Alternative Health Therapies Research Articles

Students and Depression: What Do They Know?

Students and Depression: What Do They Know?

YouTube as a source of information for patients considering surgery for ulcerative colitis

BackgroundWith the range of health information online, assessing the resources that patients access may improve the content of preoperative information. Our aim was to assess the content of the most viewed videos on YouTube related to surgery for ulcerative colitis (UC). MethodsYouTube was searched for videos containing information on surgery for UC. The 50 most viewed videos were identified and user interaction analyzed. Upload source was classified as patient, individual health care professional (HCP), or hospital/professional association. Video content was categorized using an inductive thematic analysis on a purposive sample list of videos. The overarching theme of each video was classified once data saturation was achieved. ResultsThirty videos were uploaded by patients, 15 by hospitals and 5 by HCPs. Seventeen videos (34%) discussed life after surgery. Sixteen of these were uploaded by patients who had previously undergone surgery for UC. No videos of this theme were uploaded by HCPs. Ten videos (20%) described a number of different operations. Other themes identified were alternative health therapies (12%), colonoscopy (12%), life with UC (8%), miscellaneous (8%), and education for HCPs (6%). Patient uploaded videos had significantly more comments (P = 0.0079), with 28% of comments on patient videos being users requesting further information. ConclusionsUnderstanding the sequelae of surgery is most important to preoperative patients. There are a lack of professional videos addressing this topic on YouTube. HCPs must participate in the production of videos and adapt preoperative consultations to address common preoperative concerns.

What is a clinical pathway? Refinement of an operational definition to identify clinical pathway studies for a Cochrane systematic review

Clinical pathways (CPWs) are a common component in the quest to improve the quality of health. CPWs are used to reduce variation, improve quality of care, and maximize the outcomes for specific groups of patients. An ongoing challenge is the operationalization of a definition of CPW in healthcare. This may be attributable to both the differences in definition and a lack of conceptualization in the field of clinical pathways. This correspondence article describes a process of refinement of an operational definition for CPW research and proposes an operational definition for the future syntheses of CPWs literature. Following the approach proposed by Kinsman et al. (BMC Medicine 8(1):31, 2010) and Wieland et al. (Alternative Therapies in Health and Medicine 17(2):50, 2011), we used a four-stage process to generate a five criteria checklist for the definition of CPWs. We refined the operational definition, through consensus, merging two of the checklist’s criteria, leading to a more inclusive criterion for accommodating CPW studies conducted in various healthcare settings. The following four criteria for CPW operational definition, derived from the refinement process described above, are (1) the intervention was a structured multidisciplinary plan of care; (2) the intervention was used to translate guidelines or evidence into local structures; (3) the intervention detailed the steps in a course of treatment or care in a plan, pathway, algorithm, guideline, protocol or other ‘inventory of actions’ (i.e. the intervention had time-frames or criteria-based progression); and (4) the intervention aimed to standardize care for a specific population. An intervention meeting all four criteria was considered to be a CPW. The development of operational definitions for complex interventions is a useful approach to appraise and synthesize evidence for policy development and quality improvement.

Veterans' Experiences using Complementary and Alternative Medicine for Posttraumatic Stress: A Qualitative Interpretive Meta-Synthesis

Combat Veterans struggling with combat-related post*traumatic stress disorder and subthreshold symptoms often look outside the conventional behavioral health care system for treatment because standard care has not met their needs. This study utilized a qualitative interpretive metasynthesis to describe the lived experience of combat Veterans seeking complementary and alternative health therapies for posttraumatic stress symptoms. This research aimed to understand what attracts these Veterans to complementary and alternative medicine techniques and how they benefit from their experiences with nonconventional therapies. Findings suggest the need for further research into increasing access and eliminating disparities for Veterans seeking more integrative care.

Critical Synthesis Package: CAM Health Belief Questionnaire (CHBQ)

Critical Synthesis Package: CAM Health Belief Questionnaire (CHBQ)

Do dietary supplements for weight loss work?

also reduce caloric intake, food ingestion rate, and nutrient absorption due to its soluble fi ber backbone. Glucomannan’s effect on satiety is the result of its fi ber content; it was associated with a modest weight loss of 5 pounds in 8 weeks, according to a November 2005 study published in Alternative Therapies in Health and Medicine (http:// apha.us/ZVeaAG). A slight decrease in total cholesterol and triglyceride concentrations may occur with the use of glucomannan, although similar results may be obtained with a high-fi ber diet. Sensa is another popular weight loss product heavily promoted to consumers. Invented by neurologist Alan Hirsch, the product is based on the central mechanisms that regulate satiety. Sensa’s manufacturers claim that when it is sprinkled on food, it enhances the smell and taste of the food and, as a result, the feeling of satiety. There has been no evidence documenting the effi cacy of Sensa for signifi cant weight loss or maintenance of weight loss published in peer-reviewed journals, however. White kidney bean (Phaseolus vulgaris) extract (WKBE) acts as an inhibitor of alpha amylase, resulting in decreased digestion and intestinal absorption of carbohydrates. In Diabetes, Metabolic Syndrome, and Obesity: Targets and Therapy, researchers reported a reduction in postprandial blood glucose with WKBE, which may be helpful for patients with type 2 diabetes (http:// apha.us/15i8baA). The best results occurred when WKBE was taken with meals containing large amounts of carbohydrates. The product may delay gastric emptying, thus simulating the feeling of satiety, and resulting in weight loss. WKBE should not contain phytohemagglutinin, a toxic protein found in P. vulgaris. Products should have a hemagglutinating activity less than 700 units/g and trypsin inhibiting activity less than 20 units/g (dry weight), according to a review published in Nutrition Journal (http://apha.us/ZNt3DC). Raspberry ketone, present in raspberries, cranberries, and blackberries, has a structure similar to capsaicin and synephrine. Researchers have theorized that capsaicin enhances thermogenesis, resulting in increased energy expenditure. There are limited data on the safety and effi cacy of synephrine, an alpha-adrenergic agonist, as an alternative to ephedra, and it may increase blood pressure. In a 2010 study published in Planta Medica, raspberry ketone, when fed to male mice in high dosages, prevented high-fat diet–induced increase in weight, stimulated lipolysis in white adipocytes, and increased expression of adiponectin. Bitter orange, Citrus aurantium, has been proposed to work similarly to raspberry ketone because it includes synephrine, N-methyltyramine, and furocoumarins. The product is believed to increase metabolism and suppress appetite, but evidence on its safety and effi cacy is limited. Fainting, heart attacks, and strokes in otherwise healthy people have been reported with bitter orange alone or in combination with caffeine.

Substitutes or complements? An exploration of the effect of wait times and availability of conventional care on the use of alternative health therapies in Canada

We explore how alternative and complementary care use is affected by wait list length and availability of conventional care in Canada. We use data from the 2003 Canadian Community Health Survey, Statistics Canada and the Fraser Institute to explore the effect of longer wait times on the use of alternative therapies in general and for specific therapies: Registered Massage Therapy, Chiropractics, Physiotherapy, Homeopathy and Acupuncture. We use binary variables indicating whether the individual used various types of alternative care in the year preceding the survey. Wait times for specialists are associated with lower probabilities of using alternative care, but the effect are usually not statistically significant. Longer wait times for non-emergency surgery are associated with lower probabilities of using alternative care when using data from CANSIM, but very small higher probabilities of using alternative care when using data from the Fraser Institute which includes wait times for treatments for other procedures than non-emergency surgery. We find positive but extremely small effects for total wait times from the Fraser Institute. Individuals reporting unmet health care needs are more likely to use alternative care while individuals who do not have a regular physician are less likely to use it. Reporting unmet health care needs or no family physician have more of an impact on the use of alternative therapies than wait lists do. The evidence is not clear as to whether alternative care is sometimes used as a substitute to conventional care rather than a complement.

Non-hormonal therapy of post-menopausal vasomotor symptoms: a structured evidence-based review

Interest in non-hormonal therapies for the treatment of menopausal symptoms has increased since the publication of adverse effects of estrogen replacement therapy. To provide information on the efficacy of non-hormonal therapies for menopausal vasomotor symptoms based on evidence from published randomised controlled studies. The Cochrane Database of Systematic Reviews (CDSR), MEDLINE, Alternative Therapies in Health and Medicine database (ATHMD) and Allied and Complementary Medicine database (AMED) were searched for randomised controlled trials in the English language reporting data on treatment of menopausal vasomotor symptoms. Trials including cancer breast patients were included. Our search identified 58 randomised controlled trials of which 11 involved the use of clonidine, six for SSRIs, four for gabapentin, seven for black cohosh, seven for red clover, 18 for phytoestrogens, two for ginseng, one for evening primrose, one for dong quai and one for vitamin E. Most trials had methodological deficiencies. There is evidence that clonidine, paroxetine, venlafaxine, gabapentin and black cohosh may be beneficial in the treatment of menopausal vasomotor symptoms in some women. Current evidence does not support the use of fluoxetine, red clover, phytoestrogens, Ginseng, evening primrose, dong quai and vitamin E. The side effects profile of these therapies should be considered.

TERAPIAS ALTERNATIVAS DE SAÚDE X ALOPATIA: TENDÊNCIAS ENTRE ACADÊMICOS DE MEDICINA

ALTERNATIVE HEALTH THERAPIES VERSUS ALLOPATHY: TENDENCIES AMONG MEDICAL STUDENTS. Influenced by the Cartesian-Newtonian paradigm, medical theories are based on the biomedical pattern of health assistance, where the individual is not seen as being part of the cosmos. However, by the end of the XIX century the great holistic paradigm emerged to reveal a universe which is holistic, alive, systematized, dynamic and all inter-linked. The Alternative Therapies arise in this context and, in general, they focus on the individual in a global manner (mind, body, behavior and environment). The present work is an exploratory-descriptive study in which medical students participated for the purpose of identifying the influence of the present paradigm on professional academic training and the students’ perception of Alternative Therapies, with regard to their concepts, criticism, beliefs and acceptance. It was observed that the influence of the Cartesian-Newtonian paradigm on the professional development of medical students is evident, and that the majority has a preference for allopatic therapy and also that the Alternative Therapies are seldom treated during the undergraduate period. It was also observed that there is great concern about the scientific value of Alternative Therapies. However, there are some medical students worried and unhappy about the compartmentalization of the individual. We conclude that due to the influences of the biomedical model on undergraduate teaching there is preference for the allopatic therapy, despite the increasing number of people who use and believe in Alternative Health Therapies. Furthermore, there is evidence of the existence of various scientific works that prove their efficiency, or treat this theme, which reinforces our conviction that the Cartesian-Newtonian paradigm is being surpassed. KEY WORDS: Alternative therapies; biomedical model, Holism.

Creativity.com: Aladdin’s Cave or Pandora’s Box?

Today, creativity has moved beyond its traditional home in the rhetoric of the philosopher and the exploits of the artist to form an integral part of both the theory and practice of a myriad of disciplines. Health professionals (Dossey; Kirklin & Meakin; Meites, Bein & Shafer; Rees; Satalof), scientists (Bohn 1-3, 13-15; Culross), educators (Guilford; Sawyer; Sternberg & Williams; Wilks) and those involved in the corporate world (Forbes & Domm; Mauzy & Harriman; Robinson & Stern) all consider creativity to be a fundamental criterion by which they measure and achieve their successes. 2 In this way, however, creativity has become something of an over-burdened signifier. Now the market is flooded with highly idealised and ever expanding models for understanding and transmitting creativity, in which the medium (transmission) strives to outdo the message (creativity itself). We are not attempting here to arbitrate between these various models with a view to providing a rank order of creativity. Instead, we want to focus on and explore the ways in which recent technological developments, primarily the internet, have been, and might be, used to transmit and facilitate new directions and expressions of creativity and the creative process itself. 3

Breath therapy for chronic low back pain

Summary Hands-on mind-body techniques claim to help patients with low back pain (LBP) by focusing on body-awareness. Their efficacy has been studied only in a few controlled research studies of limited rigor. A randomized controlled clinical pilot trial of Breath Therapy (BT) was conducted to determine whether patients with cLBP would benefit from an approach primarily focusing on body-awareness. BT is a Western mind-body therapy developed in Germany that integrates body-awareness, breathing, meditation, and movement. Thirty-six patients seeking primary medical care for chronic LBP of at least 3 months duration were randomly assigned either to receive BT or PT at an academic medical center. Main outcome measures at baseline, 6–8 weeks, and 6 months were pain, function, and overall health. Balance as a potential surrogate for proprioception and body-awareness was measured at the beginning and end of treatment. Patients suffering from cLBP improved clinically with BT. Changes in standard self-reported LBP measures of pain and disability were comparable to changes measured following high-quality, extended PT. The full details of the study are published elsewhere [ Mehling, W.E., et al., 2005 . Randomized, controlled trial of breath therapy for patients with chronic LBP. Alternative Therapies in Health and Medicine 11 (4), 44–52].

Developing Healing Relationships: Foreword from the Organizers

S-1 This 3rd American Samueli Symposium entitled “Developing Healing Relationships” was held on April 21–22, 2005, in Alexandria, Virginia. The symposium was designed to complement the two previous American Samueli Symposia, both of which explored the subject of optimal healing environments. The 1st symposium, “Definitions and Standards in Healing Research,” was held in January 2003. The content of that meeting focused on the variety of frameworks in which healing occurs and on approaches to the investigation of the internal environment of the patient and practitioner. The papers from this symposium were published as a supplement to the peer-reviewed journal Alternative Therapies in Health and Medicine in May 2003. The 25 papers of the 2nd symposium, “Toward Optimal Healing Environments in Health Care,” were published as a supplement to the peer-reviewed Journal of Alternative and Complementary Medicine in October 2004. This meeting explored the core domains of an Optimal Healing Environment (OHE) and provided recommendations for performing research in the inpatient, outpatient, and worksite venues. These papers are accessible on the Samueli Institute website, www.siib.org. The primary mission of the Samueli Institute is to support clinical and basic research in the science of healing. A primary goal of this research is to examine how relationships in health care either do or do not facilitate healing and self-recovery processes and to identify methods to extend that information to clinical and treatment settings. Accordingly, we fund collaborative research efforts that are oriented to the development, implementation, and evaluation of optimal healing environments and the relationship to these environments to the health care team members, the patients they serve, the patients’ significant others, and the community. To further define our research agenda, we invited colleagues who have been thoughtful contributors to this field to prepare papers related to OHE. As a result of their efforts, we have created the graphic on the back cover of this supplement. It highlights individual elements that combine to define an optimal healing environment. The graphic illustrates what we feel are the core domains of an optimal healing environment. They involve activities that do the following:

ARNICA MONTANA AND HOMEOPATHIC DOSING GUIDELINES

Alternative Therapies in Health and Medicine University of New Mexico School of Medicine Integrative Medicine Institute P.O. Box 4310 Santa Fe, N. M. 87502

A birth intervention: the therapeutic effects of Doula support versus Lamaze preparation on first-time mothers' working models of caregiving: Manning Orenstein G, Alternative Therapies in Health and Medicine 1998; 4: 73–81

A working model of caregiving has been defined as an internalized schema of caregiving that guides a mother's behavior with her infant. This schema is strongly influenced by the mother's first attachment relationship with her own mother, which frequently operates outside her conscious awareness.To examine doula support at birth as an intervention that might correct distortions of a mother's unconscious schema of caregiving, promoting more secure caregiving following childbirth.The effects of doula support versus Lamaze birth preparation on the working models of caregiving of 35 first-time pregnant mothers were compared.An interview was used to assess the mothers' working models in the third trimester of pregnancy and again 4 months after the mothers gave birth. Mood state and self-esteem were measured at these times. A post hoc analysis was performed on the mothers' birth experiences, the quality of their postpartum support, and their evaluations of their infants' temperaments.The prebirth to postbirth rating analysis of the interviews revealed that the mothers in the doula group were significantly less rejecting and helpless in their working models of caregiving than were the mothers in the Lamaze group. The mothers in the doula group also showed greater security than did mothers in the Lamaze group, a difference that approached but did not reach significance. In addition, the women in the doula group were less emotionally distressed and had higher self-esteem than did the women in the Lamaze group, and the women in the doula group rated their infants as significantly less fussy than the mothers in the Lamaze group rated their infants.When viewed in the context of working models of caregiving, mothers who used a doula were significantly less rejecting and helpless, and approached significantly higher scores on the secure scale, than did mothers who used Lamaze birth preparation. Mothers rated as secure showed significantly less mood disturbance and higher prebirth and postbirth self-esteem than did mothers rated as insecure, providing construct validity for the caregiving interviews.

Alternative Therapies in Health and Medicine

The Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice and Policy, edited by Marc S. Micozzi, quarterly, $89 (individual), $120 (institutional), New York, Mary Ann Liebert, January 1995-. Alternative Therapies in Health and Medicine is edited by Larry Dossey, MD. Coeditors include Jeanne Achterberg, PhD, from the Saybrook Institute, David Riley, MD, of the University of New Mexico, David Reilly, MB, ChB, from the Glasgow Homeopathic Hospital, and Cathie Guzzetta, RN, PhD, of Parkland Memorial Hospital. The editorial board of this peer-reviewed journal consists primarily of US-based practitioners, with a large advisory board and an international advisory board. Alternative Therapies in Health and Medicine is published bimonthly with its first issue released in March 1995. The purpose and scope are presented in an essay by the executive editor in the first issue. As he states, alternative medicine has always existed and should be carefully examined in an unbiased

Research implications for alternative health therapies.

Nontraditional health practices have gained in popularity during the past 10-15 years. Unfortunately, the effectiveness of many nontraditional approaches have been inadequately investigated. Furthermore, tradition research protocols often have fallen short in providing satisfactory strategies for these types of investigations because the nature of the personal belief system between patient and provider has not been examined. The authors discuss the implications for triangulation techniques in nursing research related to nontraditional treatments. Six types of triangulation are defined and methods for utilizing these techniques are explained.

Use of alternative health therapies by people with multiple sclerosis: an exploratory study.

Sixteen people with multiple sclerosis (MS) responded to a semi-structured questionnaire about their experiences with alternative therapies. No definition of alternative therapies was provided. Physical therapy, counseling, nutrition, and massage were the most frequently used alternative therapies. Other therapies included acupuncture, occupational therapy, aquatic therapy, Therapeutic Touch, yoga, passive exercise, and removal of mercury alloy tooth fillings. Almost two thirds of the respondents reported seeking an alternative health practitioner because traditional physicians offered no cure for MS. Just under one third of the respondents stated that the quality of their lives was improved by alternative therapies.

Prayer, Religiosity, and Healing in the Heartland, USA: A Research Note

In recent years interest has grown among sociologists of religion as well as sociologists of medicine about the plethora of alternative health therapies now consumed by Americans. Prayer is one of these. Using data taken from a random sample of Midwesterners, this study examines the prevalence and correlates of prayer specifically addressed to health concerns. Prayer, it was found, was regarded by almost one in three respondents as an efficacious tactic for maintaining and restoring health, but not at the expense of conventional biomedical care. The implications for health care professionals are considered.