ORCID Profile
0000-0001-8813-3542
Current Organisations
University of Technology Sydney
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Southern Cross University
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Publisher: Mary Ann Liebert Inc
Date: 07-2023
Publisher: Wiley
Date: 20-07-2011
DOI: 10.1111/J.1440-1584.2011.01200.X
Abstract: Complementary and alternative medicine (CAM) use is high in rural health and an agenda for research in the geography of CAM has been outlined. Unfortunately, no studies to date have mapped the geographic distribution of CAM practitioners in rural areas. For the first time we investigate CAM practitioner distributions across a large district/region in rural Australia. A CAM infrastructure audit of practitioners was performed in rural Divisions of General Practice in New South Wales, Australia. CAM providers form a significant part of the health care system in rural New South Wales with substantial representation across all degrees of rurality and in both under-serviced and well-serviced areas. CAM practitioners outnumbered GPs in four NSW Divisions of General Practice and in no Division numbered less than half of the total number of GPs. Given the challenges of access to and recruitment and retention of conventional health care providers in rural settings and the significant presence of CAM practitioners, it is possible to consider such practitioners as an untapped resource in rural health care delivery. Assuming appropriate regulatory and quality standards are in place this resource should attract careful attention as part of future rural health policy and planning. The significant presence and high prevalence of use of CAM practitioners should also serve as an impetus to reform CAM service delivery in Australia.
Publisher: Informa UK Limited
Date: 07-05-2020
Publisher: Springer Science and Business Media LLC
Date: 06-05-2020
DOI: 10.1186/S12906-020-02931-6
Abstract: Considerable number of patients, including Ebola survivors, in Sierra Leone, are using traditional and complementary medicine (T& CM). Healthcare providers’ (HCPs) views about T& CM is crucial in addressing the increased need for T& CM among patients. However, healthcare providers’ views about T& CM in Sierra Leone is unknown. Our study explores healthcare providers’ knowledge of and perception towards T& CM and how that influence their personal and professional T& CM use, communication with Ebola survivors about T& CM as well as its integration into the healthcare system in Sierra Leone. We employed a qualitative exploratory study design using semi-structured interviews to collect data from 15 conveniently s led HCPs in all four geographical regions of Sierra Leone. We analysed our data using thematic network analysis framework. Healthcare providers perceived their knowledge about T& CM to be low and considered T& CM to be less effective and less safe than conventional medicine as well as not evidence-based. HCPs perception of T& CM as non-scientific and their lack of knowledge of T& CM were the key barriers to HCPs’ self-use and recommendation as well as their lack of detailed discussion about T& CM with Ebola survivors. HCPs are open to T& CM integration into mainstream healthcare in Sierra Leone although at their terms. However, they believe that T& CM integration could be enhanced by effective professional regulation of T& CM practice, and by improving T& CM evidenced-based knowledge through education, training and research. Changing HCPs’ negative perception of and increasing their knowledge about T& CM is critical to promoting effective communication with Ebola survivors regarding T& CM and its integration into the healthcare system in Sierra Leone . Strategies such as educational interventions for HCPs, conducting rigorous T& CM research, proper education and training of T& CM practitioners and effective professional regulation of T& CM practice could help in that direction.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.YPMED.2017.09.009
Abstract: Influenza and pneumococcal vaccination is recommended for all adults, with older adults considered a high-risk group for targeted intervention. As such it is important for factors affecting vaccine uptake in this group to be examined. Complementary medicine (CM) use has been suggested as a possible factor associated with lower vaccination uptake. To determine if associations exist between influenza and pneumococcal vaccine uptake in older Australian women and the use of CM, data from women aged 62-67years surveyed as part of the Australian Longitudinal Study on Women's Health (ALSWH) were analyzed in 2013 regarding their health and health care utilization. Associations between the uptake of influenza and pneumococcal vaccinations and the use of CM were analyzed in 2016 using chi-squared tests and multiple logistic regression modelling. Of the 9151 women, 65.6% and 17.7% reported that they had influenza and pneumococcal vaccination within the past 3years respectively. Regression analyses show that women who consulted naturopaths/herbalists (OR=0.64) and other CM practitioners (OR=0.64) were less likely to have vaccination (influenza only), as were women who used yoga (OR=0.77-0.80) and herbal medicines (OR=0.78-0.83) (influenza and pneumococcal). Conversely, women using vitamin supplements were more likely to receive either vaccination (OR=1.17-1.24) than those not using vitamin supplements. The interface between CM use and influenza and pneumococcal vaccination uptake in older women appears complex, multi-factorial and often highly in idualized and there is a need for further research to provide a rich examination of the decision-making and motivations of stakeholders around this important public health topic.
Publisher: Mary Ann Liebert Inc
Date: 07-2023
Publisher: Elsevier BV
Date: 03-2020
Publisher: Springer Science and Business Media LLC
Date: 11-07-2014
Publisher: Springer Science and Business Media LLC
Date: 15-03-2019
Publisher: Cambridge Media
Date: 15-03-2019
Publisher: Wiley
Date: 06-2015
DOI: 10.1111/AJO.12324
Abstract: Use of complementary and alternative medicine (CAM), particularly herbal and alternative medicine supplements, for preconception care and fertility management is becoming increasingly common. To determine the factors associated with the use of CAMs by women for preconception care. 412 women who had visited an antenatal 'first visit' clinic situated at a Brisbane obstetric hospital or had visited a private ultrasound clinic in the same city for the purposes of a routinely indicated ultrasound scan in the first trimester were recruited into the study. Data were collected via a cross-sectional questionnaire. Complementary and alternative medicines (not including multivitamins) were used during preconception by 8.3% of women attending for obstetric care. Approximately half (55.8%) of women taking herbal and alternative medicines ceased these medications on discovery of their pregnancy, though fewer (17.4%) ceased taking multivitamin supplements. Baseline characteristics (age, education and income) are not significantly different between CAM users and those who did not take CAMs preconception. The results of statistical analyses showed that only visiting a practitioner to check for health (OR = 2.00 95% CI: 1.33, 3.00) and trying to lose weight prior to pregnancy (OR = 1.53 95% CI: 1.00, 2.36) were the key predictors for women using CAM during preconception. Women do consume CAMs to enhance preconception care to a certain extent, though CAM users remain in the minority. CAM users also tend to cease use once pregnant.
Publisher: Elsevier BV
Date: 05-2020
Publisher: Mary Ann Liebert Inc
Date: 04-2018
Abstract: This study aims to describe the Australian complementary medicine (CM) workforce, including practice and professional characteristics. National cross-sectional survey. Australia. Any in idual who self-identified as a practitioner qualified in any one of 14 CM professions and working in any state or territory of Australia was eligible to participate in the survey. A 19-item online survey was developed following a review of existing CM workforce data and in alignment with other CM workforce survey projects in progress at the time. The survey items were presented under three main constructs: demographic characteristics, professional characteristics, and practice characteristics. Descriptive statistical analysis, including frequencies and percentages, of multiple choice survey items was used. Open response items were analyzed to determine the mean, standard deviation (SD), minimum, and maximum. The demographic data were evaluated for representativeness based on previously reported CM workforce figures. The survey was completed by 1306 CM practitioners and was found to be nationally representative compared with the most recent registrant data from the Chinese Medicine Board of Australia. Participants primarily practiced in the most populous Australian states and worked in at least one urban clinical location. Most participants held an Advanced Diploma qualification or lower, obtained their qualification ten more years ago, and practiced in a clinical environment alongside at least one other practitioner from another health profession. Participants reported erse clinical practice specialties and occupational roles. Per week, participants worked an average of 3.7 days and treated 23.6 clients. The results from this survey of practitioners from most complementary professions in Australia provide new insights into the national complementary medicine workforce. Further exploration of the CM workforce is warranted to inform all who provide patient care and develop health policy for better patient and public health outcomes.
Publisher: Elsevier BV
Date: 12-2017
Publisher: Elsevier BV
Date: 2014
Publisher: Springer Science and Business Media LLC
Date: 12-03-2022
Publisher: Mary Ann Liebert Inc
Date: 08-2021
Publisher: Elsevier BV
Date: 12-2016
DOI: 10.1016/J.FOOT.2016.09.007
Abstract: Despite a long-standing tradition of naturopathic physical therapy and hydrotherapy use in the treatment of musculoskeletal conditions, neither naturopathy, nor specific aspects of hydrotherapy have been tested for efficacy in the treatment of heel pain. Patients (n=20) were assigned to standard naturopathic physiotherapy care (NPC) with two adjuvant therapy groups: a control group (therapeutic ultrasound, n=10), or alternating compresses (n=10). Pain scores were measured before and after treatment using Visual Analog Scale (VAS) and foot functionality was measured using the Foot Function Index (FFI). FFI reduced from 46.97 to 31.98 (p=0.005) among normal protocol patients and from 49.72 to 21.35 (p=<0.001) among patients receiving the alternating compress protocol. Average VAS pain intensity in the seven days of treatment decreased from 3.53 to 2.53cm (p=<0.001) among patients receiving NPC and from 4.09 to 2.61cm (p=<0.001) amongst those receiving NPC plus alternating compresses. There was no significant difference in pain score reduction between the two groups (p=0.206), but patients with alternating compresses as part of their treatment had significant improvements in foot functionality (p=0.007). Naturopathic physical therapy significantly improves foot functionality and pain scores in heel pain. Additionally, alternating compresses improve foot functionality scores.
Publisher: Elsevier BV
Date: 06-2022
Publisher: Elsevier BV
Date: 08-2014
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.CTCP.2018.09.002
Abstract: This study examines the relationship between the use of complementary medicine (CM) interventions or consultations with CM practitioners and women's choice of contraceptive method. A secondary analysis of a cross-sectional survey of Australian Women aged 34-39 years from the Australian Longitudinal Study on Women's Health (ALSWH) was conducted. Associations between use of CM and contraception were analysed using Chi-squared tests and multivariate logistic regression. Based on the responses from the included women (n = 7299), women who consulted a naturopath/herbalist were less likely to use implant contraceptives (OR 0.56 95% confidence interval (CI) 0.33 0.95). Those consulting a chiropractor (OR 1.54 95%CI 1.05 2.25) or an osteopath (OR 2.16 95% CI 1.32 3.54) were more likely to use natural contraception. There may be a link between women's choice of contraceptive method and their use of CM, in particular, with CM practitioner consultations.
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.MATH.2016.10.067
Abstract: In recent years, evidence has emerged regarding the effectiveness of osteopathic manipulative treatments (OMT). Despite growing evidence in this field, there is need for appropriate research designs that effectively reflect the person-centred system of care promoted in osteopathy and provide data which can inform policy decisions within the healthcare system. The purpose of this systematic review is to identify, appraise and synthesise the evidence from comparative effectiveness and economic evaluation research involving OMT. A database search was conducted using CINAHL, PubMed, PEDro, AMED, SCOPUS and OSTMED.DR, from their inception to May 2015. Two separate searches were undertaken to identify original research articles encompassing the economic evaluation and comparative effectiveness of OMT. Identified comparative effectives studies were evaluated using the Cochrane risk of bias tool and appraised using the Good Reporting of Comparative Effectiveness (GRACE) principles. Identified economic studies were assessed with the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. Sixteen studies reporting the findings of comparative effectiveness (n = 9) and economic evaluation (n = 7) research were included. The comparative effectiveness studies reported outcomes for varied health conditions and the majority (n = 6) demonstrated a high risk of bias. The economic evaluations included a range of analyses and considerable differences in the quality of reporting were evident. Despite some positive findings, published comparative effectiveness and health economic studies in OMT are of insufficient quality and quantity to inform policy and practice. High quality, well-designed, research that aligns with international best practice is greatly needed to build a pragmatic evidence base for OMT.
Publisher: Springer Science and Business Media LLC
Date: 11-09-2018
Publisher: Public Library of Science (PLoS)
Date: 21-01-2022
DOI: 10.1371/JOURNAL.PONE.0262211
Abstract: Medical billing errors and fraud have been described as one of the last “great unreduced healthcare costs,” with some commentators suggesting measurable average losses from this phenomenon are 7% of total health expenditure. In Australia, it has been estimated that leakage from Medicare caused by non-compliant medical billing may be 10–15% of the scheme’s total cost. Despite a growing body of international research, mostly from the U.S, suggesting that rather than deliberately abusing the health financing systems they operate within, medical practitioners may be struggling to understand complex and highly interpretive medical billing rules, there is a lack of research in this area in Australia. The aim of this study was to address this research gap by examining the experiences of medical practitioners through the first qualitative study undertaken in Australia, which may have relevance in multiple jurisdictions. This study interviewed 27 specialist and general medical practitioners who claim Medicare reimbursements in their daily practice. Interviews were recorded, transcribed, and analysed using thematic analysis. The qualitative data revealed five themes including inadequate induction, poor legal literacy, absence of reliable advice and support, fear and deference, and unmet opportunities for improvement. The qualitative data presented in this study suggest Australian medical practitioners are ill-equipped to manage their Medicare compliance obligations, have low levels of legal literacy and desire education, clarity and certainty around complex billing standards and rules. Non-compliant medical billing under Australia’s Medicare scheme is a nuanced phenomenon that may be far more complex than previously thought and learnings from this study may offer important insights for other countries seeking solutions to the phenomenon of health system leakage. Strategies to address the barriers and deficiencies identified by participants in this study will require a multi-pronged approach. The data suggest that the current punitive system of ensuring compliance by Australian medical practitioners is not fit for purpose.
Publisher: Wiley
Date: 02-2015
DOI: 10.1111/IMJ.12665
Abstract: The complexity of Medicare claiming means it is often beyond the comprehension of many, including medical practitioners who are required to interpret and apply Medicare every day. A single Medicare service can be the subject of 30 different payment rates, multiple claiming methods and a myriad of rules, with severe penalties for non-compliance, yet the administrative infrastructure and specialised human resourcing of Medicare may have decreased over time. As a result, medical practitioners experience difficulties accessing reliable information and support concerning their claiming and compliance obligations. Some commentators overlook the complexity of Medicare and suggest that deliberate misuse of the system by medical practitioners is a significant contributor to rising healthcare costs, although there is currently no empirical evidence to support this view. Quantifying the precise amount of leakage caused by inappropriate claiming has proven an impossible task, although current estimates are $1-3 billion annually. The current government's proposed copayment plan may cause increases in non-compliance and incorrect Medicare claiming, and a causal link has been demonstrated between medical practitioner access to Medicare education and significant costs savings. Medicare claiming is a component of almost every medical interaction in Australia, yet most education in this area currently occurs on an ad hoc basis. Research examining medical practitioner experiences and understanding regarding Medicare claiming and compliance is urgently required to adapt medicine responsibly to our rapidly changing healthcare environment.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.CTIM.2019.01.009
Abstract: Examine the generational differences in complementary medicine (CM) utilisation between young women from the X and Millennial generations. Secondary analysis of two cross-sectional surveys from the Australian Longitudinal Study on Women's Health (ALSWH). Australia. Differences between young Generation X women (surveyed 1996 aged 18-23 years), and Millennial women (surveyed 2014 aged 19-24 years) regarding consultations with CM practitioners, sociodemographic characteristics, and health. Predictors for CM consultations were analysed via logistic regression analyses. Of the 14,247 Generation X women, 19.4% reported consulting CM, compared to 26.8% of the 11,344 Millennial women. CM consultations was predicted in both cohorts by higher age, education beyond primary school, non-urban (vs. urban) residence, and frequent back pain or headaches. Obesity and regular smoking predicted non-use in both. Significant cohort differences were found in physical activity levels (moderate/high levels associated with increased CM consultations in Millennial, but not Generation X women), and health status (Generation X women reporting fair-poor health were more likely to consult CM practitioners, while Millennial women reporting good health were less likely to do so, compared to women with very good/excellent health). The increase in CM utilization among young Australian women from Generation X compared to the Millennial generation could indicate different health consumer patterns for future middle-aged and older adult Australian women. Further increases in CM usage may be observed as current young women age into characteristics traditionally linked with higher CM use such as worsening health status and increased disposable income.
Publisher: Cambridge Media
Date: 12-2021
Publisher: Bond University
Date: 2014
DOI: 10.53300/001C.5601
Publisher: Mary Ann Liebert Inc
Date: 04-2012
Abstract: In line with increasing complementary medicine (CAM) use, the Australian government has committed considerable resources to the training of CAM practitioners. However, it has generally failed to complement this support with regulation or accountability measures. This is particularly true in Australia's largest CAM profession (naturopaths), which remains entirely unregulated but attracts approximately AUD$40 million each year in government funding for its education sector. This article explores the consequences of such unfettered support on professional outcomes. Data on Australian government funding for naturopathic student places were collated and compared with various outcome measures including research and professional outcomes. Lack of accountability measures attached to government support has enabled the proliferation of commercial education providers in the sector. This is often at the expense of the university sector, which is financially disadvantaged in naturopathic education delivery through extra academic and research obligations not shared by private for-profit providers. The major beneficiaries of government funding have facilitated few formal contributions to naturopathic research or professional development, whereas those with the highest research, professional, and academic output attracted the least government funding. Course content has declined in the previous 5 years, and government funding is still directed to courses that do not meet the minimum education levels for the prescribed government definition of naturopath. Unfettered support has also resulted in a significant increase in student numbers growth, which significantly outstrips growth in utilization, potentially affecting the profession's sustainability. Lack of regulation in naturopathic education has resulted in significant risks to patients (through reduced standards) as well as the naturopathic profession itself. Although CAM advocates often focus on pushing for government support for the development CAM, support without the development of appropriate regulatory and accountability measures can ultimately be detrimental to the development of CAM.
Publisher: Elsevier BV
Date: 04-2016
Publisher: Elsevier BV
Date: 03-2019
Publisher: Elsevier BV
Date: 10-2021
DOI: 10.1016/J.JEP.2021.114274
Abstract: Eleutherococcus senticosus (Rupr. et Maxim.) Maxim (ES) (syn. Acanthopanax senticosus (Rupr. & Maxim.) Harms) is a medicinal plant used in traditional medicine of Russian Far East and East Asia and known as an adaptogen - a category of herbal medicinal products which have non-specific inter-system anti-stress effects throughout the human body. ES was first established as a medicinal plant officially in the pharmacopeia of the Union of Soviet Socialist Republics (USSR) in 1962, and is currently recommended by the European Medicines Agency (EMA) to be prescribed to treat symptoms of asthenia such as fatigue and weakness. During the time of the USSR, a distinct research directive was undertaken on ES to examine substances which improve stamina and endurance, with over 1000 studies published. Due to security measures within the former USSR these papers were not accessible to the public and were never translated into English. This is the first study to make findings of the USSR studies on ES available to the international research and scientific community. This study was an archival retrieval. References for studies were sought from printed journal and conference preceding's publications, then located within library catalogues of three libraries in St Petersburg Russia. Eligibility criteria included human clinical trials examining the efficacy of ES in any condition, published in the Russian language in the Soviet Union. A total of 46 studies published between 1962 and 1986 in the USSR were sourced. Of the retrieved articles, 29 were reported as placebo-controlled trials, 11 were reported as controlled trials and six studies did not report the study design. Trends in studies were those reporting on healthy volunteers (n=21) at a dose of 2 ml extract/day (n=14) examining outcomes such as physical and mental stamina under varying conditions, normal work conditions, high temperatures and high altitudes, incidence or prophylaxis of colds and influenza (n=5), effects on color perception and vision (n=2), work capacity (n=1), cognitive effects (n=1), prophylaxis of hearing loss (n=3), effects on blood cell counts (n=2) and sensitivity to UV radiation (n=1). ES appears to exhibit benefits for cognitive function and physical and mental endurance and its effect as a respiratory system infection prophylaxis treatment are promising. This study is the first to publish the findings of clinical trials on ES from the USSR, which supports the traditional use and offers a valuable contribution to the body of evidence on medicinal uses of ES when the data is applied within the context of its limitations.
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.DRUGPO.2015.01.013
Abstract: Excessive alcohol consumption is a major public health issue internationally, with alcohol consumption being recognised as a leading cause of preventable illness and major social burden. To help ameliorate the risks and harms associated with alcohol consumption, all levels of governments have explored various legislative and regulatory provisions to support responsible alcohol consumption, service and promotion. In this article, using Australia as a case study, the legislative environment around responsible alcohol promotion and consumption across the Australian retail, entertainment and media sectors will be explored, with a focus on pricing and volume-based discounts. Whilst the potential harm and effect of both the licensed and non-licensed sectors appears to be widely acknowledged as similar in both scope and size of effect, legislative protections overwhelmingly focus solely on reducing the risks associated with alcohol consumption in licensed premises. This article explores the legislative provisions around preventing excessive alcohol consumption through promotional and marketing activities, and notes that whilst the licensed premises sector is facing increasing legislative restrictions, the off-premises sector remains unregulated and in some cases has even had existing restrictions removed, despite forming an increasing part of the alcohol chain in Australia. There appear to be inconsistencies and regulatory gaps in relation to price-based and volume-based discount alcohol promotions. Regulatory loopholes allow the retail sector in particular to use discounted alcohol as a promotional tool, in a way that is inconsistent with the goals of public health alcohol legislation, and in a way which would be illegal in any other sector. There appears to be a compelling case for introducing new restrictions, or extending existing restrictions, on these forms of promotion across all sectors involved in alcohol promotion, and there is considerable evidence that there would be considerable public health benefit from doing so.
Publisher: SAGE Publications
Date: 13-06-2018
Abstract: Introduction: Complementary medicine (CM) use has been found to influence the uptake of conventional cancer treatment. This study examines associations between CM use and cancer screening rates. Methods: Women aged 62 to 67 years from the Australian Longitudinal Study on Women’s Health were surveyed regarding their use of cancer screening initiatives. Associations between cancer screening behavior and visits to CM practitioners were analyzed. Results: Of the 9151 women, 9049 (98.9%) completed questions about cancer screening. A total of 65.1% of women had received a clinical skin examination, 54.3% colorectal cancer screening, 56.2% Pap test (within past 2 years), 83.3% mammogram (within past 2 years), 55.8% clinical breast examination, and 55.8% had conducted breast self-examination. Women who had consulted a massage therapist were more likely to undergo clinical skin examination ( P = .002), clinical breast examination ( P = .018), and mammogram ( P = .001). Women who had consulted a chiropractor were more likely to undergo a clinical skin examination ( P = .001), colorectal cancer screening ( P = .020), and mammogram ( P = .011). Women who had consulted an acupuncturist were more likely to undergo colorectal cancer screening ( P = .019), and those who consulted with an osteopath were more liable to have a Pap test ( P = .049). Conclusion: Women who visit CM practitioners are more likely to participate in cancer screening initiatives. Research is required to understand the current and potential role that CM practitioners (can) have as public health advocates, recommending preventative health measures such as cancer screening. Such an examination will help ensure optimal screening utilization and effective, timely care for all cancer patients.
Publisher: Elsevier BV
Date: 08-2016
Publisher: Mary Ann Liebert Inc
Date: 02-2019
Publisher: Oxford University Press (OUP)
Date: 17-10-2023
Publisher: Elsevier BV
Date: 08-2016
Publisher: Springer Science and Business Media LLC
Date: 18-02-2020
DOI: 10.1186/S12906-020-2851-7
Abstract: Naturopathy is a distinct system of traditional and complementary medicine recognized by the World Health Organization and defined by its philosophic approach to patient care, rather than the treatments used by practitioners. Worldwide, over 98 countries have practicing naturopaths, representing 36% of all countries and every world region. The contributions of naturopaths to healthcare delivery services internationally has not been previously examined. Thus, the primary intention of this research was to conduct an international survey of naturopathic practice and patient characteristics in order to gain insight to the breadth of their practices and the type of clinical conditions routinely encountered. The cross-sectional study was conducted in naturopathic clinics in 14 countries within 4 world regions including the European (Portugal, United Kingdom, Switzerland, Spain), Americas (Canada, United States, Chile, Brazil), Western Pacific (Hong Kong, Australia, New Zealand) and African (South Africa). Naturopathic practitioners in each country were invited to prospectively complete an online survey for 20 consecutive cases. The survey was administered in four languages. A total of 56 naturopaths from 14 countries participated in the study, providing a mean of 15.1 cases each (SD 7.6) and 851 cases in total. Most patients were female (72.6%) and all age categories were represented with a similar proportion for 36–45 years (20.2%), 46–55 years (19.5%), and 56–65 years (19.3%). A substantial majority (75%) of patients were considered by the participant to be presenting with chronic health conditions. The most prevalent category of health conditions were musculoskeletal (18.5%), gastrointestinal (12.2%), and mental illness (11.0%). The most common treatment categories prescribed or recommended to patients by the participants were dietary changes (60.5%), lifestyle and behaviour changes (56.9%), herbal medicines (54.2%) and nutritional supplements (52.1%). Many patients were known by participants to be receiving care from a general practitioner (43.2%) or a specialist medical practitioner (27.8%). Naturopathic practitioners provide health care for erse health conditions in patients in different age groups. The global population would benefit from researchers and policy makers paying closer attention to the potential risks, benefits, challenges and opportunities of the provision of naturopathic care within the community.
Publisher: Elsevier BV
Date: 04-2016
Publisher: Elsevier BV
Date: 09-2022
Publisher: Elsevier BV
Date: 04-2016
Publisher: Elsevier BV
Date: 05-2014
Publisher: Elsevier BV
Date: 08-2014
Publisher: Elsevier BV
Date: 03-2019
Publisher: Elsevier BV
Date: 10-2019
Publisher: Elsevier BV
Date: 08-2023
Publisher: Springer Science and Business Media LLC
Date: 28-09-2023
Publisher: BMJ
Date: 07-2022
DOI: 10.1136/BMJOPEN-2021-056075
Abstract: Naturopathy is a traditional medicine system informed by codified philosophies and principles, and an emphasis on non-pharmacologic therapeutic interventions. While naturopathy is practised by approximately 75 000–100 000 000 naturopathic practitioners in at least 98 countries, little is known about the international prevalence of history of consultation with a naturopathic practitioner. This study reports a systematic review and meta-analysis of studies describing the global prevalence of history of consultation with a naturopathic practitioner by the general population. The included literature was identified through a systematic search of eight databases between September and October 2019, as well as the grey literature. Studies were included if they reported the prevalence rate of consultations with a naturopathic practitioner by the general population. Survey items needed to report consultations with a naturopathic practitioner as defined in the country where data was collected, and not combine naturopathic consultations with other health services or only report consulations for illness populations. Primary measures used for the analysis was consultations in the previous 12 months. Other prevalence timeframes were reported as secondary measures. Meta-analysis of prevalence data was conducted using random effects models based on in idual countries and WHO world regions. The literature search identified eight manuscripts summarising 14 studies reporting prevalence for inclusion in the review. All included studies had a low risk of bias. Meta-analysis of the included studies by world region found the 12-month prevalence of history of naturopathy consultations ranged from 1% in the Region of the Americas to 6% in the European and Western Pacific Regions. There are up to sixfold differences in the prevalence of naturopathy consults over 12 months between and within world regions, which may be driven by a range of policy, legislative and social factors. CRD42020145529.
Publisher: Research Square Platform LLC
Date: 17-02-2021
DOI: 10.21203/RS.3.RS-209399/V2
Abstract: Background: To evaluate the evidence behind claims that Chinese Herbal Medicine, specifically “three medicines and three formulations” (3M3F, comprising Jinhua Qinggan, Lianhua Qingwen, Xuebijing, Qingfei Paidu, Huashi Baidu and Xuanfei Baidu), is an effective treatment for COVID-19. Methods: We searched PubMed, MEDLINE and CNKI databases, preprint servers, clinical trial registries and supplementary sources for Chinese- or English-language randomised trials or non-randomised studies with comparator groups, which tested the constituents of 3M3F in the treatment of COVID-19 up to September 2020. Primary outcome was change in disease severity. Secondary outcomes included various symptoms. Meta-analysis (using generic inverse variance random effects model) was performed when there were two or more studies reporting on the same symptom. Results: Of 607 articles identified, thirteen primary studies (six RCTs and seven retrospective non-randomised comparative studies) with 1467 participants met our final inclusion criteria. Studies were small and had significant methodological limitations, most notably potential bias in assessment of outcomes. No study convincingly demonstrated a statistically significant impact on change in disease severity. Eight studies reported sufficiently similar secondary outcomes to be included in a meta-analysis. Some statistically significant impacts on symptoms, chest CT manifestations, laboratory variables and length of stay were demonstrated, but such findings were sparse and many remain unreplicated. Conclusions: These findings neither support nor refute the claim that 3M3F alters the severity of COVID-19 or alleviates symptoms. More rigorous studies are required to properly ascertain the potential role of Chinese Herbal Medicine in COVID-19. Systematic review registration: This review was registered on PROSPERO (CRD42020187502) prior to data collection and analysis.
Publisher: Elsevier BV
Date: 12-2014
Publisher: Cambridge Media
Date: 20-06-2019
Publisher: Elsevier BV
Date: 08-2016
Publisher: Elsevier BV
Date: 08-2018
Publisher: Elsevier BV
Date: 05-2019
Publisher: Springer Science and Business Media LLC
Date: 05-01-2022
DOI: 10.1186/S12913-021-07426-9
Abstract: The identification of typologies of health care users and their specific characteristics can be performed using cluster analysis. This statistical approach aggregates similar users based on their common health-related behavior. This study aims to examine health care utilization patterns using cluster analysis and the associations of health care user types with sociodemographic, health-related and health-system related factors. Cross-sectional data from the 2012 National Health Interview Survey were used. Health care utilization was measured by consultations with a variety of medical, allied and complementary health practitioners or the use of several interventions (exercise, diet, supplementation etc.) within the past 12 months (used vs. not used). A model-based clustering approach based on finite normal mixture modelling, and several indices of cluster fit were determined. Health care utilization within the cluster was analyzed descriptively, and independent predictors of belonging to the respective clusters were analyzed using logistic regression models including sociodemographic, health- and health insurance-related factors. Nine distinct health care user types were identified, ranging from nearly non-use of health care modalities to over-utilization of medical, allied and complementary health care. Several sociodemographic and health-related characteristics were predictive of belonging to the respective health care user types, including age, gender, health status, education, income, ethnicity, and health care coverage. Cluster analysis can be used to identify typical health care utilization patterns based on empirical data and those typologies are related to a variety of sociodemographic and health-related characteristics. These findings on in idual differences regarding health care access and utilization can inform future health care research and policy regarding how to improve accessibility of different medical approaches.
Publisher: Wiley
Date: 15-11-2010
DOI: 10.1111/J.1748-0361.2010.00348.X
Abstract: CONTEXTS: The consumption of complementary and alternative medicine (CAM) in rural areas is a significant contemporary health care issue. An understanding of CAM use in rural health can provide a new perspective on health beliefs and practice as well as on some of the core service delivery issues facing rural health care generally. This article presents the first review and synthesis of research findings on CAM use and practice in rural communities. A comprehensive search of literature from 1998 to 2010 in CINAHL, MEDLINE, AMED, and CSA Illumina (social sciences) was conducted. The search was confined to peer-reviewed articles published in English reporting empirical research findings on the use or practice of CAM in rural settings. Research findings are grouped and examined according to 3 key themes: "prevalence of CAM use and practice,""user profile and trends of CAM consumption," and "potential drivers and barriers to CAM use and practice." Evidence from recent research illustrates the substantial prevalence and complexity of CAM use in rural regions. A number of potential gaps in our understanding of CAM use and practice in rural settings are also identified.
Publisher: Wiley
Date: 07-01-2011
DOI: 10.1111/J.1365-2648.2010.05510.X
Abstract: This paper presents an integrative literature review examining the attitudes and referral practices of midwives and other maternity care professionals with regard to complementary and alternative treatment and its use by pregnant women. Use of complementary and alternative medicine during pregnancy is a crucial healthcare issue. Recent discussion has identified the need to develop an integrated approach to maternity care. However, there is a lack of understanding of attitudes and behaviours of maternity care professionals towards these treatments. A database search was conducted in MEDLINE, CINAHL, Health Source, AMED and Maternity and Infant Care for the period 1999-2009. An integrative review method was employed. Studies were selected if they reported results from primary data collection on professional practice/referral or knowledge/attitude towards complementary and alternative medicine by obstetricians, midwives and allied maternity care providers. A total of 21 papers covering 19 studies were identified. Findings from these studies were extracted, grouped and examined according to three key themes: 'prevalence of practice, recommendation and referral', 'attitudes and views' and 'professionalism and professional identity'. There is a need for greater respect and cooperation between conventional and alternative practitioners as well as communication between all maternity care practitioners and their patients about the use of complementary and alternative medicine. There is a need for in-depth studies on the social dimension of practice as well as the inter- and intra-professional dynamics that shape providers' decision to use or refer to complementary and alternative medicine in maternity care.
Publisher: Springer Science and Business Media LLC
Date: 07-02-2019
DOI: 10.1038/S41598-018-38279-8
Abstract: Concomitant complementary medicine (CM) and conventional medicine use is frequent and carries potential risks. Yet, CM users frequently neglect to disclose CM use to medical providers. Our systematic review examines rates of and reasons for CM use disclosure to medical providers. Observational studies published 2003–2016 were searched (AMED, CINAHL, MEDLINE, PsycINFO). Eighty-six papers reporting disclosure rates and/or reasons for disclosure/non-disclosure of CM use to medical providers were reviewed. Fourteen were selected for meta-analysis of disclosure rates of biologically-based CM. Overall disclosure rates varied (7–80%). Meta-analysis revealed a 33% disclosure rate (95%CI: 24% to 43%) for biologically-based CM. Reasons for non-disclosure included lack of inquiry from medical providers, fear of provider disapproval, perception of disclosure as unimportant, belief providers lacked CM knowledge, lacking time, and belief CM was safe. Reasons for disclosure included inquiry from medical providers, belief providers would support CM use, belief disclosure was important for safety, and belief providers would give advice about CM. Disclosure appears to be influenced by the nature of patient-provider communication. However, inconsistent definitions of CM and lack of a standard measure for disclosure created substantial heterogeneity between studies. Disclosure of CM use to medical providers must be encouraged for safe, effective patient care.
Publisher: Elsevier BV
Date: 09-2019
Publisher: Walter de Gruyter GmbH
Date: 23-07-2016
Abstract: This paper aims to remedy a gap in the knowledge by presenting the first critical review of the literature on major themes relating to medical students perceptions and attitudes towards the exponentially growing field of complementary and alternative medicine (CAM). After a comprehensive database search of the literature, 21 papers were chosen as suitable for the review. The results from these papers were tabled and discussed. The results indicated that medical students lacked knowledge of CAM and are generally positive towards CAM education (especially in the preclinical years, if it provided evidence of efficacy and post-placement). Medical students thought that CAM should generally be incorporated into the medical curriculum mainly so they can confidently undertake referral to CAM practitioners. Being able to communicate with future patients about their CAM use was a major motivation for medical students to learn about CAM and a factor for medical student support of further incorporation of CAM content in the medical curricula. Educational exposure to CAM in many forms and in many papers was shown to significantly affect medical student attitudes to CAM. This may be reflective of the fact that, outside direct CAM training, there may be limited accessible opportunities for medical students and if integration is to occur, educational exposure is most important. The rise of CAM as a social and clinical phenomenon necessitates consideration of further inclusion of these topics in the medical curriculum, if future physicians are to be able to fully discharge their role as care providers in an increasingly medically pluralistic world. However, the inclusion of CAM needs to be done in an objective and critical manner, which is relevant to the learner.
Publisher: SAGE Publications
Date: 03-2013
DOI: 10.1136/ACUPMED-2012-010244
Abstract: To ascertain the extent of and trends in the use of acupuncture in Australian general practice and the characteristics of patients receiving publicly subsidised acupuncture services from general practitioners (GPs). Secondary analysis of national patient Medicare data for claims by all non-specialist medical practitioners for Medicare Benefits Schedule items for an attendance where acupuncture was performed by a medical practitioner from 1995 to 2011. Use of acupuncture by GPs, patients’ sex and age and the socioeconomic disadvantage index of GP's practice. There has been a 47.7% decline in the number of acupuncture claims by GPs per 100 000 population in the period from 1995 to 2011. Acupuncture claims were made by 3.4% of GPs in 2011. Women were almost twice as likely to receive acupuncture from a GP as men, and patients in urban areas were more than twice as likely to receive acupuncture from a GP as patients in rural areas. Acupuncture claims were highest in areas that were socioeconomically advantaged. Claims for reimbursement for acupuncture by GPs have declined significantly in Australian general practice even though the use of acupuncture by the Australian public has increased. This may be due to increased use of referrals or use of non-medical practitioners, barriers to acupuncture practice in general practice or non-specific factors affecting reimbursement for non-vocationally registered GPs.
Publisher: Sri Lanka Journals Online (JOL)
Date: 31-12-2020
Publisher: Springer Science and Business Media LLC
Date: 26-05-2023
DOI: 10.1186/S12913-023-09582-6
Abstract: Shared medical appointments, also known as group visits, are a feasible and well-accepted approach for women receiving antenatal care, yet the feasibility and efficacy of this approach for female-specific reproductive conditions is uncertain. The aim of this systematic review was to (a) determine the feasibility of group visits in adults with any female-specific reproductive condition, and (b) identify whether delivering group care for these conditions impacts clinical outcomes. Six databases and two clinical trials registries were searched from inception through to 26 January 2022 for original research examining group medical visits or group consultation interventions for adults with female reproductive conditions or pathologic conditions specific to the female reproductive system. The search yielded 2584 studies, of which four met the inclusion criteria. Included studies s led women with breast cancer, chronic pelvic pain, polycystic ovary syndrome and gynaecological cancers. Studies reported high levels of patient satisfaction, with participants indicating their expectations had been met or exceeded. The impact of group visits on clinical outcomes was inconclusive however. The studies in this review indicate delivery of female-specific healthcare via a group model maybe feasible and well-accepted. The review provides a solid basis for proposing larger and longer studies on group visits for female reproductive conditions. The review protocol was registered with PROSPERO (CRD42020196995).
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.JMPT.2012.12.010
Abstract: The purpose of this study was to evaluate survey data from a national cross-sectional s le of 1427 urban and nonurban Australian women focusing on the relationship between the use of specific complementary and alternative medicine (CAM) practitioner types and the levels of CAM use across urban and nonurban areas. A cross-sectional survey of 1427 middle-aged participants from the Australian Longitudinal Study on Women's Health conducted in 2009 was performed. The survey was designed to investigate multiple factors affecting the health and well-being of a cohort of women, with a particular emphasis on urban and nonurban residence. Women in 3 age groups ("young" 18-23 years, "mid-age" 45-50 years, and "older" 70-75 years) were randomly selected from the national Medicare database. The survey covered place of residence, measures of health status, rating of health care providers/services, and consultation with CAM practitioners. The most commonly consulted CAM practitioners for this s le were massage therapists (n = 912 63.9%), doctors of chiropractic/chiropractors (n = 614 43.0%), and naturopaths/herbal therapists (n = 327 22.9%). Statistically significant differences between the areas of residence were found for women who used chiropractors (P = .0165), yoga practitioners (P = .0087), and osteopaths (P < .0001). Women residing in nonurban areas were more likely to consult with a chiropractor compared with women residing in major cities. Women in major cities were more likely to consult with a yoga practitioner or osteopath than women from nonurban areas. Women from nonurban areas who consulted a chiropractor were significantly less satisfied with their access to a medical specialist (P < .0001), access to a female general practitioner (P = .043), the number of general practitioners they have to choose from (P = .001), how long they have to wait for an appointment (0.0146), and the amount of information sharing by their general practitioner (P = .003), compared with urban women. For the population s le studied, the higher overall consultation rates with CAM therapists by Australian nonurban women were caused by consultations for chiropractic care.
Publisher: Informa UK Limited
Date: 02-01-2015
Publisher: BMJ
Date: 08-2023
DOI: 10.1136/BMJGH-2022-010813
Abstract: Management of COVID-19 in Africa is challenging due to limited resources, including the high cost of vaccines, diagnostics, medical devices and routine pharmaceuticals. These challenges, in addition to wide acceptability, have resulted in increased use of herbal medicines based on African traditional medicines (ATMs) by patients in Africa. This is in spite of the often-significant gaps in evidence regarding these traditional medicines as to their efficacy and safety for COVID-19. African scientists, with some support from their governments, and guidance from WHO and other bodies, are addressing this evidence gap, developing and testing herbal medicines based on ATMs to manage mild-to-moderate cases of COVID-19. Such efforts need further support to meet public health needs.
Publisher: Springer Science and Business Media LLC
Date: 15-07-2021
DOI: 10.1186/S12960-021-00631-X
Abstract: The World Health Organization has suggested the solution to health system waste caused by incorrect billing and fraud is policing and prosecution. However, a growing body of evidence suggests leakage may not always be fraudulent or corrupt, with researchers suggesting medical practitioners may sometimes struggle to understand increasingly complex legal requirements around health financing and billing transactions, which may be improved through education. To explore this phenomenon further, we undertook a scoping review of the literature to identify the medical billing education needs of medical practitioners and whether those needs are being met. Eligible records included English language materials published between 1 January 2000 and 4 May 2020. Searches were conducted on MEDLINE, PubMed, Google Scholar, CINAHL, LexisNexis and Heinonline. We identified 74 records as directly relevant to the search criteria. Despite undertaking a comprehensive, English language search, with no country restrictions, studies meeting the inclusion criteria were limited to three countries (Australia, Canada, US), indicating a need for further work internationally. The literature suggests the education needs of medical practitioners in relation to medical billing compliance are not being met and medical practitioners desire more education on this topic. Evidence suggests education may be effective in improving medical billing compliance and reducing waste in health systems. There is broad agreement amongst medical education stakeholders in multiple jurisdictions that medical billing should be viewed as a core competency of medical education, though there is an apparent inertia to include this competency in medical education curricula. Penalties for non-compliant medical billing are serious and medical practitioners are at risk of random audits and investigations for breaches of sometimes incomprehensible, and highly interpretive regulations they may never have been taught. Despite acknowledged significance of waste in health systems due to poor practitioner knowledge of billing practices, there has been very little research to date on education interventions to improve health system efficiency at a practitioner level.
Publisher: Elsevier BV
Date: 08-2015
Publisher: Springer Science and Business Media LLC
Date: 29-03-2021
DOI: 10.1186/S12960-021-00579-Y
Abstract: There has been a considerable increase in the number of traditional and complementary medicine (T& CM) practitioners over the past 20 years and in some jurisdictions are estimated to outnumber general practitioners. Despite this globally significant role, it is apparent that worldwide not all T& CM professions operate under adequate accountability and regulatory oversight for maintaining public protection. To date there has been no published systematic examination of stakeholder opinions regarding regulated and unregulated T& CM occupations. In response, this review aims to investigate, describe, and analyse attitudes held by a range of stakeholder groups towards the regulation of T& CM professions. A database search of AMED, CINAHL, Embase, Ovid MEDLINE, ProQuest, PsycINFO, PubMed, Scopus, and Google Scholar was conducted for original research published between 2000 and 2020 on stakeholder opinions regarding the regulation of T& CM professions. Sixty studies across 15 countries reported on the views of six health care stakeholder groups: consumers, T& CM practitioners, conventional medicine practitioners, professional associations, education providers, and policy-makers. Across all stakeholder groups there was between 15% and 95% (median 61%) support for, and 1% to 57% (median 14%) opposition to the regulation of various T& CM professions. The main reasons for supporting regulation included providing greater public protection, raising training and practice standards, establishing title protection, and gaining acceptance from conventional medicine providers. Concerns regarding regulation included potential restrictions to practice, misappropriation of practice, and medical oversight of T& CM practitioners. Few studies canvassed the views of professional associations ( n = 6), education providers ( n = 2), and policy-makers ( n = 2). There appears to be broad support for the regulation of T& CM professions, although there was wide variation in attitudes as to how this should be applied. Further research, with a particular focus on policy-makers, education providers, and professional associations, is critical to inform appropriate health policy and practice recommendations relating to T& CM professional regulation across jurisdictions. Systematic review registration: the a priori protocol for this systematic review was registered in PROSPERO and is available at: www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42020198767 .
Publisher: Mary Ann Liebert Inc
Date: 07-2023
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.JMPT.2013.09.003
Abstract: Massage therapists are an important part of the health care setting in rural and regional Australia and are the largest complementary and alternative medicine (CAM) profession based on both practitioner numbers and use. The purpose of this study was to survey medical general practitioners (GPs) in rural and regional New South Wales, Australia, to identify their knowledge, attitudes, relationships, and patterns of referral to massage therapy in primary health care. A 27-item questionnaire was sent to all 1486 GPs currently practicing in rural and regional Divisions of General Practice in New South Wales, Australia. The survey had 5 general areas: the GP's personal use and knowledge of massage, the GP's professional relationships with massage practice and massage practitioners, the GP's specific opinions on massage, the GP's information-seeking behavior in relation to massage, and the GP's assumptions on massage use by patients in their local areas. A total of 585 questionnaires were returned completed, with 49 survey questionnaires returned as "no longer at this address" (response rate of 40.7%). More than three-quarters of GPs (76.6%) referred to massage therapy at least a few times per year, with 12.5% of GPs referring at least once per week. The GP being in a nonremote location (odds ratio [OR], 14.28 95% confidence interval [CI], 3.7-50.0), graduating from an Australian medical school (OR, 2.03 95% CI, 1.09-3.70), perceiving a lack of other treatment options (OR, 2.64 95% CI, 1.15-6.01), perceiving good patient access to a wide variety of medical specialists (OR, 11.1 95% CI, 1.7-50.0), believing in the efficacy of massage therapy (OR, 2.75 95% CI, 1.58-4.78), experiencing positive results from patients using massage therapy previously (OR, 13.95 95% CI, 5.96-32.64), or having prescribed any CAM previously (OR, 1.83 95% CI, 1.03-3.27) were all independently predictive of increased referral to massage therapy among the GPs in this study. There appears to be substantial interface between massage therapy and GPs in rural and regional Australia. There are high levels of support for massage therapies among Australian GPs, relative to other CAM professions, with low levels of opposition to the incorporation of these therapies in patient care.
Publisher: Mary Ann Liebert Inc
Date: 07-2023
Publisher: Elsevier BV
Date: 10-2009
DOI: 10.1111/J.1753-6405.2009.00433.X
Abstract: The economic implications of a lack of competition in the grocery retail sector are hotly contested. However, there are also significant health implications of such anti-competitive practices that seldom receive attention. This paper hopes to draw attention to the potential public health issues that arise as a result of lack of competition in the grocery retail sector. Relevant supporting literature was reviewed to explore the possible effects of market concentration on various health outcomes. High retailer concentration may adversely affect affordability, accessibility, quality, and choice of healthy food options to consumers. In turn this has significant implications for public health. Unless these upstream factors are addressed through the development of healthy competition, policy public health programs aimed purely at encouraging the public to consume higher quantities of healthful foods may be rendered ineffective.
Publisher: Elsevier BV
Date: 04-2017
Publisher: Elsevier BV
Date: 04-2017
Publisher: Springer Science and Business Media LLC
Date: 11-06-2016
Publisher: Elsevier BV
Date: 09-2022
Publisher: Elsevier BV
Date: 08-2017
Publisher: Mary Ann Liebert Inc
Date: 12-2013
Publisher: Elsevier BV
Date: 06-2009
Publisher: Elsevier BV
Date: 06-2017
Publisher: Informa UK Limited
Date: 06-09-2017
DOI: 10.1080/13561820.2017.1351424
Abstract: Complementary and alternative medicine (CAM) is an increasingly prevalent part of contemporary health care. Whilst there have been some attempts to understand the dynamics of CAM integration in the health care system from the perspective of conventional care providers and patients, little research has examined the view of CAM practitioners. This study aims to identify the experiences of integration within a conventional healthcare system as perceived by naturopaths. Qualitative semi-structured interviews were conducted using a purposeful s le of 20 practising naturopaths in South East Queensland, Australia to discuss their experiences and perceptions of integrating with conventional medical providers. Analysis of the interviews revealed five broad challenges for the integration of CAM according to naturopaths: competing paradigms between CAM and conventional medicine co-option of CAM by conventional medical practitioners the preservation of separate CAM and conventional medical worlds by patients and providers due to lack of formalised relations negative feedback and biases created through selective or limited experience or information with CAM and indifferent, reactive and one-sided interaction between CAM and conventional medical providers. Naturopaths support the integration of health services and attempt to provide safe and appropriate care to their patients through collaborative approaches to practice. The challenges identified by naturopaths associated with integration of CAM with conventional providers may impact the quality of care of patients who choose to integrate CAM and conventional approaches to health. Given the significant role of naturopaths in contemporary health-care systems, these challenges require further research and policy attention.
Publisher: Elsevier BV
Date: 03-2021
Publisher: Wiley
Date: 25-10-2016
DOI: 10.1111/BIRT.12251
Publisher: Elsevier BV
Date: 12-2015
Publisher: Springer Science and Business Media LLC
Date: 05-02-2020
DOI: 10.1186/S12889-020-8279-7
Abstract: We examined the magnitude and correlates of Ebola virus disease (EVD)-related stigma among EVD survivors in Sierra Leone since their return to their communities. In addition, we determined whether EVD-related stigma is a predictor of informal health care use among EVD survivors. We conducted a cross-sectional study among 358 EVD survivors in five districts across all four geographic regions (Western Area, Northern Province, Eastern Province and Southern Province) of Sierra Leone. Ebola-related stigma was measured by adapting the validated HIV related stigma for people living with HIV/AIDS instrument. We also measured traditional and complementary medicine (T& CM) use (as a measure of informal healthcare use). Data were analysed using descriptive statistics and regression analysis. EVD survivors report higher levels of internalised stigma (0.92 ± 0.77) compared to total enacted stigma (0.71 ± 0.61). Social isolation (0.96 ± 0.88) was the highest reported enacted stigma subscale. Ebola survivors who identified as Christians [AOR = 2.51, 95%CI: 1.15–5.49, p = 0.021], who perceived their health to be fair oor [AOR = 2.58, 95%CI: 1.39–4.77. p = 0.003] and who reside in the northern region of Sierra Leone [AOR = 2.80, 95%CI: 1.29–6.07, p = 0.009] were more likely to experience internalised stigma. Verbal abuse [AOR = 1.95, 95%CI: 1.09–3.49, p = 0.025] and healthcare neglect [AOR = 2.35, 95%CI: 1.37–4.02, p = 0.002] were independent predictors of T& CM use among EVD survivors. Our findings suggest EVD-related stigma (internalised and enacted) is prevalent among EVD survivors since their return to their communities. Religiosity, perceived health status and region were identified as independent predictors of internalised stigma. Verbal abuse and healthcare neglect predict informal healthcare use. EVD survivor-centred and community-driven anti-stigma programs are needed to promote EVD survivors’ recovery and community re-integration.
Publisher: SAGE Publications
Date: 12-2013
DOI: 10.1136/ACUPMED-2013-010393
Abstract: Acupuncture services form a significant part of the Australian healthcare setting, with national registration of acupuncture practitioners, public subsidies for acupuncture services and high use of acupuncture by the Australian public. Despite these circumstances, there has been little exploration of the interface between acupuncture providers and conventional primary healthcare practitioners in rural and regional Australia. A 27-item questionnaire was sent by post in the second half of 2010 to all 1486 general practitioners (GPs) currently practising in rural and regional Divisions of General Practice in New South Wales, Australia to explore their practices and attitudes to a variety of complementary and alternative medicine (CAM) practices. Their responses on other therapies have been published previously this report covers acupuncture. A total of 585 GPs completed the questionnaire 49 were returned as ‘no longer at this address’, resulting in an adjusted response rate of 40.7%. Two-thirds of GPs (68.3%) referred patients to an acupuncturist at least a few times per year, while only 8.4% stated that they would not refer patients to an acupuncturist under any circumstances. GPs being older (OR=6.08), GPs being women (OR=2.94), GPs practising in a rural rather than remote area (OR=6.25), GPs having higher levels of self-reported knowledge of acupuncture (OR=5.54), the use of complementary medicine (CAM) by a GP for their personal health (OR=2.37), previous prescription of CAM to other patients (OR=2.99), lack of other treatment options (OR=4.31) and GPs using CAM practitioners as the major source of their CAM information (OR=3.05) were all predictive of increased referral to acupuncture among rural GPs. There is a significant interface between acupuncture and Australian rural and regional general practice, with generally high levels of support for acupuncture.
Publisher: MDPI AG
Date: 18-07-2019
Abstract: Background and objectives: In addition to conventional healthcare, Ebola survivors are known to seek traditional and complementary healthcare (T& CM) options to meet their healthcare needs. However, little is known about the general beliefs of Ebola survivors regarding T& CM and the impact of these beliefs in influencing their decisions around T& CM use. This study examines Ebola survivors’ attitudes towards T& CM use in Sierra Leone. Materials and Methods: We conducted a nationwide quantitative cross-sectional study of 358 Ebola survivors in Sierra Leone between January and August 2018. We used descriptive analysis, chi-square tests and backward stepwise binary logistic regression for data analysis. Results: Close to half of the survivors (n = 163, 45.5%) had used T& CM since their discharge from an Ebola treatment centre. Survivors who viewed T& CM as boosting their immune system/resistance were 3.89 times (95%CI: 1.57–9.63, p = 0.003) more likely to use T& CM than those who did not view T& CM as boosting their immune system/resistance. Additionally, survivors who viewed T& CM as having fewer side effects than conventional medicine were more likely to use T& CM [OR = 5.03 (95%CI: 1.92–13.19, p = 0.001)]. Ebola survivors were more influenced to use T& CM based on their personal experience of the effectiveness of T& CM than by clinical evidence [OR = 13.72 (95%CI: 6.10–30.84, P 0.001)]. Ebola survivors who perceived T& CM as providing them with more control than conventional medicine over their health/body were more likely to use T& CM [OR = 4.15 (95%CI: 1.74–9.89, p = 0.001)] as opposed to those who did not perceive T& CM in this way. Conclusions: Considering the widespread use of T& CM, an understanding of Ebola survivors’ attitudes/beliefs towards T& CM is useful to healthcare providers and policymakers with regard to public education and practitioner–survivors communication, T& CM regulation and research in Sierra Leone. Ebola survivors appear to turn to T& CM not only for treatment, but also to fill gaps in conventional health care services.
Publisher: Mary Ann Liebert Inc
Date: 08-2019
Publisher: Elsevier BV
Date: 12-2015
Publisher: Elsevier BV
Date: 12-2019
Publisher: Frontiers Media SA
Date: 24-03-2023
DOI: 10.3389/FPHAR.2023.1116077
Abstract: Introduction: Leaves of the Australian tea tree plant Melaleuca alternifolia were used traditionally by First Nations Australians for treating wounds, burns, and insect bites. Tea tree oil, the essential oil steam-distilled from M. alternifolia , is well-known for its medicinal properties, the evidence for most applications however is limited. This review aimed to critically appraise evidence from clinical trials examining the therapeutic efficacy and safety of tea tree oil on outcomes. Methods: Randomized controlled trials with participants of any age, gender, or health status, comparing tea tree oil to any control were included, without limit on publication date. Electronic databases were searched on 12 August 2022 with additional records sourced from article reference sections, reviews, and industry white papers. Risk of bias was assessed by two authors independently using the Cochrane risk-of-bias 1.0 tool. Results were summarized and synthesized thematically. Results: Forty-six articles were eligible from the following medical fields ( Dentistry n = 18, Dermatology n = 9, Infectious disease n = 9, Ophthalmology n = 6, Podiatry n = 3 and Other n = 1). Results indicate that oral mouthwashes with 0.2%–0.5% tea tree oil may limit accumulation of dental plaque. Gels containing 5% tea tree oil applied directly to the periodontium may aid treatment of periodontitis as an adjunctive therapy to scaling and root planing. More evidence is needed to confirm the benefits of tea tree oil for reducing acne lesions and severity. Local anti-inflammatory effects on skin, if any, also require further elucidation. Topical tea tree oil regimens show similar efficacy to standard treatments for decolonizing the body from methicillin-resistant Staphylococcus aureus , although intra-nasal use of tea tree oil may cause irritation to mucous membranes. Tea tree oil with added iodine may provide an effective treatment for molluscum contagiosum lesions in young children. More evidence on efficacy of tea tree oil-based eyelid wipes for Demodex mite control are needed. Side effects were reported in 60% of included studies and were minor, except where tea tree oil was applied topically in concentrations ≥ 25%. Discussion: Overall, the quality of research was poor to modest and higher quality trials with larger s les and better reporting are required to substantiate potential therapeutic applications of tea tree oil. Systematic Review Registration: PROSPERO, identifier [CRD42021285168].
Publisher: Elsevier BV
Date: 12-2020
Publisher: Elsevier BV
Date: 12-2014
Publisher: Elsevier BV
Date: 04-2018
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.CTIM.2017.12.008
Abstract: This study aimed to determine whether the use of complementary medicine (CM) is associated with body satisfaction and weight management methods in Australian women. Women aged 34-39 years from the Australian Longitudinal Study on Women's Health were surveyed regarding satisfaction with their body weight and shape, and the use of weight management methods. Associations with CM use were analysed using logistic regression modelling. Women using CM less likely wanted to lose weight and were more likely to cut down on fats and/or sugars, use low glycaemic diets, diet books and 'other' methods (OR: 1.33-2.83) compared to CM non-users. Women using herbal medicine products 'sometimes' were more likely to use meal replacements/slimming products (OR: 1.50-1.67) compared to non-users. Australian women using CM are more likely to be satisfied with their body weight and shape, and to use a range of weight management approaches compared to CM non-users.
Publisher: Springer Science and Business Media LLC
Date: 15-01-2022
DOI: 10.1186/S12955-022-01916-Y
Abstract: Evidence of how social factors affect the health-related quality of life (HRQoL) of Ebola virus disease (EVD) survivors is limited. Our study explores the association between socio-demographic, health-related and psycho-social (stigma) factors and EVD survivors' health-related quality of life (HRQoL) in Sierra Leone. We conducted a nationwide cross-sectional study among 358 EVD survivors between January and August 2018. We used a multistage s ling method to recruit EVD survivors, and the RAND 36-Item Health Survey item was used to assess the HRQoL. Data were analysed using descriptive statistics and multiple linear regression. When comparing by each dimension in relation to their respective summary scores, role limitation physical [0.00 (50.00)] and role limitation emotional [0.00 (33.33)] were the most affected physical health and mental health domains among EVD survivors respectively. EVD survivors who were older (β = − 3.90, 95% CI − 6.47 to − 1.32, p = 0.003), had no formal education (β = − 2.80, 95% CI − 5.16 to − 0.43, p = 0.021), experienced a unit increase in the number of post-Ebola symptoms (β = − 1.08, 95% CI − 1.74 to − 0.43, p 0.001) and experienced a unit increase in enacted stigma (β = − 2.61, 95% CI − 4.02 to − 1.20, p 0.001) were more likely to report a decreased level of physical health. EVD survivors who experienced a unit increase in the time spent in the Ebola treatment centre (β = − 0.60, 95% CI − 0.103 to − 0.18, p = 0.006) and those who experienced a unit increase in enacted Stigma were more likely to report decreased levels of mental health (β = − 1.50, 95% CI − 2.67 to − 0.33, p = 0.012). Sociodemographic, health-related, and psycho-social factors were significantly associated with decrease levels of HRQoL. Our findings improve our understanding of the factors that might influence the HRQoL and suggest the need for EVD survivors to be provided with a comprehensive healthcare package that caters for their physical and mental health needs.
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.WOMBI.2017.12.006
Abstract: The influence of complementary therapies on maternal health has attracted the attention of policy makers, health professionals and researchers globally especially in developing countries. However, there is lack of evidence on whether Sierra Leonean women use herbal medicine during pregnancy which limit the chance of providing better maternity care. This study was conducted to determine the prevalence and pattern of herbal medicines use among pregnant women attending an antenatal clinic at a tertiary maternal hospital in Sierra Leone. A cross-sectional study was conducted among pregnant women (n=134) who were at least 18 years of age and who have had at least one previous pregnancy, using face to face interview. Descriptive statistics, univariate and multivariate logistic regression analysis were used for data analysis. The response rate was 82.7%. Nearly two-thirds of pregnant women reported using herbal medicine (62.7%). Herbal medicine users were more likely to be Muslim than Christian. Luffa acutangula (L.) Roxb was the most cited herbal medicine used and was mostly indicated for urinary tract infection and pedal oedema. Perceived effectiveness and safety over conventional medicine (70.2%) was key driver for use, and majority did not disclose their use of herbs to their maternal health professional (95.2%). Herbal medicine use among pregnant women in this study was widespread. Maternal health providers should be aware of this relatively common practice and routinely discuss and educate pregnant women on the potential risks and benefits associated with the use of herbs.
Publisher: Wiley
Date: 20-03-2019
DOI: 10.1111/TMI.13226
Abstract: A myriad of physical and psychosocial sequelae have been reported among Ebola survivors from previous Ebola virus disease (EVD) outbreaks, including the most recent in West Africa. This review examines the various forms of psychological distress experienced by EVD survivors, family and community reactions to EVD survivors and EVD survivors' coping mechanisms. We conducted a literature search of original articles employing Medline (Ovid), PubMed, Web of Science, Scopus, CINAHL, EBSCO host academic search complete, PsycINFO (EBSCO) and Embase databases. Our search identified 1890 articles of which 24 met our inclusion criteria. Various forms of psychological distress were prevalent among EVD survivors including depression, anxiety, anger, grief, guilt, flashbacks, sadness, worthlessness, substance addiction, suicidal tendencies and self-stigmatisation. Family and community responses to EVD survivors ranged from acceptance to rejection, isolation, stigmatisation and discrimination. EVD survivors' coping strategies included engagement with religious faith, EVD survivors associations and involvement in EVD prevention and control interventions. Psychological distress, including that resulting from family and community stigma and discrimination, appears common among EVD survivors. Community-based mental health and psychosocial interventions integrated within a broader package of care for EVD survivors that also recognises the physical health challenges are required. Well-designed longitudinal studies can provide clear insights on the nature and trajectory of the psychosocial issues currently experienced by EVD survivors.
Publisher: Wiley
Date: 22-11-2021
DOI: 10.1111/AJO.13458
Abstract: Endometriosis is known to impact work productivity. The COVID‐19 pandemic resulted in a shift in working practices for many, with an increase in working from home and/or flexible working hours. The aim of this online cross‐sectional study was to determine if these changes resulted in changes in symptom management and productivity in Australian people with endometriosis. Three hundred and eighty‐nine people responded to the survey. The majority of respondents found that their endometriosis symptoms were much easier to manage, and they were more productive. A key factor was flexibility in work hours and the increased ability to self‐manage their time.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.CTCP.2018.01.001
Abstract: This study aimed to determine the prevalence, determinants and pattern of herbal medicine use among hypertensive patients in Freetown. We conducted a cross-sectional study among hypertensive patients attending public and private health facilities in Freetown, Sierra Leone between August and October 2016. We analyzed the data using SPSS version 24. We used Chi-square, Fisher exact two-tailed test and regression analysis for data analysis. A p-value less than 0.05 was considered statistically significant. Out of 260 study participants, over half (n = 148, 56.9%) reported using herbal medicine for the treatment of hypertension alone or together with comorbid condition(s). The most commonly used herbal medicine among users were honey (n = 89, 33.3%), moringa (n = 80, 30.0%) and garlic (n = 73, 27.3%). No significant difference existed between users and non-users of herbal medicine with regards to socio-demographic and health-related factors. The majority (n = 241, 92.7%) of respondents considered herbal medicine beneficial if it was recommended by a healthcare provider yet 85.1% (n = 126) did not disclose their herbal medicine use to their health care provider. There is a high use of herbal medicines among hypertensive patients in Freetown, Sierra Leone. It is essential for healthcare providers to take heed of the findings of this study and routinely ask their patients about their herbal medicine use status. Such practice will provide the opportunity to discuss the benefits and risks of herbal medicine use with the aim of maximizing patient desired therapeutic outcomes.
Publisher: Springer Science and Business Media LLC
Date: 31-01-2013
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.WOMBI.2019.04.012
Abstract: Despite the known prevalence of complementary medicine use by women during pregnancy and childbirth and the evolution of preferred models of maternity care, very little is known about the nature and characteristics of the care provided to women by complementary medicine practitioners during this important life stage. Woman-centred care is a speciation of person-centred care which has achieved prominence in maternity care policy in recent years. There is also evidence that the core principles of some complementary medicine systems of medicine emphasise patient-centredness and that these principles are core drivers toward complementary medicine use in multiple populations. This study aims to explore the approach to care delivered by complementary medicine practitioners to women during pregnancy and birth. Semi-structured in idual interviews were conducted with 23 complementary medicine practitioners who identified as specialising in maternity care. Data from the interviews were analysed using a framework approach. The analysis of the perspective of complementary medicine practitioner's experiences providing care to pregnant and birthing women identified three main themes: Responding to women's expectations of care providing woman-centred care and the therapeutic relationship at the heart of woman-centred care. The approach to maternity care reported by complementary medicine practitioners aligns with the principles of woman-centred care, possibly due to the similarities between woman-centred care and the core features of many systems of medicine within complementary medicine. Complementary medicine practitioners may contribute to an overall experience of woman-centred maternity care for pregnant and birthing women.
Publisher: Elsevier BV
Date: 03-2021
Publisher: Springer Science and Business Media LLC
Date: 18-11-2020
DOI: 10.1186/S12906-020-03153-6
Abstract: Australians report consulting with a naturopaths or herbalists to improve their wellbeing, yet little is known about the associations between these consultations and the patients’ health behaviours. This cross-sectional study aimed to examine the relationship between health behaviour and consultations with naturopaths or herbalists in three age cohorts of Australian women. Women aged 19–25 years, 31–36 years, and 62–67 years from the Australian Longitudinal Study on Women’s Health (ALSWH) were surveyed regarding smoking, alcohol or drug use, physical activity and dietary behaviour and whether they consulted with naturopath/herbalists in the last 12 months. Associations were analysed using multivariable logistic regression. A total of 9151 (19–25 years), 8200 (31–36 years) and 11,344 (62–67 years) women were included in the analysis. Between 7.3 and 11.9% of women reported to have consulted with naturopaths/herbalists in the last 12 months. Women of all cohorts consulting with naturopath/herbalist were less likely to smoke (19-25 yrs.: Odds Ratio [OR] 0.61 31–36 years: OR 0.58 62–67 years: OR 0.29), more likely to report at least moderate levels of physical activity (19-25 yrs.: OR 1.41 31–36 years: OR 1.34 62–67 years: OR 1.34), and the use of vegetarian diets(19-25 yrs.: OR 1.40 31–36 years: OR 1.77 62–67 years: OR 2.28), compared to women not consulting with naturopaths/herbalists. Women consulting with naturopaths/herbalists however were also more likely to have used marijuana (19-25 yrs.: OR 1.18 31–36 years: OR 1.42), or illicit drugs in the last 12 months (19-25 yrs.: OR 1.24 31–36 years: OR 1.40). Consultations with a naturopath or herbalist are associated with positive health behaviours that are protective of internationally important non-communicable diseases. Psychoactive drug use is also reported among women visiting a naturopath or herbalist. Further research is needed to understand the role naturopaths play in advising patients with regards to health and non-healthy behaviours.
Publisher: Georg Thieme Verlag KG
Date: 07-2013
DOI: 10.1016/J.HOMP.2013.03.002
Abstract: Homeopathy has attracted considerable recent attention from the Australian conventional medical community. However, despite such increased attention there has been little exploration of the interface between homeopathy and Australian conventional medical practice. This article addresses this research gap by exploring homeopathic practice and referral by rural and regional Australian general practitioners (GPs). A 27-item questionnaire was sent to all 1486 GPs currently practising in rural and regional New South Wales, Australia (response rate 40.7%). Few GPs in this study utilised homeopathy in their personal practice, with only 0.5% of GPs prescribing homeopathy in the past 12 months, and 8.5% referring patients for homeopathic treatment at least a few times over the past 12 months. Nearly two-thirds of GPs (63.9%) reported that they would not refer for homeopathy under any circumstances. Being in a remote location, receiving patient requests for homeopathy, observing positive responses from homeopathy previously, using complementary and alternative medicine (CAM) practitioners as information sources, higher levels of knowledge of homeopathy, and being interested in increasing CAM knowledge were all independently predictive of increased referral to homeopathy amongst GPs in this study. GPs in this study were less likely to refer to homeopathy if they used peer-reviewed literature as the major source of their information on CAM. Homeopathy is not integrated significantly in rural general practice either via GP utilisation or referral. There is significant opposition to homeopathy referral amongst rural and regional GPs, though some level of interaction with homeopathic providers exists.
Publisher: Wiley
Date: 16-09-2021
DOI: 10.1111/JEP.13614
Abstract: To evaluate the evidence behind claims that Chinese Herbal Medicine, specifically “three medicines and three formulations” (3M3F, comprising Jinhua Qinggan, Lianhua Qingwen, Xuebijing, Qingfei Paidu, Huashi Baidu, and Xuanfei Baidu), is an effective treatment for COVID‐19. We searched PubMed, MEDLINE and CNKI databases, preprint servers, clinical trial registries and supplementary sources for Chinese‐ or English‐language randomized trials or non‐randomized studies with comparator groups, which tested the constituents of 3M3F in the treatment of COVID‐19 up to September 2020. Primary outcome was change in disease severity. Secondary outcomes included various symptoms. Meta‐analysis (using generic inverse variance random effects model) was performed when there were two or more studies reporting on the same symptom. Of 607 articles identified, 13 primary studies (6 RCTs and 7 retrospective non‐randomized comparative studies) with 1467 participants met our final inclusion criteria. Studies were small and had significant methodological limitations, most notably potential bias in assessment of outcomes. No study convincingly demonstrated a statistically significant impact on change in disease severity. Eight studies reported sufficiently similar secondary outcomes to be included in a meta‐analysis. Some statistically significant impacts on symptoms, chest CT manifestations, laboratory variables and length of stay were demonstrated, but such findings were sparse and many remain unreplicated. These findings neither support nor refute the claim that 3M3F alters the severity of COVID‐19 or alleviates symptoms. More rigorous studies are required to properly ascertain the potential role of Chinese Herbal Medicine in COVID‐19.
Publisher: Elsevier BV
Date: 06-2019
Publisher: Elsevier BV
Date: 12-2016
Publisher: E.U. European Publishing
Date: 26-04-2023
Publisher: Springer Science and Business Media LLC
Date: 14-02-2019
Publisher: Wiley
Date: 26-05-2014
DOI: 10.1111/HIR.12060
Abstract: Complementary medicine is forming an increasingly large part of health care in developed countries and is increasingly being formally taught in tertiary academic settings. An exploratory study of naturopathic student perceptions of, use of and attitudes towards teaching resources in naturopathic clinical training and education. Focus groups were conducted with current and recent students of 4-year naturopathic degree programmes in Brisbane and Sydney to ascertain how they interact with clinical teaching materials, and their perceptions and attitudes towards teaching materials in naturopathic education. Naturopathic students have a complex and critical relationship with their learning materials. Although naturopathic practice is often defined by traditional evidence, students want information that both supports and is critical of traditional naturopathic practices, and focuses heavily on evidence-based medicine. Students remain largely ambivalent about new teaching technologies and would prefer that these develop organically as an evolution from printed materials, rather than depart from dramatically and radically from these previously established materials. Findings from this study will assist publishers, librarians and academics develop clinical information sources that appropriately meet student expectations and support their learning requirements.
Publisher: BMJ
Date: 2013
Publisher: E.U. European Publishing
Date: 26-04-2023
Publisher: Informa UK Limited
Date: 04-03-2020
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.CTCP.2018.11.017
Abstract: As many as one in two women consult with a complementary medicine (CM) practitioner for pregnancy-related health care, yet little is known about the reason for such a high rate of use. This paper presents the perceptions of CM practitioners regarding the role they play within the existing maternity care system. Semi-structured interviews with 23 CM practitioners were conducted and the transcripts analysed, using a Framework approach. Key themes pertaining to the perceived role of CM practitioners in maternity care emerged. (1) Becoming a maternity care provider: responding to a need and filling gaps in the system (2) Characterising CM maternity care: Holistic, nurturing and addressing unmet health concerns and (3) Treating health complaints neglected by conventional maternity care. CM practitioners often acknowledge their specialist roles as part of a multidisciplinary team of practitioners rather than attempting to offer comprehensive pregnancy care.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.CTIM.2017.12.012
Abstract: This study aims to provide an empirical examination of how complementary medicine practice in Australia is actually regulated under the current national registration model. Data was obtained from Australian Health Practitioner Regulation Agency (AHPRA) Annual Reports for the years 2011/12-2014/15 and supplemented by the Chinese Medical Registration Board of Victoria (CMRBV) Annual Reports in 2011/12 for Chinese Medicine complaints. The data analysed includes complaint statistics, stage of closure of complaints and the outcome of complaints concerning Chinese medicine, chiropractic and osteopathy under the National Law. During 2014-2015 the number of complaints per 100 registrants for was highest for the medical board (4.4), while much lower for the chiropractic (1.5), osteopath (0.7) and Chinese medicine (0.5) boards. For conventional boards, 58% of complaints were closed at the assessment stage, while 57%, 29% and 16% of complaints to the osteopath, Chinese medicine and chiropractic boards respectively were closed at the assessment stage. The decision to suspend or cancel registration of health professionals was 17% from the Chinese medicine board, 14% from the Osteopathy Board, 1.5% from the chiropractor board and 0.6% from the medical board. It appears that complementary medicine practitioner regulation works at least as well as conventional regulation, and at most complementary medicine boards take a stricter interpretation of misconduct though more research would need to be undertaken to state this definitively. Our findings indicate that the public are using the statutory complaint mechanisms available to them with respect to the three CM groups.
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.VACCINE.2019.10.006
Abstract: Despite the enormous benefits of childhood and maternal immunisation to in idual and population health, the uptake of maternal vaccines during pregnancy remains suboptimal. Midwives are a trusted information source for parents and play an important role in the provision of immunisation information. Understanding midwives' attitudes and vaccine knowledge, along with their confidence to discuss maternal and childhood immunisation with parents, is key to reducing parental decisional conflict and achieving immunisation goals. An online study was conducted to investigate midwives' knowledge and attitudes towards maternal and childhood vaccination along with their confidence to answer parents' vaccine-related questions. Midwives were recruited by email via the midwifery peek body, the Australian College of Midwives. A total of 359 midwives completed the online survey. The majority of midwives supported maternal (influenza 83%, pertussis 90.5%) and childhood immunisation (85.8%) however, 69.4% of respondents wanted further training about immunisation. Midwives who felt their midwifery education adequately covered immunisation were more confident advising parents about maternal (p = 0.007) and childhood immunisation (p < 0.001). Similarly, Midwives were significantly more likely to confidently advise parents about maternal (p < 0.001) and childhood immunisations (p < 0.001) if they had completed a specific immunisation training course outside of their midwifery course. Most midwives working in Australia support vaccination. However, access to contemporary, culturally appropriate education that enables midwives to engage confidently with parents about immunisation is lacking. Education based on a women-centred approach within the pre-registration curriculum along with continuing professional development programs could enable midwives to reduce the evidence to practice gap by increasing vaccine uptake.
Publisher: Elsevier BV
Date: 08-2020
Publisher: Elsevier BV
Date: 04-2015
Abstract: Excessive alcohol consumption is an increasing issue internationally. Pricing strategies, including discount restrictions, have been identified as one of the most effective policy means by which to reduce heavy alcohol consumption. In Australia, cross-promotional alcohol discounts are increasingly used by supermarket chains as a marketing tool. The purpose of the present study is to provide preliminary data on the nature and extent of cross-promotional alcohol discounting in the Australian grocery sector. A purposive s le of 34 supermarkets in Australia's three largest cities was selected and minor grocery purchases made to uncover the prevalence and level of cross-promotional alcohol discounting. Cross-promotional 'bundled' discounts were very common with 33 of the 34 supermarkets offering a 'two for one' discount on bottles of wine. Even with minor purchases (mean purchase $1.35), the mean value of discounts received was substantial ($16.23). These results appear to be consistent with claims that major supermarket chains are using alcohol discounts as loss leaders to entice new consumers. These strategies are antithetical to public health strategies aimed at reducing excessive alcohol consumption. Further examination of the impact of major retailers on public health initiatives is warranted, particularly in light of increasing retailer concentration.
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.WOMBI.2019.02.006
Abstract: Inactivated influenza vaccine and diphtheria-tetanus acellular pertussis vaccine are routinely recommended during pregnancy to protect women and their babies from infection. Additionally, the hepatitis B vaccine is recommended for infants within the first week of life however, little is known about midwives' experiences of recommending and delivering these immunisations. Midwives are a trusted source of vaccine information for parents and the confident provision of information about immunisation during antenatal clinic visits has been found to increase the uptake of antenatal and childhood vaccines. This study aims to explore midwives' experiences of discussing maternal and childhood immunisation with women and their partners and their confidence in answering parent's questions. We conducted 23 semi-structured interviews with registered Australian midwives working in public and private hospital settings, and in private practice. Midwives find negotiating the requirement to recommend immunisation within a women-centred framework challenging at times. The vast majority of midwives described their education on immunisation as inadequate and workplace issues, such as time pressure, were identified as further barriers to effective communication about immunisation. The provision of immunisation training within midwifery education and continued professional development is critical. Appropriately resourcing midwives with the necessary infrastructure, education and resources to fully inform parents about immunisation may have a positive impact on vaccine uptake.
Publisher: Springer Science and Business Media LLC
Date: 15-04-2022
DOI: 10.1186/S12906-022-03585-2
Abstract: Advances in systems science creates an opportunity to bring a complexity perspective to health care practices and research. While medical knowledge has greatly progressed using a reductionist and mechanistic philosophy, this approach may be limited in its capacity to manage chronic and complex illness. With its holistic foundation, naturopathy is a primary health profession with a purported alignment with a complexity perspective. As such this pilot study aimed to investigate the application of complexity science principles, strategies, and tools to primary health care using naturopathy as a case study. A network mapping and analysis of the naturopathic case management process was conducted. Mind maps were created by naturopathic practitioners to reflect their clinical conceptualisation of a common paper clinical case. These mind maps were inputed into Gephi , a network mapping, exploration, and analysis software. Various layouts of the data were produced, and these were analysed using exploratory data analysis and computational network analysis. Seven naturopathic practitioners participated in the study. In the combined network mapping, 133 unique elements and 399 links were identified. Obesity, the presenting issue in the case, was centrally located. Along with obesity, other keystone elements included: systemic inflammation, dysbiosis, diet, the liver, and mood. Each element was connected on average to 3.05 other elements, with a degree variation between one and 36. Six communities within the dataset were identified, comprising: the nervous system and mood, gastroinstetinal and dietary factors, systemic inflammation and obesity, the endocrine system and metabolism. This pilot study demonstrates that it is feasible to apply a complexity science perspective to investigating primary health care case management. This supports a shift to viewing the human organism as a complex adaptive system within primary health care settings, with implications for health care practices that are more cognisant with the treatment of chronic and complex conditions and research opportunities to capture the complex clinical reasoning processes of practitioners.
Publisher: Elsevier BV
Date: 06-2020
Publisher: Mary Ann Liebert Inc
Date: 11-2011
Abstract: Complementary medicine research, including naturopathic medicine research, is plagued with many methodological challenges. Many of these challenges have also been experienced in public health research. Public health research has met these challenges with a long history of multidisciplinary, multimethod, and whole systems approaches to research that may better resonate with the ?real world? clinical settings of naturopathic medicine. Additionally, many of the underlying principles of naturopathic medicine are analogous to the underlying principles and activities of public health, specifically in such areas as health promotion, prevention, patient education, and proactive rather than reactive approaches to disease management and treatment. Future research in the field of naturopathic medicine may benefit from adopting public health research models rather than focusing exclusively on biomedical models. A complementary and collaborative relationship between these fields may provide an opportunity to deliver research that more accurately reflects naturopathic medicine practice, as well as providing the opportunity to improve health outcomes more generally.
Publisher: Public Library of Science (PLoS)
Date: 30-07-2012
Publisher: Mary Ann Liebert Inc
Date: 02-2019
Abstract: To explore the recommendations of naturopathic medicine for the management of endometriosis, dysmenorrhea, and menorrhagia, drawing on traditional and contemporary sources. Content analysis. Australia, Canada, and the United States of America (USA). Contemporary sources were identified from reviewing naturopathic higher education institutions' recommended texts, while traditional sources were identified from libraries which hold collections of naturopathic sources. Sources were included if they were published from 1800 to 2016, were in English, published in Australia, Canada, or the USA, and reported on the topic. Included sources were as follows: 37 traditional texts 47 contemporary texts and 83 articles from naturopathic periodicals. Across included sources, the most reported disciplines were herbal medicine, clinical nutrition, mineral medicines, homeopathy, hydrotherapy, and chemical-based medicines. Herbal medicines were extensively reported from all sources for the management of endometriosis, dysmenorrhea, and menorrhagia. Clinical nutrition was only recommended from contemporary sources for all three conditions. Mineral medicines were mentioned in both traditional and contemporary sources, but were only recommended for dysmenorrhea and menorrhagia. There were limited recommendations for homeopathy and hydrotherapy treatments in all conditions across all sources. Chemical-based medicines were only mentioned for dysmenorrhea and menorrhagia, and recommendations ceased after 1922. Recommendations for endometriosis were not present in any of the traditional sources, across all reported disciplines. The findings of this article provide insights into the documented historical and contemporary treatments within naturopathic medicine for endometriosis, dysmenorrhea, and menorrhagia. While philosophical principles remain the core of naturopathic practice, the therapeutic armamentarium appears to have changed over time, and a number of the original naturopathic treatments appear to have been retained as key elements of treatment for these conditions. Such insights into naturopathic treatments will be of particular interest to clinicians providing care to women, educators designing and delivering naturopathic training, and researchers conducting clinical and health service naturopathic research.
Publisher: BMJ
Date: 10-2018
DOI: 10.1136/BMJGH-2018-000895
Abstract: The WHO estimates that a considerable number of people in Sub-Saharan Africa (SSA) rely on traditional, complementary and alternative medicine (TCAM) to meet their primary healthcare needs, yet there remains a dearth of research evidence on the overall picture of TCAM utilisation in the region. We conducted a literature search of original articles examining TCAM use in SSA between 1 January 2006 and 28 February 2017, employing Medline, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Scopus, ProQuest, PubMed, Embase and African Journals Online databases. A critical appraisal of relevant articles reporting a quantitative or mixed-method design was undertaken. Despite the heterogeneity and general low quality of the identified literature, the review highlights a relatively high use of TCAM alone or in combination with orthodox medicine, in both general population and in specific health conditions in SSA. TCAM users compared with non-TCAM users are more likely to be of low socioeconomic and educational status, while there were inconsistencies in age, sex, spatial location and religious affiliation between TCAM users and non-TCAM users. Most TCAM users (55.8%–100%) in SSA fail to disclose TCAM use to their healthcare providers, with the main reasons for non-disclosure being fear of receiving improper care, healthcare providers’ negative attitude and a lack of enquiry about TCAM use from healthcare providers. TCAM use in SSA is significant, although most studies emerge from a few countries. Factors associated with TCAM use in SSA are similar to those observed in other regions, but further research may be required to further elucidate challenges and opportunities related to TCAM use specific to SSA.
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.PSYCHRES.2022.114899
Abstract: Evidence exists reporting a high mental health burden among migrants globally. However, there is no global estimate of mental ill-health among African migrants despite their adverse pre-migration environments. This systematic review and meta-analysis summarise the current scholarship regarding the prevalence of anxiety, depression and Post-traumatic Stress Disorder (PTSD) in the global African migrant population. We searched six databases (Medline (EBSCOHost), PsycINFO (EBSCOHost), Web of Science, PubMed, Scopus and Cumulative Index to Nursing and Allied Health (CINAHL) from 1st January 2000 to 31st August 2021. We screened retrieved articles using strict inclusion and exclusion criteria. Study quality was assessed using the Joanna Briggs Institute Critical Appraisal tools. Random-effects meta-analyses were employed using DerSimonian and Laird estimator based on inverse variance weights. The I Our search retrieved 1091 articles, of which 46 were included representing a total of 28,367 African migrants. The weighted mean age of African migrants was 32.98 years, and nearly half were male (n= 12852, 45.31%). Among the included studies, almost nine out of ten (n=41, 89.1%) were cross-sectional studies. The pooled prevalence of anxiety, depression and PTSD was 34.60% %CI (26.30-43.00), 33.20% %CI (27.70-38.37) and 37.9% %CI (23.5- 52.4) respectively. Significant heterogeneity (I Despite significant heterogeneity among included studies, our systematic review and meta-analysis show a high prevalence of anxiety, depression, and PTSD among African migrants. Our findings underscore the need to develop and implement serious, culturally appropriate mental health interventions that address post-migration stressors that increase their risk of mental ill-health and successful integration into host communities.
Publisher: Elsevier BV
Date: 03-2020
Publisher: Elsevier BV
Date: 03-2022
Publisher: Elsevier BV
Date: 06-2018
Publisher: Elsevier BV
Date: 08-2017
Publisher: Springer Science and Business Media LLC
Date: 18-02-2021
DOI: 10.1186/S12906-021-03217-1
Abstract: This descriptive study provides the first examination of global naturopathic education, regulation and practice frameworks that have potential to constrain or assist professional formation and integration in global health systems. Despite increasing public use, a significant workforce, and World Health Organization calls for national policy development to support integration of services, existent frameworks as potential barriers to integration have not been examined. This cross-sectional survey utilized purposive s ling of 65 naturopathic organisations (educational institutions, professional associations, and regulatory bodies) from 29 countries. Organizational representatives completed an on-line survey, conducted between Nov 2016 – Aug 2019. Frequencies and cross-tabulation statistics were analyzed using SPSSv.25. Qualitative responses were hand-coded and thematically analysed where appropriate. Sixty-five of 228 naturopathic organizations completed the survey (29% response rate) from 29 of 46 countries (63% country response rate). Most education programs (68%) were delivered via a national framework. Higher education qualifications (60%) predominated. Organizations influential in education were professional associations (75.4%), particularly where naturopathy was unregulated, and accreditation bodies (41.5%) and regulatory boards (33.8%) where regulated. Full access to controlled acts, and to health insurance rebates were more commonly reported where regulated. Attitude of decision-makers, opinions of other health professions and existing legislation were perceived to most impact regulation, which was globally heterogeneous. Education and regulation of the naturopathic profession has significant heterogeneity, even in the face of global calls for consistent regulation that recognizes naturopathy as a medical system. Standards are highest and consistency more apparent in countries with regulatory frameworks.
Publisher: Elsevier BV
Date: 08-2020
Publisher: Elsevier BV
Date: 12-2013
DOI: 10.1016/J.CTIM.2013.09.003
Abstract: Developing research capacity is an essential part of professional development in the health professions, as well as essential to improving health care delivery. CAM is one area in which the importance of research capacity has been previously highlighted. To determine whether academic and research CAM practitioners were actively engaged in high-level CAM research in Australia successful National Health and Medical Research Council grants data for projects starting between 2000 to present (2013) were collated and analyzed. CAM practitioners are not involved in most NHMRC-funded research, with non-clinical academics leading nearly half of all NHMRC-funded CAM grants. Conventional medical practitioners led the majority of CAM grants headed by clinicians. Only Chinese medicine and naturopathy practitioners appear to be building capacity, with NHMRC-funded CAM grants led by these practitioner groups increasing. University CAM faculties are for the most part not engaging in high level research, with most NHMRC-funded CAM projects being led by groups outside these faculties. Even the majority NHMRC-funded research led by CAM clinicians is administered outside university CAM faculties. The CAM professions have a low level of engagement with high-level health and medical research in Australia. Current levels of engagement appear to be dependent more on in idual clinician involvement rather than professional strategy. Failure to engage with high-level health and medical research may pose challenges for the CAM professions, unless research engagement is improved. This requires an active and concerted effort from within CAM ranks to build research capacity in the CAM professions.
Publisher: Springer Science and Business Media LLC
Date: 14-01-2013
Publisher: Wiley
Date: 09-2009
Publisher: SAGE Publications
Date: 13-05-2020
Abstract: The proportional method of acupuncture point location (APL) currently taught at Endeavor College of Natural Health and advocated by the World Health Organization Regional Office for the Western Pacific (WPRO) was found to be imprecise and/or inaccurate in previous student studies. The ruler and elastic methods of APL were identified as more accurate or precise than the proportional method of APL but were not well received by student participants. Use of an adjustable ruler may overcome barriers to uptake of the more accurate APL methods. This pilot study was the first to evaluate the comparative accuracy of the adjustable ruler and the proportional methods of APL in first-year students at a major Australian acupuncture training college. After 10 weeks of in-class instruction in both proportional and adjustable ruler methods of APL, student participants (n = 14) attempted location of three acupuncture points (LI10, SP6 and ST38) on a volunteer using both APL methods of interest. A self-administered questionnaire and lecturer field notes elucidated attitudes to implementation of both APL methods. Points marked using the adjustable ruler were closer to the correct location than those marked using the proportional method across all three acupuncture points. Students and lecturers rated the adjustable ruler more highly than the proportional method for ease of learning and ease of use. Encouraging results with the adjustable ruler method warrant further larger scale studies. Use of the adjustable ruler method of APL should be considered for use in point location training at educational institutions teaching traditional acupuncture.
Publisher: Springer Science and Business Media LLC
Date: 2013
Publisher: BMJ
Date: 07-2018
DOI: 10.1136/BMJOPEN-2017-020712
Abstract: Billing errors and healthcare fraud have been described by the WHO as ‘the last great unreduced health-care cost’. Estimates suggest that 7% of global health expenditure (US$487 billion) is wasted from this phenomenon. Irrespective of different payment models, challenges exist at the interface of medical billing and medical practice across the globe. Medical billing education has been cited as an effective preventative strategy, with targeted education saving $A250 million in Australia in 1 year from an estimated $A1–3 billion of waste. This study attempts to systematically map all avenues of medical practitioner education on medical billing in Australia and explores the perceptions of medical education stakeholders on this topic. National cross-sectional survey between April 2014 and June 2015. No patient or public involvement. Data analysis—descriptive statistics via frequency distributions. All stakeholders who educate medical practitioners regarding clinical practice (n=66). 86% responded. There is little medical billing education occurring in Australia. The majority of stakeholders (70%, n=40) did not offer/have never offered a medical billing course. 89% thought medical billing should be taught, including 30% (n=17) who were already teaching it. There was no consensus on when medical billing education should occur. To our knowledge, this is the first attempt of any country to map the ways doctors learn the complex legal and administrative infrastructure in which they work. Consistent with US findings, Australian doctors may not have expected legal and administrative literacy. Rather than reliance on ad hoc training, development of an Australian medical billing curriculum should be encouraged to improve compliance, expedite judicial processes and reduce waste. In the absence of adequate education, disciplinary bodies in all countries must consider pleas of ignorance by doctors under investigation, where appropriate, for incorrect medical billing.
Publisher: Elsevier BV
Date: 12-2018
Publisher: Elsevier BV
Date: 08-2017
Publisher: Elsevier BV
Date: 08-2016
DOI: 10.1016/J.VACCINE.2016.07.026
Abstract: Vaccination is one of the most significant and successful public health measures of recent times. Whilst the use of complementary medicine (CM) continues to grow, it has been suggested that CM practitioners hold anti-vaccination views. The objective of this critical review is to examine the evidence base in relation to CM practitioner attitudes to childhood vaccination alongside attitudes to vaccination among parents who visit CM practitioners and/or use CM products. A database search was conducted in MEDLINE, PubMed, CINAHL, EMBASE and AMED for research articles published between January 2000 and September 2015 that evaluated either CM practitioner or CM user attitudes and intention towards childhood vaccination. A total of 23 articles were found that detailed the attitudes of CM practitioners to vaccination. A further 16 papers examined the association between the use of CM products and visits to CM practitioners, and immunisation. The interface between CM and vaccination is complex, multi-factorial and often highly in idualised. The articles suggest that there is no default position on immunisation by CM practitioners or parents who use CM themselves, or for their children. Although CM use does seem positively associated with lower vaccination uptake, this may be confounded by other factors associated with CM use (such as higher income, higher education or distrust of the medical system), and may not necessarily indicate independent or predictive relationships. Although anti-vaccination sentiment is significant amongst some CM practitioners, this review uncovers a more nuanced picture, and one that may be more agreeable to public health values than formerly assumed.
Publisher: WORLD SCIENTIFIC (EUROPE)
Date: 05-2019
Publisher: Elsevier BV
Date: 08-2017
Publisher: Springer Science and Business Media LLC
Date: 29-04-2023
DOI: 10.1186/S12906-023-03972-3
Abstract: Insights into the use of traditional medicine practitioners (TMP)-for common childhood diseases such as diarrhea and respiratory infections are important to understand the role of Traditional Medicine (TM) in reducing the increasing childhood morbidity and mortality in sub-Saharan Africa (SSA). However, a comprehensive picture of TMP utilisation and its associated factors for childhood illness in SSA is lacking. This study aimed to estimate the prevalence of the use of traditional medicine practitioner services to treat childhood illnesses among women with children under five years old and to identify in idual and community-level factors associated with TMP use in SSA. The analysis used Demographic and Health Surveys (DHS) dataset collected between 2010 and 2021 among 353,463 under-fives children from 32 SSA countries. Our outcome variable was the use of TMP for childhood illness, defined as having diarrhoea or fever/cough or both. Using STATA v14, we employed the random effect meta-analysis to estimate the pooled prevalence of TMP use for childhood illness and a two-level multivariable multilevel modelling to determine the in idual and community-level factors associated with consultation of a TMP. Approximately [2.80% (95%CI: 1.88–3.90)] women who sought healthcare for childhood illnesses utilised the service of a TMP with the highest occurring in Cote d’Ivoire [16.3% (95%CI: 13.87–19.06)] and Guinea (13.80% (95%CI: 10.74–17.57)] but the lowest in Sierra Leone [0.10%(95%CI:0.01–1.61)]. Specifically, approximately [1.95% (95%CI: 1.33–2.68)] and [1.09% (95%CI:0.67–1.60)] of women sought the service of a TMP for childhood diarrhea and fever/cough, respectively. Women with no formal education [AOR = 1.62 %CI:1.23–2.12], no media access [AOR = 1.19 %CI:1.02–1.39), who lived in a male-headed household [AOR = 1.64 %CI:1.27–2.11], without health insurance [AOR = 2.37 %CI: 1.53–3.66], who considered it a problem getting permission to visit a health facility [AOR = 1.23 %CI:1.03–1.47] and who perceived the size of their children at birth to be above average[AOR = 1.20 %CI:1.03–1.41] had higher odds of using TMP for childhood illnesses. Although the prevalence of TMP for childhood illnesses appeared low, our findings highlight that TMPs continue to play a critical role in managing childhood illnesses in SSA. It is essential that policymakers and service providers should incorporate the potential role of TMPs in the design, review and implementation of child health policies in SSA. Also, the interventions for curtailing childhood illnesses should be focused on the characteristics of women who use TMPs for childhood diseases identified in our study.
Publisher: Informa UK Limited
Date: 10-2021
DOI: 10.2147/JMDH.S327260
Publisher: Frontiers Media SA
Date: 13-06-2016
Publisher: Mary Ann Liebert Inc
Date: 20-04-2021
Publisher: Springer Science and Business Media LLC
Date: 29-07-2019
Publisher: Springer Science and Business Media LLC
Date: 28-06-2010
Publisher: Medical Association of Pharmacopuncture Institute
Date: 04-2019
DOI: 10.1016/J.JAMS.2018.10.009
Abstract: A number of studies have examined the accuracy and precision of acupuncture point location across various point location methods. Accuracy of point location is essential for safe, efficacious and reliable treatments and valid reproducible research outcomes. This review aims to identify, summarize, compare and critically appraise available empirical studies relating to the accuracy and precision of acupuncture point location. A comprehensive search of five electronic databases, World Journal of Traditional Chinese Medicine and Google scholar was performed for studies investigating accuracy and precision in acupuncture point location. 771 studies were screened of which 14 studies were identified, including 9 studies that investigated the localization of acupoints and 5 studies that examined the cun measurement system. Considerable variation in localization of acupoints was reported among qualified medical acupuncturists. Variation in point location among qualified non-medical acupuncturists is unknown due to lack of any identified study. The directional method was found to be significantly inaccurate and imprecise in all studies that evaluated the method. Suitability of other methods for clinical and research purposes and influencing factors such as education, training and experience were identified as topics for future studies.
Publisher: Mary Ann Liebert Inc
Date: 02-2019
Publisher: Springer Science and Business Media LLC
Date: 23-11-2018
DOI: 10.1038/S41598-018-35508-Y
Abstract: In order to describe the prevalence and characteristics of complementary medicine (CM) practice and product use by Australians, we conducted a cross-sectional online survey with Australian adults aged 18 and over. Rates of consultation with CM practitioners, and use of CM products and practices were assessed. The s le (n = 2,019) was broadly representative of the Australian population. Prevalence of any CM use was 63.1%, with 36% consulting a CM practitioner and 52.8% using any CM product or practice. Bodywork therapists were the most commonly consulted CM practitioners (massage therapists 20.7%, chiropractors 12.6%, yoga teachers 8.9%) and homeopaths were the least commonly consulted (3.4%). Almost half of respondents (47.8%) used vitamin/mineral supplements, while relaxation techniques/meditation were the most common practice (15.8%). CM users were more likely to be female, have a chronic disease diagnosis, no private health insurance, a higher education level, and not be looking for work. Prevalence of CM use in Australia has remained consistently high, demonstrating that CM is an established part of contemporary health management practices within the general population. It is critical that health policy makers and health care providers acknowledge CM in their attempts to ensure optimal public health and patient outcomes.
Publisher: Wiley
Date: 02-08-2023
DOI: 10.1111/HIR.12499
Abstract: Traditional and complementary medicine (T& CM) is highly utilised and draws on traditional knowledge (TK) as evidence, raising a need to explore how TK is currently used. Examine criteria used to select, evaluate and apply TK in contemporary health contexts. Systematic search utilising academic databases ( AMED , CINAHL , MEDLINE , EMBASE , SSCI , ProQuest Dissertations Theses Global ), Trip clinical database and Google search engine . Citations and reference lists of included articles were searched. Reported use of TK in contemporary settings was mapped against a modified ‘Exploration‐Preparation‐Implementation‐Sustainment’ (EPIS) implementation framework. From the 54 included articles, EPIS mapping found TK is primarily used in the Exploration phase of implementation ( n = 54), with little reporting on Preparation ( n = 16), Implementation process ( n = 6) or Sustainment ( n = 4) of TK implementation. Criteria used in selection, evaluation and application of TK commonly involved validation with other scientific/traditional evidence sources, or assessment of factors influencing knowledge translation. One of the difficulties in validation of TK (as a co‐opted treatment) against other evidence sources is comparing like with like as TK often takes a holistic approach. This complicates further planning and evaluation of implementation. This review identifies important criteria for evaluating current and potential contemporary use of TK, identifying gaps in research and practice for finding, appraising and applying relevant TK studies for clinical care.
Publisher: Public Library of Science (PLoS)
Date: 27-09-2019
Publisher: Elsevier BV
Date: 12-2021
Publisher: Walter de Gruyter GmbH
Date: 12-09-2023
Abstract: Endometriosis is a chronic gynaecological disease with varying symptomatology and negative health outcomes. To ensure the best care for women with endometriosis, women require a multidisciplinary team approach. While some women consult with naturopaths for endometriosis, there has been little research on naturopathic knowledge and the naturopathic approach to endometriosis care. This cross-sectional survey recruited naturopaths with experience in menstrual disorders from the Practitioner Research and Collaboration Initiative (PRACI) a Practice-Based Research Network (PBRN). Data collection was conducted via an online self-administrated 62-item questionnaire. Invitations were sent to 109 naturopaths who self-reported having experience in menstrual disorders, of whom 29 completed the survey (26.6% response rate). Naturopaths perceived endometriosis to be caused by inflammation (n=28, 96.5%) and risk factors associated with familial history (n=26, 89.6%). Many naturopaths aimed at reducing inflammation (n=27, 93.1%) and supporting gastrointestinal function (n=25, 86.2%) in their prescriptions. Naturopaths reported using various healthcare referrals to support women with endometriosis, primarily general practitioners (n=12, 41.3%), acupuncturists/Traditional Chinese Medicine practitioners (n=11, 37.9%), and gynaecologists (n=9, 31%). Naturopaths reported receiving referrals from general practitioners (n=8, 27.5%) and psychologists (n=6, 20.6%). Naturopathic knowledge and management of endometriosis targets known problematic areas of endometriosis that can have debilitating effects on women’s quality of life. Naturopathic care has the potential to align with important health outcomes for women with endometriosis however, further attention is needed to assess the effectiveness and continue to establish a multidisciplinary approach involving naturopathic care.
Publisher: Cambridge University Press (CUP)
Date: 08-02-2018
DOI: 10.1017/S1463423617000664
Abstract: This study examines GP perceptions, attitudes and knowledge of complementary medicine (CM), and to understand contextual factors that influence these perceptions, attitudes and knowledge. CM use is increasing, and its influence on primary care becoming increasingly significant. Although general practitioners (GPs) often have central primary care gate-keeper roles within health systems, few studies have looked specifically at GPs’ perceptions, attitudes and knowledge of CM. A questionnaire was mailed to all 1486 GPs registered as practicing in non-metropolitan areas of New South Wales. The survey included one free-text qualitative question, where respondents were invited to highlight issues associated with CM in their own words. Free-text responses were analyzed qualitatively using thematic analysis. In total, 585 GPs responded to the survey (adjusted response rate 40.1%), with 152 (26.0%) filling in the free-text question. Central themes which emerged were risk as a primary concern opposition to, resistance to and the inappropriateness of complementary therapies struggles with complexity and ambivalent tolerance. GPs in Australia have a wide variety of perceptions toward CM. A minority of GPs have absolute views on CM, with most GPs having numerous caveats and qualifications of in idual CM. Efficacy is only one aspect of CM critically evaluated by GPs when gauging support for in idual therapies – risk, alignment with medical principles and an openness to exploring new avenues of treatment where others have failed, all appear to be equally important considerations when GPs form their views around CM.
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.CTCP.2022.101539
Abstract: Endometriosis is a painful female reproductive disease resulting in unmet health needs. Women with endometriosis frequently access different types of health care, yet little is known about naturopathic use. The purpose of this study is to explore the naturopathic utilisation by women with endometriosis in Australia. This study reports a cross-sectional survey of Australian women with endometriosis. Participants were recruited through the not-for-profit organisations Endometriosis Australia and EndoActive social media platforms. Data was collected through a self-administered questionnaire by those eligible to participate. Participants were included if they self-reported a diagnosis of endometriosis via laparoscopic surgery and were an Australian resident. Of the recruited 303 women with endometriosis, 60 women reported consulting with a naturopath for endometriosis care. Women consulting with a naturopath, reported also consulting with a laparoscopic surgeon (66.7%, p = 0.01), acupuncturist (53.3%, p ≤ 0.01), physiotherapist (41.7%, p = 0.01), nutritionists/dietitians (n = 22, 36.7%, p = 0.01) or homeopath (15.0%, p ≤ 0.001), in addition to their naturopath in the previous 12 months for endometriosis management. Compared to non-naturopathic users, women reported frequently experiencing dyspareunia (OR 2.9, CI 1.4-5.9, p = 0.002) and reported a higher use of vitamin D supplementation for endometriosis management (OR 4.9, CI 2.5-9.9, p ≤ 0.001). Women who use naturopathy for endometriosis appear to be high users of health care services, both within complementary medicine and conventional medicine. The efficacy and role of naturopathic treatments and care for women with endometriosis requires further investigation.
Publisher: Wiley
Date: 15-06-2022
DOI: 10.1111/JEP.13721
Abstract: Traditional whole systems of medicine, such as naturopathy, are founded upon holism a philosophical paradigm consistent with contemporary complexity science. Naturopathic case management is predicated upon the understanding of an intimately interconnected internal physiological and external context of the human organism—potentially indicating a worldview aligned with a complexity perspective. In this study we investigate naturopathic clinical reasoning using a complexity lens with the aim of ascertaining the extent of correspondence between the two. Mind maps depicting case presentations were sought from Australian degree qualified naturopaths. A network mapping was undertaken, which was then analysed in accordance with a complexity science framework using exploratory data analysis and network analysis processes and tools. Naturopathic case schematics, in the form of mind maps ( n = 70), were collected, network mapped, and analysed. A total of 739 unique elements and 2724 links were identified across the network. Integral elements across the network were: stress, fatigue, general anxiety, systemic inflammation, gut dysbiosis, and diet. A modularity algorithm detected 11 communities, the primary ones of these representing the nervous system and mood the gastrointestinal tract, liver, and nutrition immune function and the immune system and diet and nutrients. Naturopathic case management is holistic and based on a perspective of an integrated physiology and external context of the human organism. The traditional concept of holism, when subjected to a complexity lens, leads to the emergence of a contemporary holistic paradigm cognisant of the human organism being a complex system. The application of complexity science to investigate naturopathic case management as employed in this study, demonstrates that it is possible to investigate traditional philosophies and principles in a scientific and critical manner. A complexity science research approach may offer a suitable scientific paradigm to develop our understanding of traditional whole systems of medicine.
Publisher: Springer Science and Business Media LLC
Date: 02-04-2018
Publisher: Springer Science and Business Media LLC
Date: 02-2017
Publisher: Center for Open Science
Date: 05-06-2019
Abstract: Australia’s Medicare is still widely considered one of the world’s best health systems. However, continual political tinkering for forty years has led to a medical billing and payment system that has become labyrinthine in its complexity and is more vulnerable to abuse now, from all stakeholders, than when first introduced. Continuing to make alterations to Medicare without addressing underlying structural issues, may compound Australia’s health reform challenges, increase the incidence of non-compliance and expenditure and thwart necessary reforms to develop a modern, data driven, digitally informed health system. For the medical practitioners who are required to navigate the increasing complexity and relentless change, they will remain at high risk of investigation and prosecution in what has become an anarchic operating environment that they cannot avoid, but do not understand.
Publisher: Elsevier BV
Date: 05-2022
Publisher: SAGE Publications
Date: 2020
Abstract: Objectives: Existing evidence supports the use of certain Chinese medicine (CM) interventions for symptom management among palliative cancer patients. However, evidence-based service recommendations tailored to the local context are needed for CM planning and implementation. In response, we aimed to establish consensus on CM clinical service recommendations for cancer palliative care among Hong Kong experts. Methods: Seven CM interventions showing statistically significant favorable results in existing systematic reviews (SRs) and overviews of SRs were subjected to a GRADE-ADOLOPMENT–based 2-round Delphi survey. Twelve Hong Kong experts in cancer palliative care, including conventionally trained physicians, CM practitioners, and nurses (n = 4 from each category), were invited to participate. Use of the Evidence to Decision framework within the GRADE-ADOLOPMENT approach enabled experts to consider aspects of problem priority, benefits, harms, equity, acceptability, and feasibility when making CM recommendations in cancer palliative care. Results: Three evidence-based CM interventions reached positive consensus as service recommendations, namely: (1) acupuncture for reducing fatigue among palliative cancer patients (2) acupressure for reducing fatigue among palliative cancer patients and (3) moxibustion for reducing nausea and vomiting among patients receiving chemotherapy. Median rating of recommendation ranged from 2.5 to 3.0 (interquartile range = 0.00-1.00) on a 4-point Likert-type scale, and the percentage agreement ranged from 83.4% to 91.7%. Conclusions: The GRADE-ADOLOPMENT approach facilitates a consensus-based process of reaching 3 evidence-based CM recommendations for cancer palliative care. Future studies may develop tailored strategies to implement these recommendations in the Hong Kong health system.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Jonathan Wardle.