There are notable differences between the dominant Western medical model of health and the model of CAM, and looking at these differences may provide a greater understanding around doctors’ views towards CAM and its place in the wider health system. The purpose of this dissertation is to provide a systematic literature review into how doctors view complementary and alternative medicine, and to see if this has changed since the 1970s through to 2009. A systematic review of the literature was conducted, mainly using online original research Journal articles from medical databases. The internet was the main tool used in locating data, and literature was included or excluded based on relevance. This was evaluated on the relevance of time period, such as 1970, subject, such as chiropractic, or theme, such as attitudes of doctors to CAM. Literature from the 1970s was scarce on this research question, but this review noted a significant increase in literature on this topic since the 1990s, identifying this research area as a relatively new field of study, with much potential for further exploration into beliefs and attitudes of doctors towards CAM. Scientific research papers that were published highlighted a strong emphasis towards doctors’ requirement for further scientific research on the efficacy of CAM. Randomised controlled trials (RCTs) were the preferred method of testing; however this review also discusses appropriate methodology to test both CAM and doctors’ views and beliefs. The difference between the Western medical model and the CAM model highlights the differences between both concepts; from which this author provides a possible interpretation of doctors’ indifferent views towards CAM using the psychological theory of cognitive dissonance (Festinger, 1957). This theory suggests that a person cannot hold two conflicting beliefs simultaneously, without the presence of cognitive ‘dissonance.’ “The existence of dissonance, being psychologically uncomfortable, will motivate the person to try to reduce the dissonance and achieve consonance” (Festinger, 3: 1957). This systematic review then provides a discussion around how this could explain doctors’ views towards CAM. . This then leads to the question of whether ‘successful integration of Western medicine and CAM is therefore possible’? The systematic review concludes with the highlighting of important issues in regard to the study design and methodology on effectively testing CAM, and on effectively testing doctors’ beliefs: also, the issues around integration and further scientific literature on CAM in a bid to potentially reduce the ‘moderate tone of answering’ that is reported in the literature in regard to doctors’ views towards CAM.

Because of the long and entrenched history of Chinese medicine in Taiwan, people have traditionally incorporated this knowledge into their health care. With the appearance and growing acceptance of Western medical practices, multiple medical approaches have become more and more popular. Yet, despite the strong foundations of Western medicine in the treatment of cancer in Taiwan, the use of Chinese medicine continues to be popular (Lin, 1992, p. 114). The focus of this research is the contextual construction of meanings about non Western medicine (NWM). The context for the study is Taiwan, the researcher's home country. The purpose of the research is to explore the motivations for, and the processes by which, Taiwanese people with cancer incorporate NWM into their cancer treatment journey. Utilising a grounded theory approach, this research sought to explore the social processes by which Taiwanese people with cancer come to use non Western medicine. Twenty four in depth interviews were undertaken in the study. The findings of the study demonstrate that the interactions between people with cancer and their use of NWM are complex. Taken-for-grantedness emerges as the core category in the study. The core category situates the use of non Western medicine outside the institutionalised and regulated domains of health care. More specifically, the meanings attributed to NWM are embedded in the philosophical beliefs and social relationships that constitute the lives of the participants. These findings suggest implications for our understanding of the co-existence of NWM and Western medicine by Taiwanese people with cancer and the social processes with which they engage.

The thesis argues that processes of contemporary social change, broadly defined as postmodernisation, are undermining the authority and practices of the medical profession. It focuses on the increasing use of alternative medicine, by orthodox medical practitioners, as a site of radical social change. The thesis employs the middle-range theory of Mary Douglas and Aaron Wildavsky to explore changes in primary health at the institutional level. Data from interviews of health providers (n=50) and primary educational sources are used to provide empirical evidence of a significant challenge to the modernist medical hierarchy and its biomedical knowledge base. The evidence broadly supports the predictions of Douglas and Wildavsky, and those of the other macro-theorists associated with the study of globalisation and postmodernisation. Namely, contemporary society is characterised by a simultaneous shift of Centre to Periphery and vice versa. In the medical context, this has resulted in the increasing hybridisation and destabilisation of established forms of culture, knowledge and authority.

abstract: This research explores the socialization and culture of naturopathic students. Naturopathic physicians are a rapidly growing group of health care providers with a different ideology than conventional physicians. At present they work on the margins of the division of labor in health care. Only 15 U.S. states explicitly recognize, regulate, and license their practice, although the number is increasing. Therefore, the professional socialization of naturopathic students is framed within a context of a changing division of labor in health care. The recent growth of naturopathic physicians reflects the American public's increased interest and use of complementary and alternative medicine (CAM). However, these practitioners are not yet accepted as legitimate physicians by most conventional physicians. This research investigates how the professional socialization of students at a naturopathic medical school prepares them to assume their role as CAM providers in a division of labor that is dominated by conventional physicians. The research examines their choice to attend a naturopathic school, formal and informal socialization at the school, and the student culture. The main research site is a four-year, accredited naturopathic medical school where participant observation, intensive interviews, and a survey were used to collect data. Additional data are presented from observations at a national conference of the American Association of Naturopathic Physicians. Results indicate that the student culture and socialization process at the naturopathic medical school differ in some important ways from the previously documented socialization process at conventional medical schools. The average age of naturopathic students is much older than conventional medical students, and a much larger percentage are women. Unlike conventional medical students, who rely heavily on role models and previous knowledge of what it takes to become a medical doctor, naturopathic students select a career path based on values and beliefs that are more aligned with their own than conventional medicine. The formal and informal training and culture of naturopathic students prepares them to work alongside, rather than within, mainstream medicine. The documentation of how a group of CAM practitioners is created contributes to a better understanding of the ever-changing ideology and division of labor in health care. / Dissertation/Thesis / Ph.D. Sociology 2011

The current study utilized an early-stage translational approach (Tashiro & Mortensen, 2006) to empirically test the immediate effect of a 15-minute mindfulness intervention on acute pain experience. The study employed a three-group, repeated measures experimental design with two active control conditions (sham mindfulness and attention control) and an analogue pain induction procedure (cold-pressor test). The sample consisted of 165 university students. Repeated measures analyses found an interaction effect between condition and time for subjective pain intensity and an interaction effect between gender and time for pain tolerance. Trends show that attention control increased pain intensity, whereas mindfulness decreased pain intensity. Females exhibited greater pain tolerance at post-intervention across conditions. Analyses yielded no significant differences between conditions among dependent variables of pain tolerance, state affect, or state anxiety. A moderate relationship was found between fear of pain and pain tolerance at pre-intervention, but failed to significantly moderate outcome in main analyses. Post-hoc analyses revealed a subset of "high pain tolerant" participants, who endorsed significantly higher trait mindfulness, lower fear of pain, and lower pain catastrophizing compared to the remainder of participants. Negative affect was related to increased pain intensity within the attention control condition. Suggestions for future research and clinical implications of research in this area are discussed.

Complementary and Alternative Medicine (CAM) is popularly used among breast cancer patients to improve their quality of life. CAM includes dietary supplements such as Active Hexose Correlated Compound (AHCC®), a cultured mushroom extract shown to positively influence the immune system and cancer. Breast cancer recurrence is believed to be caused by cancer stem cells (CSCs). We postulated that AHCC impacts CSCs epigenetically by targeting miRNA pathways. The effects of AHCC on mammosphere growth were observed in MDA-MB-231, MCF-7, and 4T1 cells. Profiling, RT2-qPCR, and western blot analyses were performed to determine AHCC influence on miRNAs and Tenascin C protein in TNBC cell line MDA-MB-231. Balb/c mice were gavaged with AHCC to examine tumorigenesis effects. Our results demonstrated that AHCC reduced mammosphere growth and cell migration, and upregulated tumor suppressor miR-335 expression in different biological settings. Inhibition of miR-335 increased Tenascin C expression. Consequently, AHCC may influence BCSCs through miRNA pathways.

This thesis applied a novel interdisciplinary approach for pharmacovigilance to examine the use of complementary and integrative medicine (CIM), focusing on herbal remedies, to manage pediatric attention-deficit hyperactivity disorder (ADHD). The safety and potential risk of herb-drug interactions in ADHD management were first evaluated through an assessment of available information on the safety and efficacy of natural health products (NHPs) commonly used by ADHD patients as a means of identifying knowledge gaps. A clinical questionnaire was administered to caregivers of pediatric patients with ADHD to determine the factors and related outcomes of CIM use, including adverse events. A systematic search was conducted to further identify clinical adverse events involving herbal remedies and ADHD drugs to determine causal links to herb-drug interactions. In vitro analysis of identified herbal remedies was conducted to determine their potential for pharmacokinetic interactions, specifically on carboxylesterase-1 (CES1) mediated metabolism. The presented research builds on otherwise scarce evidence of the safety of herbal remedies for ADHD, particularly with respect to herb-drug interactions and adverse events (AEs) associated with concurrent use of NHPs and ADHD prescription drugs. Beyond studies conducted on the pharmacokinetic safety of herbal remedies through the cytochrome P450 pathways that metabolize some ADHD drugs, including amphetamine, atomoxetine and guanfacine, few data were available for CES1, which metabolizes methylphenidate, the first line of drug used to manage ADHD. The clinical questionnaire revealed that 40% of patients had used CIM and confirmed the use of a variety of CIM. Moreover, the majority of CIM users were also concurrently taking ADHD medication, and eight mild adverse events were self-reported. The systematic search on the adverse event reporting system highlighted a potential NHP-drug interaction between methylphenidate and St. John’s wort, and the overall poor quality of NHP-related adverse event reports. As a follow-up from the adverse event results, various commercial St. John’s wort products showed variable inhibition of recombinant human CES1 in vitro. Although the concentration of marker phytochemicals was not correlated to inhibition, hyperforin showed stronger activity than hypericin and quercetin. The preliminary in vitro investigation revealed that the herbal remedies used by ADHD patients have the potential to interact with CES1 mediated metabolism, with Rhodiola rosea identified as the most potent inhibitor. Further investigation on various commercial products of Rhodiola rosea revealed both reversible and irreversible inhibition of recombinant CES1. However, the inhibition was not dependent on the concentration of marker phytochemicals, and rosarin, rosavin, rosin, and salidroside were not potent inhibitors of recombinant CES1. Moreover, a commercial Rhodiola rosea extract showed concentration-dependent inhibition of human liver microsome meditated metabolism of methylphenidate. Overall, results from this thesis suggest potential risk from use of NHPs concurrently with conventional medicine used to manage ADHD. Improved evidence and pharmacovigilance for the use of NHPs in a pediatric population is warranted.

Introduction/background: Ayurveda is an ancient holistic medical system largely used in India. Complementary and alternative forms of medicine (CAM) like Ayurveda is starting to spread to the western parts of the world. In Sweden, there is an ongoing project of integrating CAM methods in Swedish health care. Research has shown that this has been beneficial for patients and can reduce care costs. Despite the popularity of CAM methods, knowledge of the methods might be deficient among Swedish healthcare staff. Aim: The aim of this study was to examine registered nurses’ perception of the use of ayurvedic medicine compared to western medicine in a hospital in Kerala, India. Method: A qualitative method was used with an inductive design. Data was collected through semi-structured interviews with five registered nurses. A thematic analysis was used to analyze the data. Result: The analysis resulted in three themes: Pros and cons, To combine or not? and Negotiating the use of Ayurveda. Conclusion: Ayurveda can be helpful in treating less critical conditions. Western medicine was seen as more relevant when treating more serious illnesses. Ayurvedic treatments was perceived to take longer and have more side effects. A combination of the two medical approaches was not recommended, however, Ayurveda could work as a complement to western medicine in terms of less acute conditions.

No description available.

African Americans have lower vitamin D levels and reduced health outcomes compared to white Americans. Vitamin D deficiency may contribute to adverse health outcomes in African Americans. We hypothesized that race would be associated with vitamin D status and testing in African Americans veterans, and that vitamin D status is a major contributor to health care costs in African American veterans compared to white veterans. A retrospective analysis of the medical data in the Veterans Integrated Service Network 9 (southeastern United States) was performed, and 14 148 male veterans were identified. Race was designated by the patient and its relationship to vitamin D levels/status and costs was assessed. Vitamin D levels were significantly lower and the percent of patients with vitamin D deficiency was significantly higher in African American veterans. This difference was independent of latitude and seasonality. Vitamin D testing was done significantly more in white veterans compared to African American veterans (5.4% vs 3.8%). While follow-up testing was 42% more likely if a patient was found to be vitamin D deficient, white veterans were 34% more likely than African American veterans to have at least 1 follow-up 25-hydroxyvitamin D performed. African American veterans had significantly higher health care costs, which were linked to lower vitamin D levels; however, the cost differential persisted even after adjusting for vitamin D status. Vitamin D deficiency is highly prevalent in African American veterans and needs improved management within the Veteran Administration system. Vitamin D status appears not to be the sole contributor to increased health care costs in African American veterans.