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PubMed2002

Popularity of complementary and alternative medicine in Japan: a telephone survey.

OBJECTIVE: To obtain information on the use of complementary and alternative medicine (CAM) in Japan. DESIGN: Nationwide, random-sampled and population-weighted telephone survey. METHODS: The survey was conducted by a telephone survey company in April 2001. The sample size of respondents was 1000. Using a region-, gender- and age-weighted sampling table, professional operators called respondents with random-digit dialling. Respondents were asked questions about their use of CAM in the past 12 months, out-of-pocket expenditures on CAM and orthodox Western medicine, reasons for the use of CAM and so on, as well as general socio-demographics. RESULTS: The percentage of respondents who had used at least one CAM therapy in the past 12 months was greater than those who had used orthodox Western medicine (76.0% (95% CI: 73.4-78.6) vs 65.6% (95% CI: 62.7-68.5). The percentage of use for each CAM therapy was as follows: nutritional and tonic drinks (43.1%), dietary supplements (43.1%), health-related appliances (21.5%), herbs or over-the-counter Kampo (17.2%), massage or acupressure (14.8%), ethical Kampo (Kampo prescribed by medical doctors) (10.0%), aromatherapy (9.3%), chiropractic or osteopathy (7.1%), acupuncture and moxibustion (6.7%), homeopathy (0.3%), and other therapies (6.5%). Regarding the reasons for the use of CAM, 60.4% responded that 'the condition was not serious enough to warrant orthodox Western medicine', and 49.3% were 'expecting health promotion or disease prevention'. Average annual out-of-pocket expenditures of all the 1000 respondents for CAM were half as much as those for orthodox Western medicine (19,080 yen (95% CI: 15,824-22,336) vs 38,360 yen (95% CI: 30,439-46,280)). CONCLUSIONS: CAM is very popular in Japan and the expenditures for them are not negligible, although there is still an overwhelming dominance of orthodox Western medicine with regard to cost, variety of indications, and severity of conditions.

Adult↗
PubMed2002

UK: the current state of regulation of complementary and alternative medicine.

There is no legislation that restricts the practice of CAM in the UK apart from the practice of chiropractic and osteopathy and limits on advertising the treatments of certain conditions such as cancer and tuberculosis. The UK government has increasingly recognised the need for comprehensive regulation of CAM, though it abandoned its original plan for a single overarching regulatory body. Initiatives to examine and hasten the process of regulation have included setting up a central, well-recognised charitable body to facilitate progress for individual professions, and an authoritative survey of the existing professional organisations. One pathway open to individual professions is statutory self-regulation, which requires a single governing body, a systematic corpus of knowledge, recognised training courses and demonstrated efficacy. The other pathway is voluntary self-regulation. Chiropractic and osteopathy have adopted statutory self-regulation, though this has proved expensive for individual members of these professions. A recent House of Lords report on CAM has recommended that the herbal medicine and acupuncture professions should also develop a system of statutory regulation. Other professions, such as aromatherapy, are in the process of establishing single professional bodies as a first step towards self-regulation. Among the issues that remain to be resolved is the relationship between the CAM professions and statutory registered practitioners who also practise CAM.

Complementary Therapies↗
PubMed2002

Complementary cancer care in Southampton: a survey of staff and patients.

BACKGROUND: Complementary and alternative medicine (CAM) is used by one in ten of the UK population yearly and 47% during their lifetime. One-third of cancer patients seek some form of CAM treatment during their illness. AIM: To evaluate the use of and attitudes to CAM among patients and all healthcare staff in the Southampton Cancer Care Directorate (UK). SETTING: The Royal South Hants Hospital, Countess Mountbatten and Oakhaven Hospices. METHOD: A questionnaire-based survey performed between January 2001 and March 2001. RESULTS: Two hundred and seventy questionnaires were distributed to patients and 162 responses received. The distribution of cancers within this population was generally typical of those in the community. Thirty-two percent (n = 52) were receiving some form of CAM, half of those receiving CAM were in hospice care. Forty-nine percent of those not receiving CAM would like to, and 76% of all patients would be prepared to pay for this treatment. The five most popular treatments were massage, nutrition, aromatherapy, relaxation and reflexology. While most patients expected CAM to palliate their symptoms (n = 149, 92%), some had unrealistic expectations that CAM would cure their cancer (n = 13, 8%). Four hundred and forty-eight staff questionnaires were distributed and 196 responses were received: 148 (75.5%) from nurses. Twenty-one percent of staff responding had CAM training and two-thirds would like to receive training. The most popular therapies used by staff were the same as those identified by the patients. Ninety-nine percent of staff and 98.5% of patients wished to see CAM treatments introduced into service provision within the Cancer Care Directorate. CONCLUSIONS: The use of CAM for cancer care in Southampton is widespread and consistent with its use nationally. There is a clearly expressed need for CAM treatments by patients and a willingness to pay. Two-thirds of the cancer care staff responding wished to receive training in and provide these therapies. There are some misconceptions among patients about the role of CAM in cancer care which need to be discussed and resolved. We believe that all cancer care units should have clear policies on the use of CAM for cancer patients.

Adolescent↗
PubMed2002

Introducing abdominal massage in palliative care for the relief of constipation.

Constipation and its associated problems affect approximately 50% of patients admitted to hospices in the United Kingdom. It is common practice in many hospices to offer a range of complementary therapies of which aromatherapy massage is one. Abdominal massage for the relief of constipation was once a commonly practised therapy but its use declined over time, like other complementary therapies there is now a rekindling of interest in the role that abdominal massage may play in relieving constipation. This paper will explain how a safe non-invasive easily learnt technique of abdominal massage was introduced in a palliative care setting to help relieve some of the problems associated with constipation. Despite the number of patients involved in this project being small, relief from some of the symptoms associated with constipation was experienced by some patients. A formal study of the benefits of abdominal massage in palliative care far the relief of constipation is needed.

Abdomen↗
PubMed2003

Suppression of tumor necrosis factor-alpha-induced neutrophil adherence responses by essential oils.

BACKGROUND: In aromatherapy, essential oils are used as anti-inflammatory remedies, but experimental studies on their action mechanisms are very limited. AIMS: To assess their anti-inflammatory activities, effects of essential oils on neutrophil activation were examined in vitro. METHODS: Neutrophil activation was measured by tumor necrosis factor-alpha (TNF-alpha)-induced adherence reaction of human peripheral neutrophils. RESULTS: All essential oils tested at 0.1% concentration suppressed TNF-alpha-induced neutrophil adherence,and, in particular, lemongrass, geranium and spearmint oils clearly lowered the reaction even at 0.0125%. Similar inhibitory activities for the neutrophil adherence were obtained by their major constituent terpenoids: citral, geraniol, citronellol and carvone. In contrast, very popular essential oils, tea tree oil and lavender oil, did not display the inhibitory activity at the concentration. CONCLUSION: Thus, some essential oils used as antiinflammatory remedies suppress neutrophil activation by TNF-alpha at a low concentration (0.0125-0.025 %) in vitro.

Acyclic Monoterpenes↗
PubMed2004

Suppression of neutrophil recruitment in mice by geranium essential oil.

BACKGROUND: In aromatherapy, essential oils are used as anti-inflammatory remedies, but experimental studies on their action mechanisms are very limited. AIMS OF THE STUDY: To assess their anti-inflammatory activities, the effects of essential oils on neutrophil recruitment in mice were examined in vivo. METHOD: The effect of essential oils on leukocyte and neutrophil recruitment induced 6 h after intraperitoneal injection of casein in mice was examined. RESULTS: Leukocyte recruitment into the peritoneal cavity in mice was suppressed by intraperitoneal injections of geranium, lemongrass and spearmint oils at the dose of 5 microl/mouse, but was not by tea tree oil. This recruitment was inhibited dose-dependently by geranium oil. The suppression of leukocyte recruitment resulted from inhibition of neutrophil accumulation. CONCLUSION: Some essential oils used as anti-inflammatory remedies suppress neutrophil recruitment into the peritoneal cavity in mice.

Animals↗
PubMed2005

A single-blinded, randomized pilot study evaluating the aroma of Lavandula augustifolia as a treatment for mild insomnia.

BACKGROUND: Insomnia is the most common of all sleep complaints and is under-researched. The current treatments of choice are conventional hypnotics agents, but these have potential for serious adverse reactions. Uncontrolled and anecdotal evidence suggests that lavender oil is an effective treatment for insomnia, but this has not been formally investigated. OBJECTIVES: The aims of this study were to evaluate the proposed trial methodology and the efficacy of Lavandula augustifolia (lavender) on insomnia. INTERVENTIONS: INTERVENTIONS consisted of Lavandula augustifolia (treatment) and sweet almond oil as placebo/control. The aroma was supplied via an Aromastream device (Tisserand Aromatherapy, Sussex, UK). DESIGN: This was a pilot study with randomized, single-blind, cross-over design (baseline, two treatment periods, and a washout period, each of 1 week duration). SUBJECTS AND SETTING: Volunteers with defined insomnia treated on a domiciliary basis participated in the study. OUTCOME MEASURES: Outcomes were assessed with the following: Pittsburgh Sleep Quality Index (PSQI) indicating insomnia (score > 5 at entry); Borkovec and Nau (B&N) Questionnaire evaluating treatment credibility; and Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) assessing attitudes to CAM and health beliefs. RESULTS: Ten (10) volunteers (5 male and 5 female) were entered and completed the 4 week study. Lavender created an improvement of -2.5 points in PSQI (p = 0.07, 95% CI - 4.95 to - 0.4). Each intervention was equally credible and belief in CAM did not predict outcome. Women and younger volunteers with a milder insomnia improved more than others. No period or carry-over effect was observed. CONCLUSION: The methodology for this pilot study appeared to be appropriate. Outcomes favor lavender, and a larger trial is required to draw definitive conclusions.

Adult↗
PubMed2005

The integration of complementary therapies in Australian general practice: results of a national survey.

METHODS: Australian general practitioners' (GPs) attitudes toward and use of a range of complementary therapies (CTs) were determined through a self-administered postal survey sent to a random sample of 2000 Australian GPs. The survey canvassed GPs' opinions as to the harmfulness and effectiveness of CTs; current levels of training and interest in further training; personal use of, and use in practice of, CTs; referrals to CT; practitioners; appropriateness for GPs to practice and for government regulation; perceived patient demand and the need for undergraduate education. RESULTS: The response rate was 33.2%. Based on GPs' responses, complementary therapies could be classified into: nonmedicinal and nonmanipulative therapies, such as acupuncture, massage, meditation, yoga, and hypnosis, that were seen to be highly effective and safe; medicinal and manipulative therapies, including chiropractic, Chinese herbal medicine, osteopathy, herbal medicine, vitamin and mineral therapy, naturopathy, and homeopathy, which more GPs considered potentially harmful than potentially effective; and esoteric therapies, such as spiritual healing, aromatherapy, and reflexology, which were seen to be relatively safe yet also relatively ineffective. The risks of CTs were seen to mainly arise from incorrect, inadequate, or delayed diagnoses and interactions between complementary medications and pharmaceuticals, rather than the specific risks of the therapies themselves. CONCLUSIONS: Nonmedicinal therapies along with chiropractic are widely accepted in Australia and can be considered mainstream. GPs are open to training in complementary therapies, and better communication between patients and GPs about use of CTs is required to minimize the risk of adverse events. There is also a need to prioritize and provide funding for further research into the potential adverse events from these therapies and other therapies currently lacking an evidence base.

Adult↗
PubMed2005

The Advantages of Traditional Chumash Healing.

Chumash healing has been practiced in California for approximately 13 000 years. Chumash healers treat their patients with prayer, laughter, dreaming, phytotherapy, aromatherapy, healing ceremonies and other techniques. Healing involves first healing the spirit, then healing the body. Chumash people still maintain their unique identity. Chumash Healers still practice the ancient healing arts in California. This lecture is a brief introduction to Chumash Healing.

Journal Article↗
PubMed2001

Kinetic analyses of alcohol-induced potentiation of the response of GABA(A) receptors composed of alpha(1) and beta(1) subunits.

To investigate the kinetics of both the potentiation and desensitization of the response of ionotropic GABA receptors (GABA(A) receptors) in the presence of various compounds, we expressed receptors composed of alpha(1) and beta(1) subunits by injecting cells with the cRNAs synthesized from cloned bovine GABA(A) receptor cDNAs and measured the electrical responses of the cells electrophysiologically with or without the compounds. The potentiation of the GABA(A) receptor-mediated response was quantitatively analyzed using a simple model with the assumption that the receptors have two identical binding sites for GABA molecules with a dissociation constant of K(1), and one potentiation site for the compound with a dissociation constant of K(p), and that the binding of the compound to the potentiation site only increases the affinity of the GABA binding sites, changing K(1) to K(1p). The estimated K(p) and K(1p) were dependent on the functional groups and the chain length of the compounds. These results could be satisfactorily analyzed using this simple model. The potentiation of the GABA(A) receptor-mediated response by the components of essential oils used for aromatherapy was also examined. These compounds accelerated the decay of the response, possibly due to desensitization of the receptors, which was also analyzed on the basis of the model.

Alcohols↗
PubMed2001

Designing humanistic critical care environments.

The critical care environment can be designed to become more humanistic. Consideration of the environmental challenges of noise, lights, color, views, temperature, and comfort is essential. This article identifies the issues and concerns in the design of more humanistic healing in critical care units. Strategies to improve the environment include improving the physical and emotional tone of the unit through creative design, family and pet visitation, sleep promotion, and aromatherapy among others. In a life-threatening illness, attention paid to these concerns may significantly improve quality of life for patients and family.

Facility Design and Construction↗
PubMed2006

Complementary and alternative therapies: the nurse's role.

One objective of Healthy People 2010 is to increase both quality and years of healthy life. Complementary and alternative medicine (CAM) encompasses strategies that can help individuals meet this goal. CAM includes therapies such as acupuncture, dietary supplements, reflexology, yoga, massage, chiropractic services, Reiki, and aromatherapy. Many CAM therapies focus on the concept of energy. The literature describes the use of CAM in individuals with neurological diseases such as dementias, multiple sclerosis, neuropathies, spinal cord injury, and epilepsy. Nurses have a unique opportunity to provide services that facilitate wholeness. They need to understand all aspects of CAM, including costs, patient knowledge, and drug interactions, if they are to promote holistic strategies for patients seeking to achieve a higher quality of life.

Adult↗
PubMed2004

The use of complementary medicine by patients referred to a contact dermatitis clinic.

Our aim was to quantify and qualify the use of complementary medicine (CM) by patients referred to our contact dermatitis clinic in Leicester, UK. A face-to-face structured questionnaire study was made of 109 consecutive patients referred to the contact dermatitis clinic. 109 such questionnaires were completed. 21/109 (20%) of patients were Indo-Asian and 86/109 (79%) white Caucasian. 33/109 (30%) had tried some form of CM to treat their skin condition. This use was higher in the Indo-Asian group, where 13/21 (62%) had tried some form of CM. 21/33 (63%) who had used CM were happy to recommend it to other patients with skin disease, even though only 10/33 (30%) of these reported an improvement in their skin condition while using CM. The most frequently used CM treatments were herbal medicine [17/33 (51%)], Chinese herbal medicine [6/33 (18%)], traditional Indian medicine [4/33 (12%)] and aromatherapy [6/33 (18%)]. These proportions were similar in all ethnic groups. In a population of adults referred to a contact dermatitis clinic in a city-centre teaching-hospital dermatology department in Leicester, UK, 30% use, or intend to use, CM and this use is associated with ethnicity.

Adolescent↗
PubMed1995

Complementary therapies in practice: the ethical issues.

This article explores some of the ethical issues associated with the use of complementary therapies in practice. The adopted terminology and related concepts are clarified. The term 'complementary therapy' is compared and contrasted with 'alternative medicine' and 'non-conventional therapy'. The increasing emphasis on holistic nursing care is also discussed. Ethical issues of patient choice, informed consent and the principle of beneficence are examined in relation to complementary therapies. The article highlights the obligation of the nurse, midwife or health visitor to provide or facilitate holistic care including complementary therapies, such as massage or aromatherapy, for those clients who request such care, and where it can be demonstrated that there will be benefits for the patient. It is concluded that nurses should consider the possibility of incorporating or facilitating certain complementary therapies in their practice in order to benefit their patients. There is a corresponding need for an appropriate knowledge base, founded on nursing research, into the effectiveness and outcomes of complementary therapies. In addition, relevant educational courses should be developed.

Complementary Therapies↗
PubMedDate not supplied

Complementary and alternative medicine use in children with attention deficit hyperactivity disorder.

OBJECTIVES: The use of complementary and alternative medicines (CAM) is increasing in the general population. Attention deficit hyperactivity disorder (ADHD) is a chronic condition that has a major impact on children's functioning and has no cure, therefore many families may try CAM at some stage. We aimed to determine (i) the lifetime incidence of CAM use in a clinical sample of children with ADHD; (ii) parents' perceptions of the effectiveness of CAM for ADHD; and (iii) the proportion who informed their paediatrician. METHODS: The sample was drawn from patients aged 5-17 years with ADHD attending Royal Children's Hospital, Melbourne outpatient clinics from May to September 2003. A 20-item survey was posted to consenting families. RESULTS: From 105 surveys, 75 were returned (response rate 71.4%). Mean child age was 11.1 (SD 2.9, range 5.0-16.9) years; 65 (86.7%) were boys. Fifty (67.6%) families reported current or past CAM use. Of the 23 different therapies reported, the most common were modified diet (33 families), vitamins and/or minerals (16), dietary supplements (12), aromatherapy (12) and chiropractics (10). Reported effectiveness was variable. The factors most frequently rated as important in choosing CAM were minimizing symptoms (40 families), adding to the benefit of conventional treatment (30) and avoiding side-effects (29). Thirty-two (64%) of 50 families reported that they informed their paediatrician of their CAM use. CONCLUSION: Complementary and alternative medicines are commonly used in children with ADHD. Paediatricians should inquire about the use of CAM, and use available resources to help guide families in their therapeutic choices.

Adolescent↗
PubMed2005

Survey of complementary and alternative medicine use at a tertiary children's hospital.

OBJECTIVE: The use of complementary and alternative medicine (CAM) within the Australian community is common. The objective of this study was to determine the prevalence and pattern of CAM usage in children attending a tertiary children's hospital. METHODS: We conducted a cross-sectional survey of children attending the Royal Children's Hospital, Melbourne. Children were identified by consecutive acute admissions and attendance at outpatient clinics. A structured questionnaire with items about the use of CAM in the preceding year was administered by means of a face-to-face interview. RESULTS: Based on the 503 children surveyed, 51% reported CAM use in the preceding year. Forty-three percent had used at least one CAM medication. The most common medicinal CAM used were multivitamins, vitamin C, herbal remedies and homeopathic treatments. Non-medicinal CAM was used by 23% of the participants. The most commonly used therapies were chiropractic, naturopathy, aromatherapy, therapeutic massage and dietary restriction. The main reasons stated for CAM usage included promotion of general health and treatment of colds. Sixty-three percent of those reporting CAM use had not discussed this with their treating doctor. CONCLUSION: The use of CAM by children is common. Complementary and alternative medicine is particularly used for the treatment of common illnesses and conditions of childhood. Importantly, use is not always conveyed to treating physicians. Given the potential risk of adverse events associated with the use of CAM or interactions with conventional management, doctors should ask about their use as a part of routine history taking.

Adolescent↗
PubMed2004

Diamorphine for pain relief in labour : a randomised controlled trial comparing intramuscular injection and patient-controlled analgesia.

OBJECTIVES: To compare the efficacy of diamorphine administered by a patient-controlled pump (patient-controlled analgesia) with intramuscular administration for pain relief in labour. DESIGN: Randomised controlled trial. SETTING: The South Glasgow University Hospitals NHS Trust. SAMPLE: Primigravidae and multigravidae in labour at term (37-42 weeks). METHODS: Women were randomised in labour to the study (patient-controlled analgesia) or control group (intramuscular). Randomisation was achieved through a random permuted block design stratified by parity. Study group women were given a loading dose of 1.2 mg diamorphine intravenously and then attached to the pump. Control group women received intramuscular diamorphine as per hospital protocol. Participants were also given 3 mg of buccal Stemetil. Data were collected throughout labour and at six postnatal weeks. MAIN OUTCOME MEASURES: Analgesia requirements during labour and women's satisfaction with the method of pain relief. RESULTS: Women in the study group (patient-controlled analgesia) used significantly less diamorphine than women in the control group (intramuscular) but were significantly more likely to state that they were very dissatisfied with their use of diamorphine and were significantly more likely to opt out of the trial before the birth of the baby. The majority of women in both groups used other analgesia concurrent with diamorphine such as Entonox, aromatherapy or TENS. CONCLUSIONS: Patient-controlled analgesia administration of diamorphine for the relief of pain in labour offers no significant advantages over intramuscular administration. The results also suggest that diamorphine is a poor analgesic for labour pain irrespective of the mode of administration.

Analgesia, Patient-Controlled↗
PubMed2002

Inhibition of elastase activity by essential oils in vitro.

BACKGROUND: Essential oils are widely used, for example in aromatherapy and aroma massage. In aroma massage, essential oil, diluted with vegetable oil, is rubbed onto the skin. Components of essential oil penetrate into the skin and have an influence on the dermis. Elastase is an enzyme which degenerates dermal elastin. Elastase activity is believed to contribute to cutaneous wrinkling and ageing. AIM: To investigate the inhibitory effect of essential oils on elastase activity. METHODS: Inhibition of elastase activity by various essential oils was assessed using two elastase enzymes: porcine pancreatic elastase (PPE) and human neutrophil elastase (HNE). RESULTS: Elastase activity was inhibited by various essential oils, especially by those oils derived from lemons, juniper and grapefruit. Although the specific inhibitory component was not determined, lemon oil had the greatest inhibitory effect on PPE. Some essential oils also inhibited HNE. CONCLUSIONS: These studies demonstrate a possible rationale for the use of essential oil massage as a preventive treatment for cutaneous wrinkling and ageing.

Oils, Volatile↗