PURPOSE: To compare the characteristics of cancer patients in Taiwan who use complementary and alternative medicine (CAM) to cancer patients who do not use CAM and determine the predictors of quality of life (QoL) among cancer patients who use CAM. PATIENTS AND METHODS: Face-to-face interviews were conducted with and 3 questionnaires (the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire, the Brief Fatigue Inventory, and the Pittsburgh Sleep Quality Index) were administered to 216 cancer patients being treated at the Nuclear Medicine Department in southern Taiwan. Chi-square testing for categorical variables and t-testing for continuous variables were conducted to determine the correlation between sociodemographic and clinical data and CAM use. Analysis of variance was performed to conduct within-group comparison of QoL scales and CAM use. Linear regression models were established to predict QoL score. RESULTS: A total of 216 cancer patients were interviewed. The prevalence of CAM use was found to be 69.4% (150 of 216 subjects). Among the CAM users, 91.6% had used traditional Chinese medicine (TCM), dietary supplementation (vitamin, herbal, mineral, glucosamine, mushroom, and/or fish oil supplementation), or detoxification therapy. A greater percentage (49.5%) of CAM users had breast cancer than any other type of cancer, and a very large percentage (74.7%) did not inform their primary caregiver of their CAM use, whereas 52.7% used CAM after initiation of diagnosis and 26.7% increased the original frequency of their CAM use during the course of their treatment. Overall QoL was not found to be significantly different between CAM users and nonusers. Predictors of poor QoL were female gender, breast or liver cancer patient, younger age, lower education, chemotherapy, increased frequency of CAM use, non-vitamin/TCM use, and having received CAM information from primary caregiver. The factors of CAM use, number of CAM modalities used, frequency of CAM use, duration of cancer diagnosis, mineral/algae supplementation, and detoxification therapy were not found to be significant in this population. CONCLUSION: Cancer patients in Taiwan have a high rate of CAM use but a low rate of disclosure of CAM use to their primary caregivers. Multiple factors appear to have a significant correlation with poor QoL. Clinical physicians should emphasize the QoL of cancer survivors, providing more accurate CAM information and endeavoring to address their unmet needs.

This study examined a specific and controversial issue in health communication: the complementary and alternative medicine (CAM). Recent studies have shown that both online newsgroups and traditional newspapers have involved in communicating CAM information, but research has not answered whether there are differences between the new and old media. From the perspective of uses and gratifications, this study first investigated that how people are using newsgroups to solve CAM-related problems. Then contents of newsgroup messages and newspaper stories were analyzed to do the comparison in topics, source types, efficacy claims, and CAM categories. The results showed that both similarities and differences existed between the two media.

Research regarding use of complementary and alternative medicine (CAM) among all populations in America is needed to understand what seems to be an increasing trend. Education has been shown to be a significant determinant of CAM use, therefore, college students are likely to be CAM users. Little research has addressed the prevalence and predictors of CAM use among this population, so the purpose of this study was to: (1) measure the prevalence and type of CAM use among a sample of college undergraduates; and (2) test the significance of select social-cognitive constructs and demographics as predictors of CAM use. A random sample of undergraduate students within the Texas A&M University System was solicited via email to complete a web-based survey. Findings show high rates of CAM use. Gender, attitude toward CAM, outcome expectancies regarding the health care encounter, and social network use of CAM were shown to be significant predictors of CAM use. Results can inform health care and health education professionals interested in improving health care processes and addressing positive and negative issues related to CAM use.

ABSTRACT BACKGROUND: Arthritis is increasingly becoming a public health concern as it is the leading cause of disability. Glucosamine and chondroitin, which are alternative dietary supplements, are commonly marketed for persons with joint pain. The purpose of this study is to examine if self-reported 12-month and past 30-day use of glucosamine and/or chondroitin among persons with any arthritis, unspecified arthritis, and rheumatoid arthritis is associated with reports of past 12-month improved health and reports of past 30-day joint pain, aching, and stiffness, respectively. METHODS: The 2012 National Health Interview Survey (NHIS), a nationally representative cross-sectional household interview survey, was used for this study. The adult sample consisted of 34,525. Subgroup analyses were conducted on 7,654 respondents with any arthritis, 6,016 with unspecified arthritis, and 898 with rheumatoid arthritis. The independent variables were defined as the use of glucosamine only, chondroitin only, or glucosamine and chondroitin one or more times in the past 12 months and past 30 days. The dependent variables were defined as self-reported past 12 month improved health and past 30 day joint pain, aching, and stiffness. Descriptive, bivariate, and multivariate analyses were conducted using SAS 9.4 accounting for the complex survey design, computing missing values as missing completely at random for variance estimation. All multivariate logistic regression models included sociodemographics, use of other observed alternative therapies, and other chronic conditions. RESULTS: Approximately 21.8% of U.S adults had any arthritis, 17.0% had unspecified arthritis and 2.5% had rheumatoid arthritis. Among persons with any arthritis, approximately 3.7% used glucosamine, 0.4% used chondroitin, and 3.4% used both glucosamine and chondroitin within the past 12 months while approximately 5.1% used glucosamine, 0.6% used chondroitin, and 0.4% used both glucosamine and chondroitin within the past 30 days. Among persons with unspecified arthritis, approximately 3.7% used glucosamine, 0.5% used chondroitin, and 3.8% used both glucosamine and chondroitin within the past 12 months while 5.5% used glucosamine, 0.5% used chondroitin, and 0.4% used both glucosamine and chondroitin within the past 30 days. Among persons with rheumatoid arthritis, approximately 2.4% used glucosamine, 0.3% used chondroitin, and 2.1% used both glucosamine and chondroitin within the past 12 months while approximately 2.9% used glucosamine, 0.7% used chondroitin, and 0.5% used both glucosamine and chondroitin within the past 30 days. Women used more of all supplements (past 12 months and past 30 days) except past 12 month use of chondroitin among persons with any arthritis. Persons 56 to 70 years old had the highest proportion of past 12 month and 30 day supplement use among persons with unspecified arthritis. After adjusting for sex, age, race, BMI, poverty level, other health conditions, and other CAM therapies (acupuncture, energy, mind-body, and chiropractic/osteopathic therapies), the use of chondroitin only (adjusted OR= 0.6; p= <0.01) and the use of both glucosamine and chondroitin (adjusted OR= 5.7; p= <0.01) during the past 30 days was associated with self-reported past 30 day joint pain, aching, and stiffness among persons with any arthritis. After adjusting for age, BMI, poverty level, region, other health conditions, and other CAM therapies (acupuncture, energy, mind-body, and chiropractic/osteopathic therapies), the use of chondroitin only was also associated with past 30 day joint pain, aching, and stiffness among persons with unspecified arthritis (adjusted OR= 0.5; p= 0.02). CONCLUSION: Chondroitin alone was associated reports of past 30 day joint pain, aching, and stiffness among persons with any arthritis and unspecified arthritis highlighting a potential effective role and use for this supplement. In addition, the use of both glucosamine and chondroitin were associated with reports of past 30 day joint pain, aching, and stiffness among persons with any arthritis. Marketing may play a role in these relationships and should be further examined.

The purpose of this study was to investigate the co-optation of the heterodox medical system of osteopathic medicine by the hegemonic medical system of biomedicine and its impact on the practice of osteopathic medicine in America. The study particularly explored students (n=20), practitioners (n=5), and faculty (n=5) regarding their views of osteopathic medicine. The process of professionalization of osteopathic medicine has caused DOs to become more akin to MDs, which may have led to an identity crisis within the profession. This case study took place at a private osteopathic medical school in the Southeastern U.S. A content analysis of the interviews, direct observations, and curriculum analysis was conducted to answer the qualitative research questions in this study. The qualitative research questions required in-depth interviews, direct observation, survey questionnaires and analysis of curriculum.

The purpose of this study was to describe the extent and nature of CAM services that are provided and used in Texas hospices. The study investigated the significance of hospice setting characteristics such as age, geographic location, agency type, profit orientation, Medicare certification, and number of patients served as they relate to the likelihood of offering CAM, using a robust methodological and analytical strategy. Data was collected via self-administered mail surveys to 369 hospice directors in the state of Texas. A total usable response rate of 35.7% was obtained after an initial and one follow-up mail-out. A majority (N = 62, 56.4%) of hospices provided at least one type of CAM to their clients; however, a sizeable proportion of patients did not utilize the provided CAMs. The most frequently offered CAMs included massage, music, relaxation, spiritual healing and pet therapies with females and non-Hispanic whites being the most frequent users of these CAM services. Among CAM providers, short length of stay and funding were the primary obstacles to CAM provision, with most hospices relying on a combination of general hospice funds and volunteers to sustain the delivery of CAM services. The odds of offering CAM in ‘not-for-profit’ hospices were approximately four times higher than in ‘for-profit’ hospices (OR = 3.77, p = 0.022), while the odds of offering CAM increased by 13% for every 100 patients served by hospices (OR = 1.131, p = 0.015). Other hospice setting characteristics were not significantly related to CAM provision. In conclusion, a majority of hospices offered CAM services to their clients, although many patients are not utilizing these services. This observation might be connected with the fact that most CAM services are currently not being reimbursed through the Medicare Hospice Benefit, a government program that a majority of hospices depend upon for the coverage of substantial portions of their end-of-life services. Nevertheless, our study showed that CAM provision is related to the number of patients served and profit orientation status, but is not related to other measured characteristics of hospices. / text

<p>Yttrium-90 (⁹⁰Y) is one of the most commonly used radionuclides in targeted radionuclide therapy (TRT). In treatment planning, reliable prediction of the 90Y distribution <i>in vivo</i> is essential to performing both safe and effective therapy. However, the distribution of surrogate agents used in treatment planning may not exactly predict the distribution of ⁹⁰Y. Thus it would be useful to image the ⁹⁰Y distribution after therapeutic administration to provide the ground truth for the ⁹⁰Y distribution. This would facilitate evaluating and potentially improving pre-therapy methods for individualizing and optimizing the therapy. Single photon emission computed tomography (SPECT) is a powerful imaging technique for estimating 3D distribution of radionuclides <i> in vivo.</i> However, as an essentially pure &beta;-particle emitter, ⁹⁰Y does not emit gamma photons considered appropriate for SPECT imaging. One possible solution is to image bremsstrahlung photons generated by the interaction of the 13-particles with atomic nuclei in the body. The continuous and broad energy distribution of bremsstrahlung photons, however, imposes substantial challenges on quantitative SPECT imaging. The overall goal of this work was to develop and evaluate new quantitative bremsstrahlung SPECT methods for improving the reliability (accuracy and precision) of the ⁹⁰Y activity estimates for the dosimetry application. </p><p> Reconstruction method, acquisition energy window, and collimator are three crucial factors that determine the reliability of quantitative SPECT imaging. </p><p> In this work, we first developed an improved quantitative reconstruction method. The improvement resulted from more accurate modeling of the image formation process in a statistical iterative reconstruction method. Improvements in the model included enhancements to the Monte Carlo (MC) bremsstrahlung simulation used to generate various components of the model and better modeling of the energy dependence of various image degrading effects through the use of multiple energy ranges. The evaluation, using both a physical phantom experiment and an XCAT phantom simulation, demonstrated more accurate modeling of the image formation process and more accurate organ activity estimates than previous methods. </p><p> We then developed new methods for optimizing the acquisition energy window and parallel-hole collimator, respectively, for quantitative imaging. These methods account for the effects of energy window or collimator on both the bias and the variance of the activity estimates, and are applicable to radionuclides with any type of emission energy spectra. We applied these methods to optimizing the energy window and collimator for quantitative ⁹⁰Y bremsstrahlung SPECT in microsphere brachytherapy. </p><p> In addition to improving the reliability of quantitative imaging, we also did some work on improving the visual image quality for ⁹⁰Y bremsstrahlung SPECT imaging. We optimized the energy window for a detection task based on the performance of an observer that accounts for the degradation of the image quality due to model-mismatch. This is important as detection of post-administration extra-hepatic 90Y could be useful in predicting and preparing for complications such as radiation-induced gastro-intestinal ulcerations. </p>

<p> The purpose of this study was to determine the demographic profiles, the major reported health problems, and the complementary, alternative (CAM), and conventional treatments used for these health problems and for wellness by a sample of rural Appalachian chiropractic patients. Differences in patient profiles among patients with acute and chronic problems and between chiropractic and non-chiropractic problems were also analyzed.</p><p> A non-experimental descriptive cross-sectional design was employed. Descriptive analyses revealed that participants (N = 130) were 37 men and 93 women who were predominately white, married, middle-aged, well-educated and lived in Lee, Wise, Floyd or a surrounding county in Southwest Virginia. The majority of respondents were employed, insured, had an income greater than $35,000 per year, and reported their health as either "very good" or "good." They reported a low rate of alcohol and tobacco use. They tended to use either a Doctor of Chiropractic (DC) or a medical provider or both as a regular source of health care. A DC was used as a health care provider six percent more than a medical provider for regular health care visits.</p><p> Respondents reported forty separate health conditions as the main two health problems they experienced, the majority being chronic versus acute problems. Back, neck, and joint problems were the most frequently reported followed by headaches, diabetes, hypertension, thyroid, gastrointestinal, sinus and lung problems. The majority of the sample used chiropractic manipulation/adjustment with a substantial percentage of respondents using massage therapy or the two treatments concurrently. Chiropractic manipulation was used by one-quarter to one-third of those with diabetes and hypertension to treat these conditions and was employed by respondents with thyroid, gastrointestinal, sinus and lung problems as well. About one-quarter to one-half of respondents with these conditions used chiropractic manipulation, massage therapy, or both therapies together for treatment. The use of energy work, counseling, physical therapy, and reflexology were reported by only a small number of respondents.</p><p> Differences in patient profiles among patients with acute and chronic health problems were evaluated with health status found to be significantly better in those with acute as compared with chronic health conditions. Those respondents who were not working were found to have non-chiropractic or medical problems more often.</p>

Thesis (M.Tech.: Chiropratic)- Dept.of Chiropractic, Durban Institute of Technology, 2006 xvii, 148 leaves / Chiropractors and homeopaths belong to the same paradigm i.e. the biopsychosocial. Due to this fact, there has been a perception that there will automatically be a good referral relationship between these two. This was therefore assumed to be true in the South African context; however until now there has never been any quantifiable evidence as to what the interprofessional ties are between these two professions in this context. This study looked into the current status quo of the factors affecting referrals between chiropractors and homeopaths practicing in the greater Durban Metro area and looks towards future studies which may enhance the interprofessional relationship.

Thesis (M.Tech.: Homoeopathy)--Durban University of Technology, 2008. xvii, 87 leaves / Homoeopathy is a scientific, reliable and natural system of medicinal therapy, which has been in existence for over 200 years. Recent years have shown a profound shift in health and medicine, increasing numbers of the public are opting for complementary and alternative(CAM) therapies. In South Africa the situation for CAM and homoeopathy in particular looks more favorable. The government, in the form of the department of health, has drawn up specific guidelines for the regulation of homoeopathy and other CAM therapies. Much closer liaison should exist between the Allied health professions council of South Africa (AHPCSA) and the Health professions council of S.A (HPCSA) with the aim of uniting strengths to the advantage of the South African public to achieve an integrated, holistic care (Prinsloo, 2005). OBJECTIVE The purpose of this study is to provide demographic data on the perceptions and interactions of Medical specialists in the greater Durban area toward homoeopathy. Their general knowledge of homoeopathy and their views and communication with homoeopathy have been assessed. iv METHODOLOGY A survey method in the form of a questionnaire was employed to investigate the perceptions and interaction of Medical specialists towards homoeopathy. The sample of Medical specialists was drawn from the medical pages of the Durban Telephone Directory. The data was analyzed by means of descriptive statistics using frequency tables and bar charts. The Pearson’s Chi-square Test was used on selected data. RESULTS One hundred and fifty completed questionnaires were returned for analysis out of the 344 sent out. This gives a response rate of 43.60%. CONCLUSION From this study one can conclude that Medical specialists know very little about homoeopathy, and it can be assumed that this lack of knowledge is a possible reason for the poor communication that currently exists between these practitioners and homoeopaths