Anderson, F.W.J. Complementary and Alternative Medicine in Obstetrics. Int J Gynaecol Obstet Nov 2005, 91(2), 116–24.
Complementary and alternative medicine (CAM) is being used more frequently by patients and, in many cases, their physicians, in addition to or in lieu of traditional medical therapies. The CAM interventions have both measurable and immeasurable mechanisms. This review searched the Medline and Cochrane databases for randomized controlled trials (RCTs) of the use of CAM for obstetric treatment or health promotion. Searches were conducted using numerous pertinent key words and were limited to RCTs that involved humans and that were published in English after January 1, 1986.

Armstrong, Terri/ Cohen, Marlene Z./ Hess, Kenneth R./ Manning, Rochelle/ Lee, Eva Lu T./ Tamayo, Geline/ Baumgartner, Karen/ Min, Sur J./ Yung, Alfred/ Gilbert, Mark. Complementary and Alternative Medicine Use and Quality of Life in Patients with Primary Brain Tumors. Journal of Pain and Symptom Management August 2006, 32(2).
Abstract
This study explored the use of complementary and alternative medicine (CAM) approaches and their relationship with demographic and disease characteristics and quality of life (QOL) in the primary brain tumor (PBT) population. One hundred one PBT patients were enrolled in this study. The results showed that 34% of patients reported using CAM. Fortyone percent reported using more than one type of CAM. The average cost of each CAM used per month was $69, with 20% of patients spending more than $100 per month. The majority (74%) reported that their physicians were unaware of their use of CAM. Data analysis found a higher performance status to be the only factor significantly related to use of CAM therapy (P < 0.005). There was no difference in patient report of QOL between users and nonusers of CAM therapies. The high number of patients who do not report CAM use has potential implications for evaluation of symptoms and response to therapy in this population. This may be especially relevant in those patients with higher functional status participating in clinical trials.

Auerbach, Leo. CAM for men’s health. JMHG June 2006, 3(2), 128–130.
In the past century, conventional (orthodox) medicine has obtained striking and substantial success in defending exogenous as well as endogenous diseases. The rapid development of invasive and non-invasive diagnostics, surgical techniques, therapeutic regimens and new drugs result in an unprecedented life expectancy of mankind.
Quality standards for establishing new therapies have been postulated in the recent decades. According to the concept of evidence based medicine, newly developed therapeutic strategies have to undergo scientific verification applying good clinical practice (GCP). Although complementary therapeutic approaches were set aside due to the first enthusiasm about the success of orthodox medicine, there is an ongoing effort to survey complementary and alternative methods applying the same quality standards as used for conventional medicine. Moreover, topics like quality of life in health and also in chronic disease, preventive medicine and anti-ageing, which are integral fields for complementary medicine, have gained increasing attention among patients and health professionals.

Barry, Christine Ann. The Role of Evidence in Alternative Medicine: Contrasting Biomedical and Anthropological Approaches. Social Science & Medicine 2006, 62, 2646–2657.
Abstract
The growth of alternative medicine and its insurgence into the realms of the biomedical system raises a number of questions about the nature of evidence. Calls for ‘gold standard’ randomised controlled trial evidence, by both biomedical and political establishments, to legitimise the integration of alternative medicine into healthcare systems, can be interpreted as deeply political. In this paper, the supposed objectivity of scientific, biomedical forms of evidence is questioned through an illumination of the multiple rhetorics embedded in the evidence-based medicine phenomenon, both within biomedicine itself and in calls for its use to evaluate alternative therapeutic systems. Anthropological notions of evidence are constructed very differently from those of biomedical science, and offer a closer resonance with the philosophy of alternative medicine. Examples are given of the kinds of evidence produced by anthropologists researching alternative medicine. Ethnographic evidence of ‘what works’ in alternative medicine includes concepts such as transcendent, transformational experiences; changing lived-body experience; and the gaining of meaning. It is proposed that the promotion of differently constructed modes of evidence can be used to legitimise alternative medicine by widening the definition of what works in therapy, and offering a critique of what people feel is lacking from much of orthodox medical care.

Block, Keith I. The Demise of the Super-aspirins: An Opportunity for Integrative Medicine? Integrative Cancer Therapies 2005, 4(1), 7.
The recent findings of significant cardiac risks with longterm use of the selective COX-2 inhibitors and naproxen leave many patients without access to drugs they may depend on for sustained management of pain. These cardiac risks can arise from disturbances in the ratio of prostacyclin and thromboxane A-2. Integrative medicine offers a variety of interventions that do not disrupt this ratio, including herbs, nutriceuticals, mind-body strategies, and physical care. Clinical studies for evaluating these interventions, and research on sustainable production of those that are natural substances, should be given greater funding priority at this time.

Boutros, Akram. How to Make Innovation Happen–Part 1. The Physician Executive March - April 2007.

Breuner, Cora Collette. Alternative and Complementary Therapies. Adolesc Med 2006, 17, 521–546.
Interest in complementary and alternative medicine (CAM) has increased significantly [1–4]. The Cochrane Collaboration describes CAM as ‘‘a broad domain of healing resources that encompasses all health systems, modalities and practices and their accompanying theories and beliefs, other than those intrinsic to the politically dominant health systems in a particular society or culture in a given historical period’’ [5]. As of 1997, 64% of United States medical schools included elective or required CAM courses [6]. Between 1994 and 2010, the number of CAM practitioners in the United States is projected to increase by 88%, and the number of conventional physicians who incorporate CAM into their practices will increase by 16% [7].

Brink-Muinen, A van den/ Rijken, PM. Does trust in health care influence the use of complementary and alternative medicine by chronically ill people? BMC Public Health 2006, 6, 188.
Abstract
Background: People's trust in health care and health care professionals is essential for the effectiveness of health care, especially for chronically ill people, since chronic diseases are by definition (partly) incurable. Therefore, it may be understandable that chronically ill people turn to complementary and alternative medicine (CAM), often in addition to regular care. Chronically ill people use CAM two to five times more often than non-chronically ill people. The trust of chronically ill people in health care and health care professionals and the relationship of this with CAM use have not been reported until now. In this study, we examine the influence of chronically ill people's trust in health care and health care professionals on CAM use.
Methods: The present sample comprises respondents of the 'Panel of Patients with Chronic Diseases' (PPCD). Patients (≥25 years) were selected by GPs. A total of 1,625 chronically ill people were included. Trust and CAM use was measured by a written questionnaire. Statistical analyses were t tests for independent samples, Chi-square and one-way analysis of variance, and logistic regression analysis.
Results: Chronically ill people have a relatively low level of trust in future health care. They trust certified alternative practitioners less than regular health care professionals, and non-certified alternative practitioners less still. The less trust patients have in future health care, the more they will be inclined to use CAM, when controlling for socio-demographic and disease characteristics.
Conclusion: Trust in future health care is a significant predictor of CAM use. Chronically ill people's use of CAM may increase in the near future. Health policy makers should, therefore, be alert to the quality of practising alternative practitioners, for example by insisting on professional certification. Equally, good quality may increase people's trust in public health care.

Brugha, Traolach/ Rampes, Hagen/ Jenkins, Rachel. Surely You Take Complementary and Alternative Medicines? Psychiatric Bulletin 2004, 28, 36-39.
A substantial proportion of our patients use or consider using complementary and alternative medicines (CAM) and other coping strategies. It is important that we acknowledge this, know something about the subject and are aware of current or potential developments in the field. These remedies might be harmless, beneficial or harmful and their side-effects might alter and confuse clinical presentations. We need to be vigilant of the potential for significant drug interactions between complementary and orthodox treatments. There is a substantial growth in complementary and alternative medical research in the USA, now beginning to follow in the UK. This will hopefully bring useful future progress.

Clarke, Juanne N./ Arnold, Stephanie/ Everest, Michelle/ Whitfield, Kyle. The Paradoxical Reliance on Allopathic Medicine and Positivist Science Among Skeptical Audiences. Social Science & Medicine 2007, 64, 164–173.
Abstract
A number of studies have found an association between what people see, hear and read in the mass media and their corresponding actions and beliefs. This link has been demonstrated both at the micro and at the macro levels of analysis. However, when people are asked directly about the impact of mass media they tend to deny that they are personally affected. In fact, they tend to describe themselves as critical and skeptical media consumers. The purpose of this paper is to explore this contradiction through 12 in-depth focus group discussions undertaken in Ontario, Canada in 2004. Findings from the focus group interviews confirm earlier research in that people claimed that they were not susceptible to media influence. At the same time as they said that they took information from the mass media ‘‘with a grain of salt’’, they articulated sophisticated and nuanced accounts of how and why they evaluated some information as good and some as bad. In general they evaluated media stories on the basis of the values of allopathic medicine and positivistic science. Moreover, in the context of the focus groups and their explicit comments on their skepticism, they discussed health information from the magazine articles that they were given to read (on either HIV/AIDS, Alzheimer’s disease, or a heart disease). Possible explanations for these paradoxical findings are discussed.

Cora-Bramble, Denice/ Tielman, Frances/ Wright, Joseph. Traditional Practices, “Folk Remedies,” and the Western Biomedical Model: Bridging the Divide. Clin Ped Emerg Med 2004, 5, 102-108.
“I have always felt that the action most worth watching is not at the center of things but where edges meet. I like shorelines, weather fronts, international borders. There are interesting frictions and incongruities in these places, and often, if you stand at the point of tangency, you can see both sides better than if you were in the middle of either one. This is especially true…when the apposition is cultural.”

Filshie, Jacqueline/ Rubens, Carolyn N.J. Complementary and Alternative Medicine. Anesthesiology Clin N Am 2006, 24, 81–111.

Frye, Ann W./ Sierpina, Victor S./ Boisaubin, Eugene V./ Bulik, Robert J. Measuring What Medical Students Think about Complementary and Alternative Medicine (CAM): A Pilot Study of the Complementary and Alternative Medicine Survey. Advances in Health Sciences Education 2006, 11, 19–32.
Abstract. With increasing national and international support for the development of Complementary and Alternative Medicine (CAM) curricula in American medical schools, it is essential to measure what learners know and believe about CAM in order to assess outcomes of new teaching efforts. This paper describes the development and initial results of a survey designed for those purposes. The survey is constructed so that earlier single-institution studies of students’ attitudes toward CAM topics, preferred ways of learning about CAM, and students’ use of CAM therapies for self-care might be replicated and extended. A pilot test of the Complementary and Alternative Medicine (CAM) Survey was conducted with third-year medical students at the University of Texas Medical Branch. Validity and reliability studies of the survey were conducted. Findings were compared to those of previously published studies. Interpretable subscales were constructed from survey questions. Students’ attitudes toward CAM-related topics were generally favorable. More students were familiar with biological-based therapies than with other CAM therapies. The majority of respondents listed lectures as their preferred way to learn about CAM. Respondents’ own CAM use varied; minority and economically-disadvantaged students were more likely to use CAM therapies than other students. The survey is a promising assessment of student attitudes toward and knowledge of CAM therapies.

Glazer, James. The Ethics of Alternative Medicine: An Alternative Standard? Family Practice Management, April 2005, www.aafp.org/fpm

Growing Interest in Complementary and Alternative Cancer Therapies. CA Cancer J Clin 2004, 54, 285–291.

Hann, Danette/ Allen, Susan/ Ciambrone, Desirée/ Shah, Ann. Patient Satisfaction and Use of Complementary Therapies Use of Complementary Therapies During Chemotherapy: Influence of Patients’ Satisfaction With Treatment Decision Making and the Treating Oncologist. Integrative Cancer Therapies 2006, 5(3), 224-231.
The relationship between the use of complementary therapy (CT) and satisfaction with medical treatment decision making and with the treating oncologist was evaluated in a sample of 166 women who were undergoing an initial course of chemotherapy for early-stage breast cancer. At the beginning of chemotherapy, 39% indicated already trying CT and an additional 13% reported planning to try CT. These women mentioned a variety of vitamin, nutritional, herbal, physical, mental, and spiritual approaches. Four months later, when most patients had completed chemotherapy, more than half (53%) reported using CT, with another 8% planning to try it. Regression analysis controlling for psychosocial and medical variables revealed that women who were younger and less satisfied with their treatment decision making experience were significantly more likely to use CT. When predicting use of CT at the conclusion of treatment, baseline utilization was the greatest predictor, but dissatisfaction with the oncologist was also a significant predictor. These findings suggest that patients who are dissatisfied with their medical care may be more likely to use CT during treatment. Further research is needed to elucidate the relationship between satisfaction with medical decision making and the patient-physician relationship to CT use among cancer patients. The findings also highlight the importance of good patient-physician communication about CT use throughout the cancer treatment experience.

Hemming, Laureen/ Maker, David. Complementary therapies in palliative care: a summary of current evidence. British Journal of Community Nursing, 10(10).
In some areas of care, such as cancer and specialist palliative care, there has been growing interest has in recent years in using complementary therapies (also known as complementary and alternative medicine (CAM)) to improve the quality of life for patients with a terminal illness. In the majority of cases, this happens alongside orthodox medical treatment, rather than as a replacement for it (Ott, 2002; Pearce and Manasse, 2002; Chatwin and Tovey, 2004). Approximately 1 in 4 people use some form of CAM (Farrant, 2003) and approximately 1 in 3 people with cancer will access CAM to help them manage symptoms of the disease or the side-effects of treatment (Chatwin and Tovey, 2004; Pearce and Manasse, 2002). The treatment of cancer and its symptoms is usually based on research and the most recent scientific knowledge, and some authors have expressed surprise that complementary therapies are so widely used in this context (e.g. Chatwin and Tovey, 2004). The assumption is that complementary therapies are not evidence-based. There have been several books written by terminally ill people that highlight the desperation they can feel to be cured (Picardie, 1998), and have been extremely critical of the CAM 'industry', accusing practitioners of exploiting this desperation (Diamond, 2001). The question is whether complementary therapies are more advantageous in symptom management than orthodox treatment and whether there is sufficient evidence to warrant their use?
Abstract
Complementary therapies are often cited as a possible alternative to the management of symptoms in palliative care, as another element in the armoury for coping with unmanageable problems. But how efficacious are these therapies, and what is the evidence to support their use in symptom management? Patients who are in the terminal stages of illness or require palliative care are in a very vulnerable position, so are they being exploited or are there real benefits from using complementary therapies? This article review some of the evidence currently available.

Hendrickson, Darren/ Zollinger, Brett/ McCleary, Roseanna. Determinants of the Use of Four Categories of Complementary and Alternative Medicine. Complementary Health Practice Review January 2006, 11(1), 3-26.
The purpose of this research is to assess the social and health determinants of the use of four separate and distinct categories of complementary and alternative medical therapies: biologically based, mind-body, manipulative, and whole CAM medical systems. The behavioral model of health services use, which holds that health service use is a function of predisposing, enabling, and need characteristics, is used as the theoretical framework for linking specific determinants with the four categories of CAM use. Data are taken from a statewide interview survey of Kansas adults (N = 2,166) conducted in 2001.
Results from multivariate analyses demonstrate that there is variation in the determinants of the use of different categories of CAM therapies. Overall, the results indicate that future research on the determinants of CAM must delineate between various CAM therapies to gain an accurate portrayal of the factors contributing to CAM use.

Julliard, Kell/ Klimenko, Elena/ Jacob, Mary S. Definitions of Health Among Healthcare Providers. Nursing Science Quarterly July 2006, 19(3), 265-271.
Providers’ definitions of health may affect the kind of care they provide. This study examined healthcare practitioners’ definitions of health across practitioner types. Interviews with 73 healthcare practitioners were analyzed for themes. Most practitioners identified health as the interrelatedness of several factors. Physical, mental, and spiritual factors all played important roles. Mainstream and integrative practitioners emphasized health as good functioning, absence of disease, and chronic disease under control. Integrative and alternative practitioners emphasized health as balance and as the free flow of elements such as motion and energy. All types of practitioners freely combined elements from models of health described as separate in the literature. Understanding providers’ definitions of health could enhance communication among them.

Kaptchuk, Ted J./ Miller, Franklin G. Viewpoint: What is the Best and Most Ethical Model for the Relationship Between Mainstream and Alternative Medicine: Opposition, Integration, or Pluralism? Academic Medicine 2005, 80, 286–290.
Abstract
Despite radical improvements in medicine over the past 60 years, patients maintain multiple health care pathways that include high utilization of unconventional treatments. The authors examine three possible relationships between mainstream and alternative medicine: opposition, integration, and pluralism. Opposition, the traditional ethical position that the medical profession must eradicate unconventional medicine for the good of the patient, has withered away. Integration of mainstream and alternative medicine is increasingly advocated in tandem with hospital-based programs that amalgamate the use of conventional and alternative therapies. While advocates of integrative medicine often speak of evidence-based” complementary and alternative medicine (CAM), integration fosters double standards for validating conventional and unconventional treatments. Integration also ignores unbridgeable epistemological beliefs and practices between mainstream and alternative medicine. Pluralism, which has been relatively ignored, calls for cooperation between the different medical systems rather than their integration. By recognizing the value of freedom of choice in medical options, pluralism is compatible with the principle of patient autonomy. Nonetheless, the pluralistic model does not amount to a relativistic stance according in which there would be no objective standards for comparing the therapeutic merit of conventional and CAM treatments. As an ethical model, pluralism realizes that physicians must be prepared to disagree with patient choices to pursue alternative therapies, and urge patients not to forgo medically indicated treatment. Pluralism encourages cooperation, research, and open communication and respect between practitioners despite the possible existence of honest disagreement, and preserves the integrity of each of the treatment systems involved.

Kligler, Benjamin/ Lee, Roberta. Integrative Medicine: Principles for Practice, New York, NY: McGraw-Hill 2004.

Kung, Christine C. Defining a Standard of Care in the Practice of Acupuncture. American Journal of Law & Medicine 2005, 31, 117-130.

Lafferty, William E./ Tyree, Patrick T./ Bellas, Allen S./ Watts, Carolyn A./ Lind, Bonnie K./ Sherman, Karen J./ Cherkin,  Daniel C./ Grembowski, David E.  Insurance Coverage and Subsequent Utilization of Complementary and Alternative Medicine Providers. Am J Manag Care 2006, 12, 397-404.
Background: Since 1996, Washington State law has required that private health insurance cover licensed complementary and alternative medicine (CAM) providers.
Objective: To evaluate how insured people used CAM providers and what role this played in healthcare utilization and expenditures.
Study Design: Cross-sectional analysis of insurance enrollees from western Washington in 2002.
Methods: Analysis of insurance demographic data, claims files, benefit information, diagnoses, CAM and conventional provider utilization, and healthcare expenditures for 3 large health insurance companies.
Results: Among more than 600 000 enrollees, 13.7% made CAM claims. This included 1.3% of enrollees with claims for acupuncture, 1.6% for naturopathy, 2.4% for massage, and 10.9% for chiropractic. Patients enrolled in preferred provider organizations and point-of-service products were notably more likely to use CAM than those with health maintenance organization coverage. The use of CAM was greater among women and among persons 31 to 50 years of age. The use of chiropractic was more frequent in less populous counties. The CAM provider visits usually focused on musculoskeletal complaints except for naturopathic physicians, who treated a broader array of problems. The median per-visit expenditures were $39.00 for CAM care and $74.40 for conventional outpatient care. The total expenditures per enrollee were $2589, of which $75 (2.9%) was spent on CAM.
Conclusions: The number of people using CAM insurance benefits was substantial; the effect on insurance expenditures was modest. Because the long-term trajectory of CAM cost under third party payment is unknown, utilization of these services should be followed.

Lind, Bonnie K./ Abrams, Chad/ Lafferty, William E./ Diehr, Paula K./ Grembowski, David E. The Effect of Complementary and Alternative Medicine Claims on Risk Adjustment. Medical Care December 2006, 44(12).
Objective: We sought to assess how the inclusion of claims from complementary and alternative medicine (CAM) providers affects measures of morbidity burden and expectations of health care resource use for insured patients.
Methods: Claims data from Washington State were used to create 2 versions of a case-mix index. One version included claims from all provider types; the second version omitted claims from CAM providers who are covered under commercial insurance. Expected resource use was also calculated. The distribution of expected and actual resource use was then compared for the 2 indices.
Results: Inclusion of claims from CAM providers shifted 19,650 (32%) CAM users into higher morbidity categories. When morbidity categories were defined using claims from all providers, CAM users in the highest morbidity category had average (+ SD) annual expenditures of $6661 (+ $13,863). This was less than those in the highest morbidity category when CAM provider claims were not included in the index ($8562 +  $16,354), and was also lower than the highest morbidity patients who did not use any CAM services ($8419 + $18,885).
Conclusions: Inclusion of services from CAM providers under third-party payment increases risk scores for their patients but expectations of costs for this group are lower than expected had costs been estimated based only on services from traditional providers. Risk adjustment indices may need recalibration when adding services from provider groups not included in the development of
the index.

Lipson, Juliene G./ Dibble, Suzanne L. Culture & Clinical Care. San Francisco, Calif: UCSF Nursing Press; 2005.
This book is based on the premise that healthcare providers who are culturally aware, sensitive to others’ needs, and knowledgeable in appropriate cross-cultural healthcare are likely to have successful outcomes when they care for culturally diverse clients. The book is written for healthcare providers to identify cultural issues that may affect healthcare. With chapters on European American groups, this book is a newer edition to Culture Care & Nursing Care: A Pocket Guide by the same editors.
The introduction lays the foundation for further discussion among clinicians in respect to the importance of culture and its relationship to delivering appropriate cross-cultural healthcare. Sources of diversity, such as immigrant status, race or ethnicity, socioeconomic class, sexual orientation, disability, and communication patterns, are described. Examples that demonstrate how these sources apply to specific cultural groups are provided. The editors make it clear that clients who are the experts of their own “lives, culture, and experiences” are the most important sources of cultural assessment data.

Milton, Julie. The impact of complementary therapy on mainstream practice. International Journal of Palliative Nursing, 2006, 12(3).
Complementary therapies refer to a wide range of health interventions originating from different cultures across thousands of years of history. They take a holistic approach to patient care where physical, psychological, social and spiritual factors are taken into account.
Ernst et al (1995) define complementary medicine as including all such practices and ideas which are outside the domain of conventional medicine. Complementary medicine is defined by its users as preventing or treating illness, or promoting health and well-being. These practices complement mainstream medicine by: contributing to a common whole; satisfying a demand not yet met by conventional practices; and diversifying the conceptual framework of medicine (Ernst et al, 1995).

Montalto, Catherine P./ Bhargava, Vibha/ Hong, Gong Soog. Use of Complementary and Alternative Medicine by Older Adults: An Exploratory Study. Complementary Health Practice Review January 2006, 11(1), 27-46.
Determinants of complementary and alternative medicine (CAM) use and characteristics of users are examined using a sample of 848 adults aged 50 and older from the 2000 Health and Retirement Survey. Logistic regression is used to identify the factors associated with the likelihood of using CAM. Nearly 70% of the respondents use at least one CAM modality, with 44% reporting use of curative CAM and 58% reporting use of preventive/curative CAM. Whites, relative to Blacks, were more likely to use curative and less likely to use preventive/curative CAM. Widowed older adults were more likely to use preventive/curative CAM. Number of limitations in activities of daily living was positively associated with use of both types of CAM. Recommendations are made for improving research on alternative health care utilization, for educating CAM users, and for qualitative studies to gain further insight into factors affecting the use of specific CAM modalities.

Nelson, Jenenne P. Being in Tune With Life Complementary Therapy Use and Well-Being in Residential Hospice Residents. Journal of Holistic Nursing September 2006, 24(3), 152-161.
Complementary therapies are commonly used by the public. Increasingly, complementary therapies are being used in hospices for symptom management; however, little research is available on their effect on patient well-being.
Purpose: This study explores experiences of 15 hospice residents who received complementary therapies and describes the hospice cultural patterns where complementary therapies were delivered.
Method: Ethnography was used to guide data collection. Data were collected by participant observations, formal and informal interviews, and complementary therapy charts in a residential hospice during 9 months.
Findings: Three themes of experiencing complementary therapies, reconnecting to life through caring, and presence in relationship were uncovered during data analysis.
Implications: Study results suggest that presence may be more important to the patient’s well-being than the physical responses of complementary therapies. Also, a caring culture may influence staff job satisfaction and retention.

New Developments in the Realm of Complementary Medicine. First International Conference of the Society of Integrative Oncology. The Journal of Supportive Oncology Observations May-June 2005, 3(3), 238-246. www.SupportiveOncology.net

Nichols, Andrew W./ Harrigan, Rosanne. Complementary and Alternative Medicine Usage by Intercollegiate Athletes. Clin J Sport Med 2006, 16, 232–237.
Objective: The purpose of this study is to determine the prevalence and types of provider-delivered complementary and alternative medicine (CAM) used by intercollegiate student athletes attending a Division I NCAA University.
Design and Setting: Survey methodology within a group of intercollegiate student athletes at a Division I NCAA university during the fall semester of 2004.
Participants: All incoming and returning intercollegiate student athletes were invited to participate. Surveys were completed by 309 (122 women, 187 men) of 482 (64.1%) student athletes representing 20 sports (11 women’s, 9 men’s teams).
Main Outcome Measurements: A 28-item reliable and valid survey instrument that measured the use of provider delivered CAM and allopathic medical care was administered. Data were analyzed using descriptive statistics, x² tests, and logistic regressions.
Results: Fifty-six percent of subjects reported using CAM within the past 12 months, including a significantly higher percentage of women (67%) than men (49%) (P<0.01). Massage was the most commonly used type (38%), followed by chiropractic (29%), Lomilomi (14%), and acupuncture (12%). CAM usage overall did not differ significantly by sport, year in college, nor ethnicity. Hawaiian, Samoan, and Tongan subjects were more likely to use the Hawaiian-originated forms of CAM. Sixty percent of respondents have a regular medical doctor, eighty percent of which are family practitioners. Forty-two percent of subjects were referred to a medical specialist within the previous three years.
Conclusions: CAM usage is common among collegiate student athletes and rates are higher than in adults nationwide and within the state of Hawai. This study and future investigations will increase the awareness of CAM use patterns by collegiate athletes, and hopefully improve allopathic physicians’ abilities to provide optimal athletic health care.

Pearson, Nancy J./ Johnson, Laura Lee/ Nahin, Richard L. Insomnia, Trouble Sleeping, and Complementary and Alternative Medicine Analysis of the 2002 National Health Interview Survey Data. Arch Intern Med. 2006, 166, 1775-1782.
Background: Insomnia and other disorders that result in trouble sleeping are common in the United States and are often associated with chronic health conditions. Some individuals with insomnia or trouble sleeping use complementary and alternative medicine (CAM) therapies to treat their condition, but the prevalence of such use and the most common types of CAM therapies selected are not known.
Methods: Prevalence of insomnia or trouble sleeping and of CAM use for treating such conditions was examined using the 2002 National Health Interview Survey. Logistic regression was used to examine associations between insomnia or trouble sleeping, comorbid conditions, and use of CAM treatments.
Results: The 12-month prevalence rate of insomnia or trouble sleeping was 17.4%. There was a strong positive association between adults who reported having insomnia or trouble sleeping and adults who reported 4 of 5 common conditions: obesity (adjusted odds ratio [OR], 1.15; 99% confidence interval [CI], 1.01-1.31), hypertension (OR, 1.32; 99% CI, 1.16-1.51), congestive heart failure (OR, 2.24; 99% CI, 1.60-3.14), and anxiety or depression (OR, 5.64; 99% CI, 5.07-6.29). Of those with insomnia or trouble sleeping, 4.5% used some form of CAM therapy to treat their condition.
Conclusions: According to the National Health Interview Survey analysis, over 1.6 million civilian, noninstitutionalized adult US citizens use CAM to treat insomnia or trouble sleeping. The details of this analysis will serve as a guide for future research on CAM therapies for sleep disorders.

Rakel, David P./ Faass, Nancy. Complementary Medicine in Clinical Practice. Sudbury, MA: Jones and Bartlett Publishers 2006.
Complementary Health Practice Review, 10(3), October 2005, 211-212.
This eminently practical resource targets mainstream health professionals at a time when complementary and alternative therapies and services are increasingly being utilized in the United States and other Western countries, often in addition to, rather than instead of, conventional health care. The book is designed to introduce conventional practitioners, particularly physicians, to an integrative approach to healing and to familiarize them with the range of therapeutic options available for integration.
The book is well organized into 10 major sections: expanding the continuum of care, clinical nutrition, exercise and fitness, mind-body medicine, self-care, therapeutic massage, acupuncture, chiropractic, herbal therapy, and models of integrative medicine.
Within these sections, 70 chapters written by 63 contributors who are experts in various aspects of complementary and integrative care present a range of perspectives and topics useful to the practicing health professional.

Samdup, Dawa Z./ Smith,  Ronald G./ Song, Soon Il. The Use of Complementary and Alternative Medicine in Children with Chronic Medical Conditions. Am J Phys Med Rehabil 2006, 85, 842–846.
Abstract
Objectives: The objectives of this study were to examine whether progressive medical conditions lead to greater use of complementary and alternative medicine (CAM) as compared with more stable conditions, to see whether disease severity influences CAM use, and to identify the main motivations behind CAM use.
Methods: Subjects were selected from outpatient clinics at Hotel Dieu Hospital. Surveys were conducted by mail and telephone. Medical diagnosis and severity were obtained from medical files. Statistical tests included x², Kruskal-Wallis, and correlations.
Results: One hundred ninety-four children were surveyed. The “progressive” group included 15 patients with Duchenne muscular dystrophy and 22 patients with cystic fibrosis. The “nonprogressive” group included 85 patients with cerebral palsy (CP), 49 with diabetes mellitus, and 23 with spina bifida. Twenty-three percent were using CAM. CP had the highest use; diabetes mellitus had the lowest. Popular therapies included massage and dietary/herbal remedies. Progressiveness had no impact on CAM use. Within the CP group, greater disease severity was associated with higher use (P < 0.001). The main reason for CAM use was to complement conventional medicine.
Conclusions: Disease progressiveness had no impact on CAM use, but severity within the CP group did. Complementing conventional medicine was the main motive. Understanding the reasons and patterns of use of CAM is beneficial in efforts to improve the care of children with chronic medical conditions.

Sawni, Anju/ Ragothaman, Ramesh/ Thomas, Ronald L./ Mahajan, Prashant. The Use of Complementary/Alternative Therapies Among Children Attending an Urban Pediatric Emergency Department. Clinical Pediatrics 2007, 46, 36.
The incidence of and factors associated with complementary/alternative medicine use by pediatric patients was determined by face-to-face interviews with 602 parents/caregivers of children aged birth to 18 years who presented to an urban pediatric emergency department from February 2004 to September 2004. The overall use of complementary/alternative medicine among children was 15% and more common among children older than 5 years (21%). Families who used complementary/alternative medicine thought results were best when both complementary/alternative medicine and conventional medicine were integrated (P < .001). Most common types of complementary/alternative therapies used were folk remedies/home remedies (59%), herbs (41%), prayer healing (14%), and massage therapy (10%). Complementary/alternative medicine use was significant among the sample of children visiting an urban pediatric emergency department. Pediatricians should inquire about complementary/alternative use in the emergency department, particularly in children older than 5 years and those with parents/caretakers using complementary/alternative medicine themselves.

Shmueli, Amir/ Shuval, Judith. Are Users of Complementary and Alternative Medicine Sicker than Non-Users? eCAM 2006, 1-5.
Higher utilization of complementary and alternative medicine (CAM), both in cross-sections and over time, is commonly related to better socioeconomic status and to increased dissatisfaction with conventional medicine and its values. Little is known about health differences between users and nonusers of CAM. The objective of the paper is to explore the difference in health measured by the SF-36 instrument between users and non-users of CAM, and to estimate the relative importance of the SF-36 health domains scales to the likelihood of consulting CAM providers. Interviews were used to collect information from a sample of 2000 persons in 1993 and 2500 persons in 2000, representing the Israeli Jewish urban population aged 45–75 in those years. Bivariate and logistic regression analyses were used to explore the above associations. The results show that while users of CAM enjoy higher socioeconomic status and younger age, they tend to report worse health than non-users on the eight SF-36 health domains scales in both years. However, controlling for personal characteristics, lower scores on the bodily pain, role-emotional and vitality scales are related to greater likelihood of CAM use in 2000.
In 1993, no scale had a significant adjusted association with the use of CAM. The conclusions are that CAM users tend to report worse health. With CAM becoming a mainstream, though somewhat luxurious, medical practice, pain and affective-emotional distress are the main drivers of CAM use.

Sunter, Ahmet Tevfik/ Guz, Hatice/ Ozkan, Aysen/ Peksen, Yildiz. The Search for Non-Medical Treatment by Patients with Psychiatric Disorders. Journal of Religion and Health Fall 2006, 45(3).
Abstract: Patients in Turkey frequently seek help from non-physicians such as hodjas and fortune-tellers. The aim of this study is to assess the prevalence, reasons for and results of the search for non-medical help by patients with psychiatric disorders. It was determined that 42.2% of patients consulted a hodja or a fortune-teller, and many (23.1%) were either the subject of prayers or else were advised to pray themselves as treatment. Considering that a significant number of patients seek non-medical treatment, it is thought that people should be informed about psychiatric disorders, therapies, and how to obtain them.

Toveya, P./ Adams, Jon. Comment on: ‘‘Conceptualizing mainstream health care providers’ behaviours in relation to complementary and alternative medicine’’ by Hirschkorn and Bourgeault. Social Science & Medicine 2006, 63, 563–565.

Traynor, Kate. Report Urges Scientific Standards for Alternative Medicine. Am J Health-Syst Pharm Mar 15, 2005, 62.

Venesy, Deborah A. Physical Medicine and Complementary Approaches. Neurol Clin 2007, 25,  523–537.

Why Integrative Therapies? Integrative Cancer Therapies 2006, 5(1).

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