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Use of alternative–complementary-medicine (CAM) in Calabrian children
Dolceamore Teresa Rita,Altomare Federica,Zurlo Francesco,Miniero Roberto
The Italian Journal of Pediatrics , 2012, DOI: 10.1186/1824-7288-38-70
Abstract: Objective The use of complementary and alternative medicine (CAM) has not been widely studied among children in Italy. ISTAT-2005 survey showed a prevalence of 10% concerning children treated with CAM. The lack of data about the use of CAM in pediatrics in the South of Italy aimed us to conduct an epidemiological inquiry in Calabria. Methods The study has been conducted from 2009 and 2011 at the Pediatric Units of: University “Magna Graecia”- Catanzaro (CZ), Pugliese-Ciaccio Hospital-Catanzaro (CZ), Annunziata Hospital-Cosenza (CS), Jazzolino Hospital- ViboValentia (VV), Riuniti Hospitals- Reggio Calabria (RC) and San Giovanni di Dio Hospital- Crotone (KR). All information was collected through a questionnaire proposed to children’s parents admitted to these hospitals as out-patients or in-patients. Results 1387 parents were approached to complete the questionnaire. 21(1,5%) refused to answer. A total of 1366 questionnaire was analyzed: 378 at CZ , 450 at CS, 131 at KR, 201 at VV and 206 at RC, with a response rate of 98,5%. In total, the percentage of children using CAM varied from 18% in Crotone to 38% in Cosenza. The parents who used CAM for their children were older and with a higher education. Phytotherapy was preferred to homeopathy. The gastrointestinal pathologies and upper respiratory tract are those ones for which frequently parents recur to CAM. Of note we have not to disregard their use “ to strengthen” the immune system. In most of cases CAM have been prescribed by pediatrician. Conclusions Our study remarks that the use of CAM is increased dramatically among the calabrian children in the last years as well as in other countries. Pediatricians need to improve their knowledge about CAM in order to better manage the parental attitude.
Forensic aspects of complementary and alternative medicine (CAM)  [cached]
Zaami S,Iovenitti L,Catarinozzi I,di Luca NM
Prevention and Research : International Open Access Journal of Prevention and Research in Medicine , 2012, DOI: 10.7362/2240-2594.045.2012
Abstract: Background: Currently, in Italy the professions - which are divided into regulated and unregulated - can be an alternative to traditional employment, or complementary to it.In the recent years arised the phenomenon of not recognized professional associations, so that the NCEL (National Council for Economy and Labour) compiled a list called Database on professional association , made from about 200 associations, 42 of which included in the category “Unconventional Medicine”. However, since the work done outside of professional associations is living a situation of lack of consideration, it would be necessary to recognize a proper dignity also to the activities performed outside of a register. Objectives: In this study the authors examine the current Italian legislation related to the use of alternative medicine practices in order to illustrate the need for a definitive legal framework of the subject setting clear rules for the use of unconventional treatments.Recently, in the Anglo-Saxon world came into force the acronym CAM (Complementary and Alternative Medicine), a group of different medical and therapeutic practices which are not part of the group of conventional medicine, but not even are in contrast to this.In the wake of this new acronym, also in Italy is becoming increasingly common use to define these medical practices with the expression of "Integrated Medicine". Methods: The authors analyze the possibility to integrate the practices of conventional medicine with traditional medicine in public clinics, making by example the experimental model of some regions such as Emilia Romagna and Tuscany. Furthermore, looking at the last Judgment on the case "Di Bella," the authors emphasize that, despite the widespread national practices of alternative medicine, the latter must be supported by evidence of how effective these can be in order to be provided by public clinics and therefore be borne by the NHS. Results and Conclusions: Whereas the unconventional practices are areas that are fully and legitimately part of the professional health, it is desirable to come to a permanent legal framework in this area, setting clear rules for unconventional treatments, in order to guarantee to citizens who choose such treatments the competence of those who practice them and to the same professionals the opportunity to stand out from figures without adequate experience.
Social and Cultural Factors Affecting Complementary and Alternative Medicine (CAM) Use during Menopause in Sydney and Bologna  [PDF]
Corinne van der Sluijs,Flavia L. Lombardo,Grazia Lesi,Alan Bensoussan,Francesco Cardini
Evidence-Based Complementary and Alternative Medicine , 2013, DOI: 10.1155/2013/836234
Abstract: Background. Previous surveys found CAM use during menopause to be popular. This paper compares the results from two surveys (Sydney and Bologna) to examine factors that determine the extent and pattern of CAM use to alleviate menopausal symptoms. Methods. Women, aged 45–65 years, who were symptomatic when transitioning through menopause or asymptomatic but taking menopause-specific treatments, were recruited in Sydney ( ) and Bologna ( ) to complete the same voluntary, anonymous, and self-administered questionnaire. The results were reanalysed using stratified analyses to determine similarities and differences. Results. Demographics of the two cohorts differed significantly. CAM was more popular in Sydney. The most significant determinants of CAM use were the use of CAM for other conditions besides menopause and the severity of vasomotor symptoms. Occupational status was a determinant of CAM use amongst Bologna respondents only. In order to relieve symptoms, Australian and Italian women used different CAM modalities whose effectiveness was generally perceived as good. Conclusion. CAM use is popular amongst menopausal women from Sydney and Bologna. Differences in the patterns of CAM use seem to depend on CAM availability and on the educational level and professional status of users. The complex interaction between market, social, and cultural factors of CAM use seems to be more influential on women’s choice of CAM than the available evidence of their effectiveness. 1. Introduction Complementary and alternative medicine (CAM) use is popular amongst middle aged women for the alleviation of symptoms related to menopause [1–4]. The most commonly used CAM therapies include herbal products such as red clover (Trifolium pratense), black cohosh (Cimicifuga racemosa), and soy (Glycine max); practitioner centred modalities such as acupuncture, naturopathy, and homeopathy; and body work therapies including chiropractic and massage. We conducted two surveys, one in Sydney (Australia) and the other in Bologna (Italy), using the same reliable and validated questionnaire to investigate the use of CAM amongst women transitioning through menopause [1, 2]. For consistency of this research, we defined CAM as any nonconventional medical practices in Australia and Italy. The term “CAM products” refers to complementary medicines approved for over the counter sale. “CAM practitioners” denoted health-care providers who may or may not be medical doctors, administering CAM treatments or recommending CAM products. Our findings indicated that a significant number of women in both
Developing CAM Research Capacity for Complementary Medicine  [PDF]
George Lewith,Marja Verhoef,Mary Koithan,Suzanna M. Zick
Evidence-Based Complementary and Alternative Medicine , 2006, DOI: 10.1093/ecam/nel007
Abstract: This article describes initiatives that have been central to the development of complementary and alternative medicine (CAM) research capacity in the United Kingdom, Canada and the United States over the last decade. While education and service delivery are essential parts of the development of CAM, this article will focus solely on the development of research strategy. The development of CAM research has been championed by both patients and politicians, primarily so that we may better understand the popularity and apparent effectiveness of these therapies and support integration of safe and effective CAM in health care. We hope that the perspective provided by this article will inform future research policy.
General practitioners' knowledge and practice of complementary/alternative medicine and its relationship with life-styles: a population-based survey in Italy
Massimo Giannelli, Marina Cuttini, Monica Da Frè, Eva Buiatti
BMC Family Practice , 2007, DOI: 10.1186/1471-2296-8-30
Abstract: A cross-sectional study was conducted in Tuscany, a region of central Italy. One hundred percent female GPs (498) and a 60% random sample of male GPs (1310) practising in the region were contacted through a self-administered postal questionnaire followed by a postal reminder and telephone interview.Overall response rate was 82.1%. Most respondents (58%) recommended CAM but a far smaller fraction (13%) practised it; yet 36% of CAM practitioners had no certificated training. Being female, younger age, practising in larger communities, having had some training in CAM as well as following a vegetarian or macrobiotic diet and doing physical activity were independent predictors of CAM recommendation and practice. However, 42% of GPs did not recommend CAM to patients mostly because of the insufficient evidence of its effectiveness.CAM knowledge among GPs is not as widespread as the public demand seems to require, and the scarce evidence of CAM effectiveness hinders its professional use among a considerable number of GPs. Sound research on CAM effectiveness is needed to guide physicians' behaviour, to safeguard patients' safety, and to assist policy-makers in planning regulations for CAM usage.Complementary and alternative medicine (CAM) includes a variety of diagnostic and therapeutic practices whose underlying theory or explanatory mechanisms do not conform to current medical thinking [1]. In its various forms, CAM is enjoying a growing popularity among the public [2,3]. Dissatisfaction with mainstream modern medicine particularly with regards to patient-physician relationship, concerns about the side effects of chemical drugs, and personal beliefs favouring a more holistic orientation to health care are often quoted as possible explanations [3-5]. Estimates of CAM use in Western countries range from about one-third to half of the general population [6,7]. In Italy the proportion has almost doubled during the last decade [8], although it still remains far below the estima
A Methodological Framework for Evaluating the Evidence for Complementary and Alternative Medicine (CAM) for Cancer  [PDF]
Robert Zachariae,Helle Johannessen
Cancers , 2011, DOI: 10.3390/cancers3010773
Abstract: In spite of lacking evidence for effects on cancer progression itself, an increasing number of cancer patients use various types of complementary and alternative medicine (CAM). There is disagreement between CAM practitioners, researchers and clinical oncologists, as to how evidence concerning effects of CAM can and should be produced, and how the existing evidence should be interpreted. This represents a considerable challenge for oncologists; both in terms of patient needs for an informed dialogue regarding CAM, and because some types of CAM may interact with standard treatments. There is a need for insight into which kinds of CAM may work, for whom they work, what the possible effects and side-effects are, and in what ways such effects may come about. The present article presents a framework for evaluating effects of CAM by suggesting a taxonomy of different levels of evidence related to different types of research questions and discussing the relevance of different research methodologies for different types of effects.
COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) THERAPIES FOR MANAGEMENT OF PAIN RELATED TO ENDOMETRIOSIS
Panda Roshni,A Suneetha Susan Cleave,Suresh P.K
International Research Journal of Pharmacy , 2012,
Abstract: Endometriosis is a gynaecological disease with a complex etiology. It is associated with severe pelvic pain, sub fertility and reduced quality of life. Endometriosis has a multifactorial etiology and therefore its management is also multidimensional. The main targets of therapy are controlling of the pain symptoms and increasing fertility where it is desired. Hormonal and surgical therapies are the two major treatment modalities available currently. But they are not without their side effects. Therefore many women explore Complementary and Alternative Medicine (CAM) forms of treatment for symptomatic relief from pain. These CAM therapies have been used as an adjuvant to conventional therapy or as an independent form of treatment. CAM therapies are purported to have lesser side effects as compared to conventional medical formulations. Ancient Chinese and Indian medicine system have laid the foundation of several of the prevalent Cam practices. The following CAM practices have been discussed in the article-Acupuncture, Herbal therapy, Meditation and Hypnotherapy, Yoga, Exercise, Dietary therapy Aromatherapy and Massage, Reiki, Magnet therapy and Chiropractice. Randomized Clinical Trials (RCT) have been conducted for some of the CAM therapies in Endometriosis and Acupuncture and Herbal and Dietary therapies have been found to have some positive effect on the patients. The efficacy of CAM therapies still needs substantial evidence to be integrated into general healthcare practices.
The Difficulty and Significance of NursingPracticeUsing Complementary and Alternative Medicine (CAM)
American Journal of Sociological Research , 2012, DOI: 10.5923/j.sociology.20120205.03
Abstract: Japan’s national healthcare system is based solely on modern medicine. This study aims to clarify the expectations surrounding CAM and the factors hindering the practice of CAM in nursing. The informants for the interview survey were five nurses who have had professional training in aromatherapy. We asked them about their expectations ofCAM and about the difficulty of nursing care as a CAM practitioner. Whether or not informants were using CAM in their work, they understood the difficulty nursesface in attempting to practice CAM therapy.We found thatapproval of the boss and co-workers is indispensable for using CAMin nursing care. In addition, the practitioner must show evidence that the therapy works. Informants spoke of the difficultyofshowing evidence when it is not possible to do a clinical study. On the other hand, the view on the value of CAMnursing may be revisedif nurses can show the evidence for its efficacy and if the therapy can become more widespread.Nursing science may be able to contribute to the evidence, and healthcare system reform could facilitate its wider use.
Is complementary and alternative medicine (CAM) cost-effective? a systematic review
Patricia M Herman, Benjamin M Craig, Opher Caspi
BMC Complementary and Alternative Medicine , 2005, DOI: 10.1186/1472-6882-5-11
Abstract: The data sources used were Medline, AMED, Alt-HealthWatch, and the Complementary and Alternative Medicine Citation Index; January 1999 to October 2004. Papers that reported original data on specific CAM therapies from any form of standard economic analysis were included. Full economic evaluations were subjected to two types of quality review. The first was a 35-item checklist for reporting quality, and the second was a set of four criteria for study quality (randomization, prospective collection of economic data, comparison to usual care, and no blinding).A total of 56 economic evaluations (39 full evaluations) of CAM were found covering a range of therapies applied to a variety of conditions. The reporting quality of the full evaluations was poor for certain items, but was comparable to the quality found by systematic reviews of economic evaluations in conventional medicine. Regarding study quality, 14 (36%) studies were found to meet all four criteria. These exemplary studies indicate CAM therapies that may be considered cost-effective compared to usual care for various conditions: acupuncture for migraine, manual therapy for neck pain, spa therapy for Parkinson's, self-administered stress management for cancer patients undergoing chemotherapy, pre- and post-operative oral nutritional supplementation for lower gastrointestinal tract surgery, biofeedback for patients with "functional" disorders (eg, irritable bowel syndrome), and guided imagery, relaxation therapy, and potassium-rich diet for cardiac patients.Whereas the number and quality of economic evaluations of CAM have increased in recent years and more CAM therapies have been shown to be of good value, the majority of CAM therapies still remain to be evaluated.Complementary and alternative medicine (CAM) has a reputation for good value among health conscious consumers [1]. In the United States consumers spend over $34 billion per year on CAM therapies [2], dollars spent outside the conventional health care f
Academic doctors' views of complementary and alternative medicine (CAM) and its role within the NHS: an exploratory qualitative study
Nita Maha, Alison Shaw
BMC Complementary and Alternative Medicine , 2007, DOI: 10.1186/1472-6882-7-17
Abstract: This exploratory study used qualitative methods to explore academic doctors' views of CAM and the rationales they provided for their views. A purposeful sampling strategy was used to identify doctors with a dual clinical and academic role in the Bristol area, with an anticipated variety of views on CAM. Semi-structured interviews were conducted with nine doctors. The data were analysed thematically, drawing on the Framework Approach.The doctors expressed a spectrum of views on CAM, falling into three broad groups: the 'enthusiasts', the 'sceptics' and the 'undecided'. Scepticism or uncertainty about the value of CAM was prominent, except among those practising a form of CAM. A variety of rationales underpinned their perspectives on CAM, a key recurring rationale being their perspective on the scientific evidence base. The main themes arising included: the role of doctors' professional experiences of conventional medicine and CAM in shaping their attitudes towards CAM, doctor-patient communication about CAM and patient disclosure, whether there is a need for training and education in CAM for doctors, a hierarchy of acceptability of CAM and the nature of evidence; and the role of CAM within the NHS.Despite the caution or scepticism towards CAM expressed by doctors in this study, more open doctor-patient communication about CAM may enable doctors' potential concerns about CAM to be addressed, or at least enhance their knowledge of what treatments or therapies their patients are using. Offering CAM to patients may serve to enhance patients' treatment choices and even increase doctors' fulfilment in their practice. However, given the recurring concerns about lack of scientific evidence expressed by the doctors in this study, perceptions of the evidence base may remain a significant barrier to greater integration of CAM within the NHS.There has been a marked increase in the use of complementary and alternative medicine (CAM) in the UK population in recent years. CAM has b
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