Complementary Alternative Treatments Research Articles

Epidemiology of Diabetes and Atherosclerotic Cardiovascular Disease Among Asian American Adults: Implications, Management, and Future Directions: A Scientific Statement From the American Heart Association.

Asian American individuals make up the fastest growing racial and ethnic group in the United States. Despite the substantial variability that exists in type 2 diabetes and atherosclerotic cardiovascular disease risk among the different subgroups of Asian Americans, the current literature, when available, often fails to examine these subgroups individually. The purpose of this scientific statement is to summarize the latest disaggregated data, when possible, on Asian American demographics, prevalence, biological mechanisms, genetics, health behaviors, acculturation and lifestyle interventions, pharmacological therapy, complementary alternative interventions, and their impact on type 2 diabetes and atherosclerotic cardiovascular disease. On the basis of available evidence to date, we noted that the prevalences of type 2 diabetes and stroke mortality are higher in all Asian American subgroups compared with non-Hispanic White adults. Data also showed that atherosclerotic cardiovascular disease risk is highest among South Asian and Filipino adults but lowest among Chinese, Japanese, and Korean adults. This scientific statement discusses the biological pathway of type 2 diabetes and the possible role of genetics in type 2 diabetes and atherosclerotic cardiovascular disease among Asian American adults. Challenges to provide evidence-based recommendations included the limited data on Asian American adults in risk prediction models, national surveillance surveys, and clinical trials, leading to significant research disparities in this population. The large disparity within this population is a call for action to the public health and clinical health care community, for whom opportunities for the inclusion of the Asian American subgroups should be a priority. Future studies of atherosclerotic cardiovascular disease risk in Asian American adults need to be adequately powered, to incorporate multiple Asian ancestries, and to include multigenerational cohorts. With advances in epidemiology and data analysis and the availability of larger, representative cohorts, furthering refining the Pooled Cohort Equations, in addition to enhancers, would allow better risk estimation in segments of the population. Last, this scientific statement provides individual- and community-level intervention suggestions for health care professionals who interact with the Asian American population.

AİLELERİN COVİD-19 PANDEMİSİ SÜRECİNDE ÇOCUKLARININ SAĞLIĞINI KORUMAK VE GELİŞTİRMEK İÇİN BAŞVURDUKLARI GELENEKSEL TAMAMLAYICI ALTERNATİF TEDAVİ YÖNTEMLERİ (GETAT)

Giriş: İnsanlar hastalık belirtilerin, ilaçların yan etkilerini azaltmak ve bağışıklık sistemini güçlendirmek amacıyla geleneksel tamamlayıcı alternatif tedavi yöntemlerine başvurmaktadır. COVİD-19 salgını sürecinde her kesimden insanın tamamlayıcı uygulamalar ve tedbirler kapsamında geleneksel tedavi yöntemlerini, özellikle şifalı olduklarını düşündükleri bitkileri kullandıkları, çocukları için de bu yöntemlere başvurdukları düşünülmektedir.
 Amaç: Ailelerin COVİD-19 pandemisi sürecinde çocuklarının sağlığını korumak ve geliştirmek için başvurdukları geleneksel tamamlayıcı alternatif tedavi (GETAT) yöntemlerini belirlemektir. 
 Materyal Metod: Tanımlayıcı tipte planlanan çalışmanın verileri, araştırmacılar tarafından oluşturulan “Tanıtıcı Bilgi Formu” kullanılarak google form aracılığı ile toplanılmıştır. Bu formda sosyo-demogratif veriler, COVİD-19 pandemisi süreci ile ilgili sorular ve ailelerin COVİD-19 pandemisi öncesi ve sürecinde kullandıkları GETAT yöntemlerini belirlemeye yönelik sorulardan oluşmaktadır. Verilerin tanımlayıcı analizleri yapılmıştır.
 Bulgular: Çalışmada ebeveynlerin % 88.4’ü kadın ve %52’si üniversite mezunudur. Çocuklarının ise %38.4’ü 7-13 yaş arasında ve %51’i erkektir. Ailelerin çocukları için COVİD-19 pandemisi öncesi sağlığı korumak ve bağışıklığı güçlendirmek için GETAT yöntemleri kullananların oranı %38.9 iken COVİD-19 pandemisi sürecinde bu oranın %92.5 olduğu belirlenmiştir. Ailelerin bu süreçte çocukları için %99.9’unun bağışıklık sitemini güçlendirici, balık yağı ve vitamin içeren ilaçlar kullandığı saptanmıştır. Ayrıca ailelerin %31.8’inin sirke, %31.5’inin bal ve ürünlerini ve %24.5’inin ıhlamur gibi bazı besin ve bitkileri kullandıkları görülmüştür. 
 Sonuç: Ailelerin COVİD-19 pandemisi sürecinde GETAT yöntemlerini daha sık kullandıkları belirlenmiştir. Ayrıca ailelerin çocukları için bazı besin ve bitkilerden oluşan GETAT yöntemlerine başvurdukları görülmüştür. Sağlık ekibinin ailelere COVİD-19 pandemisi sürecinde çocuklarının sağlığı korumak ve geliştirme konusunda teknolojik araçlar yolu ile eğitim ve danışmanlık hizmeti sunmaları önerilmektedir.

EFFECTIVENESS OF REFLEXOLOGY ON HEMIPARESIS MUSCLE STRENGTH FOR STROKE PATIENTS IN PUSKESMAS GULUK – GULUK, SUMENEP REGENCY

There are several treatments for hemiparesis stroke patients, namely medical treatment (conventional) and complementary alternative medicine. So far, in rural areas treating hemiparase stroke patients prefer complementary alternative treatments in the form of reflexology, namely massaging the hands, feet and other body parts by focusing on the nerves of the body. The purpose of this study was to determine the effectiveness of reflexology on hemiparesis muscle strength in stroke patients in the working area of the Puskesmas Guluk-guluk, Sumenep Regency. In this study using analytical methods. The variables in this study consisted of pre-test variables, namely muscle strength before being given reflexology and post-test variables, namely hemiparesis muscle strength after reflexology. The technique of collecting data is purposive sampling in getting 5 respondents. With research data using muscle strength observation sheets with data processing editing, scoring, coding, tabulating, and statistical tests using SPSS. The results of the output test statistics in the Mann-Whitney test found that the asymmp.sig (2-tailed) value in the upper and lower extremities of 0.007 is smaller than the probability value of 005. Based on the results of the p-value, there are differences in the results of muscle strength before reflexology and after reflexology. Because there is a significant difference, reflexology is effective in increasing the hemiparesis muscle strength of stroke patients. Therefore, good family support is needed for stroke patients in the rehabilitation phase who experience hemiparesis so that reflexology is carried out regularly.Keywords: Reflexology, Muscle strength, Hemiparesis

Acne Vulgaris among Egyptian Secondary School Adolescents:Prevalence, Complementary Alternative Treatment and Impact on Quality Of Life

Acne Vulgaris among Egyptian Secondary School Adolescents:Prevalence, Complementary Alternative Treatment and Impact on Quality Of Life

Attention Dysregulation in Breast Cancer Patients Following a Complementary Alternative Treatment Routine: A Double-Blind Randomized Trial.

Introduction:Breast cancer patients and survivors frequently report fatigue, emotional, and cognitive disturbances, which reduce performance at all levels of occupation and make life quality issues a considerable clinical concern. The aim of this study is to evaluate attention and emotion regulation across radiotherapy period and the possible effects of complementary alternative medicine (CAM).Methods:Fifty-seven patients with unilateral breast cancer underwent surgery and systemic chemotherapy before participating in this double-blind randomized study. Two thirds were given CAM (n = 38) while the rest received placebo (carrier only, n = 19). Patients’ attention and anxiety were physiologically tested at baseline, 2 and 4 weeks during the radiation period as well as 1-month after the end of radiation session.Results:Both groups showed similar levels of anxiety with no significant differences at baseline nor post-radiotherapy. Long-term significant recovery of attention performance was observed in the CAM patients, accompanied by a similar tendency in anxiety level, measured by the eye-blink probability.Conclusions:This study physiologically validates the attention impairment reported among breast cancer survivors; also, it depicted a beneficial late-effect of a routine CAM on attention dysregulation. The suggested non-invasive physiological measures can physiologically monitor patients’ psychological and cognitive well-being as well as evaluate the beneficial effect of CAM in breast cancer patients by assessing their coping ability to support the treatment plan. Thus, the results have potential clinical implications on patients’ and survivors’ quality of life.Trial Registration:NIH, NCT02890316. Registered July 2016, http://www.ClinicalTrials.gov

Connecting Mind-Body Therapy-Mediated Effects to Pathological Features of Alzheimer's Disease.

Alzheimer's disease (AD) is a complex, multifactorial neurodegenerative disorder that represents a major and increasing global health challenge. In most cases, the first clinical symptoms of AD are preceded by neuropathological changes in the brain that develop years to decades before their onset. Therefore, research in the last years has focused on this preclinical stage of AD trying to discover intervention strategies that might, if implemented effectively, delay or prevent disease progression. Among those strategies, mind-body therapies such as yoga and meditation have gained increasing interest as complementary alternative interventions. Several studies have reported a positive impact of yoga and meditation on brain health in both healthy older adults and dementia patients. However, the underlying neurobiological mechanisms contributing to these effects are currently not known in detail. More specifically, it is not known whether yogic interventions, directly or indirectly, can modulate risk factors or pathological mechanisms involved in the development of dementia. In this article, we first review the literature on the effects of yogic practices on outcomes such as cognitive functioning and neuropsychiatric symptoms in patients with mild cognitive impairment and dementia. Then, we analyze how yogic interventions affect different risk factors as well as aspects of AD pathophysiology based on observations of studies in healthy individuals or subjects with other conditions than dementia. Finally, we integrate this evidence and propose possible mechanisms that might explain the positive effects of yogic interventions in cognitively impaired individuals.

GINGEL: Development and Evaluation of AntiArthritic Gel Containing Ginger (Zingiber officinale)

Arthritis is a musculoskeletal system disorder which involves destabilization of normal mechanisms. Due to changing habits of living life, the number of arthritic people will increase rapidly. Currently, the existing anti-rheumatic drugs mostly show side effects like acne, blurred vision, high blood pressure and more effective to reduce pain and improve disease conditions but still, they do not treat the disease completely. Literature available indicates that most of the people seek complementary alternative treatments (CAM). Ginger (Zingiber officinale) has empirically explored its use as an anti-inflammatory agent. Amongst others, the Topical route of drug delivery has built up popularity because it avoids first-pass effects, metabolic breakdown associated with oral administration and gastrointestinal irritation. Also, they are less greasy and can be easily washed off from the skin surface. The current study aimed to formulate antiarthritic gel containing ginger extract and to evaluate its drug release activity. The topical ginger gels were prepared using Carbopol 934 as a gelling agent with varying concentrations, i.e., 0.5 %, 1 %, and 1.5 % w/w. The gel was assayed to determine percent purity and cumulative drug release. Results indicated that the 1.5 % w/w concentration of carbopol in ginger gel exhibited an adequate drug release. In conclusion, an antiarthritic gel containing 1.5 % w/w of carbopol had a good consistency, acceptable spreadability, and showed a good drug release profile. The topical prepared herbal ginger gel is a simple, easily formulated, convenient and economical alternative that needs to be weighed in the treatment of RA.

Ampelopsin Improves Cognitive Impairment in Alzheimer's Disease and Effects of Inflammatory Cytokines and Oxidative Stress in the Hippocampus.

Neuroinflammation and oxidative stress have significant effects on cognitive deficiency in the pathophysiological development of Alzheimer's disease (AD). In the present study, we studied the influences of Ampelopsin (AMP) on proinflammatory cytokines (PICs, IL-1β, IL-6 and TNF-α), and products of oxidative stress 8-isoprostaglandin F2α (8-iso PGF2α, a product of oxidative stress); and 8-hydroxy-2'-deoxyguanosine (8-OHdG, a key biomarker of protein oxidation) in the hippocampus using a rat model of AD. ELISA was used to examine PICs and oxidative stress production; and western blotting to examine NADPH oxidase (NOXs). The Spatial working memory tests and Morris water maze were utilized to assess cognitive functions. We observed amplification of IL-1β, IL-6 and TNF-α as well as 8-iso PGF2α and 8-OHdG in the hippocampus of AD rats. AMP attenuated upregulation of PICs and oxidative stress production. AMP also inhibited NOX4 in the AD rat hippocampus. Notably, AMP mostly improved learning performance in AD rat and this was linked to signal pathways of PIC and oxidative stress. AMP plays a significant role in improving the memory deficiency in AD rats via inhibition of signal pathways of neuroinflammation and oxidative stress, suggesting that AMP is likely to prospect in preventing and relieving development of the cognitive dysfunctions in AD as a complementary alternative intervention.

The relationship between the attitudes of individuals towards traditional and complementary alternative treatment and their health perceptions

This study was conducted to determine the relationship between the attitudes of individuals towards traditional and complementary alternative treatment and their health perceptions. This cross-sectional study was carried out with 300 individuals. The data were collected by using a descriptive information form, the Complementary and Alternative Medicine Attitude Scale and Health Perception Scale. It was determined that 20.7% of the participants used alternative treatment; most used herbal products and utilized alternative treatment to protect their health. There was a positive relationship between attitudes towards complementary alternative treatment and health perceptions. Educational level, chronic diseases and status of having knowledge about alternative treatment affected its usage, and as the perceptions of health increased, positive attitudes towards alternative treatment also increased.

Extract from Butea monosperma inhibits β-catenin/Tcf signaling in SW480 human colon cancer cells

The colorectal cancer (CRC) is the fourth leading cause of cancer death in worldwide. It has been found that >90% of CRC is caused by aberrant activation of canonical Wnt/β-catenin signaling pathway. Continuous activation of this pathway believes to be an initiating event in colorectal carcinogenesis. There are growing evidences suggest that traditional herbal plant medicines are being raised as a complementary alternative treatment for cancer. In this series, Butea (B) monosperma has been illustrated as a valuable traditional medicinal plant with >45 medicinal traits. Therefore, by targets this pathway using n-butanol fraction of B. monosperma flower extract (NBF-BMFE) could be a better therapeutic strategy for treating CRC. In this present study, we evaluate the inhibitory effect of NBF-BMFE against over activated Wnt signaling mediated colon cancer cells (SW480). Interestingly, the in vitro finding described that the NBF-BMFE had good antiproliferative effect against SW480 human colon cancer cells. Moreover, it showed significant level of down regulated expression in Wnt signaling proteins such as β-catenin, adenomatous polyposis coli (APC), glycogen synthase kinase 3β (GSK-3β), cyclin D1 and c-myc in time-dependent manner. Further, the in silico results of NBF-BMFE derived compounds have shown good binding interaction with target sites of β-catenin, APC and GSK-3β protein. In conclusion, NBF-BMFE may be used as an effective inhibitor for Wnt signaling targeted combined chemotherapeutic agents against CRC.

Hypertensive patients’ adherence to pharmacological and non-pharmacological treatment methods, in Turkey

Background: The present study was aimed at determining hypertensive patients’ adherence to pharmacological and non-pharmacological treatment methods and factors affecting their adherence. Methods: This cross-sectional study was conducted with 418 patients aged 18 and over who met the inclusion criteria. Adherence to pharmacological and some non-pharmacological treatment methods is the dependent variable of the study. Data were collected using the personal information form, Morisky medication adherence scale. In the analysis, descriptive statistics, the chi square test, and logistic regression analysis were used. The significance level was accepted as p<0.05. Results: The rate of adherence to the pharmacological treatment was 78.2%. The rates of adherence to smoking cessation, diet and physical activity were 49.0%, 55.7% and 20.6% respectively. Age, employment status and perceived health status were associated with the adherence to smoking cessation; perceived income, resort to complementary alternative treatment methods and having regular controls (check-ups) were related to the adherence to the diet, and gender and perceived economic status were related to the adherence to physical activities (p<0.05). Conclusions: While approximately four out of five patients complied with the pharmacological treatment, rates of adherence to non-pharmacological treatment methods were low. Multidisciplinary intervention programs should be planned in order to regularly monitor patients at family health centers, to assess their adherence to treatment modalities and to promote adherence.

A randomized, placebo controlled trial of omega-3 fatty acids in the treatment of young children with autism.

BackgroundAutism spectrum disorder (ASD) is a neurodevelopmental disorder affecting more than 1% of children. It is characterized by social communication deficits and repetitive behaviors/restricted interests. In the absence of any medications known to improve core symptom domains, parents often use complementary alternative treatments, including omega-3 fatty acid supplements.MethodsWe conducted a 6-month, randomized, placebo controlled trial of omega-3 fatty acid supplements (1.5 g) vs placebo in children 2 to 5 years of age with ASD. Primary outcome measures included the autism composite score of the Pervasive Developmental Disorders Behavioral Inventory (PDDBI) and the externalizing problems score of the Behavior Assessment System for Children (BASC-2). Secondary outcome measures included clinical global improvement (Clinical Global Impression-Improvement (CGI-I)), adaptive function (Vineland Adaptive Behavior Scale (VABS-II)), and language gains (Preschool Language Scale (PLS-4)), as well as safety. Exploratory analysis investigated potential correlations between changes in cytokine profiles and treatment response.ResultsThirty-eight participants were randomized in a 1:1 fashion. There was no significant difference between groups on the 0- to 24-week change in PDDBI autism composite scores (p = 0.5). There was a significant group by week interaction on the BASC-2 externalizing problem score, with participants randomized to the treatment group demonstrating worsening scores (p = 0.02). There was no statistically significant week by group effect on either adaptive function (p = 0.09) or language (p = 0.6). Omega-3s were relatively well tolerated. Changes in cytokines during the study did not significantly correlate with treatment response.ConclusionsThis study does not support high dose supplementation of omega-3 fatty acids in young children with ASD.Trial registrationClinicaltrials.gov NCT01248728. Registered 22 November 2010.Electronic supplementary materialThe online version of this article (doi:10.1186/s13229-015-0010-7) contains supplementary material, which is available to authorized users.

Effect of Light Therapy on Sleep Disturbance and Depression in Climacteric Women.

The purpose of this study was to examine the effects of light therapy on sleep disturbance and depression in climacteric women with menopausal symptoms. The research design was a nonequivalent control group pre test-post test design. Data were collected from September 29, 2013 to November 11, 2013. Participants included 17 climacteric women in an artificial light therapy group, 17 climacteric women in a sun light therapy group and 16 climacteric women in a control group. Measures consisted of the sleep disturbance, depression, melatonin, and serotonin. There was a statistically significant difference of Korean Sleep Scale A (F=53.87, p<.001), and melatonin (F=31.19, p<.001) among three groups. There was a statistically significant difference of Self-Rating Depression Scale (F=121.86, p<.001), and serotonin (F=102.37, p<.001) among three groups. Artificial and sun light therapy can be applied as a supportive nursing intervention to subjects with sleep disturbance and depression in climacteric women with menopausal symptoms. Artificial and sun light therapy is expected to be a complementary alternative intervention for health management of the subjects with sleep disturbance and depression in climacteric women with menopausal symptoms.

Parental experiences of childhood cancer treatment in Kenya.

Our study explores socioeconomic, treatment-related, and psychological experiences of parents during cancer treatment of their children at an academic hospital in Kenya. This cross-sectional study used semi-structured questionnaires. Parents whose children came for cancer treatment consecutively between November 2012 and April 2013 were interviewed. Between 2012 and 2013, 115 oncology patients attended the hospital and 75 families (response rate 65%) were interviewed. Cancer treatment resulted in financial difficulties (89%). More information about cancer and treatment was required (88%). More contact with doctors was needed (83%). At diagnosis, cancer was perceived as curable (63%). However, parents were told by health-care providers that most children with cancer die (49%). Parents had difficulties with understanding doctors' vocabulary (48%). Common reasons to miss hospital appointments were travel costs (52%) and hospital costs (28%). Parents (95%) used complementary alternative treatment (CAM) for their children. Health-care providers told parents not to use CAM (49%). Parents had not discussed their CAM use with doctors (71%). Community members isolated families because their child had cancer (25%), believed that child was bewitched (57%), advised to use CAM (61%), and stopped conventional treatment (45%). Some families (15%) never disclosed the child's illness to community members. Parents shared experiences with other parents at the ward (97%) and would otherwise not understand the disease and its treatment (87%). Parents suffer financial hardships and are dissatisfied with doctors' communication regarding their children's condition. CAM is very commonly used. Doctors need to improve their communication skills and discuss CAM more openly. Cancer programs should include more support for parents: financial assistance, a facility where parents and children can stay during the course of therapy, and parent support groups.

정신지체 및 자폐스펙트럼장애에서 다양한 치료방법의 사용실태

Objectives : The purpose of this study was to investigate the use of various treatment modalities including pharmacotherapy, educational-behavioral therapy, and complementary alternative treatment for children with mental retardation (MR) or autism spectrum disorder (ASD) in Korea. Methods : The sample consisted of 50 parents who have children with MR (N=28) or ASD (N=22) : 38 boys, 12 girls ; mean age 14.06 (4.14) years old. A questionnaire was composed of the experienced modality, duration, cost, satisfaction, etc. Results : According to the results, 56.0%, 100.0%, and 36.0% of children with MR or ASD have experienced pharmacological treatment, educational-behavioral therapy and complementary alternative medicine (CAM), respectively. Children who experienced educational-behavioral therapy and CAM experienced 3.52 kinds of education-behavioral therapy and 2.78 kinds of CAM, respectively. Monthly cost of pharmacological treatment was lowest among three modality categories. Regarding treatment satisfaction by parental report, the lowest score was recorded for CAM. Conclusion : Parents who have a child with MR or ASD are trying many treatment modalities and feeling the burden of their treatment.

Effect of Aroma Hand Massage on Anxiety and Immune Function in Patients with Gynecology Surgery under Local Anesthesia.

The purpose of this study was to examine the effects of aroma hand massage on anxiety and immune function in patients who had gynecology surgery under local anesthesia. The research design was a nonequivalent control group with pre- and posttest design. Data were collected from June 5 to October 6, 2010. Participants included 20 patients in the aroma hand massage group, 20 patients in a hand massage group, and 20 in a control group. As an experimental treatment, hand massage was carried out following the hand massage protocol. Measures consisted of the State Trait Anxiety, Numeric Rating Scale (NRS) for anxiety, vital signs (systolic and diastolic blood pressure, pulse rate), and salivary cortisol for anxiety, and immunoglobulin A for immune function. Aroma hand massage and hand massage group showed lower levels in NRS for anxiety, systolic and diastolic blood pressure, and pulse rate (p<.001) compared to controls. No group differences were found for state anxiety, salivary cortisol and immunoglobulin A. The results indicate that aroma hand massage and hand massage are effective in reducing anxiety and can be complementary alternative interventions for women having gynecology surgery under local anesthesia.

Complementary alternative medicine use in children with type 1 diabetes mellitus in Erzurum, Turkey

The aims of this study were: (i) to determine the types of complementary and alternative medicine use among children with type I diabetes mellitus as reported by parents and (ii) to describe sociodemographic and medical factors associated with the use of such treatments in families residing in Eastern Turkey. Type 1 diabetes mellitus is a tremendously challenging and complex disease for children and families to manage. Therefore, the use of complementary and alternative medicines among children with type 1 diabetes is becoming increasingly popular. Survey. Parents of 100 paediatric patients (who were diagnosed with type 1 diabetes at least 6 months prior to the study) who visited the participating paediatric endocrinology multidisciplinary centres and clinics for diabetes management were included in the study. Data were collected by using a semi-structured questionnaire. Results. Fifty-two per cent of the parents reported the use of one or more complementary alternative medicine therapies. Most such users (59.6%) were using oral herbal preparations; including morus alba (leaves) aloe vera and stinging nettle. Since we found that 78.6% of those using herbals were satisfied with their results and 69.2% were planning to continue use, it is important for healthcare providers to have relevant knowledge about complementary alternative medicine use and learn about its efficacy and effects (positive and adverse) of these treatments. Relevance to clinical practice. Botanical substitute for insulin seems unlikely, but complementary alternative treatments may provide valuable clues for the development of new oral hypoglycaemic agents and simple dietary agents. It is important for healthcare providers to have up-to-date knowledge about the use and effects of complementary alternative medicines in the outpatient clinical care setting.

Effects of Koryo Hand Therapy on Menopausal Symptoms and FSH, LH, and Estradiol in Climacteric Women

The purpose of this study was to examine the effects of Koryo Hand Therapy (KHT) on menopausal symptoms and hormone levels (Follicle Stimulating Hormone [FSH], Luteinizing Hormone [LH], and estradiol [E(2)]) in climacteric women. The research design was a nonequivalent control group pretest-posttest design. Data were collected from November 28, 2005 to February 28, 2006. The 45 participants were assigned to either the experimental group (23) or control group (22). KHT was applied three times a week, for a total of 8 weeks to the women in the experimental group. There was a statistically significant decrease in menopausal symptoms (F=42.49, p=.000), FSH level (F=26.98, p=.000) and LH level (F=5.31, p=.026) between the experimental and control groups. There was an increase of the estradiol level in the experimental group but the difference between the two groups was not statistically significant. KHT can be applied as a supportive nursing intervention to climacteric women. KHT is expected to be a complementary alternative intervention for health management of the climacteric women.

Rheumatic Disease and Complementary-Alternative Treatments

Complementary-alternative medicine (CAM) has been widely used by rheumatic patients for many years, but doctors are often unaware of the actual use. This study aimed at patients' experience and perceptions of CAM as a way for long-term coping with illness. Fifteen in-depth interviews were conducted with patients sampled by contact with voluntary patient-driven rheumatic disease societies, outside of any treatment settings. Strategically, the sampling included a variety of rheumatic diseases and CAM-treatments, but strived otherwise to be typical of CAM-users. Interviews were taped and fully transcribed; coding and analysis of themes were assisted by computer software. Rheumatic disease patients expressed use of CAM as methods of regulation of discomforts, the feeling of the body, and self-empowerment, not for unrealistic healing of their rheumatic disease. They experienced a variety of effects, most often expressed in terms of mind-body interrelated experiences, such as "lightness of the body" rather than relief in specific symptoms. They expressed the feeling of "have been helped" when leaving a CAM-session and appreciated to have more than 1 way to understand their disease and symptoms. They were usually not naive, but were critical consumers. The patients typically believed in the alternative viewpoints of "natural is best" and in "energy meridians," but they were otherwise not believers in any alternative, "new age"-type worldview. These findings suggest that clinical practice may be enriched by listening to or asking rheumatic disease patients' CAM-experiences in a nonpatronizing way.

Complementary alternative treatments used by patients with cancer in eastern Turkey.

Interest in complementary-alternative medicine therapies is growing rapidly in Turkey. Therefore, the purpose of this research was to determine the types and prevalence of alternative therapies used by the patients with a diagnosis of cancer, and to determine factors influencing the choices of their therapies in Erzurum, Turkey. Approximately 10-minute face-to-face interviews were conducted with each subject in the radiation oncology department. The factors associated with the use of alternative therapies after a diagnosis of cancer were assessed by chi-square analysis. The findings indicated that complementary-alternative medicine therapies were used by 41.1% of the subjects after their diagnosis, and that all of the alternatives they used were herbs. The most commonly used herb was stinging nettle leaf (urtica dioica) or seed of nettle. Almost all (93.2%) of the herbs used were nettle. In general, especially the women and the younger patients of both genders were more likely to be using alternative therapies. There was no difference in demographic and cancer characteristics between users of alternative therapy and nonusers. More than the half of the patients using alternative therapies (54.5%) reportedly did not discuss the use of herbs with their healthcare professionals. Most of the patients using stinging nettle and other herbs therapies reported that they had heard about the use of herbs from friends or relatives (52.3%), or from the other patients in this clinic (43.2%). This study found that there is a high prevalence of alternative therapies used by patients with cancer in eastern Turkey. The use of these alternative therapies requires that nursing professionals rethink staff competency, patient assessment, and patient-focused care. Communication between patients and healthcare professionals should initiate dialogues on this topic for a better understanding of patient choices with regard to treatment options.