Complementary and Alternative Medicine Use among Norwegian Cancer Survivors: Gender-Specific Prevalence and Associations for Use

This article is part of Agnethe E. Kristoffersen's doctoral thesis, available in Munin at http://hdl.handle.net/10037/5255The associations for CAM use are only occasionally differentiated by gender in populations where both male and female cancer survivors occur. The aim of this study is to describe the prevalence of CAM use in individuals with a previous cancer diagnosis and to investigate gender differences regard to factors associated with use. A total of 12982 men and women filled in a questionnaire with questions about life style and health issues. Eight hundred of those had a previous cancer diagnosis of whom 630 answered three questions concerning CAM use in the last 12 months. A total of 33.8% of all cancer survivors reported CAM use, 39.4% of the women and 27.9% of the men (�<0.01). The relationship between the demographic variables and being a CAM user differed significantly between men and women with regard to age (�=0.03), education (�=0.04), and income (�<0.01). Female CAM users were more likely to have a university degree than the nonusers,while male CAM users were more likely to have a lower income than the nonusers. According to this study, prevalence and factors associated with CAM use differ significantly between male and female survivors of cancer

Freezing cold injuries among soldiers in the Norwegian Armed Forces – A cross sectional study

Introduction: Freezing cold injuries (FCI) are a common risk in extreme cold weather warfare operations. The Norwegian Armed Forces (NAF) have the expertise and capabilities in education and training for warfighting capabilities in the Arctic. Nevertheless, a substantial number of Norwegian soldiers sustain freezing cold injuries annually. The aim of this study was to describe the FCI in the NAF, the associated risk factors and clinical associations. Methodology: The subjects for the study were soldiers registered with FCI in the Norwegian Armed Forces Health Registry (NAFHR) between January 1st 2004–July1st 2021. The soldiers answered a questionnaire regarding background, activities at the time of injury, description of the FCI, risk factors, medical treatment and any sequelae from their FCI. Results: FCI in the NAF were most frequently reported among young conscripts (mean20.5 years). Hands and feet are most often injured (90.9%). Only a minority (10.4%) received medical treatment. The majority (72.2%) report sequelae. Extreme weather conditions was the most important risk factor (62.5%). Conclusions: Most soldiers had the knowledge to avoid FCI, but they were injured anyway. It is concerning that only one in 10 injured soldiers received medical treatment after diagnosed with FCI, increasing the risk of FCI sequelae

The classification of freezing cold injuries - a NATO research task group position paper

Introduction: Freezing cold injuries (FCI) are a common risk in extreme cold weather operations. Although the risks have long been recognised, injury occurrences tend to be sparse and geographically distributed, with relatively few cases to study in a systematic way. The first challenge to improve FCI medical management is to develop a common nomenclature for FCI classification. This is critical for the development of meaningful epidemiological reports on the magnitude and severity of FCI, for the standardisation of patient inclusion criteria for treatment studies, and for the development of clinical diagnosis and treatment algorithms. Methodology: A scoping review of the literature using PubMed and cross-checked with Google Scholar, using search terms related to freezing cold injury and frostbite, highlighted a paucity of published clinical papers and little agreement on classification schemes. Results: A total of 74 papers were identified, and 28 were included in the review. Published reports and studies can be generally grouped into four different classification schemes that are based on (1) injury morphology; (2) signs and symptoms; (3) pathophysiology; and (4) clinical outcome. The nomenclature in the different classification systems is not coherent and the discrete classification limits are not evidence based. Conclusions: All the classification systems are necessary and relevant to FCI medical management for sustainment of soldier health and performance in cold weather operations and winter warfare. Future FCI reports should clearly characterise the nature of the FCI into existing classification schemes for surveillance (morphology, symptoms, and appearance), identifying risk-factors, clinical guidelines, and agreed inclusion/exclusion criteria for a future treatment trial

The Prognostic Impact of Protein Expression of E-Cadherin-Catenin Complexes Differs between Rectal and Colon Carcinoma

The E-cadherin-catenin complex provides cell-cell adhesion. In order for a carcinoma to metastasize, cancer cells must let go of their hold of neighboring cells in the primary tumor. The presence of components of the E-cadherin-catenin complex in 246 rectal adenocarcinomas was examined by immunohistochemistry and compared to their presence in 219 colon carcinomas. The expression data were correlated to clinical information from the patients' records. There were statistically significant differences in protein expression between the rectal and the colon carcinomas regarding membranous β-catenin, γ-catenin, p120-catenin, and E-cadherin, as well as nuclear β-catenin. In the rectal carcinomas, there was a significant inverse association between the expression of p120-catenin in cell membranes of the primary tumors and the occurrence of local recurrence, while membranous protein expression of β-catenin was inversely related to distant metastases

Evaluating Complex Healthcare Systems: A Critique of Four Approaches

The purpose of this paper is to bring clarity to the emerging conceptual and methodological literature that focuses on understanding and evaluating complex or ‘whole’ systems of healthcare. An international working group reviewed literature from interdisciplinary or interprofessional groups describing approaches to the evaluation of complex systems of healthcare. The following four key approaches were identified: a framework from the MRC (UK), whole systems research, whole medical systems research described by NCCAM (USA) and a model from NAFKAM (Norway). Main areas of congruence include acknowledgment of the inherent complexity of many healthcare interventions and the need to find new ways to evaluate these; the need to describe and understand the components of complex interventions in context (as they are actually practiced); the necessity of using mixed methods including randomized clinical trials (RCTs) (explanatory and pragmatic) and qualitative approaches; the perceived benefits of a multidisciplinary team approach to research; and the understanding that methodological developments in this field can be applied to both complementary and alternative medicine (CAM) as well as conventional therapies. In contrast, the approaches differ in the following ways: terminology used, the extent to which the approach attempts to be applicable to both CAM and conventional medical interventions; the prioritization of research questions (in order of what should be done first) especially with respect to how the ‘definitive’ RCT fits into the process of assessing complex healthcare systems; and the need for a staged approach. There appears to be a growing international understanding of the need for a new perspective on assessing complex healthcare systems

Publication status and reporting quality of case reports on acupuncture-related adverse events: A systematic reviews of case studies

Introduction: Case reports on acupuncture-related adverse events (AEs) have been consistently published in the literature. This review aims to assess the current publication status of case reports on acupuncture-related AEs and evaluate their reporting quality in order to identify areas for improvement. Methods: This study is a systematic review (SR) of case reports. Studies describing cases for acupuncture-related AEs between 2010 and 2023 (until July) were searched in PubMed, Embase, and local databases (China and Korea), as well as by hand-searching references included in published relevant SRs. A bibliometric analysis was conducted to examine the publication trends of the included literature. The appropriateness of the acupuncture described in the cases, the causality assessment between AEs and acupuncture treatment, and the presence of necessary items from the CAse REport guidelines (CARE) checklist were narratively analyzed. Results: A total of 169 case reports were included in this review. Over the past decade, an average of 12 case reports on acupuncture-related AEs were published annually. However, only 38.2% of the articles provided sufficient information to determine the appropriateness of the acupuncture treatment used in the reported cases, and considerable numbers of the included case reports did not suggest enough information for the assessment of a causal relationship. The majority of cases did not report the timeline (n =164), patient perspectives (n =157), and informed consent (n = 121) items from the CARE checklist. Discussion: Acupuncture-related AEs persist in being frequently reported in the literature. Nonetheless, the information concerning acupuncture and causality assessment within these publications is still found to be insufficient. The development of reporting guidelines for future case reports on acupuncture-related AEs is anticipated to promote an academic environment conducive to more comprehensive reporting.publishedVersio

Reflexology for acute rhinosinusitis – Results from a blinded, early-phase comparative trial

Background - Reflexology is commonly used as an adjunct to conventional treatment by patients with respiratory tract infections. The effect of reflexology needs to be tested in a full-scale randomized controlled study. Small early-phase trials can give an indication on whether full-size clinical trials are warranted. The objective of this study is to determine whether the study design is feasible in a full-scale study of reflexology as an add-on to usual care compared to usual care alone in acute rhinosinusitis, and further if there is a statistical indication of an effect of reflexology warranting a full-scale study. Methods - 20 patients with symptoms compatible with acute rhinosinusitis, and an illness duration of 28 days or less were randomized to additional reflexology treatment along with usual medical care, or usual care alone. The patients scored how much each of 16 sinus-related symptoms bothered them in the past few days on a six-point scale (zero = no problem to five = severe problem). To determine if there is a statistical indication of an effect of reflexology warranting a full-scale study, the separation test was used. Results - The methodology was considered feasible and could therefore be applied in a full-scale study of reflexology for acute rhinosinusitis. The mean reduction in symptom score from baseline to day two was 0.95 in the reflexology group and 0.78 in the control group. From baseline to day ten the mean reduction in symptom score was 2.12 in the reflexology group and 1.63 in the control group. A statistical indication of effect in a full-scale study in favor of reflexology was found from baseline to day ten but not from baseline to day two. Conclusions - The research methodology in this study could be used in a full-scale study of reflexology in acute sinusitis. The results from the separation test indicates an effect warranting a full-scale study of reflexology regarding effects in acute sinusitis ten days after treatment

Ambulatory Anesthesia Dovepress Acupuncture in ambulatory anesthesia: a review

Background: Post-anesthetic morbidities remain challenging in our daily practice of anesthesia. Meta-analyses and reviews of acupuncture and related techniques for postoperative nausea and vomiting (POVN) and postoperative vomiting (POV) show promising results while many clinicians remain skeptical of the value of acupuncture. Given the interest in finding safe nonpharmacological approaches toward postoperative care, this body of knowledge needs to be considered. This review critically appraises and summarizes the research on acupuncture and acupressure in ambulatory anesthesia during the last 15 years. Methods: Articles were identified through searches of Medline, PubMed, and Embase using the search terms &quot;acupuncture&quot; or &quot;acupuncture therapy&quot; in combination with &quot;ambulatory anesthesia&quot; or &quot;ambulatory surgery&quot; or &quot;day surgery&quot; or &quot;postoperative&quot;. A corresponding search was done using &quot;acupressure&quot; and &quot;wristbands&quot;. The searches generated a total of 104, 118, and 122 references, respectively. Results: Sixteen studies were included; eight studies reported on acupuncture and eight on acupressure. Nine studies found acupuncture or acupressure effective on primary endpoints including postoperative nausea and vomiting, postoperative pain, sore throat, and emergence agitation. Four studies found acupuncture had a similar effect to antiemetic medication. Conclusion: Overall, the studies were of fairly good quality. A large proportion of the reviewed papers highlights an effect of acupuncture or acupressure on postoperative morbidities in an ambulatory setting. However, one should bear in mind that research on acupuncture/acupressure in an ambulatory setting contributes to ambiguous conclusions. Hence, we have addressed some of the issues related to this diversity in acupuncture research

Opplevde sammenhenger mellom amalgam og helse i den norske befolkning

Sosial og helsedirektoratet arbeider med retningslinjer for pasientbehandling ved mistanke om helseskade fra amalgamfyllinger. Som bakgrunn for dette arbeid fikk Nasjonalt Forskningssenter innen Komplementær og Alternativ Medisin (NAFKAM) ved Universitetet i Tromsø i oppdrag å beskrive hvordan befolkningen opplever sammenhengen mellom amalgam og helse. Kvantitative og kvalitative metoder har vært brukt for å belyse ulike sider av amalgamproblematikken. Resultatene viser at 7,7% i den norske befolkning mener amalgam i tannfyllinger har påvirket egen helsetilstand. De fleste av disse beskriver vedvarende/kronisk og/eller stadig tilbakevendende helseplager. Nesten hver femte person som skifter ut sine amalgamfyllinger har en helsemessig årsak til utskiftning. En bedring av helsetilstanden etter utskiftning er vanligst dersom alle fyllinger byttes ut. Pasienter med dårligst helse angir størst bedring ved amalgamutskiftning. Personene rapporterer en diffus sykehistorie som kan være vanskelig å skille fra andre uspesifikke lidelser. Helsevesenet oppleves som kunnskapsløst og uten interesse/empati i forhold til problemstillingen. Svært mange personer har søkt forklaring, hjelp og støtte innen alternativ medisin. Resultatene viser at store deler av befolkningen har et annet syn på sammenhengen mellom amalgamfyllinger og helseskader enn de fleste medisinske undersøkelser hittil har vist

Opplevde sammenhenger mellom amalgam og helse i den norske befolkning

Sosial og helsedirektoratet arbeider med retningslinjer for pasientbehandling ved mistanke om helseskade fra amalgamfyllinger. Som bakgrunn for dette arbeid fikk Nasjonalt Forskningssenter innen Komplementær og Alternativ Medisin (NAFKAM) ved Universitetet i Tromsø i oppdrag å beskrive hvordan befolkningen opplever sammenhengen mellom amalgam og helse. Kvantitative og kvalitative metoder har vært brukt for å belyse ulike sider av amalgamproblematikken. Resultatene viser at 7,7% i den norske befolkning mener amalgam i tannfyllinger har påvirket egen helsetilstand. De fleste av disse beskriver vedvarende/kronisk og/eller stadig tilbakevendende helseplager. Nesten hver femte person som skifter ut sine amalgamfyllinger har en helsemessig årsak til utskiftning. En bedring av helsetilstanden etter utskiftning er vanligst dersom alle fyllinger byttes ut. Pasienter med dårligst helse angir størst bedring ved amalgamutskiftning. Personene rapporterer en diffus sykehistorie som kan være vanskelig å skille fra andre uspesifikke lidelser. Helsevesenet oppleves som kunnskapsløst og uten interesse/empati i forhold til problemstillingen. Svært mange personer har søkt forklaring, hjelp og støtte innen alternativ medisin. Resultatene viser at store deler av befolkningen har et annet syn på sammenhengen mellom amalgamfyllinger og helseskader enn de fleste medisinske undersøkelser hittil har vist