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Freels L, Herman A, Lukas S, Chan AHY, Pearce CJ, Arackal J, Beyene K. Asthma control and associated risk factors among adults with current asthma: Findings from 2019 behavioral risk factor surveillance system asthma call-back survey. Respir Med 2024; 221:107479. [PMID: 38013060 DOI: 10.1016/j.rmed.2023.107479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/22/2023] [Accepted: 11/19/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Despite the availability of effective treatments, many adults with asthma have uncontrolled asthma. Uncontrolled asthma can lead to severe exacerbations. This study aimed to determine the prevalence and predictors of uncontrolled asthma among adults (≥18 years) with current asthma in the United States. METHODS We analyzed the 2019 Behavior Risk Factor Surveillance System Asthma Call-Back Survey data from 27 states. Asthma control status was classified as "well-controlled" or "uncontrolled" according to the National Asthma Education and Prevention guidelines. The study population consisted of 7937 adults (weighted n = 13,793,220) with current asthma. We used multivariable logistic regression models to identify predictors of uncontrolled asthma. RESULTS Overall, 62 % of adults with asthma reported having uncontrolled asthma, and 26 % had emergency or urgent care visits or hospitalizations in the past year. Potentially modifiable risk factors associated with uncontrolled asthma included cost barriers to asthma-related healthcare (OR = 2.94; 95%CI 1.96-4.40), complementary and alternative medicine use (OR = 1.84; 95%CI 1.45-2.32), current smoking (OR = 2.25; 95%CI 1.48-3.44), obesity (OR = 1.39; 95%CI 1.02-1.89), COPD (OR = 1.98; 95%CI 1.43-2.74), depression (OR = 1.47; 95%CI 1.16-1.88), fair/poor general health (OR = 1.54; 95%CI 1.14-2.07), household income <$15,000 (OR = 2.59; 95%CI 1.42-4.71), and less than high school education (OR = 2.59; 95%CI 1.42-4.71). Non-modifiable risk factor was Hispanic ethnicity (OR = 1.73; 95%CI 1.09-2.73). CONCLUSION Our findings suggest that uncontrolled asthma is common among adults and can be impacted by several factors. Effective asthma control programs are needed to improve asthma management and reduce unnecessary healthcare utilization.
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Affiliation(s)
- Lauren Freels
- Department of Pharmaceutical and Administrative Sciences, University of Health Sciences and Pharmacy in St. Louis, St. Louis, MO, USA
| | - Abigail Herman
- Department of Pharmaceutical and Administrative Sciences, University of Health Sciences and Pharmacy in St. Louis, St. Louis, MO, USA
| | - Stephanie Lukas
- Department of Pharmaceutical and Administrative Sciences, University of Health Sciences and Pharmacy in St. Louis, St. Louis, MO, USA
| | - Amy Hai Yan Chan
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Christina Joanne Pearce
- Department of Psychology, Health Psychology Section, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Joel Arackal
- Department of Pharmacy Practice, University of Health Sciences and Pharmacy, St. Louis, MO, USA
| | - Kebede Beyene
- Department of Pharmaceutical and Administrative Sciences, University of Health Sciences and Pharmacy in St. Louis, St. Louis, MO, USA.
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Carpio-Arias TV, Verdezoto N, Guijarro-Garvi M, Abril-Ulloa V, Mackintosh N, Eslambolchilar P, Ruíz-Cantero MT. Healthcare professionals' experiences and perceptions regarding health care of indigenous pregnant women in Ecuador. BMC Pregnancy Childbirth 2022; 22:101. [PMID: 35120490 PMCID: PMC8815715 DOI: 10.1186/s12884-022-04432-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 01/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnancy is an important life experience that requires uniquely tailored approach to health care. The socio-cultural care practices of indigenous pregnant women (IPW) are passed along the maternal line with respect to identity, worldview and nature. The cultural differences between non-indigenous healthcare professionals (HPs) and IPW could present a great challenge in women's health care. This article presents an analysis from a human rights and gender perspective of this potential cultural divide that could affect the health of the IPW in an Andean region of Ecuador with the objective of describing the health challenges of IPWs as rights holders through the experiences and perceptions of HP as guarantors of rights. METHODS We conducted 15 in-depth interviews with HPs who care for IPW in Chimborazo, Pichincha provinces of Ecuador. We utilized a semi-structured interview guide including questions about the experiences and perceptions of HPs in delivering health care to IPW. The interviews were recorded, transcribed and subjected to thematic analysis in Spanish and translated for reporting. RESULTS We found disagreements and discrepancies in the Ecuadorian health service that led to the ignorance of indigenous cultural values. Common characteristics among the indigenous population such as illiteracy, low income and the age of pregnancy are important challenges for the health system. The gender approach highlights the enormous challenges: machismo, gender stereotypes and communication problems that IPWs face in accessing quality healthcare. CONCLUSIONS Understanding the diverse perspectives of IPW, acknowledging their human rights particularly those related to gender, has the potential to lead to more comprehensive and respectful health care delivery in Ecuador. Further, recognizing there is a gender and power differential between the provider and the IPW can lead to improvements in the quality of health care delivery and reproductive, maternal and child health outcomes.
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Affiliation(s)
- Tannia Valeria Carpio-Arias
- Research Group on Food and Human Nutrition (GIANH), Faculty of Public Health, Higher Polytechnic School of Chimborazo, Pan-American Sur Km 1 1/2, Riobamba, Ecuador
| | - Nervo Verdezoto
- School of Computer Science and Informatics, Human-centered Computing Group, Cardiff University, Cardiff, UK
| | - Marta Guijarro-Garvi
- Department of Economics, University of Cantabria, Cantabria, Spain
- Public Health Research Group, University of Alicante, Alicante, Spain
| | - Victoria Abril-Ulloa
- Research Group on Public Health, Nutrition and Physical Activity in the Life Cycle, University of Cuenca, Cuenca, Ecuador
| | - Nicola Mackintosh
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Parisa Eslambolchilar
- School of Computer Science and Informatics, Human-centered Computing Group, Cardiff University, Cardiff, UK
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Antonelli M, Donelli D. Reinterpreting homoeopathy in the light of placebo effects to manage patients who seek homoeopathic care: A systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:824-847. [PMID: 30456773 DOI: 10.1111/hsc.12681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 10/10/2018] [Accepted: 10/12/2018] [Indexed: 06/09/2023]
Abstract
Homoeopathy is widespread, and users claim to benefit from it. However, clear evidence of its efficacy over placebo is not available to date. As a consequence, a social separation between homoeopathy users and mainstream medicine exists, exposing these patients to many risks. Our primary objective is to assess homoeopathy efficacy by systematically reviewing existing systematic reviews and meta-analyses and to systematically review trials on open-label placebo (OLP) treatments. A secondary objective is to understand if homoeopathy as a whole may be considered as a placebo treatment. PubMed/Medline, Embase, Google Scholar, and Cochrane Library were systematically searched for systematic reviews and meta-analyses on homoeopathy efficacy, and 61 studies were included. Same databases plus Journal of Interdisciplinary Placebo Studies (JIPS) were also systematically searched for randomised controlled trials (RCTs) on OLP treatments, and 10 studies were included. Databases were searched up to 24 February 2018. Two authors independently screened all retrieved articles and selected studies eligible for inclusion. The quality of reviews of included studies was evaluated with a dedicated NIH tool in the first review, whereas the risk of bias of trials of included studies was assessed with the specific Cochrane tool in the second review. Qualitative syntheses show that homoeopathy efficacy can be considered comparable to placebo, and that OLP treatments may be effective in some health conditions. Placebo effects like placebo itself, treatment context, physician-patient relationship, and other nonspecific factors can define the idea of placebo treatments, which may be effective in some conditions. If homoeopathy efficacy is comparable to placebo, and if placebo treatments can be effective in some conditions, then homoeopathy as a whole may be considered as a placebo treatment. Reinterpreting homoeopathy as a placebo treatment would define limits and possibilities of this practice. This perspective shift suggests a strategy to manage patients who seek homoeopathic care and to reconcile them with mainstream medicine in a sustainable way.
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Affiliation(s)
- Michele Antonelli
- Department of Medicine and Surgery, Institute of Public Health, University of Parma, Parma, Italy
- Terme di Monticelli, Parma, Italy
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Liu J, Ma T, Liu Y, Zou J, Gao M, Zhang R, Wu J, Liu S, Xie H. History, advancements, and perspective of biological research in deep-underground laboratories: A brief review. ENVIRONMENT INTERNATIONAL 2018; 120:207-214. [PMID: 30098554 DOI: 10.1016/j.envint.2018.07.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/20/2018] [Accepted: 07/22/2018] [Indexed: 02/05/2023]
Abstract
The world is entering a new era of exploring and exploiting the deep-underground space. With humans poised to reach historical depths in the use of the deep Earth, it is essential to understand the effect of the deep-underground environment on the health of humans and other living organisms. This article outlines the history and development of biological research conducted in deep-underground laboratories and provides insight into future areas of investigation. Many deep-underground laboratories have investigated the effects of reduced cosmic ray muons flux, searching for rare events such as proton decay, dark matter particles, or neutrino interactions, but few have focused on the influence of the environmental factors in the deep-underground on living organisms. Some studies revealed that prokaryote and eukaryote cells maintained in low levels of background radiation exhibited an stress response, which manifested as changes in cell growth, enzyme activity, and sensitivity to factors that cause genetic damage; however, the underlying mechanisms are unclear. There remains an urgent need to understand the detrimental and beneficial biological effects of low background radiation and other factors in the deep-underground on humans and other organisms. Consequently, a multidisciplinary approach to medical research in the deep-underground has been proposed, creating a new discipline, deep-underground medicine, and representing a historical milestone for exploring the deep Earth and in medical research.
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Affiliation(s)
- Jifeng Liu
- Deep Underground Space Medical Center, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, China; Department of Otolaryngology Head & Neck Surgery, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, China; Department of Head & Neck Surgery, Sichuan Cancer Hospital and Institute, School of Medicine, University of Electronic Science and Technology of China, No. 55, Section 4, South Renmin Road, Chengdu, China
| | - Tengfei Ma
- Deep Underground Space Medical Center, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, China; Department of Otolaryngology Head & Neck Surgery, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, China
| | - Yilin Liu
- Deep Underground Space Medical Center, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, China; Department of Ophthalmology, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, China
| | - Jian Zou
- Deep Underground Space Medical Center, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, China; Department of Otolaryngology Head & Neck Surgery, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, China.
| | - Mingzhong Gao
- Deep Underground Space Medical Center, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, China; College of Water Resources & Hydropower, Sichuan University, No. 24 South Section 1, Yihuan Road, Chengdu, China.
| | - Ru Zhang
- College of Water Resources & Hydropower, Sichuan University, No. 24 South Section 1, Yihuan Road, Chengdu, China.
| | - Jiang Wu
- Deep Underground Space Medical Center, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, China.
| | - Shixi Liu
- Department of Otolaryngology Head & Neck Surgery, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, China
| | - Heping Xie
- Deep Underground Space Medical Center, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu, China; Institute of Deep Earth Science and Green Energy, Shenzhen University, Nanhai Ave, 3688 Shenzhen, China.
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Chen W, FitzGerald JM, Rousseau R, Lynd LD, Tan WC, Sadatsafavi M. Complementary and alternative asthma treatments and their association with asthma control: a population-based study. BMJ Open 2013; 3:e003360. [PMID: 24005131 PMCID: PMC3773646 DOI: 10.1136/bmjopen-2013-003360] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Many patients with asthma spend time and resources consuming complementary and alternative medicines (CAMs). This study explores whether CAM utilisation is associated with asthma control and the intake of asthma controller medications. DESIGN Population-based, prospective cross-sectional study. SETTING General population residing in two census areas in the province of British Columbia, Canada. Recruitment was based on random-digit dialling of both landlines and cell phones. PARTICIPANTS 486 patients with self-reported physician diagnosis of asthma (mean age 52 years; 67.3% woman). PRIMARY AND SECONDARY OUTCOME MEASURES We assessed CAM use over the previous 12 months, level of asthma control as defined by the Global Initiative for Asthma and the self-reported intake of controller medications. Multivariate logistic regression was performed to study the relationship between any usage of CAMs (outcome), asthma control and controller medication usage, adjusted for potential confounders. RESULTS A total of 179 (36.8%) of the sample reported CAM usage in the past 12 months. Breathing exercises (17.7%), herbal medicines (10.1%) and vitamins (9.7%) were the most popular CAMs reported. After adjustment, female sex (OR 1.66; 95% CI 1.09 to 2.52) and uncontrolled asthma (vs controlled asthma, OR 2.25, 95% CI 1.30 to 3.89) were associated with a higher likelihood of using any CAMs in the past 12 months. Controller medication use was not associated with CAM usage in general and in the subgroups defined by asthma control. CONCLUSIONS Clinicians and policy makers need to be aware of the high prevalence of CAM use in patients with asthma and its association with lack of asthma control.
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Affiliation(s)
- Wenjia Chen
- Faculty of Pharmaceutical Sciences, Collaboration for Outcomes Research and Evaluation, University of British ColumbiaVancouver British Columbia Canada
- Division of Respiratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - J Mark FitzGerald
- Division of Respiratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Institute for Heart and Lung Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Roxanne Rousseau
- Division of Respiratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Larry D Lynd
- Faculty of Pharmaceutical Sciences, Collaboration for Outcomes Research and Evaluation, University of British ColumbiaVancouver British Columbia Canada
- Centre for Health Evaluation and Outcome Sciences, Providence Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Wan C Tan
- Institute for Heart and Lung Health, University of British Columbia, Vancouver, British Columbia, Canada
- James Hogg Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Mohsen Sadatsafavi
- Division of Respiratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Institute for Heart and Lung Health, University of British Columbia, Vancouver, British Columbia, Canada
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Rivera DG, Hernández I, Merino N, Luque Y, Álvarez A, Martín Y, Amador A, Nuevas L, Delgado R. Mangifera indica L. extract (Vimang) and mangiferin reduce the airway inflammation and Th2 cytokines in murine model of allergic asthma. ACTA ACUST UNITED AC 2012; 63:1336-45. [PMID: 21899550 DOI: 10.1111/j.2042-7158.2011.01328.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The aim was to study the effects of Mangifera indica extract and its major component mangiferin on lung inflammation response and Th2 cytokine production using a murine experimental model of allergic asthma. METHODS BALB/c mice were intraperitoneally sensitized with 10 µg of ovoalbumin (OVA) adsorbed on aluminium hydroxide on days 0, 7 and 14. Seven days after the last injection, the mice were challenged with 2% aerosolized OVA inhalation for 30 min beginning on day 21 and continuing until day 24. To evaluate the protective effect, mice were orally treated with M. indica extract (50, 100 or 250 mg/kg) or mangiferin (50 mg/kg) from days 0 to 24. Anti-OVA immunoglobulin E, interleukin (IL)-4 and IL-5 were determined by ELISA and lungs were analysed by histology. KEY FINDINGS M. indica extract and mangiferin produced a marked reduction of airway inflammation around vessels and bronchi, inhibition of IL-4 and IL-5 cytokines in bronchoalveolar lavage fluid and lymphocyte culture supernatant, IgE levels and lymphocyte proliferation. CONCLUSION This is the first pre-clinical report of the anti-inflammatory properties of M. indica extract and mangiferin in experimental asthma and it could be an important part of pre-clinical requirement necessary for its use to complement the treatment of this complex disease.
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Affiliation(s)
- Dagmar García Rivera
- Laboratory of Pharmacology, Department of Biomedical Research, Center for Pharmaceutical Chemistry, Atabey, Playa, Havana City, Cuba.
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Tokem Y, Aytemur ZA, Yildirim Y, Fadiloglu C. Investigation into the use of complementary and alternative medicine and affecting factors in Turkish asthmatic patients. J Clin Nurs 2011; 21:698-707. [PMID: 22040480 DOI: 10.1111/j.1365-2702.2011.03823.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
AIMS The purpose of this study was to examine the frequency of complementary and alternative medicine usage in asthmatic patients living in the west of Turkey, the most frequently used complementary and alternative medicine methods and socio-demographic factors affecting this and factors related to the disease. BACKGROUND While the rate of complementary and alternative medicine usage in asthmatic patients and the reasons for using it vary, practices specific to different countries and regions are of interest. Differing cultural and social factors even in geographically similar regions can affect the type of complementary and alternative medicine used. METHODS Two hundred asthmatic patients registered in the asthma outpatient clinic of a large hospital in Turkey and who had undergone pulmonary function tests within the previous six months were included in this study, which was planned according to a descriptive design. The patients filled out a questionnaire on their demographic characteristics and complementary and alternative medicine usage. RESULTS The proportion of patients who reported using one or more of the complementary and alternative medicine methods was 63·0%. Of these patients, 61·9% were using plants and herbal treatments, 53·2% were doing exercises and 36·5% said that they prayed. The objectives of their use of complementary and alternative medicine were to reduce asthma-related complaints (58%) and to feel better (37·8%). The proportion of people experiencing adverse effects was 3·3% (n = 4). Factors motivating asthmatic patients to use complementary and alternative medicine were the existence of comorbid diseases and a long period since diagnosis (p < 0·05). No statistically significant difference was found between the use of complementary and alternative medicine and the severity of the disease, pulmonary function test parameters, the number of asthma attacks or hospitalisations because of asthma within the last year (p > 0·05). RELEVANCE TO CLINICAL PRACTICE Understanding by nurses of the causes and patterns of the use of complementary and alternative medicine in asthmatic patients helps them in directing patient care and patient safety. Nurses should conduct comprehensive diagnostics in the light of complementary and alternative medicine use, and they should be aware of the potential risks.
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Yin LM, Jiang GH, Wang Y, Wang Y, Liu YY, Jin WR, Xu YD, Zhang QH, Yang YQ. Use of serial analysis of gene expression to reveal the specific regulation of gene expression profile in asthmatic rats treated by acupuncture. J Biomed Sci 2009; 16:46. [PMID: 19419550 PMCID: PMC2698896 DOI: 10.1186/1423-0127-16-46] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Accepted: 05/06/2009] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Asthma has become an important public health issue and approximately 300 million people have suffered from the disease worldwide. Nowadays, the use of acupuncture in asthma is increasing. This study intended to systematically analyze and compare the gene expression profiles between the asthmatic and acupuncture-treated asthmatic rat lung, and tried to gain insight into the molecular mechanism underlying the early airway response (EAR) phase of asthma treated by acupuncture. METHODS Four tag libraries of serial analysis of gene expression (SAGE) were established from lung tissues of control rats (CK), asthmatic rats (AS), asthmatic rats treated by acupuncture (ASAC), and control rats treated by acupuncture (CKAC). Bioinformatic analyses were carried out by using the methods including unsupervised hierarchical clustering, functional annotation tool of the database for annotation, visualization, and integrated discovery (DAVID), gene ontology (GO) tree machine, and Kyoto encyclopedia of genes and genomes (KEGG) pathway analysis. RESULTS There were totally 186 differentially expressed tags (P < 0.05, P(CK/AS)) between the libraries of CK and AS, 130 differentially expressed tags between libraries of AS/ASAC (P < 0.05, P(AS/ASAC)), and 144 differentially expressed tags between libraries of CK/CKAC (P < 0.05, P(CK/CKAC)). The gene expression profiles of AS and ASAC were more similar than other libraries via unsupervised SAGE clustering. By comparison of P(CK/AS) and P(AS/ASAC), the DAVID genes functional classification was found to be changed from "immune response" to "response to steroid hormone stimulus", and the GO term "antigen processing and presentation of peptide antigen" disappeared in P(AS/ASAC). Totally 3 same KEGG pathways were found among the three groups. Moreover, 21 specific tags of the acupuncture in treating asthma were detected using Venn diagrams. CONCLUSION Our SAGE research indicates that the gene expression profile of the EAR phase of asthma could be effectively and specifically regulated by acupuncture, which suggests that the gene expression of immune response and steroid hormone may play an important role in the treatment.
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Affiliation(s)
- Lei-Miao Yin
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Gong-Hao Jiang
- National Key Laboratory of Plant Molecular Genetics, Institute of Plant Physiology & Ecology, Chinese Academy of Sciences, Shanghai, PR China
| | - Yu Wang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Yan Wang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Yan-Yan Liu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Wei-Rong Jin
- National Engineering Center for Biochips at Shanghai, Shanghai, PR China
| | - Yu-Dong Xu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Qing-Hua Zhang
- National Engineering Center for Biochips at Shanghai, Shanghai, PR China
| | - Yong-Qing Yang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
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Sidora-Arcoleo K, Yoos HL, Kitzman H, McMullen A, Anson E. Don't ask, don't tell: parental nondisclosure of complementary and alternative medicine and over-the-counter medication use in children's asthma management. J Pediatr Health Care 2008; 22:221-9. [PMID: 18590866 PMCID: PMC2517627 DOI: 10.1016/j.pedhc.2007.07.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2007] [Revised: 07/09/2007] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Parent-health care provider (HCP) communication is an important component of pediatric asthma management. Given the high prevalence of complementary and alternative medicine (CAM) and over-the-counter (OTC) medication use among this population, it is important to examine parental nondisclosure of these asthma management strategies. METHOD One-time interview and 1-year retrospective medical record review with 228 parents of 5- to 12-year-old children with asthma enrolled from six pediatric primary care practices examining parental nondisclosure of CAM and OTC medication use, reasons for nondisclosure, medical record documentation of CAM usage, and association between parent-HCP relationship and nondisclosure. RESULTS Seventy-one percent of parents reported using CAM and/or OTC medication for children's asthma management, and 54% of those parents did not disclose usage. Seventy-five percent "did not think" to discuss it. Better parent-HCP relationship led to decreased nondisclosure. DISCUSSION HCPs can play an important role in creating an environment where parents feel comfortable sharing information about their children's asthma management strategies in order to arrive at a shared asthma management plan for the child, leading to improved asthma health outcomes.
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Affiliation(s)
- Kimberly Sidora-Arcoleo
- Arizona State University College of Nursing & Healthcare Innovation, Phoenix, Arizona 85004, USA.
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Sidora-Arcoleo K, Yoos HL, McMullen A, Kitzman H. Complementary and alternative medicine use in children with asthma: prevalence and sociodemographic profile of users. J Asthma 2007; 44:169-75. [PMID: 17454333 DOI: 10.1080/02770900701209640] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Research on complementary and alternative medicine use in children with asthma is in its infancy. This study examined the prevalence, types of CAM used and sociodemographic differences in CAM use among children 5-12 years with asthma. 65% of parents reported using CAM. Usage was highest among black, poor, lesser educated parents and children with persistent symptoms. Types of CAM differed by poverty and a trend for differences by race and education emerged. Health care providers who educate themselves on CAM therapies parents use for asthma can then discuss the implications of using these therapies and potentially improve adherence to the prescribed medication regimen.
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Affiliation(s)
- Kimberly Sidora-Arcoleo
- Arizona State University College of Nursing and Healthcare Innovation, Phoenix, AZ 85004, USA.
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Chen FP, Kung YY, Chen TJ, Hwang SJ. Demographics and patterns of acupuncture use in the Chinese population: the Taiwan experience. J Altern Complement Med 2006; 12:379-87. [PMID: 16722788 DOI: 10.1089/acm.2006.12.379] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM), including Traditional Chinese Medicine (TCM) and acupuncture, has substantially increased in western countries in the past decade. However, informative data concerning large-scale investigations of acupuncture used in the Chinese society remain rare so far. DESIGN AND OUTCOME MEASURE: The complete datasets of acupuncture outpatient reimbursement claims from 1996 to 2002 were supplied by the National Health Insurance Research Database, Taiwan, and the usage frequencies and characteristics of the acupuncture users, as well as the disease categories that were treated by acupuncture in Taiwan were analyzed. RESULTS At the end of 2002, among the 21,869,478 total valid beneficiaries of National Health Insurance (NHI), 1,362,351 subjects (6.2%) used acupuncture during this year, but 4,948,464 subjects (22.6%) had used it for the whole 7-year period since 1996. A mean increment of 1,191,164 (53.6%) new users had been involved yearly. Among all those acupuncture users, a female predominance was observed (female:male = 1.12:1), and the age distribution displayed a peak at around the 40s, followed by the 30s and 50s. Private TCM clinics provided more acupuncture usage (82.0%) than did private TCM hospitals (13.7%). The disease categories treated mostly by acupuncture were diseases of the musculoskeletal system (46.2%); injury (41.8%); diseases of the nervous system (3.5%); and symptoms, signs, and ill-defined conditions (2.7%). CONCLUSIONS Twenty-three percent (23%) of people in Taiwan had used acupuncture during this 7-year period. Musculoskeletoal and neurologic disorders were two major categories commonly treated with acupuncture.
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Affiliation(s)
- Fang-Pey Chen
- Center for Traditional Medicine, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan
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Bellavite P, Ortolani R, Pontarollo F, Piasere V, Benato G, Conforti A. Immunology and homeopathy. 4. Clinical studies-part 2. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2006; 3:397-409. [PMID: 17173103 PMCID: PMC1697745 DOI: 10.1093/ecam/nel046] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2006] [Accepted: 06/09/2006] [Indexed: 12/26/2022]
Abstract
The clinical studies on the effectiveness of homeopathy in respiratory allergy (18 randomized trials and 9 observational studies) are described. The literature of common immunologic disorders including also upper respiratory tract infections (URTI) and otorhinolaryngology (reported in part 1), is evaluated and discussed. Most of initial evidence-based research was addressed to the question of whether homeopathic high dilutions are placebos or possess specific effects, but this question has been often equivocal and is still a matter of debate. The evidence demonstrates that in some conditions homeopathy shows significant promise, e.g. Galphimia glauca (low dilutions/potencies) in allergic oculorhinitis, classical individualized homeopathy in otitis and possibly in asthma and allergic complaints, and a few low-potency homeopathic complexes in sinusitis and rhinoconjunctivitis. A general weakness of evidence derives from lack of independent confirmation of reported trials and from presence of conflicting results, as in case of homeopathic immunotherapy and of classical homeopathy for URTI. The suitable methods to evaluate homeopathy effectiveness, without altering the setting of cure, are also analyzed.
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Affiliation(s)
- Paolo Bellavite
- Department of Scienze Morfologico-BiomedichePiazza L.A. Scuro, 37134 Verona, Italy
| | - Riccardo Ortolani
- Association for Integrative Medicine ‘Giovanni Scolaro’Piazza L.A. Scuro, 37134 Verona, Italy
| | - Francesco Pontarollo
- Department of Scienze Morfologico-BiomedichePiazza L.A. Scuro, 37134 Verona, Italy
| | - Valeria Piasere
- Department of Scienze Morfologico-BiomedichePiazza L.A. Scuro, 37134 Verona, Italy
| | - Giovanni Benato
- Association for Integrative Medicine ‘Giovanni Scolaro’Piazza L.A. Scuro, 37134 Verona, Italy
| | - Anita Conforti
- Department of Medicina e Sanità Pubblica, University of VeronaPiazza L.A. Scuro, 37134 Verona, Italy
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Hedman J, Hugg T, Sandell J, Haahtela T. The effect of salt chamber treatment on bronchial hyperresponsiveness in asthmatics. Allergy 2006; 61:605-10. [PMID: 16629791 DOI: 10.1111/j.1398-9995.2006.01073.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Randomized controlled trials are needed to evaluate the effects of complementary treatments in asthma. This study assessed the effect of salt chamber treatment as an add-on therapy to low to moderate inhaled steroid therapy in asthma patients with bronchial hyperresponsiveness (BHR). METHODS After a 2-week baseline period, 32 asthma patients who exhibited BHR in the histamine inhalation challenge were randomized: 17 to 2-week active treatment, during which salt was fed to the room by a salt generator, and 15 to placebo. The salt chamber treatment lasted 40 min and was administered five times a week. RESULTS Median provocative dose causing a decrease of 15% in Fev(1) (PD(15)FEV(1)) [corrected] increased significantly in the active group (P = 0.047) but not in the placebo group. The difference in changes between the active and placebo groups was significant (P = 0.02). Nine patients (56%) in the active group and two patients (17%) in the placebo group exhibited at least one doubling dose decrease in BHR (P = 0.040). Six patients (38%) in the active group and none in the placebo group became non-hyperresponsive (P = 0.017). Neither the peak expiratory flow (PEF) values measured just before and after the treatment, nor FEV(1) values measured before the histamine challenges, changed. The reduction in BHR was not caused by changes in the baseline lung function. CONCLUSIONS Salt chamber treatment reduced bronchial hyperresponsiveness as an add-on therapy in asthmatics with a low to moderate dose of inhaled steroids. The possibility that salt chamber treatment could serve as a complementary therapy to conventional medication cannot be excluded.
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Affiliation(s)
- J Hedman
- Department of Pulmonary Diseases, South Karelia Central Hospital, Lappeenranta, Finland
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16
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Hwang BY, Park MN, Choi HS, Choi CW, Yoo JH, Kang HM, Park MJ. The Current Status of Complementary-Alternative Medicine for Asthmatics in Korea : Experience in One Tertiary Care Hospital. Tuberc Respir Dis (Seoul) 2006. [DOI: 10.4046/trd.2006.61.4.339] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Bo Young Hwang
- Division of Pulmonology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Mi Na Park
- Division of Pulmonology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hye Sook Choi
- Division of Pulmonology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Cheon Woong Choi
- Division of Pulmonology, East-West Neomedical Center, Seoul, Korea
| | - Ji Hong Yoo
- Division of Pulmonology, East-West Neomedical Center, Seoul, Korea
| | - Hong Mo Kang
- Division of Pulmonology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Myung Jae Park
- Division of Pulmonology, Kyung Hee University College of Medicine, Seoul, Korea
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Langewitz W, Izakovic J, Wyler J, Schindler C, Kiss A, Bircher AJ. Effect of self-hypnosis on hay fever symptoms - a randomised controlled intervention study. PSYCHOTHERAPY AND PSYCHOSOMATICS 2005; 74:165-72. [PMID: 15832067 DOI: 10.1159/000084001] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Many people suffer from hay fever symptoms. Hypnosis has proved to be a useful adjunct in the treatment of conditions where allergic phenomena have an important role. METHODS Randomised parallel group study over an observation period of two consecutive pollen seasons. Outcome data include nasal flow under hypnosis, pollinosis symptoms from diaries and retrospective assessments, restrictions in well-being and use of anti-allergic medication. We investigated 79 patients with a mean age of 34 years (range 19-54 years; 41 males), with moderate to severe allergic rhinitis to grass or birch pollen of at least 2 years duration and mild allergic asthma. The intervention consisted of teaching self-hypnosis during a mean of 2.4 sessions (SD 1.7; range 2-5 sessions) and continuation of standard anti-allergic pharmacological treatment. RESULTS Of 79 randomised patients, 66 completed one, and 52 completed two seasons. Retrospective VAS scores yielded significant improvements in year 1 in patients who had learned self-hypnosis: pollinosis symptoms -29.2 (VAS score, range 0-100; SD 25.4; p < 0.001), restriction of well-being -26.2 (VAS score, range 0-100; SD 28.7; p < 0.001. In year 2, the control group improved significantly having learned self-hypnosis as well: pollinosis symptoms -24.8 (SD 29.1; p < 0.001), restriction of well-being -23.7 (SD 30.0; p < 0.001). Daily self-reports of subjects who learnt self-hypnosis do not show a significant improvement. The hazard ratio of reaching a critical flow of 70% in nasal provocation tests was 0.333 (95% CI 0.157-0.741) after having learnt and applied self-hypnosis.
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Affiliation(s)
- Wolf Langewitz
- Division of Psychosomatic Medicine, Department of Internal Medicine, University Hospital Basel, Basel, Switzerland.
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Abstract
Complementary and alternative medicine (CAM) represent a group of diverse medical and health care systems, practices, and products that are not considered to be part of conventional medicine. Biofeedback, acupuncture, herbal medication, massage, bioelectromagnetic therapy, meditation, and music therapy are examples of CAM treatments. Some dentists in the United States have used some of these treatments and products in their practices. Complementary medicines include herbal remedies, homeopathic medicines, and essential oils. There has been an increase in the use of herbal medicines in the US over the last 15-20 years. There is a public belief that these medicines are safe because they are made from natural sources. However, some of these products have associated adverse effects including toxicity and drug interactions. The health history taken by the dentist should include questions regarding the taking of herbal and over-the-counter medications. The dentist needs to be informed regarding the herbal and over-the-counter products that may impact the delivery of safe and effective dental treatment. In addition, the use of CAM treatments in dentistry should be based on evidence of effectiveness and safety as demonstrated in randomized clinical trials.
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