinterest (attitude) and over half of them having not utilized this form of medicine (practice). [ABSTRACT FROM AUTHOR]

Objective: The non-motor symptoms of Parkinson's disease (PD) are an important part of PD. In recent years, more and more non-drug interventions have been applied to alleviate the non-motor symptoms of PD, but the relevant evidence is limited. This systematic review and meta-analysis was designed to evaluate the efficacy of non-drug interventions in patients with non-motor symptoms in patients with PD. Methods: Seven databases, including Pubmed, Embease, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang database (WANFANG), VIP database (VIP), and China Biomedical Literature Service System (CBM) were searched from the establishment of the database to December 2023. Non-drug interventions such as acupuncture, cognitive behavioral therapy (CBT), exercise, repetitive transcranial magnetic stimulation (rTMS), and non-motor symptoms of Parkinson's disease were selected as search words, and two independent evaluators evaluated the included literature's bias risk and data extraction. The therapeutic efficacy was evaluated by the Parkinson's Disease Sleep Scale (PDSS), Hamilton Depression Scale (HAMD), Beck Depression Inventory (BDI), Hamilton Anxiety Scale (HAMA), Montreal Cognitive Assessment (MoCA), Minimum Mental State Examination (MMSE), and Parkinson's Disease Questionnaire-39 (PDQ-39). RevMan 5.4.1 (Reviewer Manager Software 5.4.1). Cochrane Collaboration, Oxford, United Kingdom analyzed the data and estimated the average effect and the 95% confidence interval (CI). A heterogeneity test is used to assess differences in the efficacy of different non-drug treatments. Results: We selected 36 from 4,027 articles to participate in this meta-analysis, involving 2,158 participants. Our combined results show that: PDSS: [mean difference (MD) =-19.35, 95% CI (-30.4 to -8.28), p<0.0006]; HAMD: [MD = -2.98, 95% CI (-4.29 to -1.67), p<0.00001]; BDI: [MD = -2.69, 95% CI (-4.24 to 4.80), p = 0.006]; HAMA: [MD=-2.00, 95% CI (-2.83 to -1.17), p<0.00001]; MMSE: [MD = 1.20, 95% CI (0.71 to 1.68), p< 0.00001]; CoMA: [MD = 2.10, 95% CI (-0.97 to 3.23), p = 0.0003]; PDQ-39: [MD = -4.03, 95% CI (-5.96 to -1.57), p < 0.00001]. Conclusion: The four non-drug measures used in our review showed significant improvements in sleep, depression, anxiety, cognition, constipation, and quality of life compared with the control group, and no serious adverse events were reported in the included research evidence, and we found that there were some differences among the subgroups of different intervention methods, but due to the less literature included in the subgroup, and the comparison was more indirect. So, we should interpret these results carefully. [ABSTRACT FROM AUTHOR]

Background: Healthcare workers are currently making efforts to offer services that cater to the holistic care needs of their patients. Previous studies have shown that some healthcare workers encounter challenges when advising patients about Complementary and Alternative Medicine (CAM), even though its use is widespread. Many health care workers may not have received formal education or training in CAM and consequently are unable to address their patients' questions about it. This study explored the knowledge, perception, attitude and practice of CAM by healthcare workers in Garki Hospital, Abuja, Nigeria. Methods: This was an institution-based cross-sectional study, design and a convergent parallel, mixed methods design was used for data collection. Five (5) healthcare workers were purposively selected as participants for the key informant interviews, while two hundred and fifty (250) selected using a simple random sampling method completed the questionnaire. The data collection instruments used were a key informant interview guide and a 35-item self-administered questionnaire. Knowledge was assessed with a 4-item scale with a maximum score of 8. Perceptions and attitudes were assessed using Likert scales with a maximum score of 45 and 20, respectively. Practice was assessed with a 6-item scale with a maximum score of 18. Qualitative data was analysed using framework analysis. Quantitative data was analysed using descriptive and inferential statistics. Data acquired from both methods were integrated to form the findings. Results: The average age of respondents for the quantitative study was 34.0 ± 7.8 years, and they were predominantly females (61.2%) with one to ten years of work experience (68.8%). The mean knowledge, perception and attitude scores were 1.94 ± 1.39, 13.08 ± 2.34 and 32.68 ± 6.28, respectively. Multiple linear regression result showed that knowledge (t = 2.025, p = 0.044) and attitude (t = 5.961, p = 0.000) had statistically significant effects on the practice of CAM. Qualitative data revealed that the majority of the participants perceive CAM favourably, provided it is properly introduced into mainstream medicine with evidence of safety and research to prove its efficacy. Conclusion: The study has shown the gaps in knowledge and the practices of CAM by conventional medical practitioners. This has implications for their ability to counsel and refer patients who may require CAM therapies. Policy, research and programmatic initiatives that seek to enhance their knowledge of CAM, and improve collaboration with CAM practitioners are recommended. [ABSTRACT FROM AUTHOR]

Background: Supine percutaneous nephrolithotomy (s-PCNL) offers great benefits from urological and anaesthetic points of view. We present the first evaluation of the outcomes of s-PCNL in Malaysia. Our aim was to explore the safety and efficacy of s-PCNL. Methods: Institutional review board approval was obtained from the National Medical Research Register (NMRR ID-21002225-WLP). We retrospectively reviewed 115 patients with renal pelvis stones who underwent single renal access during s-PCNL between November 2020 and May 2023. Patients who underwent simultaneous ipsilateral or contralateral endourological procedures were included. The data were analysed to determine stone-free rates (SFR), major complication rates, blood transfusion rates, operative times and lengths of hospital stay (LOS). Results: The SFR was higher for the single middle calyceal renal access (MCA) group than for the lower calyceal renal access (LCA) or upper calyceal renal access (UCA) groups (OR: 1.76; 95% confidence interval [CI]: 0.63, 4.92). In total, 0, 1 and 2 patients had major complications in the UCA, MCA and LCA groups, respectively (P = 0.453). One of the 115 patients (0.9%) needed blood transfusion. Subgroup analysis revealed mean operative times of 76.3 min and 78.6 min for patients who underwent sole s-PCNL (PCNL-only group) and those who had simultaneous ipsilateral and contralateral endourological procedures (PCNL-plus group), respectively (P = 0.786). The overall mean LOS was 2.9 days. Conclusion: s-PCNL is a safe and effective alternative treatment for renal stones. We would recommend s-PCNL for patients who require an ipsilateral/contralateral endourological procedure (URS/RIRS) because it is time-efficient. All renal accesses are safe. Single MCA is recommended for complete stone clearance. [ABSTRACT FROM AUTHOR]

Background: For elderly people with chronic lower back pain who need long-term management, there is a need for a nursing intervention study that is effective, is easy to perform, and applies complementary and alternative therapies to manage pain without repulsion. Hand pressure therapy is a treatment indigenous to Korea used to reduce pain and improve functions of daily life by applying acupuncture, pressure sticks, and moxibustion to parts of the hand as they relate to parts of the body. This research is to identify the effects of pellet pressed on the hand on pain and the daily lives of elders with chronic lower back pain (CLBP). Methods: The hand pressed-pellet intervention period was six weeks long. Twenty-seven patients in the intervention group and twenty-four patients in the placebo control group were recruited from elderly over sixty-five who used welfare centers. In the intervention group, hand pressed-pellet therapy was conducted in eleven acupressure response zones related to CLBP, and the placebo control group was provided with similar therapy and zones, but unrelated to CLBP. The research tool measured the intensity of CLBP using the Visual Analogue Scale (VAS), the Korean Owestry Disability Index (K-ODI), which are subjective indicators, and the Compact Digital Algometer, which is an objective indicator. Result: The pain intensity (VAS) measured after six weeks of hand pressed-pellet therapy showed significant difference between the two groups compared to their pain before the experiment (F = 60.522, p <.001). There was a significant difference between the two groups in the pain pressure threshold using pressure statistics (F = 8.940, p <.001), and in CLBP dysfunction evaluation index (K-ODI) after applying pressed pellet to the hand (Z = − 3.540, p <.001). Conclusion: Subjective indicators were measured to verify the effect of hand pressed-pellet therapy on CLBP, and the result confirmed that the hand pressed-pellet therapy was effective in alleviating CLBP. Trial registration: The study was registered retrospectively with reference number KCT0008024 on 23/12/2022. [ABSTRACT FROM AUTHOR]

Copyright of Health Bulletin / Zdravstveni Glasnik is the property of Faculty of Health Studies, University of Mostar and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of General Health Sciences (JGEHES) is the property of Journal of General Health Sciences (JGEHES) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Raspberry leaf use during pregnancy in Australia is widespread. There has been little research exploring the potential beneficial or harmful effects of raspberry leaf on pregnancy, labour, and birth. More research is needed to appropriately inform childbearing women and maternity healthcare professionals on the effects of raspberry leaf so that women can make informed choices. Methods: This study aimed to determine associations between raspberry leaf use in pregnancy and augmentation of labour and other secondary outcomes. Data was derived from questionnaires which captured demographic information and herbal use in pregnancy. Clinical outcomes were accessed from the maternity services' clinical database. Data analysis was conducted in R via package 'brms' an implementation for Bayesian regression models. Results: A total of 91 completed records were obtained, 44 exposed to raspberry leaf and 47, not exposed. A smaller proportion of women in the raspberry leaf cohort had augmentation of labour, epidural anaesthesia, instrumental births, caesarean section, and postpartum haemorrhage. A larger proportion had vaginal birth and length of all phases of labour were shorter. Under these conditions the use of raspberry leaf was strongly predictive of women not having their labours medically augmented. Conclusions: While our study demonstrated that raspberry leaf was strongly predictive of women not having their labours medically augmented, the results cannot be relied on or generalised to the wider population of pregnant women. While there were no safety concerns observed in our study, this should not be taken as evidence that raspberry leaf is safe. A randomised controlled trial is urgently needed to provide women and healthcare providers with robust evidence on which to base practice. [ABSTRACT FROM AUTHOR]

While previous reports have established the anti-inflammatory effects of hangeshashinto, the intracellular signal transduction pathways involved have yet to be elucidated. We aim to employ an experimental system using oral cancer cells to assess the impact of hangeshashinto on intracellular signal transduction pathways in response to stimulation by Porphyromonas gingivalis pathogen-associated molecular patterns (PAMP). Hangeshashinto demonstrated the ability to inhibit the production of interleukin (IL)-6 and IL-8 induced by P. gingivalis PAMP. Furthermore, hangeshashinto suppressed the activation of the IL-6 promoter stimulated by PAMP. Hangeshashinto, like Toll-like receptor (TLR) signaling inhibitors (resatorvid and C29) and an immunosuppressant (dexamethasone), exhibited the ability to suppress TLR-mediated activation of the transcription factor nuclear factor-κB (NF-κB) in response to PAMP stimulation. This study suggests that the anti-inflammatory effects of hangeshashinto may be attributed to the inhibition of TLR signal transduction pathways including NF-κB activation, thereby suppressing NF-κB-dependent gene expression. [ABSTRACT FROM AUTHOR]