Complementary and alternative medical therapy utilization by people with chronic fatiguing illnesses in the United States

<p>Abstract</p> <p>Background</p> <p>Chronic fatiguing illnesses, including chronic fatigue syndrome (CFS), pose a diagnostic and therapeutic challenge. Previous clinical reports addressed the utilization of health care provided to patients with CFS by a variety of practitioners with other than allopathic training, but did not examine the spectrum of complementary and alternative medicine (CAM) therapies used. This study was designed to measure CAM therapy use by persons with fatiguing illnesses in the United States population.</p> <p>Methods</p> <p>During a random-digit dialing survey to estimate the prevalence of CFS-like illness in urban and rural populations from different geographic regions of the United States, we queried the utilization of CAM including manipulation or body-based therapies, alternative medical systems, mind-body, biologically-based, and energy modalities.</p> <p>Results</p> <p>Four hundred forty fatigued and 444 non-fatigued persons from 2,728 households completed screening. Fatigued subjects included 53 persons with prolonged fatigue, 338 with chronic fatigue, and 49 with CFS-like illness. Mind-body therapy (primarily personal prayer and prayer by others) was the most frequently used CAM across all groups. Among women, there was a significant trend of increasing overall CAM use across all subgroups (p-trend = 0.003). All categories of CAM use were associated with significantly poorer physical health scores, and all but one (alternative medicine systems) were associated with significantly poorer mental health scores. People with CFS-like illness were significantly more likely to use body-based therapy (chiropractic and massage) than non-fatigued participants (OR = 2.52, CI = 1.32, 4.82). Use of body-based therapies increased significantly in a linear trend across subgroups of non-fatigued, prolonged fatigued, chronic fatigued, and CFS-like subjects (p-trend = 0.002). People with chronic fatigue were also significantly more likely to use body-based therapy (OR = 1.52, CI = 1.07, 2.16) and mind-body (excluding prayer) therapy than non-fatigued participants (OR = 1.73, CI = 1.20 – 2.48).</p> <p>Conclusion</p> <p>Utilization of CAM was common in fatiguing illnesses, and was largely accounted for by the presence of underlying conditions and poor physical and mental health. Compared to non-fatigued persons, those with CFS-like illness or chronic fatigue were most likely to use body-based and mind-body therapies. These observations have important implications for provider education programs and development of intervention strategies for CFS.</p

Region versus site variation in the population dynamics of three short-lived perennials

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Running away with health: the urban marathon and the construction of charitable bodies

The increase in fundraising through mass-participation running events is emblematic of a series of issues pertinent to contemporary conceptualizations of health and illness. This increasingly popular spectacle serves as an indicator of present-day social relationships and broader cultural and ideological values that pertain to health. It highlights contemporary discourses on citizenship; ‘active citizens’ can ostentatiously fulfil their rights and responsibilities by raising money for those ‘in need’. Involvement in such events comprises an example of the current trend for drawing attention to illness, and sharing one’s experiences with others. We examine these issues through a consideration of charity advertisements and offer a fourfold typology of runners in terms of their orientations to both mass-participation running and charity. We conclude that ‘charitable bodies’ are constructed out of the interrelationships between philanthropic institutions, sport and individual performance

Dispersal and microsite limitation of a rare alpine plant

Knowledge on the limitation of plant species’ distributions is important for preserving alpine biodiversity, particularly when the loss of alpine habitats because of global warming or land use changes is faster than colonization of new habitats. We investigated the potential of the rare alpine plant Campanula thyrsoides L. to colonize grassland sites of different suitability on a small mountain plateau in the Swiss Alps. A total of 15 experimental sites were selected according to their differences in habitat suitability for adult C. thyrsoides, which was measured by the Beals index. At each site we applied a disturbance treatment, added seeds at different densi- ties and monitored the survival of seedlings over two consecutive years. The number of surviving seedlings was not positively related to habitat suitability for adult C. thyrsoides. Furthermore, C. thyrsoides appears to be strongly dispersal limited at the regional scale because seed addition to unoccupied habitats resulted in successful germination and survival of seedlings. Since an increase of seed density in already occupied sites did not affect the number of seedlings, we suggest that C. thyrsoides is microsite limited at the local scale. Microsite limitation is supported by the result that seedling survival of the species was enhanced in vegetation gaps created by disturbance. We conclude E. S. Frei (&) J. F. Scheepens, J. Sto ̈cklin Section of Plant Ecology, Institute of Botany, University of Basel, Scho ̈nbeinstrasse 6, 4056 Basel, Switzerland e-mail: [email protected] that C. thyrsoides may become endangered in the future if environmental changes cause local extinction of populations. An appropriate management, such as a disturbance regime for enhancing recruitment in existing populations, may ensure the long-term sur- vival of this rare alpine plant species