Journal of Integrative and Complementary Medicine最新文献

Background: As a prominent part of complementary and alternative medicine, Chinese Medicine (CM) has proved its strengths in treating a diverse range of acute and chronic medical conditions and is at present recognized in 196 countries and territories worldwide. In 2012, Australia regulated the CM profession under the National Regulation and Accreditation Scheme (NRAS) by legislation and reports quarterly demographic information about individual CM practitioners so to ensure public interest, although research examining the change of CM workforce in Australia has been scarce. Objective: This study aims to investigate the construction of the CM workforce in Australia and more importantly, evaluated its development in the last decade to capture the trajectory and trend in the present period and future potential changes. Methods: Data were sourced from the Australian Health Practitioner Regulation Agency (AHPRA) annual reports and the Chinese Medicine Board of Australia (CMBA) registration statistics from 2012 to 2023. A descriptive analysis was conducted with demographic variables, including profession, age, and gender, and chi-square tests and linear regression modeling were carried out to assess the variations between regions and across years. Results: The population of CM practitioners in 2022/2023 stagnated with slight decrease to 4,823, in contrast to the increase rate of 2.9% in the whole health care community. The number of young CM registrants (<35 y) shrank by 37.5% from 691 in 2012 to 432 in 2023. In comparison with other health care professions, CM comprises the smallest proportion of the population aged younger than 25 (0.2%) and the largest proportion aged older than 65 years (16.2%), advancing into an aging era. Conclusions: This study indicates a worrying potential decline in CM workforce in Australia, which is likely to be further exacerbated by the lack of new graduates and rise of median age among practitioners. Meanwhile, continued advancement in Western medicine technology and standards requires substantial efforts to increase both a better understanding of CM and demonstration of its efficacy. Furthermore, greater effort is needed to recruit and educate new young CM practitioners in Australia and to broaden the international training pipeline for a sustainable development of CM practice.

Introduction: Patients with acute coronary syndrome (ACS) often experience high levels of anxiety, which can significantly impact their prognosis. However, evidence regarding anxiety reduction by aromatherapy in patients with ACS is lacking. This study aimed to investigate the effects of aromatherapy on anxiety in patients with ACS. Methods: The literature search was conducted using PubMed, CINAHL, Embase, Web of Science, Cochrane Library, and PsycINFO from their inception until February 21, 2024. Based on inclusion criteria, randomized controlled trials (RCTs) on aromatherapy in patients with ACS aged ≥ 18 years were included. The risk of bias in the included studies was assessed using the revised Cochrane risk-of-bias tool for RCTs. Results: A total of 14 studies were included in the final analysis. Aromatherapy significantly reduced anxiety among patients with ACS, with a large effect size (standardized mean difference [SMD] = -1.66, 95% confidence interval [CI]: -2.47 to -0.85). The effect on systolic blood pressure (SBP) was -0.65 (95% CI: -1.15 to -0.15), indicating a moderate effect size, whereas there was no significant effect on diastolic blood pressure. Inhalation therapy demonstrated a large effect size (SMD = -1.70, 95% CI: -2.33 to -1.08), whereas massage therapy did not show a significant effect on reducing anxiety. Discussion/Conclusions: The findings show that aromatherapy can effectively reduce anxiety and SBP in patients with ACS. In particular, inhalation therapy showed a significant effect on reducing anxiety levels. Applying aromatherapy in clinical settings to reduce anxiety among patients with ACS should be considered. However, the limited number of studies analyzed hinders a comprehensive evaluation of the effectiveness of massage therapy. Hence, further research is necessary to elucidate its potential role in reducing anxiety among patients with ACS.

Objectives: Several studies have indicated that dietary interventions may offer protection against the development of cardiac damage in the case of anthracycline-induced cardiomyopathy (AIC). The goal of this study was to assess whether an evidence-based cardioprotective diet can be effective in preventing AIC in patients with breast cancer. Design: Randomized, open-label, controlled trial. The study period was set for 18 weeks, and the data were analyzed by generalized estimating equation modeling and one-way repeated measures analysis of variance. Setting/Location: Shahid Rajaie Hospital affiliated (Tehran, Iran). Subjects: Fifty anthracycline-treated patients with breast cancer. Interventions: Patients were randomized to receive either a 2-hour training in evidence-based cardio-protective diet or Carvedilol 6.25 mg bid. Outcome Measures: The primary outcome was the number of patients with abnormal left ventricular ejection fraction (LVEF) after 18 weeks. Results: At week 18, 12 (48%) out of 25 participants in the cardioprotective diet group had abnormal LVEF in comparison with 21 (84%) out of 25 in the carvedilol group (p = 0.007). Also, 2 (8%) out of 25 in the cardioprotective diet group compared with 7 (28%) out of 25 participants in the carvedilol group had abnormal global longitudinal strain (p = 0.066). The diet group showed significant improvements in the quality-of-life dimensions named "health change" and "general health" compared with the carvedilol group using the Short Form-36 Health Survey questionnaire. Conclusions: This study suggests that an evidence-based cardioprotective diet can contribute to the prevention of AIC. Although current treatments for AIC can be effective, further research is mandatory for more options.

Introduction: Mindfulness interventions can improve a broad range of patient outcomes, but traditional mindfulness-based interventions are time and resource intensive. Emerging evidence indicates brief, single-session mindfulness interventions can also improve patient outcomes, and brief mindfulness interventions can be embedded into medical care pathways with minimal disruption. However, the direct impact of a brief mindfulness intervention on patients' pain while waiting in the clinic waiting room remains unexamined. Objective: A series of three, pilot, randomized controlled trials (RCTs) were conducted to examine the impact of a brief, audio-recorded, mindfulness intervention on patients' pain in the clinic waiting room. Method: Study 1 examined an 8-min mindfulness recording delivered before a provider visit; Study 2 examined a 5-min mindfulness recording after a provider visit; and Study 3 examined a 4-min mindfulness recording before a provider visit. Time- and attention-matched control conditions were used in each study. Studies 1 and 2 were conducted in an academic cancer hospital. Study 3 was conducted at a walk-in orthopedic clinic. Pain intensity was measured in each of the three studies. Anxiety and depression symptoms were measured in Studies 2 and 3. Pain unpleasantness was measured in Study 3. Results: A brief (i.e., 4- to 8-min), audio-recorded mindfulness intervention decreased patients' pain intensity in the clinic waiting room, whether delivered before (Study 1 Cohen's d=1.01, Study 3 Cohen's d=0.39) or after (Study 2 Cohen's d=0.89) a provider visit. Mindfulness had a significant effect on anxiety symptoms in both studies in which it was measured. No effect on depression symptoms was observed. Conclusions: Results from these three pilot RCTs indicate brief, audio-recorded, mindfulness interventions may be capable of quickly decreasing clinical symptoms. As such, embedding brief, audio-recorded, mindfulness interventions in clinic waiting rooms may have the potential to improve patient outcomes. The continued investigation of this intervention approach is needed. Clinical Trial Registrations: NCT04477278 and NCT06099964.

Collaboration among members of a client's/patient's wellness team is a key goal for effective service delivery, and yet often remains elusive. It is proposed that complementary health care practitioners are well situated to lead the way in collaboration. In this article, a framework for how practitioners in any discipline can begin to develop these professional collaborations is presented-NOTP! Network, openness, time, patience. It is a call to action.

Background: In community and school settings, gardens and garden interventions have been shown to confer several psychosocial, physiological, and nutritional benefits. However, little is known about the implementation and impact of health care gardens on patients, visitors, and staff health and well-being. The primary aim of this review is to identify and describe the types of gardens and common design elements implemented in health care settings and the impact these gardens have on the health and well-being of patients, visitors, and staff. A secondary aim is to assess the quality of available evidence. Methods: PubMed, CINAHL, EMBASE, and PsycINFO were systematically searched on October 28, 2022. Primary qualitative and quantitative studies (excluding case reports and studies) were eligible for inclusion if they described the types of gardens and common design elements implemented in health care settings (hospitals, aged care, rehabilitation facilities, and medical centers) and/or assessed the impact of garden interventions on the health and well-being of patients, visitors, and staff. Review, selection, and data extraction were conducted by two independent researchers, with findings synthesized and presented in narrative form. Articles were critically appraised using the mixed methods appraisal tool (MMAT). Results: Eighteen articles were included. Eight studies provided detailed descriptions of the types of gardens implemented in health care settings (healing [n = 3], therapeutic [n = 2], sensory [n = 2], children's fairy gardens [n = 1], and enriched [n = 1] gardens). Studies examining the psychosocial impacts of gardens were most frequently reported (n = 16), followed by physical (n = 4) and nutritional (n = 2). A wide range of positive outcomes, predominantly relating to patients (n = 12), were reported, including improvements in stress, quality of life (QOL), cognitive function, physical activity, and fruit and vegetable intake. The evidence was heterogeneous and low-medium quality. Conclusions: The findings suggest that implementing gardens and garden interventions in health care settings may positively impact the health and well-being of patients, visitors, and staff. Most studies related to the impact of gardens on patients' mental health and QOL, indicating the need for further research to explore physical and nutritional outcomes, as well as health outcomes of staff and visitors. Findings also suggest the need for high-quality study designs (e.g., cluster control trials) and standardized measurement tools.