Elad Schiff

Publications (35)94.48 Total impact

• Article: Integrating complementary medicine in supportive cancer care models across four continents.

  Eran Ben-Arye, Elad Schiff, Catherine Zollman, Peter Heusser, Pablo Mountford, Moshe Frenkel, Gil Bar-Sela, Ofer Lavie
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  ABSTRACT: The need to integrate complementary medicine (CM) consultation in supportive care of patients with cancer is acknowledged by oncologists owing to the ongoing research on CM efficacy and awareness of its potential risks. In this article, we aim to provide oncologists with models for CM integration within supportive care. Descriptive analysis of key elements which facilitate CM integration is presented by physicians leading six integrative cancer care programs across four continents. Perspectives of integration are supplemented by a literature review, quantitative data on the clinical activity in each center, and qualitative narrative-based citations of seven oncology patients and healthcare providers. It is recommended that CM consultation be provided by physicians with extensive CM training. The following key elements were identified as essential for integrative program design within oncological supportive care: (1) Location of the integrative physician (IP) room within the oncology department area, (2) Required oncologist referral to CM consultation, (3) Allocated time to IP-oncologist communication, (4) Research-based integrative practice, (5) Inclusion of paid professional CM practitioners, (6) Institutional cost covered service. Integration of CM consultation within oncological supportive care needs to take in account six key elements that ensure high-quality evidence-based concomitant integrative practice.
  Medical Oncology 06/2013; 30(2):511. · 2.14 Impact Factor
• Article: Advising Patients on the Use of Non-Herbal Nutritional Supplements During Cancer Therapy: A Need for Doctor-Patient Communication.

  Eran Ben-Arye, Aaron Polliack, Elad Schiff, Tamar Tadmor, Noah Samuels
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  ABSTRACT: CONTEXT: Many cancer patients are using non-herbal nutritional supplements (NHNS), often without informing their oncologists. OBJECTIVES: To review the literature and summarize the beneficial effects and safety of NHNS in the prevention and reduction of treatment-related symptoms. METHODS: Databases were searched for randomized, controlled clinical trials (Jadad score ≥ 2) using AltHealthWatch, Cochrane Database of Systematic Reviews, Embase, MEDLINE, Memorial Sloan-Kettering Integrative Medicine Service Database, Natural Standard Database, and PubMed. The key words searched were the following: alternative and/or complementary medicine, nutritional and/or dietary supplements, quality of life, symptoms and/or side effects, specific toxicities (e.g., neuropathy, mucositis), and specific supplements (e.g., vitamin E, glutamine, etc.). RESULTS: A number of NHNS products were found to be effective. The incidence and severity of peripheral sensory neuropathy associated with taxane-agents such as paclitaxel can be reduced with vitamin E, glutamine, and acetyl-L-carnitine. Vitamin E and glutamine also have been shown to reduce oral mucositis resulting from radiation and chemotherapy, and glutamine and probiotics can reduce chemotherapy-induced diarrhea. CONCLUSION: There is a need to develop an open and nonjudgmental dialogue between oncologists and cancer patients, addressing the needs of the patient while dealing with issues related to the efficacy and safety of these products. Referral of patients to an integrative medicine consultant may help achieve these goals, providing both parties with the option of reaching an informed and respectful decision about treatment.
  Journal of pain and symptom management 05/2013; · 2.42 Impact Factor
• Article: We and They in the House of Healing: Debate Among Arab Complementary Medicine Practitioners on an Integrative Versus Alternative Approach to Supportive Cancer Care.

  Ariela Popper-Giveon, Elad Schiff, Eran Ben-Arye
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  ABSTRACT: PURPOSE: Complementary and traditional medicine (CTM) plays an important role in culture-centered care for cancer patients in the Middle East. In this article, we have studied the attitudes of Arab CTM therapists concerning integration of complementary medicine within the conventional supportive cancer care of Arab patients in northern Israel. METHODS: Semistructured interviews were held with 27 Arab therapists who use medicinal herbs, the Quran, and various CTM modalities, with the aim of characterizing their treatment practices and learning about their perspectives regarding conventional cancer care. RESULTS: We first summarized the different characteristics of the various CTM therapists, including training, typical practice, and so on. Thematic analysis revealed that folk healers and complementary medicine therapists describe their role as supportive and secondary to that of physicians. Their goal was not to cure patients with cancer but rather to enhance their quality of life by reducing the severity of both the disease symptoms and the side effects of cancer treatment. Religious healers, by contrast, purport to cure the disease. While folk healers opt for parallel alternative care and complementary therapists support integrative care, religious healers claimed that they offer an alternative to conventional medicine in terms of both etiology and practice. CONCLUSIONS: The majority of Arab CTM therapists support integration of their treatments with the conventional system, but in practice, they are not sure how to bring about this change or create a parallel model in which 2 different systems are active, but not integrated. Our findings emphasized the need to promote doctor-CTM practitioner communication based on structured referral and bidirectional consultation. Moreover, we recommend intensifying research on the efficacy and safety of CTM in the Middle East and the potential role in promoting culture-based supportive care.
  Integrative Cancer Therapies 04/2013; · 2.14 Impact Factor
• Article: The use of boundary objects to enhance interprofessional collaboration: integrating complementary medicine in a hospital setting.

  Yael Keshet, Eran Ben-Arye, Elad Schiff
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  ABSTRACT: Because of the inherent complexity of human health, the provision of good quality patient care requires collaboration in multidisciplinary teams. Integrative healthcare provides a unique setting for the study of interprofessional collaboration in the context of power disparities. The research objective was to examine which means and mechanisms were used to facilitate interprofessional collaboration when integrating complementary medicine (CM) into a hospital's surgical department. Throughout 2010 we conducted a qualitative study in an Israeli public hospital's surgical department, using observations and 30 in-depth interviews with managers, surgeons, physicians, nurses, patients and CM practitioners. The sociological concepts of boundary actor and boundary object and the context of power relations served as a framework for this research. This article contributes to the field of interprofessional collaborative care research by: analysing types of collaboration inhibitors - epistemological and social-structural gaps; pointing to boundary actors who establish interprofessional collaboration in an integrative hospital setting and noting the boundary objects they use; and comparing collaboration levels. The collaboration between CM practitioners and the department's staff is a loosely coupled system. When coordination was achieved, reaching profound agreements seemed of lesser importance to the parties. Closer collaboration and cross-fertilisation were found among CM practitioners.
  Sociology of Health & Illness 09/2012; · 1.88 Impact Factor
• Article: Integrating complementary medicine and supportive care: patients' perspectives toward complementary medicine and spirituality.

  Eran Ben-Arye, Elad Schiff, Haya Vintal, Olga Agour, Liora Preis, Mariana Steiner
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  ABSTRACT: The association of spirituality and complementary and alternative medicine (CAM) in oncology is unfolding as a research theme that may have practical implications in supportive care. The purpose of this study was to explore patients' perspectives regarding CAM and spirituality in order to address their needs in an integrative oncology program. A 27-item questionnaire was developed that was administered by research assistants to a convenience sample of patients attending a community-based oncology service in northern Israel. Of the 509 respondents, 302 (67.4%) were undergoing active oncological treatment and 146 (32.6%) were doing follow-up surveillance. Current and/or previous year CAM use for oncology treatment was reported by 244 of 495 respondents (49%). A logistic regression model indicated that CAM use was associated with younger age, Jewish religion, and higher cancer-related spiritual quest [EXP(B)=2.102, 95% confidence interval for EXP(B) 1.236-3.575, p=0.006]. Compared with patients with lower spiritual quest, CAM users with higher spiritual quest expressed more expectations of CAM counseling in the following themes: improving daily functioning and coping with disease, lessening chemotherapy side-effects, and supporting the patient and family emotionally and spiritually. In addition, they expected their social worker to be more involved in building the CAM treatment plan compared to patients with average spiritual quest (35.3% versus 16.3%, p=0.038). Higher degree of spiritual quest is associated with increased CAM use, and higher expectations from CAM providers and social workers in the context of CAM integration within cancer care.
  Journal of alternative and complementary medicine (New York, N.Y.) 09/2012; 18(9):824-31. · 1.69 Impact Factor
• Article: Chemotherapy-related cognitive impairment: does integrating complementary medicine have something to add? Review of the literature.

  Adva Avisar, Yaron River, Elad Schiff, Gil Bar-Sela, Mariana Steiner, Eran Ben-Arye
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  ABSTRACT: Chemotherapy-related cognitive impairment is a phenomenon of cognitive decline that some patients experience during and after chemotherapy. The prevalence of chemotherapy-related cognitive impairment in cancer survivors ranges from 14 to 85 %. Memory loss and lack of concentration are the most frequent symptoms, often resulting in deterioration of daily functioning and a decreased quality of life. Despite ongoing research on chemotherapy-related cognitive impairment, a clear understanding of the underlying mechanisms of the neurotoxicity induced by chemotherapy and the factors that determine a patient's vulnerability are still lacking. We review current knowledge regarding the etiology of chemotherapy-related cognitive impairment, risk factors, conventional therapy, coping strategies, and potential complementary and integrative medicine treatments. Complementary and integrative medicine modalities that may improve chemotherapy-related cognitive impairment include mind-body techniques and acupuncture, as well as nutrition and herbal therapies. Studies on these modalities have not directly tested the hypothesis of modifying chemotherapy-related cognitive impairment and were done on different disorders of memory loss and lack of concentration. We recommend conducting further research on the potential role of complementary and integrative medicine modalities in the treatment and prevention of chemotherapy-related cognitive impairment.
  Breast Cancer Research and Treatment 08/2012; 136(1):1-7. · 4.43 Impact Factor
• Article: Can holism be practiced in a biomedical setting? A qualitative study of the integration of complementary medicine to a surgical department.

  Yael Keshet, Eran Ben-Arye, Elad Schiff
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  ABSTRACT: In recent decades, complementary medicine (CM) has been increasingly integrated to conventional healthcare organizations, in which the biomedical profession clearly maintains dominance. Our objective was to investigate empirically what integration and 'holism' mean to the diverse professional groups involved and whether treatment becomes more holistic when CM is integrated. A qualitative study was conducted in a general surgery department at a public hospital in Israel. Data were collected by means of observations of medical encounters and daily work, and 30 in-depth interviews with medical directors, surgeons, senior nurses, CM practitioners and hospitalized patients. We found that most of the interviewed nurses, surgeons and directors and some patients believed that CM treatments were of value in addressing the psychological needs of patients within this predominantly somatic-oriented department. To CM practitioners and some of the patients, integration means introducing and practicing a holistic outlook in this biomedical context, which involves elements such as Qi, energy, soul and spirit. Such practices were directed to a suitable audience, namely, patients as well as conventional medical staff who were willing to explore a holistic approach. We concluded that patient care tends to become more comprehensive when CM is integrated. Despite the overall dominance of biomedicine, holistic CM practices were introduced to the biomedical setting of the hospital. Yet, the question whether holistic CM practices and perceptions will eventually lead nurses and physicians toward paradigmatic integration, has still to be examined.
  Health 04/2012; 16(6):585-601. · 2.10 Impact Factor
• Article: I will always be with you: Traditional and complementary therapists' perspectives on patient-therapist-doctor communication regarding treatment of Arab patients with cancer in Israel.

  Ariela Popper-Giveon, Elad Schiff, Eran Ben-Arye
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  ABSTRACT: OBJECTIVE: In 2008, an Integrative Oncology Program was implemented at the Clalit Oncology Service in Haifa, Israel, to promote patients' well-being during chemotherapy and advanced stages of disease. We hypothesized that studying the perceptions of Arab complementary and alternative medicine (CAM) therapists would facilitate development of a cross-culturally integrative oncology approach. METHODS: Semi-structured interviews were held with 27 Arab therapists who use medicinal herbs, the Quran and various CAM modalities, with the aim of characterizing their treatment practices and learning about their perspectives regarding conventional cancer care. RESULTS: Thematic analysis revealed that therapists act as go-betweens, mediating between patients and conventional physicians. Therapists translate diagnoses into Arabic and elucidate key concepts. They tend to perceive their role as gatekeepers accompanying patients through the conventional health system, referring them for further examinations, and providing CAM-based supportive care consultation. CONCLUSIONS: CAM therapists have an essential role in supportive care of Arab patients with cancer. Triangular patient-therapist-oncologist communication may have an impact on patients' experience and treatment quality. PRACTICE IMPLICATIONS: Recognition of CAM therapists as mediators between patients' health beliefs and conventional perceptions of care may improve doctor-patient dialogue and facilitate supportive care provision in a cross-cultural context.
  Patient Education and Counseling 04/2012; · 2.31 Impact Factor
• Article: Perceiving integration of a complementary medicine service within a general surgery department through documentation of consultations: A thematic analysis.

  Elad Schiff, Eran Ben-Arye, Samuel Attias, Gideon Sroka, Ibrahim Matter, Yael Keshet
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  ABSTRACT: OBJECTIVE: This study aims to examine the meaning and practical implications of integration of a complementary medicine-based surgery service in a hospital setting (CISS - Complementary/Integrative Surgery Service) through analysis of consultation reports associated with this service. METHODS: Thematic analysis was used to evaluate CISS consultation reports in a hospital electronic consultant charting system during the first half year of the service's activity. RESULTS: 304 consultation reports were analyzed. Nurses initiated significantly more consultations than physicians (55% vs 7%). Consultation requests were gradually more focused on specific symptoms, possibly manifesting a better understanding of the scope of complementary medicine in the surgery setting. CISS practitioners responded in more biomedical language over time, albeit offering a more holistic perspective regarding patients' needs as well as clarifications regarding the nature of the treatment they provided. CONCLUSIONS: Diverse communication patterns in consultations evolved over time representing dynamics in multiple levels of integration of the CISS. PRACTICE IMPLICATIONS: Documented communication through consultations can provide a window to the process of integration of complementary medicine-based services in health systems.
  Patient Education and Counseling 03/2012; · 2.31 Impact Factor
• Article: Integrating a complementary medicine service within a general surgery department: from contemplation to practice.

  Elad Schiff, Shmuel Attias, Haim Hen, Gur Kreindler, Zahi Arnon, Gideon Sroka, Eran Ben-Arye
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  ABSTRACT: This article describes experience in developing a complementary and alternative medicine (CAM) service within a general surgery department in a public academic hospital in Israel. A framework is suggested for integrating CAM services within a hospital, based on the authors' experience, along three themes: the organizational structure of such a service, communication with the conventional team, and self-appraisal using a research-based documentation and assessment process. With the anticipated increase in CAM utilization within medical institutions, it is hoped this article will provide foundations for successful integration of other such services.
  Journal of alternative and complementary medicine (New York, N.Y.) 03/2012; 18(3):300-5. · 1.69 Impact Factor
• Source

  Available from: Moshe A Frenkel

  Article: Modeling an integrative oncology program within a community-centered oncology service in Israel.

  Eran Ben-Arye, Elad Schiff, Chen Shapira, Moshe Frenkel, Tamar Shalom, Mariana Steiner
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  ABSTRACT: OBJECTIVE: Describing the processes that preceded the opening of an integrative oncology program (IOP) within the oncology service (OS) of the largest health maintenance organization in northern Israel. METHODS: The groundwork towards initiation of the IOP was based on three key elements (1) Interviews with patients, practitioners and directors were performed in order to explore perspectives regarding complementary medicine integration (CM) within the OS; (2) review of research data on CM efficacy and safety in cancer care; (3) critical comparative analysis of seven models of IOPs in Israel, Europe, and the U.S. RESULTS: Ninety-three interviews included 24 patients, 34 conventional practitioners, 9 medical directors, and 26 CM-trained practitioners. The interviews revealed that there is a need for CM in the OS, aimed towards improving patients' well-being during chemotherapy and advanced disease. An integrative oncology score (IOS) was formulated based on 6 themes considered promoters of successful integration. CONCLUSIONS: Integration of CM within an oncology service should address patients' needs and research knowledge and be built upon mandatory practitioners' communication. PRACTICE IMPLICATIONS: IOP modeling necessitates in-depth study aimed at revealing the OS needs and expectations, adjusting research data to the OS clinical challenges, and tailoring an appropriate model of integrative care.
  Patient Education and Counseling 03/2012; · 2.31 Impact Factor
• Source

  Available from: PubMed Central

  Article: Barriers to integration of traditional and complementary medicine in supportive cancer care of arab patients in northern Israel.

  Eran Ben-Arye, Mariana Steiner, Khaled Karkabi, Tamar Shalom, Levava Levy, Ariela Popper-Giveon, Elad Schiff
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  ABSTRACT: In 2008, an Integrative Oncology Program (IOP), aiming to improve patients' quality of life during chemotherapy and advanced cancer, was launched within the Clalit Health Organization's oncology service at the Lin Medical Center, Haifa, Israel. The IOP clinical activity is documented using a research-based registry protocol. In this study, we present an analysis of the registry protocol of 15 Arab patients with cancer who were referred to the IOP. Analysis of patients' reported outcomes using the Edmonton Symptom Assessment Scale suggests that integrative medicine care improves fatigue (P = 0.024), nausea (P = 0.043), depression (P = 0.012), anxiety (P = 0.044), appetite (P = 0.012), and general well-being (P = 0.031). Barriers to integration of traditional and complementary medicine in supportive care of Arab patients are discussed followed by six practical recommendations aimed at improving accessibility of patients to integrative supportive care, as well as compliance with treatments.
  Evidence-based Complementary and Alternative Medicine 01/2012; 2012:401867. · 4.77 Impact Factor
• Article: Binding phylacteries: mind and body meet in the operating room.

  Zahi Arnon, Zeev Loberman, Eran Ben-Arye, Elad Schiff
  Patient Education and Counseling 10/2011; 87(3):291-2. · 2.31 Impact Factor
• Chapter: Evidence-based Anticancer Materia Medica for Lymphoma

  Eran Ben-Arye, Tamar Tadmor, Aaron Polliack, Elad Schiff
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  ABSTRACT: The increasing use of herbal remedies during the course of conventional treatment of patients with lymphoma and other hemato-oncological neoplasms is clearly evident. In this chapter we focus on the in vitro, in vivo data and clinical evidence available about herbs with potential efficacy and their safety as well as those used for centuries in various traditional systems of medicine. Traditional medicine has now become a source for ongoing laboratory research relating to the activity of herbs on cultured human lymphoma cell lines. Although the number of clinical studies on lymphoma is limited, herbs may be a valuable resource for improving patients’ well-being during treatment and can decrease the toxicity induced by chemotherapy and biological agents. Potential benefit and efficacy of Anthroposophic treatment with mistletoe (Viscum album) is readily apparent as with other herbs used in traditional medicine systems in China, Japan, India, the Middle East and other countries. Some small trials in lymphoma have reported complete and partial remissions rates with herbal therapies (e.g. the Chinese herbal remedy Shenqi Fuzheng). Trials with herbs for effective symptom control, including nausea, fatigue, and pain in other types of cancer illustrate their potential in palliative care of patients with lymphoma. Safety issues are also reviewed, as well as, the documented and potential side effects related to these compounds and known herb–drug interactions. We suggest that doctor–patient communication relating to herbal use should be enhanced by adopting a patient-centered attitude, essentially based on scientific perspectives.
  10/2011: pages 171-194;
• Article: Attitudes of patients with gynecological and breast cancer toward integration of complementary medicine in cancer care.

  Eran Ben-Arye, Elad Schiff, Mariana Steiner, Yael Keshet, Ofer Lavie
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  ABSTRACT: The purpose of this study was to explore prospectively the perspectives of patients with breast and gynecological cancers regarding integration of complementary and alternative medicine (CAM) in conventional oncology settings. We developed a 27-item questionnaire that was administered to convenient sample of patients with breast cancer and another with gynecological cancer who were attending a community-based oncology service in northern Israel. Of the 275 respondents, 109 (39.6%) had gynecological cancers and 166 (60.4%) had breast cancer. Current and/or previous year CAM use for oncology treatment was significantly higher among the patients with gynecological cancer (73/166 [44%] vs 67/106 [63%], P = 0.03). A logistic regression model indicated that CAM use was associated with gynecological cancer (EXP [B], 2.51; 95% confidence interval for EXP [B], 1.29-4.88; P = 0.007], younger age, Jewish religion, and lesser degree of religiosity. The patients highly expected their gynecologist-oncologist and family doctor to refer them to CAM counseling. Moreover, they expected their gynecologist-oncologist to participate in building a CAM treatment plan if CAM were to be integrated into the oncology service. The patients expected the CAM consultant to inform them of the safety and efficacy of CAM treatments, emphasizing expectations to strengthen their general ability to cope with the disease, reduce chemotherapy side effects, and provide emotional and spiritual support. Although patients with gynecological malignancies use CAM significantly more than patients with breast cancer, both groups share similar conceptions regarding the active role of their gynecologist oncologists in the process of CAM integration within supportive care and expect CAM consultation to focus on improving their well-being.
  International Journal of Gynecological Cancer 09/2011; 22(1):146-53. · 1.65 Impact Factor
• Article: [Integrating complementary medicine in oncology supportive care: assessment of patients' needs and expectations during chemotherapy].

  Tamar Shalom, Elad Schiff, Mariana Steiner, Michell Katz, Eran Ben-Arye
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  ABSTRACT: During the Last decade complementary medicine is gradually being integrated within conventional oncology care in Western countries. In 2008, an integrative oncology program was implemented within the Clalit Oncology Service (COS) of the Haifa and Western-Galilee district of Clalit Health Organization aiming to promote patients' well-being during chemotherapy and in advanced disease. To identify needs and distress of patients with regard to combining complementary medicine with the supporting treatment for improvement of quality of life. A study using semi-constructed interviews with 31 patients during chemotherapy was performed at two outpatient oncology centers of the Clalit HMO in northern Israel. Most participants reported significant deterioration in their quality of life during chemotherapy, mainly related to fatigue, work cessation and mood disorder. Interest in complementary medicine significantly correlated with the participants' awareness of the mind-body connection. Most participants reported on their interest to consult with physicians specializing in complementary medicine as an integral part of the oncology service care. The most favorable complementary therapies reported by patients were nutritional counseling, herbal medicine and traditional healing. Asking patients during chemotherapy on their beliefs regarding mind and body connections may be used as a screening question to identify patients interested in experiencing complementary therapies. Integrating physician counseling regarding complementary medicine within the oncology service may address patients' needs and concerns by matching therapies to specific symptoms and chemotherapy side-effects.
  Harefuah 08/2011; 150(8):642-5, 689.
• Source

  Available from: mohammed saleem ali-shtayeh

  Article: Integrative oncology research in the Middle East: weaving traditional and complementary medicine in supportive care.

  Eran Ben-Arye, Mohammed Saleem Ali-Shtayeh, Mati Nejmi, Elad Schiff, Esmat Hassan, Kamer Mutafoglu, Fatma U Afifi, Rana Majed Jamous, Efraim Lev, Michael Silbermman
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  ABSTRACT: Complementary and alternative medicine (CAM) has an important role in supportive cancer care in the Middle East and is often used in association with traditional medicine. This article provides a comprehensive review of published data on CAM research in supportive cancer care in the Middle East. A multi-disciplinary Middle-Eastern Research Group in Integrative Oncology (MERGIO) was established in six countries. Authors independently searched Medline database for articles in Arabic, Hebrew, French, and Turkish using oncology and CAM-related keywords. Articles were recorded according to the first author's affiliation with an academic or clinical institution in the Middle East. We identified 143 articles on CAM and cancer care that had been published in 12 Middle-Eastern countries. Eighty-five articles were directly related to cancer supportive care. The latter included studies on the prevalence of CAM use by patients with cancer, aspects related to of doctor-patient communication, ethics and regulation, psychosocial aspects of CAM, CAM safety and quality assurance, studies of CAM education for health care providers, and ethno-botanical studies and reviews. Twenty-eight articles referred to clinical research on supportive care, and the use of specific CAM modalities that included acupuncture, anthroposophic medicine, dietary and nutritional therapies herbal medicine, homeopathy, mind-body medicine, shiatsu, therapeutic touch, and yoga. CAM-related supportive care research is prevalent in the Middle East, a fact that may serve as a basis for future multinational-multidisciplinary research work in supportive care in oncology.
  Supportive Care in Cancer 03/2011; 20(3):557-64. · 2.09 Impact Factor
• Article: Exploring association of spiritual perspectives with complementary medicine use among patients with Type 2 diabetes in Israel.

  Eran Ben-Arye, Elad Schiff, Khaled Karkabi, Yael Keshet, Efraim Lev
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  ABSTRACT: Spirituality, as distinct from religiosity, has become a most common term in complementary and alternative medicine (CAM) discourse. The association between religiosity and spirituality in the context of CAM use is a complex one and is worthy of being researched in specific local cultural contexts. Exploring the association between CAM use and religiosity, in patients with and without diabetes Type 2 attending primary care clinics in Northern Israel. Research assistants administered a questionnaire developed to assess CAM use in primary care to a convenience sample of patients attending seven primary care clinics. Of the 3742 respondents, 485 (12.9%) reported having Type 2 diabetes. Respondents with diabetes reported more overall CAM use during the previous year (46.9% vs. 42%, P=0.049). A logistic regression model of patients with diabetes Type 2 indicated that CAM use was associated with higher self-assessed religiosity [Exp(B)=1.898, 95% CI for Exp(B) 1.02-3.529, P=0.043]. CAM use among patients with diabetes was also associated more with female gender, higher education, and age under 60. The positive association between CAM use and degree of self-assessed religiosity was further studied in sub-populations of Jewish and Arab patients with diabetes Type 2. A logistic regression model of the Jewish population indicated significant association between CAM use and higher religiosity [Exp(B)=3.668, 95% CI for Exp(B) 1.232-10.922, P=0.02]. Primary care physicians need to be aware of a possible association between religiosity and CAM use in patients with diabetes. Physicians may consider adding questions on CAM and religiosity to routine clinical interviews in order to enrich their dialog with diabetes patients.
  Ethnicity and Health 02/2011; 16(1):1-10. · 1.64 Impact Factor
• Article: Touching ethics: assessing the applicability of ethical rules for safe touch in CAM--outcomes of a CAM (complementary and alternative medicine) practitioner survey in Israel.

  Elad Schiff, Eran Ben-Arye, Margalit Shilo, Moti Levy, Leora Schachter, Na'ama Weitchner, Ofra Golan, Julie Stone
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  ABSTRACT: Recently, ethical guidelines regarding safe touch in CAM were developed in Israel. Publishing ethical codes does not imply that they will actually help practitioners to meet ethical care standards. The effectiveness of ethical rules depends on familiarity with the code and its content. In addition, critical self-examination of the code by individual members of the profession is required to reflect on the moral commitments encompassed in the code. For the purpose of dynamic self-appraisal, we devised a survey to assess how CAM practitioners view the suggested ethical guidelines for safe touch. We surveyed 781 CAM practitioners regarding their perspectives on the safe-touch code. There was a high level of agreement with general statements regarding ethics pertaining to safe touch with a mean rate of agreement of 4.61 out of a maximum of 5. Practitioners concurred substantially with practice guidelines for appropriate touch with a mean rate of agreement of 4.16 out of a maximum of 5. Attitudes toward the necessity to touch intimate areas for treatment purposes varied with 78.6% of respondents strongly disagreeing with any notion of need to touch intimate areas during treatment. 7.9% neither disagreed nor agreed, 7.9% slightly agreed, and 7.6% strongly agreed with the need for touching intimate areas during treatment. There was a direct correlation between disagreement with touching intimate areas for therapeutic purposes and agreement with general statements regarding ethics of safe touch (Spearman r=0.177, p<0.0001), and practice guidelines for appropriate touch (r=0.092, p=0.012). A substantial number of practitioners agreed with the code, although some findings regarding the need to touch intimate area during treatments were disturbing. Our findings can serve as a basis for ethical code development and implementation, as well as for educating CAM practitioners on the ethics of touch.
  Complementary therapies in medicine 02/2011; 19(1):12-8. · 1.95 Impact Factor
• Source

  Available from: PubMed Central

  Article: Treatment of upper respiratory tract infections in primary care: a randomized study using aromatic herbs.

  Eran Ben-Arye, Nativ Dudai, Anat Eini, Moshe Torem, Elad Schiff, Yoseph Rakover
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  ABSTRACT: This study is a prospective randomized double-blind controlled trial whose aim was to investigate the clinical effects of aromatic essential oils in patients with upper respiratory tract infections. The trial was conducted in six primary care clinics in northern Israel. A spray containing aromatic essential oils of five plants (Eucalyptus citriodora, Eucalyptus globulus, Mentha piperita, Origanum syriacum, and Rosmarinus officinalis) as applied 5 times a day for 3 days and compared with a placebo spray. The main outcome measure was patient assessment of the change in severity of the most debilitating symptom (sore throat, hoarseness or cough). Sixty patients participated in the study (26 in the study group and 34 in the control group). Intention-to-treat analysis showed that 20 minutes following the spray use, participants in the study group reported a greater improvement in symptom severity compared to participants in the placebo group (P = .019). There was no difference in symptom severity between the two groups after 3 days of treatment (P = .042). In conclusion, spray application of five aromatic plants reported in this study brings about significant and immediate improvement in symptoms of upper respiratory ailment. This effect is not significant after 3 days of treatment.
  Evidence-based Complementary and Alternative Medicine 01/2011; 2011:690346. · 4.77 Impact Factor