Families of children with cancer and nonmalignant blood disorders frequently explore complementary medicine (CM). Despite growing evidence supporting CM for pediatric populations, physician communication about its use remains limited. This study evaluates caregiver awareness, interest, and use of CM among pediatric hematology/oncology patients. A cross-sectional survey was conducted among caregivers at the University of North Carolina Pediatric Hematology/Oncology Clinic (May-September 2024). Eligible participants spoke English or Spanish and had attended at least one clinic visit. The survey assessed awareness and use of CM, including nutrition, supplements, mind-body practices (e.g., prayer, acupuncture, and yoga), and whole medical systems (e.g., traditional Chinese and Ayurvedic medicines)-as well as costs, motivations, and barriers. A total of 150 caregivers completed the survey. Only 30% of respondents were familiar with CM terminology, yet 58% reported using at least one CM form. Dietary modifications were most common (47%), followed by mind-body practices (20%). Caregivers of cancer patients prioritized CM to reduce treatment side effects, whereas caregivers for those of patients with nonmalignant hematology conditions prioritized long-term quality-of-life. Barriers included lack of awareness (61%) and cost (15%). Only 17% had discussed CM or PIM (pediatric integrative medicine) with clinicians, and in most cases (60%), caregivers initiated the conversation. Findings highlight significant gaps in awareness, access, and clinician-family communication regarding pediatric CM. Despite limitations such as single-site design and modest sample size, results underscore the need for caregiver education and accessible services to better support pediatric patients and families.

Integrative medicine is gradually becoming established in the French-speaking Swiss medical landscape. Driven by both patient demand and the desire of institutions to structure the services on offer, this model of care has become established both in the private and public sectors. This article presents public initiatives in French-speaking Switzerland that have reached a milestone in 2025 in the field of integrative medicine. These initiatives are notable for their commitment to research and teaching. They consolidate the integration of complementary practices in hospitals and form communities of practice.

Migrant populations drive Canada’s demographic expansion, making their successful integration a national priority. However, research has consistently shown that refugees and immigrants experience declining mental health and encounter significant barriers to accessing culturally appropriate mental health support. This scoping review examined the breadth of evidence on culturally adapted mental health education (MHE) programs for migrant populations, including those that integrate traditional and complementary healing practices, and their effectiveness. Systematic searches across six databases (Medline, EMBASE, PsycINFO, Global Health, CINAHL, and Scopus) identified 4075 peer-reviewed articles, with 28 studies meeting inclusion criteria. These included mental health education and awareness programs that integrate psychoeducation and skill-building. Inclusion criteria required cultural adaptation of programs through one or more approaches such as language modification, culturally adapted content, community-based delivery, or integration of traditional and complementary healing practices. Thematic analysis of the programs revealed seven key themes characterizing effective MHE programs: cultural adaptation and sensitivity, addressing unique migration-related stressors, integration of traditional and Western approaches, use of theoretical frameworks and evidence-based practices, rigorous evaluation methodologies, application of holistic frameworks, and community-based peer support models. Programs predominantly utilized psychoeducation and culturally adapted interventions, with common theoretical frameworks including cognitive–behavioral therapy and the PRECEDE–PROCEED model. Across the reviewed studies, program evaluations reported positive outcomes including increased mental health literacy, reduced stigma, enhanced coping skills, and decreased depression, anxiety, and PTSD symptoms, suggesting that culturally adapted MHE programs are acceptable and feasible interventions for migrant populations.

Objective: This study aimed to identify traditional and complementary medicine practices observed by nursing students in wound care. Method: This descriptive and cross-sectional study was conducted with nursing students. The sample consisted of 249 students. Data were collected through a sociodemographic questionnaire and a 15-item open-ended form designed to explore traditional and complementary medicine practices in wound care. Descriptive statistics were used for data analysis, and frequency (n) and percentage (%) distributions were calculated. Institutional and ethics committee approvals were obtained prior to the study. Results: Among the participants, 10.4% were male and 89.6% were female; the largest group was second-year students (32.5%). The most common practice for sunburn was applying yogurt (78.4%). For infection-related wounds, cologne (23.2%), onion juice (19.6%), and St. John’s wort oil (19.6%) were frequently observed. In burn injuries, cold-water application (47.9%), yogurt (11.8%), and ice (11.1%) were reported. For surgical wounds, St. John’s wort oil (65.2%) and Aloe vera (21.3%) were applied; in traumatic wounds, ice (53.6%) was preferred. Conclusion: The findings highlight culturally embedded practices in wound care, emphasizing the need to strengthen patient-centered approaches and distinguish non-evidence-based methods to promote evidence-based nursing care.

Oxyfertigation with hydrogen peroxide (H2O2) has been successfully applied in several crops and production systems, but its use in mature citrus orchards under no-tillage conditions and semi-arid Mediterranean environments remains scarcely studied. This study aimed to evaluate the physiological responses of adult citrus trees and the agronomic performance of a mature citrus orchard subjected to chemical oxyfertigation based on the application of H2O2 in irrigation water as an oxygen source for the root zone. The experiment was conducted over four consecutive seasons (2018–2021) on adult ‘Ortanique’ hybrid mandarin trees grown in an orchard located in Torre Pacheco (Murcia, Spain). Two treatments were established: a ‘Control’ (0 mg L−1 of H2O2) and an ‘OXY’ treatment (50–100 mg L−1 of H2O2 applied throughout the growing season). Oxyfertigation significantly increased the dissolved oxygen in irrigation water and soil oxygen diffusion rate, with treatment and treatment × time effects showing greater oxygenation under conditions favoring transient root-zone hypoxia. Soil CO2 and H2O vapor fluxes exhibited marked seasonal dynamics but no consistent treatment effect, and soil salinity and macro- and micronutrient contents were not significantly altered. At the plant level, oxyfertigation episodically enhanced leaf gas exchange and transiently improved the water status, but did not produce a sustained increase in leaf-level water use efficiency. In contrast, OXY trees showed greater pruning biomass, more fruits (+18%), higher cumulative yield (+13%), and significantly higher crop water use efficiency (YWUE) while the mean fruit weight and most quality attributes were governed by interannual climatic variability. In summary, oxyfertigation acted as a complementary and safe agronomic practice that improved rhizosphere oxygenation and supported modest gains in fruit load and YWUE in mature citrus orchards.

The COVID-19 pandemic outbreak caused physical, psychological, and social problems all over the world, especially in individuals with chronic diseases such as diabetes mellitus. People have sought complementary and alternative medicine methods to prevent this disease or treat its symptoms. This study aimed to evaluate the use of complementary and alternative medicine practices among diabetes patients during the pandemic. The study adopted a cross-sectional descriptive design. The study sample comprised patients diagnosed with diabetes who were treated at a state hospital in southern Turkey from September 2022 to October 2023. Data were collected using a questionnaire (containing three sections) form prepared by the researcher in line with the literature. Patients with diabetes mellitus, aged over 18 years, were included in the study. A total of 300 patients completed a demographic information questionnaire and a questionnaire regarding complementary and alternative medicine use. The data obtained from the study were analyzed using descriptive tests and the SPSS 22 package program. The findings revealed that 75.3% of participants were knowledgeable about complementary and alternative medicine methods, and 94.7% reported using them during the pandemic. The commonly preferred practices included drinking herbal tea (68.0%), consuming a variety of vegetables and fruits (54.3%), using probiotic products (37%), taking vitamin and nutritional supplements (23%), and engaging in prayer (65.7%). Hygiene practices mainly included using hand sanitizer and cleaning household surfaces with bleach. The study's findings suggest that diabetes patients widely utilized nutritional supplements, medicinal plants, and personal hygiene products during the Coronavirus disease 2019 outbreak. Towards this end, healthcare professionals must educate patients on the correct and effective use of complementary and alternative medicine methods and hygiene products to ensure their safety and well-being. coronavirus disease 2019, diabetes mellitus, complementary and alternative medicine, nursing, prevention.

Yoga is a term derived from the Sanskrit term “Yuj”, which means to merge or to unite. That can be conceptualized as mind and body practice. The term Yoga collectively would be used in reference to the physical movements accompanying with breathing exercises and the mental relaxation or meditation. Pregnancy is said to be the state in which mother goes through various physiological as well as psychological changes which may create certain hindrance in leading a normal life to a pregnant mother. Practicing Yoga during pregnancy provides a great range of emotional regulation, develops strong compassion to the unborn child, and gives the capacity to pregnant woman to adjust the inner and outer changes flexibly and minimizes the complications of pregnancy. Yoga is said to be a low impact, intentional and readily modifiable exercise making it suitable for pregnant women. The most assessed pregnancy-related factors include stress, anxiety, depression, pregnancy and labor pain and sleep. Yoga has been practiced for thousands of years known for its ability to strengthen the social, physical, and mental health of women and emerged as a complementary antenatal practice among the pregnant women. This article is an approach to Yoga in Pregnancy can improve the course of pregnancy and pregnancy outcomes as well.

Celiac disease (CD) is an autoimmune disorder triggered by pepsin-resistant, gluten-derived immunogenic peptides (GIPs) in genetically predisposed individuals. Enzyme therapy targeting GIPs has been suggested as a complementary practice to a gluten-free diet to help reduce the symptoms of CD. Here, we present the crystal structure of RmuAP1, a pepsin-like aspartic protease from Rhodotorula mucilaginosa, which effectively degrades the toxic 33-mer and 26-mer GIPs under postprandial gastric conditions (pH 3.0–6.0). RmuAP1 has a canonical fold characteristic of the aspartic protease subfamily A1; however, it features a distinct flap and a flexible loop structure. Compared to pepsin, RmuAP1 accommodates the tetrapeptides PQQP and PQPQ, motifs frequently repeated on GIPs, via an adaptable binding cleft. Molecular dynamics (MD) simulations have shown that RmuAP1 stably engages these ligands, maintaining both the catalytic water in position and a closed flap conformation, primarily through ligand-induced remodeling of the S1′ pocket. In contrast, pepsin neither binds these ligands effectively nor achieves a catalytically competent conformation. Structural comparisons and dihedral analysis further support an induced-fit mechanism underlying RmuAP1’s pocket remodeling. Together, this study clarifies the structural basis for RmuAP1 to hydrolyze GIPs, emphasizing the potential of RmuAP1 as a platform for developing enhanced oral peptidase for CD patients through protein engineering approaches.

Introduction: The pursuit of holistic health aligns with Ayurvedic principles emphasizing mind-body harmony. Psychological well-being, an essential determinant of overall health, influences stress resilience, emotional stability and cognitive function. Pranayama (~breath control techniques), particularly Bhramari Kumbhaka (~humming bee breath), is recognized for its role in balancing Prana (~life force) and stabilizing the nervous system. This case report explores the effects of Bhramari Kumbhaka on salivary cortisol and serum dopamine levels, essential biomarkers linked to stress response and psychological well-being. Methods: A healthy 22-year-old male with a Kapha-dominant Prakruti(~Nature) underwent a structured three-month Yogic breathing intervention. Daily sessions included Bhramari Kumbhaka with complementary practices. Salivary cortisol and serum dopamine levels were assessed pre- and post-intervention, along with psychological well-being scales and QOL-BREF scale. Results: Post-intervention, serum dopamine levels increased significantly (74.19 to 98.21 pg/mL), indicating enhanced neurophysiological balance while Salivary cortisol remained unchanged. Psychological well-being scores in WMWBS and physiological and mental health domains in QOL were improved. Discussion: The findings suggest that Bhramari Kumbhaka may modulate neuroendocrine function, supporting stress resilience and cognitive well-being. Its impact on autonomic regulation aligns with Ayurvedic principles of stabilizing Vata and promoting Sattva Guna (~mental clarity). Further research is required to validate its long-term benefits in preventive healthcare.

Scenario planning is a valuable tool for managing uncertainty in an organization, but its impact can be limited if the insights it generates fail to gain traction. Two experts explain how to better manage scenario planning and help it take root in large enterprises by linking it to complementary practices. They propose a conceptual model consisting of three scenario-planning phases supported by three crucial organizational capabilities that help connect all the pieces.

Trataka Karma is one of the Shatkarma practices mentioned in Yogic literature, and it holds an important place in both ocular and mental health traditions of ancient India. Ayurveda considers the Netra (eye) a highly delicate sense organ, governed primarily by Alochaka Pitta and nourished by all seven Dhatus. Imbalance of Doshas, especially due to overuse, misuse, or excessive strain, leads to visual disturbances such as Timira, which begins with blurred or unclear vision. Yoga provides complementary practices to purify and strengthen both the eyes and the mind. Among these, Trataka Karma, steady gazing without blinking until tears naturally flow, is described in texts such as the Hatha Yoga Pradipika and Gheranda Samhita as beneficial for cleansing the eyes, improving concentration, and calming mental restlessness. This review compiles references from classical Ayurvedic and Yogic sources, including the Rigveda, Upanishads, Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, Hatha Yoga Pradipika, and Gheranda Samhita, along with modern scientific insights. The conceptual basis of Trataka Karma is explored through the lens of Netra Sharira, Dosha dynamics, and Yogic purification techniques. Modern correlations, such as accommodation exercise, tear-film stability, relaxation response, and attention enhancement, help validate the classical claims. With digital eye strain, myopia, and mental stress rising globally, Trataka Karma emerges as a safe, inexpensive, and practical preventive tool. Its enduring relevance demonstrates the wisdom of integrating ancient holistic knowledge with contemporary wellness needs.

ABSTRACT This article examines the economic activities of Jews, Mudejars and, above all, New Christians in the Kingdom of Aragon during the fifteenth century. It argues that these confessional communities cultivated complementary economic practices that sustained a pragmatic mode of urban coexistence. This equilibrium was first unsettled by the anti-Jewish riots of 1391 and later reshaped by the mass conversions that followed the Disputation of Tortosa (1413–1414). A distinctive converso micro-society then emerged, whose elites – jurists, notaries, merchants and brokers – rapidly integrated into civic life, especially in Aragonese towns, where their absorption proved less conflictive than in Valencia or Catalonia. Drawing on notarial protocols, inquisitorial records and municipal documentation, the study reconstructs these groups' economic networks and analyses their roles in credit, commerce and the professions. Particular attention is paid to women's participation in property transmission and marital strategies, and to the prominence of Jewish and converso physicians, whose expertise often enabled social mobility across confessional boundaries. By situating Jewish and converso economic profiles within the multicultural framework of late medieval Aragon, the article highlights both minority resilience and the structural tensions that ultimately culminated in the establishment of the Inquisition.

Integrative and complementary practices (ICPs) comprise complex medical systems and therapeutic resources that seek to stimulate natural disease prevention and health recovery mechanisms by promoting changes in lifestyle habits. The aim is to investigate the association between the use of ICPs and the prevalence of healthy eating habits in Brazil's population. This cross-sectional study used data on adult and older adult participants in Brazil's 2019 National Health Survey. Prevalence of habits was estimated by categories of ICP use, together with prevalence ratios adjusted by sociodemographic characteristics and chronic disease, using Poisson regression models with robust variance and 95% confidence intervals. ICP use was 5.5% prevalent. Interviewees who used some ICP during the period, returned a higher prevalence of regular consumption of fruits and vegetables and a lower prevalence of consumption of soft drinks, ultra-processed foods and beans. ICP users reported a higher prevalence of healthy eating habits, which is consistent with the approach the practices foster. Expanding access to ICPs can contribute to a healthier lifestyle.

The article presents the way in which gamification can be used as a formative assessment method in primary education, by conducting a pedagogical experiment carried out in the second grade, within the Romanian Language and Literature classes. The experiment was carried out over five months and had as reading support the volumes “Heidi, the Little Mountain Girl” by Johanna Spyri and “The Wizard of Oz” by L. Frank Baum. The assessment of the comprehension of literary texts was carried out through the Plickers application, a digital resource that allows the rapid collection of students’ responses through the use of coded cards, without the need for individual electronic devices. This feature makes it suitable for the primary cycle, while providing instant feedback and favoring a playful dynamic of the assessment. This assessment method was used complementary to other methods, with the emphasis being placed on the formative nature of the assessment. The results of the experiment indicated an increase in the average scores obtained by students observed in the results obtained by students, as well as a constant and active participation in the activities. Direct observations highlighted the fact that gamification, integrated with the help of digital resources, stimulates involvement and supports active learning, without generating the pressure associated with traditional assessments. It was also noted that the success of the method depends on the digital and pedagogical skills of the teaching staff, an aspect that emphasizes the importance of continuous training of teachers in the use of educational technology. The article supports the promotion of formative assessment, in which the mistake is accepted as a learning opportunity, and feedback becomes a tool to support progress. The conclusions of the research recommend the integration of gamification and digital resources as complementary practices in primary school teaching activities.

The use of gamification as an active learning methodology offers an alternative approach to teaching and learning for undergraduate pharmacy students and healthcare professionals working in the Brazilian Unified Health System (SUS), particularly those involved in Integrative and Complementary Practices in Phytotherapy. Considering that Phytotherapy is one of the oldest integrative practices and is recognized by the World Health Organization (WHO), especially for its relevance within the National Policy on Integrative and Complementary Practices (PNPIC), it contributes to expanding humanized and comprehensive healthcare. However, gaps still remain between popular knowledge and the scientific knowledge regulated by SUS, especially regarding the standardization and safety of medicinal plant use. Based on the information gathered, the educational game FITOSUS was developed to assess the feasibility and practicality of using gamification as a playful training tool in education. The game contains thematic cards with descriptive and scientific clues about the medicinal plants included in SUS. Its objective is to stimulate clinical reasoning and learning among pharmacy students and healthcare professionals, integrating theory and practice through an active and interactive methodology.

Forest therapy, guided by clinical professionals (psychologists or psychotherapists), is increasingly recognized as a preventive and complementary health practice with evidence-based therapeutic potential; however, the specific contribution of therapist guidance compared to self-guided immersion remains unclear. This retrospective study evaluated the short-term mental health outcomes of therapist-guided (TG) compared to self-guided (SG) forest immersion, based on the validated State–Trait Anxiety Inventory and Profile of Mood States questionnaires. Data were collected from 282 adults participating in eight paired TG–SG sessions conducted at the same forest sites across Italy. The results showed that TG sessions were associated with greater improvements in state anxiety, self-esteem, and total mood disturbance, with statistically significant effects in most cases. Therapist-led guidance also occasionally reduced interindividual variability, suggesting enhanced emotional regulation. An illustrative economic assessment, based on standardized psychometric improvements translated into quality-adjusted life years (QALYs), indicated that the TG sessions yielded approximately 1.7 times the annual per-person economic value of the SG sessions, outweighing the associated therapist-related costs. These findings suggest that TG forest therapy interventions deliver significant and economically quantifiable added value compared to SG experiences, supporting their inclusion in preventive health and mental well-being programs and justifying further longitudinal and cost-effectiveness investigations.

Psychological distress in cancer patients is a frequent and complex condition that significantly compromises quality of life, from diagnosis to palliative care. In this context, the use of music emerges as a promising, safe, and low-cost complementary practice capable of alleviating symptoms such as emotional distress. However, there are still gaps in the literature regarding the types, contexts, and specific effects of musical interventions in cancer patients. Thus, this protocol proposes a scoping review to map the available scientific evidence on the use of music as an intervention for the reduction of psychological distress in cancer patients. The methodology will adhere to the guidelines of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. The search will be conducted across twenty data sources, including PubMed Central, Latin American and Caribbean Literature in Health Sciences, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Scientific Electronic Library Online, Cochrane Library, Elsevier’s Scopus, ScienceDirect, Wiley Online Library, and the Virtual Health Library. For gray literature, Catalog of Theses and Dissertations of the Coordination for the Improvement of Higher Education Personnel, the Networked Digital Library of Theses and Dissertations,Google Scholar, European Thesis Portal; Electronic Thesis Online Service; Open Access Scientific Repository of Portugal; National Theses and Dissertations; Theses Canada; Treasury of the National Library of Australia; Online Academic Archive will be searched. Study screening and selection will be performed independently by two researchers according to the inclusion and exclusion criteria. Relevant data will be extracted into a structured spreadsheet, including study characteristics, type and setting of the musical intervention, outcomes related to psychological distress, and the role of nursing. The findings are expected to inform clinical practice, particularly in the field of oncology nursing, as well as to identify gaps for future research.

Background: Hypertension is a major public health problem, accounting for approximately 13% of total mortality and causing around 8 million deaths each year. It is highly prevalent among the elderly (aged over 60 years), with rates ranging from 60% to 80%. According to the 2018 Basic Health Research, hypertension cases in Indonesia continue to rise, affecting 63.2% of individuals aged 65–74 years and 69.5% of those aged 75 years and above. Objective: This program aimed to improve the knowledge and skills of elderly individuals in managing hypertension through acupuncture therapy and self-care training. Method: In collaboration with Puskesmas Kowel, the program involved socialization activities, workshops, and a one-month acupuncture therapy service conducted by traditional medicine therapists from Universitas Airlangga. Pre-test and post-test evaluations were administered to assess knowledge improvement and the effectiveness of the therapy in reducing blood pressure. Results: The program successfully enhanced the elderly participants’ understanding of hypertension and acupuncture therapy, as well as their ability to perform self-acupressure techniques. It also strengthened the role of Puskesmas Kowel as an educational and acupuncture therapy center for elderly care in Pamekasan. Conclusion: This initiative provides a foundation for improving the quality of life among the elderly through sustainable complementary therapy practices.

Background:Chronic stress disrupts the neuroendocrine system, leading to imbalances in neurotransmitters and stress hormones such as oxytocin, β endorphins and cortisol, contributing to mood disorders and poor emotional regulation. Complementary and alternative practices like meditation have shown promising results in stress regulation and mood elevation. Heartfulness (HFN) meditation, rooted in yogic traditions and incorporating yogic transmission, is an emerging technique to improve emotional resilience and hormonal homeostasis. Therefore, this study aimed to evaluate the effects of HFN meditation on oxytocin, β-endorphins, and cortisol. It also evaluated the changes in meditation depth using validated psychometric tools.Methods:A randomized controlled trial was conducted. Participants were divided into experimental and control groups. The experimental group practiced guided HFN meditation for 30 days. Following this, a crossover design was implemented in which, the control group participants were now given the intervention of HFN meditation. Biochemical markers (serum oxytocin, β-endorphins, cortisol) were measured at day 30, and day 60. Psychometric assessments included the Meditation Depth Questionnaire and the Positive and Negative Affect Schedule (PANAS).Results:HFN meditation significantly improved meditation depth (ΔM = –14.87, 95% CI [–23.61,–6.13], P = .001, r = 0.333) and positive affect (ΔM = –8.48, 95% CI [–12.03,–4.93], P < .001, r = 0.29), while reducing negative affect (ΔM = 7.70, 95% CI [3.81, 11.60], P < .001, r = 0.21). Oxytocin and endorphin levels increased (oxytocin ΔM = +88.18, P = .003, r = 0.355 and endorphin ΔM = +94.83, P = .003, r = 0.357), and cortisol decreased (ΔM = –133.55, P < .001, r = 0.661). After crossover, the control group exhibited similar improvements. Negative correlations were found between cortisol and both oxytocin and β-endorphins.Conclusion:HFN meditation significantly modulates stress-related neuroendocrine markers and enhances positive emotional states. By increasing the levels of these happy hormones and reducing cortisol, HFN presents a promising non-pharmacological intervention for improving mental health and stress resilience.

In this Special Issue: Complementary Practices—Community, Workforce, and Economic Development