Objectives Naturopathy is a traditional medicine system informed by codified philosophies and principles, and an emphasis on non-pharmacologic therapeutic interventions. While naturopathy is practised by approximately 75 000–100 000 000 naturopathic practitioners in at least 98 countries, little is known about the international prevalence of history of consultation with a naturopathic practitioner. This study reports a systematic review and meta-analysis of studies describing the global prevalence of history of consultation with a naturopathic practitioner by the general population. Setting The included literature was identified through a systematic search of eight databases between September and October 2019, as well as the grey literature. Participants Studies were included if they reported the prevalence rate of consultations with a naturopathic practitioner by the general population. Interventions Survey items needed to report consultations with a naturopathic practitioner as defined in the country where data was collected, and not combine naturopathic consultations with other health services or only report consulations for illness populations. Primary and secondary outcome measures Primary measures used for the analysis was consultations in the previous 12 months. Other prevalence timeframes were reported as secondary measures. Methods Meta-analysis of prevalence data was conducted using random effects models based on individual countries and WHO world regions. Results The literature search identified eight manuscripts summarising 14 studies reporting prevalence for inclusion in the review. All included studies had a low risk of bias. Meta-analysis of the included studies by world region found the 12-month prevalence of history of naturopathy consultations ranged from 1% in the Region of the Americas to 6% in the European and Western Pacific Regions. Conclusions There are up to sixfold differences in the prevalence of naturopathy consults over 12 months between and within world regions, which may be driven by a range of policy, legislative and social factors. PROSPERO registration number CRD42020145529.
Elevated oxidative stress is a common denominator between pathways implicated in the pathogenesis of diabetes mellitus and diabetes complications, prompting the use of antioxidant compounds in diabetes therapy. Alpha-lipoic acid (ALA), has been investigated for its role as a potent antioxidant in diabetes treatment and the results from clinical trials indicate improved glucose metabolism, reduced oxidative stress, improved endothelial dysfunction, a decline in platelet reactivity and moderate improvements to weight loss yet conflicting data regarding insulin metabolism. ALA inhibits nuclear factor kappa B (NFkB), chelates divalent transient metal ions and induces the expression of adenosine monophosphate-activated protein kinase (AMPK). This narrative review explores the results from clinical trials investigating the role of ALA in the treatment of diabetes mellitus.
Background The transition from student to practitioner can be challenging, resulting in stress, burnout and attrition. While there has been ample research examining graduate medical and allied health practitioner experiences of transitioning to practice, there is a paucity of research exploring such experiences in newly qualified naturopathic medicine practitioners. In light of this knowledge gap, the objective of this study was to ascertain the experiences of practicing as a naturopath in Australia within the first 5 years post-graduation. Methods Using a qualitative descriptive approach, recent graduates of an Australian Bachelor of Naturopathy (or equivalent) program were invited to participate in a semi-structured telephone interview to address the study objective. Data were analysed utilising a framework approach. Results A total of 19 new graduates (94.7% female; 57.9% aged 40–59 years) undertook an interview. Five inter-related themes emerged from the data: practitioner, practice, proprietorship, professions, and perceptions. Connected with these themes were contrasting feelings, multiplicity of duties, small business challenges, professional collaboration, and professional identity, respectively. Conclusions Participants were generally content with their decision to become a naturopath. However, most were confronted by a range of challenges as they transitioned from graduate to practitioner, for which many felt ill-prepared. In light of the complexity of the issue, and the potential impact on the sustainability of the profession, it is evident that a multi-pronged, multi-stakeholder approach would be needed to better support graduate naturopath transition to practice.
IntroductionLinking places to people is a core element of the UK government's geospatial strategy. Matching patient addresses in electronic health records to their Unique Property Reference Numbers (UPRNs) enables spatial linkage for research, innovation and public benefit. Available algorithms are not transparent or evaluated for use with addresses recorded by health care providers. Objectives To describe and quality assure the open-source deterministic ASSIGN address-matching algorithm applied to general practitioner-recorded patient addresses. Methods Best practice standards were used to report the ASSIGN algorithm match rate, sensitivity and positive predictive value using gold-standard datasets from London and Wales. We applied the ASSIGN algorithm to the recorded addresses of a sample of 1,757,018 patients registered with all general practices in north east London. We examined bias in match results for the study population using multivariable analyses to estimate the likelihood of an address-matched UPRN by demographic, registration, and organisational variables. ResultsWe found a 99.5% and 99.6% match rate with high sensitivity (0.999,0.998) and positive predictive value (0.996,0.998) for the Welsh and London gold standard datasets respectively, and a 98.6% match rate for the study population. The 1.4% of the study population without a UPRN match were more likely to have changed registered address in the last 12 months (match rate: 95.4%), be from a Chinese ethnic background (95.5%), or registered with a general practice using the SystmOne clinical record system (94.4%). Conversely, people registered for more than 6.5 years with their general practitioner were more likely to have a match (99.4%) than those with shorter registration durations. ConclusionsASSIGN is a highly accurate open-source address-matching algorithm with a high match rate and minimal biases when evaluated against a large sample of general practice-recorded patient addresses. ASSIGN has potential to be used in other address-based datasets including those with information relevant to the wider determinants of health.
Ovarian cancer has the lowest survival rate in gynaecologic malignancies with a 5-year survival rate of 43%. Platinum resistance is one of the main drivers of ovarian cancer mortality, of which aberrant methylation has been cited as a significant contributor. Understanding the essential role of the methylenetetrahydrofolate reductase enzyme (MTHFR) on DNA synthesis and repair, and how nutrient status can vastly affect its performance, led to the investigation of MTHFR status and dietary influence on platinum response in epithelial ovarian cancer (EOC) patients. Twenty-five adult female patients who completed first-line platinum-based chemotherapy for primary ovarian cancer were selected from Icon Cancer Centres in Australia. Participants were grouped based on platinum response. A full medical and family history, food frequency questionnaire and single blood test were completed, testing for MTHFR polymorphisms, serum folate, serum and active B12 and homocysteine levels. Nineteen of twenty-five participants had an MTHFR polymorphism. Of those, 20% were compound heterozygous, 12% were heterozygous C677T (CT), 4% homozygous C677T, 12% homozygous A1298C and 28% were heterozygous A1298C (AC). Statistically significant associations were found between dietary zinc (p = 0.0086; 0.0030; 0.0189) and B12 intakes in CT genotypes (p = 0.0157; 0.0030; 0.0068) indicating that zinc or vitamin B12 intakes below RDI were associated with this genotype. There were strong associations of vitamin B6 intakes in AC genotypes (p = 0.0597; 0.0547; 0.0610), and dietary folate in compound heterozygotes with sensitive and partially sensitive disease (p = 0.0627; 0.0510). There were also significant associations between serum folate (p = 0.0478) and dietary B12 (p = 0.0350) intakes above RDI and platinum sensitivity in wild-types as well as strong associations with homocysteine levels (p = 0.0886) and zinc intake (p = 0.0514). Associations with dietary B12 (p = 0.0514) and zinc intakes (p = 0.0731) were also strong in resistant wild types. Results indicate that dietary zinc, B12 and B6 intakes may be associated with platinum sensitivity dependent on MTHFR genotype. These results require further research to clarify the dosages necessary to elicit a response; however, they provide a novel foundation for acknowledging the role of diet on treatment response in EOC.
Introduction To report for the first time the image quality of mammograms performed in Papua New Guinea (PNG) using the Perfect, Good, Moderate, Inadequate (PGMI) image evaluation system (IES); and to benchmark the image quality against BreastScreen Australia (BSA) National Accreditation Standards (NAS). Methods A retrospective image quality analysis of the de-identified mammograms of 102 women imaged at the Port Moresby General Hospital (PMGH) was undertaken using the PGMI IES. Each craniocaudal (CC) and mediolateral oblique (MLO) image was assigned a grade and the reasons for the grade recorded. Age was recorded in years. Simple frequency analysis was undertaken and comparison with BSA NAS 2.4 was made. Results Women were aged between 25 and 74 years. There were 111 CC views and 109 MLO views. The most frequent individual grade for the CC view was G (83.8%) and for the MLO view M (72.48%); and for a routine series (four images), P and G combined (14.8%). Non-visualisation of the IMA (28%), nipple not in profile (26%) and short length of pectoral muscle (12%) were the most cited reasons for assigning an M grade. Conclusion The reported image quality is not commensurate with that required by BSA (P and G > 50%) and while common positioning errors can be rectified through education and training, it is also important to recognise the complex challenges faced by PNG radiographers in obtaining mammographic images that extend beyond education and training and reflect the emerging nature of the modality as well as wider health, economic and other issues. This work raises the need for national standards, dedicated equipment, and radiographer education to best serve the women of PNG.
Ativishadi churna is a traditional classical formulation pioneered by the science of Ayurveda. The very first reference regarding the formulation was documented in the Charka Samhita under title Ativishadi Yoga. The main indication of this formulation is to cure diarrhoea due to pitta dosha vitiation. It contains an equal part of powdered and dried Ativisha roots, Kutaj bark and Indrayava (dried Kutaj seeds). The polyherbal formulations comprise a wide range of bioactive compounds and the standardization of such formulations is a great concern these days. Hence, the present study evolves around standardizing Ativishadi Churna, for this purpose physicochemical parameters were performed of individual drugs by keeping the values of API as a standard. A complete pharmacognostic profile of ingredients has been validated to authenticate plant materials and to confirm the absence of any adulterants or impurities in the formulation. The preliminary phytochemical tests, Pharmacognostic and phytochemical standardization of the formulation were performed as a part of an SOP development. The formulation besides has been proven to possess antimicrobial properties against pathogens responsible for common infectious diseases in humans. The recent concern lies in the fact that some traditional medicines have been claimed to possess heavy metals. For this purpose, the heavy metal content has also been determined which shows that the formulation is devoid of heavy metals that may cause toxicity. The pharmacognostic and phytochemical study of this formulation would be very important for establishing standards in the future.
Background Chronic pelvic pain (CPP) in women is persistent, intermittent cyclical and non-cyclical lower abdominal pain, lasting for more than 6 months. Traditional Chinese Medicine (TCM) is a popular treatment option for women’s health conditions, but little is known about how treatment for CPP is delivered by TCM practitioners. The aim of this survey was to explore practitioners understanding and treatment of women with CPP, and how they integrate their management and care into the health care system. Method An online cross-sectional survey of registered TCM practitioners in Australia and New Zealand between May and October 2018. Survey domains included treatment characteristics (e.g. frequency), evaluation of treatment efficacy, referral networks, and sources of information that informed clinical decision making. Results One hundred and twenty-two registered TCM practitioners responded to this survey, 91.7% reported regular treatment of women with CPP. Treatment decisions were most-often guided by a combination of biomedical and TCM diagnosis (77.6%), and once per week was the most common treatment frequency (66.7%) for acupuncture. Meditation (63.7%) and dietary changes (57.8%) were other commonly used approaches to management. The effectiveness of treatment was assessed using multiple approaches, most commonly pain scales, (such as the numeric rating scale) and any change in use of analgesic medications. Limitations to TCM treatment were reported by over three quarters (83.7%) of practitioners, most commonly due to cost (56.5%) and inconvenience (40.2%) rather than safety or lack of efficacy. Sources informing practice were most often Integration within the wider healthcare system was common with over two thirds (67.9%) receiving referrals from health care providers. Conclusion TCM practitioners seeing women with various CPP symptoms, commonly incorporate both traditional and modern diagnostic methods to inform their treatment plan, monitor treatment progress using commonly accepted approaches and measures and often as a part of multidisciplinary healthcare for women with CPP.
Background Cannabis for cancer is very topical and, given the use of illicit cannabis preparations used in this vulnerable population, research investigating standardised, quality-assured medicinal cannabis is critical to inform clinicians and assist patient safety. Methods A randomized trial involving adult patients diagnosed with a high-grade glioma, no history of substance abuse, liver or kidney damage or myocardial infarction were eligible for inclusion in a tolerability study on two different ratios of medicinal cannabis. Baseline screening of brain morphology, blood pathology, functional status, and cognition was conducted. A retrospective control group was used for comparison for secondary outcomes. Results Participants (n=88) were on average 53.3 years old. A paired t-test assessed the Functional Assessment of Cancer Therapy for Brain Cancer (FACT-Br) between groups from baseline to week 12 found that the 1:1 ratio favoured both physical (p=0.025) and functional (p=0.014) capacity and improved sleep (p=0.009). Analysis of changes from baseline to week 12 also found 11% of 61 participants had a reduction in disease, 34% were stable, 16% had slight enhancement, and 10% had progressive disease. No serious adverse events occurred. Side effects included dry mouth, tiredness at night, dizziness, drowsiness. Conclusion This study demonstrated that a single nightly dose of THC-containing medicinal cannabis was safe, had no serious adverse effects and was well tolerated in patients. Medicinal cannabis significantly improved sleep, functional wellbeing, and quality of life. Clinical Trial Registration Australian New Zealand Clinical Trials Registry (ANZCTR) http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373556&isReview=true , identifier ACTRN12617001287325.
Objectives The aim of this literature review is to examine the relationship between Methylenetetrahydrofolate reductase (MTHFR) polymorphisms and assisted reproductive technologies in men and women accessing fertility services. Design Systematic literature review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses Methods This systematic literature review involved searches conducted through the Medline, EMBASE, CINAHL and Scopus databases to identify observational studies examining MTHFR polymorphism incidence in infertile couples seeking support through In vitro fertilisation and/or Fertility clinics. Results The included studies (n=16) identified an association with male infertility including azoospermia, oligozoospermia and teratozoospermia for the Methylenetetrahydrofolate reductase polymorphisms C677T and A1298C. A newly-identified AA allele of the MTHFR G1793A polymorphism was found to be protective against oligospermia and males with this polymorphisms had higher sperm counts. Studies also associated the new allele MTHFR179GA GG allele with female infertility. A strong association between individuals with C677T homozygous alleles receiving assisted reproductive technology and higher AMH levels, implantation failure, and lower ovarian responsiveness was also reported. Women with A1298C polymorphisms had few follicles, lower E2 levels and were less likely to have a viable pregnancy or live birth after in vitro fertilisation. Implantation failed in one in four embryos that were homozygous for C677T. Conclusions The MTHFR genetic polymorphism may be associated with infertility in couples seeking assisted reproductive technologies.
Background Clinical guidelines recommend nonpharmacological interventions as the first choice of treatment for agitation in dementia. One intervention that shows some promise as a treatment for agitation is essential oils. Objective To provide preliminary evidence of the effectiveness and feasibility of using topically-administered, individualised essential oil preparations for the alleviation of agitation in persons with dementia. Methods We conducted a 10-week pragmatic, cluster-randomised, placebo-controlled, pilot feasibility trial to compare the effectiveness of topically-administered, individualised essential oil preparations to control (placebo) preparations. Outcomes included frequency and severity of agitation, quality of life, frequency of antipsychotic medication use and physical restraint, incidence of adverse events, and trial feasibility. Participants with dementia and clinically significant agitation, were recruited from five residential aged-care facilities across regional South Australia. Results Thirty-eight participants were randomised from five sites. Accounting for random effects, we found statistically significant differences between the intervention and control groups in Pittsburgh Agitation Scale (PAS) aberrant vocalisation subscore, Cohen Mansfield Agitation Inventory (CMAI) verbally agitated subscore and CMAI total score at week 4, but not at weeks 8 (post-intervention) or 10 (follow-up). No significant time-group interactions were observed for other PAS/CMAI scores or subscores, quality of life - Alzheimer's disease total score, or frequency of physical restraint or as-needed antipsychotic medication. No adverse events were reported in any group. Conclusions The study findings highlight some promising effects of topically-administered, individualised essential oil preparations for agitation in dementia, and indicate that a large multi-centre, cluster-randomised controlled trial of this treatment is feasible. Trial registration Australian New Zealand Clinical Trial Registry [ACTRN12617001159347].
Objectives: This study aims to describe the characteristics of published peer-reviewed journal articles authored by naturopathic practitioners (NPs) Design: The study used bibliometric analysis of data extracted from journal articles. Settings/Location: International Subjects: Articles were included if they had at least one author with a naturopathic qualification and were published in a peer-reviewed, indexed journal. Data collection: A snowballing method was used between June 2018 and July 2019 to identify relevant articles. Outcome measures: Data related to geography, affiliation, year of publication, article type or research design, article topic, and journal were extracted from each included article. Results: Identified articles (n = 2,218) were published by NP from 22 countries between 1987 and 2019, with 80.9% published in the last 10 years. Most articles were published by NP from the America (52.5%) and Western Pacific (28.3%) World Health Organization regions. The most common type of study design or article type was reviews and meta-analyses (23.2%) and clinical trials or intervention studies (19.4%). Explicit mention of naturopathy was reported in 8.1% of articles. Almost half (48.4%) of all included articles were published in 40 journals, and 56.9% of these were published in journals ranked in the first quartile of at least one subject area. Articles focused on mental health were more likely to be conducted in Australia (odds ratio [OR] 3.3) and focused on lifestyle behavior (OR 2.5) or clinical nutrition (OR 1.6). Articles about cancer or cancer-related conditions were more likely to include lifestyle behavior (OR 2.0) and less likely to be conducted in Australia (OR 0.1) or Germany (OR 0.5). Conclusions: The international naturopathy research community has produced peer-reviewed literature for over 30 years and has demonstrated sustained commitment to codifying existing knowledge, generating new knowledge, and disseminating this knowledge to the wider clinical and research community.
Introduction Urinary kryptopyrroles (UKP), or the ‘Mauve factor’, was first described in in the early 1960s with an observed association with psychiatric illness. Since this time, there has been growing interest in the clinical importance of UKP testing for a range of clinical conditions. However, there are substantive gaps in the available evidence to inform appropriate application and interpretation of UKP tests. With this in mind, this study describes the observed health conditions, treatments and diagnostic application of UKP by clinicians using it within their clinical practice. Methods Observational cross-sectional self-report online survey of Australian clinicians, recruited through a company that provides functional testing (including UKP analysis), who identify as having used UKP testing within their clinical practice. The survey collected data on participant demography and characteristics of their clinical practice, their approach to the diagnosis and interventions used to clinically manage elevated UKP (eUKP), and the observed clinical importance of eUKP for a range of health conditions. Results The survey was completed by 86 respondents. The majority of participants used nutritional supplements (76.7%), dietary therapy (60.5%) and lifestyle changes (58.1%) to clinically manage eUKP. Nervous system (86.0%) and gastrointestinal (64.0%) conditions were most commonly observed by respondents to be linked to eUKP. Anxiety was observed by 91.9% of respondents to be associated with eUKP and was also the condition most commonly described as markedly improving following treatment of eUKP. A number of factors were reported to be associated with eUKP by the majority of respondents including mood swings (100%), social withdrawal (92.5%), compulsive behaviour (82.4%) and emotional eating (77.8%). Implications Given the substantive gaps in evidence associated with UKP testing, this data may provide direction for researchers to design projects that reflect UKP testing as it is used in grass-roots clinical practice.
Alpha-lipoic acid (ALA) is a substantial antioxidant in the prevention of diabetes and diabetes complications. It can regenerate other antioxidants like vitamin E, vitamin C, Coenzyme Q10 and glutathione and is often known as a universal antioxidant. Antioxidants play a role in diabetes treatment due to hyperglycemia-induced stimulation of the polyol pathway and formation of advanced glycation end products (AGE) and reactive oxygen species (ROS). Clinical trials examining alpha-lipoic acid supplementation on diabetic neuropathy, nephropathy, cardiomyopathy and erectile dysfunction display positive results, particularly in pain amelioration in neuropathy, asymmetric dimethylarginine reductions in nephropathy and improved oscillatory potential and contrast sensitivity in retinopathy. In diabetic cardiomyopathy (DCM), ALA offers protection through inhibition of NF-kB activation, reduction of fas-ligand and decrease in matrix metalloproteinase-2. This comprehensive review summarises and provides an understanding of the importance of alpha-lipoic acid supplementation to prevent diabetes complications.
Background: Fibromyalgia (FMS) is a complex condition that is characterized by various pain syndromes and fatigue, among other symptoms experienced. Current medical treatment of FMS involves both pharmacological and nonpharmacological approaches, but often with ineffective outcomes. Medicinal cannabis has the potential to be a therapeutic option for patients with FMS due to the positive research in chronic pain management. In addition, it has been found to have fewer adverse effects compared with currently available pain medications. This literature review aims at answering whether medicinal cannabis is reported to be safe and effective for the treatment of pain and symptomology experienced by people with FMS. Methods: A systematic review was conducted on human trials utilizing cannabis in FMS. MEDLINE, Embase, CINAHL, AMED, Scopus, and Cochrane CENTRAL were used for databases search, and mesh terms were used for cannabis and FMS. The search was limited to studies conducted from 2000 to 2020. Results: From the 181 citations identified, 10 studies were included after title, abstract, and full text screening occurred. A total of 1136 of patients (intervention n = 945, control n = 108, crossover n = 83) participated in the 10 studies ranging from 9 to 383 patients (mean = 114, median = 36). Of these studies, there were three randomized controlled trials, six observational studies, and one study that compared the management of chronic pain patients with FMS patients. Cannabis was found to be safe and well tolerated in FMS. The main adverse events identified included feeling ‘‘high,’’ dizziness/vertigo, dry mouth, cough, red eyes, and drowsiness with no serious adverse events reported. Conclusions: This literature review identified that medical cannabis may be beneficial for some people with FMS. Further studies are required to confirm its efficacy, what type of cannabis is the most effective form to use, and what assessment tools need to be utilized to understand how to quantify clinical outcomes.
Introduction Representing patient-registered addresses as pseudonymised Unique Property Reference Numbers (UPRNs) enables linkage of environmental and household information to electronic health records (EHRs). However, the accuracy and potential biases in address-matching algorithm results applied to patient addresses is unknown. Objectives and Approach To investigate accuracy, match rate, and biases in assigning UPRNs to general practitioner (GP)-registered patient addresses for a geographically-defined UK population, using a bespoke deterministic address-matching algorithm comprising 213 rules applied in rank order of minimising false-positives, developed for the Discovery Data Service. We ran this algorithm to match 906,220 adult patient GP-registered addresses (48% female, 47% non-White, 89% 20-64) sampled in mid-2018 from 159 GP practices in four London boroughs to Ordnance Survey’s AddressBase Premium database. We evaluated the error rates using a gold-standard dataset. We used binary logistic regression to estimate the likelihood (Odds Ratio [OR]; 95% Confidence Intervals [CI]) of no UPRN match according to and adjusting for patient age, sex, ethnic background, deprivation, residential mobility and multiple GP registrations. Results 96% of patient addresses were successfully assigned a UPRN. Algorithm sensitivity, specificity, positive and negative predictive-values and F-measure were, respectively: 0.993, 0.019, 0.914, 0.204, and 0.9516. After mutual adjustment, UPRN assignment was less likely for: men (OR: 0.87; 95%CI: 0.83,0.91); adolescents and the elderly (15-19 years: 0.57;0.43,0.77; ≥90 years: 0.39;0.18,0.84); those from Chinese ethnic backgrounds (0.87;0.8,0.91), living in the least deprived areas (0.25;0.21,0.31), or with two or more distinct UPRNs across multiple registrations (0.37;0.28,0.49); and more likely for: those from Bangladeshi ethnic backgrounds (1.79;1.61,2.00), registered before 2018 (5.10;4.42,5.87), or with multiple GP registrations (2.36;1.82,3.05). Conclusion / Implications The Discovery open-source algorithm achieves a high accurate match rate and quantifies the demographic groups that may be under-represented among those successfully matched. This is the first time that bias in matching rates for an address-matching algorithm has been evaluated using patient-registered addresses.
Background Health inequities or disparities challenge governments and public health systems, impacting health service delivery worldwide. Inherent disadvantage linked to the social determinants of health is intrinsic to the health outcomes among society’s marginalised and most vulnerable members. It is acknowledged that marginalised individuals present with higher levels of chronic disease, multi-morbidities and adverse health behaviours than their non-disadvantaged peers. Marginalised individuals and communities present with complex health problems and often receive poor quality or inadequate health care that is unable to meet their needs, leading to stigmatisation and perpetuating the cycle of disadvantage. Discussion Emerging research indicates that there may be a role for acupuncture in managing the health needs of marginalised populations and that when historical barriers to accessing acupuncture treatment (such as awareness, availability and affordability of this therapy) are removed, certain marginalised populations are open to engaging with acupuncture treatment. Acupuncture has been used by low-income, refugee, veteran and ethnic minority groups to manage chronic pain, substance use disorders, stress and the impacts of trauma in conventional health settings such as community clinics and hospitals. There is the suggestion that integrative health settings and group treatment models may improve access and uptake of acupuncture among marginalised groups. Conclusion Evidence suggests that the sociodemographic profile of acupuncture users is diverse and acupuncture therapy holds potential value in the treatment of marginalised populations. Further research that investigates reframing and expanding the scope of practice for acupuncture is timely and may contribute to tackling health inequity.
Olive leaf extract (OLE), prepared from the fresh or dried leaves of Olea europaea L., is generating interest as a cardiovascular and metabolic disease risk modifier. Positive effects for the leaf extract and its key phytochemical constituents have been reported on blood pressure, respiratory infections, inflammation, and insulin resistance. A variety of OLE products are available both over-the-counter and for professional dispensing. The aim of this research was to quantitatively explore the phytochemical profile of different OLE products on the Australian market. Ten OLE products available on the Australian market (five over-the-counter products and five products for professional compounding and dispensing) were quantitatively analyzed for oleuropein, hydroxytyrosol, oleacein, oleocanthal, total biophenols, maslinic acid, and oleanolic acid, using high-performance liquid chromatography (HPLC). Substantial variation in oleuropein and hydroxytyrosol levels was noted between extracts, with a trend towards higher oleuropein and lower hydroxytyrosol levels being noted in products produced using the fresh olive leaf as opposed to dry olive leaf. These results suggest that OLE products on the Australian market vary substantially in their phytochemical profiles. Products for professional compounding and dispensing in many cases contained less oleuropein than over-the-counter products, but more hydroxytyrosol and comparable total biophenol levels.
Purpose: Palliative care for cancer deals with physical, psychosocial, and spiritual issues faced by cancer patients, their families, communities, and healthcare providers. Research on complementary medicine (CM) use in France is limited despite high rates of reported CM use in other countries including by palliative patients. This study describes the use of CM by individuals receiving palliative care in Lyon, France. Design: This study employed an observational cross-sectional survey design. Setting/participants: The study was conducted in three palliative care centers in Lyon, France; two tertiary hospitals and one palliative care unit (3 sites). Inpatients and outpatients visiting the palliative care clinic with a primary diagnosis of cancer at each study site were invited to participate. Results: Of 138 eligible patients, 100 completed the survey (RR 72.4%). The majority (90.7%) reported using CM in the previous 6 months or since their primary cancer diagnosis. Participant CM use was either the same (20.7%) or increased since their primary cancer diagnosis (33.7%). Average out-of-pocket expenses associated with CM use in the previous 6 months or since diagnosis were €157.40 (SD €330.15). The most common CM health professional visited was an aromatherapist (72.7%), a Coupeurs de feu (38.6%), osteopath (28.6%) and naturopath (15.3%). The most common CM used were aromatherapy oils (33.7%), homeopathy (30.0%), and vitamins (29.4%). Conclusion: This second survey on CM use in France; is the first conducted in palliative care centers. Results show people with cancer in Lyon, France, have a very high prevalence of CM utilization.
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