Efficacy of a topical herbal and mineral formulation (Dynamiclear) for the treatment of herpes simplex labialis in the community setting : study protocol for a randomised, double-blind placebo-controlled trial

Introduction Herpes simplex labialis (HSL) is a common infection that can cause painful lesions on the oral mucosa, commonly referred to as cold sores. Current biomedical treatments include topical aciclovir, which reduces the episode duration by an average of 0.5 days. This study will examine the efficacy and tolerability of an over-the- counter topical treatment, Dynamiclear in reducing duration and severity of HSL episodes. Methods and analysis This prospective, randomised, double-blind, placebo-controlled, multi-centre trial will recruit a minimum of 292 adult participants across Australia and New Zealand who present with a cold sore within 48 hours of onset. They will be randomly allocated in a 2:1 ratio to receive either topical Dynamiclear (active) or placebo. Dynamiclear’s active ingredients are Hypericum perforatum, Calendula Officinalis and copper sulfate. A single topical treatment of active or placebo will be applied by a pharmacy-based investigator, and participants will be provided with a viral swab kit to confirm presence of herpes virus 1 or 2 from ulcerated lesions. Participants will receive reminders by email and/ or SMS to complete an online daily diary assessing their cold sore lesion using a visual guide, and recording other symptoms on numeric scales until healed. The primary outcome variable is median duration of HSL episode in days (participant evaluated) from presentation to return to normal skin. Secondary outcomes include severity of lesion pain, itching, burning and tingling during the symptomatic phase and proportion of lesions progressing to ulceration

Use of traditional and complementary medicine by ethnic Indian women living with polycystic ovary syndrome: a global survey

Background: Traditional, complementary, and integrative medicine (TCIM) is commonly used by those living with Polycystic Ovary Syndrome (PCOS) but little is known about the use of TCIM such as yoga and Ayurveda in ethnic Indian women with PCOS living worldwide. This survey aimed to explore the prevalence and types of TCIM used and in particular the pattern of use of yoga and Ayurveda including reasons for not using and future interest in using them among non-users. Method: An online, international cross-sectional survey was conducted using a pre-designed survey tool. Participants were ethnic Indian women of reproductive age who reported that they were medically diagnosed with PCOS. Descriptive analysis was used to identify the proportion of TCIM users, while a multivariable binary logistic regression was used to analyze their characteristics. Results: Data from 3130 respondents were analysed. The prevalence of TCIM use was 80% (2515/3130). Yoga and Ayurveda were the most frequently practised TCIM modalities with a prevalence of 57% and 37% respectively. We found a high future interest in using yoga (81%) and Ayurveda (70%) among the non-users. The motivation for most Ayurveda use was a recommendation from family/friends (66%), rather than personal choice (38%) or the internet (19%). Most women used Ayurveda because it has natural ingredients (64%) and it is safe (60%) and cited its use to be safe and somewhat helpful. The majority of women were currently practising yoga (73%) up to four times a week (54%) at home (93%). Yoga was primarily used to improve overall health (67%), manage weight (64%), stress (54%) hormonal imbalance (49%) and emotional well-being (48%). Barriers to practising yoga were common among the current users and non-users and included lack of motivation (59% and 59%), time constraints (48% and 39%), and non-availability of yoga teachers specialised in PCOS (31% and 23%). Most women found yoga to be helpful and preferred individual one-on-one (52%) yoga sessions specifically tailored for PCOS (58%). Conclusion: This is the first international study that discovered the prevalence and pattern of TCIM use among ethnic Indian women with PCOS living worldwide. We support the urgent need for more research, education, and regulation of different TCIM modalities to promote safe and effective practices globally

Complementary therapies and medicines and reproductive medicine

Complementary therapies and medicines are a broad and diverse range of treatments, and are frequently used by women and their partners during the preconception period to assist with infertility, and to address pregnancy-related conditions. Despite frequent use, the evidence examining the efficacy, effectiveness, and safety for many modalities is lacking, with variable study quality. In this article, we provide an overview of research evidence with the aim of examining the evidence to inform clinical practice. During the preconception period, there is mixed evidence for acupuncture to improve ovulation, or increase pregnancy rates. Acupuncture may improve sperm quality, but there is insufficient evidence to determine whether this results in improved pregnancy and live birth rates. Acupuncture can be described as a low-risk intervention. Chinese and Western herbal medicines may increase pregnancy rates; however, study quality is low. The evaluation of efficacy, effectiveness, and safety during the first trimester of pregnancy has most commonly reported on herbs, supplements, and practices such as acupuncture. There is high-quality evidence reporting the benefits of herbal medicines and acupuncture to treat nausea in pregnancy. The benefit from ginger to manage symptoms of nausea in early pregnancy is incorporated in national clinical guidelines, and vitamin B6 is recommended as a first-line treatment for nausea and vomiting in pregnancy. The safety of ginger and vitamin B6 is considered to be well established, and is based on epidemiological studies. Acupuncture has been shown to reduce back pain and improve function for women in early pregnancy. There is little evidence to support the use of cranberries in pregnancy for prevention of urinary tract infections, and chiropractic treatment for back pain. Overall the numbers of studies are small and of low quality, although the modalities appear to be low risk of harm

Media Consumption and Mental Health during COVID-19 lockdown: A UK Cross-sectional study across England, Wales, Scotland and Northern

As individuals adjust to new ‘norms’ and ways of living during the COVID-19 lockdown, there is a continuing need for up-to-date information and guidance. This has elevated the importance of media channels, such as social media and traditional media. Evidence suggests that frequent media exposure is related to a higher prevalence of mental health problems, especially anxiety and depression. The aim of this study is to determine whether COVID-19 related media consumption is associated with changes in mental health outcomes. This paper presents baseline data from the COVID-19 Psychological Wellbeing Study. The results showed a statistically significant correlation between COVID-19 media exposure and increases in anxiety (GAD-7) and depression (PHQ-9). The study suggested that media usage is statistically significantly associated with anxiety and depression on the GAD-7 and PHQ-9 scales with excessive media exposure related to higher anxiety and depression scores

Developing and testing a community based, online vs. face-to-face peer led intervention to improve mental well-being in Cambodian adults with physical disabilities

Background: Despite growing international attention, there remains an urgent need to develop mental health services within low and middle income countries. The Khmer Rouge period in Cambodia saw the destruction of all health services infrastructure in the 1970s. Consequently, Cambodia has struggled to rebuild both its economy and healthcare system, with the number of qualified mental health clinicians remaining disproportionately low. Resultantly, there is a pressing need to develop low-cost community based alternatives of mental healthcare.Methods: Using a mixed methods design, researchers developed an 8-week peer-led intervention, known as a Friendship Group, for adults with physical disabilities using both face-to-face and online delivery methods. The Wilcoxon Signed-Rank test was used to assess changes in pre-post survey scores and qualitative data was collected in form of five focus groups post intervention.Results: 41 participants were allocated across four Friendship groups – two were online and two face-to-face. Attrition rate was 22% post-intervention (n = 32). ITT analyses showed a statistically significant decrease in psychological distress scores [Z = −3.808, p &lt; .001] from pre [Mdn = 20, IQR = 16.5–25.5] to post [Mdn = 16, IQR = 14–18.5] intervention. A Wilcoxon signed-ranks test also showed a statistically significant decrease in PTSD scores [Z = −2.239, p &lt; .025] from pre [Mdn = 4, IQR = 3–5] to post [Mdn = 3, IQR = 2.75–4] intervention. There was also a statistically significant decrease in worry scores [Z = −3.904, p &lt; .001] from pre [Mdn = 5, IQR = 3.5–6.5] to post [Mdn = 3, IQR = 3–4] intervention. There were no significant group differences between the face to face and online groups. A number of interconnected themes emerged from focus group data (n = 5), these included the mental health benefits of Friendship Groups as conceptualised through knowledge acquisition, skill development and peer support.Conclusions: The Friendship group intervention delivered in both online and face-to-face formats appears feasible and acceptable within the Cambodian context. Initial data revealed positive findings in terms of reduction in psychological distress, worry and PTSD symptoms as well increased feeling as calm.<br/

Naturopaths' approach to care of women with infertility : a cross-sectional survey

Introduction: Infertility affects approximately one in six couples of reproductive age. Many women use traditional, complementary and integrative medicine to improve their chances of conceiving. While there is evidence of the use of naturopathy by women attempting to conceive, there is no evidence of the way that naturopaths approach and manage their treatment. This study aims to describe how naturopaths manage female infertility, including their approaches, clinical decisions, knowledge sources, and safety considerations in providing naturopathic care. Methods: Naturopaths in Australia or New Zealand, routinely treating female reproductive health concerns and practicing for at least two years were invited to complete an online survey through their professional naturopathic associations. Results: Data from 45 respondents were included. Women seeking preconception health and fertility promotion were frequently seen by 53 % and 44 % of the naturopaths, respectively. The naturopaths’ clinical management approaches for infertility were wide-ranging and extended beyond fertility. They reported prioritising peer-reviewed journal articles in guiding clinical decisions, collaborating with health practitioners (mostly general practitioners) and reporting adverse events. Most naturopaths (95 %) utilised multiple treatment strategies, recommending dietary and lifestyle modifications and a combination of ingestible substances. Conclusions: The naturopathic approach to management of women with infertility is holistic, considering physical, emotional, and environmental factors and promoting natural healing mechanisms. Greater knowledge of scientific methods for clinical decision-making and improved awareness of adverse event reporting would enhance naturopathic care. Additionally, evaluating the effectiveness of naturopathic treatment would improve safety, inform the profession, and clarify the role of naturopathy within a multidisciplinary approach to infertility

Establishing key components of naturopathic management of women with diminished ovarian reserve : a Delphi study

Given the time constraints on a woman’s ability to conceive, and the limited options available, complementary options are frequently sought. Many women in Australia use traditional, complementary and integrative medicine (TCIM) to improve their chances of having a live healthy baby with women attempting to conceive more likely to consult with a naturopath than women who are not trying to conceive

[In Press] Health needs, treatment decisions and experience of traditional complementary and integrative medicine use by women with diminished ovarian reserve : a cross-sectional survey

Background: Women with diminished ovarian reserve (DOR) have fewer eggs than would be expected at their age. It is estimated that 10% of women seeking fertility treatment are diagnosed with DOR. However, the success rate of medically assisted reproduction (MAR) is significantly lower in women with DOR, thus many seek additional approaches. Aim: To explore the health needs of women with DOR, treatment options and experience of treatment including traditional complementary integrative medicine (TCIM). Methods: Anyone with a diagnosis of DOR, living in Australia or New Zealand, aged over 18 were invited to complete an online survey distributed via fertility support networks and social media platforms from April to December 2021. Results: Data from 67 respondents were included. The main aspects of health that were impacted by DOR were fertility (91.0%) and mental health (52.2%). The main treatment recommended was MAR with most women either currently using MAR (38.8%) or having previously used MAR (37.3%). TCIM was widely used with 88.1% of women utilising supplements, 74.6% consulting with TCIM practitioners, and 65.7% adopting self-care practices. The main reasons for using TCIM were to improve fertility or support pregnancy, and to support general health and well-being. Conclusions: Women with DOR have additional health needs apart from infertility, most notably mental health support. The main form of treatment utilised is MAR, despite DOR being challenging for fertility clinicians. TCIM was widely used, and respondents perceived benefits related to improving fertility, supporting pregnancy, or improving well-being through use of acupuncture, meditation, naturopathy, massage, yoga

Individual agency, community capacity building, and chronic illness care: Using participatory methods to implement the Stanford Chronic Disease Self Management Program in a Housing First Program

Research questions: Is a standardized chronic disease self management program (CDSMP) experienced as a valuable intervention by Pathways\u27 consumers? What is the impact of collaborative inquiry into health program development on participant\u27s critical agency