Complementary And Alternative Medicine Approaches Research Articles

Prevalence, Reasons, and Perceived Benefits of Complementary and Alternative Medicine Among Patients With Rheumatic Diseases in Morocco: A Monocentric Cross-Sectional Study.

Background In general, rheumatologists often have limited knowledge regarding the use of complementary and alternative medicine (CAM) among patients with rheumatic diseases. Understanding the prevalence, reasons for use, and perceived benefits of CAM can help improve patient care and guide clinical practices. This study aimed to assess the prevalence, reasons for use, and perceived benefits of cupping therapy, apitherapy, and traditional cautery treatments among patients with rheumatic diseases. Additionally, it aimed to explore adverse effects, location and pricing disparities in CAM practices, information sources, and the rate of reporting CAM use to treat rheumatologists and to identify factors associated with the use of these CAM approaches. Methodology This single-center, cross-sectional study was conducted in a Moroccan University Hospital and included patients receiving care for rheumatic diseases during hospitalization or outpatient visits from January 2024 to March 2024. The data were collected using a structured, validated, and pilot-tested questionnaire administered by attending rheumatologists. The questionnaire aimed to gather demographic information and to identify patients using CAM, collecting data related to their utilization. Results A total of 100 patients were enrolled (mean age: 52.3 ± 12.8 years, 75% female). Among them, 43% had chronic inflammatory rheumatism. Additionally, 46% reported using at least one of the three CAM methods studied, with 36% using cupping therapy (specifically the wet method), 9% using apitherapy, and 16% using traditional cautery. The main reason for using CAM was to alleviate their pain (55%). Perceptions of effectiveness were reported by 38% of patients using cupping therapy, 20% using apitherapy, and 5.9% using traditional cautery. The use of CAM was significantly lower in patients with a university education (odds ratio = 0.05, 95% confidence interval = 0.003-0.92). Conclusions Our study revealed a significant prevalence of CAM use among patients with rheumatic diseases in Morocco, with cupping therapy emerging as the most commonly utilized method. These findings underscore the importance of enhancing awareness and understanding of CAM practices among both patients and healthcare providers to promote more structured and informed CAM practices.

“I Felt Like I Was Cut in Two”: Postcesarean Bodies and Complementary and Alternative Medicine in Switzerland

In neoliberal cultural contexts, where the ideal prevails that female bodies should be unchanged by reproductive processes, women often feel uncomfortable with their postpartum bodies. Cesareaned women suffer from additional discomfort during the postpartum period, and cesarean births are associated with less satisfying childbirth experiences, fostering feelings of failure among women who had planned a vaginal delivery. In Switzerland, one in three deliveries is a cesarean. Despite the frequency of this surgery, women complain that their biomedical follow-up provides minimal postpartum support. Complementary and alternative medicine (CAM) therapists address these issues by providing somatic and emotional postcesarean care. CAM is heavily gendered in that practitioners and users are overwhelmingly women and in that most CAM approaches rely on the essentialization of bodies. Based on interviews with cesareaned women and with CAM therapists specialized in postcesarean recovery, I explore women’s postpartum experiences and how they reclaim their postcesarean bodies.

Interdisciplinary Integrative Oncology Group-Based Program: Evaluation of Long-Term Effects on Resilience and Use of Complementary and Alternative Medicine in Patients With Cancer.

Cancer often causes reduced resilience, quality of life (QoL) and poorer overall well-being. To mitigate these problems, complementary and alternative medicine (CAM) is widely used among patients with cancer. This study aimed to evaluate the long-term effects of an interdisciplinary integrative oncology group-based program (IO-GP) on the resilience and use of CAM in patients with cancer. This was a prospective, observational, single-center study. Resilience (RS-13), CAM usage (I-CAM-G), QoL (SF-12) and health-related lifestyle factor (nutrition, smoking, alcohol consumption and physical exercise) data were collected for 70 patients who participated in a 10-week IO-GP between January 2019 and June 2022 due to cancer. The IO-GP is offered at the setting of a university hospital and is open to adult patients with cancer. It contains elements from mind-body medicine and positive psychology, as well as recommendations on healthy diet, exercise and CAM approaches. Patients who completed the IO-GP at least 12 months prior (1-4.5 years ago) were included in this study. Statistical analysis included descriptive analysis and parametric and nonparametric tests to identify significant differences (P < .05). Resilience increased significantly ≥12 months after participation in the IO-GP (n = 44, P = .006, F = 8.274) and had a medium effect size (r = .410). The time since the IO-GP was completed ("12-24 months," "24-36 months," and ">36 months") showed no statistically significant interaction with changes in resilience (P = .226, F = 1.544). The most frequently used CAM modalities within the past 12 months were vitamins/minerals (85.7%), relaxation techniques (54.3%), herbs and plant medicine (41.1%), yoga (41.4%) and meditation (41.4%). The IO-GP was the most common source informing study participants about relaxation techniques (n = 24, 64.9%), meditation (n = 21, 72.4%) and taking vitamin D (n = 16, 40.0%). Significantly greater levels of resilience were found in those practicing meditation (P = .010, d = -.642) or visualization (P = .003, d = -.805) compared to non-practitioners. IO-GPs have the potential to empower patients with cancer to continue using CAM practices-especially from mind-body medicine-even 1 to 4.5 years after completing the program. Additionally, resilience levels increased. These findings provide notable insight into the long-term effects of integrative oncology interventions on resilience and the use of CAM, especially in patients with breast cancer.

Prevalence of Complementary and Alternative Medicine Use and Its Associated Factors among Iranian Diabetic Patients: A Cross-Sectional Study

ObjectiveThis cross-sectional study aimed to assess the prevalence of complementary and alternative medicine (CAM) use and its associated factors among diabetic patients in Fasa, a city in southern Iran. MethodsData were collected from diabetic patients who visited the endocrinology clinics at Fasa University of Medical Sciences. A structured questionnaire was administered to gather information on CAM use, including the types of CAM modalities used, and reasons for use. The patient's demographic and clinical characteristics, such as age, gender, duration of diabetes, glycosylated hemoglobin (HbA1c) levels, and quality of life (QoL) were also recorded. Descriptive statistics were used to determine the prevalence of CAM use, while logistic regression analysis was employed to identify factors associated with CAM use. ResultsA total of 376 diabetic patients participated in the study, with more than 89% reporting CAM use within the past year. Herbal preparations were the most commonly used type of CAM, with a prevalence rate of 99.4%. Factors associated with CAM use included patients’ psychological health, attitude towards the safety of CAM, belief in the synergistic effects of combining routine medications with CAM, and previous positive experiences with CAM. ConclusionThe high prevalence of CAM use highlights the importance of considering it in diabetes management and the need for healthcare professionals’ engagement in open discussions with patients about their CAM practices. Understanding the factors influencing CAM use can inform healthcare providers and policymakers in developing appropriate strategies for integrating CAM approaches into conventional diabetes care.

The use of complementary and alternative medicine for the treatment of gastrointestinal symptoms in Long COVID: a systematic review.

Most people with coronavirus disease 2019 (COVID-19) experience resolution of symptoms within days to weeks following initial infection. In a subset of individuals, symptoms persist longer than 4 weeks, known as 'Long COVID'. Many gastrointestinal (GI) symptoms persist as part of this syndrome; yet, an approach to treatment remains unclear. Prior studies have demonstrated the efficacy of complementary and alternative medicine (CAM) for the treatment of acute COVID-19 infections, but little data exist regarding the potential use of CAM in the treatment of Long COVID. Identify CAM approaches useful in treating the GI symptoms of Long COVID. A systematic review of studies reporting on the use of CAM for the treatment of GI symptoms of Long COVID was performed. Five electronic databases were searched from January 2019 to November 2022. Studies describing the use of CAM to treat GI symptoms of Long COVID were included and assessed by two independent reviewers. Studies not reporting on GI symptoms or using CAM were excluded. Studies chosen for final review underwent quality and bias assessment using predetermined criteria. The extracted data were synthesized utilizing a framework derived from the National Center of Complementary and Integrative Health categories. The initial search yielded 396 articles. After applying the eligibility criteria, a total of four studies (three case reports and one case series) were included for final review. Two studies used nutritional supplements and two studies used traditional Chinese medicine. Reductions in nausea, loss of appetite, diarrhea, acid reflux, epigastric pain, and bloating were reported. This is the first systematic review to explore the role of CAM in treating GI manifestations of Long COVID. The review identified four studies, all reporting reductions in the GI symptoms of Long COVID. Despite the positive studies included in this review, the overall search yielded few results, all of which were non-experimental. As the post-infectious sequelae of COVID-19 become better recognized in the wake of the pandemic, higher-quality clinical studies are needed.

Knowledge and experiences of complementary and alternative medical practices among patients presenting to an orthopedic clinic: A cross-sectional study

This study aimed to determine the level of knowledge about complementary and alternative medicine (CAM) practices and the frequency of CAM use and treatment among patients who presented to an orthopedic outpatient clinic. Patients who presented to the orthopedics outpatient clinic of Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital between February 1 and April 1, 2020, were invited to participate in this study. A questionnaire containing 11 questions about 14 different CAM approaches, designed to determine patients’ knowledge of and attitudes toward each of these practices, was administered by the responsible physician through face-to-face interviews. A total of 359 patients were included in the study, the mean age was 49.0 ± 16.1 years and 240 (66.9%) were women. Of the 455 individuals who were considered eligible for the study, 96 refused to participate. The majority of the participants (78.8%) stated that they knew of at least one CAM approach. The most common sources of information were families or friends (54.1%). Of the participants, 30.6% had previously received at least one CAM treatment. About half of the participants (52.6%) stated that they would consider using the methods that they had heard of. The three most commonly known and applied methods were cupping, leech therapy, and acupuncture, respectively. Only 36.4% of the treatments were applied by health professionals. Almost all patients presenting to the orthopedics outpatient clinic had some knowledge of CAM approaches and more than half of them stated that they received such treatments. Health professionals should be aware that society is interested in these practices, regardless of professional support or opposition. All patients presenting to outpatient clinics should be asked about their usage of CAM methods, and the potential interactions of patients’ treatments with CAM practices should be considered.

Prevalence and determinants of using complementary and alternative medicine for the treatment of chronic illnesses: A multicenter study in Bangladesh.

While conventional medicine (CM) is commonly used to treat non-communicable diseases (NCDs), complementary and alternative medicine (CAM) is gaining popularity as a healthcare option in Bangladesh. We aimed to investigate the prevalence and factors associated with using CAM solely and using CAM in conjunction with CM for chronic illness treatment among NCD patients in Bangladesh. A multicenter cross-sectional study was conducted, including 549 adults with a confirmed chronic illness diagnosis from three tertiary care hospitals in Dhaka city. Interviews were used to gather socio-demographic data, while medical records were used to get information on chronic illnesses. A multinomial logistic regression model was used to determine the associated factors of utilizing CAM primarily and CAM use in conjunction with CM to manage the chronic disease. Out of 549 NCD patients (282 women [51.4%], mean [standard deviation] age 45.4 [12.8] years), 180 (32.8%) ever used CAM for the treatment of chronic illness. Also, 15.3% of patients exclusively used CAM among the NCD patients, while 17.5% used CAM in conjunction with CM. Homeopathy medicine was the most prevalent type of treatment among CAM users (52.2%). Furthermore, 55.5% of CAM users said they used it due to its less adverse effects, and 41.6% trusted its effectiveness for chronic illness. Elderly patients (≥60 years) preferred CAM in complementary with CM, but they did not rely only on CAM. According to the multinomial regression analysis, unmarried patients, predominantly in the younger age group, adopted CAM significantly for chronic illness treatment (Relative risk ratio, RRR = 0.29, 95% CI = 0.12-0.71, reference = Unmarried). Patients in the high-income group used CAM in conjunction with CM (RRR = 6.26, 95% CI = 1.35-18.90, reference: low-income), whereas patients in the high-income group did not rely on CAM alone (RRR = 0.99, 95% CI = 0.34-2.85). Although CM remains the mainstream of health care in Bangladesh, CAM services play an essential role in people's health care, particularly in treating chronic illnesses. Physicians of Bangladesh should be aware that their patients may be using other services and be prepared to ask and answer questions regarding the risks and benefits of using CAM in addition to regular medical care. Thus, clinicians required to follow best-practice guidelines, which are currently not practiced in Bangladesh, when disseminating information regarding integrative techniques that combine CM and CAM approaches.

Biological Therapy with Complementary and Alternative Medicine in Innocuous Integrative Oncology: A Case of Cervical Cancer.

Good medicine is based on good science, inquiry driven and open to new paradigms. For a complex disease such as cancer, a complex treatment regime that is well structured and multifactorial is indispensable. In the present day, Complementary and Alternative Medicine (CAM) therapies are being used frequently for cancer, alongside modern biological therapies and allopathic medicine, in what is called integrative oncology. In all conscience, the use of natural, less invasive interventions whenever possible is ideal. However, a comprehensive understanding of not only the etiopathology of individual cancers, but also the detailed genetic and epigenetic characteristics, the cancer hallmarks, that clearly show the blueprint of the cancer phenotype is a requisite. Different tumors have a common behavioral pattern, but their specific features at the genetic and epigenetic levels vary to a great extent. Henceforth, with so many failed attempts to therapy, drug formulations and combinations need a focused pre-assessment of the inherent features of individual cancers to destroy the tumors holistically by targeting these features. This review therefore presents innocuous therapeutic regimes by means of CAM and integrative medicine approaches that can specifically target the hallmarks of cancer, using the case of cervical cancer.

Complementary and alternative medicine therapies and COVID-19: a systematic review.

Despite the high prevalence of coronavirus and various treatment approaches, including complementary and alternative medicine (CAM), there is still no definitive treatment for coronavirus. The present study aimed to evaluate the effect of CAM interventions on COVID-19 patients. Four databases (Web of Science, PubMed, Scopus, and EMBASE) were searched from the inception of databases until July 16, 2020. Keywords included complementary and alternative medicine therapies and Coronavirus. Of the 1,137 studies searched, 14 studies performed on 972 COVID-19 patients entered the systematic review final stage. The results showed that different CAM interventions (acupuncture, Traditional Chinese medicine [TCM], relaxation, Qigong) significantly improved various psychological symptoms (depression, anxiety, stress, sleep quality, negative emotions, quality of life) and physical symptoms (inflammatory factors, physical activity, chest pain, and respiratory function) in COVID-19 patients. The results showed that various CAM interventions have a positive effect on improving the various dimensions of coronavirus disease but since there are few studies in this regard, further studies using different CAM approaches are recommended.

Complementary and Alternative Medicine for Threatened Miscarriage: Advantages and Risks

Threatened miscarriage is one of the most common complications causing pregnancy loss, and it affects approximately 20% of confirmed pregnancies. More and more women are seeking treatment with complementary and alternative medicine (CAM) for this common complication, and it has been reported that women have had successful pregnancies after threatened miscarriage when being treated with CAM, which mainly includes Chinese herbal medicines, acupuncture, and nutritional supplements as well as psychological interventions and other approaches. However, many experts are concerned about the safety and adverse events of certain CAM approaches in women with threatened miscarriage. Therefore, this review focuses on the status of CAM for threatened miscarriage and presents the potential therapeutic efficacy and safety of CAM based on some clinical and experimental studies. We thus hope to provide some instructive suggestions for the application of CAM for treating threatened miscarriage in the future.

Complementary and alternative therapies for poststroke depression: A protocol for systematic review and network meta-analysis.

Background:Poststroke depression (PSD) is an important complication of stroke, resulting in increased disability and mortality, which is a great threat to stroke survivors and public health. Complementary and alternative medicine (CAM) therapies is widely used in the treatment of PSD, However, the selection strategies of different CAM approaches in clinical practice is still not clear, and the purpose of this protocol is to compare the efficacy and acceptability of different CAM therapies using systematic review and network meta-analysis.Methods:According to the strategy, the authors will retrieve a total of seven electronic databases by August 2020, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chinese Scientific Journals Database, and Wan-fang databases. The network meta-analysis will be performed using Aggregate Data Drug Information System 1.16.8 and Stata 13.0 software. In addition, the Cochrane Collaboration's tool is employed for the methodological quality, and the quality of evidence will be evaluated according to the Grading of Recommendations Assessment, Development, and Evaluation system.Results:This study will provide a reliable evidence for the selection strategy of CAM therapies for PSD.Conclusion:The results of this study will provide references for evaluating the effects of different CAM therapies on PSD, and provide decision-making references for clinical practitioners, patients, and health policy makers.Ethics and dissemination:This study does not require ethical approval. the results will be disseminated through a peer-reviewed publication.OSF registration number:DOI 10.17605/OSF.IO/TNGH6.

The Perceived Credibility of Complementary and Alternative Medicine: A Survey of Undergraduate and Graduate Students

ABSTRACT The popularity of complementary and alternative medicine (CAM) appears to be increasing, especially among college students. We surveyed 146 undergraduate and graduate students with the CAM Health Belief Questionnaire and obtained credibility and frequency ratings for a select group of CAM therapies: yoga, meditation, massage, chiropractic medicine, biofeedback, hypnosis, acupuncture, spirituality/religion, therapeutic touch, the use of herbs/vitamins, and aromatherapy/essential oils. Graduate students held more favorable views about integrating CAM into conventional medical practice. Female students reported using a wider variety of therapies than male students. Spirituality/religion and herbs/vitamins were the most popular CAM approaches. Students rated yoga, meditation, and massage as being highly credible practices. They rated hypnosis and therapeutic touch low in credibility. We discuss hypnosis as an example of a therapy that suffers from poor public perception despite having a relatively strong evidentiary base.

Complementary and alternative therapies from the Turkish Physician's perspective: An embedded mixed-method study

PurposeThis study aimed to elucidate the attitudes of Turkish physicians toward complementary and alternative medicine (CAM). MethodsThis mixed-method study was carried out on Turkish physicians (n = 103). Eight participants were personally interviewed in detail. The attitudes of the physicians were obtained after the quantitative phase and were analyzed using qualitative content analysis. Data were collected using the Holistic Complementary and Alternative Health Questionnaire (HCAMQ), and socio-demographics. ResultsThe mean HCAMQ scores were 34.98 ± 4.65. Prevailing themes were: (1) the placement of CAM in medicine, (2) unclear aspects of CAM, (3) underlying factors of attitudes toward CAM, (4) acceptance of CAM subject to conditions, (5) reactions to CAM usage, and (6) popular CAM approaches and their positive effects. ConclusionThe majority of physicians were skeptical about CAM but reported being non-judgmental toward patients that had used CAM. However, they also highlighted that considering evidence-based outcomes.

Gender specific association between the use of complementary and alternative medicine (CAM) and alcohol consumption and injuries caused by drinking in the sixth Troms\xf8 study

BackgroundAlcohol is consumed almost worldwide and is the most widely used recreational drug in the world. Harmful use of alcohol is known to cause a large disease-, social- and economic burden on society. Only a few studies have examined the relationship between CAM use and alcohol consumption. To our knowledge there has been no such research in Norway. The aim of this study is to describe and compare alcohol consumption and injuries related to alcohol across gender and different CAM approaches.MethodsThe data used in this study is based on questionnaire data gathered from the sixth Tromsø Study conducted between 2007 and 2008. Information on CAM use and alcohol consumption was available for 6819 women and 5994 men, 64.8% of the invited individuals. Pearson chi-square tests and independent sample t-tests were used to describe the basic characteristics of the participants and to calculate the differences between men and women regarding these variables. Binary logistic regression analyses were used to investigate the associations between the different CAM approaches and alcohol consumptions and injuries caused by drinking.ResultsWomen who drank alcohol more than once a month were more likely to have applied herbal or “natural” medicine and self-treatment techniques (meditation, yoga, qi gong or tai-chi), compared to those who never drank, and those who only drank monthly or less. For women, an association was also found between having experienced injuries caused by drinking and use of self-treatment techniques and visit to a CAM practitioner. No association was found between amount of alcohol consumed and use of CAM approaches. For men, an association was found between injuries caused by drinking and use of herbal or “natural” medicine.ConclusionThe findings from this cross-sectional study suggests that women who drink frequently are more likely to use “natural” medicine and self-treatment techniques. Both men and women who had experienced injuries because of their drinking were more likely to have used CAM approaches.

Naturopaths in Ontario, Canada: geographic patterns in intermediately-sized metropolitan areas and integration implications.

Evaluating conventional medicine (CM) and complementary and alternative medicine (CAM) with respect to integration opportunities (such as patient referrals and professional knowledge sharing) and possible geographic implications is novel. This research utilizes nearest neighbour and local spatial autocorrelation statistical analyses and surveys directed towards Doctors of Naturopathic Medicine (NDs) and their patients to better understand the geographic patterns of NDs and potential integration qualities. While the statistical tests reveal that the offices of NDs and Doctors of Medicine (MDs) display clustered patterns in intermediately-sized census metropolitan areas in Ontario and that the majority of NDs are near MDs, proximity is not manifesting in discernible integration tendencies between NDs and MDs. The NDs polled were strongly in favour of greater integration with the CM sector (as were their patients) to: achieve better patient health outcomes and to gain efficiencies within the health care system. Yet, both surveys also indicate that the barriers to integration are substantial and, generally speaking, centre on the perception that many MDs lack respect for, and/or knowledge about, naturopathic approaches. It is speculated that as students in conventional medical schools are increasingly exposed to CAM approaches, perhaps more MDs in the future will be receptive to greater integration with CAM. Should this occur, then it is also possible that geographic proximity may be a catalyst for deeper CAM-CM integration; as it has been for CAM-CAM relationships.

KNOWLEDGE, OPINIONS AND PRACTICES OF NURSING STUDENTS ABOUT COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) APPROACHES: A TURKISH EXAMPLE

The study was carried out to explore the knowledge, opinions and practices of nursing students when it comes to complementary and alternative medicine (CAM) approaches. The study was done with 264 nursing students who were studying at a health school located in Turkey. The data was collected using a student information form. To assess the data; percentage, averages, standard deviation (SD) and Chi-squared test were employed. The most common CAM approaches were praying (63.3%), exercising (53.0%) and imagery therapy (46.2%). Of the 33.7% students had received information about CAM from some sources. As information sources; 58.4% of the students used internet, TV and 42.6% of them used newspaper, magazines and books. Additionally, 49.6% of the students stated that they have used CAM approaches. The most frequently used CAM approach by students was praying (42.0%). About half of the students (48.5%) resorted to CAM approaches in stress situations. Most of the students (79.9%) stated that massage was helpful. Of the 64.0% students emphasized that they wanted CAM approaches to be included in nursing curriculum. There were no statistically significant differences between use of CAM approaches and students� age, sex, marital status and family�s place of residence (p>0.05) but there was a statistically significant differences between students� class and use of CAM approaches (p<0.05). In light of the study results; it was discovered that nursing students had a generally positive opinion about CAM approaches but their knowledge level and practices related to CAM approaches were insufficient.

Psychosomatic and physical responses to a multi-component stress management program among teaching professionals: A randomized study of cognitive behavioral intervention (CB) with complementary and alternative medicine (CAM) approach

BackgroundThe present study aims to assess psychosomatic and physical responses to a multi-component stress management program with the use of CAM and CB approaches among teaching professionals in Hong Kong. MethodA random controlled trial (RCT) was used to compare between CB group (n = 26) and the CAM-CB group (n = 30). Interventions were administered for 1.5 h once a week for eight consecutive weeks. A self-administered questionnaire including perceived stress scale (PSS) and frequency of psychosomatic symptoms were measured at baseline (T1), immediate after the program (T2), and 4 weeks after the program (T3). Physical parameters were measured at T1 and T2. ResultsA reduction of 23% in PSS was observed in the CB group, while the CAM-CB group yielded 18% reductions in PSS from T1 to T3 [F(2,108) = 3.099; p = .049]. No significant interactions were observed in the frequency of psychosomatic symptoms and physical parameters. However, a significant downward time trend was observed (p < .001) and larger percentage changes in physical responses were shown in the CAM-CB group than CB group. ConclusionClinical evidence of both the CAM-CB and CB program has been demonstrated in the current study and both approaches are easy to be self-implemented. The CAM technique might serve as an alternative choice for self-administered stress management to replace the additional time needed for professional follow-up contacts. It might further improve some physical responses such as handgrip strength and resting heart rate, which are associated with better psychosomatic health and better occupational stress management.

Value-Added Services in Hospitals: Does Chiropractic Care Have Economic and Marketing Impact

Chiropractic services as mainstream medicine continues to be a major debate among allopathic providers, chiropractic physicians, payers, consumers, and most health care stakeholders. It has been viewed by many as an alternative to traditional treatment for pain relief, structural manipulation for body alignment, and other acute and chronic anatomy and physiological conditions. Historically viewed by many as the outskirts of medical care, chiropractic care recently has become more prevalent among first and second choice care among consumers for certain health ailments. The evolution of complementary and alternative medicine (CAM) beginning in the late 1990’s has helped support the chiropractic profession in establishing ground to be more mainstream medicine including some claims coverage by insurance carriers. Post Patient Protection and Affordable Care Act (PPACA) America has one of its main focuses on improving primary and preventive care as well as hospital care across the United States with a purpose of reducing the overall cost of healthcare. Chiropractic care, being one of the largest CAM approaches, is certain to see changes. In this systemic review article (N=22) we will look at the role of chiropractic services in hospital settings, its funding, and potential marketing and economic value added to hospitals and the health system. The authors identify relevant literature to the research question through an exhaustive review and draw conclusions based on common factors within the literature. Hospital continues to find treatment protocols and efficiencies to reduce cost per inpatient stay. The results of this study suggest that chiropractic care can reduce cost per stay and improve health outcomes. The impact of increased integration of chiropractic services into hospital settings needs to be studied to determine long-term cost/benefit.

Improving Sustainability of Cognitive-Behavioral Therapy (CBT) by Complementary and Alternative Medicine Approaches (CAM) on Reducing Workplace Stress of Teachers

This article argues that the sustainability of cognitive behavioral therapy (CBT) may be improved by the addition of complementary and alternative medicine (CAM) approach in helping teachers reduce their workplace stress. This is demonstrated by two clinical trials testing the effectiveness of a multi-component stress management program with the concurrent use of CBT and CAM approaches developed in Hong Kong. The multi-component stress management is shown to be effective in reducing and relieving stress-related emotional or psychosomatic symptoms. Meanwhile, the self-administered CAM techniques may serve to sustain the effects produced by CBT approach. This has the advantage of saving the additional resources needed from intervention by trained professionals such as occupational therapists and psychologists. Implications and future directions are discussed

Race, Pain, and Beliefs Associated with Interest in Complementary and Alternative Medicine among Inner City Veterans.

To investigate the prevalence and determinants of complementary and alternative medicine (CAM) interest level among a racially diverse cohort of inner city veterans who receive primary care at the VA Medical Center. Cross-sectional survey study Philadelphia VA Medical Center Primary care patients (n = 258) METHODS: Interest in CAM was measured using a single item question. Patient treatment beliefs were assessed using validated instruments. We evaluated factors associated with patient interest in CAM using a multivariate logistic regression model. In this sample of 258 inner city primary care VA patients, interest in CAM was high 80% (n = 206). Interest in CAM was strongly associated with African American race [adjusted odds ratio (AOR) 2.19, 95% Confidence Interval (CI) 1.05-4.60, P = 0.037], higher levels of education (AOR 4.33, 95% CI 1.80-10.40, P = 0.001), presence of moderate to severe pain (AOR 2.02, 95% CI 1.02-4.78, P = 0.043), and expectations of benefit from CAM use (AOR 1.21, 95% CI 1.06-1.36, P = 0.004). CAM approaches have broad appeal within this inner city cohort of veterans, particularly among African Americans, those that experience pain and those that expect greater benefit from CAM. These findings may inform the development of patient-centered integrative pain management for veterans.