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Romero-García PA, Ramirez-Perez S, Miguel-González JJ, Guzmán-Silahua S, Castañeda-Moreno JA, Komninou S, Rodríguez-Lara SQ. Complementary and Alternative Medicine (CAM) Practices: A Narrative Review Elucidating the Impact on Healthcare Systems, Mechanisms and Paediatric Applications. Healthcare (Basel) 2024; 12:1547. [PMID: 39120250 PMCID: PMC11311728 DOI: 10.3390/healthcare12151547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/29/2024] [Accepted: 07/03/2024] [Indexed: 08/10/2024] Open
Abstract
While research on complementary and alternative medicine (CAM) for the general population is expanding, there remains a scarcity of studies investigating the efficacy and utilisation of CAM practices, specifically in the paediatric population. In accordance with the World Health Organization (WHO), the prevalence of the parental utilisation of CAM in their dependents is estimated to reach up to 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM's applications and effectiveness, primarily attributed to variance in sociodemographic factors and differences in national healthcare systems. Additionally, the review identified a lack of consensus and polarised positions among mainstream professionals regarding the mechanisms of action, applications, and effectiveness of CAM. This narrative review presents varied results concerning the efficacy of most CAM therapies and their applications; however, some evidence suggests potential benefits for acupuncture, yoga, tai chi, and massage in improving physical and mental health. Moreover, the available evidence indicates that meditation may enhance mental health, while reiki may only influence patients' perceptions of comfort. In light of the intricate and multifaceted nature of herbal medicine, it is imperative to assess its efficacy on a case-by-case basis, taking into account the specific compounds and procedures involved. This comprehensive review serves as a valuable resource for health professionals, offering guidance for personalised healthcare approaches that consider the values and beliefs of patients, thereby facilitating integrated, evidence-based practices aimed at enhancing the quality of healthcare services and patient satisfaction.
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Affiliation(s)
- Patricia Anaid Romero-García
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
| | - Sergio Ramirez-Perez
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
- Instituto de Investigación en Reumatología y del Sistema Músculo-Esquelético (IIRSME), CUCS, Universidad de Guadalajara, Guadalajara 44100, Jalisco, Mexico
| | - Jorge Javier Miguel-González
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
- Departamento de Investigación, Instituto Cardiovascular de Mínima Invasión (ICMI), Zapopan 45116, Jalisco, Mexico
| | - Sandra Guzmán-Silahua
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
- Unidad de Investigación Epidemiológica y en Servicios de Salud, CMNO OOAD Jalisco Instituto Mexicano del Seguro Social, Guadalajara 44160, Jalisco, Mexico
| | - Javier Adan Castañeda-Moreno
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
| | - Sophia Komninou
- Faculty of Health and Life Science, Swansea University, Swansea SA2 8PP, UK;
| | - Simón Quetzalcoatl Rodríguez-Lara
- School of Medicine, Universidad Autónoma de Guadalajara, Zapopan 45129, Jalisco, Mexico; (S.R.-P.); (J.J.M.-G.); (S.G.-S.); (J.A.C.-M.)
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Petran M, Dragoș D, Stoian I, Vlad A, Gilca M. Current use of medicinal plants for children's diseases among mothers in Southern Romania. Front Pharmacol 2024; 15:1377341. [PMID: 38841372 PMCID: PMC11150775 DOI: 10.3389/fphar.2024.1377341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 04/11/2024] [Indexed: 06/07/2024] Open
Abstract
There is a limited number of studies focusing on ethnomedical practices in children, particularly in Eastern Europe. Romania has a rich history of using medicinal plants in ethnopediatric care, and our objective was to identify the medicinal plants currently employed in treating childhood illnesses in the southern region of the country. Material and methods Our investigation used structured interviews, focusing on respondent demographics, local names of therapeutically employed herbs, the specific plant part(s) utilized, methods of preparation and administration, and local folk indications of taxa. A total of 326 mothers with children aged 0 to 18, hospitalized in the "Grigore Alexandrescu" Children Emergency Hospital Bucharest and residing in Southern Romania, were enrolled in the study. Use Value Citation Index (UVc), Informant Consensus Factor (Fic), and Fidelity Level (FL) were calculated. Results Twenty-five plants were identified for treating children's diseases in Southern Romania. The majority of informants resided in urban areas, and mothers primarily acquired knowledge from family members and healthcare professionals. The herbs most frequently employed were Mentha spp. (UV = 0.509) for diarrhea, Matricaria spp. (UV = 0.301) for skin infections (Fic = 0.99) and digestive diseases (Fic = 0.98), and Calendula officinalis L. (UV = 0.365) for skin diseases (Fic = 0.99). Less utilized were Raphanus raphanistrum subsp. sativus (L.) Domin in respiratory diseases, Prunus avium (L.) L. stalks in urinary tract ailments, Helianthus annuus L. in ear infections, Allium sativum L. in intestinal parasitosis, Viola tricolor L. in hives, Triticum aestivum L. in dermatitis and Allium ursinum L. as a tonic. In 184 cases herbal treatment was used in conjunction with conventional medications. Education level correlated with the number of employed plants and the variety of treated ailments, while residency (rural vs. urban) did not. Both residency and education influenced plant procurement methods: rural background and, surprisingly, higher education were linked to a preference for harvesting rather than purchasing plants. Conclusion Botanical remedies are still commonly used in the treatment of pediatric diseases in Southern Romania, although the variety of taxa seems reduced compared to the past. Further exploration is essential to unlock the maximum benefits of ethnopediatric practices.
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Affiliation(s)
- Madalina Petran
- Department of Functional Sciences I/Biochemistry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Dorin Dragoș
- Department of Medical Semiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
- First Internal Medicine Clinic, University Emergency Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Irina Stoian
- Department of Functional Sciences I/Biochemistry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Adelina Vlad
- Department of Functional Sciences I/Physiology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Marilena Gilca
- Department of Functional Sciences I/Biochemistry, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Shawarb N, Badrasawi M, Qaoud HA, Hussein F. An ethno-botanical study of medicinal plants used for the management of respiratory tract disorders in northern parts of Palestine. BMC Complement Med Ther 2023; 23:387. [PMID: 37891535 PMCID: PMC10612229 DOI: 10.1186/s12906-023-04176-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 09/19/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The medicinal application of natural plant remedies is well established. These medicinal plants are still in use within the Palestinian community to treat several illnesses. This research is intended to study the use of natural plants to treat different types of respiratory tract disorders. METHOD This ethno botanical study focused on the medicinal plants that are used to treat respiratory diseases in the northern part of Palestine; Nablus, Tulkarm, Qalqilia, and Jenin. A questionnaire was distributed to 120 respondents. The data obtained included names of the plants used, the parts used, the diseases for which the products were applied, as well as the method of preparation. To evaluate results, percentages (%), Fic (factor of informant consensus), and FL (fidelity-level) were calculated. RESULTS A total of 120 participants were selected for the final analysis. The highest percentage of herbal use was reported for flu 85.8% (103 participants) followed by cough 83.3%, while the lowest percentage of users was for bronchitis with 54.1%. The study showed that 31 plant species of 19 families were used for respiratory disorders treatment. Six species were from the Lamiaceae family, three species from the Apiaceae family, two species from Amaryllidaceae, Fabaceae, Myrtaceae, Rutaceae and Zingiberaceae, and one plant species for each of the rest of families. Leaves and fruits were the most commonly used parts of plants. Decoction was the method of preparation and was taken as a hot drink. Chamomile, mint, sage, lemon, and ginger were in the recipes for the five respiratory diseases. CONCLUSION In Palestine, patients with respiratory diseases rely heavily on the use of herbal remedies. Leaves and fruits were the most commonly used plat elements. Age and marriage were significantly associated with the use of botanical remedies. Whereas there was no significant association between the source of information about medicinal plants and the location where medicinal plants were purchased. It is vital to conduct comprehensive clinical investigations and pharmacological assessments of these herbal remedies, in order to identify their efficacy, safety, and toxicity levels.
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Affiliation(s)
- Nuha Shawarb
- Department of Chemistry, Faculty of Science, An-Najah National University Nablus, P.O. Box 7, Nablus, State of Palestine.
| | - Manal Badrasawi
- Nutrition and Food Technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University Tulkarem, Nablus, State of Palestine
| | - Hassan Abu Qaoud
- Department of Plant Production and Protection, Faculty of Agriculture and Veterinary Medicine, An-Najah National University Tulkarem, Nablus, State of Palestine
| | - Fatima Hussein
- Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University Nablus, Nablus, State of Palestine
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Tek Ayaz S. The roles of health literacy in parents' honey use and the use of complementary alternative medicine in a Turkish population. BMC Complement Med Ther 2023; 23:376. [PMID: 37872587 PMCID: PMC10594736 DOI: 10.1186/s12906-023-04209-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 10/09/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND As a biologically based therapy, honey is used by parents in many parts of the world as a home remedy for their children. While information exists regarding the traditional use of honey for health issues in children, data regarding its relationship with health literacy is lacking. The aims of this study were to determine the use of honey to address children's health issues among parents of children aged 0-72 months and to explore the relationship between the use of complementary and alternative medicine (CAM) and health literacy. METHODS The data for this descriptive, cross-sectional study were collected between October and November 2022 via an online survey of 907 parents of children aged 0-72 months. A sociodemographic data collection form, the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ), and the Turkey Health Literacy Scale-32 (THLS-32) were used to collect the data. A t-test, one-way analysis of variance, and Pearson correlation analysis were used to analyze the data. RESULTS The majority (86.5%) of the parents used honey for their children's health problems. Among the parents, 83.1% utilized honey as a remedy for alleviating cough symptoms, 10.4% employed it as a treatment for diarrhea, and 14% administered it for the management of oral mucositis. The mean THLS-32 and HCAMQ scores of the parents were 29.39 and 21.31, respectively, and there was a moderate correlation between the parents' THLS-32 and HCAMQ mean scores (r = 0.662, p < 0.001). CONCLUSION This study revealed that a significant proportion of parents who used honey to alleviate their children's health issues displayed positive attitudes toward complementary and alternative medicine (CAM) while concurrently exhibiting insufficient or limited health literacy levels. Therefore, it is advisable to enhance health literacy regarding the proper and safe utilization of honey, which functions as a biologically based CAM therapy.
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Affiliation(s)
- Suzan Tek Ayaz
- Yozgat Bozok University, Akdagmadeni School of Health, Nursing Department, Yozgat, Turkey.
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Solomonian L, Blesoff J, Garofalo L, Lucas S, Picardo A, Garber A, Wilson M, Leach M. Naturopathic Management of Acute Pediatric Respiratory Infections: A Modified Delphi Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:181-195. [PMID: 36827416 DOI: 10.1089/jicm.2022.0669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
Objective: Both the United Nations and the World Health Organization have identified antimicrobial resistance as a significant threat to global health. The Centers for Disease Control and Prevention identified five pediatric respiratory conditions as requiring particular scrutiny in terms of antibiotic stewardship. This study sought to identify strategies used by experienced naturopathic practitioners to treat acute respiratory infections in children. The authors theorize that naturopathic strategies safely fill the gap between watchful waiting and antibiotic prescription, thus reducing the use of antibiotics. Methods: Naturopathic practitioners in Canada, the United States, and Australia with a minimum of 5 years of experience in clinical naturopathic care of children were recruited for a modified Delphi study. A 14-person panel of practitioners was selected to complete a series of four iterative surveys assessing agreement to statements in five domains of knowledge/attitudes, assessment/diagnosis, management, monitoring, and education. Items were deemed to have reached consensus if they reached a predetermined threshold of 70% agreement, or failed to reach a threshold of 40% agreement. Items between these boundaries were modified and retested until either consensus was reached or the four surveys had been completed. Results: Results yielded a large degree of agreement on core naturopathic approaches to the management of acute pediatric respiratory infections, especially lifestyle strategies, including adequate rest and dietary recommendations. The use of vitamins C and D was strongly supported, as were herbs, particularly echinacea and elderberry. Some hydrotherapy and topical applications specific to the individual focus on infection also reached consensus. Results suggested that most respondents, even if they have the authority to prescribe antibiotics, rarely deem it necessary to do so. Conclusion: Findings of this study provide (1) clarity on the role of naturopathic doctors in the management of pediatric health concerns and the stewardship of antibiotics; and (2) initial guidance to less experienced naturopathic practitioners. The findings also identify key priorities for research into the safety and effectiveness of naturopathic interventions to reduce the unnecessary prescribing of antibiotics.
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Affiliation(s)
| | - Jamine Blesoff
- National University of Health Sciences, Lombard, IL, USA
| | | | - Sandra Lucas
- School of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Andrea Picardo
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Anna Garber
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Mariah Wilson
- Canadian College of Naturopathic Medicine, Toronto, ON, Canada
| | - Matthew Leach
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
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Tian EJ, Veziari Y, Leach MJ, Kumar S. The effectiveness of reflexology on mental health in cancer patients: A systematic review and meta-analysis of randomised controlled trials. Complement Ther Clin Pract 2023; 50:101708. [PMID: 36434907 DOI: 10.1016/j.ctcp.2022.101708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/19/2022] [Accepted: 11/13/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND PURPOSE The current body of research examining the effectiveness of reflexology in patients with cancer have predominantly focused on managing physical symptoms and treatment side effects. This review aimed to synthesise evidence from randomised controlled trials (RCTs) examining the effectiveness of reflexology on mental health outcomes in people with cancer. METHODS RCTs published in English and measuring stress, anxiety, depression or quality of life (QoL) were included. Eligible RCTs were identified through search of MEDLINE, Embase, Emcare, PsycINFO, Scopus, the Cochrane Library, OTseeker, PEDro (18 June 2021) and Google and Google Scholar (21 June 2021). The Critical Appraisal Skills Programme Randomised Controlled Trials Checklist was used to assess risk of bias. Meta-analysis and narrative synthesis were undertaken. The certainty of evidence was assessed by using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. RESULTS Fifteen RCTs (1356 adult participants) were included. Evidence for stress and anxiety (primary outcomes), as well as depression and QoL (secondary outcomes), were mixed and conflicting. The certainty of the evidence was low to very low. CONCLUSION An unequivocal recommendation supporting reflexology cannot be made. Greater utilisation of well-established reporting guidelines, together with increased investment in well-designed, high-quality clinical research are required.
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Affiliation(s)
- Esther Jie Tian
- UniSA Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Yasamin Veziari
- UniSA Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
| | - Matthew J Leach
- Southern Cross University, Lismore Campus, Military Road, East Lismore, New South Wales, 2480, Australia.
| | - Saravana Kumar
- UniSA Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide, South Australia, 5001, Australia.
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Munekata PES, Pateiro M, Conte-Junior CA, Domínguez R, Nawaz A, Walayat N, Movilla Fierro E, Lorenzo JM. Marine Alkaloids: Compounds with In Vivo Activity and Chemical Synthesis. Mar Drugs 2021; 19:374. [PMID: 34203532 PMCID: PMC8306672 DOI: 10.3390/md19070374] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 12/15/2022] Open
Abstract
Marine alkaloids comprise a class of compounds with several nitrogenated structures that can be explored as potential natural bioactive compounds. The scientific interest in these compounds has been increasing in the last decades, and many studies have been published elucidating their chemical structure and biological effects in vitro. Following this trend, the number of in vivo studies reporting the health-related properties of marine alkaloids has been increasing and providing more information about the effects in complex organisms. Experiments with animals, especially mice and zebrafish, are revealing the potential health benefits against cancer development, cardiovascular diseases, seizures, Alzheimer's disease, mental health disorders, inflammatory diseases, osteoporosis, cystic fibrosis, oxidative stress, human parasites, and microbial infections in vivo. Although major efforts are still necessary to increase the knowledge, especially about the translation value of the information obtained from in vivo experiments to clinical trials, marine alkaloids are promising candidates for further experiments in drug development.
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Affiliation(s)
- Paulo E. S. Munekata
- Centro Tecnológico de la Carne de Galicia, Parque Tecnológico de Galicia, rúa Galicia No. 4, San Cibrao das Viñas, 32900 Ourense, Spain; (P.E.S.M.); (M.P.); (R.D.)
| | - Mirian Pateiro
- Centro Tecnológico de la Carne de Galicia, Parque Tecnológico de Galicia, rúa Galicia No. 4, San Cibrao das Viñas, 32900 Ourense, Spain; (P.E.S.M.); (M.P.); (R.D.)
| | - Carlos A. Conte-Junior
- Centro de Tecnologia, Programa de Pós-Graduação em Ciência de Alimentos, Instituto de Química, Universidade Federal do Rio de Janeiro, Avenida Athos da Silveira Ramos 149, Cidade Universitária, Rio de Janeiro 21941-909, RJ, Brazil;
| | - Rubén Domínguez
- Centro Tecnológico de la Carne de Galicia, Parque Tecnológico de Galicia, rúa Galicia No. 4, San Cibrao das Viñas, 32900 Ourense, Spain; (P.E.S.M.); (M.P.); (R.D.)
| | - Asad Nawaz
- Jiangsu Key Laboratory of Crop Genetics and Physiology, College of Agriculture, Yangzhou University, Yangzhou 225009, China;
| | - Noman Walayat
- Department of Food Science and Engineering, College of Ocean, Zhejiang University of Technology, Hangzhou 310014, China;
| | | | - José M. Lorenzo
- Centro Tecnológico de la Carne de Galicia, Parque Tecnológico de Galicia, rúa Galicia No. 4, San Cibrao das Viñas, 32900 Ourense, Spain; (P.E.S.M.); (M.P.); (R.D.)
- Área de Tecnología de los Alimentos, Facultad de Ciencias de Ourense, Universidad de Vigo, 32004 Ourense, Spain
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Ruan Z, Qi J, Qian Z, Zhou M, Yang Y, Zhang S, Vaughn MG, LeBaige MH, Yin P, Lin H. Disease burden and attributable risk factors of respiratory infections in China from 1990 to 2019. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 11:100153. [PMID: 34327361 PMCID: PMC8315661 DOI: 10.1016/j.lanwpc.2021.100153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/17/2021] [Accepted: 03/31/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND There was lack of data on the burdens and trends of upper and lower respiratory infections (URIs and LRIs) over the past three decades in China. METHODS We estimated the incidence, mortality, and disability-adjusted life years (DALYs) due to upper and lower respiratory infections (URIs and LRIs) and attributable risk factors in China by a systematic analysis of the Global Burden of Disease 2019 study. Incidence, mortality, and DALYs were stratified by sex, age, and province. Risk factors for respiratory infections were analyzed from exposure data. FINDINGS The age-standardized incidence rates of URIs and LRIs were 179,077 and 3926 per 100,000 persons in 2019, with a 7•52% and 35•07% decrease from 1990, respectively. Moreover, 2801 and 185,264 persons died of URIs and LRIs in 2019, respectively. DALYs for URIs and LRIs also decreased from 1,516,727 in 1990 to 928,617 in 2019 and from 38,278,504 in 1990 to 4,020,676 in 2019. The burden of URIs and LRIs were generally similar in males and females, but relatively higher in the new-borns and the elderly. Child malnutrition and low birth weight were the most important cause of age-standardized DALYs of LRIs and URIs, respectively. INTERPRETATION Future URI and LRI prevention strategies should focus on the maternal and child health, air pollution, and tobacco control, especially in young children and the elderly population. FUNDING National Key R&D Program of China (2018YFA0606200); National Natural Science Foundation of China (82041021); Fundamental Research Funds for the Central Universities (20ykpy86) and Guangdong Basic and Applied Basic Research Foundation (2019A1515110003); Bill & Melinda Gates Foundation (No.: INV-006371).
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Affiliation(s)
- Zengliang Ruan
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou 510080, China
| | - Jinlei Qi
- National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Zhengmin (Min) Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Maigeng Zhou
- National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Yin Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou 510080, China
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou 510080, China
| | - Michael G. Vaughn
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63103, USA
| | - Morgan H. LeBaige
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Peng Yin
- National Centre for Chronic and Noncommunicable Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, No. 27 Nanwei Road, Xicheng District, Beijing 100050, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou 510080, China
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Wopker PM, Schwermer M, Sommer S, Längler A, Fetz K, Ostermann T, Zuzak TJ. Expert consensus-based clinical recommendation for an integrative anthroposophic treatment of acute bronchitis in children: A Delphi survey. Complement Ther Med 2021; 60:102736. [PMID: 34058369 DOI: 10.1016/j.ctim.2021.102736] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 03/16/2021] [Accepted: 05/04/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Acute bronchitis is one of the most common pediatric diseases. In addition to conventional therapies, a frequent use of complementary and alternative medicine (CAM) has been stated. Anthroposophic medicine (AM) is one of the most practiced complementary and integrative medicine (CIM) approaches in Central Europe but hitherto no consensus-based clinical recommendations or guidelines are available. Therefore, a consensus-based recommendation leading to an informed and reasonable use of AM in the treatment of acute bronchitis in pediatrics was developed. METHODS A total of 61 physicians in Germany with expertise in the field of anthroposophic pediatrics was invited to complete an online multistep Delphi process. Two independent reviewers quantitatively and qualitatively evaluated the results. The survey was completed when >75 % consensus was achieved. RESULTS The clinical recommendation comprises 15 subitems related to treatment as well as clinical and psychosocial aspects. All items reached strong consensus (>90 %; N = 9) or consensus (75-90 %; N = 6). CONCLUSION The comprehensive clinical recommendation creates a scientific base for the anthroposophic integrative treatment of acute bronchitis in children in Germany. It will make the anthroposophic approach more applicable, understandable and comparable to a wider public of physicians and other health professionals in Germany.
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Affiliation(s)
- Pilar Marie Wopker
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany; Witten/Herdecke University, Faculty of Health, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany
| | - Melanie Schwermer
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany; Witten/Herdecke University, Faculty of Health, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany.
| | - Simon Sommer
- Department of Pediatrics, Vestische Kinder- und Jugendklinik Datteln, Dr.-Friedrich-Steiner-Straße 5, 45711, Datteln, Germany
| | - Alfred Längler
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany; Witten/Herdecke University, Faculty of Health, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany
| | - Katharina Fetz
- Department of Psychology, Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany
| | - Thomas Ostermann
- Department of Psychology, Chair of Research Methodology and Statistics in Psychology, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, 58455, Witten, Germany
| | - Tycho Jan Zuzak
- Department of Pediatrics, Gemeinschaftskrankenhaus Herdecke, Gerhard-Kienle-Weg 4, 58313, Herdecke, Germany; Department of Pediatric Oncology and Hematology, University of Duisburg-Essen, Hufelandstr.55, 45147, Essen, Germany
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Antiviral Activity of the Propylamylatin TM Formula against the Novel Coronavirus SARS-CoV-2 In Vitro Using Direct Injection and Gas Assays in Virus Suspensions. Viruses 2021; 13:v13030415. [PMID: 33807769 PMCID: PMC7999574 DOI: 10.3390/v13030415] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/19/2021] [Accepted: 02/27/2021] [Indexed: 12/17/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of novel coronavirus disease 2019 (COVID-19), has become a severe threat to global public health. There are currently no antiviral therapies approved for the treatment or prevention of mild to moderate COVID-19 as remdesivir is only approved for severe COVID-19 cases. Here, we evaluated the antiviral potential of a Propylamylatin formula, which is a mixture of propionic acid and isoamyl hexanoates. The Propylamylatin formula was investigated in gaseous and liquid phases against 1 mL viral suspensions containing 105 PFU of SARS-CoV-2. Viral suspensions were sampled at various times post-exposure and infectious virus was quantified by plaque assay on Vero E6 cells. Propylamylatin formula vapors were effective at inactivating infectious SARS-CoV-2 to undetectable levels at room temperature and body temperature, but the decline in virus was substantially faster at the higher temperature (15 min versus 24 h). The direct injection of liquid Propylamylatin formula into viral suspensions also completely inactivated SARS-CoV-2 and the rapidity of inactivation occurred in an exposure dependent manner. The overall volume that resulted in 90% viral inactivation over the course of the direct injection experiment (EC90) was 4.28 µls. Further investigation revealed that the majority of the antiviral effect was attributed to the propionic acid which yielded an overall EC90 value of 11.50 µls whereas the isoamyl hexanoates provided at most a 10-fold reduction in infectious virus. The combination of propionic acid and isoamyl hexanoates was much more potent than the individual components alone, suggesting synergy between these components. These findings illustrate the therapeutic promise of the Propylamylatin formula as a potential treatment strategy for COVID-19 and future studies are warranted.
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Esposito C, Garzarella EU, Bocchino B, D'Avino M, Caruso G, Buonomo AR, Sacchi R, Galeotti F, Tenore GC, Zaccaria V, Daglia M. A standardized polyphenol mixture extracted from poplar-type propolis for remission of symptoms of uncomplicated upper respiratory tract infection (URTI): A monocentric, randomized, double-blind, placebo-controlled clinical trial. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2021; 80:153368. [PMID: 33091857 DOI: 10.1016/j.phymed.2020.153368] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 10/03/2020] [Accepted: 10/07/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The most common symptoms of mild upper respiratory tract infections (URTIs) are sore throat, muffled dysphonia, and swelling and redness of the throat, which result from the inflammation process following acute bacterial or viral infection. HYPOTHESIS/PURPOSE As propolis is a natural resinous substance traditionally used to maintain oral cavity and upper respiratory tract health due to its antimicrobial and anti-inflammatory properties, the aim of this study is to evaluate the efficacy of an oral spray based on poplar-type propolis extract with a known and standardized polyphenol content, on the remission of the symptoms associated with mild uncomplicated URTIs. STUDY DESIGN A monocentric, randomized, double-blind, placebo-controlled clinical trial was performed. METHODS This study was conducted in 122 healthy adults who had perceived mild upper respiratory tract infections. Participants, randomly assigned to receive either propolis oral spray (N = 58) or placebo (N = 64), underwent four visits (baseline = t0, after 3 days = t1 and after 5 days = t2 and after a follow-up of 15 days = t3) in an outpatient setting. Propolis oral spray total polyphenol content was 15 mg/ml. The dosage was 2-4 sprays three times/day (corresponding to 12-24 mg of polyphenols/day), for five days. The duration of the study was 8 weeks. RESULTS After 3 days of treatment, 83% of subjects treated with propolis oral spray had remission of symptoms, while 72% of subjects in the placebo group had at least one remaining symptom. After five days, all subjects had recovered from all symptoms. This means that resolution from mild uncomplicated URTIs took place two days earlier, instead of taking place in five days as recorded in the control group. There was no relationship between the ingestion of propolis oral spray or placebo and adverse reactions. CONCLUSION Propolis oral spray can be used to improve both bacterial and viral uncomplicated URTI symptoms in a smaller number of days without the use of pharmacological treatment, leading to a prompt symptom resolution.
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Affiliation(s)
- Cristina Esposito
- Department of Pharmacy, University of Naples Federico II, via Domenico Montesano 49, 80131 Naples, Italy
| | - Emanuele Ugo Garzarella
- Department of Pharmacy, University of Naples Federico II, via Domenico Montesano 49, 80131 Naples, Italy
| | - Bruno Bocchino
- Samnium Medical Soc. Cooperative, 82100 Benevento, Italy
| | - Maria D'Avino
- Department of Internal Medicine, Hospital Cardarelli, Via Antonio Cardarelli, 80131 Naples, Italy
| | - Giuseppe Caruso
- Department of Internal Medicine, Hospital Cardarelli, Via Antonio Cardarelli, 80131 Naples, Italy
| | - Antonio Riccardo Buonomo
- Department of Clinical Medicine and Surgery - Section of Infectious Diseases, University of Naples Federico II, via Sergio Pansini 5, 80131 Naples, Italy
| | - Roberto Sacchi
- Applied Statistic Unit, Department of Earth and Environmental Sciences, University of Pavia, viale Taramelli 24, 27100 Pavia, Italy
| | - Fabio Galeotti
- Department of Life Sciences, University of Modena and Reggio Emilia, Via Campi 213/D, 41121 Modena, Italy
| | - Gian Carlo Tenore
- Department of Pharmacy, University of Naples Federico II, via Domenico Montesano 49, 80131 Naples, Italy
| | | | - Maria Daglia
- Department of Pharmacy, University of Naples Federico II, via Domenico Montesano 49, 80131 Naples, Italy; International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang 212013, China.
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Adithya J, Nair B, Aishwarya TS, Nath LR. The Plausible Role of Indian Traditional Medicine in Combating Corona Virus (SARS-CoV 2): A Mini-Review. Curr Pharm Biotechnol 2021; 22:906-919. [PMID: 32767920 DOI: 10.2174/1389201021666200807111359] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 02/08/2023]
Abstract
SARS-CoV 2 is a novel virus strain of Coronavirus, reported in China in late December 2019. Its highly contagious nature in humans has prompted WHO to designate the ongoing pandemic as a Public Health Emergency of International Concern. At this moment, there is no specific treatment and the therapeutic strategies to deal with the infection are only supportive, with prevention aimed at reducing community transmission. A permanent solution for the pandemic, which has brought the world economy to the edge of collapse, is the need of the hour. This situation has brought intense research in traditional systems of medicine. Indian Traditional System, Ayurveda, has a clear concept of the cause and treatment of pandemics. Through this review, information on the potential antiviral traditional medicines along with their immunomodulatory pathways are discussed. We have covered the seven most important Indian traditional plants with antiviral properties: Withania somnifera (L.) Dunal (family: Solanaceae), Tinospora cordifolia (Thunb.) Miers (family: Menispermaceae), Phyllanthus emblica L. (family: Euphorbiaceae), Asparagus racemosus L. (family: Liliaceae), Glycyrrhiza glabra L. (family: Fabaceae), Ocimum sanctum L. (family: Lamiaceae) and Azadirachta indica A. Juss (family: Meliaceae) in this review. An attempt is also made to bring into limelight the importance of dietary polyphenol, Quercetin, which is a potential drug candidate in the making against the SARS-CoV2 virus.
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Affiliation(s)
- J Adithya
- Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Ponekkara P.O., Kochi, Kerala 682041, India
| | - Bhagyalakshmi Nair
- Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Ponekkara P.O., Kochi, Kerala 682041, India
| | - T S Aishwarya
- Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Ponekkara P.O., Kochi, Kerala 682041, India
| | - Lekshmi R Nath
- Department of Pharmacognosy, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Science Campus, Ponekkara P.O., Kochi, Kerala 682041, India
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Lucas S, Kumar D, Leach D, Phillips D. Complementary and alternative medicine use in Australian children with acute respiratory tract infection - A cross-sectional survey of parents. Complement Ther Clin Pract 2020; 39:101171. [DOI: 10.1016/j.ctcp.2020.101171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 04/02/2020] [Indexed: 12/18/2022]
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Langeder J, Grienke U, Chen Y, Kirchmair J, Schmidtke M, Rollinger JM. Natural products against acute respiratory infections: Strategies and lessons learned. JOURNAL OF ETHNOPHARMACOLOGY 2020; 248:112298. [PMID: 31610260 DOI: 10.1016/j.jep.2019.112298] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE A wide variety of traditional herbal remedies have been used throughout history for the treatment of symptoms related to acute respiratory infections (ARIs). AIM OF THE REVIEW The present work provides a timely overview of natural products affecting the most common pathogens involved in ARIs, in particular influenza viruses and rhinoviruses as well as bacteria involved in co-infections, their molecular targets, their role in drug discovery, and the current portfolio of available naturally derived anti-ARI drugs. MATERIALS AND METHODS Literature of the last ten years was evaluated for natural products active against influenza viruses and rhinoviruses. The collected bioactive agents were further investigated for reported activities against ARI-relevant bacteria, and analysed for the chemical space they cover in relation to currently known natural products and approved drugs. RESULTS An overview of (i) natural compounds active in target-based and/or phenotypic assays relevant to ARIs, (ii) extracts, and (iii) in vivo data are provided, offering not only a starting point for further in-depth phytochemical and antimicrobial studies, but also revealing insights into the most relevant anti-ARI scaffolds and compound classes. Investigations of the chemical space of bioactive natural products based on principal component analysis show that many of these compounds are drug-like. However, some bioactive natural products are substantially larger and have more polar groups than most approved drugs. A workflow with various strategies for the discovery of novel antiviral agents is suggested, thereby evaluating the merit of in silico techniques, the use of complementary assays, and the relevance of ethnopharmacological knowledge on the exploration of the therapeutic potential of natural products. CONCLUSIONS The longstanding ethnopharmacological tradition of natural remedies against ARIs highlights their therapeutic impact and remains a highly valuable selection criterion for natural materials to be investigated in the search for novel anti-ARI acting concepts. We observe a tendency towards assaying for broad-spectrum antivirals and antibacterials mainly discovered in interdisciplinary academic settings, and ascertain a clear demand for more translational studies to strengthen efforts for the development of effective and safe therapeutic agents for patients suffering from ARIs.
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Affiliation(s)
- Julia Langeder
- Department of Pharmacognosy, Faculty of Life Sciences, University of Vienna, Althanstraße 14, 1090, Vienna, Austria
| | - Ulrike Grienke
- Department of Pharmacognosy, Faculty of Life Sciences, University of Vienna, Althanstraße 14, 1090, Vienna, Austria.
| | - Ya Chen
- University of Hamburg, Center for Bioinformatics (ZBH), Bundesstraße 43, 22763, Hamburg, Germany
| | - Johannes Kirchmair
- Department of Chemistry, University of Bergen, N-5020, Bergen, Norway; Computational Biology Unit (CBU), University of Bergen, N-5020, Bergen, Norway
| | - Michaela Schmidtke
- Section of Experimental Virology, Department of Medical Microbiology, Jena University Hospital, Hans-Knöll-Straße 2, Jena, 07745, Germany
| | - Judith M Rollinger
- Department of Pharmacognosy, Faculty of Life Sciences, University of Vienna, Althanstraße 14, 1090, Vienna, Austria
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Lucas S, Leach MJ, Kumar S, Phillips AC. Complementary And Alternative Medicine Practitioner's Management Of Acute Respiratory Tract Infections In Children - A Qualitative Descriptive Study. J Multidiscip Healthc 2019; 12:947-962. [PMID: 31819469 PMCID: PMC6875505 DOI: 10.2147/jmdh.s230845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 10/29/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Acute respiratory tract infection (ARTI) is one of the most prevalent types of infection among children and a common reason for hospital admission. Although parents frequently consult complementary and alternative medicine (CAM) practitioners to assist with the management of childhood ARTI, little is known about the treatments that CAM practitioners recommend and why. The aim of this research was to understand what CAM practitioners typically prescribe for the management of childhood ARTI and how practitioners formulate decisions regarding the management of this condition. METHOD The research was guided by a qualitative descriptive framework. CAM practitioners across Greater Melbourne (Victoria, Australia) who had treated children aged 0-12 years with ARTI in the past 12 months were eligible to participate. Data were captured using semi-structured interviews, which were audio-recorded and transcribed verbatim. Multiple strategies to improve trustworthiness were implemented (e.g., triangulation of data). Data were analysed using inductive content analysis. RESULTS Twenty-four CAM practitioners from ten different disciplines participated in the interviews. Most participants were female (75%), and more than half (54%) were practicing naturopaths. The treatments most commonly recommended were lifestyle modification (95%), nutrition/diet-based treatments (91%), and vitamin/mineral supplementation (87%). Practitioners' decision-making process was underpinned by four key concepts namely: the approach to management, individualisation, do no harm, and collaborative practice. Individualisation and the safety of the child are cornerstones of treatment in the practitioner's decision-making process. CONCLUSION This research sheds light on commonly used CAM interventions, many of which build on easily accessible and readily available treatments (such as soups) and are aligned with mainstream recommendations (such as rest). Practitioners' decision-making process too aligns well with mainstream health care where the focus is on safety and informed by a biopsychosocial-cultural approach.
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Affiliation(s)
- Sandra Lucas
- School of Health Sciences, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Matthew J Leach
- Department of Rural Health, University of South Australia, Adelaide, SA, Australia
| | - Saravana Kumar
- School of Health Sciences, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Anna C Phillips
- School of Health Sciences, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia
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Lucas S, Kumar S, Leach MJ, Phillips A. Parent use of complementary medicine remedies and services for the management of respiratory tract infection in children: a qualitative study. J Multidiscip Healthc 2019; 12:749-766. [PMID: 31571893 PMCID: PMC6750007 DOI: 10.2147/jmdh.s216687] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 08/15/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) is increasing globally, in both adults and children. A common condition where CAM is used in children is acute respiratory tract infection (ARTI). However, limited information exists regarding specific CAM modalities used in children, and the factors that influence a parent's decision to use CAM for ARTI in children. This research aimed to address this knowledge gap. METHOD This research used a qualitative descriptive approach. Parents residing in Greater Melbourne, Australia, who had children aged from 0-12 years, and had used CAM for treating ARTI in their children in the last 12 months, were eligible to participate. Parents' perspectives were captured using individual semi-structured interviews, which were then transcribed verbatim. Data were analysed using content analysis. RESULTS Twenty-four families were interviewed. Several strategies to improve trustworthiness were implemented. Three themes underpinning the parents' decision to use CAM emerged from the data: safety, internal drivers and external drivers. Parents used a breadth of different treatments, predominantly food as medicine, followed by aromatherapy and other CAM remedies typically found in the kitchen, to manage ARTI in their children. Parents often used both CAM practitioners and mainstream medicine to manage ARTI in their children. While mainstream medicine was typically used to rule out any sinister pathology, CAM was often used as a frontline treatment option, with food as medicine (e.g. soups) dominating. This was due in part to concerns regarding the negative aspects of pharmaceutical use. Parents utilised a diverse range of information sources to inform their decision-making, including friends, families and the internet; traditional sources of research evidence were generally not used. CONCLUSION Child safety was a major factor influencing a primary carer's decision to utilise CAM for ARTI. The safety and effectiveness of remedies utilised by parents now warrants further investigation.
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Affiliation(s)
- S Lucas
- School of Health Sciences, Department of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - S Kumar
- School of Health Sciences, Department of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - MJ Leach
- Department of Rural Health, University of South Australia, Adelaide, South Australia, Australia
| | - A Phillips
- School of Health Sciences, Department of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Li H, Zhao M, Shi Y, Xing Z, Li Y, Wang S, Ying J, Zhang M, Sun J. The effectiveness of aromatherapy and massage on stress management in nurses: A systematic review. J Clin Nurs 2018; 28:372-385. [DOI: 10.1111/jocn.14596] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/26/2018] [Accepted: 06/25/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Huanhuan Li
- Basic Nursing Department School of Nursing Jilin University Changchun China
| | - Minghui Zhao
- Department of Endocrinology The Second Hospital of Jilin University Changchun China
| | - Ying Shi
- Basic Nursing Department School of Nursing Jilin University Changchun China
| | - Zhuangjie Xing
- Basic Nursing Department School of Nursing Jilin University Changchun China
| | - Yuan Li
- Basic Nursing Department School of Nursing Jilin University Changchun China
| | - Shouqi Wang
- Basic Nursing Department School of Nursing Jilin University Changchun China
| | - Jie Ying
- Basic Nursing Department School of Nursing Jilin University Changchun China
| | - Meiling Zhang
- Basic Nursing Department School of Nursing Jilin University Changchun China
| | - Jiao Sun
- Basic Nursing Department School of Nursing Jilin University Changchun China
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