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Although athletics participation provides benefits that can be protective for mental health, stressors unique to athletics are present. This article reviews the frequency and symptoms of the most common mental health concerns impacting collegiate student-athletes. Treatment approaches and best practices are discussed. The importance of prioritizing mental health and well-being at all levels within the university and athletics department by reducing stigma and providing access to providers is emphasized. Multidisciplinary treatment teams and coordination of care provides a holistic approach that ensures student-athletes are able to optimize their personal, social, academic, and athletic goals. [ABSTRACT FROM AUTHOR]

Objectives: To describe and contrast the prevalence and trends of sick leave in patients with pain or stress disorders referred to inpatient care that integrates conventional and complementary therapies, that is, integrative care (IC). Methods: County council and social insurance data were used to retrospectively observe cross-sectional sick leave prevalence at four time points: 1 year before the first registered inpatient visit with the target diagnosis, after referral at index, and at 1 and 2 years after index. To contrast the IC findings, observations of patients with similar background characteristics referred to conventional care (CC) were used. Results: The sick leave prevalence of IC pain patients and IC stress patients increased from the preceding year to peak at index, where after it decreased back toward preindex levels over 2 years. Overall sick leave prevalence was higher in IC than in CC, where analogous but lower prevalence trends of sick leave changes were observed. Conclusions: Observed sick leave prevalences, which were higher in IC than in CC, gradually decreased over time following IC or CC referral. While natural recovery or other reasons for change of sick leave cannot be excluded, future prospective and randomized clinical trials are recommended. [ABSTRACT FROM AUTHOR]

While the biopsychosocial nature of inflammatory bowel disease (IBD) is now well accepted by clinicians, the need for integrated multidisciplinary care is not always clear to institutional administrators who serve as decision makers regarding resources provided to clinical programs. In this commentary, we draw on our own experience in building successful integrated care models within a division of pediatric gastroenterology (GI) to highlight key considerations in garnering initial approval, as well as methods to maintain institutional support over time. Specifically, we discuss the importance of making a strong case for the inclusion of a psychologist in pediatric IBD care, justifying an integrated model for delivering care, and addressing finances at the program level. Further, we review the benefit of collecting and reporting program data to support the existing literature and/or theoretical projections, demonstrate outcomes, and build alternative value streams recognized by the institution (e.g., academic, reputation) alongside the value to patients. Ultimately, success in garnering and maintaining institutional support necessitates moving from the theoretical to the practical, while continually framing discussion for a nonclinical/administrative audience. While the process can be time-consuming, ultimately it is worth the effort, enhancing the care experience for both patients and clinicians.

Integrative palliative care is the early intervention of palliative medicine for the patients with serious illness,jointly providing care with the patients' primary care team.By literature review and real-life experience study,we conclude that the integrative palliative care can make effective use of existing healthcare resources and provide the original treatment team with palliative medical technical support,thereby improving the patients' quality of life.The healthcare institutions need to choose an appropriate care model on the basis of evaluating its own strengths and weaknesses.The palliative care team needs to establish a long-term and sustainable relationship with each department in the hospital to provide patients with a safer and more effective medical experience.

Purpose: Purpose of this paper is to describe the project design for the development of a context-specific and patient-focused integrative care programme for an intensive care unit for paediatric oncology to ease the strain of the treatments for patients and their families. Integrative care interventions based on anthroposophical medicine such as wraps, compresses and rhythmic body oiling can be used to ease typical side effects such as nausea, pain and agitation.Methods: Conduct of a literature research on existing integrative care programmes in medical hospitals and biomedical settings and the identification of appropriate methods to achieve the research aim.Results: A project design was developed which can be used as a basis for developing, introducing and evaluating an integrative care programme for a paediatric oncological intensive care unit in a German university hospital. A qualitative study design was chosen to develop this programme. This included participant observations and interviews with all stakeholders at the respective oncology ward as well as in existing oncology wards that work with an integrative care programme. The primary emphasis was on the criteria appropriateness for the specific setting, sustainability and financial viability as well as on the development of an appropriate evaluation model.Conclusions: When developing an integrative care programme for use in the specific setting of a paediatric oncology ward and selecting the appropriate interventions for inclusion in the programme, particular attention should be paid to the needs of the patients as well as to the practicability for the nursing staff, particularly with regard to resources such as time and personnel. Both the nursing team and nursing management should be actively involved in the project design from the outset. In the evaluation particular importance is attached to feasibility. The challenge for the economic evaluation is to create a robust database for negotiation of financing possibilities. [ABSTRACT FROM AUTHOR]

Abstract Introduction The use of Complementary and Alternative Medicine (CAM) among cancer patients in Saudi Arabia is an emerging subject in the field of healthcare. This study aimed to examine the dynamics between perspectives of cancer patients and healthcare professionals in tertiary hospitals that do not provide CAM. Method Qualitative interviews were undertaken with 38 cancer patients and 30 healthcare professionals. After familiarization with the data, results were analysed using interpretation, categorizing and thematic analysis. Results The analysis suggests that CAM is highly popular among cancer patients. All the cancer patient respondents used at least one type of CAM as an adjunct to conventional medical treatments. These patients affirmed their understanding that CAM originates from a non-biomedical healthcare model. Patients desired CAM treatments and frequently questioned why CAM was not made available alongside conventional medicine. In contrast, the data showed that healthcare professionals were concerned about the implications of mixing CAM, in the form of cultural interventions provided by nonprofessional healers, with biomedicine. Doctors, in particular, were less willing to establish policies or to follow guidelines regarding the integration of CAM into cancer treatment and care. Conclusion The impacts of cancer are not confined to physical realms. Cancer creates a medical crisis that affects a patient's mind, spirit and lifestyle. This research suggests that, in Saudi Arabia, cancer should be understood not only in biomedical terms but in light of cultural beliefs about disease aetiology and the contingent need for culturally-appropriate supportive CAM treatments. The application of conventional medicine alone does not appear to adequately address cancer patients' expressed needs. The authors concluded that healthcare professionals in Saudi Arabia should be prepared to discuss with patients their perceived benefits of CAM as an integral element of their patient-centred care. [ABSTRACT FROM AUTHOR]

Objectives: This study evaluated the change in the concerns, wellbeing, and lifestyle behaviors of informal caregivers of people with cancer attending Penny Brohn UK's Living Well Course (LWC), a self-management education intervention. Design: A pre–postcourse design collected self-reported quantitative and qualitative data from informal caregivers attending a LWC. Setting/Location: Penny Brohn UK is a United Kingdom-based charity (not-for-profit) providing specialist integrative, whole person support, free of charge, to people affected by cancer. Subjects: Informal caregivers taking part in a Penny Brohn UK LWC between June 2014 and May 2016 attending alongside the person with cancer. Intervention: The LWC is a structured 15 h, multimodal group self-management educational course, designed to help people affected by cancer learn tools and techniques to help build resilience. Trained facilitators deliver LWCs to around 12 people with various types and stages of cancer and their informal caregivers. Outcome measures: Measure Yourself Concern and Wellbeing (MYCaW) completed precourse and at 6 weeks postcourse; and bespoke 6-week follow-up Patient Reported Experience Measure. Results: Four hundred eighty informal caregivers attended a LWC June 2014 to May 2016. One hundred eighteen completed a 6-week follow-up MYCaW: MYCaW Concerns 1 and 2 showed statistically significant improvements (p < 0.0001), there was no significant improvement in wellbeing. Informal caregivers' most reported concerns relating to themselves were psychological and emotional issues (59%). The primary concern of the caregiver for the care recipient was related to the physical health of the person with cancer (40%). Eighty-seven percent of responding informal caregivers stated that the LWC enabled health self-management. Conclusions: The LWC was followed by an improvement in informal caregivers' concerns, and increased self-management of their own health needs. More studies, with larger sample size, are needed to explore if better self-management by informal caregivers may also lead to improvements in patients' health and wellbeing. [ABSTRACT FROM AUTHOR]

• Women remain in a hypoestrogenic state for approximately one-third of their lives. • This affects overall health and specifically bone health. • In this setting, sequential treatment should be designed to account for agonist effects on bone as well as other health effects. • We summarize the approaches to the sequential management of osteoporosis. • The order of implementation of therapeutic interventions should be carefully tailored to each patient. Increased life expectancy means that women are now in a hypoestrogenic state for approximately one-third of their lives. Overall health and specifically bone health during this period evolves in accordance with aging and successive exposure to various risk factors. In this review, we provide a summary of the approaches to the sequential management of osteoporosis within an integrative model of care to offer physicians a useful tool to facilitate therapeutic decision-making. Current evidence suggests that pharmacologic agents should be selected based on the risk of fractures, which does not always correlate with age. Due to their effect on bone turnover and on other hormone-regulated phenomena, such as hot flushes or breast cancer risk, we position hormone therapy and selective estrogen receptor modulators as an early postmenopause intervention for the management of postmenopausal osteoporosis. When the use of these agents is not possible, compelling evidence supports antiresorptive agents as first-line treatment of postmenopausal osteoporosis in many clinical scenarios, with digestive conditions, kidney function, readiness for compliance, or patient preferences playing a role in choosing between bisphosphonates or denosumab during this period. For patients at high risk of osteoporotic fracture, the "anabolic first" approach reduces that risk. The effect on bone health with these bone-forming agents or with denosumab should be consolidated with the subsequent use of antiresorptive agents. Regardless of the strategy, follow-up and treatment should be maintained indefinitely to help prevent fractures. [ABSTRACT FROM AUTHOR]

Understanding how best to manage the complex healthcare needs of hospitalised, mostly multimorbid medical patients is an international priority. Healthcare should be effective, safe and provide high quality at a reasonable cost. However, basic logistic and organisational issues of medical ward-based care have received less attention than the medical treatment of specific pathologies. Consequently, we still use old-fashioned care and transition procedures for medical inpatients. This contrasts with dynamic developments in other, non-healthcare industries, where process optimisation is a major part of innovation. Promising new approaches to better align healthcare needs of hospitalised medical patients from clinical trials will help to advance the field significantly. Healthcare costs attributable to the aging, multimorbid population are rising worldwide. One cost driver is the high resource use of in-hospital treatment. In view of the expected demographic evolution of an aging population, better resource allocation is important. As in other countries, the Swiss healthcare system is in the midst of transformation aiming to improve health outcomes of patients at an affordable cost. One important area of redesign is identifying the best setting for diagnosis, treatment and management of acute medical conditions with a shift of in-hospital to outpatient care. Also, safely reducing in-hospital length of stay of inpatient treatment is important, because inpatient care accounts for the largest share of total Swiss healthcare costs. Integration of new technology into these processes holds promises for optimisation. Use of electronic health record-based tools has resulted in improved patient care and patient transitions. But evidence from clinical studies regarding the effect of inter-professional team care interventions on patient relevant outcomes, including activity of daily living, mortality and length of hospital stay, are inconsistent. Thus, there is room for improvement and a need for high quality trials providing evidence on how best to combine technology with innovative transition models for an ameliorated care of medical inpatients. We review in narrative form different transition interventions that have been evaluated for improved medical inpatient care and highlight important patient-centred outcome measures that were investigated. Further, we discuss a novel patient-management tool (In-HospiTOOL), which is currently being evaluated in an ongoing large Swiss multicentre study.

Introduction Despite widespread use, there remains a paucity of research exploring cancer patients’ experiences of receiving complementary therapy treatment. We wanted to gain insight into the experiences of patients using a complementary therapy outpatient service offering aromatherapy, massage, reflexology and Reiki. At this London Cancer Centre, therapies are offered to patients as a self-referral service as part of their treatment pathway at any stage of treatment or follow up. Methods New patients (n = 96) attending the outpatient complementary therapy service for the first time were asked about their main concerns. The MyCaW (Measure your concerns and wellbeing) evaluation tool was used to collect data. Follow up MyCaW data from these patients was also collected after 4 sessions of complementary therapy. Patients were able to choose which therapy they wished to receive at each session. Results Patient reported outcomes after receiving 4 sessions of complementary therapies demonstrated significant improvements (indicated by at least a 1 point change in MYCAW scores) across a range of concerns. The greatest improvements were seen in relaxation, sleep problems, and pains/aches. Conclusion Qualitative comments collected from this evaluation indicate that complementary therapies can address both physical and emotional concerns often simultaneously and provide a unique therapeutic space for patients. Many patients have not had this experience before and this may introduce them to new methods of addressing complex multi dimensional issues resulting from living with a cancer diagnosis. [ABSTRACT FROM AUTHOR]

Metastatic cancer, especially in the growing population of geriatric patients, presents a big challenge to these patients, as well as to treatment teams and the entire health care system. This article describes some common medical problems faced by patients with metastases to liver and bone, and presents a diagnostic approach, and therapeutic management of various symptoms, relevant to advanced stages of the malignant disease. The article highlights the importance of patient education on various aspects of metastatic cancer, and underscores the unique position of pharmacists practicing pharmaceutical care, which is particularly beneficial in this group of patients with advanced malignancy. Also, this paper emphasizes that achieving a proper balance between managing the malignant disease and maintaining the patients' quality of life, especially in the elderly population, should involve coordinated efforts of the oncology treatment team, primary care physicians, pharmacists, therapists and nurses, as well as patients, their families and caregivers. [ABSTRACT FROM AUTHOR]

Chronic illnesses challenge established patterns of functioning forcing individuals to develop new ways of coping and adaptation. Living with Multiple Sclerosis (MS) entails feelings of uncertainty, unpredictability and helplessness. This review highlights the need for addressing and focusing upon psychological and emotional burden of MS and creates inroads for interventions. An attempt is made to bring together research documenting the challenges and difficulties of living with MS. The authors hope to emphasize the need for a holistic approach towards diagnosis, treatment and management of MS and chronic health conditions. [ABSTRACT FROM AUTHOR]

Copyright of Der Ophthalmologe is the property of Springer Nature 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.)

In the article there are presented: prevalence; pathophysiology; diagnosis; treatment (conventional therapy and complementary and alternative medicine – CAM); integrative therapy

Taiwan has been an aging society since 2018. As a result, long-term care, end-of-life autonomy, and hospice care have received increasing attention. The government of Taiwan promotes home-based healthcare through the National Health Insurance System to enable the efficient utilization of medical resources and reduce overall medical costs. Taiwan's community hospice and palliative care network is expected to serve as the main care model supplementing partial hospitalization and institutional care. In this article, we review the history of and policies related to hospice and palliative care in Taiwan using a literature review and examining Pingtung County as a case study. The implementation of home-based palliative care is also outlined and policy revisions are proposed. The results are intended to provide a reference for healthcare authorities and medical institutions to promote community hospice and palliative care policies. The integrated care model can enhance the capacity of community-based palliative care, support patients receiving palliative care and their family members and caregivers, and ensure physical and psychological comfort for patients. This model contributes to the realization of older adults' preference for dying at home, which is especially pronounced in cultures where traditional Chinese ideas are deeply rooted.

Background: Patients who sustain a motor vehicle accident may experience long-term distress, even if they are uninjured or only slightly injured. There is a risk of neglecting patients with minor or no physical injuries, which might impact future health problems. The aim of this study was to explore patients' subjective experiences and perspectives on pain and other factors of importance after an early nursing intervention consisting of “caring touch” (tactile massage and healing touch) for patients subjected to a motor vehicle accident with minor or no physical injuries. Methods: A mixed method approach was used. The qualitative outcomes were themes derived from individual interviews. The quantitative outcomes were measured by visual analogue scale for pain (VAS, 0-100), sense of coherence (SOC), post-traumatic stress (IES-R) and health status (EQ-5D index and EQ-5D self-rated health). Forty-one patients of in total 124 eligible patients accepted the invitation to participate in the study. Twenty-seven patients completed follow-up after 6 months whereby they had received up to eight treatments with either tactile massage or healing touch. Results: Patients reported that caring touch may assist in trauma recovery by functioning as a physical “anchor” on the patient's way of suffering, facilitating the transition of patients from feeling as though their body is “turned off” to becoming “awake”. By caring touch the patients enjoyed a compassionate care and experience moments of pain alleviation. The VAS pain ratings significantly decreased both immediately after the caring touch treatment sessions and over the follow-up period. The median scores for VAS (p < 0.001) and IES-R (p 0.002) had decreased 6 months after the accident whereas the EQ-5D index had increased (p < 0.001). There were no statistically significant differences of the SOC or EQ-5D self-rated health scores over time. Conclusions: In the care of patients suffering from a MVA with minor or no physical injuries, a caring touch intervention is associated with patients' report of decreased pain and improved wellbeing up to 6 months after the accident. Trial registration: ClinicalTrials.gov Id: NCT02610205. Date 25 November 2015. [ABSTRACT FROM AUTHOR]

OVERVIEW: As the use of complementary and alternative medicine-CAM-has surged in popularity in the United States, many hospitals have begun integrating complementary services and therapies to augment conventional medical care. In this article, the first in a five-part series that will examine various aspects of holistic nursing and forms of complementary care currently in use, the authors provide an overview of some of the integrative care initiatives being introduced in hospitals throughout the United States and report on findings from a survey they conducted of nursing leaders at hospitals that have implemented integrative care programs. [ABSTRACT FROM AUTHOR]

Infertility patients report high levels of anxiety and depressive symptoms, leading to a variety of challenges for the health care team. These include the impact of patient distress on nurses and physicians, patient treatment termination, and potentially lower pregnancy rates. Integrating a mental health professional into the infertility treatment team has the potential to lower distress for patients, support staff, and clinicians, leading to increased patient retention and an easier working environment. [ABSTRACT FROM AUTHOR]

Copyright of Gefaesschirurgie is the property of Springer Nature 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.)

Abstract: Introduction: The concept of integrative medicine/care – often referred to as the new medicine – typically signifies a sound combination of safe and effective ancient traditional medicine or complementary and alternative medicine, and state-of-the-art conventional medicine. In this opinion article, we draw on a decade of research and development including our own experiences in low-, middle- and high-income countries, by means of qualitative and quantitative research approaches, and explore trends vital to the development of evidence-informed integrative care and communication systems. Discussion: Proponents suggest that an integrative health care system with a diversity of therapeutic options – and no particular differentiation between any evidence-informed health care paradigms – might be the best way to revitalize health care and reduce societal health care costs. Opponents argue – based on reasoning common to followers of scientism – that such developments constitute pseudoscience and will effectively overburden the healthcare system. Integrating insights from medicine, the humanities, ethics and philosophy in a health care model, which combines high-tech conventional health care with ancient health care systems and therapies, with the aim to achieve a pluralistic, accessible, affordable, safe and effective health system is clearly a challenge, but one which in fact has been recommended by the Director General of the WHO. Conclusion: To maintain a polarized situation in the light of the growing demand for person-centred health care services, is unhelpful to nations and patients alike, detrimental to therapeutic relationships and may even occasionally be dangerous. [Copyright &y& Elsevier]

Abstract: Objectives: To suggest and discuss an integrative medicine model for stroke patients, we introduce our experience in Korea, describe treatment modalities used for stroke in Korean medicine, and present safety data on integrative care. Summary: For inpatients, integrative management is applied at the request of the primary physician with the consent of patients or their families. In the acute stage, neurologists or neurosurgeons take charge as the primary physicians. Korean medicine doctors cooperate as secondary physicians to the neurologists and neurosurgeons. After the acute stage, responsibilities are exchanged. The rehabilitation program is conducted under the supervision of rehabilitation medicine doctors. The most frequently used complementary and alternative medicine modalities are acupuncture (including manual acupuncture, electroacupuncture and intradermal acupuncture), moxibustion, herbal prescriptions, and acupuncture point injection. Conclusion: Based on our field experiences, we believe it is worthwhile to continue efforts to integrate complementary and alternative medicine and Western medicine. [Copyright &y& Elsevier]

Background: Despite the absence of conclusive evidence of effectiveness, complementary and alternative medicine (CAM) is used by 4 of 10 adults in the US; little is known about the association between CAM use and health status.Objective: To determine the relation between CAM use and self-reported health status and health improvement over time.Design and Participants: We performed a secondary database analysis using data from the 2007 National Health Interview Survey of non-institutionalized US residents conducted by the National Center of Health Statistics of the Center for Disease Control. We identified CAM users and compared them to non-users. We used multivariable logistic regression to model the health status of respondents. We controlled for confounders including socio-demographic, clinical, and behavioral factors. The models were evaluated for discrimination and calibration.Main Measures: The likelihood of respondents to report 'Excellent' current health and 'Better' health than in the prior year.Key Results: Based on 23,393 respondents, we found 37% of U.S. adults used complementary and alternative medicine and 63% did not use any CAM. Compared to those who did not use CAM, CAM users were more likely to rate their health as 'Excellent' (adjusted-odds ratio (AOR) = 1.14, 95% CI = [1.03,1.26]). Similarly, CAM users were more likely to report their health as 'Better' than in the prior year (AOR = 1.64, 95% CI = [1.49,1.83]). The c-statistics for the two models were 0.755 and 0.616, respectively.Conclusion: We found a significant association between CAM use and self-rated excellent health and health improvement over the prior year. Prospective trials are required to determine whether CAM use is causally related to excellent health status and better health than in the prior year. [ABSTRACT FROM AUTHOR]

Healing encompasses Reiki, therapeutic touch and healing touch, and is often used by cancer patients to supplement their health care, but the extent of healing provision in conventional cancer care is unknown. This study used snowball sampling to map the healing provision in UK conventional cancer care settings. Sixty-seven individuals at 38 centres were identified who provided healing within conventional care, 16 NHS-based. Less than half were paid or had specialist cancer training. Self-referral was the usual route to healing, followed by hospital nurse referral. Healing was perceived as well accepted and useful by healers. Providing healing in conventional cancer care may improve patient empowerment and choice. Despite the value to patients, staff and healers, many services receive little financial support. Exchange of information and communication on referral possibilities between healers and conventional staff needs to be improved. Voluntary healer self-regulation will facilitate the safe incorporation of healing into conventional care. [Copyright &y& Elsevier]

Medical schools have recognized and endorsed integrative health care. As such, integrated care is becoming more common. Biofeedback practitioners already trained to work in medical settings and those willing to be so trained have a real opportunity to expand their base of services because self-regulation is an important part of integrated care and lifestyle change. Working in medical settings requires a broad base of knowledge and skill, including an understanding of both the formal and informal rules that govern activities in such settings. Having a mentor or supervisor who already possesses the requisite skills can be most useful in helping the practitioner acquire the needed knowledge and skills and to make a shift from focusing on pathology to one of promoting good physical and mental health. Issues of competence, informed consent, and confidentiality must also be addressed and often in ways not common in other settings. [ABSTRACT FROM AUTHOR]

In the article there are presented: prevalence; pathophysiology; diagnosis; treatment (conventional therapy and complementary and alternative medicine - CAM); integrative therapy. [ABSTRACT FROM AUTHOR]

Summary: The complexity of contemporary clinical practice demands that increasingly skilled high quality health and social care is provided to individuals. However, the failure of health and social care professionals to work collaboratively has been widely reported in the international literature. Hence, interprofessional education has been suggested as a means of improving both interprofessional understanding and respect across a diverse range of practice disciplines. In this way, functional barriers can be challenged or broken down; teamwork enhanced and healthcare outcomes improved. Lack of conclusive evidence to substantiate the above healthcare benefits has been attributed to weak methodological approaches when evaluating such educational initiatives. In Spain barriers to implementing interprofessional education are potentially less challenging. Recent legislative demands following the Bologna Agreement on European Higher Education is compelling Spanish higher education institutes to engage in radical educational reforms. Consequently, this paper examines some of the advantages and disadvantages of introducing interprofessional education into health and social care curricula in Spain to see when and how interprofessional initiatives might be assimilated into the health care curricula. In this way lessons learned from a thorough review of the relevant literature might help to inform such educational reforms across mainland Europe and beyond. [Copyright &y& Elsevier]

Over the last few years, there has been increased awareness and use of complementary/alternative therapies (CAM) in many countries without the health care infrastructure to support it. The National Centre for Complementary and Alternative Medicine referred to the combining of mainstream medical therapies and CAM as integrative medicine. The creation of integrative health care teams will definitely result in redefining roles, but more importantly in a change in how services are delivered. The purpose of this paper is to describe a model of the necessary health care agency resources to support an integrative practice model. A logic model is used to depict the findings of a review of current evidence. Logic models are designed to show relationships between the goals of a program or initiative, the resources to achieve desired outputs and the activities that lead to outcomes. The four major resource categories necessary for implementing integrative care are within the domains of a) professional and research development, b) health human resource planning, c) regulation and legislation and d) practice and management in clinical areas. It was concluded that the system outcomes from activities within these resource categories should lead to freedom of choice in health care; a culturally sensitive health care system and a broader spectrum of services for achieving public health goals. [ABSTRACT FROM AUTHOR]

Background: The Danish Multiple Sclerosis Society has initiated a research project dealing with bridge building and integrative treatment. Little attention has been paid to research on the experience of conventional and alternative practitioners with bridge building and integrative treatment through teamwork. Objective: The objective of this article is to describe essential features of the preparatory phase of the research project focusing on the process of initiating and developing a team of conventional and alternative practitioners before treating people with Multiple Sclerosis at a specialized MS hospital in Denmark. The team consists of five conventional and five alternative practitioners. Materials and Methods: The preparatory phase took place from August 2004 to May 2005. In-depth, semi-structured interviews were conducted with the ten team practitioners. Each practitioner was interviewed before and eight months after joining the team, and after participating in four practitioner-researcher seminars. Written materials and participatory observations of practitioner-researcher seminars have been used in addition. Results: The team-building process involved motivation, emotions, challenges, professional and personal competences, and the development of a professional team identity. The practitioners assessed the preparatory phase based on researcher-practitioner seminars as an essential basis for moving on to provide treatments to people with MS. [ABSTRACT FROM AUTHOR]

This study used a qualitative approach to explore family physicians’ beliefs, attitudes, and practices regarding the integration of patient spirituality into clinical care. Participants included family medicine residents completing training in the Southwest USA. The qualitative approach drew upon phenomenology and elements of grounded-theory. In-depth interviews were conducted with each participant. Interviews were recorded, transcribed and coded using grounded-theory techniques. Four main themes regarding physicians’ attitudes, beliefs, and practices were apparent from the analyses; (1) nature of spiritual assessment in practice, (2) experience connecting spirituality and medicine, (3) personal barriers to clinical practice, and (4) reflected strengths of an integrated approach. There was an almost unanimous conviction among respondents that openness to discussing spirituality contributes to better health and physician–patient relationships and addressing spiritual issues requires sensitivity, patience, tolerance for ambiguity, dealing with time constraints, and sensitivity to ones “own spiritual place.” The residents’ voices in this study reflect an awareness of religious diversity, a sensitivity to the degree to which their beliefs differ from those of their patients, and a deep respect for the individual beliefs of their patients. Implications for practice and education are discussed. [ABSTRACT FROM AUTHOR]

Background: Geriatric medicine is an emerging subspecialty in Nigeria. The interest in the care of older Nigerians followed the Madrid International Plan of Action on Ageing in April 2002. This led to an increase in research, publications and advocacy culminating in the establishment of the pioneer geriatric centre in Nigeria in 2012. Since then, there has been an increase in capacity building, manpower development and institutionalization of geriatric care in Nigeria. This is an account of the evolution of the Chief Tony Anenih Geriatric Centre, University College Hospital, Ibadan (UCH)., Methods: We undertook the review of the history, structure and key service elements in the Geriatric Centre, UCH from January 1, 2013, to December 31, 2020., Results: The number of patients rose from 2,559 in the first year to 19,300 by the end of 2020. The initial four multidisciplinary units increased to 12 over the review period. Likewise, the in-patient admission increased between the first year (122 patients) and 2020 (141 patients). The overall mortality rate was 11.4% over the review period. Internship opportunities were provided to students including resident doctors, undergraduates (medical) and postgraduate students (Masters and PhD). Besides, 139 medical doctors have undergone the annual basic certificate training in geriatric medicine organised by the Centre. Also, 7 fellowship dissertations and 11 peer-reviewed papers have been published., Conclusion: The centre has demonstrated the possibility of caring for older patients in a low-resource setting. The employment of the multidisciplinary approach yielded a low mortality rate, higher attendance and manpower development., Competing Interests: The Authors declare that no competing interest exists, (Copyright © 2021 by West African Journal of Medicine.)