The research crisis in American institutions of complementary and integrative health: one proposed solution for chiropractic profession.

A crisis confronts the Complementary and Integrative Health (CIH) teaching institutions in the US. Research infrastructure is needed to build and sustain productive research programs and retain their own research faculty. In most health professions, this infrastructure is largely built through research grants. In CIH, most educational institutions are funded through student tuition, which has historically also had to be the source for building their research programs. Only a limited number of these institutions have emerged as National Institute of Health (NIH) grant-funded programs. As a result, the American chiropractic institutions have seen a retrenchment in the number of active research programs. In addition, although research training programs e.g., NIH's K awards are available for CIH researchers, these programs generally result in these researchers leaving their institutions and depriving future CIH practitioners of the benefit of being trained in a culture of research. One proposed solution is to leverage the substantial research infrastructure and long history of collaboration available at the RAND Corporation (https://www.rand.org) This article presents the proposed five components of the RAND Center for Collaborative CIH Research and the steps required to bring it to being: 1) the CIH Research Network - an online resource and collaborative site for CIH researchers; 2) the CIH Research Advisory Board - the governing body for the Center selected by its members; 3) the RAND CIH Interest Group - a group of RAND researchers with an interest in and who could provide support to CIH research; 4) CIH Researcher Training - access to existing RAND research training as well as the potential for the Center to provide a research training home for those with training grants; and 5) CIH RAND Partnership for Research - a mentorship program to support successful CIH research. By necessity the first step in the Center's creation would be a meeting between the heads of interested CIH institutions to work out the details and to obtain buy-in. The future success of CIH-directed research on CIH will require a pooling of talent and resources across institutions; something that the American chiropractic institutions have not yet been able to achieve. This article discusses one possible solution

Challenges of systematic reviewing integrative health care.

This article is based on an extensive review of integrative medicine (IM) and integrative health care (IHC). Since there is no general agreement of what constitutes IM/IHC, several major problems were identified that make the review of work in this field problematic. In applying the systematic review methodology, we found that many of those captured articles that used the term integrative medicine were in actuality referring to adjunctive, complementary, or supplemental medicine. The objective of this study was to apply a sensitivity analysis to demonstrate how the results of a systematic review of IM and IHC will differ according to what inclusion criteria is used based on the definition of IM/IHC. By analyzing 4 different scenarios, the authors show that, due to unclear usage of these terms, results vary dramatically, exposing an inconsistent literature base for this field

First national survey of anthroposophic nurses in NZ

Anthroposophic health care although listed as a Complementary and Alternative Medicine (CAM) – approach according to the Ministerial Advisory Committee for Complementary and Alternative Health (MACCAH, 2002;2004) in New Zealand (NZ), is an integrated healing system that has been practiced and widely used in Europe. Based on foundations developed by Rudolf Steiner and Ita Wegman, anthroposophic medicine is a holistic healing approach considering the whole human being, namely body, soul and spirit (Evans & Rogers, 1992; Steiner & Wegman, 1991; Therkleson, 2005). Instead of focusing on individual symptoms, anthroposophic therapeutic approaches will aim not only at the physical complaint but target the whole person, inclusive of emotional, psycho-social and spiritual aspects. Diagnosis and therapies are therefore based on assessing the individual with a holistic framework and rather than aiming for a cure, the emphasis is on salutogenic strategies, supporting the person to find equilibrium by stimulating innate healing abilities (Evans & Rogers, 1992; Mittelmark & Bauer, 2017; Therkleson & Sherwood, 2004). Health care professionals practicing with anthroposophic principles use orthodox, scientific foundations and extend their practice with the holistic foundations of anthroposophic health care. In NZ anthroposophic nurses (ANs) work in a variety of clinical settings, e.g. in anthroposophic health centers (e.g. Helios Integrative Medical Center), primary health practices (Manchester, 2009), in therapeutic communities (Freeman Rock, 2014), hospice and some as independent practitioners in the community. AN therapies support the human being through rhythmical massage/embrocation, hydrotherapy, poultices, compresses and biography work (Therkleson, 2004). In the past education to gain registration as an anthroposophic nurse was offered through the Taruna College in Hawkes Bay (Certificate and Diploma in Holistic Healthcare). The diploma qualification is a requisite for inclusion on the ANANZ Register of Anthroposophic Nurses (AN). Some of the ANs currently practicing in NZ have gained registration overseas at an Anthroposophic Hospital (Germany or Switzerland)

A Literature Review of Complementary and Alternative Medicine Used Among Diabetes Mellitus Patients

Diabetes is a chronic disease that requires regular and sustainable health management that involves proper treatment. Some diabetic patients use CAM, as well as conventional medicine, to maintain their health and control their blood sugar. This literature review aimed to 1) determine the prevalence of CAM used by patients with diabetes, summarize and evaluate the CAM use that includes: characteristics, patterns, types and reasons, 2) propose a conceptual model associated with CAM used by patients with diabetes. Systematic reviews were searched using an electronic database. The systematic reviews were published between 2005 and 2015 by using specific keywords. The number of systematic reviews obtained as a search result is 14 articles from 14 countries. The prevalence of CAM used by patients with diabetes ranged from 16.6% to 76%. Determinants associated with the CAM use were age, gender, family income, occupation, residence, and the characteristics of the disease, such as the length of time since diagnosed and complications. Most patients used CAM, along with the conventional treatment, and did not inform health professionals about the CAM use. The CAM use by patients with diabetes was relatively high and the confidence of patients believed the benefits of CAM. Therefore, integration with health professionals to develop CAM management is highly required

Relationships and implications for complementary and alternative medicine in Aotearoa New Zealand: A discussion paper

The purpose of this paper is to initiate a discussion on contextualising the relationship between the nursing profession and complementary and alternative medicine (CAM) within Aotearoa New Zealand. There is limited research and data linking complementary and alternative medicine to nursing or how this could be integrated into health care delivery. The authors’ intentions are to raise awareness of a trend within health and wellness that could have implications for the nursing profession in Aotearoa New Zealand. Existing knowledge from overseas research is discussed to raise awareness on complementary and alternative medicine knowledge and any perceptions or educational needs nurses may require when considering the utilisation of complementary and alternative medicine. A range of questions are presented aimed at highlighting areas of development and future research for nursing in Aotearoa New Zealand if complementary and alternative medicine therapies or theory are applied within mainstream health care settings. Ngā ariā matua Te kaupapa ia o tēnei tuhinga he wāhi i te kōrero kia whakatatangia mai te hononga o te umanga tapuhi ki ngā rongoā tāpiri, kaupapa tuarua hoki (CAM) i Aotearoa. He iti noa ngā rangahau me ngā raraunga e tūhono ana i ngā rongoā tāpiri, kaupapa tuarua hoki ki te ao tapuhi, me pēhea rānei e taea te tūhono ki te horanga taurimatanga hauora i Aotearoa. Te whāinga ia o ngā kaituhi he whakapiki i te māramatanga ki tētahi ia i roto i te hauora me te waiora e puta ake ai he pānga ki te umanga tapuhi i Aotearoa. Ka whakamahia ngā mōhiotanga mai i ngā rangahau i tāwāhi hei whakapiki i te māramatanga ki ngā rongoā tāpiri, kaupapa tuarua hoki, me ngā kitenga, ngā hiahia whakangungu rānei e tika ana mā te tapuhi ina whakaaro ake ki te whakamahi i ngā rongoā tāpiri, kaupapa tuarua hoki. Ka tāpaetia mai te huhua o ngā pātai hei miramira i ngā wāhanga mō te whanaketanga me ngā rangahau mō te mahi tapuhi i Aotearoa mehemea ka whakamahia ngā rongoā tāpiri, kaupapa tuarua hoki i ngā horopaki hauora auraki

Leveraging Mindfulness to Build Resilience and Professional Quality of Life in Human Service Professionals

Objective: Mindfulness-based interventions (MBIs) have shown promise in cultivating resilience and are widely accepted as efficacious in the treatment of a range of psychological disorders. This paper explores the feasibility of a Mindful-Awareness and Resilience Skills Training (MARST) program to enhance mindfulness and resilience, as a means of increasing psychological well-being and alleviating burnout and compassion fatigue in human service professionals. Method: In this randomised control trial, 46 human service professionals were randomly allocated to either a MARST group or to a no intervention, control group. Results: Multivariate analysis of covariance (MANCOVA), with pre-test scores as the covariates, revealed that the MARST intervention resulted in significant improvements in mindfulness, resilience, compassion satisfaction, and psychological well-being, and significant reductions in burnout and compassion fatigue; at post-intervention. These results were maintained at one month follow-up, with the exception of compassion satisfaction which was non-significant. Mediation analysis using a bootstrap resampling method indicated that mindfulness fully mediated changes in resilience and psychological well-being, as a result of the MARST intervention. Self-reported reductions in burnout following the intervention were mediated by mindfulness and resilience, and decreased compassion fatigue was mediated by resilience. Conclusions: The results of this study suggest that the MARST program may assist in developing resilience and ameliorating burnout and compassion fatigue in human service professionals. The study also provides evidence for the potential of mindfulness-based approaches to enhance resilience.</jats:p

The Effects of Mindful Movement and Exercise on Depression

This evidence based review looked at any correlation between aerobics, running, Qi\u27 gong and mindfulness practices like meditation and yoga. What were their effects if any on depression? The findings from meta-analysis concluded that each in their own way did in fact relieve, improve or prevent signs and symptoms of depression as well as other dysregulatory and co-occurring health concerns like PTSD, Anxiety, Chronic Pain, insomnia and addiction issues. There was a clear correlation that an integrative approach to treatments and therapies needs further research in conventional medicine. Some treatments were found to be as effective if not more so than pharmaceuticals. As health care costs continue to rise, alternative, complementary and integrative cost effective treatments and therapies should be researched and considered. This review helps open the door for policy makers and medical professionals to look at treatment modalities in their own professions

Massage Therapy in Outpatient Cancer Care: A Metropolitan Area Analysis.

Massage offers cancer patients general quality of life benefits as well as alleviation of cancer-related symptoms/cancer-treatment-related symptoms including pain, anxiety, and fatigue. Little is known about whether massage is accessible to cancer patients who receive treatment in the outpatient setting and how massage is incorporated into the overall cancer treatment plan. Outpatient cancer centers (n = 78) in a single metropolitan area were included this mixed-methods project that included a systematic analysis of website information and a telephone survey. Massage was offered at only 40 centers (51.3% of total). A range of massage modalities were represented, with energy-based therapies (Reiki and Therapeutic Touch) most frequently provided. Although massage therapists are licensed health care providers in the states included in this analysis, massage was also provided by nurses, physical therapists, and other health care professionals