TM/CAM Update First Quarter 2011

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update First Quarter 2011

The purpose of this update on traditional medicine and complementary medicine (TM/CAM) is to inform healthcare professionals, researchers, funders and policy‐makers about developments. The update provides links to new material published or released as well as links to classic resources on traditional, complementary and integrative medicine as we gather them for the web‐site.

1. Policy and Legislation

World Health Organization (WHO) The World Health Organization (WHO) has a site devoted to Traditional Medicine (TM), including Complementary and Alternative Medicine (CAM). See http://www.who.int/medicines/areas/traditional/en/index.html

The first ENZCAM Brief for Professionals will deal in more detail with WHO policy with respect to TM/CAM.

2. Research Organisations

National Center for Complementary and Alternative Medicine (NCCAM) The National Center for Complementary and Alternative Medicine (NCCAM), is part of the National Institutes of Health (NIH) in the USA. http://nccam.nih.gov/

NCCAM is the USA “Federal Government's lead agency for scientific research on the diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine.” NCCAM “is dedicated to exploring complementary and alternative healing practices in the context of rigorous science, training CAM researchers, and disseminating authoritative information to the public and professionals.”

The Resources for Health Care Providers section at http://nccam.nih.gov/health/providers/ includes:  Educational Resources: including lectures, material for continuing education and data on CAM use;  Evidence‐based Medicine: Results of NCCAM‐sponsored research and literature reviews of CAM modalities;  Clinical Practice Guidelines: Abstracts and full‐text guidelines from other organizations; and  For Patients: printable fact sheets for patients.

ENZCAM Newsletter TM/CAM Update First Quarter 2011

The Herbs at a Glance section is at http://nccam.nih.gov/health/herbsataglance.htm . Herbs at a Glance is a series of fact sheetsa that provides basic information about specific herbs or botanicals—common names, uses, potential side effects, and resources for more information. A PDF of the full series can be downloaded.

There is a monthly clinical newsletter, NCCAM Clinical Digest Newsletter.

http://nccam.nih.gov/news/subscribe.htm “NCCAM's monthly e‐newsletter offers evidence‐based information on CAM, including scientific literature searches, summaries of NCCAM‐funded research, fact sheets for patients, and more.”

Literature Reviews on Specific CAM Modalities (PubMed® Citations) http://nccam.nih.gov/health/providers/evidencebased.htm  Acupuncture  Chiropractic  Massage  Meditation

There are also literature reviews using pre‐set PubMed searches for specific conditions in the section Health Topics A–Z at http://nccam.nih.gov/health/atoz.htm .

Cochrane CAM Field http://www.compmed.umm.edu/cochrane_about.asp

“The Cochrane CAM Field is an international group of individuals dedicated to facilitating the production of systematic reviews of randomized clinical trials in areas such as acupuncture, massage, chiropractic, herbal medicine, homeopathy and mind‐body therapy. It is a member entity of the Cochrane Collaboration, a worldwide organization that prepares systematic reviews of all kinds of healthcare therapies, and publishes these reviews in The Cochrane Library.”

“Founded in 1996 and coordinated by the University of Maryland Center for Integrative Medicine, the Cochrane CAM Field has worked steadily to meet the growing demand for information about CAM therapies among both practitioners and the general public by identifying published clinical trials of alternative therapies, preparing systematic reviews, training systematic reviewers, disseminating systematic reviews to the general public and healthcare providers, and conducting research to improve systematic review methodology.”

A list of all Cochrane Collaboration's systematic reviews related to CAM is at: http://www.compmed.umm.edu/cochrane_reviews.asp

Some examples from the extensive listb:

 Acupuncture for acute stroke  Acupuncture for shoulder pain  Antioxidant vitamin and mineral supplements for slowing the progression of age‐related macular degeneration

a There were 42 fact sheets available on 28 January 2011 b There were 438 Complementary and Alternative Medicine Reviews in Cochrane Library Issue 10, 2010. There were also 256 Complementary and Alternative Medicine Protocols in that Library.

ENZCAM Newsletter TM/CAM Update First Quarter 2011

 Antioxidants for preventing pre‐eclampsia  Calcium supplementation for the management of primary hypertension in adults  Chelation therapy for atherosclerotic cardiovascular disease  Dietary advice for the prevention of type 2 diabetes mellitus in adults  Dietary interventions for rheumatoid arthritis  Ginkgo biloba for cognitive impairment and dementia  Gluten‐ and casein‐free diets for autistic spectrum disorder  Homeopathy for chronic asthma  Homocysteine lowering interventions for peripheral arterial disease and bypass grafts  Homocysteine lowering interventions for preventing cardiovascular events  Honey as a topical treatment for wounds  Hypnotherapy for smoking cessation  Low glycaemic index, or low glycaemic load, diets for diabetes mellitus  Magnesium supplementation for the management of essential hypertension in adults  Mistletoe therapy in oncology  Music therapy for end‐of‐life care  Nutritional supplementation for hip fracture aftercare in the elderly  Omega 3 fatty acids for prevention and treatment of cardiovascular disease  Oral zinc for arterial and venous leg ulcers  Phytoestrogens for vasomotor menopausal symptoms  Probiotics for induction of remission in ulcerative colitis  Saline nasal irrigation for acute upper respiratory tract infections  Silver based wound dressings and topical agents for treating diabetic foot ulcers  Therapeutic ultrasound for venous leg ulcers  Valerian for anxiety disorders  Vitamin C for preventing and treating the common cold

The CAM‐related Cochrane reviews and protocols below are available in The Cochrane Library. Abstracts of the reviews can be viewed at no charge. See http://www.cochrane.org/cochrane‐reviews and http://www.thecochranelibrary.com/view/0/index.html

Another way to access the Cochrane Reviews on CAM topics only is to use: http://www2.cochrane.org/reviews/en/subtopics/22.html or http://www2.cochrane.org/reviews/en/topics/22_reviews.html

3. Practitioner Organisations in the Region

The Australasian Integrative Medicine Association (AIMA) “Integrating complementary and Mainstream Medicine” http://www.aima.net.au/home.html

“Mission Statement: To act as the peak medical body promoting the practice of evidence‐based integrative medicine, research and education as the gold standard for optimising wellbeing, prevention and management of disease in Australasian healthcare systems.”

“The Australasian Integrative Medicine Association (AIMA) is an independent not for profit organisation of individual medical practitioners seeking to provide whole person medical care by

ENZCAM Newsletter TM/CAM Update First Quarter 2011 integrating evidence‐based complementary medicine into mainstream practice. AIMA is supported by its membership and governed by a Board of voluntary doctors and academic leaders in the field of integrative medicine. Since its inception in 1992, AIMA has grown to be the leading voice for integrative practitioners. AIMA’s membership and successful events, including the International Holistic Health Conference, have helped promote the growing body of research and provide education about complementary medicines and therapies.”

AIMA New Zealand http://www.aima.net.au/aima_nz.html

Education in Integrative Medicine in Australia http://www.aima.net.au/resources/education.html

E‐Newsletter http://www.aima.net.au/resources/e‐newsletter.html

4. New Books

General Practice: The Integrative Approach By Prof. Kerryn Phelps and Dr. Craig Hassed Publication Date: 15 Nov 10 http://shop.elsevier.com.au/article.jsp?pageid=9305 http://shop.elsevier.com.au/product.jsp?isbn=9780729538046

“The aim of this book is to provide a comprehensive, contemporary and integrative approach to diagnosis, investigation and management of health issues and disease states encountered in the general practice environment. General Practice: The Integrative Approach informs doctors as fully as possible about potential treatment and prevention options, as well as potential pitfalls according to the growing evidence base in this area. The book is directed at best practice rather than alternative practice. The first section of the textbook lays the foundations and principles of Integrative Medicine and the second section examines important medical conditions in a systems based approach.”

“Each chapter begins by detailing the medical and consulting knowledge required of a standard GP text, discussing physiology and pharmacological management plans of systems‐based conditions. The chapter then leads into an evidence‐based discussion of the therapeutic options available for the treatment of associated factors, essentially providing practitioners with the knowledge required to adapt their approach to meet the needs of the individual patient. Approaches covered include specific lifestyle advice, nutrition, herbs and supplements, mind‐body therapies, Traditional Chinese Medicine and acupuncture, and manual therapies.”

“A national panel of experts with experience in Chinese medicine, herbal medicine, nutritional medicine, naturopathy, and exercise therapy have contributed to their various fields of expertise to incorporate management plans that utilise a variety of therapeutic modalities to achieve the best clinical outcome.”

ENZCAM Newsletter TM/CAM Update First Quarter 2011 A Guide to Evidence‐based Integrative and Complementary Medicine By Dr Vicki Kotsirilos, Associate Professor Luis Vitetta & Professor Avni Sali Publication Date: 31 Dec 2010 http://shop.elsevier.com.au/ISBN/9780729539081/A‐Guide‐to‐Evidencebased‐Integrative‐and‐ Complementary‐Medicine

“A Guide to Evidence‐based Integrative and Complementary Medicine is designed for General Practitioners, specialists, medical students and health practitioners with an interest in integrative medicine. The book covers non‐pharmacologic treatments for common medical practice problems, with the support of current scientific evidence. Approaches include advice for lifestyle and behavioural factors, mind‐body medicine, stress management, dietary changes, exercise and sleep advice, nutritional and herbal medicine, acupuncture and complementary medicines that may impact on the treatment of the disease(s). Only proven therapies from current research are included, particularly from Cochrane reviews and research from systematic reviews, randomized control trials and published cohort and case studies.”

5. Journals

The Journal of Alternative and Complementary Medicine Volume: 17, Number: 1 January 2011 This issue is now available online from Liebert Online at: http://www.liebertonline.com/toc/acm/17/1?ai=s3&ui=1mzh0&af=HThe

Editorial  Time, Perception and the Aging Mind: The National Alzheimer's Project Act 2011 Enacted–Is This the Beginning of a New Era in Health Care Research? Letter to the Editor  Potential Use of Taurine Against Pterygium Formation Original Articles  Relaxing on a Bed of Nails: An Exploratory Study of the Effects on the Autonomic, Cardiovascular, and Respiratory Systems, and Saliva Cortisol  Multipractitioner Upledger CranioSacral Therapy: Descriptive Outcome Study 2007–2008  How Patients Choose Acupuncturists: A Mixed‐Methods Project  High‐Velocity Insertion of Acupuncture Needle Is Related to Lower Level of Pain  Selecting Acupuncture Treatment for Hot Flashes: A Delphi Consensus Compared with a Clinical Trial  Evaluation of a Standardized Wellness Protocol to Improve Anthropometric and Physiologic Function and to Reduce Health Risk Factors: A Retrospective Analysis of Outcome  Effect of Korean Red Ginseng on Arterial Stiffness in Subjects with Hypertension  Factor Analysis on Symptoms and Signs of Chronic Low‐Back Pain Based on Traditional Chinese Medicine Theory  Noneffect of Manual Needle Acupuncture on Experimental Pain Parameters in Healthy Young Men Education, Initiatives, and Information Resources  A Preliminary Assessment of the Fifth‐Year Chiropractic Students' Knowledge of Anatomy Case Reports  Integrative Approach Focusing on Acupuncture in the Treatment of Chronic Complex Regional Pain Syndrome

ENZCAM Newsletter TM/CAM Update First Quarter 2011

 Acupuncture for Symptom Management in Patients with Hyper‐IgE (Job's) Syndrome  Physiologic Correlates of T'ai Chi Chuan Review Article  Mindfulness‐Based Interventions for Chronic Pain: A Systematic Review of the Evidence

Alternative and Complementary Therapies Volume: 16, Number: 6 December 2010 This issue is now available online from Liebert Online at: http://www.liebertonline.com/toc/act/16/6?ai=st&ui=1mzh0&af=HNews

Contents  News You Can Use  Smart Talk on Supplements and Botanicals: Update on Dietary Soy and Breast Cancer  Roundoc Rx: A Functional Medicine Approach to Metabolic Syndrome: Part 1—Metabolic Syndrome Explained  Roundtable Discussion: Consumer Reports Cover Story on Dangerous Dietary Supplements: A Missed Opportunity to Highlight Supplement Successes  Easing Chronic Low‐Back Pain with Complementary Therapies  Animal‐Assisted Therapy for Inpatients: Tapping the Unique Healing Power of the Human– Animal  Herbs for Gastroesophageal Reflux Disease  From Herbs to Medicines: The Madagascar Periwinkle’s Impact on Childhood Leukemia: A Serendipitous Discovery for Treatment  The Common Cold: An Integrative Approach: A Natural Standard Monograph  Clinical Roundup: How Do You Treat Back Pain in Your Practice?  Medical Journal Watch: Context and Applications

Journal of Medicinal Food Volume: 14, Number: 1‐2 January 2011 This issue is now available online from Liebert Online at: http://www.liebertonline.com/toc/jmf/14/1‐2?ai=t3&ui=1mzh0&af=H

Editorial

 Medicinal Food Meets Epigenetics

Full Communications  Does the Agaricus blazei Murill Mushroom Have Properties That Affect the Immune System? An Integrative Review  Grape Seed Extract Regulates Androgen Receptor‐Mediated Transcription in Prostate Cancer Cells Through Potent Anti–Histone Acetyltransferase Activity  Anti‐Obesity and Hypolipidemic Effects of Boussingaultia gracilis Miers var. pseudobaselloides Bailey in Obese Rats  Buckwheat Polysaccharide Exerts Antiproliferative Effects in THP‐1 Human Leukemia Cells by Inducing Differentiation  The Grapevine‐Shoot Extract Vineatrol30 Inhibits the Chemically Induced Malignant Transformation of BALB/c‐3T3 Cells  Cytotoxicity Screening of Several Tomato Extracts

ENZCAM Newsletter TM/CAM Update First Quarter 2011

 Treatment of Ovarian Cancer Cells with Nutlin‐3 and Resveratrol Combination Leads to Apoptosis via Caspase Activation  Specific Blockage of Caspase‐1 Activation by Purple Bamboo‐Salt Prevents Apoptosis of Auditory Cell Line, HEI‐OC1  Emblica officinalis Ameliorates Alcohol‐Induced Brain Mitochondrial Dysfunction in Rats  Regular Consumption of Concord Grape Juice Benefits Human Immunity  Beneficial Effects of a Synbiotic Supplement on Self‐Perceived Gastrointestinal Well‐Being and Immunoinflammatory Status of Healthy Adults  Dietary Bitter Melon Seed Increases Peroxisome Proliferator‐Activated Receptor‐γ Gene Expression in Adipose Tissue, Down‐Regulates the Nuclear Factor‐κB Expression, and Alleviates the Symptoms Associated with Metabolic Syndrome  Soy β‐Conglycinin (7S Globulin) Reduces Plasma and Liver Cholesterol in Rats Fed Hypercholesterolemic Diet  Dose–Response Study of Sajabalssuk Ethanol Extract from Artemisia princeps Pampanini on Blood Glucose in Subjects with Impaired Fasting Glucose or Mild Type 2 Diabetes  Supplementation of Cheonggukjang and Red Ginseng Cheonggukjang Can Improve Plasma Lipid Profile and Fasting Blood Glucose Concentration in Subjects with Impaired Fasting Glucose  Hypolipidemic and Antioxidant Potentials of Xylopia aethiopica Seed Extract in Hypercholesterolemic Rats  Neuroprotective Effects of SG‐168 Against Oxidative Stress‐Induced Apoptosis in PC12 Cells  Antifungal Activity of the Honeybee Products Against Candida spp. and Trichosporon spp.  Transwell‐Grown HepG2 Cell Monolayers as In Vitro Permeability Model to Study Drug–Drug or Drug–Food Interactions  Wound Repair Potential of Olea europaea L. Leaf Extracts Revealed by In Vivo Experimental Models and Comparative Evaluation of the Extracts' Antioxidant Activity  Beneficial Effects of Emblica officinalis in l‐Arginine‐Induced Acute Pancreatitis in Rats  Effect of Ingestion of Rice Bran Drink in Rats Subjected to Forced Swimming and Elevated Plus Maze Tests  Evaluation of the Marine Alga Ulva rigida as a Food Supplement: Effect of Intake on Intestinal, Hepatic, and Renal Enzyme Activities in Rats  Thermal Degradation Characteristics and Antioxidant Activity of Fructose Solution with Heating Temperature and Time  Preventive Effect of Probiotics and α‐Tocopherol on Ethanol‐Induced Gastric Mucosal Injury in Rats

6. Conferences in the Region

AIMA 17th International Integrative Medicine Conference Friday 14th, Saturday 15th and Sunday 16th October 2011 at the Novotel Sydney Manly Pacific, Manly Beach, NSW, Australia http://www.aima.net.au/events/conference_2011_.html

“The annual International Integrative Medicine Conference is a must attend event on the calendar for integrative medicine practitioners. The conference reviews and discusses the diverse challenges and opportunities facing the various streams of integrative medicines and therapies as a result of the dramatically increasing demand for holistic medical treatment by patients. This popular event

ENZCAM Newsletter TM/CAM Update First Quarter 2011 provides practitioner oriented education for health professionals. Our commitment is to bring together leaders and like‐minded practitioners in this multi‐disciplinary field.”

“The focus of each conference will be on presenting the latest evidence and how it works in practice. Practitioners can learn and apply integrative medicine techniques ethically, creatively and effectively. This conference is recognised for its unique approach in providing a focus on caring for the carer as well as a focus on patient care. The conference, therefore, draws together like‐minded professionals in a supportive, informative and nurturing manner.”

7. Clinical Integration of TM/CAM

There is a regular NCCAM Clinical Digest from the National Center for Complementary and Alternative Medicine (NCCAM) in the USA (see section 2). “NCCAM Clinical Digest, a monthly e‐ newsletter, offers evidence‐based information on CAM, including scientific literature searches, summaries of NCCAM‐funded research, fact sheets for patients, and more.”

To subscribe to NCCAM Clinical Digest, visit http://nccam.nih.gov/news/subscribe.php?digest=1

The January 2011 edition is entitled “Colds and Flu and CAM”.

Clinical Guidelines: Herbs and Supplements in Managed Care (The Permanente Journal) http://xnet.kp.org/permanentejournal/sum08/herbs.html

Systematic Reviews/Reviews/Meta‐Analysis (PubMed® Citations) http://www.ncbi.nlm.nih.gov/pubmed?term=%28%22Common%20Cold%22%5BMajr%5D%20OR%2 0%22Influenza%2C%20Human%22%5BMajr%5D%29%20AND%20%22Complementary%20Therapies %22%5BMajr%5D%20AND%20%28%22humans%22%5BMeSH%20Terms%5D%20AND%20%28Meta‐ Analysis%5Bptyp%5D%20OR%20Review%5Bptyp%5D%29%20AND%20English%5Blang%5D%20AND %20%28cam%5Bsb%5D%20OR%20systematic%5Bsb%5D%29%20AND%20%222005/10/21%22%5BP DAT%5D%20%3A%20%222010/10/19%22%5BPDAT%5D%29&cmd=DetailsSearch

Randomized Controlled Trials (PubMed® Citations) http://www.ncbi.nlm.nih.gov/pubmed?term=%28%22Common%20Cold%22%5BMajr%5D%20OR%2 0%22Influenza%2C%20Human%22%5BMajr%5D%29%20AND%20%22Complementary%20Therapies %22%5BMajr%5D%20AND%20%28%22humans%22%5BMeSH%20Terms%5D%20AND%20Randomiz ed%20Controlled%20Trial%5Bptyp%5D%20AND%20English%5Blang%5D%20AND%20cam%5Bsb%5D %20AND%20%222005/10/21%22%5BPDAT%5D%20%3A%20%222010/10/19%22%5BPDAT%5D%29 &cmd=DetailsSearch

Information for Patients Common Cold/Flu: http://nccam.nih.gov//health/flu/?nav=cd Echinacea: http://nccam.nih.gov//health/echinacea/?nav=cd Vitamin C: http://ods.od.nih.gov/factsheets/VitaminC‐Consumer/ Zinc: http://ods.od.nih.gov/factsheets/Zinc‐Consumer/

ENZCAM Newsletter TM/CAM Update First Quarter 2011

Produced for ENZCAM by Heather McLeod

2 May 2011

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

ENZCAM is based within the Health Sciences Centre, University of Canterbury, Christchurch, New Zealand. The Centre was established in 2005 with the aim to research the efficacy and safety of Complementary and Alternative Medicine (CAM), with a particular focus on CAM in the New Zealand setting. The centre acts as a focal point to develop novel research ideas in the field of CAM and foster partnerships with researchers both within New Zealand and overseas.

http://www.hsci.canterbury.ac.nz/enzcam/

As the purpose of this series is to put in the public domain material and evidence that will progress the integration of complementary medicine into health systems, we would be delighted if you make use of it in other research and publications. All material produced for ENZCAM and made available on the web‐site may be freely used, provided the source is acknowledged. The material is produced under a Creative Commons Attribution‐Noncommercial‐Share Alike licence.

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update April 2011

1. Policy and Legislation

World Health Organization (WHO) The WHO has begun to release the World Medicines Situation Report 2011. “The third edition of the World Medicines Situation Report brings together new data on 24 key topics relating to pharmaceutical production and consumption, innovation, regulation and safety … Each chapter of this report is written by a different author. Chapters are being published electronically, in batches, between April and December 2011. The new report updates the 1988 and 2004 reports.” http://www.who.int/medicines/areas/policy/world_medicines_situation/en/index.html

The chapters released in April 2011 include “Traditional Medicines: Global Situation Issues and Challenges”. This chapter describes the use of traditional medicines, including herbal medicines, around the world.

“Traditional medicines, including herbal medicines, have been, and continue to be, used in every country around the world in some capacity. In much of the developing world, 70–95% of the population rely on these traditional medicines for primary care.”

“The global market for traditional medicines was estimated at US$ 83 billion annually in 2008, with a rate of increase that has been exponential. Regulatory status and the associated terminology varies widely. Traditional medicines are used as prescription or over‐the‐counter (OTC) medications, as self‐medication or self‐care, as home remedies, or as dietary supplements, health foods, functional foods, phytoprotectants, and under any of many other titles in different jurisdictions, with only minimal consistency between the definitions of these terms from country to country and significant communication issues as a result.”

“Regulation of traditional medicines is a complicated and challenging issue as it is highly dependent upon experience with use of these products. Model countries such as China, India, and South Africa present usable templates, as do the guidelines on regulation and registration of traditional or herbal medicines produced in the WHO African, Eastern Mediterranean, and South‐East Asian regions and in the European Union."

“Evaluation of quality, safety and efficacy based on research is needed to improve approaches to assessment of traditional medicines, a situation made difficult to remedy in light of historically inadequate public and private funding to address this growing concern.”

ENZCAM Newsletter TM/CAM Update April 2011 Page 2 2. Research Organisations

Project ‘CAMbrella’ to Build European Research Network for CAM

A journal article published in April 2011a describes the “CAMbrella” initiative in Europeb.

“The project aims to evaluate the conditions surrounding CAM use and provision in Europe and to develop a roadmap for European CAM research. Specific objectives are to establish an EU network involving centres of research excellence for collaborative projects, to develop consensus‐ based terminology to describe CAM interventions, to create a knowledge base that facilitates the understanding of patient demand for CAM and its prevalence, to review the current legal status and policies governing CAM provision, and to explore the needs and attitudes of EU citizens with respect to CAM.”

“Based on this information a roadmap will be created that will enable sustainable and prioritised future European research in CAM. CAMbrella encompasses 16 academic research groups from 12 European countries and will run for 36 months starting from January 2010. The project will be delivered in 9 work packages coordinated by a Management Board and directed by a Scientific Steering Committee with support of an Advisory Board.”

The authors represent the following groups involved in CAMbrella:  Competence Centre for Complementary Medicine and Naturopathy (KoKoNat), Klinikum rechts der Isar, Technische Universität, Munich, Germany  Complementary and Integrated Medicine Research Unit, University of Southampton, UK  Research Unit for Integrative Healthcare Research, Karolinska Institute, Stockholm, Sweden  National Research Center on Complementary and Alternative Medicine (NAFKAM), University of Tromsø, Norway  Institute of Public Health, Research Unit Health, Man and Society, University of Southern Denmark, Odense, Denmark  International Academy for Holistic Medicine, Vienna, Austria  Institute of Complementary Medicine, Dept. of Internal Medicine, University Hospital Zurich,  Institute of Complementary Medicine (KIKOM), University of Berne, Switzerland  Bavarian Research Alliance, Munich, Germany.  Institute for Social Medicine, Epidemiology, and Health Economics, Charité – University Medical Center, Berlin, Germany.

There are 16 research groups in CAMbrella with the others being:  Comitato Permanente di Consenso e Coordinamento per le Medicine Non‐Convenzionali in Italia (ComCAM), Italy  Université Paris 13 (SMBH), France  Servicio Andaluz de Salud (SAS), Spain a Weidenhammer, W., Lewith, G., Falkenberg, T., Fonnebo, V., Johannessen, H., Reiter, B., et al. (2011). EU FP7 Project 'CAMbrella' to Build European Research Network for Complementary and Alternative Medicine. Forschende Komplementarmedizin, 18(2), 69‐76. URL: http://www.ncbi.nlm.nih.gov/pubmed/21576975 b With thanks to Paolo Roberti di Sarsina of Italy for this paper.

ENZCAM Newsletter TM/CAM Update April 2011 Page 3

 Agenzia sanitaria e sociale regionale – Regione Emilia‐Romagna (ASSR), Italy  Pécsi Tudományegyetem, University of Pecs (PTE), Hungary  Universitatea de Medicina si Farmacie Victor Babes Timisoara (UMFT), Romania.

The composition of the Advisory Board gives some useful links to organisations involved in CAM issues in Europe:  Association of Natural Medicine in Europe (ANME) www.anme.info  European Central Council of Homeopaths (ECCH) www.homeopathy‐ecch.org  European Coalition on Homeopathic and Anthroposophic Medicinal Products (ECHAMP) www.echamp.org  European Committee for Homeopathy (ECH) www.homeopathyeurope.org  European council of doctors for plurality in medicine (ECPM) www.ecpm.org  European Forum for Complementary and Alternative Medicine (EFCAM) www.efcam.eu  European Herbal and Traditional Medicine Practitioners’ Association (EHTPA) www.ehpa.eu  European Information Centre for Complementary and Alternative Medicine (EICCAM) www.eiccam.eu  European Public Health Association (EPHA) www.epha.org  International Council of Medical Acupuncture and Related Techniques (ICMART) www.icmart.org  International Federation of Anthroposophic Medical Associations (IVAA) www.ivaa.eu  Kneipp‐Bund eV (KB) www.kneippbund.de

3. Journals

The first time a journal is listed, the contents of that edition will be given in full to give readers a sense of the scope of the publication. For subsequent editions, only some articles may be highlighted. Earlier editions of this newsletter are available from http://www.hsci.canterbury.ac.nz/enzcam/

Journal of Evidence‐Based Complementary & Alternative Medicine http://chp.sagepub.com/ Journal of Evidence‐Based Complementary & Alternative Medicine (JEBCAM) (formerly Complementary Health Practice Review) is an interdisciplinary, peer‐reviewed biomedical journal publishing hypothesis‐driven and evidence‐based articles concerning healing practices encompassed by the terms complementary, alternative, and integrative medicine. JEBCAM articles include editorial comments, original articles, brief communications, topical reviews, historical vignettes, correspondence, and book reviews.

ENZCAM Newsletter TM/CAM Update April 2011 Page 4

Volume 16, Number 2: April 2011 Articles  Vitamin B2: Riboflavin  Pharmacologic Use of Niacin  Folic Acid: Beyond Metabolism  Does Vitamin E and C Supplementation Improve the Recovery From Anterior Cruciate Ligament Surgery?  Coenzyme Q10: Clinical Update and Bioavailability  Calcium: An Essential Mineral  Clinical Meditation Teacher: A New Role for Health Professionals  Mythology of Antioxidant Vitamins? Book Reviews  The Alzheimer’s Caregiving Puzzle: Putting Together the Pieces  Making Health Care Whole: Integrating Spirituality Into Health Care

Integrative Cancer Therapies http://ict.sagepub.com/ Integrative Cancer Therapies (ICT) is a peer‐reviewed quarterly journal focused on the scientific understanding of alternative medicine and traditional medicine therapies, and their responsible integration with conventional health care. Integrative care includes therapeutic interventions in diet, lifestyle, exercise, stress care, and nutritional supplements, as well as experimental vaccines, chrono‐ chemotherapy, and other advanced treatments. Volume 10, Number 1: March 2011  In This Issue  Exercise in Patients With Breast Cancer and Healthy Controls: Energy Substrate Oxidation and Blood Lactate Responses  Impact of Relaxation Training According to Yoga in Daily Life® System on Perceived Stress After Breast Cancer Surgery  Polarity Therapy for Cancer‐Related Fatigue in Patients With Breast Cancer Receiving Radiation Therapy: A Randomized Controlled Pilot Study  Complementary and Alternative Medicine Use Among Pediatric Patients With Leukemia: The Case of Lebanon  Exercise Preconditioning Provides Long‐Term Protection Against Early Chronic Doxorubicin Cardiotoxicity  Regulation of p21, MMP‐1, and MDR‐1 Expression in Human Colon Carcinoma HT29 Cells by Tian Xian Liquid, a Chinese Medicinal Formula, In Vitro and In Vivo  Ultrasound‐Induced Cell Death of Nasopharyngeal Carcinoma Cells in the Presence of Curcumin  Amelioration of Radiation‐Induced Hematological and Biochemical Alterations in Swiss Albino Mice  Aqueous Extracts of Fructus Ligustri Lucidi Enhance the Sensitivity of Human Colorectal Carcinoma DLD‐1 Cells to Doxorubicin‐Induced Apoptosis via Tbx3 Suppression  Effects of Sesquiterpenes Isolated From Largehead Atractylodes Rhizome on Growth, Migration, and Differentiation of B16 Melanoma Cells  An Experimental Study on the Antileukemia Effects of Gypenosides In Vitro and In Vivo

ENZCAM Newsletter TM/CAM Update April 2011 Page 5 Journal of Holistic Nursing http://jhn.sagepub.com/ Journal of Holistic Nursing (JHN) is a peer‐reviewed quarterly journal with a focus on integrating holistic health concepts with traditional Western medicine. JHN provides a forum for caring and innovative nurses in clinical practice, research, individual wellness practice, and academia to exchange critical information, share clinical and personal experiences, and communicate research pertaining to nursing practice, health care, wellness, healing, and human potential. Volume 29, Number 1: March 2011 Editorial  Holism as a Socio‐political Enterprise Research  Finding a Balance: Toward a Substantive Theory of Employed Mothers’ Personal and Family Health Decision Making  Continuing Nursing Education for “Finding a Balance: Toward a Substantive Theory of Employed Mothers’ Personal and Family Health Decision Making”  The Influence of a Spirituality‐Based Intervention on Quality of Life, Depression, and Anxiety in Community‐Dwelling Adults With Cardiovascular Disease: A Pilot Study  The Effect of Reiki on Work‐Related Stress of the Registered Nurse  Language and the (Im)possibilities of Articulating Spirituality Practice  Forging Partnerships Between Rural Women With Chronic Conditions and Their Health Care Providers Education  A History of Massage in Nurse Training School Curricula (1860‐1945) Aesthetics  Art Interpretation as a Clinical Intervention Toward Healing

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter First Quarter 2011] These issues are now available online from Liebert Online at: Volume 17, Number 2: February 2011 http://www.liebertonline.com/toc/acm/17/2

Volume 17, Number 3: March 2011 http://www.liebertonline.com/toc/acm/17/3

Volume 17, Number 4: April 2011 http://www.liebertonline.com/toc/acm/17/4

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter First Quarter 2011] These issues are now available online from Liebert Online at: Volume 17, Number 1: February 2011 http://www.liebertonline.com/toc/act/17/1

Volume 17, Number 2: April 2011 http://www.liebertonline.com/toc/act/17/2

ENZCAM Newsletter TM/CAM Update April 2011 Page 6

Journal of Medicinal Food [First listed in ENZCAM Newsletter First Quarter 2011] These issues are now available online from Liebert Online at: Volume 14, Number 3: March 2011 http://www.liebertonline.com/toc/jmf/14/3

Volume 14, Number 4: April 2011 http://www.liebertonline.com/toc/jmf/14/4

4. Conferences

International Society for Complementary Medicine Research The 5th Summer School on Research Methods in Complementary and Alternative Medicine http://www.iscmr.org/Events

September 14‐18, 2011 in Potsdam (near Berlin), Germany

An International Summer School Supported by the Robert Bosch Foundation. The International Summer School on CAM Research methodology is run by Klaus Linde and Claudia Witt and presented in English. For the fifth time a practical training course providing the necessary skills to design, organize and plan own clinical studies will be offered.

5. Clinical Integration of TM/CAM

NCCAM Clinical Digest

Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA. To subscribe to NCCAM Clinical Digest, visit http://nccam.nih.gov/news/subscribe.php?digest=1

March 2011: Hepatitis C and CAM

April 2011: Zinc and the Common Cold

Evidence‐Based Information for Health Care Providers

National Center for Complementary and Alternative Medicine (NCCAM) Launches Web Resource on Complementary and Alternative Medicine www.nccam.nih.gov/health/providers/

“A new online resource, designed to give health care providers easy access to evidence‐based information on complementary and alternative medicine (CAM), was unveiled [in April 2011] by the National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health. With this new resource, providers will have the tools necessary to learn about the various

ENZCAM Newsletter TM/CAM Update April 2011 Page 7

CAM practices and products and be better able to discuss the safety and effectiveness of complementary and alternative medicine with their patients.”

“The portal on the NCCAM web site is tailored to fit the needs of all health care providers, including physicians, nurses and nurse practitioners, physician assistants, and CAM providers. It includes information on the safety and efficacy of a range of common health practices that lie outside of mainstream medicine—natural products, such as dietary supplements, herbs, and probiotics, as well as mind‐body practices such as meditation, chiropractic, acupuncture, and massage.”

“This resource was developed based on a series of NCCAM‐sponsored focus groups where health care providers identified the need for an evidence‐based, one‐stop place to help answer their patients’ questions on CAM. With this need in mind, NCCAM developed a resource that provides reliable, objective, and evidenced‐based information on CAM, including:  links to relevant clinical practice guidelines  safety and effectiveness information  links to systematic reviews  summaries of research studies  scientific literature searches  programs for continuing education credit  patient fact sheets  NCCAM’s Time to Talk tool kit on communicating about CAM.

Produced for ENZCAM by Heather McLeod

25 May 2011

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update May 2011

1. Policy and Legislation

New Zealand Natural Health Regulator http://www.greens.org.nz/press‐releases/greens‐and‐national‐set‐nz‐natural‐health‐regulator

“The Green Party and the Government have agreed to set up a new stand‐alone New Zealand natural health regulator and plan to introduce legislation before the election. ‘More and more New Zealanders are turning to natural health products to keep themselves well, so it's important that consumers can be confident that the products are safe and true to label,’ Green Party Health spokesperson Sue Kedgley said [recently].

“There are more than 6,000 natural health products on sale in New Zealand, and over 450 natural health companies in the sector, with an estimated annual turnover of $760 million.”

"We have listened carefully to feedback we received during consultation on our original proposal, and we have come up with a streamlined system which protects consumers, but does not impose unreasonable costs on business, or penalise the growing number of small, innovative natural health businesses”.

"We are also pleased to announce that monitoring and enforcement costs and capital costs will be funded by the Crown.”… “Natural health regulation will cover a wide range of products such as vitamins and Chinese medicines. There will be further work to come on the regulations that will accompany the legislation.” http://www.scoop.co.nz/stories/PA1106/S00274l.htm

“Cabinet has given the green light for work to commence on a new natural health products regulator, Associate Health Minister Jonathan Coleman confirmed”.

“The Ministry of Health consulted on a proposed regulatory scheme for the industry last year with 1500 submissions lodged by consumers, industry groups, and practitioners. It is proposed that a new regulator would be based in the Ministry of Health.”

Prime Ministers John Key (New Zealand) and Julia Gillard (Australia) announced plans for a new trans‐Tasman agency on 20 June 2011. The Australia New Zealand Therapeutic Products Agency will regulate medicines, medical devices and new medical interventions. Natural health products will be separately regulated (as above) but this is to be reviewed after five years.

ENZCAM Newsletter TM/CAM Update May 2011 Page 2 2. Research and Practitioner Organisations

The International Society for Complementary Medicine Research (ISCMR) http://www.iscmr.org/

“The International Society for Complementary Medicine Research (ISCMR) is an international scientific organization of researchers, practitioners and policy makers that fosters Complementary and Integrative Medicine research and provides a platform for knowledge and information exchange to enhance international communication and collaboration.”

“ISCMR has policy to collaborate and cooperate with other organizations for the mutual benefits. ISCMR has established its first Memorandum of Understanding (MoU) with PedCAM. The goal of the MoU is to enhance the opportunities for members to participate in events in both societies and to increase the exchange of information between the members of the two organizations.”

Pediatric Complementary and Alternative Medicine Research and Education (PedCAM) Network http://www.pedcam.ca/

“Created in 2004, the Pediatric Complementary and Alternative Medicine Research and Education (PedCAM) Network is a Canadian network that aims at disseminating a wide range of CAM information and building collaborative relationships between researchers, educators, clinicians, and policy‐makers, both nationally and internationally. PedCAM is an academic, non‐commercial organization, housed within the Complementary and Alternative Research and Education program.

Complementary & Alternative Research & Education (CARE) Department of Pediatrics, University of Alberta, Canada http://www.pediatrics.med.ualberta.ca/Research/AffiliatedUnits/CARE/Pages/default.aspx

“CARE is an evidence‐driven pediatric integrative medicine program that focuses on generating and disseminating evidence about pediatric complementary and alternative medicine (CAM) in order to ensure its usage is safe and informed. Traditional Chinese medicine, naturopathy, and massage therapy are just a few examples of CAM that CARE works with. The program combines research, education and clinical assessment to:  create a supportive and collaborative environment that fosters learning, at all health care provider levels about CAM therapies, products  equip patients, families and health care providers with the knowledge required to ensure CAM is safely administered and effective  generate high‐quality evidence and provide support for pediatric CAM use.”

ENZCAM Newsletter TM/CAM Update May 2011 Page 3 3. Journals

European Journal of Integrative Medicine http://www.europeanintegrativemedicinejrnl.com/home European Journal of Integrative Medicine understands Integrative Medicine as the link between conventional medicine and evidence‐based complementary and alternative medicine (CAM). To strengthen the understanding and cooperation between these polarised fields is the major target of this Journal. Therefore, it aims to connect medical researchers and clinicians as well as members of other medical professions and health care organisation, who seeks objective and critical information on Integrative Medicine in order to deepen their understanding of these approaches.

Volume 3, Number 1: April 2011 Articles  Economic consequences of overweight and obesity in Asia‐Pacific  Complementary therapies for side effects of chemotherapy and radiotherapy in the upper gastrointestinal system  CAM‐education in the medical curriculum: Attitude towards and knowledge of CAM among Dutch medical students  Evaluation of an Ayurvedic formulation (Cystone), in urolithiasis: A double blind, placebo‐ controlled study  Complementary medicine oncology research in the Middle‐East: Shifting from traditional to integrative cancer care  Rapid method for isolation of plumbagin, an alternative medicine from roots of Plumbago zeylanica

Complementary Therapies in Medicine http://www.complementarytherapiesinmedicine.com/ Complementary Therapies in Medicine is an international, peer‐reviewed journal that has considerable appeal to anyone who seeks objective and critical information on complementary therapies or who wishes to deepen their understanding of these approaches. It will be of particular interest to healthcare practitioners including family practitioners, complementary therapists, nurses, and physiotherapists; to academics including social scientists and CAM researchers; to healthcare managers; and to patients.

Volume 19, Issue 2, April 2011 Original Articles  Prevalence and socio‐demographic correlates of spiritual healer use: Findings from the National Survey of American Life  The prevalence and characteristics of young and mid‐age women who use yoga and meditation: Results of a nationally representative survey of 19,209 Australian women  Cupping – Is it reproducible? Experiments about factors determining the vacuum

ENZCAM Newsletter TM/CAM Update May 2011 Page 4

 Integrative medicine models in contemporary primary health care Review  Upright water‐based exercise to improve cardiovascular and metabolic health: A qualitative review Education and Debate  Psychotherapy and professional identity development: The relevance of CAM Letter to the Editor  Randomized blinding in basic research of homeopathy: Some comments

Volume 19, Issue 3, June 2011 Original Articles  A pilot study of yoga treatment in children with functional abdominal pain and irritable bowel syndrome  Association between tongue appearance in Traditional Chinese Medicine and effective response in treatment of rheumatoid arthritis  Effect of yogic practices on lipid profile and body fat composition in patients of coronary artery disease  Are complementary medicine practitioners implementing evidence based practice  Use of Chinese medicine by women with breast cancer: A nationwide cross‐sectional study in Taiwan  Acupuncture for low back pain: A survey of clinical practice in the UK  Complementary and alternative medicine: Perception and use by physiotherapists in the management of low back pain  The quality of information on websites selling St. John's wort  Effectiveness of light therapy for depression among active duty service members: A nonrandomized controlled pilot trial  The effect of extremely diluted agitated gibberellic acid (10e−30) on wheat stalk growth—A two researcher pilot study Review  Potential health benefits of simulated laughter: A narrative review of the literature and recommendations for future research

Explore: The Journal of Science and Healing http://www.explorejournal.com EXPLORE: The Journal of Science & Healing addresses the scientific principles behind, and applications of, evidence‐based healing practices from a wide variety of sources, including conventional, alternative, and cross‐cultural medicine. It is an interdisciplinary journal that explores the healing arts, consciousness, spirituality, eco‐environmental issues, and basic science as all these fields relate to health.

Volume 7, Issue 3, May‐June 2011 Explorations and Guest Editorial  Why Are Scientists Afraid of Daryl Bem?  High‐Tech, High‐Touch: Reconciling Technology and Integrative Medicine Clinical Articles: Original Research  Effects of Acupuncture in Reducing Attrition and Mortality in HIV‐Infected Men with Peripheral Neuropathy

ENZCAM Newsletter TM/CAM Update May 2011 Page 5

 The Immediate Effect of a Brief Energy Psychology Intervention (Emotional Freedom Techniques) on Specific Phobias: A Pilot Study  Spirituality in Tobacco Dependence: A Mayo Clinic Survey Review Article  The Chiropractic Care of Infants with Colic: A Systematic Review of the Literature Methodology  Complementary Therapy Systems and Their Integrative Evaluation Other  Commentary on the Cochrane Review of Acupuncture for Depression  Clinical Practices in Integrative Medicine: Neck and Low Back Pain Management  Innovations in Integrative Healthcare Education: Teaching Group Drumming to Mental Health Professionals

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter First Quarter 2011] Volume 17, Number 5: May 2011 http://www.liebertonline.com/toc/acm/17/5

Selected articles  Traditional Chinese Medicine for Parkinson's Disease in China and Beyond  Phytothermotherapy in Osteoarthritis: A Randomized Controlled Clinical Trial  Use of Acupuncture and Other CAM Methods in Obstetrics: An Analysis of 409,413 Deliveries from Hesse, Germany  Development of an Instrument to Assess the Quality of Acupuncture: Results from a Delphi Process  Ayurvedic Genomics, Constitutional Psychology, and Endocrinology: The Missing Connection

Integrative Cancer Therapies http://ict.sagepub.com/ Published online 15 April 2011 http://ict.sagepub.com/content/early/2011/03/07/1534735411403476 Beliefs of New Zealand Doctors About Integrative Medicine for Cancer Treatment By Christina Bocock, Anthony I. Reeder, David Perez and Judy Trevena (all from Dunedin School of Medicine, University of Otago).

“Aims. This study aimed to give an up‐to‐date description of the views and knowledge that health professionals in New Zealand (NZ) have about complementary and alternative medicine (CAM) and its use in the context of integrative medicine. Study design. A self‐administered questionnaire. Methods. Doctors in the Otago region of New Zealand (n = 235 out of 395, 59% response rate) answered questions addressing attitudes toward the principle of integrative medicine, attitudes indigenous Māori holistic views of health, and attitudes about CAM. Information on physician demographics was also gathered. Results. Almost all doctors (95%) agreed that they should address all aspects of a patient’s health, whereas around 60% agreed that CAM can be integrated into a treatment regime to provide the best care for a patient. Most (93%) agreed that in a NZ context, it is important to be aware of Māori holistic views of health. Doctors had many concerns about CAM, and only 26% personally used any

ENZCAM Newsletter TM/CAM Update May 2011 Page 6

CAM therapies themselves. However, many doctors wanted to learn more about CAM (58%) and Māori holistic views of health (62%). Doctors who believed that they “knew enough” about CAM were more likely to ask about it and to recommend it to patients. Conclusion. Integrative medicine is increasingly being accepted in medical practice, although many doctors still do not agree with the use of CAM. There is a need for increased patient–doctor discussions of CAM use. Doctors’ lack of knowledge about CAM may be a barrier to communication and should be addressed with specific medical training.”

4. Education and Training

Masters Course “Health Systems, Traditional and Non‐Conventional Medicine" University of Milano‐Bicocca, Italy, October 2011 to June 2012 www.master‐sistemisanitari‐medicinenonconvenzionali.org www.medicinacentratasullapersona.org

This course “ aims to provide participants with the tools for grasping and analysing the real state of the health system at present and projected into the future, bearing in mind the dynamics of change and the increasing resort to Traditional and Non‐Conventional Medicines. This first edition sets out to give a sound theoretical and practical basis: it will include rudiments of management and economics, clinical practice, familiarization with various differing schools of medicine and applied relating skills. How Traditional and Non‐Conventional Medicines are being included in healthcare systems will be a particular focus.

As part of planning and assessment of health systems (regionally, nationally, internationally) course participants will be taught to analyse, quantitatively and qualitatively, the inequalities of health arising from the various systems of treatment and research. The Master‐course will address the subjects of health, person‐centred medicine, Traditional and Non‐Conventional Medicines, anthropological health systems. To this end it will survey various health models and their impact on welfare, and go into the latest topics of Health Sociology.

The intention is to train managers, decision‐makers, researchers and health workers to plan a person‐centred, sustainable, transparent and honest health model of relevance to the individual citizen, health units and epidemiological research teams. The Master‐course aims, in short, to train a manager to plan a health model from the citizen’s angle.”

The course will be run for the first time in 2011‐2012 in Italian. Please contact Paolo Roberti di Sarsina at [email protected] about future opportunities to run the course in English. [with acknowledgements to Paolo Roberti di Sarsina, MD, Expert for Non‐Conventional Medicine, High Council of Health, Ministry of Health, Italy; Observatory and Methods for Health, University of Milano‐Bicocca, Italy]

ENZCAM Newsletter TM/CAM Update May 2011 Page 7 5. Clinical Integration of TM/CAM

NCCAM Clinical Digest

Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA. To subscribe to NCCAM Clinical Digest, visit http://nccam.nih.gov/news/subscribe.php?digest=1

May 2011: Irritable Bowel Syndrome and CAM

6. Health System Integration of TM/CAM

Patients Whose GP Knows Complementary Medicine Tend to Have Lower Costs and Live Longer

By Peter Kooreman (Tilburg University) and Erik W. Baars (Louis Bolk Institute), May 2011 http://d.repec.org/n?u=RePEc:iza:izadps:dp5753&r=hea

“Health economists have largely ignored complementary and alternative medicine (CAM) as an area of research, although both clinical experiences and several empirical studies suggest cost‐ effectiveness of CAM. The objective of this paper is to explore the cost‐effectiveness of CAM compared to conventional medicine. A data set from a Dutch health insurer was used containing quarterly information on healthcare costs (care by general practitioner (GP), hospital care, pharmaceutical care, and paramedic care), dates of birth and death, gender and 6‐digit postcode of all approximately 150,000 insurees, for the years 2006‐2009. Data from 1913 conventional GPs were compared to data from 79 GPs with additional CAM training in acupuncture (25), homeopathy (28) and anthroposophic medicine (26).

Patients whose GP has additional CAM training have 0 to 30 percent lower healthcare costs and mortality rates, depending on age groups and type of CAM. The lower costs result from fewer hospital stays and fewer prescription drugs. Since the differences are obtained while controlling for confounders including neighbourhood specific fixed effects at a highly detailed level, the lower costs and longer lives are unlikely to be related to differences in socio‐economic status.

Possible explanations include selection (e.g. people with a low taste for medical interventions might be more likely to choose CAM) and better practices (e.g. less overtreatment, more focus on preventive and curative health promotion) by GPs with knowledge of complementary medicine. More controlled studies (replication studies, research based on more comprehensive data, cost‐ effectiveness studies on CAM for specific diagnostic categories) are indicated.”

[with acknowledgements to Yong Yin, of State University of New York‐Buffalo (SUNY), USA]

Produced for ENZCAM by Heather McLeod

21 June 2011

ENZCAM Newsletter TM/CAM Update May 2011 Page 8

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update June 2011

1. Research Organisations

Cochrane CAM Field http://www.compmed.umm.edu/cochrane_about.asp [See ENZCAM newsletter First Quarter 2011 for more information]

Cochrane review commentary series “The Cochrane CAM Field column in the journal Explore [see ENZCAM newsletter May 2011] is designed to promote an awareness of the Cochrane Collaboration and to improve the understanding of Cochrane reviews among complementary and alternative medicine (CAM) researchers and practitioners. Each Explore column typically begins with the reproduction of the abstract of a relevant CAM‐related Cochrane review, followed by a commentary on the review.”

 The July‐August 2011 Explore column, by Ting Bao, MD, is a commentary on the Cochrane review of Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. http://www.explorejournal.com/article/S1550‐8307(11)00110‐8/fulltext

 The May‐June 2011 Explore column, by Rosa Schnyer, DPhil, is a commentary on the Cochrane review of Acupuncture for depression. http://www.explorejournal.com/article/S1550‐8307(11)00047‐4/fulltext

 The Mar‐April 2011 Explore column, by Elizabet Stener‐Victorin and Eric Manheimer, is a commentary on the Cochrane review of Acupuncture and assisted conception. http://www.explorejournal.com/article/S1550‐8307(10)00295‐8/fulltext

 The Jan‐Feb 2011 Explore column, by Vinjar Fønnebø, is titled "Cochrane CAM reviews commentary: is there more to quality than the research method itself". http://www.explorejournal.com/article/S1550‐8307(10)00238‐7/fulltext

[Source: CCInfo. Electronic news bulletin of The Cochrane Collaboration, 7 July 2011]

ENZCAM Newsletter TM/CAM Update June 2011 Page 2

Network of Researchers in the Public Health of Complementary and Alternative Medicine (NORPHCAM) http://www.norphcam.org/

“NORPHCAM is the first international collaborative network dedicated to promoting and advancing the public health and health services research of traditional, complementary and alternative medicine and integrative health care. … NORPHCAM is guided by a number of key objectives:  To promote excellence in public health and health services research focusing upon CAM use, CAM practice and workforce, CAM‐conventional health care integration, economics of CAM, CAM policy and regulation  To lead and advance the empirical investigation of CAM drawing upon health social science, epidemiology, biostatistics, health economics, health geography and related disciplines  To help widen the CAM research gaze and supplement clinical research in the area of CAM  To promote and foster closer ties between CAM researchers and practitioners to ensure scholarship includes practitioner input where relevant and is reflective of practice‐realities and needs  To develop research capacity in CAM research (including promoting research skills amongst practitioners)

See particularly the sections on:  NORPHCAM Researcher Collaborators  NORPHCAM Practitioner Collaborators  Publications  Research program:  Gender, Ageing, Chronic Illness and CAM Use: New Analysis of Population Health Datasets  CAM Use Amongst Specific Patient Groups: Palliative Care Patients  CAM‐Primary Care Interface and Integrative Medicine  CAM and Community Pharmacists  Health Economics and Cost Effectiveness Analysis  Practitioner Research Capacity Building

2. Books

The African Herbal Pharmacopoeia

Publisher: Association for African Medicinal Plants Standards; First edition (August 31, 2010) 324 pages Publication Date: 31 August 2010 http://www.amazon.com/African‐Herbal‐Pharmacopoeia‐AfrHP‐First/dp/9990389098

“The African Herbal Pharmacopoeia (AfrHP) provides comprehensive, up to date botanical, commercial and phytochemical information on over fifty of the most important African medicinal plants. The technical data were made on plant samples sourced from across the continent. These monographs prepared by leading African scientists, have been reviewed by international experts.”

ENZCAM Newsletter TM/CAM Update June 2011 Page 3

“Additional data include micro morphology of the plant material, distribution maps, HPLC traces and TLC chromatograms of adulterants. These data are crucial for producers, collectors and traders in medicinal plants and extracts as well as researchers, manufacturers and practitioners. The scope, quality and standard of these herbal monographs are comparable to those prepared in Europe, North America and Asia. This publication comes at a crucial moment in the history of African herbal medicine.”

See the “Review of the African Herbal Pharmacopoiea” by Dr Andrew Marston in The Journal of Alternative and Complementary Medicine, Volume: 17 Issue 6: June 7, 2011 http://www.liebertonline.com/doi/abs/10.1089/acm.2011.0225

3. Journals

The first time a journal is listed, the contents of that edition will be given in full to give a sense of the scope of the publication. For subsequent editions, only some articles may be highlighted. Earlier editions of this newsletter are available from: http://www.hsci.canterbury.ac.nz/enzcam/

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter First Quarter 2011] Volume 17, Number 3: June 2011 http://www.liebertonline.com/toc/act/17/3

Selected articles:  Smart Talk on Supplements and Botanicals: Trends in Pregnancy and Birth Management— Challenges and Concerns  Roundoc Rx: A Functional Medicine Approach to Mood Disorders: Part 1—A Systems Biology Approach  Current Controversies in Nutrition: What’s the Story with Saturated Fats?  Neuroimaging for Mind–Body Medicine: Understanding the Brain’s Critical Role  CAM Interventions for Multiple Sclerosis: Part 1—Diet and Supplements for Relieving Symptoms  From Herbs to Medicines: A World History of Tea—from Legend to Healthy Obsession  Spasmolytic Botanicals: Relaxing Smooth Muscle with Herbs  Parkinson’s Disease: An Integrative Approach: A Natural Standard Monograph

Complementary Therapies in Clinical Practice http://www.elsevier.com/wps/find/journaldescription.cws_home/704176/description#description

This “is an internationally refereed journal published to meet the broad ranging needs of the healthcare profession in the effective and professional integration of complementary therapies within clinical practice.”

“Complementary Therapies in Clinical Practice, aims to provide rigorous peer reviewed papers addressing research, implementation of CIMa in the clinical setting, legal and ethical concerns, evaluative accounts of therapy in practice, philosophical analysis of emergent social trends in CIM, a CIM is understood to mean Complementary and Integrative Medicine

ENZCAM Newsletter TM/CAM Update June 2011 Page 4 excellence in clinical judgement, best practice, problem management, therapy information, policy development and management of change in order to promote safe and efficacious clinical practice. Complementary Therapies in Clinical Practice welcomes and considers accounts of reflective practice.”

“It will be of interest to all members of the healthcare profession including nurses, midwives, pharmacists, hospital doctors, general practitioners, physiotherapists, social scientists, psychologists, CIM researchers, practitioners of CIM, educationalists, managers, patients and individuals interested in CIM.”

Volume 17, Issue 2: May 2011

Guest editorial  Tackling the ‘big five’ – Global issues for midwifery and complementary medicine Papers  Changes in the cortisol awakening response (CAR) following participation in Mindfulness‐ Based Stress Reduction in women who completed treatment for breast cancer  Complementary and alternative medicine use among Jordanian patients with diabetes  Personal health budgets: A new way of accessing complementary therapies?  Approaches to clinical decision‐making: A qualitative study of naturopaths  Pilates for low back pain: A systematic review  A study of costs and length of stay of inpatient naturopathy – Evidence from Germany  Perceptions, experiences, and shifts in perspective occurring among urban youth participating in a mindfulness‐based stress reduction program  Take me to a clinical reflexologist: An exploratory survey  Food as medicine in psychiatric care: Which profession should be responsible for imparting knowledge and use of omega‐3 fatty acids in psychiatry  The effects of pomegranate juice consumption on blood pressure and cardiovascular health  Aromasticks in cancer care: An innovation not to be Sniffed at News updates and forthcoming events  Academic and professional recognition for midwifery complementary therapies

Integrative Cancer Therapies [First listed in ENZCAM Newsletter April 2011] Volume 10, Number 2: June 2011 http://ict.sagepub.com/content/10/2.toc

Selected articles:  Traditional Chinese Medicine Herbal Treatment May Have a Relevant Impact on the Prognosis of Patients With Stage IV Adenocarcinoma of the Lung Treated With Platinum‐ Based Chemotherapy or Combined Targeted Therapy and Chemotherapy  Classification of CAM Use and Its Correlates in Patients With Early‐Stage Breast Cancer  The Culinary‐Medicinal Mushroom Coprinus comatus as a Natural Antiandrogenic Modulator  Suppression of Proliferation and Invasive Behavior of Human Metastatic Breast Cancer Cells by Dietary Supplement BreastDefend

ENZCAM Newsletter TM/CAM Update June 2011 Page 5 Journal of Holistic Nursing [First listed in ENZCAM Newsletter April 2011] Volume 29, Number 2: June 2011 http://jhn.sagepub.com/content/vol29/issue2/?etoc

Selected articles:  The Global Presence of Holistic Nursing  Feasibility of a Mindfulness‐Based Stress Reduction Program for Early‐Stage Breast Cancer Survivors  Spring Forest Qigong and Chronic Pain: Making a Difference  Continuing Nursing Education for "Spring Forest Qigong and Chronic Pain: Making a Difference"  What Is Esoteric Healing?  Using Guided Reflection to Reduce Test Anxiety in Nursing Students

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter First Quarter 2011] Volume 17, Number 6: June 2011 http://www.liebertonline.com/toc/acm/17/6

Selected articles:  Distinguishing Between Complementary and Alternative Medicine and Integrative Medicine Delivery: The United Kingdom Joins World Leaders in Professional Integrative Medicine Education  Prameha in Ayurveda: Correlation with Obesity, Metabolic Syndrome, and Diabetes Mellitus. Part 1–Etiology, Classification, and Pathogenesis  Guarana (Paullinia cupana) Improves Fatigue in Breast Cancer Patients Undergoing Systemic Chemotherapy  Risk of Hemorrhage Associated with Co‐Prescriptions for Ginkgo biloba and Antiplatelet or Anticoagulant Drugs  Efficacy of Individualized Chinese Herbal Medication in Osteoarthrosis of Hip and Knee: A Double‐Blind, Randomized‐Controlled Clinical Study  Review of The African Herbal Pharmacopoiea

The International Journal of User‐Driven Healthcare (IJUDH) http://www.igi‐global.com/bookstore/titledetails.aspx?titleid=41022

“The International Journal of User‐Driven Healthcare (IJUDH) is a refereed, applied research journal designed to provide comprehensive coverage and understanding of clinical problem solving in healthcare.”

Call for papers for special issue regarding user driven healthcare (UDH) ‐ complementary and alternative medicine (CAM)

Introduction: User driven healthcare (UDH), participatory healthcare, stems from a concept where all stakeholders, enabled by information software and cyber‐communities, focus on healthcare values.

ENZCAM Newsletter TM/CAM Update June 2011 Page 6

Objective of the special issue: 1. Why do individuals use CAM? Orthodox medicine Failure, lack of care available, attraction to a different world‐view of evidence? 2. Are there deep philosophical differences between the worldview of CAM proponents as compared with the worldview of orthodox medicine? If so, are the philosophical differences resolvable and in what way? 3. What sort of philosophical view attracts people to CAM? 4. What part does advertising play in UDH: how reliably does it portray the putative success of CAM?

Submission due date: 30 October 2011 Submissions and enquiries to Associate editor, Dr. Donald E. Stanley Email: [email protected]

4. Clinical Integration of TM/CAM

NCCAM Clinical Digest

Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA. To subscribe to NCCAM Clinical Digest, visit http://nccam.nih.gov/news/subscribe.php?digest=1

June 2011: Fibromyalgia and CAM http://nccam.nih.gov/health/providers/digest/fibromyalgia.htm

Chiropractic Management of Fibromyalgia (Council on Chiropractic Guidelines and Practice Parameters). http://www.ccgpp.org/downloads/chiropractic_management_fibromyalgia.pdf

See also:  Clinical Guidelines  Systematic Reviews/Reviews/Meta‐Analysis (PubMed® Citations)  Randomized Controlled Trials  Information for Patients

Integrating complementary and alternative therapies into psychological practice: A qualitative analysis

By Lee‐Ann M. Wilson and Katherine M. White Australian Journal of Psychology 2011 http://onlinelibrary.wiley.com/doi/10.1111/j.1742‐9536.2011.00022.x/abstract

“Although complementary and alternative therapies (CATs) are utilised widely for treating psychological disorders, little research has examined psychologists’ beliefs about integrating CAT into psychological practice. Six practicing psychologists and six psychology students were interviewed about their CAT integration beliefs, in particular integrating CAT into clinical practice via recommending CATs, offering referrals to CAT practitioners, or undertaking training to utilise CATs within psychological practice. Guided broadly from a theory of planned behaviour perspective, participants raised a number of costs and benefits, discussed referent groups who would influence their decisions, and suggested motivators and barriers for integration. A number of additional

ENZCAM Newsletter TM/CAM Update June 2011 Page 7 themes were raised, including risks, such as the possibility of litigation and the need for clear Society guidelines, as most participants were unclear about what constitutes appropriate practice. Identifying these themes serves as an important initial step to informing discussion and policy for this emerging practice issue within psychology.”

Attitudes and referral practices of maternity care professionals with regard to complementary and alternative medicine: an integrative review

By Jon Adams, Chi‐Wai Lui, David Sibbritt, Alex Broom, Jon Wardle, Caroline Homer Journal of Advanced Nursing, Volume 67, Issue 3, March 2011 www.onlinelibrary.wiley.com/doi/10.1111/j.1365‐2648.2010.05510.x/abstract

“This paper presents an integrative literature review examining the attitudes and referral practices of midwives and other maternity care professionals with regard to complementary and alternative treatment and its use by pregnant women.”

[See http://norphcam.org/pages/posts/norphcam‐programme‐exploring‐cam‐in‐maternity‐care‐ attracts‐international‐media‐attention‐march‐1152.php ]

“University‐based members of [NORPHCAM] reviewed 19 studies covering the views of more than 3,000 maternity professionals from Australia, Canada, the USA, UK, Germany, New Zealand and Israel. The studies, which were all based on interviews or surveys, were published between 1999 and 2009, 13 in the last five years. The review raised concern that most medical professionals have no CAM training and little understanding of the pharmacological nature of alternative therapies and their possible risks to pregnant women.

Key findings from the most recent 2008 and 2009 studies include:

 A survey of 343 midwives from Canada and New Zealand found that 72% had recommended or offered CAM. The most common referrals were to homeopaths (51%), acupuncturists (50%), naturopaths (48%), chiropractors (36%), massage therapists (31%) and osteopaths (20%).

 All but one of the 381 obstetric departments who took part in a German survey said they offered at least one CAM therapy, with acupuncture (97%), homeopathy (93%) and aromatherapy (77%) heading the list.

 78% of the 227 midwives who took part in an American study reported using CAM and 89% would refer a patient to CAM providers.

 The three most commonly used treatments were herbal preparations (85%), pharmacologic/biologic treatments (82%) and mind‐body interventions (80%).

 A study of 401 American obstetricians found that 98% routinely endorsed, provided or referred patients for at least one CAM treatment. Movement therapies topped the list at 86%, followed by biofeedback and acupuncture (both 80%).

Dr Adams said the popularity of CAM – including acupuncture, chiropractic, naturopathy, herbal medicine and yoga – had grown significantly in recent years. The use of CAM during pregnancy has been debated by practitioners and policy makers around the world and it is clear that there is a real need to develop an integrated approach to maternity care.”

ENZCAM Newsletter TM/CAM Update June 2011 Page 8 5. Consumer Integration of TM/CAM

Complementary and alternative medicine (CAM) among hospitalised patients: Reported use of CAM and reasons for use, CAM preferred during hospitalisation, and the socio‐ demographic determinants of CAM users

By Seyed Afshin Shorofi [Flinders University, Adelaide, Australia] Complementary Therapies in Clinical Practice. Available online 25 June 2011. http://www.sciencedirect.com/science/article/pii/S1744388111000454

“This paper reports a study to examine hospitalised patients’ frequency and patterns of CAM use, their reasons for CAM use, their preferences of CAMs during hospitalisation, and the association between patients’ socio‐demographic variables and use of each individual CAM/CAM domain.

A convenience sample of 353 patients hospitalised in 19 surgical wards at four metropolitan hospitals completed a questionnaire on CAM use and socio‐demographic variables.

The response rate was 73.5%, and over 90% of the sample acknowledged using CAMs. Non‐herbal supplements (60.3%) and massage therapy (45%) were the most frequently used CAMs, with biologically based therapies (68.8%) as well as mind–body interventions (65.4%) being the most often used CAM domains. About 1 in 10 patients (9.6%) used CAMs from all five domains. With the exception of herbal‐botanical therapies, self‐prayer for health reasons/spiritual healing and music therapy, all CAMs were mainly used on an ‘only when needed’ basis.

The most common reason nominated for using CAMs was that ‘[it] fits into my way of life/philosophy’ (26%). The majority of patients declared interest in and support for the hospital providing CAMs. Patients were most inclined to choose therapies categorised as manipulative and body‐based methods (65.4%) for use in hospital. Massage therapy (53.5%) and non‐herbal supplements (43.1%) were the top two CAMs favoured for use in hospital. CAM use was also dependent of socio‐demographic data (age, gender, marital status, place of residence, education level, religion, and income in hospitalised patients).”

The Use of Complementary and Alternative Medicine During Pregnancy: A Longitudinal Study of Australian Women

By Jon Adams, David Sibbritt, Chi‐Wai Lui Birth: Issues in Perinatal Care Article first published online: 20 May 2011, due to be published September 2011. http://onlinelibrary.wiley.com/doi/10.1111/j.1523‐536X.2011.00480.x/abstract

“The use of complementary and alternative medicine is increasingly prevalent in contemporary Western societies. The objective of this study was to explore trends and patterns in complementary and alternative medicine practitioner consultations and the use of complementary and alternative medicine consumption before, during, and after pregnancy and between pregnancies.

Methods: Analysis focused on data from 13,961 women from the younger cohort of the Australian Longitudinal Study on Women’s Health collected between 1996 and 2006. Chi‐square tests were employed for the cross‐sectional analysis of categorical variables and t tests for continuous variables. Generalized estimating equations were used to conduct multivariate longitudinal analysis.

ENZCAM Newsletter TM/CAM Update June 2011 Page 9

Results: Complementary and alternative medicine use among pregnant and non‐pregnant women continued to increase over the 10‐year period. Although pregnancy status was not predictive of the use of alternative treatments, pregnant women employed these therapies or modalities for the relief of pregnancy‐related complaints and symptoms. Analysis also revealed that women used complementary and alternative treatments selectively during pregnancy.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

18 July 2011

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update July 2011

1. Research Organisations

Complementary and Alternative Medicine Library and Information Service (CAMLIS) http://www.cam.nhs.uk/library/

“CAMLIS, is a central London library open to all for reference, and to members as a borrowing library. We also house an historical archive and offer … online research resources. CAMLIS is open to the public. Anybody with an interest in CAM (Complementary and Alternative Medicine) can use the reading room” which is situated at the Royal London Hospital for Integrated Medicine.

“Our library catalogue is available to search online. … CAMLIS users can access the complete back‐ run of our print journal holdings. We hold over 200 journal titles covering all areas of complementary and alternative medicine, in many languages, some dating back to the Nineteenth‐ Century. … Full‐text articles from our e‐journal subscriptions are available online for our members to read or download from wherever they are.” These include e‐journals, e‐books and databases.

The library holds 200 print journals, and 50 online journals. The full list of journals is at: http://www.cam.nhs.uk/journals/

Good Practice in Traditional Chinese Medicine Research in the Post‐genomic Era (GP‐TCM) http://www.gp‐tcm.org/ In collaboration with European Union FP7 Consortium "CAMbrella" a

“GP‐TCM is a European Coordination Action funded under the 7th framework programme. The overall aim of the project is to inform best practice and harmonise research of the safety and efficacy of Traditional Chinese Medicine (TCM) in EU Member States using a functional genomics approach through exchange of opinions, experience and expertise among scientists in EU Member States and China.” aFor more information on CAMbrella, see ENZCAM newsletter April 2011: http://www.hsci.canterbury.ac.nz/enzcam/

ENZCAM Newsletter TM/CAM Update July 2011 Page 2

“The main objectives of the GP‐TCM consortium are:  Develop a European‐Chinese network collaborating on functional genomics research in TCM  Review current practice of TCM research, identifying problems and proposing ways out  Propose standard protocols of methodology  Propose priority areas of future research  Develop online resources to support and enhance Pan‐European studies of TCM research  Facilitate and foster a sustainable European Collaboration by founding the European Society of CM Research (ESCMR)”

“In contrast to the reductionist approach of Western medicine that is based on modern anatomy, physiology, pathology, pharmacology as well as cell and molecular biology, TCM uses a unique theory system and an individualised and holistic approach to describe health and disease, based on the philosophy of Yin‐Yang balance and an emphasis on harmony of functions. These two medicine systems disagree with each other in many situations as both of them may observe health from their limited perspective. GP‐TCM aims to inform best practice, and harmonise research of safety and efficacy of TCM, especially Chinese herbal medicines (CHM) and acupuncture, in EU Member States and China.”

“This Coordination Action has grouped together a network of institutions and experts … more than 150 scientists, clinicians and TCM practitioners from 13 EU Member States, and 6 Non‐EU countries including 5 leading Chinese TCM institutions.” The consortium has 29 funded partner organisations and 71 unfunded collaborating partner organisations. See http://www.gp‐tcm.org/about/partners/

“To facilitate multilateral interaction, this project is being delivered in 10 independent and interacting Work Packages, in which there are both specialists of TCM research and experts of functional genomics. The project is being managed by a Steering Committee and supported by a Scientific Advisory Committee and a Functional Genomics Technology Committee.” See http://www.gp‐tcm.org/work‐packages/ for work packages.

“During the funded lifetime of the project, the European Society of Chinese Medicine (CM) Research will be established and will be kept running autonomously to continue the guidance and coordination of EU‐China collaboration in TCM research.”

[with acknowledgements to Paolo Roberti di Sarsina, MD, Expert for Non‐Conventional Medicine, High Council of Health, Ministry of Health, Italy; Observatory and Methods for Health, University of Milano‐Bicocca, Italy]

2. Practitioner Organisations in the Region

The Australian Traditional‐Medicine Society (ATMS) http://www.atms.com.au/index.asp

“The Australian Traditional‐Medicine Society (ATMS) is Australia's largest professional association of natural medicine practitioners, representing about 65% of the total natural medicine profession. ATMS was founded in 1984. … As at November 2010, ATMS had 11,757 financial members. ATMS is the only natural medicine practitioner association appointed to two Commonwealth statutory committees, where it represents the interests of the entire natural medicine practitioner profession.”

ENZCAM Newsletter TM/CAM Update July 2011 Page 3

“ATMS is governed by an Executive Board of Directors. The functions of ATMS are carried out by the Directors, assisted by fulltime and part‐time staff. Additionally specialised Departments of Massage Therapy, Traditional Chinese Medicine, Homeopathy, Naturopathic Nutrition, Naturopathy and Western Herbal Medicine address the specific needs of practitioners in these disciplines. State Representatives further represent the needs of members and promote ATMS in each State and the ACT.”

“ATMS promotes and represents professional practitioners of natural medicine, who are encouraged to pursue the highest ideals of professionalism in their natural medicine practice and education.”

ATMS publishes the Journal of the Australian Traditional‐Medicine Society. http://www.atms.com.au/journal/index.asp http://www.atms.com.au/journal/Journal_Contents.asp

“The Journal of the Australian Traditional‐Medicine Society publishes articles on the activities of the Australian Traditional‐Medicine Society, as well as on all aspects of natural medicine as taught and practised in Australia.”

Integration of CAM with Private Health Insurance in Australia Details are given about CAM coverage by Australian health plans. (see section 6 of this newsletter) http://www.atms.com.au/membership/Membership_Funds.asp

3. Journals

European Journal of Integrative Medicine [First listed in ENZCAM Newsletter May 2011] Volume 3, Issue 2: June 2011 http://www.sciencedirect.com/science/issue/59075‐2011‐999969997‐3459746

Selected articles:  White‐Berry Mistletoe (Viscum album L.) as complementary treatment in cancer: Does it help?  Effectiveness of exercise after PCI in the secondary prevention of coronary heart disease: A systematic review  Acupuncture and Chinese herbal treatment for women undergoing intrauterine insemination  Anti‐arthritic and antioxidant activity of leaves of Alstonia scholaris Linn. R.Br.  From traditional medicine to integrative care—A global research perspective: Keynote lecture Complementary and Alternative Medicine Strategies, Training, Research and New Developments (CAMSTRAND) Conference 2011, Southampton, UK  Involving patients in designing research into using acupuncture and moxibustion in the management of breast cancer related lymphoedema  Acupuncture in a group setting: A qualitative study of patients’ attitudes and experiences  Exploring Chinese medicine's diversity

ENZCAM Newsletter TM/CAM Update July 2011 Page 4

 A half‐eaten biscuit: Mid study reflections on the feasibility of economically evaluating the Bristol Homeopathic Hospital using a matched controlled cohort approach (the BISCUIT study)  The UK back pain subpopulation study: Predictors of outcome in patients receiving chiropractic treatment  Double blind randomised controlled study of the acute (immediate) cardiovascular effects of reflexology: A pilot study in health volunteers  Patients’ perceptions of post‐treatment experiences in osteopathy: A qualitative study using focus groups  The effects of integrating the Haven programme with standard medical treatment in women with breast cancer: A randomised feasibility pilot study  A systematic review to assess the evidence of the positive and negative effects of Chinese herbal medicine in the treatment of depression  From research to practice: Do users of an ear acupuncture service to manage breast cancer related hot flushes and night sweats do as well as research  CAM for supportive cancer care: Communication strategies used by health professionals  Pilot study for a randomised controlled trial of mistletoe in newly diagnosed breast cancer (MBC): Methodological issues in protocol development  How far have we come in the use of economic evaluation techniques to make the case for complementary and alternative medicines? A systematic review of methodological developments, trends in quality and robustness of findings  Investigating patient experienced outcomes among people with multiple sclerosis— Establishing an appropriate research design  Working at the coalface: An action research study into the experience of ‘integrative medicine’ in the NHS

Evidence‐Based Complementary and Alternative Medicine (eCAM) http://www.hindawi.com/journals/ecam/aims/

“Evidence‐Based Complementary and Alternative Medicine (eCAM) is an international, peer‐ reviewed journal that seeks to understand the sources and to encourage rigorous research in this new, yet ancient world of complementary and alternative medicine. The journal seeks to apply scientific rigor to the study of complementary and alternative medicine (CAM) modalities, particularly traditional Asian healing systems. eCAM emphasizes health outcome, while documenting biological mechanisms of action. The journal is devoted to the advancement of science in the field of basic research, clinical studies, methodology or scientific theory in diverse areas of Biomedical Sciences.” eCAM is an open access journal.

Published Special Issues:  Neuroendocrine Mechanisms of Acupuncture  Oncology in the Cross‐Cultural Region of the Middle East and South Asia  Medical Ethnobiology and Ethnopharmacology in Latin America  Marine Biotechnology

Open Special Issues [expected publication date in brackets]:  Medical Ethnobiology and Ethnopharmacology in Latin America [January 15, 2012]  Complementary and Integrative Oncology in the Cross‐Cultural Region of the Middle East and South Asia [March 1, 2012]

ENZCAM Newsletter TM/CAM Update July 2011 Page 5

 Ethnopharmacological Approaches to Wound Repair [March 1, 2012]  The Potential Benefit of Complementary/Alternative Medicine in Cardiovascular Diseases [April 13, 2012]  Complementary and Alternative Medicine and Cancer Survivorship [June 1, 2012]  Anti‐infective and Anti‐proliferative Potential of African Medicinal Plants [July 6, 2012]

EXPLORE: The Journal of Science and Healing [First listed in ENZCAM Newsletter May 2011] Volume 7, Issue 4: July‐August 2011 http://www.sciencedirect.com/science/issue/23253‐2011‐999929995‐3384822

Selected articles:  The Whole Systems Medicine of Tomorrow: A Half‐Century Perspective  Meditation Reduces Pain Scores  Healing the Heart: A Randomized Pilot Study of a Spiritual Retreat for Depression in Acute Coronary Syndrome Patients  Impact of Spirituality/Religiosity on Mortality: Comparison With Other Health Interventions  Pain Modulation by Meditation and Electroacupuncture in Experimental Submaximum Effort Tourniquet Technique (SETT)  Building Bridges: Qualitative Assessment of a Clinical Faculty Exchange Between a Naturopathic and an Allopathic Medical Training Program  Book Review: Integrative Rheumatology by Randy Horwitz, MD, PhD, and Daniel Muller, MD, PhD New York, NY: Oxford University Press ISBN 978‐0‐19‐531121‐1.  Commentary on the Cochrane Review of Stimulation of the Wrist Acupuncture Point P6 for Preventing Postoperative Nausea and Vomiting  Innovations in Integrative Healthcare Education

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter First Quarter 2011] Volume 17, Number 7: July 2011 http://www.liebertonline.com/toc/acm/17/7

Selected articles:  Shenmai Injection for Chronic Pulmonary Heart Disease: A Systematic Review and Meta‐ Analysis  Prameha in Ayurveda: Correlation with Obesity, Metabolic Syndrome, and Diabetes Mellitus.  Yoga Therapy as an Adjunctive Treatment for Schizophrenia: A Randomized, Controlled Pilot Study  Massage Therapy Usage and Reported Health in Older Adults Experiencing Persistent Pain  Treatment of Constipation in Long‐Term Care with Chinese Herbal Formula: A Randomized, Double‐Blind Placebo‐Controlled Trial  The International Collaboration on Complementary Therapy Resources (ICCR): Working Together to Improve Online CAM Information

ENZCAM Newsletter TM/CAM Update July 2011 Page 6 The International Journal of User‐Driven Healthcare (IJUDH) http://www.igi‐global.com/bookstore/titledetails.aspx?titleid=41022

Call for papers for special issue regarding user driven healthcare (UDH) ‐ complementary and alternative medicine (CAM) [See first article in ENZCAM newsletter June 2011]

Submission due date: 30 October 2011 Submissions and enquiries to Associate editor, Dr. Donald E. Stanley Email: [email protected] More information on the call for papers from an e‐mail from Dr Stanley:

Suggested topics:  Why do people believe in interventions that have no biological (orthodox scientific rationality) e.g. megadose vitamins for the common cold, reflexology and Ayurveda medicine?  How do social media and mobile technologies influence research in CAM? e.g. personalities endorse CAM based on personal experience.  How does CAM incorporate personal values in treatment procedures e.g. patients may want control over real or perceived illnesses, require more explanations for chronic conditions, are willing to try an auxiliary system of treatment when orthodox medicine is of no avail.  How do natural food labels influence health‐conscious individuals to choose unproven nutritional aids?  How do patients evaluate claims of validity and efficacy of CA?  How often do orthodox medical practitioners allow or suggest CAM as an adjunct to medical care?  Do potential patients choose cam for fear of 'high‐technology' medicine?  Does the patient who chooses CAM because various modalities promote treatment of the 'whole' person rather than reductionistic disease oriented medicine?  Is CAM a part of the shopping mode in health care?  Do differing belief systems, cultural norms; change scientific points of view? Are evaluative methods for CAM culturally determined? Do these factors promote a different & specific scientific attitude?  How does advertising influence people to choose CAM over Western style medicine. Why?

4. Education and Training

Complementary Medicine Unit, Peninsula Medical School , Universities of Exeter & Plymouth, http://sites.pcmd.ac.uk/compmed/ Professor of complementary medicine resigns to save his research unit at Peninsula Medical School http://www.bmj.com/content/343/bmj.d4789.short “Peninsula Medical School is about to advertise for a successor to Edzard Ernst, Britain’s first professor of complementary and alternative medicine. The action would seem to allay doubts raised about the future of the Exeter based research unit after Professor Ernst’s resignation earlier this year. “This is important,” he says. “We are probably the only unit worldwide taking the critical evaluation of complementary medicine seriously.”

ENZCAM Newsletter TM/CAM Update July 2011 Page 7

Professor Ernst was appointed to his chair in 1993. Initially funded by a grant from the Laing Foundation, recent years have found him struggling to get sufficient cash from outside sources to keep going. The university, he says, has shown little enthusiasm for trying to raise money on his behalf. Responding to suggestions that he might have found it easier to get money if so many of his reports had not been so negative about alternative medicine, Professor Ernst said that he has simply reported what he has found. “A negative result, from my perspective, is a positive result as long as it’s good science,” he said. How far Professor Ernst’s much publicised disagreements with Prince Charles over homoeopathy, the integration of complementary medicine within the NHS, and other such matters have influenced potential funders is a matter of speculation. But whatever the connection, if any, Peninsula Medical School’s agreement to continue funding a chair in complementary medicine came after Professor Ernst’s decision to resign it.”

Further papers and articles on this issue:

Edzard Ernst: the prince and me http://www.bmj.com/content/343/bmj.d4937.short?rss=1 “I’m not as undiplomatic as I look,” says Edzard Ernst. Sat in the conservatory of his seaside home by the Suffolk coast, Britain’s first professor of complementary medicine does seem to be a picture of polite gentility. Not so a few days earlier when, at a press conference in London, he branded Prince Charles a snakeoil salesman for promoting homoeopathy. The statement made headlines across the world. Ernst chuckles at the mention of this. “I know what I’m doing and I do it on purpose,” he says. “I’m not against royalty, I’m just confrontational with Prince Charles because he is speaking out of his proverbial when it comes to medicine and science.” Ernst has spent the past 18 years studying the safety and efficacy of complementary and alternative medicines (CAMs). He has masterminded over 30 clinical trials and 200 systematic reviews. His results have led him to criticise many CAMs as no better than placebo, and to say some even do harm. He has also found that around 20 work better than placebo. His results have often brought him into open confrontation with both CAM proponents—they feel he’s out to rubbish their field— and conventional medics, who think he’s devoting precious effort and resources to what, they are convinced, is quackery. He insists that neither is the case. “I honestly think that I am entirely evidence led,” he says.”

Prince Charles branded a 'snake oil salesman' by scientist http://www.guardian.co.uk/science/2011/jul/25/prince‐charles‐snake‐oil‐salesman

A legacy of scepticism : Nature News http://www.nature.com/news/2011/110530/full/news.2011.322.html

ENZCAM Newsletter TM/CAM Update July 2011 Page 8 5. Clinical Integration of TM/CAM

NCCAM Clinical Digest

Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA. To subscribe to NCCAM Clinical Digest, visit http://nccam.nih.gov/news/subscribe.php?digest=1

July 2011: Low‐Back Pain and CAM This issue summarizes the current scientific knowledge about the effects of some of the CAM approaches that people use for low‐back pain, including spinal manipulation, acupuncture, massage, and other CAM therapies. http://nccam.nih.gov/health/providers/digest/lowback‐science.htm?nav=cd

Clinical Guidelines * Chronic Pain Management (Anesthesiology) http://www.asahq.org/publicationsAndServices/~/media/For%20Members/Practice%20Manageme nt/PracticeParameters/ChronicPainManagement.ashx * Diagnosis and Treatment of Low‐Back Pain (Annals of Internal Medicine) http://www.annals.org/content/147/7/478.full.pdf+html * Pain Management Task Force Final Report (Office of The Army Surgeon General) http://www.armymedicine.army.mil/reports/Pain_Management_Task_Force.pdf

The Scientific Literature * Systematic Reviews/Reviews/Meta‐Analysis (PubMed® Citations) http://www.ncbi.nlm.nih.gov/pubmed?term=%22Low%20Back%20Pain%22%5BMesh%5D%20AND% 20%22Complementary%20Therapies%22%5BMesh%5D%20AND%20%28%22humans%22%5BMeSH %20Terms%5D%20AND%20%28Meta‐ Analysis%5Bptyp%5D%20OR%20Review%5Bptyp%5D%29%20AND%20English%5Blang%5D%20AND %20%222006/04/17%22%5BPDat%5D%20%3A%20%222011/04/15%22%5BPDat%5D%29&cmd=Det ailsSearch * Randomized Controlled Trials (PubMed® Citations) http://www.ncbi.nlm.nih.gov/pubmed?term=%22Low%20Back%20Pain%22%5BMesh%5D%20AND% 20%22Complementary%20Therapies%22%5BMesh%5D%20AND%20%28%22humans%22%5BMeSH %20Terms%5D%20AND%20Randomized%20Controlled%20Trial%5Bptyp%5D%20AND%20English%5 Blang%5D%20AND%20%222006/04/17%22%5BPDat%5D%20%3A%20%222011/04/15%22%5BPDat %5D%29&cmd=DetailsSearch

NCCAM Research Spotlights * Massage Therapy Holds Promise for Low‐Back Pain (July 2011) http://nccam.nih.gov/research/results/spotlight/070411.htm?nav=cd * Review of CAM Practices for Back and Neck Pain Shows Modest Results (October 2010) http://nccam.nih.gov/research/results/spotlight/100110.htm?nav=cd * Analysis of National Survey Reveals Perceived Benefit of CAM for Back Pain (May 2010) http://nccam.nih.gov/research/results/spotlight/060110.htm?nav=cd * Preliminary Trial Finds Possible Benefits of Osteopathic Treatment for Back Pain During the Third Trimester of Pregnancy (January 2010) http://nccam.nih.gov/research/results/spotlight/032210.htm?nav=cd * Iyengar Yoga for Chronic Low‐Back Pain Shows Promising Results (September 2009) http://nccam.nih.gov/research/results/spotlight/112409.htm?nav=cd * Study Finds Simulated and Real Acupuncture Equally Effective Versus Usual Care in Treating Low‐ Back Pain (May 2009)

ENZCAM Newsletter TM/CAM Update July 2011 Page 9

http://nccam.nih.gov/research/results/spotlight/050910.htm?nav=cd * Managing Low‐Back Pain: An Evidence‐Based Approach for Primary Care Physicians (April 2009) http://nccam.nih.gov/research/results/spotlight/040209.htm?nav=cd * Study Points to Cost‐Effectiveness of Naturopathic Care for Low‐Back Pain (May 2008) http://nccam.nih.gov/research/results/spotlight/070708.htm?nav=cd

Information for Your Patients * Chronic Pain and CAM: At a Glance http://nccam.nih.gov/health/pain/chronic.htm?nav=cd * Acupuncture for Pain http://nccam.nih.gov/health/acupuncture/acupuncture‐for‐pain.htm?nav=cd * Spinal Manipulation for Low‐Back Pain http://nccam.nih.gov/health/pain/spinemanipulation.htm?nav=cd * Back Pain (NIAMS) http://www.niams.nih.gov/Health_Info/Back_Pain/default.asp

6. Health System Integration of TM/CAM

Switzerland Five complementary therapies supported again by Swiss Health service http://www.cam.nhs.uk/news/five‐complementary‐therapies‐supported‐again‐by‐swiss‐health‐ service/ “Five complementary therapies are once again available to Swiss people via their health system, with all becoming reimburseable under Swiss health insurance. They are: homeopathy, herbalism, Traditional Chinese medicine, ‘holistic medicine’ (an integrated approach) and neural therapy. They all become available again in 2012, however, the medicines must prove their ‘efficacy, cost effectiveness and suitability by 2017.”

“These therapies were available until 2005, when they were removed. However, a massive petition led to a vote in 2009, in which two thirds of Swiss people backed the therapies, leading to their reinstatement.”

“For the new trial, providers of homeopathy, holistic, herbal and neural therapies and traditional Chinese medicine will have to evaluate their effectiveness. The findings will then go before a recognised international institute – still to be determined – that will provide an independent scientific assessment. The UK’s NICE and the US NIH are both being considered. The re‐evaluation will not include new trials, rather an examination of existing data.”

Full story at: http://www.swissinfo.ch/eng/swiss_news/Alternative_therapies_are_put_to_the_ test.html?cid=29242484

ENZCAM Newsletter TM/CAM Update July 2011 Page 10 Australia Integration of CAM with Private Health Insurance

A particularly useful section of the Australian Traditional‐Medicine Society web‐site deals with the willingness of healthcare funders in Australia to fund specific CAM therapies. The accreditation criteria required by each health plan for each therapy are given. The web‐site is thus an excellent reference source for coverage of CAM by Australian health plans. http://www.atms.com.au/membership/Membership_Funds.asp

Produced for ENZCAM by Heather McLeod and Ray Kirk

17 August 2011

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update August 2011

1. Policy and Legislation

Registration of CAM Practitioners in New Zealand Proposal that Traditional Chinese Medicine become a Regulated Profession under the Health Practitioners Competence Assurance Act 2003

“Traditional Chinese medicine (TCM) practitioners groups have applied to the Ministry of Health to be regulated under the Health Practitioners Competence Assurance Act 2003.” The proposal to regulate the TCM profession “outlines the reasons for regulating a profession, a brief background on the profession and invites comments on the proposal.” Submissions closed in August 2011. http://www.health.govt.nz/consultations/proposal‐traditional‐chinese‐medicine‐become‐regulated

The document contains much useful information on the definition of TCM, the training of practitioners in New Zealand and the proposed scope of practice.

Criteria for Assessing Applications for Regulation of CAM Practitioners

The material in the proposal on the reasons for regulating a profession and what a profession needs to demonstrate are useful for all other CAM professions in New Zealand. The approach taken by the Ministry could be useful as a guide for other countries.

“Any profession applying to become regulated under the HPCA Act must show consistency with the principal purpose of the HPCA Act, which is: to protect the health and safety of members of the public by providing for mechanisms to ensure that health practitioners are competent and fit to practise their professions. (s 3(1))

Implicit in the HPCA Act is the protection of public interest through ensuring the public can readily find out what services a health practitioner is competent and entitled to provide. This will enable the public to know what health services can be expected from their chosen practitioner, and to know that practitioner is competent and safe.

To determine whether a health profession should be regulated under the HPCA Act, primary and secondary criteria have been developed. The primary criteria are specific requirements set out in the Act and must be met in order for a health practice to be regulated. Applications that meet the

ENZCAM Newsletter TM/CAM Update August 2011 Page 2 primary criteria will then be assessed on the extent to which they meet the secondary criteria. The secondary criteria focus more on the practicalities of a profession being regulated under the HPCA Act and whether this is, in fact, the most appropriate means to protect the health and safety of the public.”

“The primary criteria for regulation under the HPCA Act are that: A. the profession delivers a health service as defined by the HPCA Act B. the health services concerned pose a risk of harm to the health and safety of the public C. it is otherwise in the public interest that the health services be regulated as a health profession under the HPCA Act.”

The following second‐level criteria measure the appropriateness of regulation under the HPCA Act. “Criterion 1: Existing regulatory or other mechanisms fail to address health and safety issues. Criterion 2: Regulation is possible to implement for the profession in question. Criterion 3: Regulation is practical to implement for the profession in question. Criterion 4: The benefits to the public of regulation clearly outweigh the potential negative impact of such regulation.”

More detailed guidelines on what needs to be answered for each of the criteria are provided in Appendix 1 of the document on the Ministry web‐site: http://www.health.govt.nz/consultations/proposal‐traditional‐chinese‐medicine‐become‐regulated

Commentary on Developments to Regulate TCM and Other CAM Professions

The August 2011 newsletter of the New Zealand School of Acupuncture and Traditional Chinese Medicine provides more background on the application by TCM practitioners. See: http://www.acupuncture.ac.nz/

“In September last year, the TCM profession applied for statutory regulation under the [HPCA Act]. The application broadens the voluntary regulation of the profession from its narrow and exclusive focus on traditional acupuncture to include TCM’s three branches: acupuncture, Chinese herbal medicine and tuina (Chinese traditional massage). ‘This is an important shift and helps redefine the profession in New Zealand in a similar way to other countries like Australia which intends to bring TCM under statutory regulation next year. It also provides the possibility of developing a system similar to China’s where ‘Chinese medicine doctors’ work alongside ‘Western medicine doctors’ as equals within an integrative health system,’ says Dr St George”, the MoH’s Chief Advisor for Integrative Care.

“If it’s given the green light, the Minister will appoint a regulatory authority for TCM. This could be a separate new body but, Dr St George thinks, it’s likely one of the existing 16 health practitioner regulatory authorities would be changed into a multi‐professional body to facilitate the purpose.”

“Over the past year, communication has been growing between China’s State Administration of Traditional Chinese Medicine (SATCM) and New Zealand’s Ministry of Health, on the possibility of bilateral cooperation over the development of TCM in New Zealand. In mid‐June a six‐member SATCM delegation arrived led by Vice Minister of Health and CEO, Dr Wang Guoqiang. Representatives of the two governments agreed that a formal mechanism should be put in place for bilateral communication and cooperation, and they will now move towards signing an MOU to bring this about. ‘This would facilitate bilateral exchanges between New Zealand and Chinese institutions that could focus on research and post‐graduate education,’ adds Dr St George.”

ENZCAM Newsletter TM/CAM Update August 2011 Page 3

“ ‘There are no laws stopping DHBs from introducing TCM as part of their health care services right now. However, DHBs have other funding priorities and they also claim there is insufficient evidence of efficacy to enable them to consider TCM practitioners for public health care provision. What we need, therefore, are demonstration models which will establish and evaluate the role of TCM practitioners in a variety of clinical setting, from primary care through hospital acute care to end‐of‐ life care. For example, in the hospital setting we need to identify key specialties, key medical conditions, and develop integrative care projects in collaboration with sister hospitals in China. These projects should be carefully and objectively evaluated, to establish the role and effectiveness of TCM practitioners in such settings,’ adds Dr St George.”

2. Research Organisations

The International Society for Complementary Medicine Research (ISCMR) [See ENZCAM Newsletter May 2011]

ISCMR launches a new website: www.iscmr.org

The new host for the website is the Charité University Medical Center Berlin. The new ISCMR website has several new features, including areas downloads for special interest groups and other functions exclusive for members, such as the download of conference presentations.

3. Books

Clinicians’ and Educators’ Desk Reference on the Licensed Complementary and Alternative Healthcare Professions By Elizabeth Goldblatt, PhD, MPA/HA, Pamela Snider, ND, Sheila Quinn, John Weeks Published: 12 January 2011 http://www.accahc.org/link2book

“A reference text on the complementary and alternative medicine professions written by leading educators from each discipline that is meant … to create appropriate and respectful collaboration between the disciplines to provide optimal health care.”

“This guide to the 5 licensed complementary and alternative healthcare professions [in the USA], written by vetted experts, is a desk reference for clinicians and a textbook and resource for educators and students. Also included is information on emerging fields of traditional world medicines, holistic nursing and holistic and integrative medicine.”

Developed by the Academic Consortium for Complementary and Alternative Health Care (ACCAHC) [see section Error! Reference source not found.], together with Organizational Partners:  American Massage Therapy Association—Council of Schools  Association of Accredited Naturopathic Medical Colleges  Association of Chiropractic Colleges  Council of Colleges of Acupuncture and Oriental Medicine  Midwifery Education Accreditation Council

ENZCAM Newsletter TM/CAM Update August 2011 Page 4

Other organizations that assisted were the American Holistic Nurses Association, American Holistic Medical Association, American Medical College of Homeopathy, Consortium of Academic Health Centers for Integrative Medicine, International Association of Yoga Therapists and the National Ayurvedic Medical Association.

4. Journals

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter First Quarter 2011] Volume 17, Number 4: August 2011 http://www.liebertonline.com/toc/act/17/4

Selected articles:  Smart Talk on Supplements and Botanicals: An Integrative Approach to Attention Deficit Hyperactivity Disorder  Roundoc Rx: A Functional Medicine Approach to Mood Disorders: Part 2—Nutrients and Herbs to Nourish the Brain  Current Controversies in Nutrition: Do Supplements Enhance the Effects of Chemotherapy?  The Role and Impact of Acupuncture After Head and Neck Treatments  CAM Interventions for Multiple Sclerosis: Part 2—Integrative Non‐dietary Approaches  Undervalued Herbs: Use in Clinical Practice and Need for Validating Research  Turmeric (Curcuma longa): An Evidence‐Based Systematic Review

Complementary Therapies in Clinical Practice [First listed in ENZCAM Newsletter June 2011] Volume 17, Issue 3: August 2011 http://www.sciencedirect.com/science/journal/17443881

Selected articles:  The impact of yoga upon female patients suffering from hypothyroidism  Attitudes and views on chiropractic: A survey of United States midwives  Use of herbal drugs during pregnancy among 600 Norwegian women in relation to concurrent use of conventional drugs and pregnancy outcome  Traditional Chinese herbal medicine in the supportive management of patients with chronic cytopaenic marrow diseases – A phase I/II clinical study  CAM: Naturopathic dietary interventions for patients with Type 2 diabetes  Effects of thermal therapy combining sauna therapy and underwater exercise in patients with fibromyalgia  Effects of olive oil on striae gravidarum in the second trimester of pregnancy  News: Postgraduate courses offered at the University of Westminster. London UK  The British College of Integrative Medicine (BCIM): Two years on

ENZCAM Newsletter TM/CAM Update August 2011 Page 5 Complementary Therapies in Medicine [First listed in ENZCAM Newsletter May 2011] Volume 19, Number 4: August 2011 http://www.complementarytherapiesinmedicine.com/issues/contents?issue_key=S0965‐ 2299%2811%29X0005‐5

Selected Articles:  Patient consensus on mode of use of nettle sting for musculoskeletal pain  A multicenter, randomized, double‐blind, placebo‐controlled trial evaluating the efficacy and safety of a far infrared‐emitting sericite belt in patients with primary dysmenorrhea  Use of complementary and alternative medicine among USA adults with functional limitations: For treatment or general use  Complementary medicines (herbal and nutritional products) in the treatment of Attention Deficit Hyperactivity Disorder (ADHD): A systematic review of the evidence  The molecular basis of nutritional intervention in multiple sclerosis: A narrative review

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter First Quarter 2011] Volume 17, Number 8: August 2011 http://www.liebertonline.com/toc/acm/17/8

Selected articles:  Progress in the Placebo Debate for Homeopathy?  Women's Use of Complementary and Alternative Medicine for Fertility Enhancement: A Review of the Literature  A Feasibility Study Exploring the Role of Chinese Herbal Medicine in the Treatment of Endometriosis  Tilting Whole Body Vibration Improves Quality of Life in Women with Fibromyalgia: A Randomized Controlled Trial  Mid‐Age Women's Consultations with Acupuncturists: A Longitudinal Analysis of 11,200 Women, 2001–2007  Acupuncture for Symptom Management in Hemodialysis Patients: A Prospective, Observational Pilot Study

5. Conferences and Training

4th European Congress for Integrative Medicine (ECIM)

“On the 7th and 8th of October 2011, the 4th European Congress for Integrative Medicine (ECIM) will take place in Berlin.” See http://www.ecim‐congress.org/

The Gawler Foundation: Profound Healing ‐ Sustainable Wellbeing Conference Saturday 19 & Sunday 20 November 2011 Hilton on the Park ‐ Melbourne http://www.gawler.org/conference‐program

ENZCAM Newsletter TM/CAM Update August 2011 Page 6

“This 2‐day event focussing on health, healing, wellbeing and prevention of illness brings together thought and practice leaders in mind‐body medicine. Experience 12 keynote addresses and 12 interactive workshops, incorporating the latest research and strategies.”

Research related to Complementary and Alternative/Integrative Medicine (CAM/IM) ENZCAM, University of Canterbury, Christchurch, New Zealand

A five‐day course on CAM/IM research is planned for early 2012. Professor Ian Coulter will be the lead presenter: see http://www.rand.org/about/people/c/coulter_ian_d.html Further information to follow.

6th Research Methods in Complementary and Integrative Medicine training course “To be held March 29 through April 4, 2012, for the first time in the United States. The course will provide participants with the skills necessary to both critically appraise clinical research, identify gaps, and to plan and perform their own study projects. Another important aim of the course is to foster international networking among participants.”

“The course will be taught by internationally recognized experts in complementary medicine research, who have extensive experience in both teaching research methodology and conducting research studies, including:  Klaus Linde, MD, Professor of Medicine, Research Methodologist, Technical University Munich;  Eric Manheimer, MS Research Associate, University of Maryland School of Medicine, Administrator and Research Methodologist, Cochrane CAM Field;  Susan Wieland, MPH, PhD, Research Associate, University of Maryland School of Medicine, Research Methodologist, Cochrane CAM Field; and  Claudia Witt, MD, MBA, Professor of Medicine, Research Methodologist, Charite, University Medical Center Berlin; Visiting Professor University of Maryland School of Medicine; President International Society for Complementary Medicine Research.” http://tiih.org/training‐retreats http://tiih.org/research‐methods

3rd International Research Congress on Integrative Medicine and Health, and the 7th International Congress on Complementary Medicine Research (ICCMR)

“On May 15‐18, 2012 the Consortium of Academic Health Centers for Integrative Medicine will host the third International Research Congress on Integrative Medicine and Health at the Portland Marriott Downtown Waterfront with ISCMR as a partner organization (7th International Congress on Complementary Medicine Research)

Submission period for abstracts and sessions is September 1‐ November 15. For more information, please visit http://imconsortium‐congress2012.org/

8th International Congress on Complementary Medicine Research (ICCMR)

May 30 ‐ June 1, 2013 in London, UK. Further information to follow.

ENZCAM Newsletter TM/CAM Update August 2011 Page 7 6. Academic Integration of TM/CAM

Academic Consortium for Complementary and Alternative Health Care (ACCAHC) http://accahc.org/

ACCAHC is a USA‐based organization, “the mission of which is to enhance patient care through fostering mutual respect and understanding among diverse healthcare professionals and disciplines.” ACCAHC is funded 2/3 through philanthropic contributions and publications, with the remaining third from dues of core members.

“Our core Organizational Membership consists of councils of colleges and schools, accrediting agencies, and certification and testing organizations associated with the five distinctly licensed complementary healthcare professions which have a federally recognized accrediting agency”:  Acupuncture and Oriental medicine  Chiropractic  Direct entry (homebirth) midwifery  Massage therapy, and  Naturopathic medicine. “Our membership also includes organizations representing Traditional World Medicines and emerging professions that are engaging the self‐regulatory challenges which help protect the health of the public. In additions, individual accredited schools are also eligible for membership.” The web‐ site has links to the organizational members at: http://accahc.org/org‐mem

“Following a lengthy collaborative process involving academic leaders from 8 disciplines, the ACCAHC has endorsed what it calls the Competencies for Optimal Practice in Integrated Environments. ACCAHC is presently focused on aggregating and creating content to develop a rich web‐portal, the Center for Optimal Integration, to assist educators, practitioners and organizations of all types to move toward such competencies.” See http://www.optimalintegration.org/

7. Clinical Integration of TM/CAM

NCCAM Clinical Digest

Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA. To subscribe to NCCAM Clinical Digest, visit http://nccam.nih.gov/news/subscribe.php?digest=1

August 2011: High Cholesterol and CAM http://nccam.nih.gov/health/providers/digest/cholesterol.htm

“Approximately one in six U.S. adults has high total cholesterol. Lowering cholesterol levels can slow down, reduce, or even stop plaque from building up in the walls of arteries and may decrease the chance of having a heart attack. According to the 2007 National Health Interview Survey, cholesterol is one of the top 10 conditions prompting complementary and alternative medicine (CAM) use among adults. This issue provides information on "what the science says" about the effectiveness of several dietary supplements used by people with high cholesterol, including flaxseed and flaxseed oil, garlic, green tea, noni, red clover, red yeast rice, and soy.”

ENZCAM Newsletter TM/CAM Update August 2011 Page 8 8. Consumer Integration of TM/CAM

Australian adults use complementary and alternative medicine in the treatment of chronic illness: a national study By Andrew R. Armstrong

Australian and New Zealand Journal of Public Health Volume 35, Issue 4, pages 384–390, August 2011 http://onlinelibrary.wiley.com/doi/10.1111/j.1753‐6405.2011.00745.x/full

“Objectives: The objectives of this study were to identify the prevalence of the use of vitamin/mineral supplements or natural/herbal remedies, concurrent use of pharmaceutical medication, and to profile those most likely to use these complementary and alternative medicines (CAM) in the treatment of five chronic conditions identified as national health priorities (asthma, diabetes, arthritis, osteoporosis, heart or circulatory condition) within the Australian adult population. Methods: Analysis of the Australian National Health Survey database, 2004‐05. Results: Approximately 24% (1.3 million) of Australian adults with a chronic condition regularly applied CAM to treatment. CAM was most often used exclusively or in combination with pharmaceutical medicine in the treatment of arthritis and osteoporosis. Fewer than 10% of adults with asthma, diabetes or a heart or circulatory condition used CAM, most preferring pharmaceutical medicine. … Conclusion and implications: Arthritis, osteoporosis and, to a lesser extent, heart or circulatory conditions are illnesses for which doctors should advise, and patients need to be most aware about the full effects of CAM and possible interactive effects with prescribed medicine. They are also conditions for which research into the interactive effects of CAM and pharmaceutical medication would seem of most immediate benefit.”

9. Health Systems Integration of TM/CAM

Complementary and Alternative Medicine Practitioners and Accountable Care Organizations: The Train Is Leaving the Station http://www.liebertonline.com/doi/abs/10.1089/acm.2011.0364 Matthew A. Davis, James M. Whedon and William B. Weeks. The Journal of Alternative and Complementary Medicine. August 2011, 17(8): 669‐674. doi:10.1089/acm.2011.0364. “Legislation that supports the establishment of Accountable Care Organizations (ACOs) was recently enacted into law as part of the Patient Protection and Affordable Care Act, and in 2012 the Centers for Medicare and Medicaid Services will begin contracting with ACOs. Although ACOs will play a significant role in reform of the U.S. health care delivery system, thus far, discussions have focused exclusively on the coordination of conventional health services. This article discusses the potential engagement of the complementary and alternative (CAM) workforce in ACOs and the foreseeable impacts of ACO legislation on the future of U.S. CAM services.” “Estimating the national supply and demand of CAM practitioner services is a challenge due to the extreme diversity among CAM providers and newly emerging modalities that make it difficult to consistently define what constitutes CAM.”

ENZCAM Newsletter TM/CAM Update August 2011 Page 9

“In the United States, the most common CAM practitioners are licensed acupuncturists/practitioners of Oriental medicine, chiropractors, massage therapists, and naturopathic physicians. According to the authors’ conservative estimates from 2006 and 2007 data sources, there are at least 180,600 CAM practitioners in the United States (approximately 8 CAM practitioners per 10,000 adult capita).” “Given that there are approximately 940,000 physicians (300,000 primary care physicians and 600,000 specialists), it suggests that the CAM workforce is relatively large in comparison. With the exception of naturopathy, most states now license CAM practitioners and payment sources are provided by a mix of self‐pay, private, and public payers (although most expenditures are out‐of‐ pocket).” “There continues to be strong support for CAM practitioner services when compared to other health services. Our estimates generated from the 2007 Medical Expenditure Panel Survey (MEPS) and the National Health Interview Survey are that 20 million adults are regular users: 202 million visits are made annually to CAM practitioners at a cost of over $14 billion.” “The U.S. health care system is now positioned for substantial change; at the center of reform is a health care delivery system that promotes practitioner accountability for population health outcomes, care coordination, and the control of health care spending. Considering the strong demand for CAM and the relatively large CAM workforce, CAM practitioners could become active participants in ACOs, especially if professional organizations combine efforts. Although there is considerable uncertainty pertaining to the design of ACOs, who will be involved, and which services will be included, should CAM practitioners and professions fail to get involved in the discussion now, they may not have the opportunity later.”

The Integrator Blog Produced by John Weeks http://theintegratorblog.com

The Integrator Blog is an excellent and reliable source of material on the integration of CAM in the USA, with occasional articles on facilities in other countries. The monthly newsletter provides “news, reports, opinion and networking for the business, education, policy and practice of integrative medicine, CAM and integrated health care”.

Integrator Resource: Inclusion of Integrative Health and Complementary and Alternative Medicine in the June 2011 National Prevention Strategy http://theintegratorblog.com/index.php?option=com_content&task=view&id=763&Itemid=189

“The National Prevention, Health Promotion and Integrative Health Council established under the Obama‐Pelosi Affordable Care Act mandated development of a whole system approach to prevention and health promotion. The law highlighted the new concept of "integrative health." Lawmakers mandated the inclusion of integrative practitioners in the Council's Advisory Group. In June 2011, the Council published the National Prevention Strategy: America's Plan for Better Health and Wellness.” This resource deals with the lack of mention of CAM and integrative medicine in the latter document.

Produced for ENZCAM by Heather McLeod and Ray Kirk

8 September 2011

ENZCAM Newsletter TM/CAM Update August 2011 Page 10

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update September 2011

1. Policy and Legislation

New Zealand Natural Health Products Bill “Joint Green Party‐Government legislation to ensure natural health products are safe and true to label is having its first reading in Parliament [on 15 September 2011]. Green Party MP Sue Kedgley said the Greens‐National Natural Health Products Bill would create a stand‐alone regulator to protect the growing number of New Zealanders using natural health products to improve their health.”

“The initiative to create a natural health regulator within the Ministry of Health was developed under the Green and National parties' Memorandum of Understanding. The memorandum between the parties also included successful projects in home insulation, protecting native bush from pests, creating a national cycleway and toxic site management.”

“Key points:  The natural health regulation will cover a wide range of products such as vitamins and Chinese medicines.  There will be a two year transition for product approvals and three years for meeting manufacturing standards.  Any products used in other countries with recognised regulatory schemes will be automatically recognised under this scheme.  Virtually all ingredients and products that are already on the market will be automatically approved by the regulator.  The government will fund the costs of the regulatory policy, advice, as well as compliance, enforcement and monitoring.  Set up costs will be paid for by government. Otherwise, the agency will operate on a cost recovery basis.  Before bringing a product to market, a business will have to enter product information onto an online, electronic data base.  Instead of lumping natural health products in with food and medicine, the Bill sets up a risk based system for the regulation of natural health products, as a separate and low risk, category of product.  The practice of Rongoa Maori will be exempt from the Bill, as will products made for a consumer and low‐risk products like homeopathy, and export only products.

ENZCAM Newsletter TM/CAM Update September 2011 Page 2

 The Bill will be referred to a select committee and submissions will be called for, so that it can be progressed early in the next term of Parliament. The Government expects to have a report on or before 30 April 2012.  There are more than 6000 natural health products on sale in New Zealand and over 450 natural health companies. Those companies have an estimated annual turnover of $760 million.”

[Source: Green Part media release 15 September 2011]

Natural Health Products Bill in Parliament http://www.parliament.nz/en‐NZ/PB/Legislation/Bills/b/c/8/00DBHOH_BILL11034_1‐Natural‐ Health‐Products‐Bill.htm

Natural Health Products Bill (full text) http://www.legislation.govt.nz/bill/government/2011/0324/latest/versions.aspx

2. Research Organisations

Centre for Complementary Medicine Research (CompleMED) College of Health and Science, University of Western Sydney (UWS), Australia http://www.uws.edu.au/complemed

“CompleMED's principal aim is to promote an evidence based approach to the use of complementary medicine in healthcare. … “CompleMED’s research program focuses on the safety, efficacy and use of complementary medicine, and employs a diverse range of disciplines to investigate these issues. We have established state of the art clinical, analytical and pharmacology laboratory facilities to research how herbal medicines work on cellular, molecular and physiological levels, and to analyse and quantify the complex components contained in the medicines and their effect on our health.”

“Our clinical research investigating the effect of herbal medicines on a range of important health conditions has been published in leading medical journals, and CompleMED established Australia’s first hospital based traditional Chinese medicine research facility with Liverpool Hospital in Sydney. CompleMED has also played a key role in the development of national policies for practitioner regulation, and in the establishment of Australia’s National Institute of Complementary Medicine.”

“The Centre collaborates with a range of government and industry partners both nationally and internationally, undertaking independent research to support the development of the complementary medicine sector, and to provide opportunities for innovation in research, policy and commercialisation.”

“To address the broad range of issues related to the development and integration of complementary medicine, CompleMED’s research program is structured into three strands of research activity:  clinical research to validate the efficacy and safety of complementary medicine and therapies  laboratory research on the identification, bioavailability and mechanisms of action of herbal medicines  health policy research on issues such as safety, industry regulation and practice standards in complementary medicine.”

ENZCAM Newsletter TM/CAM Update September 2011 Page 3 3. Practitioner Organisations and Licencing

Establishing a new American Board of Integrative Medicine Source: The Integrator Blog Special Report: "Strategic Change in Direction" as Weil's Arizona Center Commits to Creation of American Board of Integrative Medicine http://theintegratorblog.com/index.php?option=com_content&task=view&id=780&Itemid=189

“Should "integrative medicine" be a movement to transform all of medicine? Or should it be an effort to create a new medical specialty?”

“In a major strategic shift, the University of Arizona Center for Integrative Medicine (ACIM) has announced that it will lead the creation of a formal specialty for medical doctors in integrative medicine. ACIM, founded by Andrew Weil, MD and directed by Victoria Maizes, MD, is in dialogue with the American Board of Physician Specialties toward establishing an American Board of Integrative Medicine. They are collaborating with leaders of the American Board of Integrative and Holistic Medicine (ABIHM).”

“Should "integrative medicine" be a separate MD specialty within the field of medicine? Or should integrative medicine proponents target a broader shift toward integrative medicine as a model for all conventional care, whether primary care of oncology or pediatrics? … This month the single most important academic medical center came down on the side of not only supporting, but leading a drive to establish integrative medicine as a formal medical specialty. … This step is huge for the field, and for the broader integrative healthcare movement.”

University of Arizona Center for Integrative Medicine (ACIM): http://integrativemedicine.arizona.edu/about/

American Board of Integrative and Holistic Medicine (ABIHM) http://www.abihm.org/

American Board of Physician Specialties http://abpsus.org/index.html

4. Books

Naturopathy Around the World By Hans A. Baer and Stephen Sporn Publication Date: 2009 http://www.amazon.com/Naturopathy‐Around‐World‐Stephen‐Sporn/dp/1606925903

Dr Hans Baer: http://www.sph.unimelb.edu.au/about/allstaff/baer

“Whereas various professionalised heterodox medical systems found in Western societies, such as homeopathy, chiropractic, osteopathy, Chinese traditional medicine, and even acupuncture have been the object of considerable historical and social scientific research, naturopathy has been, at best, spotty. This book constitutes the first effort to provide a broad social historical and ethonographic account, particularly in the United States, Canada, and Australia, but to a lesser extent in Germany, Britain, New Zealand and India.”

ENZCAM Newsletter TM/CAM Update September 2011 Page 4

“Naturopathy emerged in the early twentieth century under the leadership of Benedict Lust, a German immigrant to the United States who had studied under Father Kneipp (a strong proponent of water cure), as a highly eclectic therapeutic system that drew not only from hydropathy, but also herbalism, colonic irrigation, dietetics, fasting, exercise, iridology, and manipulative therapy. While some naturopaths advocate these modalities, others today draw upon homeopathy, vitamin and nutritional supplements, acupuncture, Ayurveda, and other therapies.”

“Naturopaths or naturopathic physicians are the ultimate therapeutic eclectics within the broader confines of complementary and alternative medicine. Yet naturopathy is not a monolithic entity but has been shaped by historical developments in the larger plural medical systems and national socio‐ political contexts in which it is embedded. Like other medical systems, naturopathy is a cultural construction with fluid borders within specific countries across the globe.”

5. Journals

BMC Complementary and Alternative Medicine http://www.biomedcentral.com/bmccomplementalternmed/

“BMC Complementary and Alternative Medicine is an open access journal publishing original peer‐ reviewed research articles in interventions and resources that complement or replace conventional therapies, with a specific emphasis on research that explores the biological mechanisms of action, as well as their efficacy, safety, costs, patterns of use and/or implementation. BMC Complementary and Alternative Medicine is the official journal of The International Society for Complementary Medicine Research (ISCMR). [The journal] is indexed/tracked/covered by PubMed, MEDLINE, CAS, EMBASE, Scopus, Cinahl, FSTA, CABI, Thomson Reuters (ISI) and Google Scholar.”

Selected articles:  Study protocol: Effect of plant sterols on the lipid profile of patients with hypercholesterolaemia. Randomised, experimental study  Antiproliferative Effect of Methanolic Extraction of Tualang Honey on Human Keloid Fibroblasts  Moxibustion for cephalic version: a feasibility randomised controlled trial  BACE1 inhibitory activity of fungal endophytic extracts from Malaysian medicinal plants  Preliminary Examination of the Efficacy and Safety of a Standardized Chamomile Extract for Chronic Primary Insomnia: A Randomized Placebo‐Controlled Pilot Study  Responding to GPs' information resource needs: implementation and evaluation of a complementary medicines information resource in Queensland general practice  In Vitro Antioxidant and Anticancer Activity of Young Zingiber officinale Against Human Breast Carcinoma Cell Lines

ENZCAM Newsletter TM/CAM Update September 2011 Page 5 Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] http://www.hindawi.com/journals/ecam/2012/

Selected new articles:  Efficacy and Safety of Human Placental Extract Solution on Fatigue: A Double‐Blind, Randomized, Placebo‐Controlled Study  Ethnobiology and Ethnopharmacology of Lepidium meyenii (Maca), a Plant from the Peruvian Highlands  Levels of Tannins and Flavonoids in Medicinal Plants: Evaluating Bioprospecting Strategies  Comparison of Effects of the Ethanolic Extracts of Brazilian Propolis on Human Leukemic Cells As Assessed with the MTT Assay  Protective Effects of Emodin and Chrysophanol Isolated from Marine Fungus Aspergillus sp. on Ethanol‐Induced Toxicity in HepG2/CYP2E1 Cells  Tetraarsenic Hexoxide Induces Beclin‐1‐Induced Autophagic Cell Death as well as Caspase‐ Dependent Apoptosis in U937 Human Leukemic Cells  Chemical Composition, Antioxidant, and Antimicrobial Activities of Lichen Umbilicaria cylindrica (L.) Delise (Umbilicariaceae)  Protective Effect of Proanthocyanidin against Diabetic Oxidative Stress  A Therapeutic Approach for Wound Healing by Using Essential Oils of Cupressus and Juniperus Species Growing in Turkey  Immunomodulatory Effect of Rhaphidophora korthalsii on Natural Killer Cell Cytotoxicity  Gelam (Melaleuca spp.) Honey‐Based Hydrogel as Burn Wound Dressing

Explore: The Journal of Science and Healing [First listed in ENZCAM Newsletter May 2011] Volume 7, Number 5: September 2011 http://www.explorejournal.com/current

Selected articles:  Military to Implement Integrative Medicine for Comprehensive Pain Management  Trends That Will Affect Your Future … The Coming Food Crisis—The Social Tsunami Headed Our Way  Electro‐cortical Activity Prior to Unpredictable Stimuli in Meditators and Non‐meditators  The Struggle for Wholeness: Addressing Individual and Collective Trauma in Violence‐Ridden Societies  Patient‐Reported Outcomes in Studies of Complementary and Alternative Medicine: Problems, Solutions, and Future Directions  Mind‐Body Therapy: Attitudes, Beliefs and Practices of Graduate Faculty and Students from Accredited Marriage and Family Therapy Programs in the U.S. and Canada

Integrative Cancer Therapies [First listed in ENZCAM Newsletter March 2011] Volume 10, Number 2: June 2011 http://ict.sagepub.com/content/current

ENZCAM Newsletter TM/CAM Update September 2011 Page 6

Selected articles:  Rehabilitation in Neuro‐Oncology: A Meta‐Analysis of Published Data and a Mono‐ Institutional Experience  Classification of CAM Use and Its Correlates in Patients With Early‐Stage Breast Cancer  The Culinary‐Medicinal Mushroom Coprinus comatus as a Natural Antiandrogenic Modulator  Proteomic and Functional Analyses Reveal the Potential Involvement of Endoplasmic Reticulum Stress and α‐CP1 in the Anticancer Activities of Oridonin in HepG2 Cells  Chemopreventive Effect of Curcuma longa Linn on Liver Pathology in HBx Transgenic Mice  Suppression of Proliferation and Invasive Behavior of Human Metastatic Breast Cancer Cells by Dietary Supplement BreastDefend  Isatis indigotica Induces Hepatocellular Cancer Cell Death via Caspase‐Independent Apoptosis‐Inducing Factor Translocation Apoptotic Pathway In Vitro and In Vivo

Journal of Holistic Nursing [First listed in ENZCAM Newsletter April 2011] Volume 29, Number 3: September 2011 http://jhn.sagepub.com/content/vol29/issue3/?etoc http://jhn.sagepub.com/cgi/content/abstract/29/3/189

Selected articles:  A Randomized Study of a Novel Zen Dialogue Method for Producing Spiritual and Well‐Being Enhancement: Implications for End‐of‐Life Care  To Intend to but Not Being Able to: Frequent Attenders’ Experiences of Suffering and of Their Encounter With the Health Care System  Effects of Healing Touch in Clinical Practice: A Systematic Review of Randomized Clinical Trials  Soul Mate: Exploring the Concept of Soul

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter First Quarter 2011] Volume 17, Number 9: September 2011 http://www.liebertonline.com/toc/acm/17/9

Selected articles:  Electrodermal Mapping of an Acupuncture Point and a Non‐Acupuncture Point  The Assessment of Complementary and Alternative Medicine Use Among Individuals with HIV: A Systematic Review and Recommendations for Future Research  The Role of Spinal Manipulation, Soft‐Tissue Therapy, and Exercise in Chronic Obstructive Pulmonary Disease: A Review of the Literature and Proposal of an Anatomical Explanation  Employee Use and Perceived Benefit of a Complementary and Alternative Medicine Wellness Clinic at a Major Military Hospital: Evaluation of a Pilot Program  The Quantification of Placebo Effects Within a General Model of Health Care Outcomes  Effects of Oral Glutathione Supplementation on Systemic Oxidative Stress Biomarkers in Human Volunteers  Survey of the Antimicrobial Activity of Commercially Available Australian Tea Tree (Melaleuca alternifolia) Essential Oil Products In Vitro  Lymphedema After Breast or Gynecological Cancer: Use and Effectiveness of Mainstream and Complementary Therapies

ENZCAM Newsletter TM/CAM Update September 2011 Page 7 6. Education and Training

ENZCAM, University of Canterbury, Christchurch, New Zealand Research related to Complementary and Alternative/Integrative Medicine (CAM/IM)

The course to be run in the first half of 2012 has been finalised and is described below. This course examines issues related to research in Complementary and Alternative/Integrative Medicine, including specific issues in CAM/IM research, as well as research design, data collection and data analysis, ethical issues and dissemination of results. Participants will receive individual mentoring for a research proposal of their choice. There are three two‐day blocks of teaching and the Director, Ray Kirk, has said it might also be possible for those from other countries to participate virtually. He should be contacted for more details if this is of interest. HLTH442: Special Topic: Research related to Complementary and Alternative/Integrative Medicine (CAM/IM) Semester One 2012 (Distance) http://www.canterbury.ac.nz/courseinfo/GetCourseDetails.aspx?course=HLTH442&occurrence=12S 1%28D%29&year=2012#other 20 Feb 2012 ‐ 24 Jun 2012

Pre‐requisites: Subject to approval of the Director, Health Sciences Centre Fees: Domestic fee NZD 1,748.00 International fee NZD 7,750.00 Minimum enrolment: This course will not be offered if fewer than 4 people apply to enrol. The course will be taught in three two‐day blocks:  Thursday 23 February‐ Friday 25 February (9 a.m.‐5 p.m.)  Thursday 22 March‐ Friday 23 February (9 a.m.‐)  Thursday 26 April‐ Friday 27 April (9 a.m.‐) Professor Ian Coulter will be the lead presenter http://www.rand.org/about/people/c/coulter_ian_d.html

For further information or to enrol, contact Prof Ray Kirk or Philippa Drayton of the Health Sciences Centre: http://www.hsci.canterbury.ac.nz/contacts.shtml

Bastyr University Seattle, Washington, USA http://www.bastyr.edu

“Bastyr University, located north of Seattle, Washington, is an accredited institution, internationally recognized as a pioneer in natural medicine. Bastyr is the largest university for natural health arts and sciences in the U.S., combining a multidisciplinary curriculum with leading‐edge research and clinical training.” “Founded in 1978 as the John Bastyr College of Naturopathic Medicine, Bastyr University now offers more than 15 accredited degree and certificate programs. Bastyr was the nation's first natural health arts and sciences university to receive funding from the National Institutes of Health (NIH), and the

ENZCAM Newsletter TM/CAM Update September 2011 Page 8

Bastyr University Research Institute plays a key role in the growth of complementary and alternative medicine (CAM) research. The University's teaching clinic, Bastyr Center for Natural Health, offers quality natural health care to the greater Seattle community while providing essential clinical training for students.” “Bastyr offers a range of graduate and undergraduate programs including naturopathic medicine, acupuncture and Oriental medicine, midwifery, nutrition, health psychology, exercise science and herbal sciences.” http://www.bastyr.edu/academic/profiles/

Doctor of Naturopathic Medicine

“Named by The Princeton Review as one of the 168 best medical schools in the country, the School of Naturopathic Medicine at Bastyr University is committed to developing leaders in the evolving field of natural medicine. Bastyr's fully accredited naturopathic doctor (ND) program is internationally renowned for its rigorous curriculum, comprehensive clinical training and ground‐ breaking research.” “Students come to Bastyr because they seek careers that resonate with their core values, including a belief in natural healing and whole‐person medicine.”

See four‐year Doctor of Naturopathic Medicine (ND) curriculum: http://www.bastyr.edu/education/naturopath/degree‐curriculum/4‐year‐track.asp

Bastyr University is planning a second campus to be situated in San Diego, Southern California. The Doctor of Naturopathic Medicine degree program will be offered when the school opens in fall 2012, with other degree programs expected to be offered in the future. Applications for fall of 2012 for Bastyr in both Seattle and Southern California are now open. http://www.bastyr.edu/education/naturopath/degree/admissions‐timeline.asp

7. Health System Integration of TM/CAM

Complementary and Alternative Medicine Survey of American Hospitals 2010 http://www.siib.org/news/2468‐ SIIB/version/default/part/AttachmentData/data/CAM%20Survey%20FINAL.pdf

On September 7, 2011, the American Hospital Association and Samueli Institute announced the release of their 2010 survey on complementary and alternative medicine (CAM) use in hospitals. “Hospitals across the nation are responding to patient demand and integrating complementary and alternative medicine (CAM) services with the conventional services they normally provide, according to the results of a new survey released today by Health Forum, a subsidiary of the American Hospital Association (AHA) and Samueli Institute, a non‐profit research organization that investigates healing oriented practices.” “The survey shows that more than 42 percent of responding hospitals indicated they offer one or more CAM therapies, up from 37 percent in 2007.” “CAM is not based solely on traditional western allopathic medical teachings, and can include acupuncture, chiropractic, homeopathy, diet and lifestyle changes, herbal medicine, massage therapy and more. CAM services also reflect hospitals’ desire to treat the whole person—body, mind and spirit.”

ENZCAM Newsletter TM/CAM Update September 2011 Page 9

“The rise of complementary and alternative medicine reflects the continued effort on the part of hospitals and caregivers to broaden the vital services they provide to patients and communities,” said Nancy Foster, vice president for quality and patient safety at the AHA. “Hospitals have long known that what they do to treat and heal involves more than just medications and procedures. It is about using all of the art and science of medicine to restore the patient as fully as possible.” “According to the survey, 85 percent of responding hospitals indicated patient demand as the primary rationale in offering CAM services and 70 percent of survey respondents stated clinical effectiveness as their top reason.” “Today’s patients have better access to health information and are demanding more personalized care,” said study author Sita Ananth, director of knowledge services for Samueli Institute. “The survey results reinforce the fact that patients want the best that both conventional and alternative medicine can offer, and hospitals are responding.” Other survey results included:  “Massage therapy, acupuncture, and guided imagery were the top outpatient CAM services offered by reporting hospitals, while pet therapy, massage therapy, and music/art therapy ranked at the top of the list for inpatients.  Top wellness services offered to patients were pastoral care, nutrition counselling, and smoking cessation. For hospital employees, stress management, fitness training, and smoking cessation were most prevalent.  Patient demand was the leading reason for hospitals to offer CAM services.  Since most CAM services are not covered by insurance plans, the services were most often self‐paid by patients.”

The conclusion of the report asks: “So why does any of this matter, and why should hospital executives be paying attention to this phenomenon? The reasons are compelling:  With the aging population, there is a greater prevalence of chronic disease, more interest in spirituality and greater demands by patients for personalized care are all increasing CAM’s popularity.  Patients are seeking to complement their treatment for conditions that are difficult to cure with conventional medicine—cancer, diabetes, AIDS, chronic pain, etc. The bottom line is that consumers and patients want the best that both allopathic and alternative medicine can offer.  Widely available health information is driving demand for care and therapies that may not be part of the standard delivery model in hospitals.  CAM users tend to be more satisfied with their care and to recommend a friend or relative. Cancer patients report that complementary therapies promote relaxation, reduce cancer‐ related distress, help alleviate the side effects of conventional treatment, and empower them to take charge of their treatment.  Many hospitals that offer integrative health services to patients also make them available to, and an integral part of, health care benefits offered to their employees. In many large institutions, employees make up a large percentage of the users of these services.”

ENZCAM Newsletter TM/CAM Update September 2011 Page 10 8. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

September 2011: Stress and Relaxation Techniques http://nccam.nih.gov/health/providers/digest/relaxation.htm

“Stress is a physical and emotional reaction that people experience as they encounter changes in life. Stress is a normal feeling. However, long‐term stress may contribute to or worsen a range of health problems including digestive disorders, headaches, sleep disorders, and other symptoms. Stress may worsen asthma and has been linked to depression, anxiety, and other mental illnesses.”

“Some people use relaxation techniques (also called relaxation response techniques) to release tension and to counteract the ill effects of stress. Relaxation techniques often combine breathing and focused attention on pleasing thoughts and images to calm the mind and the body. Some examples of relaxation response techniques are autogenic training, biofeedback, deep breathing, guided imagery, progressive relaxation, and self‐hypnosis.”

“This issue provides information on "what the science says" about relaxation techniques for several stress‐related disorders, including anxiety, depression, headaches, asthma, heart disease and heart symptoms, high blood pressure, insomnia, and irritable bowel syndrome.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

14 October 2011

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update October 2011

1. Policy and Legislation

WHO Africa Region Progress Report on Decade of Traditional Medicine in the African Region The sixty‐first session of the WHO Regional Committee for Africa took place from 29 August to 2 September 2011 in Yamoussoukro, Côte d'Ivoire. http://www.afro.who.int/en/sixty‐first‐session.html

At the meeting, a document “Progress Report on Decade of Traditional Medicine in the African Region” was discussed. The results from that report are presented in section 6 of this newsletter under Health System Integration of TM/CAM. http://www.afro.who.int/index.php?option=com_docman&task=doc_download&gid=6665

CAM Status in Europe Project CAMbrellaa is preparing updates on the legal status and regulation of CAM in Europe (see section 2 for more information). The following summaries have appeared to date:

CAM in Hungary: http://www.cambrella.eu/home.php?il=158 CAM in Austria: http://www.cambrella.eu/home.php?il=154&l=deu CAM in Romania: http://www.cambrella.eu/home.php?il=150&l=deu CAM in Italy: http://www.cambrella.eu/home.php?il=106&l=deu CAM in Sweden: http://www.cambrella.eu/home.php?il=116&l=deu CAM in Norway: http://www.cambrella.eu/home.php?il=121&l=deu CAM in Spain: http://www.cambrella.eu/home.php?il=121&l=deu

a http://www.cambrella.eu

ENZCAM Newsletter TM/CAM Update October 2011 Page 2 2. Research Organisations

CAMbrella: Autumn News CAMbrella is a pan‐European research network for complementary and alternative medicine, funded by the European Commission Seventh Framework Programme FP7 http://www.cambrella.eu [See introduction to CAMbrella in ENZCAM Newsletter April 2011]

Legal status and regulation of CAM in Europe

“There are major differences between countries with regard to whether or not CAM is regulated by a separate act. These differences influence the practice of CAM in Europe, so CAMbrella is to find out how CAM is regulated and governmentally supervised in the individual countries. The status of reimbursement for CAM (including non‐pharmacological medicinal products) in Europe will also be reviewed. The number of countries to be investigated was expanded to 39 after a thorough re‐ appraisal of the inclusion criteria. Collection of relevant information from each country is currently still on‐going, including personal visits to selected countries. The findings will eventually be described in three reports:  Report 1 addresses the “Legal, regulatory, supervisory and reimbursement status of CAM in Europe”, building on a report published by NAFKAMb in 2005. The current and previous regulatory system will be described based on current and previous EU rules and regulations in the area, supplemented by information from personal interviews with bureaucrats responsible for this area in the EU system.  The regulatory status of CAM medicinal products will be addressed in Report 2.  The description of EU‐wide regulation and potential obstacles to such regulation (Report 3) will be built partly on the NAFKAM reportc and partly on other published work in the area.

A final two‐day workshop will be held in the beginning of 2012 to complete WP2. The Work Package leader is Vinjar Fønnebø, University of Tromsø, Norway.”

Progress on roadmap for future CAM research

“From September 7 to 9 the members of Work Package 7 gathered for a workshop in Castellaro Lagusello, close to the lake of Garda, Italy. … The purpose of this very intense and fruitful meeting was the discussion and preparation of WP 7´s central task: the roadmap for future CAM research in Europe. Each CAMbrella Work Package reported on its current status in order to consider their findings for a future research strategy. Another input to the discussion was the findings of a systematic literature review on methods for the investigation of CAM presented by Felix Fischer from the Berlin group. A detailed report on the meeting will be part of the next CAMbrella newsletter in December 2011.” The Work Package leader is Benno Brinkhaus from Berlin.

b NAFKAM is the National Research Center in Complementary and Alternative Medicine, University of Tromsø, Norway. See http://www2.uit.no/ikbViewer/page/ansatte/organisasjon/hjem?p_ dimension_id=88112&p_menu=42374&p_lang=1 c “How are European patients safeguarded when using complementary and alternative medicine (CAM) Jurisdiction, supervision and reimbursement status in the EEA area (EU and EFTA) and Switzerland”, NAFKAM 2005

ENZCAM Newsletter TM/CAM Update October 2011 Page 3

Canadian Interdisciplinary Network for CAM Research (IN‐CAM) http://www.incamresearch.ca

“The Canadian Interdisciplinary Network for CAM Research (IN‐CAM) is an interdisciplinary, collaborative research network, created to foster excellence in complementary and alternative medicine (CAM) research in Canada.” IN‐CAM was founded in 2004.

“IN‐CAM's activities include:  Maintaining an interactive website, with a rich database of information related to CAM research and individuals interested in CAM research.  Hosting an bi‐annual IN‐CAM Research Symposium, which brings together researchers, policy makers, practitioners and educators in the CAM field. The symposium provides an opportunity to share research findings and discuss emerging issues and topics in the CAM field in the Canadian context.  Linking with networks, organizations and educational institutions to develop partnerships that further IN‐CAM’s objectives and streamline research initiatives within the CAM field.”

IN‐CAM has two priority research areas: “Effectiveness, Efficacy and Safety Research including n of 1 trials, observational studies, qualitative research, adverse effects monitoring, and randomized controlled trials to study the safety, efficacy and effectiveness of CAM systems, products and therapies. A special emphasis will be placed on the exploration of relevant and rigorous, new and existing methodological approaches in addressing issues of safety and effectiveness. A particularly relevant example is the evaluation of CAM whole systems in which multiple approaches are combined to ensure that all relevant aspects of such systems are assessed. This research area also involves identifying and incorporating appropriate outcome measures.

CAM Health Care Delivery and Policy Research including contributions to optimal CAM health care delivery and policy by investigating areas such as models of CAM (or integrative) practice; access to CAM; cost‐effectiveness of CAM and the relationship of CAM and public health. The position of CAM within the Canadian health care system and CAM policy decisions (e.g., regulation of Natural Health Products and CAM providers, insurance/government policies on reimbursement, intellectual property rights) are also included, as are studies of the evolution and professionalization of CAM practitioner groups.”

3. Books

Nutritional Medicine By Alan R. Gaby, M.D. Publication Date: 2011 http://www.doctorgaby.com/ http://www.amazon.com/Nutritional‐Medicine‐Alan‐Gaby/dp/B005ERQLS4

“Nutritional Medicine is a comprehensive textbook on the use of dietary modifications, nutritional supplements, and other natural substances for the prevention and treatment of more than 400 health conditions. Written by one of the world’s foremost authorities on nutritional therapy, this book has been widely acclaimed as the leading textbook in its field. Meticulously documented and clearly written, Nutritional Medicine combines an exhaustive review of the medical literature with Dr. Gaby's extensive clinical experience.”

ENZCAM Newsletter TM/CAM Update October 2011 Page 4

“Nutritional Medicine is a textbook designed to teach healthcare practitioners how to use nutritional therapy as an alternative or adjunct to conventional medicine. Although the book is written for practitioners, it is also useful for educated members of the lay public who would like to be well informed regarding nutritional options for preventing and treating various health concerns.”

“Nutritional Medicine discusses more than 400 different health conditions and disorders. It also contains 60 chapters on individual nutrients (i.e., vitamins, minerals, amino acids, and other therapeutic agents) including biochemical effects, clinical indications, signs and symptoms of deficiency, adverse effects, drug interactions, nutrient interactions, and dosage and administration. Chapters on fundamentals of nutritional medicine (including dietary fundamentals, food additives, reactive hypoglycemia, food allergy, "sub‐laboratory" hypothyroidism, and candidiasis) are also included.”

“With … over 15,000 references to the scientific literature, Nutritional Medicine is a foundational cornerstone and should be on the desk of every healthcare practitioner.”

4. Journals

African Journal of Traditional, Complementary and Alternative Medicines (AJTCAM) http://journals.sfu.ca/africanem/index.php/ajtcam

“The African Journal of Traditional, Complementary and Alternative Medicines (AJTCAM), a broad‐ based journal, is founded on two key tenets: To publish exciting research in all areas of applied medicinal plants, Traditional medicines, Complementary Alternative Medicines, food and agricultural technologies, and promotion of healthy use of medicinal products. Secondly, to provide the most rapid turn‐around time possible for reviewing and publishing, and to disseminate the articles freely for teaching and reference purposes. All articles published in AJTCAM are peer‐reviewed.”

“The African Journal of Traditional, Complementary and Alternative Medicines is published quarterly, and online. AJTCAM is published by http://www.africanethnomedicines.net , an independent network committed to ensuring peer‐reviewed ethnomedicinal works and is permanently available online without charge or any other barriers to access.”

“AJTCAM is indexed and abstracted in: PUBMED/MEDLINE, Science Citation Index‐Expanded, Current Contents/Clinical Medicine, and Journal Citation Reports‐Science, Free Medical Journals, AJOL, African Index Medicus, Chemical abstracts, Bionline journals International, Directory of Open Access Journals, African Index Medicus, EBSCO, Scopus and HINARI.”

ENZCAM Newsletter TM/CAM Update October 2011 Page 5

Volume 9, Number 1: 2012 http://journals.sfu.ca/africanem/index.php/ajtcam/issue/view/68

Selected articles:  Advances in the analytical methods for determining the antioxidant properties of honey: a review  Recommendations for the development of regulatory guidelines for registration of traditional medicines in South Africa  Ethnomedical study and iron content of some medicinal herbs used in traditional medicine in Cote d’Ivoire for the treatment of anaemia  Traditional use of plants against snakebite in Indian subcontinent: a review of the recent literature  The novel antihyperglycaemic action of Hunteria Umbellata seed fractions mediated via intestinal glucose uptake inhibition  Analgesic and antipyretic activities of Drymaria Cordata (linn.) Willd (Caryophyllaceae) extract  In–vitro propagation and antimycotic potential of extracts and essential oil of roots of Aristolochia Bracteolata Linn. (Aristolochiaceae)  Flavonoids from Sudanese Albizia Zygia (Leguminosae, subfamily Mimo‐Soideae), a plant with antimalarial potency  Effects of Sutherlandia Frutescens extracts on normal t‐lymphocytes in vitro  Bioactive diterpenes and sesquiterpenes from the rhizomes of wild ginger (Siphonochilus Aethiopicus (Schweinf) b.l Burtt)  Traditional and alternative therapy for mental illness in Jamaica: patients’ conceptions and practitioners’ attitudes  The effect of pumpkin (Cucurbita Pepo l) seeds and l‐arginine supplementation on serum lipid concentrations in atherogenic rats

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter Q1 2011] Volume 17, Number 5: October 2011 http://www.liebertonline.com/toc/act/17/5 Selected articles:  Smart Talk on Supplements and Botanicals: Developing and Maintaining Healthy Bones  Roundoc Rx: Immunomodulators: Fighting Recurrent Upper Respiratory Infections Naturally  Roundtable Discussion: An Integrative Approach to Diabetes  Current Controversies in Nutrition: The Blind Leading the Blind: Common Problems with the Nature of Clinical Trials  Physician Burnout: The Need for Mindful Solutions  Atherosclerosis: An Integrative Approach: A Natural Standard Monograph  Clinical Roundup: How Do You Treat Indigestion in Your Practice?

ENZCAM Newsletter TM/CAM Update October 2011 Page 6 BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] Volume 11, October 2011 http://www.biomedcentral.com/bmccomplementalternmed/

Selected articles:  Rural Australian community pharmacists' views on complementary and alternative medicine: a pilot study  Developments on drug discovery and on new therapeutics: highly diluted tinctures act as biological response modifiers  Understanding, perceptions and self‐use of complementary and alternative medicine (CAM) among Malaysian pharmacy students  Hypnosis for hot flashes among postmenopausal women study: A study protocol of an on‐ going randomized clinical trial  The evidence for Shiatsu: a systematic review of Shiatsu and acupressure  Complementary and alternative medicine for patients with chronic fatigue syndrome: A systematic review  A comparison of complementary and alternative medicine users and use across geographical areas: A national survey of 1,427 women

Complementary Therapies in Medicine [First listed in ENZCAM Newsletter May 2011] Volume 19, Number 5: October 2011 http://www.sciencedirect.com/science/issue/272589‐1‐s2.0‐S0965229911X00067

Selected articles:  Acupuncture in children and adolescents with bronchial asthma: A randomised controlled study  The impact of eurythmy therapy on stress coping strategies and health‐related quality of life in healthy, moderately stressed adults  A comparison of the effectiveness between Western medicine and Chinese medicine outpatient consultations in primary care  Is yoga effective for pain? A systematic review of randomized clinical trials

European Journal of Integrative Medicine [First listed in ENZCAM Newsletter May 2011] Volume 3, Number 3: September 2011 http://www.sciencedirect.com/science/issue/277409‐1‐s2.0‐S1876382011X00045

Selected articles:  Integrative oncology in the Middle East: Researching traditional remedies to address supportive cancer care  The effect of progressive muscle relaxation and guided imagery in improving psychological well‐being and quality‐of‐life for breast and prostate cancer patients: Initial report  Integrative approach for cancer pain management  Using mind‐body medicine skills to improve wellness in cancer caregivers: An initiative of the Middle East cancer consortium

ENZCAM Newsletter TM/CAM Update October 2011 Page 7

 Herbal medicines in cancer care in the Palestinian Authority  The state of traditional Arabic Palestinian herbal medicine (TAPHM) in the Palestinian authority (West Bank and Gaza Strip)  European and Oriental mistletoe: From mythology to contemporary integrative cancer care  Integrative and complementary medicine among cancer patients: At what price?  Flavonoid‐enriched extracts from Nelumbo nucifera leaves inhibits proliferation of breast cancer in vitro and in vivo  Self‐aromatherapy massage of the abdomen for the reduction of menstrual pain and anxiety during menstruation in nurses: A placebo‐controlled clinical trial  Efficacy of Sphaeranthus indicus and cream of Lawsonia inermis in cervical erosion with cervicitis  A multimodal exercise program and multimedia support reduce cancer‐related fatigue in breast cancer survivors: A randomised controlled clinical trial  Clinical efficacy of Stragol™ herbal heart drop in ischemic heart failure of stable chest angina  Attitudes towards integrative medicine among healthcare professionals in the Netherlands  Chinese herbal medicines versus disease modifying antirheumatic drugs for management of rheumatoid arthritis: A systematic review  Integrative nutritional approaches to loss of weight and appetite in patients with advanced cancer

Journal of Evidence‐Based Complementary & Alternative Medicine [First listed in ENZCAM Newsletter April 2011] Volume 16, Number 3: October 2011 http://chp.sagepub.com/content/16/3.toc

Selected articles:  Molybdenum Nutriture in Humans  Growing Evidence for Human Health Benefits of Boron  Beneficial Effects of Magnesium Supplementation  Iodine: Health Implications of Deficiency  Low Vitamin D Impairs Strength Recovery After Anterior Cruciate Ligament Surgery  Risk and Efficacy in Biomedical Media Representations of Herbal Medicine and Complementary and Alternative Medicine (CAM)  Characteristics of Dispositional Mindfulness in Patients With Severe Cardiac Disease  The Bill Henderson Protocol: Consumer Perspectives and Practices on an Alternative Dietary Intervention for Cancer Treatment and Cure  Book Review: A Clinical Guide to Autistic Spectrum Disorders

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 17, Number 10: October 2011 http://www.liebertonline.com/toc/acm/17/10

Selected articles:  Bipolar Disorder and Complementary Medicine: Current Evidence, Safety Issues, and Clinical Considerations  Structural Integration, an Alternative Method of Manual Therapy and Sensorimotor Education

ENZCAM Newsletter TM/CAM Update October 2011 Page 8

 The Effect of Therapeutic Horseback Riding on 5 Children with Attention Deficit Hyperactivity Disorder: A Pilot Study  Effect of Traumeel S on Cytokine Profile in a Cecal Ligation and Puncture (CLP) Sepsis Model in Rats  The Effect of Acupuncture on Psychosocial Outcomes for Women Experiencing Infertility: A Pilot Randomized Controlled Trial  Sustained Impact of MBSR on Stress, Well‐Being, and Daily Spiritual Experiences for 1 Year in Academic Health Care Employees  What Factors Are Influencing Preferences Toward Conventional Versus Complementary and Alternative Medical Clinic Advertisements?  The Interface Between Tradition and Science: Naturopaths' Perspectives of Modern Practice  Case Reports of Sarcoma Patients with Optimized Lectin‐Oriented Mistletoe Extract Therapy

5. Education, Training and Conferences

The International Society for Complementary Medicine Research (ISCMR) Research Methodology Training ISCMR is co‐organizing research methodology training and the next course will be: 29 March – 4 April, 2012 in Baltimore (USA) http://www.iscmr.org/events/ “This modular training course will provide participants with the skills necessary to critically appraise clinical research studies and to plan and perform their own study projects. Another important aim of the course will be to foster international networking among participants. The course taught by internationally recognized ISCMR members will comprise the following 3 modules: 1) Basic study design and basic statistics (Claudia Witt and Klaus Line); 2) Designing pragmatic trials for comparative effectiveness research (Claudia Witt); and 3) Cochrane‐style systematic reviews and meta‐analyses (Eric Manheimer and Susan Wieland). Participants may register for 1, 2, or all 3 modules. The course will consist of small‐group teaching with hands‐on practical work at computer stations, as well as group work. http://www.iscmr.org/events/

Canadian IN‐CAM Research Symposium 2012 www.incamresearch.ca/index.php?id=19,0,0,1,0,0&menu=7 “The next IN‐CAM Research Symposium is scheduled to take place November 2‐4 2012 in Toronto ON Canada at the Leslie Dan Faculty of Pharmacy, University of Toronto. The theme of the 2012 Symposium is: ‘Evaluation of CAM practices: Issues of effectiveness, safety, integration and cost’”

ENZCAM Newsletter TM/CAM Update October 2011 Page 9 6. Health System Integration of TM/CAM

African Traditional Medicine

African Traditional Medicine Day, Conservation of medicinal plants: Africa's Heritage Message of the WHO Regional Director, Dr Luis Gomes Sambo, August 31, 2011 http://www.un.cv/en/arquivo‐traditionalmedicine‐en.php

“Today, we commemorate the Ninth African Traditional Medicine Day under the theme ‘Conservation of medicinal plants: Africa's Heritage’. More than two thirds of the world's plant species are estimated to have medicinal value. Between 25‐50% of modern medicines are derived from plants. Some notable examples are Artemisinin and Quinine, both of which are medicines for malaria. The World Health Organization estimates that nearly 80% of the population in developing countries depend on traditional medicine for their primary health care needs.

The theme for this year's African Traditional Medicine Day celebration underscores the World Health Assembly resolution on medicinal plants; the Regional Strategy on Traditional Medicine; the Plan of Action on the Organization of African Unity Decade (2001–2010) for African Traditional Medicine; and the United Nations Convention on Biological Diversity. The adoption and ratification of these policy frameworks by countries of the Region has placed the conservation, rational and sustainable use of medicinal plants in the arena of public health.

Countries in the African Region are making progress in the cultivation and conservation of medicinal plants. Thirteen countries have adopted national policies on conservation of medicinal plants and the WHO Guidelines on Good Agricultural and Collection Practices. Seventeen countries are cultivating medicinal plants to varying degrees. Other countries have cultivated new medicinal plant varieties, conducted inventories including compilation of scientific information on medicinal plants and have developed guidelines on their collection and conservation.

Despite progress in many aspects of traditional medicine, countries are confronted with challenges such as the depletion of uncommon medicinal plants due to environmental degradation, deforestation, uncontrolled burning, livestock grazing, poor agricultural practices and timber logging. … Mitigating these challenges and consolidating the gains so far requires the formulation and implementation of comprehensive national policies for conservation of medicinal plants. We recommend the cultivation of medicinal plants including development of botanical gardens; establishment of comprehensive databases on existing medicinal plants; and protection of endangered species of medicinal plants. …

I call upon academic and research institutions to compile medicinal plants inventories; conduct relevant research to generate scientific evidence on the safety, efficacy and quality of medicinal plants; and build capacity of human resources in this field. I also encourage the compilation of scientific information on medicinal plant species, focusing on scarce medicinal plants in Africa. …

Saving the African Region's medicinal plant resources needs an effective, sustainable and coordinated conservation strategy. The stakes are high; we have to do all we can to conserve medicinal plants, our African heritage.”

ENZCAM Newsletter TM/CAM Update October 2011 Page 10

Progress made by countries in the implementation of the Regional Strategy on Traditional Medicine and Plan of Action for the Decade (2001–2010) in the African Region www.afro.who.int/index.php?option=com_docman&task=doc_download&gid=6665

The report shows substantial progress in the integration of African Traditional Medicine in African health systems, as measured by a number of indicators. The table of indicators is summarised for the decade to 2010 below.

Number of Countries Indicators Baseline survey: 2010 1999/2000 N=39 N=30 National policies on Traditional Medicine 8 39 Legal framework for the practice of Traditional Medicine 1 28 National Strategic Plans/National Health Strategic Plans that 0 18 include traditional medicine Code of ethics for traditional health practitioners 0 18 National Office of Traditional Medicine in Ministry of Health 22 39 National traditional medicine programme in Ministry of 10 24 Health National Expert Committee for traditional medicine 10 25 Law or regulation on Traditional Medicine practice 8 21 Registration system for traditional medicines 4 15 Issuance of marketing authorizations for traditional medicines 1 12 National research institute on Traditional Medicine 18 28 Law or regulations on herbal medicines 10 20 Inclusion of traditional medicines in national essential 1 5 medicines lists New research institutes 0 4 Local production of traditional medicines 15 17

“Traditional medicine gains ground in African universities” By Emeka Johnkingsley, 15 September 2011 See article for further commentary and insights on the WHO Africa report on the integration of African Traditional Medicine.

ENZCAM Newsletter TM/CAM Update October 2011 Page 11 7. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

October 2011: Alzheimer's Disease and CAM http://nccam.nih.gov/health/providers/digest/alzheimers.htm

“According to the National Institute on Aging, Alzheimer's disease affects nearly 4.5 million Americans and is the most common form of dementia in the elderly. Alzheimer's disease is an incurable disease with a slow progression beginning with mild memory loss and ending with severe brain damage and death.

While no treatment is proven to stop Alzheimer's disease, some conventional drugs may limit symptoms for a short period of time in the early stages of the disease. Research on several dietary supplements is on‐going to determine whether they are effective in preventing or slowing the progression of Alzheimer's disease. This issue provides information on "what the science says" about the effectiveness of antioxidants, Asian ginseng, cat's claw, ginkgo, and grape seed extract for Alzheimer's disease.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

18 November 2011

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update November 2011

1. Policy and Legislation

World Health Organization (WHO) Quality control methods for herbal materials http://www.who.int/medicines/publications/qas_herbalmed/en/index.html

“WHO published Quality control methods for medicinal plant materials in 1998 in order to support WHO Member States in establishing quality standards and specifications for herbal materials, within the overall context of quality assurance and control of herbal medicines. This is the updated edition of the 1998 publication, with an updated title.

The purpose of this updated edition remains unchanged from that of the first edition. It is to support the development of national standards based on local market conditions, with due regard to existing national legislation and national and regional norms. It describes a series of internationally harmonized tests for assessing the quality of herbal materials, including the determination of pesticide residues, arsenic and toxic heavy metals, microorganisms and aflatoxins.

A collection of recommended test procedures for assessing the identity, purity, and content of herbal materials, intended to assist national laboratories engaged in pharmaceutical quality control, the manual responds to the growing use of herbal medicines, the special quality problems they pose, and the corresponding need for international guidance on reliable methods for quality control. Where relevant, suitable test apparatuses are illustrated and explained.

The publication includes chapters that cover internationally harmonized procedures for preparing culture media, strains of microorganisms suitable for use in tests, specifications for adsorbents for use in thin‐layer chromatography, and detailed descriptions of the reagents, test solutions, and volumetric solutions used in the recommended tests.

Recommended procedures ‐ whether involving visual inspection or the use of thin‐layer chromatography for the qualitative determination of impurities ‐ should also prove useful to the pharmaceutical industry and pharmacists working with herbal materials.

In order to promote good practices and to provide general technical guidance in conducting the test methods described in this publication, WHO good practices for pharmaceutical quality control laboratories is annexed to this publication for easy reference.”

ENZCAM Newsletter TM/CAM Update November 2011 Page 2 2. Practitioner and Patient Organisations

CAMDOC Alliance http://camdoc.eu/index.html

“The European Committee for Homeopathy (ECH), the European Council of Doctors for Plurality in Medicine (ECPM), the International Council of Medical Acupuncture and Related Techniques (ICMART) and the International Federation of Anthroposophic Medical Associations (IVAA), constitute the CAMDOC Alliance representing 132 European associations of medical doctors practising Complementary Medicine.

The mission of CAMDOC is to develop and facilitate the integration of the well‐established and respectable CAM‐methods into European Health Policies with the aim to provide the European citizens with the added value to medicine that CAM can provide.

Surveys over the past decade have reflected a growing demand by the European citizens for [CAM], which is mainly aimed at restoring the patients’ own natural systems for fighting disease and maintaining health with the aid of natural medicines, modification of lifestyle, dietary change and health psychology approaches.

There is also considerable interest in CAM among primary care doctors, and many are already practising CAM, referring to CAM practitioners or suggesting referral. In the European Union there are approximately 150,000 medical doctors who have taken training courses in a particular CAM therapy such as acupuncture, homeopathy, anthroposophic medicine or natural medicine, with figures for each therapy that are comparable to those of mainstream medical specialties. Most doctors practising CAM work in the ambulatory sector as GPs or medical specialists (any sort of specialty), in several European countries some of them work in mainstream hospitals including university teaching hospitals.”

A list of the CAM medical associations affiliated with the partner organisations is given at: http://camdoc.eu/Footer/Members.html

Therapies practised include acupuncture, anthroposophic medicine, ayurvedic medicine, herbal medicine, homeopathy, naturopathic medicine, traditional Chinese and Tibetan medicine, shiatsu, yoga, amongst others.

Documents available from the CAMDOC site:  Complementary Medicine (CAM) Its current position and its potential for European healthcare  The regulatory status of Complementary and Alternative Medicine for medical doctors in Europe 2010  Model Guidelines for the Practice of Complementary Therapies (CAM) by Medical Doctors in the European Union.

EUROCAM

“EUROCAM, the alliance of patients, doctors and practitioners in the field of CAM, is committed to raising public awareness of the public‐health benefits of CAM, especially in terms of prevention and health promotion, patient safety, patient‐centred health services, mental health, palliative care, health economics and healthy ageing.”

ENZCAM Newsletter TM/CAM Update November 2011 Page 3

EUROCAM is a network of the entire CAM sector in the EU. “Within the EUROCAM platform collaborate the CAM‐medical doctors umbrella organisations allied in CAMDOC, the European Federation of Patients’ Associations for Anthroposophic Medicine EFPAM, the European Federation of Homeopathic Patients’ Associations EFHPA, the European Federation for Complementary and Alternative Medicine EFCAM for the nonmedical practitioners’ organizations and the producers of CAM medicinal products ECHAMP ‐ the latter in a status of observers”

3. Journals

BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] Volume 11, November 2011 http://www.biomedcentral.com/bmccomplementalternmed/

Selected articles:  Which Canadians seek alternative care?  Acupuncture and chiropractic care for chronic pain in an integrated health plan: a mixed methods study  Estrogenic botanical supplements, health‐related quality of life, fatigue, and hormone‐ related symptoms in breast cancer survivors: a HEAL Study report  Safety and effects of two mistletoe preparations on production of Interleukin‐6 and other immune parameters ‐ a placebo controlled clinical trial in healthy subjects  Rose hip and its constituent galactolipids confer cartilage protection by modulating cytokine, and chemokine expression  Modulation of T cell proliferation and cytokine response by Plumbagin extracted from Plumbago zeylanica in collagen induced arthritis  Inhibitory effect of aqueous dandelion extract on HIV‐1 replication and reverse transcriptase activity

Complementary Therapies in Clinical Practice [First listed in ENZCAM Newsletter June 2011] Volume 17, Number 4: November 2011 http://www.sciencedirect.com/science/issue/273294‐1‐s2.0‐S1744388111X0004X

Selected articles:  The need to include the subject of natural remedies in midwifery education  The role of naturopathy in pregnancy, labour and post‐natal care: Broadening the evidence‐base  Exploring the impact of osteopathic treatment on cranial asymmetries associated with nonsynostotic plagiocephaly in infants

ENZCAM Newsletter TM/CAM Update November 2011 Page 4

 Complementary and alternative medicine (CAM) among hospitalised patients: Reported use of CAM and reasons for use, CAM preferred during hospitalisation, and the socio‐ demographic determinants of CAM users  Complementary medicine use is not associated with non‐adherence to conventional medication in the elderly: A retrospective study  Pilot study: Retreat intervention predicts improved quality of life and reduced psychological distress among breast cancer patients  The efficacy of lavender oil on perineal trauma: A review of the evidence  Patients' views of CAM as spiritual practice  Hand pain is reduced by massage therapy  The use of complementary and alternative medicine by patients with cancer: In Turkey  Herbal preparation use by patients suffering from cancer in Palestine  Meditation for the management of adjustment disorder anxiety and depression  Vital Healing‐Energy, Mind and Spirit in Traditional Medicines of India, Tibet and the Middle East‐Middle Asia  Complementary therapies in pregnancy and childbirth – Accredited courses for midwives, therapists and other maternity supporters

Explore: The Journal of Science and Healing [First listed in ENZCAM Newsletter May 2011] Volume 7, Number 6: November‐December 2011 http://www.sciencedirect.com/science/issue/273308‐1‐s2.0‐S1550830711X0006X

Selected articles:  All Tangled up: Life in a Quantum World  Meditation—The Controlled Psychophysical Self‐Regulation Process That Works  The Almost Obvious Case for a Transcendental Understanding of Life  Effects of Mass Consciousness: Changes in Random Data during Global Events  A Systematic Review of the Literature on the Chiropractic Care of Patients with Autism Spectrum Disorder  Tai chi, glucosamine, probiotics, acupressure, and pelargonium sidoides  Advancing Integration Through Evidence Informed Practice: Northwestern Health Sciences University's Integrated Educational Model

Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] Volume 2012 http://www.hindawi.com/journals/ecam/aip/

Selected articles:  Greco‐Arab and Islamic Herbal‐Derived Anticancer Modalities: From Tradition to Molecular Mechanisms  A Systematic Review and Meta‐Analysis of Efficacy, Cost‐Effectiveness, and Safety of Selected Complementary and Alternative Medicine for Neck and Low‐Back Pain

ENZCAM Newsletter TM/CAM Update November 2011 Page 5 Journal of Medicinal Food [First listed in ENZCAM Newsletter Q1 2011] Volume 14, Number 11: November 2011 http://www.liebertonline.com/toc/jmf/14/11

Selected articles:  Gnetum africanum: A Wild Food Plant from the African Forest with Many Nutritional and Medicinal Properties  The Effect of Supplementation of Grape Seed Proanthocyanidin Extract on Vascular Dysfunction in Experimental Diabetes  Bioactive Chemicals from Carrot (Daucus carota) Juice Extracts for the Treatment of Leukemia  Fatty Acid Profiles of Four Wild Mushrooms and Their Potential Benefits for Hypertension Treatment  Garlic Allicin as a Potential Agent for Controlling Oral Pathogens  Suppression of Tumor Necrosis Factor‐α‐Induced Nuclear Factor κB Activation and Aromatase Activity by Capsaicin and Its Analog Capsazepine  Preventing Bone Loss and Weight Gain with Combinations of Vitamin D and Phytochemicals  Protective Effects of Haematococcus Astaxanthin on Oxidative Stress in Healthy Smokers  Evaluation of Cholinesterase Inhibitory and Antioxidant Activities of Wild and Cultivated Samples of Sage (Salvia fruticosa) by Activity‐Guided Fractionation

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 17, Number 11: November 2011 http://www.liebertonline.com/toc/acm/17/11

Selected articles:  Naturopathic Medicine and Public Health: Teaming Up for a Transformative Tomorrow  Mindfulness and Psychologic Well‐Being: Are They Related to Type of Meditation Technique Practiced?  The Relationship Between Dental Occlusion/Temporomandibular Joint Status and General Body Health: Part 1. Dental Occlusion and TMJ Status Exert an Influence on General Body Health  What is Bowenwork®? A Systematic Review  Reduced Health Resource Use After Acupuncture for Low‐Back Pain  Relaxation Response–Based Yoga Improves Functioning in Young Children with Autism: A Pilot Study  Management of Distress During Climacteric Years by Homeopathic Therapy  A Randomized, Double‐Blinded, Placebo‐Controlled Study of the Effect of a Combination of Lemon Verbena Extract and Fish Oil Omega‐3 Fatty Acid on Joint Management  Pulmonary Functions of Children with Asthma Improve Following Massage Therapy  Attitude of Conventional and CAM Physicians Toward CAM in India  The Intersecting Paradigms of Naturopathic Medicine and Public Health: Opportunities for Naturopathic Medicine  Five Keys to Real Transformation in Health Care  Review of Frequency‐Specific Microcurrent in Pain Management

ENZCAM Newsletter TM/CAM Update November 2011 Page 6 4. Academic Integration of TM/CAM

United Kingdom Medical Schools: Factors influencing the Inclusion of CAM Factors influencing the inclusion of complementary and alternative medicine (CAM) in undergraduate medical education By Kevin R Smith http://bmjopen.bmj.com/content/1/1/e000074.full.html

“This paper examines the inclusion (or otherwise) of complementary and alternative medicine (CAM) in medical syllabi in UK medical schools.

Various definitions of CAM exist. … Given the foregoing difficulties in defining CAM, it is perhaps more effective to list the forms of CAM actually used by patients, rather than attempt to claim a precise definition of CAM. In the UK, the major forms of CAM used by patients have been reported to include (in order of frequency of use) herbal medicine, aromatherapy, homeopathy, acupuncture/acupressure, massage, reflexology, osteopathy and chiropractic.

CAM encompasses a set of therapeutic modalities which occupy a paradoxical position in modern medicine and healthcare: the plausibility and evidence base of many CAM treatments is very limited, and CAM approaches have been criticised and challenged by some scientists and physicians opposed to CAM; despite this, some forms of CAM are manifestly popular among many lay people and a significant number of medical professionals.

Such increased demand has reached the sphere of education. Indeed several universities in the UK, USA and elsewhere have in recent years launched degree‐level education and training in CAM. Perhaps most importantly, undergraduate medical education (i.e., the means by which future medical doctors are produced) is also showing signs of being influenced by the increased prominence of CAM. The GMC sets the standards for undergraduate medical syllabi in the UK, via its document Tomorrow's Doctors—Outcomes and Standards for Undergraduate Medical Education. The most recent (2009) version of this document (due for application from 2011/12 onwards) requires, as an educational outcome, that graduate doctors must: “Demonstrate awareness that many patients use complementary and alternative therapies, and awareness of the existence and range of these therapies, why patients use them, and how this might affect other types of treatment that patients are receiving”. This outcome is open to fairly wide interpretation.

Individual medical schools must satisfy the requirements of the GMC, but are not limited by these requirements. Thus, although the above outcome from Tomorrow's Doctors appears only to demand the inculcation of a simple ‘awareness’ of CAM, a medical school could choose to deliver as much CAM education as it wished, insofar as time existed in the syllabus for its inclusion. In this regard, other pressures (beyond GMC requirements) may operate to promote—or limit—the adoption of CAM into medical syllabi.”

“The purpose of this study was to investigate the factors that influence the inclusion of CAM in undergraduate medical syllabi in the UK. A survey was used to measure, in a simple and brief way, the views of deans (or equivalent) of the country's medical schools. The goal was to provide answers to the following questions: To what extent is CAM being integrated into the education of future doctors? What factors influence decisions regarding the inclusion of CAM in medical curricula? To what extent may the inclusion of CAM represent an ethical problem?”

ENZCAM Newsletter TM/CAM Update November 2011 Page 7 5. Integration of TM/CAM in the Military

NATO: Integrative Medicine Interventions for Military Personnel http://www.rto.nato.int/activities.aspx (insert “complementary medicine” in search)

NATO began this project in January 2010 and it is expected to conclude with a sixth meeting scheduled for October 2013. “The past twenty years have seen the increasing acceptance of complementary and alternative medicine (CAM) or integrative medicine in the treatment or prevention of an increasing number of conditions. Data show that more than 50% of the military population, including dependants, have used CAM interventions in recent years, and 66% of active duty personnel use dietary supplements.” “Military personnel are increasingly taking charge of their own health, without resorting to the usual military medical services. More and more try to stay away from prescription or Over‐The‐Counter (OTC) drugs because of the side effects, and for many, this self‐empowerment is shown by their increasing use of natural products, or non‐drug therapies such as acupuncture, homeopathy, magnets, laser stimulation, yoga, mind‐body interventions, , etc.” The objectives of this research are: “Identify and evaluate countries’ data on the use of CAM among military personnel; Determine how personnel in each country access CAM interventions (directly or by prescription), and with what frequency; Assess how important, accepted, and regulated is the use of CAM in the therapeutic arsenal; and Share all available research on the indications and effects of any type of CAM interventions, as well as any possible adverse effects on military readiness.” “The main topics will include: acupuncture, homeopathy, relaxation, nutritional supplements, phytotherapy, chiropraxy, osteopathy, magnets, electrical stimulation, laser therapy (non‐surgical), yoga, and any mind‐body‐based interventions.” The countries actively participating in the project are France, Germany, Hungary, Italy, Netherlands and the United States.

Complementary and Alternative Therapies for Post‐Traumatic Stress Disorder By Elizabeth Adams, Veterans Affairs Technology Assessment Program (VATAP), USA http://www.inahta.org/Publications/Briefs‐Checklist‐Impact/2011/4814/ (see also VATAP: http://www.va.gov/vatap/ )

Aim: To update current research on the effectiveness of complementary and alternative medicine (CAM) interventions to treat post‐traumatic stress disorder (PTSD) in adults and to guide future CAM research. Conclusions and results: Nine studies met the inclusion criteria. The evidence was insufficient to draw conclusions regarding the net benefit of CAM treatments as primary therapies for PTSD patients. However, evidence suggests that acupuncture and mantram repetition may have an adjunctive role in treatment. Recommendations: Patients with PTSD should be aware of the uncertainty regarding the balance of benefits and harms for these four treatments: yoga/yogic breathing, Vipassana meditation, mantram repetition, and acupuncture.

ENZCAM Newsletter TM/CAM Update November 2011 Page 8

Methods: In December 2010, VATAP searched the literature for articles written in English in the following databases: MEDLINE, EMBASE, and Current Contents via Dialog Information Services®. Keywords for 29 CAM interventions were combined with PTSD and combat terms, e.g., "war", "terror", and "deployment". Further research/reviews required: Eight on‐going clinical trials are investigating CAM for PTSD. More large studies with intention‐to‐treat analyses are needed for CAM treatments applicable to young combat veterans. Studies need to improve in design (e.g., validated outcome measures), conduct (e.g., comparing CAM to well‐established PTSD treatments) and reporting (e.g., systematic documentation of adverse effects and reasons why patients have dropped out of a study). A table lists additional recommendations for future research.

6. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

November 2011: Headaches and Complementary Health Practices http://nccam.nih.gov/health/providers/digest/headaches.htm

“Headaches are one of the most common forms of pain. More than 45 million Americans have headaches severe enough to require the help of a health care professional. Headaches occur when pain‐sensitive nerve endings around the scalp, in the blood vessels that surround the skull, in the lining around the brain, and in other areas around the head send impulses to the part of the brain that interprets pain signals from the rest of the body. Some headaches are related to tender spots in head, neck, and shoulder muscles.

Researchers are studying treatments for different types of headaches, including a number of complementary health practices. This issue provides information on "what the science says" about the effectiveness and safety of selected complementary health practices for headaches, including relaxation training, biofeedback, acupuncture, tai chi, cognitive‐behavioral therapy, massage, spinal manipulation, and dietary supplements.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

9 December 2011

ENZCAM Newsletter TM/CAM Update November 2011 Page 9

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update December 2011

1. Policy and Legislation

CAM Status in Switzerland Project CAMbrella is preparing updates on the legal status and regulation of CAM in Europe. A new summary on Switzerland has been published. See the October 2011 edition of the ENZCAM newsletter for summaries on seven other countries in Europe.

CAM in Switzerland: http://www.cambrella.eu/home.php?il=168

“Five CAM therapies provided by doctors were reimbursed by the NHS in 1999‐2005. Four therapies will be preliminarily reimbursed in 2012‐2017 and have to be evaluated regarding efficiency, utility, safety, and cost‐effectiveness. In 2006‐2011 these CAM treatments had to be paid out‐of‐the‐pocket or were financed by additional insurance in the same manner as therapies provided by non‐medical practitioners.”

“Due to a public vote in 1995 a chair of complementary medicine was implemented at the University of Bern, comprising four of five physicians’ therapies represented by doctors with additional CAM qualifications. … Phytotherapy as the fifth complementary therapy is represented with a chair at the University of Zurich …” In Zurich CAM lessons are not part of the core curriculum, whereas at the University of Bern CAM has been in medical students' compulsory curriculum since 2009.

Integrative Medicine Policy and Action in the USA Top 10 for Integrative Medicine Policy and Action in 2011 http://www.huffingtonpost.com/john‐weeks/top‐10‐for‐integrative‐me_b_1157148.html

Commentator John Weeks produces an annual list of the top ten issues or events in the USA. He says “The year was a good one for integrative medicine. Many of these developments grew out of the mandated inclusion of integrative and complementary and alternative medicine practices in the Obama‐Pelosi Affordable Care Act. … “I personally am struck by the influence of Obamacare. [Accountable Care Organizations] shift payment toward creating health in a population. Academic medicine elevates team‐care. Research engages the real world of what patients care about. The [Institute of Medicine]’s brain trust delivers an integrative‐oriented pain blueprint. Integrative leaders are included in the national health promotion strategy. These broad arcs of substantive change are each linked to the Affordable Care Act.”

ENZCAM Newsletter TM/CAM Update December 2011 Page 2 Patient Protection and Affordable Healthcare Act, 2010, USA See the reference resource prepared by John Weeks on the Affordable Healthcare Act and the specific wording that encourages integrative medicine. http://theintegratorblog.com/site/index.php?option=com_content&task=view&id=658&Itemid=189

“Included are locations and exact language in the sections of the Patient Protection and Affordable Healthcare Act (HR 3590) that will shape policy action relative to integrative practices in coming years. Complementary and alternative medicine practitioners and integrative practices are included in these sections (2706, 3502, 4001, 4206, 5101, 6301 and 2301) relative to non‐discrimination, workforce planning, community medical homes, wellness, prevention and health promotion, comparative effectiveness research and birthing services.”

See also: http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act

State of Integrative Medicine in Canada http://theintegratorblog.com/index.php?option=com_content&task=view&id=786&Itemid=189

“While Canada is one of the world's leaders in integrating Complementary and Alternative medicine into the national health care system, CAM is clearly not yet a fully integrated option. However, the increasing acceptance of CAM is supported by a wide‐ranging and well‐articulated research base, and is also due to academic support in universities, the passing of more enlightened regulatory laws, and the support of health professional associations and corporate partners.

Canadians widely endorse the use of CAM. A recent study reports 54% of Canadians used CAM in the previous year and 74% have used CAM a least once in their lifetimes.”

2. Research and Practitioner Organisations

Institute of Complementary Medicine (KIKOM) University of Bern, Switzerland http://www.kikom.unibe.ch/content/index_eng.html

“KIKOM is an institution at the University in Bern, combining conventional medicine and complementary medicine in patient care, research and teaching. The fields of research are [include] basic research, epidemiology, diagnosis related studies, randomized controlled trials and medicinal product surveillance.”

KIKOM consists of the following divisions of complementary medicine: Anthroposophic Medicine Homeopathy Neural therapy Traditional Chinese Medicine / Acupuncture.

See “Publications in peer‐reviewed journals” and “Projects and Doctoral Theses”: http://www.kikom.unibe.ch/content/forschung/projects__doctoral_theses/index_eng.html

ENZCAM Newsletter TM/CAM Update December 2011 Page 3

European Association for Predictive, Preventive & Personalised Medicine (EPMA) http://www.epmanet.eu/index.php/about‐epma/european‐coordination

“Current healthcare practices essentially rely on emergence of signs and symptoms of human pathologies prior to initiation of interventional modalities. A major limitation of this approach relates to the fact that often the disease process has already taken its toll through manifestation of its complications (e.g. diabetes‐associated renal and cardiovascular complications). As a result, despite high costs associated with care of these individuals, long‐term prognosis usually remains poor due to inadequate control of disease manifestations, treatment failure, disease‐recurrence and the appearance of severe secondary complications, among others, thereby contributing to relatively low life‐quality of the treated persons, high morbidity and mortality.

“The major premise of the improved strategies is that initially, chronic pathologies are generally triggered at the molecular level followed by pathology‐specific molecular events predisposing the potentially affected organs to certain pathologies long before organ damage and symptomatic manifestation of the disease. Therefore, detection of pathology‐specific molecular patterns can create a well‐founded basis for the predictive approaches desirable in good healthcare. It advocates the application of innovative biotechnologies to predict human pathologies, devise appropriate and timely preventive strategies and individualized treatment planning. As a result, predictive medicine offers great promise for the future practice of medicine.

Essential components of this approach include  well‐organised population screening protocols using novel diagnostic biomarkers of disease states,  targeted prevention of common human pathologies,  optimal treatment planning and  personalised medicine thereby resulting in substantial improvement of the quality of life.”

See also the EPMA Journal in the section below.

3. Journals

African Journal of Traditional, Complementary and Alternative medicines (AJTCAM) [First listed in ENZCAM Newsletter October 2011] Volume 9, Number 1, 2012. Released December 2011. http://journals.sfu.ca/africanem/index.php/ajtcam/issue/view/68

Selected articles:  Advances in the analytical methods for determining the antioxidant properties of honey: a review

ENZCAM Newsletter TM/CAM Update December 2011 Page 4

 Recommendations for the development of regulatory guidelines for registration of traditional medicines in South Africa  Effects of Sutherlandia Frutescens extracts on normal t‐lymphocytes in vitro

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter Q1 2011] Volume 17, Number 6: December 2011 http://www.liebertonline.com/toc/act/17/6

Selected articles:  Roundoc Rx: Cardiovascular Disease Prevention—Five Natural Interventions  Overprescribing of Antibiotics for Children’s Upper Respiratory Infections: Alternative Options to Consider  Therapeutic Massage: Significant Advancements in the Field  Botanical Medicines and Ionizing Radiation: Part 1—Radioprotective Herbs  Current Controversies in Nutrition: Why Nutrition Should Be Your First‐Line Therapy  Probiotics (Bifidobacterium, Lactobacillus, and Saccharomyces boulardii): An Evidence‐Based Systematic Review by the Natural Standard Research Collaboration  Clinical Roundup: Selected Treatment Options for Bronchitis

BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] Published in December 2012 http://www.biomedcentral.com/bmccomplementalternmed/

Selected articles:  Motion style acupuncture treatment (MSAT) for acute low back pain with severe disability: a multicenter, randomized, controlled trial protocol  Influence of the Chungkookjang on histamine‐induced wheal and flare skin response: a randomized, double‐blind, placebo controlled trial  Association of Health Literacy with Complementary and Alternative medicine use: A Cross‐ sectional study in Adult Primary Care Patients  Developing a Patient‐Centered Outcome Measure for Complementary and Alternative Medicine Therapies I: Defining Content and Format  Developing a patient‐centered outcome measure for complementary and alternative medicine therapies II: refining content validity through cognitive interviews  Characteristics and job satisfaction of general practitioners using Complementary and Alternative Medicine in Germany ‐ is there a pattern?  Phenolic content and antioxidant property of the bark extracts of Ziziphus mucronata Wild. subsp. mucronata Wild.  Boswellia sacra essential oil induces tumor cell‐specific apoptosis and suppresses tumor aggressiveness in cultured human breast cancer cells  The effectiveness of moxibustion for the treatment of functional constipation: a randomized, sham‐controlled, patient blinded, pilot clinical trial  Survey of CAM interest, self‐care, and satisfaction with health care for type 2 diabetes at Group Health Cooperative

ENZCAM Newsletter TM/CAM Update December 2011 Page 5 Complementary Therapies in Medicine [First listed in ENZCAM Newsletter May 2011] Volume 19, Number 6: December 2011 http://www.complementarytherapiesinmedicine.com/issues

Selected articles:  Health economic evaluation in complementary medicine: Development within the last decades concerning local origin and quality  The use of Complementary and Alternative Medicine in pregnancy: Data from the Avon Longitudinal Study of Parents and Children (ALSPAC)  Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: A systematic review  The effectiveness of music listening in reducing depressive symptoms in adults: A systematic review  Comment on the “Assessment of a traditional acupuncture therapy for chronic neck pain: A pilot randomized controlled study”

EPMA Journal

The Official Journal of the European Association of Predictive, Preventive and Personalised Medicine http://www.springer.com/biomed/journal/13167

“EPMA Journal explores a new philosophy in medicine, and tracks novel trends in healthcare and biomedical education.”

“Predictive, preventive and personalised medicine (PPPM) offers great promise for the future practice of medicine. Essential components of this approach include well‐organised population screening protocols utilising novel diagnostic biomarkers of disease states; targeted prevention of common human pathologies; optimal treatment planning and personalised medicine, resulting in substantial improvement of the quality of life. This approach also offers the advantage of delivering care at potentially reduced costs to the population at large, addressing social and ethical issues related to healthcare access and affordability.”

“Over a two‐year publication cycle, each quarterly issue of EPMA Journal is devoted to worldwide progress in PPPM as related to a specific health problem: Diabetes mellitus; Neurodegenerative Diseases; Cancer; Cardiovascular Diseases; Pediatrics & Reproductive Medicine; Body Culture and Sports medicine. An annual issue provides a detailed overview of the state and outlook of Healthcare in European area and worldwide.”

Examples of articles, submitted by Paolo Roberti di Sarsina (Ministry of Health, Italy and member of the editorial board of the EPMA Journal):  Why we need integrative medicine http://www.springerlink.com/content/223644p5p521v122/fulltext.pdf  Towards salutogenesis in the development of personalised and preventive healthcare http://www.springerlink.com/content/h087624175304852/fulltext.pdf  Salutogenesis and Ayurveda: indications for public health management http://www.springerlink.com/content/974771483461406h/fulltext.pdf

ENZCAM Newsletter TM/CAM Update December 2011 Page 6

 Tibetan medicine: a unique heritage of person‐centered medicine http://www.springerlink.com/content/6503187543882747/fulltext.pdf  The need for higher education in the sociology of traditional and non‐conventional medicine in Italy: towards a person‐centered medicine http://www.springerlink.com/content/f03t128mn9757617/fulltext.pdf  Traditional and non‐conventional medicines: the socio‐anthropological and bioethical paradigms for person‐centred medicine, the Italian context http://www.springerlink.com/content/h87ju68052u1h553/fulltext.pdf  Regional Health Systems and non‐conventional medicine: the situation in Italy http://www.springerlink.com/content/473102n22851277k/fulltext.pdf

European Journal of Integrative Medicine [First listed in ENZCAM Newsletter May 2011] Volume 3, Number 4: December 2011 http://www.europeanintegrativemedicinejrnl.com/issues Selected articles:  Acupuncture treatment for depression—A systematic review and meta‐analysis  Self‐reported changes in quality of life among people with multiple sclerosis who have participated in treatments based on collaboration between conventional healthcare providers and CAM practitioners  Antifungal efficacy of Brazilian green propolis extracts and honey on Tinea capitis and Tinea versicolor  Magnolol: A multifunctional compound isolated from the Chinese medicinal plant Magnolia officinalis  Do patients tell their clinicians they are using both prescribed and over the counter allopathic and  Complementary and Alternative Medicine (CAM) among adults in Italy: Use and related satisfaction.

Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] Volume 2012 http://www.hindawi.com/journals/ecam/aims/ Selected articles:  A Comparative Randomised Controlled Trial of the Effects of Brain Wave Vibration Training, Iyengar Yoga, and Mindfulness on Mood, Well‐Being, and Salivary Cortisol  Control Strategy on Hypertension in Chinese Medicine  Barriers to Integration of Traditional and Complementary Medicine in Supportive Cancer Care of Arab Patients in Northern Israel  The Effect of Traditional Cupping on Pain and Mechanical Thresholds in Patients with Chronic Nonspecific Neck Pain: A Randomised Controlled Pilot Study  Acupuncture for Treatment of Autism Spectrum Disorders  Reflections on Palliative Care from the Jewish and Islamic Tradition

ENZCAM Newsletter TM/CAM Update December 2011 Page 7 Integrative Cancer Therapies [First listed in ENZCAM Newsletter April 2011] Volume 10, Number 4: December 2011 http://ict.sagepub.com/content/10/4.toc?etoc

Selected articles:  Use of Complementary and Alternative Medicine by Cancer Patients at a Montreal Hospital  Trends in Chinese Medicine Use Among Prostate Cancer Patients Under National Health Insurance in Taiwan: 1996‐2008  Exploiting Tyrosinase Expression and Activity in Melanocytic Tumors: Quercetin and the Central Role of p53  Glabridin Inhibits Migration, Invasion, and Angiogenesis of Human Non–Small Cell Lung Cancer A549 Cells by Inhibiting the FAK/Rho Signaling Pathway  Polysaccharide of Cordyceps sinensis Enhances Cisplatin Cytotoxicity in Non–Small Cell Lung Cancer H157 Cell Line

Journal of Holistic Nursing [First listed in ENZCAM Newsletter April 2011] Volume 29, Number 4: December 2011 http://jhn.sagepub.com/content/29/4.toc?etoc Selected articles:  Exploring Co‐Meditation as a Means of Reducing Anxiety and Facilitating Relaxation in a Nursing School Setting  The Role of Spirituality in the Breast Cancer Experiences of African American Women  Managing Polycystic Ovary Syndrome: What Our Patients Are Telling Us  Effect of Jin Shin Jyutsu Energy Medicine Treatments on Women Diagnosed With Breast Cancer  Guided Imagery as a Treatment Option for Fatigue: A Literature Review  The Process of Healing Transformations: A Model for Holistic Practice

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 17, Number 12: December 2012 http://www.liebertonline.com/toc/acm/17/12

Selected articles:  Authors' Reply to Response to “Mindfulness and Psychological Well‐Being: Are They Related to Type of Meditation Technique Practiced?”  The Relationship Between Dental Occlusion/Temporomandibular Joint Status and General Body Health: Part 2. Fascial Connection of TMJ with Other Parts of the Body  Can Micronutrients Improve Neurocognitive Functioning in Adults with ADHD and Severe Mood Dysregulation? A Pilot Study  Local Thermal Therapy Effects on Menopausal Symptoms and Bone Mineral Density  Homeopathic Potentization Based on Nanoscale Domains  Detoxification in Naturopathic Medicine: A Survey  The Dutch Complementary and Alternative Medicine (CAM) Protocol: To Ensure the Safe and Effective Use of Complementary and Alternative Medicine Within Dutch Mental Health Care

ENZCAM Newsletter TM/CAM Update December 2011 Page 8 4. Conferences

2012 International Research Congress on Integrative Medicine and Health 7th International Congress on Complementary Medicine Research (ICCMR)

15‐18 May 2012, Portland, Oregon, USA http://imconsortium‐congress2012.org/

“This meeting is sponsored by the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM), and it also serves as the 7th International Congress on Complementary Medicine Research sponsored by the International Society for Complementary Medicine Research (ISCMR). …. We look forward to welcoming you along with more than 1,000 participants to Portland, OR in May 2012.”

5th European Congress for Integrative Medicine

The Future of Comprehensive Patient Care 21‐22 September 2012 Palazzo dei Congressi, Florence, Italy http://www.ecim‐congress.org/

“The Congress is promoted by Tuscany Region, General Directorate of Health Department, and by the Tuscany Network for Integrative Medicine, with the Charité University of Berlin, Institute for Social Medicine, Epidemiology, and Health Economics, in co‐operation with the University of Florence, the other Tuscan Universities and the regional Chamber of Medical Doctors and Dentists.

This is the main European and international event for physicians, healthcare professionals, scientists, and sponsors about the efficacy of complementary/unconventional medicines and their integration with conventional medicine. … The aim of the Italian edition of ECIM is to help the exchange between medical doctors and researchers, and promote the dialogue and debate among the experiences of integration of complementary/unconventional medicines in the National Health Services of Northern and Central Europe with those of Mediterranean countries.”

8th International Congress on Complementary Medicine Research (ICCMR)

11‐13th April 2013, University College, London, UK http://www.iscmr.org/membership/

“Our title is: “Long‐term conditions: developing integrated and sustainable healthcare” and our objective is to inform and create a global strategy for the integrated management to address the rapidly increasing problem of chronic long‐term conditions. Our agenda will be to seek to develop effective treatments, sustainable in environmental and economic terms, and to mobilise all the relevant resources, particularly those largely untapped and under‐valued aspects of traditional and complementary medicine, as well as self‐care, from diverse regions of the world. We are in the process of inviting … keynote speakers from all over the world (India, China and Latin American as well as Europe and the US). We will make available a whole range of benefits to ISCMR members including pre conference workshops and reduced registration fees.”

ENZCAM Newsletter TM/CAM Update December 2011 Page 9 5. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

December 2011: Depression and Complementary Health Practices http://nccam.nih.gov/health/providers/digest/depression.htm

“Among the common symptoms of depression are persistent sad, anxious, or "empty" feelings; feelings of hopelessness, guilt, and/or worthlessness; restlessness or irritability; fatigue; difficulty concentrating; insomnia; overeating, or loss of appetite; and/or thoughts of suicide. Many people with a depressive illness never seek treatment. But the majority, even those with the most severe depression, can get better with treatment. Depression can be treated effectively with conventional medicine, including antidepressants and certain types of psychotherapy.

Some people turn to complementary health products and practices for depression, including the dietary supplement St. John's wort; however, no complementary approach has been proven effective for the long‐term treatment of depression. This issue provides information on "what the science says" about the effects of complementary health products for depression, including the dietary supplements omega‐3 fatty acids, St. John's wort, valerian, as well as other complementary practices such as massage, relaxation techniques, and yoga.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

12 January 2012

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update January 2012

1. Policy and Legislation: Regional Health Systems in Italy

Regional Health Systems and non‐conventional medicine: the situation in Italy

By Mara Tognetti Bordogna http://www.springerlink.com/content/473102n22851277k/

“In this paper we examine whether and how the regional healthcare systems include alternative medicines and, if so, whether this can be specifically attributed to the different organisational models in place. This analysis will be preceded by a framework to show how in Italy there is a constant and continuous increase in non‐conventional medicine (NCM), determined from a research by citizens of a person‐centred medicine and preventive. We shall examine how NCM has been incorporated in the National Health System (SSN) in Italy, from the time the Regional Health Systems were set up, and the factors that have contributed to their inclusion or exclusion.”

2. Research: Adverse Event Reporting in the USA

http://online.wsj.com/article/SB10001424052970203920204577193052426275904.html

The U.S. Food and Drug Administration has millions of "adverse event" reports,” ranging from fatigue to fatal heart attacks, for thousands of prescription drugs dating back to 1969. But the information hasn't been readily accessible—until now.”

“A start‐up company, AdverseEvents Inc., has streamlined the FDA's often impenetrable database and made it easy to search the adverse‐event reports for more than 4,500 drugs, free and online.

Another start‐up, Clarimed LLC, has done the same for reports filed with the FDA on 130,000 medical devices, a far more complex group that runs the gamut from syringes to stents to tanning beds and diagnostic machines that could impact tens of thousands of lives.

While basic searches will remain free, AdverseEvents plans to charge consumers $10 a month for access to full drug reports starting Wednesday, and will offer health‐care professionals and businesses more detailed information for additional fees. Clarimed may follow suit.”

ENZCAM Newsletter TM/CAM Update January 2012 Page 2

“The adverse‐event reporting system for drugs (known as AERS) helps the FDA monitor side effects that crop up after a medication is approved and used in the real world. (The system for devices, called Maude, for Manufacturer and User Facility Device Experience, started in the 1990s.) AERS has received 6.4 million reports, and the volume has risen steadily. There were 759,000 for drugs and 238,000 for devices in 2010. But reporting is voluntary, and represents only a fraction of all the side effects and malfunctions, the FDA says.”

“People seeking AERS information can download raw quarterly data from the FDA's website, but it isn't cumulative and requires technical expertise to use. They can also file a Freedom of Information Act request for more specific data, but what they get back may be voluminous and impenetrable.”

“One problem is that the data are sometimes jumbled. Most reports come through drug and device manufacturers, but patients, physicians, family members—even lawyers—can send reports to the FDA, and they often contain errors and inconsistencies. “

“AdverseEvents Inc. developed an algorithm that filters out duplicates and combines spelling variations, reducing over 200,000 drug names to about 4,500. It also made the data easily searchable and comparable for thousands of conditions and side effects back to 2004.”

The FDA files also don’t give a sense of the incidence or the number of reports relative to the use of a particular drug. “AdverseEvents plans to post prescription data for some drugs. But sales information isn't available for many medical devices”.

Adverse Events Inc. http://adverseevents.com/

Clarimed LLC http://www.clarimed.com/

3. Practitioner and Patient Organisations

Integrated Healthcare Policy Consortium, USA http://ihpc.info/about/about.shtml

“The Integrated Healthcare Policy Consortium (IHPC) is a broad coalition of healthcare professionals, patients and organizations driving public policy ….”

“The mission of the IHPC is to direct the national healthcare agenda toward a health‐oriented, integrated system, ensuring all people access to the full range of safe and regulated conventional, complementary, and alternative healthcare professionals, therapies and products, and to the building blocks of health, including clean air and water as well as a healthy food supply.

IHPC serves:  Policymakers as a trusted consensus voice of the Integrated Health Care (IHC)/Complementary and Alternative Medicine (CAM) communities.  CAM and conventional integrated health care practitioners and their organizations by creating equality for all qualified health care providers/professions.  Health care consumers by representing their interests, particularly in ensuring access to the full range of safe and effective forms of health care.

ENZCAM Newsletter TM/CAM Update January 2012 Page 3

What We Believe

“Integrated Health Care (IHC) is a matter of both smart policy and equity‐‐for healthcare consumers and professionals. It is what the American people want.

We believe that integrated health care has a critical role to play in addressing the two main issues of the current US healthcare crisis‐‐cost and quality.

Specifically we believe the US healthcare system should be reprioritized to:

 Reduce the need for expensive heroic and emergency care by giving greater attention to disease prevention and health promotion.

 Alleviate the physician shortage that leaves some people without ready access to health care through greater utilization in primary care of naturopathic and chiropractic physicians, as well as nurse practitioners and physician assistants.

We believe that Americans should have real choice about their health care, and should be able to access the full range of conventional, complementary, and alternative health care professionals, selecting those most appropriate to their conditions and preferences.

We know that Americans want integrated health care. Surveys document that Americans make more visits per year to complementary and alternative healthcare providers than to conventional medical doctors. But they don't just want access to CAM providers, they want truly integrated care, in which conventional and CAM providers work cooperatively with one another on behalf of each patient's well‐being.”

4. Books

Fundamentals of Complementary and Alternative Medicine

By Marc S. Micozzi Publication Date: Fourth Edition, April 2010 http://www.amazon.com/Fundamentals‐Complementary‐Alternative‐Medicine‐ Complimentary/dp/1437705774

“Focusing on emerging therapies and those best supported by clinical trials and scientific evidence, Fundamentals of Complementary and Alternative Medicine describes some of the most prevalent and the fastest‐growing CAM therapies in use today. Prominent author Dr. Marc Micozzi provides a complete overview of CAM, creating a solid foundation and context for therapies in current practice.

Coverage of systems and therapies includes mind, body, and spirit; traditional Western healing; and traditional ethnomedical systems from around the world. Discussions include homeopathy, massage and manual therapies, chiropractic, a revised chapter on osteopathy, herbal medicine, aromatherapy, naturopathic medicine, and nutrition and hydration.”

“An evidence‐based approach focuses on treatments best supported by clinical trials and scientific evidence.”

ENZCAM Newsletter TM/CAM Update January 2012 Page 4 5. Journals

African Journal of Traditional, Complementary and Alternative medicines (AJTCAM) [First listed in ENZCAM Newsletter October 2011] Volume 9, Number 2, 2012. Released January 2012. http://journals.sfu.ca/africanem/index.php/ajtcam/issue/view/70

Selected articles:  Mitochondria as pharmacological targets: the discovery of novel anti‐obesity mitochondrial uncouplers from Africa’s medicinal plants  Anti‐inflammatory activity of crude Saponin extracts from five Nigerian medicinal plants  Chinese herbal medicine: a safe alternative therapy for urinary tract infection in patients with renal insufficiency  Anti‐inflammatory, antioxidant, and selective antibacterial effects of Euadenia Eminens root bark.  The influence of phytotherapy on macroprolactinoma size  Antihyperglycemic activities of leaves of three edible fruit plants (Averrhoa Carambola, Ficus Hispida and Syzygium Samarangense) of Bangladesh

BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] Published in January 2012 http://www.biomedcentral.com/bmccomplementalternmed/

Selected articles:  Impact of Tai Chi exercise on multiple fracture‐related risk factors in post‐menopausal osteopenic women: a pilot pragmatic, randomized trial  Attitudes toward integrative pediatrics: a national survey among youth health care physicians in the Netherlands  The use of complementary and alternative medicine among people living with diabetes in Sydney.  Any difference? Use of a CAM provider among cancer patients, coronary heart disease (CHD) patients and individuals with no cancer/CHD

Complementary Therapies in Clinical Practice [First listed in ENZCAM Newsletter June 2011] Volume 18, Number 1: January 2012 http://www.sciencedirect.com/science/journal/17443881

ENZCAM Newsletter TM/CAM Update January 2012 Page 5

Selected articles:  Effect of an integrated support programme on the concerns and wellbeing of women with breast cancer: A national service evaluation  Ginger to reduce nausea and vomiting during pregnancy: Evidence of effectiveness is not the same as proof of safety  Tai Chi effects on neuropsychological, emotional, and physical functioning following cancer treatment: A pilot study  The healers journey: A literature review  Delivering shiatsu in a primary care setting: Benefits and challenges  Use of complementary and alternative medicine by patients seen at the dermatology department of a tertiary care center  Impact of self‐administered relaxation and guided imagery techniques during final trimester and birth  Episiotomy pain relief: Use of Lavender oil essence in primiparous Iranian women

Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] Volume X, Number X: Month 2012 http://www.hindawi.com/journals/ecam/aims/

Selected articles:  Zingiber officinale Improves Cognitive Function of the Middle‐Aged Healthy Women  Randomised, Double Blind, Placebo‐Controlled Trial of Echinacea Supplementation in Air Travellers,  Pharmacological Basis for the Medicinal Use of Lepidium sativum in Airways Disorders  Inhibitory Effect of Polyphenol‐Rich Fraction from the Bark of Acacia mearnsii on Itching Associated with Allergic Dermatitis  Usage and Attitudes of Physicians in Japan Concerning Traditional Japanese Medicine (Kampo Medicine): A Descriptive Evaluation of a Representative Questionnaire‐Based  Adverse Drug Reactions in a Complementary Medicine Hospital: A Prospective, Intensified Surveillance Study  Honey‐Based Mixtures Used in Home Medicine by Nonindigenous Population of Misiones, Argentina,  The Cortical and Striatal Gene Expression Profile of 100 Hz Electroacupuncture Treatment in 6‐Hydroxydopamine‐Induced Parkinson's Disease Model  Zerumbone, a Southeast Asian Ginger Sesquiterpene, Induced Apoptosis of Pancreatic Carcinoma Cells through p53 Signaling Pathway

Explore: The Journal of Science and Healing [First listed in ENZCAM Newsletter May 2011] Volume 8, Number 1: January 2012 http://www.explorejournal.com/issues

Selected articles:  Effect of Pranayama (Breathing Exercise) on Arrhythmias in the Human Heart  Symbolic Diseases and “Mindbody” Co‐emergence. A Challenge for Psychoneuroimmunology

ENZCAM Newsletter TM/CAM Update January 2012 Page 6

 Vedic Principles of Therapy  Living with Type 2 Diabetes Mellitus in a Modern Mexican City and Opting for Phytotherapy  Integrative Mental Health (IMH): Paradigm, Research, and Clinical Practice  Innovations in Integrative Healthcare Education: Evidence Informed Practice as the Catalyst for Culture Change in CAM

Journal of Evidence‐Based Complementary & Alternative Medicine [First listed in ENZCAM Newsletter April 2011] Volume 17, Number 1: January 2012 chp.sagepub.com/content/vol17/issue1/?etoc

Selected articles:  Fluoride: Its Metabolism, Toxicity, and Role in Dental Health  A Review and Update of Red Yeast Rice  Cyclotides: From Gene Structure to Promiscuous Multifunctionality  Content of Commercially Available, Single‐Ingredient Vitamin D Dietary Supplements  Study on Protection Against β‐Amyloid Peptide Toxicity With Oral Administration of Medicinal Herbs  Beyond Randomized Controlled Trials: Evidence in Complementary Medicine

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 1: January 2012 http://online.liebertpub.com/toc/acm/18/1

Selected articles:  Older Australian Women Use Complementary Fertility Care: A Practice Audit  Use of Ayurvedic Diagnostic Criteria in Ayurvedic Clinical Trials: A Literature Review Focused on Research Methods  Using Whole‐Body Vibration Training in Patients Affected with Common Neurological Diseases: A Systematic Literature Review  The Personality of Homeopaths: A Cross‐Sectional Survey of the Personality Profiles of Homeopaths Compared to a Norm Sample  Effects of an 8‐Week Meditation Program on Mood and Anxiety in Patients with Memory Loss  Isoflavones in Treating Watchful Waiting Benign Prostate Hyperplasia: A Double‐Blinded, Randomized Controlled Trial  Effects of Whole‐Body Vibration With or Without Localized Radiofrequency on Anthropometry, Body Composition, and Motor Performance in Young Nonobese Women  Living with HIV: Responses to a Mantram Intervention Using the Critical Incident Research Method  Symmetry States of the Physical Space: An Expanded Reference Frame for Understanding Human Consciousness

ENZCAM Newsletter TM/CAM Update January 2012 Page 7 6. Campaign against TM/CAM in the UK

Number of Bachelors and Masters Degrees in CAM Halved http://www.telegraph.co.uk/education/universityeducation/degree‐courses/8989183/Lie‐back‐and‐ relax‐reflexology‐and‐aromatherapy‐degrees‐are‐dropped.html

“From this year, it will no longer be possible to study homoeopathy to degree level in a British university. The number of bachelor and masters degrees in subjects such as reflexology, aromatherapy, acupuncture and homoeopathy has halved since 2007, from more than 40 to 21. Many of the surviving courses are under review. In a shrinking job market, prospective students are returning to “traditional” degrees such as physics and chemistry.

Derby University has confirmed that this year its complementary medicine department is to be scrapped. The University of Westminster, which used to be the leading provider of complementary medicine degrees, is to drop nearly all of its courses for this year after applications dropped by half.

Five years ago, Westminster offered 14 BSc degrees in seven types of complementary medicine. Students this year will be offered four degrees in two subjects — acupuncture and herbal medicine.

Although the university says it remains “fully committed to excellence in complementary medicine” The Daily Telegraph understands that the remaining courses are under review and may soon be cut. This follows a spate of closures in the past two years after mounting pressure from scientists and doctors, who are furious that taxpayers’ money is being spent on teaching students about crystal‐ therapies and “energy fields”.

The closures are partly the result of a campaign led by Dr David Colquhoun, professor of pharmacology at University College London, and the rationalist pressure group Sense about Science.

… In 1992, John Major’s administration created 66 universities which were able to award complementary medicine degrees. Their popularity was helped by the support of the Prince of Wales, who campaigned to enhance the status of alternative medicine in the NHS.

With thanks for this link to John Weeks of the Integrator Blog: http://theintegratorblog.com/index.php?option=com_content&task=view&id=802&Itemid=189

John Weeks commented : “This is an important development for integrative academics in the U.S. to observe, especially given the parallel efforts of academics here to shut down integrative programs in academic health centers.”

Some of the people and groups that are waging a campaign against CAM:

Sense About Science http://www.senseaboutscience.org/pages/health‐and‐medicine.html

“We are a charitable trust that equips people to make sense of scientific and medical claims in public discussion. [We] work in partnership with scientific bodies, research publishers, policy makers, the public and the media, to change public discussions about science and evidence. Through award‐ winning public campaigns, we share the tools of scientific thinking and scrutiny. Our growing international Voice of Young Science network engages hundreds of early career researchers in public debates about research and evidence. Our activities and publications are used and shaped by community groups, civic bodies, patient organisations, information services, writers, publishers, educators, health services and many others.”

ENZCAM Newsletter TM/CAM Update January 2012 Page 8

“People look to us to:  Make sense of science and evidence  Provide quick help and advice  Make a fuss about things that are wrong  Represent the public interest in sound science  Activate networks of scientists and others in defence of evidence”.

Ben Goldacre’s Bad Science http://www.badscience.net/index.php?s=complementary+medicine

David Colquhoun: DC’s Improbable Science http://www.dcscience.net/

7. Campaign against TM/CAM in Australia

Scientists urge unis to axe alternative medicine courses http://www.smh.com.au/national/tertiary‐education/scientists‐urge‐unis‐to‐axe‐alternative‐ medicine‐courses‐20120125‐1qhtm.html#poll

“More than 400 doctors, medical researchers and scientists have formed a powerful lobby group to pressure universities to close down alternative medicine degrees. Almost one in three Australian universities now offer courses in some form of alternative therapy or complementary medicine, including traditional Chinese herbal medicine, chiropractics, homeopathy, naturopathy, reflexology and aromatherapy. But the new group, Friends of Science in Medicine, wrote to vice‐chancellors this week, warning that by giving "undeserved credibility to what in many cases would be better described as quackery" and by "failing to champion evidence‐based science and medicine", the universities are trashing their reputation as bastions of scientific rigour. The group … is also campaigning for private health insurance providers to stop providing rebates for alternative medical treatments.” “Of particular concern to the group is the increase in chiropractic courses, following the recent announcement of a new chiropractic science degree by Central Queensland University. More than 30 scientists, doctors and community advocates wrote to the vice‐chancellor and health science deans at the university voicing their concern, which laid the foundations for Friends of Science in Medicine.” “Australia's vice‐chancellors will meet in March and Professor Dwyer said his group was aiming to get a commitment from them to endorse health courses only with evidence‐based science.”

Friends of Science in Medicine Introduction letter: http://www.scribd.com/doc/77302596/FSIM‐Medicine‐Introduction‐Email

Linked In group formed but only has one member as of 9 February 2012: http://www.linkedin.com/groups/Friends‐Science‐in‐Medicine‐4227901

ENZCAM Newsletter TM/CAM Update January 2012 Page 9

Reaction to this story http://www.asianscientist.com/features/complementary‐alternative‐medicine‐pseudoscience‐ friends‐of‐science‐in‐medicine‐2012/ “The lobby has come under fire from alternative medicine practitioners such as the Australian Acupuncture & Chinese Medicine Association Limited (AACMA) and the National Herbalists Association of Australia (NHAA), which have called it a “witch hunt,” with the intention of stripping complementary medicine of its credibility and standing in Australia.” http://www.nytimes.com/2012/02/06/world/asia/australian‐universities‐defend‐alternative‐ medicine‐teaching.html “Mr. Dwyer said more than 50 scientists from Britain, the United States and Canada involved in similar efforts had expressed their support for the Australian group. “It’s becoming an international effort,” he said…. David Colquhoun, a professor of pharmacology at University College London who has called for ending of alternative‐medicine programs in Britain, is a member of the Australian group”. http://theconversation.edu.au/alternative‐medicine‐can‐be‐scientific‐say‐besieged‐academics‐ 5058?utm_source=E‐Healthcare+Brief&utm_campaign=3b28058a81‐ AHHA_e_healthcare_brief_31_January&utm_medium=email

“The “lesser universities” that have aroused the ire of FSM include the Australian Catholic University, Charles Sturt University, Central Queensland University, Edith Cowan University, Macquarie University, Monash University, Murdoch University, RMIT University, Southern Cross University, Swinburne University, the University of Ballarat, the University of New England, the University of Newcastle, the University of Queensland, the University of Technology Sydney, the University of Western Sydney, and the University of Wollongong. To buttress its case, FSM has gathered a list of offending courses, which includes Chinese Medicine, Wellness studies, Applied Eastern Anatomy, Clinical Science with options to study osteopathy and naturopathy, Mind/Body Medicine, and many others.” “’It should be a policy that all universities, higher education institutions, should not be involved in in this woolly teaching,’ Professor Dwyer said, adding that ‘I suspect that these are well attended, popular, money‐earning courses for cash‐strapped universities.’” “The claims of FSM, however, ignore the evidence about CAM in higher education, said Dr Wardle, a NHMRC Research Fellow at the University of Queensland’s School of Population Health and co‐ director of the Network of Researchers in Public Health and Complementary and Alternative Medicine (NORPHCAM), an international group promoting clinical research in CAM. ’They’re actually not that interested in evidence, because the overwhelming evidence is that putting CAM into universities has increased the standards, decreased the fringe element, and improved public safety, so it definitely smacks of dogmatism,’ said Dr Wardle, who is a naturopath. ’They love to say that there’s no such thing as complementary medicine and conventional medicine, there’s just evidence‐based and non‐evidence‐based, but, for example, St John’s Wort for over a decade now has been shown to be equally as effective as any pharmaceutical indication for mild to moderate depression, yet there’s still a large group of doctors who refuse to integrate it simply because it’s a herbal medicine,’ Dr Wardle said.”

ENZCAM Newsletter TM/CAM Update January 2012 Page 10

“He questioned how representative FSM’s roll call of doctors really is, saying that he has just completed a survey of every rural GP in NSW and qualitative interviews with about 30. ‘About a third wouldn’t have anything to do with complementary medicine providers, another third were very open to it – maybe too open – and the other third if they knew a practitioner who got results they’d send people on.’ About 70 per cent of Australians use CAM and it thus makes sense for research and training to be carried out within the regulation and scientific rigour of the universities, Dr Wardle said.”

John Dwyer and Kerryn Phelps debating complementary medicine in universities on ABC:. http://www.abc.net.au/radionational/programs/breakfast/2012‐01‐30/3799620

8. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

January 2012: Safe Use of Dietary Supplements http://nccam.nih.gov/health/providers/digest/safety.htm

“While there is a great deal of evidence to indicate that dietary supplements help in preventing and treating states of nutrient deficiency, there is much less evidence about their usefulness in preventing or treating other diseases. Natural products such as herbal medicines or botanicals are often sold as dietary supplements and are readily available to consumers; however, there is a lot we don't know about the safety of many of these products, in part because a manufacturer does not have to prove the safety and effectiveness of a dietary supplement before it is available to the public.

Two of the main safety concerns for dietary supplements are

* The possibilities of drug interactions‐‐for example, research has shown that St. John's wort interacts with drugs such as antidepressants in ways that can interfere with their intended effects

* The possibilities of product contamination‐‐supplements have been found to contain hidden prescription drugs or other compounds, particularly in dietary supplements marketed for weight loss, sexual health including erectile dysfunction, and athletic performance or body‐building.

This issue provides information about the safe use of dietary supplements, including the Federal regulation of dietary supplements, sources of science‐based information, and tips for talking with your patients.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

9 February 2012

ENZCAM Newsletter TM/CAM Update January 2012 Page 11

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update February 2012

1. Industry Organisations and Legislation

Natural Products New Zealand http://www.naturalproductsnz.org/

Natural Products New Zealand is the national industry organisation for people involved in the functional foods, dietary supplements, complementary medicines, cosmetic products and nutraceuticals industries.

Founded in 2002 by industry and with support of the New Zealand Government’s business and export development agency, New Zealand Trade & Enterprise, NPNZ works to maximise the industry’s competitive advantage and increase the profile of New Zealand as a source of high quality natural products.

NPNZ provides a national voice for the New Zealand industry, representing members at all levels including communications with government, media, industry commentators and related professional bodies.

Natural industry steadily growing http://www.stuff.co.nz/marlborough‐express/news/6453743/Natural‐industry‐steadily‐growing

Last year, the industry exceeded $1 billion revenue, with 71 per cent of revenue coming from exports. That's four times the amount of exports compared to seven years ago … "The industry has continued to show significant growth – the quiet achiever of New Zealand's economy," [Michelle Palmer, the executive director], said. "It is now larger than the biotechnology and organics industries combined."

One of the most difficult things for people in the industry is staying ahead of changing regulations around the world. … At last count, 60 per cent of countries Natural Products New Zealand companies export to are in the process of changing their regulations…

The National Health Products Bill is currently going through Parliament in New Zealand, to replace the "dinosaur" dietary supplement regulations 1985, she said. Mrs Palmer is collating the consensus of the industry's views to present to Parliament before the deadline on February 24. "The 1985 regulations are not enforced; they are old and out of step with other countries," she said. "It will step up the domestic market and create a level of reassurance for the public where all products available on the market will be of a very high quality."

ENZCAM Newsletter TM/CAM Update February 2012 Page 2 2. Research Organisations

National Research Center in Complementary and Alternative Medicine (NAFKAM) http://en.uit.no/ansatte/organisasjon/hjem?p_dimension_id=88112&p_menu=42374

NAFKAM is organized as a center at the Faculty of Medicine, the University of Tromsø, Norway, and it is funded by the Norwegian Ministry of Health and Care Services.

NAFKAM promotes, implements and coordinates Norwegian research in complementary and alternative treatment. The center emphasises multidisciplinary research. In addition NAFKAM is working with education, consultancy services, international and national cooperation/network building and information. NAFKAM was designated as a WHO Collaborating Centre for Traditional Medicine in 2008.

The Registry of Exceptional Courses of Disease http://uit.no/ansatte/organisasjon/artikkel?p_menu=42374&p_document_id=91200&p_dimension_ id=88112 This is a Scandinavian registry run by NAFKAM. The registry is collecting information from people who have experienced an exceptional course of disease after the use of alternative treatment compared to what was expected based upon medical examinations.

NIFAB ‐ The National CAM Information Bank http://www.nifab.no/om_nifab/information_in_english In 2004 the Norwegian government gave the first budget appropriation for the creation of a national CAM information bank. The aim of this knowledge‐based database is to provide Norwegian and English speaking users with unbiased research based information about complementary and alternative medicine (CAM). The National CAM Information Bank, NIFAB, was launched in May 2007. Read more at http://www.nifab.no/.

European Information Centre for Complementary & Alternative Medicine (EICCAM) http://www.eiccam.eu/home.php?il=1&l=eng

The worldwide use of CAM (Complementary and Alternative Medicine) has grown considerably in the past 20 years. Analysing surveys done over the past ten years the general conclusion can be made that 20% of the EU‐citizens have a clear preference for CAM healthcare; another 20% are regular users of CAM. More than 100 million citizens in the EU make use of CAM today.

The most commonly used CAM therapies in Europe are: homeopathy, phytotherapy (=herbal medicine), anthroposophic medicine, naturopathy, traditional Chinese medicine (including acupuncture), osteopathy and chiropractic.

The European Information Centre for Complementary and Alternative Medicine (EICCAM) has been created with the aim of providing and disseminating understandable, objective and high‐quality information on the safety, effectiveness and efficiency of Complementary and Alternative Medicine

ENZCAM Newsletter TM/CAM Update February 2012 Page 3

(CAM). EICCAM has been set up as a Public Utility Foundation under Belgian Law, with a Management Board and a Scientific Board.

Research Facts http://www.eiccam.eu/home.php?il=7&l=eng EICCAM Research Facts are intended to illustrate the type and quality of research that has been conducted into the effects and costs of specific complementary therapies on important health conditions or on an aspect of interest such as mechanism of action of a therapy.

Each fact sheet summarises a research study on a specific complementary therapy and then discusses the study's strengths and weaknesses. Potential implications of each study's findings for decision‐making are discussed.

3. Practitioner Organisations

PHAA establishes a new CAM special interest group http://norphcam.org/pages/posts/phaa‐establishes‐a‐new‐cam‐special‐interest‐group‐october‐ 201161.php

The Public Health Association of Australia (PHAA) has established a new Special Interest Group (SIG) on 'Evidence, Research and Policy in Complementary Medicine'. This new group is a major boost to the NORPHCAM vision and programme helping to develop rigorous public health debate, research and scholarship focused upon complementary medicine in Australia and internationally.

The SIG is proud to announce that early work is focused upon developing collaborative ties and activities with the equivalent SIG at the American Public Health Association (APHA) … For information on the new PHAA SIG please see the link below: http://www.phaa.net.au/complementaryMedicine.php

4. Books

Clinical Research in Complementary Therapies, 2nd Edition Principles, Problems and Solutions Edited by George Thomas Lewith, Wayne B. Jonas and Harald Walach Published December 2010 http://www.elsevier.ca/ISBN/9780443069567/Clinical‐Research‐in‐Complementary‐Therapies http://www.amazon.com/Clinical‐Research‐Complementary‐Therapies‐Principles/dp/0443063672

“There is a considerable and increasing interest in research related to complementary therapies to establish a base of research results which will support practice. However, not all therapies can be treated the same way, either from the same perspective of what health and treatment are, or channelled through the process of randomized, controlled trials. This book analyzes the key questions often asked and the controversies debated in complementary medicine research, and offers clear guidance written by experts in this field.”

ENZCAM Newsletter TM/CAM Update February 2012 Page 4

Randomized Controlled Trials: Questions, Answers and Musings, 2nd Edition By Alehandro R. Jadad, Murray W. Enkin Published 2007 http://au.wiley.com/WileyCDA/WileyTitle/productCd‐1405132663.html http://www.amazon.com/Randomised‐Controlled‐Trials‐Questions‐Answers/dp/1405132663

Randomized controlled trials are one of the most powerful and revolutionary tools of research. This book is a convenient and accessible description of the underlying principles and practice of randomized controlled trials and their role in clinical decision‐making.

Structured in a jargon‐free question‐and‐answer format, each chapter provides concise and understandable information on a different aspect of randomized controlled trials, from the basics of trial design and terminology to the interpretation of results and their use in driving evidence‐based medicine. The authors end each chapter with their musings, going beyond the evidence or citations, and sometimes even beyond orthodox correctness to share their thoughts and concerns about different aspects of randomized controlled trials, and their role within the health system.

Updated to include insights from the last decade, this second edition challenges over‐reliance on randomized controlled trials by debating their strengths and limitations and discussing their optimal use in modern healthcare. It also includes a new and increasingly relevant chapter on the ethics of randomized trials.

5. Journals

African Journal of Traditional, Complementary and Alternative medicines (AJTCAM) [First listed in ENZCAM Newsletter October 2011] Volume 9, Number 3S: Special Issue 2012 Traditional medicine in the era of HIV/AIDS in South Africa http://journals.sfu.ca/africanem/index.php/ajtcam/issue/view/73

Selected articles:  In Vitro Testing of African Traditional Medicines for Cytotoxic, Immune Modulatory and Anti‐ HIV Activities  A Model for the Incorporation of the Traditional Healers into the National Health Care Delivery System Of South Africa  Traditional Complementary and Alternative Medicine: Knowledge, Attitudes and Practices of Health Care Workers in HIV and AIDS Clinics in Durban Hospitals  Perspectives of Traditional Health Practitioners on the Use of Microbicides for the Prevention of HIV

ENZCAM Newsletter TM/CAM Update February 2012 Page 5

 The Immunomodulatory Effects of Sutherlandia Frutescens Extracts in Human Normal Peripheral Blood Mononuclear Cells  Evaluation of Traditional Medicines I: Identification of Phela Using Different Chromatographic Techniques  Evaluation of Traditional Medicines II: The Use Of Metabolite Peak‐Kinetics  Evaluation of Traditional Medicines III: The Mechanism of Immune Modulation by Phela.

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 1: February 2012 http://online.liebertpub.com/toc/act/18/1

Selected articles:  Neurodegenerative Disease: Part 1—Common Pathways to Brain Injury in Alzheimer’s and Parkinson’s Disease  Diagnostic Challenges and Treatment Options for Thyroid Conditions  Integrative Nurse Coaching for Health and Wellness  Patients and Evidence Motivate Hospitals’ Increase in CAM Services  American Indian Health: Integrating Traditional Native Healing Practices and Western Medicine  Botanical Medicines and Ionizing Radiation: Part 2—Radiosensitizing Herbs  Moving Forward in Integrative Oncology: An Interview with Gary E. Deng, MD, PhD  Peripheral Vascular Disease: An Integrative Approach: A Natural Standard Monograph  Clinical Roundup: Selected Treatment Options for Chronic Prostatitis

Complementary Therapies in Clinical Practice [First listed in ENZCAM Newsletter June 2011] Volume 18, Number 1: February 2012 http://www.ctcpjournal.com/issues

Selected articles:  Effect of an integrated support programme on the concerns and wellbeing of women with breast cancer: A national service evaluation  Complementary and alternative medicine use amongst Palestinian diabetic patients  Ginger to reduce nausea and vomiting during pregnancy: Evidence of effectiveness is not the same as proof of safety  Tai Chi effects on neuropsychological, emotional, and physical functioning following cancer treatment: A pilot study  The healers journey: A literature review  Delivering shiatsu in a primary care setting: Benefits and challenges  Place visualization: Conventional or unconventional practice?  Use of complementary and alternative medicine by patients seen at the dermatology department of a tertiary care center  Impact of self‐administered relaxation and guided imagery techniques during final trimester and birth  Episiotomy pain relief: Use of Lavender oil essence in primiparous Iranian women

ENZCAM Newsletter TM/CAM Update February 2012 Page 6 Complementary Therapies in Medicine [First listed in ENZCAM Newsletter May 2011] Volume 20, Number 1‐2: February‐April 2012 http://www.complementarytherapiesinmedicine.com/issues

Selected articles:  Randomised controlled trial with medical leeches for osteoarthritis of the knee  Measuring possible effect on health‐related quality of life by tactile massage or relaxation in patients  Osteopathic manipulative treatment effectiveness in severe chronic obstructive pulmonary disease: A pilot study  A network‐based analysis of traditional Chinese medicine cold and hot patterns in rheumatoid arthritis  A pilot study to compare the views of traditionally trained and CAM‐trained therapists using the clinical exemplar of the management of neck/upper limb pain to assess barriers to effective integration of approaches  Factors influencing the use of complementary and alternative medicine and whether patients inform their primary care physician  Measuring differential beliefs in complementary therapy research: An exploration of the Complementary and Alternative Medicine Beliefs Inventory (CAMBI)  Evaluating the impact of cancer on complementary and alternative medicine use, distress and health related QoL among Australian women: A prospective longitudinal investigation  Complementary medicine and safety: A systematic investigation of design and reporting of systematic reviews  Placebo effect was influenced by publication year in three‐armed acupuncture trials  Future perspectives of personalized medicine in traditional Chinese medicine: A systems biology approach  Quality of herbal medicines: Challenges and solutions

Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] February 2012 http://www.hindawi.com/journals/ecam/contents/

Selected articles:  Hematopoietic Cell Transplant and Use of Massage for Improved Symptom Management: Results from a Pilot Randomized Control Trial  Potent Antifungal Activity of Pure Compounds from Traditional Chinese Medicine Extracts against Six Oral Candida Species and the Synergy with Fluconazole against Azole‐Resistant Candida albicans  Traditional Chinese Herbal Patch for Short‐Term Management of Knee Osteoarthritis: A Randomized, Double‐Blind, Placebo‐Controlled Trial  Systematic Review of Chinese Herbal Medicines for Preventing in‐Stent Coronary Restenosis after Percutaneous Coronary Intervention  Reliability and External Validity of AMSTAR in Assessing Quality of TCM Systematic Reviews  Effect of Human Placental Extract on Health Status in Elderly Koreans [Note: the use of human placenta was recently the topic of television news stories in New Zealand]

ENZCAM Newsletter TM/CAM Update February 2012 Page 7

 The Effects of Meditation on Perceived Stress and Related Indices of Psychological Status and Sympathetic Activation in Persons with Alzheimer's Disease and Their Caregivers: A Pilot Study  A Survey of Complementary and Alternative Medicine Use in Cancer Patients Treated with Radiotherapy in Thailand  Acupuncture Use among American Adults: What Acupuncture Practitioners Can Learn from National Health Interview Survey 2007?  Acupuncture for the Treatment of Opiate Addiction  History and Mechanism for Treatment of Intracerebral Hemorrhage with Scalp Acupuncture

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 2: February 2012 http://online.liebertpub.com/toc/acm/18/2

 Patient–Practitioner–Remedy: Quantum Interactions in Living Systems  The Shortcomings of Clinical Trials Assessing the Efficacy of Probiotics in Irritable Bowel Syndrome  Analysis on Postmortem Tissues at Acupuncture Points in the Image Datasets of Visible Human Project  Hegu Acupuncture for Chronic Low‐Back Pain: A Randomized Controlled Trial  Effects of Noninvasive Electroacupuncture at Hegu (LI4) and Sanyinjiao (SP6) Acupoints on Dysmenorrhea: A Randomized Controlled Trial  Effect of Whole‐Body Vibration Exercise on Balance in Women with Fibromyalgia Syndrome: A Randomized Controlled Trial  Utilizing Mobile Networks for the Detection of Clinically Relevant Interactions Between Chemotherapy Regimens and Complementary and Alternative  The Analgesic Effect of Thermal Therapy After Total Knee Arthroplasty  A Homeopathic Approach to Treat Patients with Advanced Gallbladder, Periampullary, and Liver Carcinomas: A Report of 3 Cases

6. Conferences

A Mechanism‐Based Natural Product Development Conference 21 and 22 September 2012, Whistler Mountain Convention Centre, British Columbia, Canada http://www.naturalproductswhistler.com/

“We are bringing together some of the leading thinkers in the natural medicines and science fields. They will explore the discovery and development of therapeutic natural product medicines from the perspectives of systems biology, clinical and preclinical studies, and quality assurance.” Convernor, Professor Basil Roufogalis, Pharmaceutical Chemistry, University of Sydney

ENZCAM Newsletter TM/CAM Update February 2012 Page 8 5th Western Africa Network of Natural Products Research Scientists August 6‐9, 2012, Iloko, Osun State, Nigeria http://journals.sfu.ca/africanem/index.php/ajtcam/announcement/view/25

Theme: Tackling non‐infectious diseases with medicinal plants and natural products. A special Session will also be devoted to Traditional Medical Practitioners presentations

Information on the background of WANNPRES can be found on: www.wannpres.net

Online registration: http://ocs.wannpres.net/index.php/waamps/waamps )

7. Health System and Academic Integration of TM/CAM

Integrative Medicine in America http://www.bravewell.org/current_projects/mapping_field/ A new publication from the Bravewell Collaborative, “Integrative Medicine in America: How Integrative Medicine Is Being Practiced in Clinical Centers Across the United States” provides current data on the patient populations and health conditions most commonly treated with integrative strategies. In a survey of 29 U.S. integrative medicine centers, 75 percent reported success using integrative practices to treat chronic pain and more than half reported positive results for gastrointestinal conditions, depression and anxiety, cancer and chronic stress. “With chronic health issues costing the U.S. economy more than $1 trillion a year, it’s essential to find the most effective ways to treat and prevent the most prevalent conditions,” said Donald Abrams, MD, co‐author of the report and professor of clinical medicine at the University of California San Francisco. “This report demonstrates how an integrative approach is being used to improve patient outcomes.” With thanks to John Weeks for the link http://www.huffingtonpost.com/john‐weeks/integrative‐medicine_b_1281103.html

USA Indian Health Service Includes Licensed Naturopaths, Acupuncturists and Chiropractors in Loan Repayment Program “A bit of integrative medicine history was made in January 2012 when the U.S. Indian Health Service (IHS) quietly announced that licensed naturopathic doctors, acupuncturists and chiropractors would be included in 2012 in the IHS' student loan repayment programs. The announcement magnetized students and recent graduates. … The inclusion was immediately celebrated by the American Association of Naturopathic Physicians (AANP). The American Chiropractic Association followed suit with a release to their own members. … The AANP letter suggests hopefully that "this paves the way for inclusion in all federal loan repayment programs and is a significant step towards equity in education for naturopathic students."” Source: John Weeks http://www.huffingtonpost.com/john‐weeks/integrative‐medicine_b_1251375.html

ENZCAM Newsletter TM/CAM Update February 2012 Page 9

8. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

February 2012: The Flu, the Common Cold, and Complementary Health Practices http://nccam.nih.gov/health/providers/digest/coldflu.htm

Each year, approximately 5 to 20 percent of Americans come down with the flu. Although most recover without incident, flu‐related complications result in more than 200,000 hospitalizations and between 3,000 and 49,000 deaths each year. Colds generally do not cause serious complications, but they are among the leading reasons for visiting a doctor and for missing school or work.

To prevent or treat these illnesses, some people turn to complementary health practices such as herbs or vitamins and minerals. This issue provides information on “what the science says” about some of these practices for the flu and for the common cold, including zinc, vitamin C, echinacea, and probiotics.

Produced for ENZCAM by Heather McLeod and Ray Kirk

9 March 2012

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

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New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

ENZCAM Newsletter TM/CAM Update March 2012

1. CAM in Israel

The Israel Journal of Health Policy Research published an article and a commentary on CAM in Israel in February 2012. See http://www.ijhpr.org/content/1/February/2012

In the paper “Complementary and alternative health care in Israel” by Judith T Shuval and Emma Averbuch, the authors said:

“The present paper draws on over ten years of research on CAM in Israel that included observation, survey research, and more than one hundred in‐depth interviews with a variety of CAM practitioners ‐ many with bio‐medical credentials ‐ and with policy makers in the bio‐medical system. The overall goal of that research was to explore the multiplicity of empirical types of coexistence between alternative and bio‐medicine that have emerged in Israel.”

“The principal forms of CAM practiced in Israel include homeopathy, Chinese medicine, acupuncture, herbal medicine, reflexology, Reiki, shiatsu, chiropractic, biofeedback, Ayurvedic Medicine, naturopathy, massage techniques, Bach flower remedies, Feldenkrais, anthroposophy, Tuina, osteopathy, Paula (a system of orifice muscle exercises developed in Israel), and others. While this list is not comprehensive, it includes the forms of CAM practice that have generally been incorporated into the clinics of the public medical care system in Israel and in many private clinics. Folk and traditional forms of health care, which may also be viewed as a form of CAM, have not been incorporated into the medical care system …”.

“In 2011 there were an estimated 20,000 CAM practitioners working full time and part time in Israel. Of these only 2,800 are members of professional organizations representing a wide variety of CAM specialties …”. “Data from a survey in Israel by BDI‐COFACE in 2008 indicate 1,750,000 CAM visits a year or 145,833 a month [compared to a total population of 7.5 million in 2009].

“There were approximately 60 programs for teaching CAM in Israel in the framework of courses lasting between three months to four years. The courses vary widely in the quality of training they provide. There is no supervision or control regarding content. … The four medical schools vary in their attitudes to CAM. Some include short elective courses about CAM but none include such courses in the compulsory curriculum. At the same time, Israeli medical students show a high level of interest in CAM: 79% of medical students in their last year of study expressed an interest in learning about CAM during their course of study; 65% stated that they would be interested in applying CAM techniques to treat patients …”.

ENZCAM Newsletter TM/CAM Update March 2012 Page 2

“Sixty‐five percent of CAM services in Israel are provided in the public sector of the health care system: by three of the sick funds and about one‐third of the hospitals.

In a commentary, Jeffrey Borkan said: “As Shuval and Averbuch note, despite the widespread use of CAM practices in Israel, there is relatively little governmental control and, to date, no formal jurisdictional regulation or licensing procedures have been established. Though often ascribed to the domination of bio‐medicine in Israel, other important factors that have resulted in this regulatory chasm may be the sheer number and literal cacophony of treatment modalities, providers, and training standards. Having done research on CAM in Israel in the past and recently informally sampled CAM in two areas in Israel, I am impressed by the spectrum of practices that vary from common choices such as acupuncture to offshoots of esoteric movement therapies to spirit mediums. Regulating and controlling such a range of therapeutic modalities would be challenging, if not impossible.”

With thanks to Paolo Roberti di Sarsina for the links

2. NCCAM Third Strategic Plan 2011–2015

On 4 February 2011, the National Center for Complementary and Alternative Medicine (NCCAM) in the USA “released its third strategic plan, Exploring the Science of Complementary and Alternative Medicine: Third Strategic Plan 2011–2015. The plan presents a series of goals and objectives to guide NCCAM in determining priorities for future research in complementary and alternative medicine.”

The full report is available at: http://nccam.nih.gov/about/plans/2011

“According to the 2007 National Health Interview Survey, which gathered information on more than 32,800 Americans, 38.2 percent of adults in the United States aged 18 years and over and nearly 12 percent of children aged 17 years and under used some form of CAM within the previous 12 months. Use among adults remained relatively constant from previous surveys. The 2007 survey provided the first population‐based estimate of children’s use of CAM.”

“Americans spent $33.9 billion out‐of‐pocket on CAM during the 12 months prior to the survey. This accounts for approximately 1.5 percent of total United States health care expenditures, but 11.2 percent of total out‐of‐pocket expenditures. A substantial portion of this expenditure is self‐care (i.e., does not include the guidance of a health care provider or CAM practitioner).”

The Director said:

“At its core is a vision in which rigorous scientific evidence about complementary and alternative medicine (CAM) informs both the decisions Americans make regarding CAM use and the potential for integration of CAM interventions into health care.

NCCAM’s first decade was a period of rapid growth in which we studied a wide array of CAM modalities. As we move into our second decade, we will build on this foundation by focusing a portion of our efforts on study of specific CAM approaches that show the greatest promise to improve upon existing treatment and health promotion strategies.”

ENZCAM Newsletter TM/CAM Update March 2012 Page 3

NCCAM Strategic Objectives

“This plan seeks to address three long‐range goals…:  GOAL 1: Advance the science and practice of symptom management.  GOAL 2: Develop effective, practical, personalized strategies for promoting health and well‐ being.  GOAL 3: Enable better evidence‐based decision‐making regarding CAM use and its integration into health care and health promotion. The plan is organized around the following five strategic objectives, which are summarized below and discussed in greater detail in the [document]. Each strategic objective serves, to varying and often overlapping degrees, the above three long‐range goals.  Advance research on mind and body interventions, practices, and disciplines.  Advance research on CAM natural products.  Increase understanding of “real world” patterns and outcomes of CAM use and its integration into health care and health promotion.  Improve the capacity of the field to carry out rigorous research.  Develop and disseminate objective, evidence‐based information on CAM interventions.”

The Range of Research Questions

“While the need for clinical research evidence is at the heart of NCCAM’s mission, developing that evidence requires support across the continuum of basic, translational, and clinical research.

 Basic science: defining biological effects and mechanisms of action; clarifying scientific hypotheses; supporting development of translational tools.

ENZCAM Newsletter TM/CAM Update March 2012 Page 4

 Translational research: identifying and validating biomarkers or other signatures of biological effect; developing and validating measures of outcome; validating treatment algorithms and measures of quality control; developing preliminary clinical evidence regarding efficacy and safety; establishing feasibility or estimates of sample size for future studies

 Efficacy studies: determining the specific effects of an intervention under carefully controlled conditions that minimize nonspecific and contextual effects

 Outcomes and effectiveness research: studying usefulness and safety in general populations or health care settings.

3. Research Organisations

The Richard and Hinda Rosenthal Center for Complementary and Alternative Medicine New York‐Presbyterian Hospital/Columbia University Medical Centre. http://nyp.org/services/complementary.html

The Center “was created to facilitate and conduct rigorous scientific investigation to evaluate the effectiveness, safety, and mechanisms of action of alternative and complementary practices. The Center's research is carried out with intrinsic interest in and respect for the traditions from which many alternative therapies originate, and is mindful of the importance of the subjective human experience to health and healthcare. The Center also serves as a forum for identification and discussion of social, economic, environmental, and political considerations influencing complementary and alternative medicine in order to inform policy decisions.”

The Samueli Institute http://www.samueliinstitute.org/

“The mission of Samueli Institute is to transform health care through the scientific exploration of healing.” “Samueli Institute advises health care professionals and health policy planners on important research questions regarding complementary, alternative and integrative medicine. As an independent scientific adviser, the Institute strives to provide research that is unbiased, evidence‐ based and grounded in science.” “The Institute’s Integrative Medicine and Clinical Research (IM) program conducts rigorous and pragmatic clinical and health services research that explores healing and wellness with a commitment to conducting research that can be readily translated into clinical practice.” See http://www.samueliinstitute.org/research/research‐home/integrative‐medicine.html

ENZCAM Newsletter TM/CAM Update March 2012 Page 5 The Bravewell Collaborative http://www.bravewell.org/bravewell_collaborative/

“The Bravewell Collaborative is a community of philanthropists who work together to transform the health care system and improve the health of the American public through the advancement of integrative medicine. “Integrative medicine is a philosophy of care that puts the patient at the center and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences affecting a person’s health. Bravewell believes that by addressing the whole person and shifting the focus of health care to prevention, health maintenance, and early intervention, integrative medicine holds the power to transform the economic models that impede our present system and vastly improve the health of the public, which is essential to our nation’s future.”

The Bravewell Collaborative Declaration for a New Medicine http://www.bravewell.org/integrative_medicine/declaration_for_a_new_medicine/

“Transforming health care means moving the boundaries of the existing field of medicine to include the wisdom inherent in healing the "whole person"—mind, body and spirit. People drawn to integrative medicine—as providers, patients or philanthropists—are attracted to it because their values match those of this approach to health and healing. The Declaration is a reflection of the values The Bravewell Collaborative believes characterize integrative medicine at its best.”

Critique of Bravewell Report on Integrative Medicine in America (report covered in ENZCAM Newsletter February 2012) The two links below provide a critique of the description of “integrative medicine” as used in the report: http://theintegratorblog.com/index.php?option=com_content&task=view&id=811&Itemid=189 http://theintegratorblog.com/index.php?option=com_content&task=view&id=814&Itemid=189

With thanks to John Weeks for the links

4. Conferences

Symposium "Beyond the Placebo" Biomedical, Clinical and Philosophical Aspects of the Placebo Effect. 22‐25 August 2012, University of Zurich, Switzerland http://www.ethik.uzh.ch/ibme/veranstaltungen/placebo.html

“Many issues related to placebos and placebo effects puzzle physicians, patients, and the scientific community. Are placebo effects clinically relevant? How can they be understood in neurophysiological and neurophilosophical perspectives? What is their place in modern medicine? The aim of the symposium is to bring together a multidisciplinary group of researchers to set the current knowledge in a broader context and to discuss the implications for the goal of good health care.”

ENZCAM Newsletter TM/CAM Update March 2012 Page 6

Up‐coming conferences on CAM and integrative healthcare in the Australasian region:

New Zealand:

Integrative Medicine, the Art, Science and Politics The Australasian Integrative Medicine Association – New Zealand (AIMA‐NZ) 28‐29 April 2012, Massey University, Auckland http://www.aima.net.au/aima_nz/new_zealand_2012.html

Australia:

Clinical Complementary Healthcare Summit 2012: "Medicine of the future" 23‐24 June 2012 in Melbourne http://www.healthcaresummit.com.au/

18th International Integrative Medicine Conference “Bridging the Gap” The Australasian Integrative Medicine Association (AIMA) 31 August – 2 September 2012 http://www.aima.net.au/events/conference_2012.html

Gawler Foundation Profound Healing, Sustainable Well‐being Conference 17‐18 November 2012 in Melbourne http://www.gawler.org/2012‐conference/

5. Books

Clinical Research in Complementary and Integrative Medicine: A Practical Training Book By Claudia Witt and Klaus Linde Publication Date: September 2011 http://www.amazon.co.uk/Clinical‐Research‐Complementary‐Integrative‐Medicine/dp/0702034762

“You want to conduct a CAM study but don't know how? Problem solved ‐ "Clinical Research" demonstrates all aspects of state‐of‐the‐art study design in an understandable and practical way. You will get a comprehensive overview and instruction ‐ step by step. The code in the book will give you 12 months of free online access to the content and illustrations of the book.”

Prof. Dr. Claudia Witt is V ice Director of the Institute for Social Medicine, Epidemiology and Health Economics, University Medical Center Charité, in Berlin. She is the current president of the International Society for Complementary Medicine Research (ISCMR). http://www.iscmr.org/

ENZCAM Newsletter TM/CAM Update March 2012 Page 7 6. Journals

BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] March 2012 http://www.biomedcentral.com/bmccomplementalternmed/content

Selected articles:  Effect of self‐administered auricular acupressure on smoking cessation ‐‐a pilot study  A placebo‐controlled trial of Korean red ginseng extract for preventing Influenza‐like illness in healthy adults  Acupuncture as a therapeutic treatment option for threatened miscarriage  An update on the strategies in multicomponent activity monitoring within the phytopharmaceutical field  Anthelmintic and relaxant activities of Verbascum Thapsus Mullein  Effect of hawthorn standardized extract on flow mediated dilation in prehypertensive and mildly  Randomized trial of Tapas Acupressure Technique for weight loss maintenance

Complementary Therapies in Medicine [First listed in ENZCAM Newsletter May 2011] Volume 20, Number 1‐2: February‐April 2012 http://www.sciencedirect.com/science/issue/272589‐1‐s2.0‐S0965229912X00025

Selected articles:  Randomised controlled trial with medical leeches for osteoarthritis of the knee  Measuring possible effect on health‐related quality of life by tactile massage or relaxation in patients with type 2 diabetes  Osteopathic manipulative treatment effectiveness in severe chronic obstructive pulmonary disease: A pilot study  A network‐based analysis of traditional Chinese medicine cold and hot patterns in rheumatoid arthritis  Peripheral pulsed electromagnetic fields may reduce the placebo effect in migraine patients that do not respond to the sham intervention in a randomized, placebo‐controlled, double‐ blind, cross‐over clinical trial  A pilot study to compare the views of traditionally trained and CAM‐trained therapists using the clinical exemplar of the management of neck/upper limb pain to assess barriers to effective integration of approaches  Factors influencing the use of complementary and alternative medicine and whether patients inform their primary care physician  Measuring differential beliefs in complementary therapy research: An exploration of the Complementary and Alternative Medicine Beliefs Inventory (CAMBI)

ENZCAM Newsletter TM/CAM Update March 2012 Page 8

 Evaluating the impact of cancer on complementary and alternative medicine use, distress and health related QoL among Australian women: A prospective longitudinal  Profile of minority and under‐served patients using acupuncture  Complementary medicine and safety: A systematic investigation of design and reporting of systematic reviews  Placebo effect was influenced by publication year in three‐armed acupuncture trials  Future perspectives of personalized medicine in traditional Chinese medicine: A systems biology approach  Quality of herbal medicines: Challenges and solutions

European Journal of Integrative Medicine [First listed in ENZCAM Newsletter May 2011] Volume 4, Number 1: March 2012 http://www.europeanintegrativemedicinejrnl.com/issues

Selected articles:  Ethical integrative pediatric care: A new perspective  Pediatric integrative medicine and the balance of power  Focus groups used to explore patients’ experience in a randomised controlled trial of traditional Chinese acupuncture for chronic stress  The perceived impact of integrative medicine in a surgical department  Introducing integrative integrated migraine care (IIMC): A model and case presentation  Effect of oriental medicine music therapy on idiopathic chronic fatigue: A case study  Effects of auricular stimulation on obese women: A randomized, controlled clinical trial  A survey of health professionals’ views about integration of Traditional Chinese Medicine (TCM) Acupuncture into NHS Scotland  Perceptions and self‐use of Complementary and Alternative Medicine (CAM) among Malaysian dental students  Application of complementary and alternative medicine in epileptic children at a tertiary pediatric neurology center in Turkey  Citation classics in the integrative and complementary medicine literature: 50 frequently cited articles  Chinese herbal medicines for treatment of hand, foot and mouth disease: A systematic review of randomized clinical trials

Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] Notification received in March 2012 http://www.hindawi.com/journals/ecam/contents/

Selected articles:  The Movement Imagery Questionnaire‐Revised, Second Edition (MIQ‐RS) Is a Reliable and Valid Tool for Evaluating Motor Imagery in Stroke Populations  A Six‐Month Supplementation of Mulberry, Korean Red Ginseng, and Banaba Decreases Biomarkers of Systemic Low‐Grade Inflammation in Subjects with Impaired Glucose Tolerance and Type 2 Diabetes  Sino‐European Transcontinental Basic and Clinical High‐Tech Acupuncture Studies—Part 2: Acute Stimulation Effects on Heart Rate and Its Variability in Patients with Insomnia

ENZCAM Newsletter TM/CAM Update March 2012 Page 9

 Neural Acupuncture Unit: A New Concept for Interpreting Effects and Mechanisms of Acupuncture  A Study of the Wound Healing Mechanism of a Traditional Chinese Medicine, Angelica sinensis, Using a Proteomic Approach  Clinical and Epidemiological Investigation of TCM Syndromes of Patients with Coronary Heart Disease in China  A Study of Prognosis, Outcome, and Changing Tendency of Hospitalized AMI Patients in Beijing Third‐Grade A‐Level Traditional Chinese Medicine Hospitals from 1999 to 2008  Design and Methods for a Pilot Study of a Phone‐Delivered, Mindfulness‐Based Intervention in Patients with Implantable Cardioverter Defibrillators

Explore: The Journal of Science and Healing [First listed in ENZCAM Newsletter May 2011] Volume 8, Number 2: March 2012 http://www.explorejournal.com/issues

Selected articles:  Integrative Medicine in 2021: An Imagined Retrospective  Survey of Integrative Medicine Centers Released  Social Values, Social Wellness: Can We Know What Works?  A Mind‐Body Technique for Symptoms Related to Fibromyalgia and Chronic Fatigue  Randomized Expectancy‐Enhanced Placebo‐Controlled Trial of the Impact of Quantum BioEnergetic Distant Healing and Paranormal Belief on Mood Disturbance: A Pilot Study  How Might Yoga Help Depression? A Neurobiological Perspective  Longitudinal Impact of Yoga on Chemotherapy‐Related Cognitive Impairment and Quality of Life in Women with Early Stage Breast Cancer: A Case Series  Saw Palmetto, Chinese Red Yeast Extract, Music Therapy, Ginkgo Biloba, Increased Practitioner Interaction  Teaching Anatomy to Chiropractic Students: Experiences from Macquarie University, Sydney

Comparative Effectiveness Research http://www.dovepress.com/comparative‐effectiveness‐research‐journal

A new “international, peer‐reviewed open access journal focusing on comparative effectiveness of health care including preventative health care strategies, diagnostic strategies, diagnostic technology, medical devices, drugs, medical technology, health systems and organization.”

“Comparative Effectiveness Research seeks papers concerning all aspects of comparative effectiveness research. We welcome papers presenting empirical results from trials, observational studies, and research syntheses. We encourage papers discussing how effects are achieved and for whom (i.e., concerning moderation and mediation). We welcome papers reporting null findings. We encourage conceptual papers discussing theoretical, methodological, and analytical issues surrounding comparative effectiveness research.”

Although this is not specifically a CAM or integrative medicine journal, comparative effectiveness research can be a very useful approach for CAM research. Journal of Holistic Nursing [First listed in ENZCAM Newsletter April 2011]

ENZCAM Newsletter TM/CAM Update March 2012 Page 10

Volume 30, Number 1: March 2012 http://jhn.sagepub.com/content/30/1.toc

Selected articles:  Identifying the Diversity and Impact of Holistic Nursing Scholarship  A Concept Analysis of Person‐Centered Care  Becoming Whole: The Role of Story for Healing  T.R.U.S.T.: An Affirming Model for Inclusive Spiritual Care  Continuing Nursing Education for “T.R.U.S.T.: An Affirming Model for Inclusive Spiritual Care”  Soothability and Growth in Preterm Infants  Use of Creative Arts as a Complementary Therapy by Rural Women Coping With Chronic Illness  Mind Magic: A Pilot Study of Preventive Mind‐Body‐Based Stress Reduction in Behaviorally Inhibited and Activated Children

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 3: March 2012 http://online.liebertpub.com/toc/acm/18/3

Selected articles:  New Zealand Kanuka Honey Has High Levels of Methylglyoxal and Antimicrobial Activity no access  Ayurvedic Gender Differences Revisited  Earthing the Human Organism Influences Bioelectrical Processes  Use of Complementary Therapies for Cancer Symptom Management: Results of the 2007 National Health Interview Survey  Is the Diurnal Profile of Salivary Cortisol Concentration a Useful Marker for Measuring Reported Stress in Acupuncture Research? A Randomized Controlled Pilot Study  Stress Reduction with Osteopathy Assessed with GDV Electrophotonic Imaging: Effects of Osteopathy Treatment  Confidence in Clinical Practice of Chinese Medicine Degree Graduates 1 Year After Graduation: A Pilot Study  Comparing the Health Status of U.S. Taijiquan and Qigong Practitioners to a National Survey Sample Across Ages  Effects of Traditional Japanese Massage Therapy on Various Symptoms in Patients with Parkinson's Disease: A Case‐Series Study  Integrating a Complementary Medicine Service Within a General Surgery Department: From Contemplation to Practice

ENZCAM Newsletter TM/CAM Update March 2012 Page 11 7. NCCAM Clinical Digest

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

March 2012: Talking With Your Patients About Complementary Health Practices http://nccam.nih.gov/health/providers/digest/ttt

“Did you know that approximately 38 percent of adults (about 4 in 10) and approximately 12 percent of children (about 1 in 9) are using some type of complementary health practice? However, according to a telephone survey of people aged 50 and older, only a third of all respondents said they have ever discussed these practices with their health care providers.

To ensure safe, coordinated care among all conventional medicine and complementary health practices, it’s time to talk. Talking not only allows fully integrated care, but it also minimizes risks of interactions with a patient’s conventional treatments. When patients tell their providers about their use of complementary health practices, they can better stay in control and more effectively manage their health. When providers ask their patients, they can ensure that they are fully informed and can help patients make wise health care decisions.

This issue provides tips for starting the conversation with your patients, reliable resources on complementary health practices, and findings from the survey.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

10 April 2012

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update April 2012

1. The Advisory Committee on Complementary Medicines (ACCM), Australia http://www.tga.gov.au/about/committees‐accm.htm

“The Advisory Committee on Complementary Medicines (ACCM) was formed in January 2010 to advise and make recommendations to the Therapeutic Goods Administration (TGA) on the inclusion, variation or retention of a complementary medicine in the Australian Register of Therapeutic Goods.

ACCM may also provide advice to the TGA on any other matters concerning complementary medicines, and any other matters referred to it by the TGA (whether or not related to a complementary medicine).ACCM supersedes the Complementary Medicines Evaluation Committee (CMEC) and has an increased focus on the advisory role within the regulatory framework of complementary medicines.

A major role for ACCM is to provide scientific and policy advice relating to controls on the supply and use of complementary medicines in Australia. The ACCM provides this advice with particular reference to the safety and quality of products and, where appropriate, efficacy relating to the claims made for products.”

ACCM held its seventh meeting on 2nd September 2011 in Sydney. Extracts from the minutes were released on 12 April 2012. http://www.tga.gov.au/about/accm‐minutes‐2011‐07.htm Included in the minutes are sections on:  Guidelines on levels and kinds of evidence to support claims  Evaluation of new substances  Safety or efficacy reviews  Registration applications  Regulatory reforms  Adverse drug reactions associated with complementary medicines.

2. Swiss Government Report on Homeopathy

By Dana Ullman http://www.huffingtonpost.com/dana‐ullman/homeopathic‐medicine‐_b_1258607.html

“The Swiss government's "Health Technology Assessment" on homeopathic medicine is much more comprehensive than any previous governmental report written on this subject to date. Not only did this report carefully and comprehensively review the body of evidence from randomized double‐

ENZCAM Newsletter TM/CAM Update April 2012 Page 2 blind and placebo controlled clinical trials testing homeopathic medicines, they also evaluated the "real world effectiveness" as well as safety and cost‐effectiveness. The report also conducted a highly‐comprehensive review of the wide body of preclinical research (fundamental physio‐chemical research, botanical studies, animal studies, and in vitro studies with human cells).

[This] report evaluated systematic reviews and meta‐analyses, outcome studies, and epidemiological research. This wide review carefully evaluated the studies conducted, both in terms of quality of design and execution (called "internal validity") and how appropriate each was for the way that homeopathy is commonly practiced (called "external validity"). …

After assessing pre‐clinical basic research and the high quality clinical studies, the Swiss report affirmed that homeopathic high‐potencies seem to induce regulatory effects (e.g., balancing or normalizing effects) and specific changes in cells or living organisms.”

The Health Technology Assessment on Homeopathy was finalised in 2006 but published in book form in September 2011:

Homeopathy in Healthcare: Effectiveness, Appropriateness, Safety, Costs By Gudrun Bornhöft and Peter Matthiessen http://www.amazon.com/Homeopathy‐Healthcare‐Effectiveness‐Appropriateness‐ Safety/dp/3642206379

3. Research Organisations

Center for Integrative Medicine, University of Maryland School of Medicine (CIM) http://www.compmed.umm.edu/default.asp

Founded in 1991, CIM “is an inter‐departmental center within the University of Maryland School of Medicine. A leading international center for research, patient care, education and training in integrative medicine, the CIM is a National Institutes of Health (NIH) Center of Excellence for research in complementary medicine. Emphasizing an approach to healing that values mind, body, and spirit, the Center is committed to: Evaluating the scientific foundation of complementary medicine; Educating health professionals and the public; and Integrating evidence‐based complementary therapies into clinical care to help people achieve and maintain optimal health and well‐being.”

RAND Corporation: Complementary and Alternative Medicine http://www.rand.org/topics/complementary‐and‐alternative‐medicine.html

“RAND Health is a major research division within the RAND Corporation, a non‐profit institution headquartered in Santa Monica, California. RAND Health's mission is to serve as the world's most trusted source of objective analysis and effective solutions for improving health.” RAND Health includes more than 280 experts—physicians, economists, psychologists, mathematicians, organizational analysts, political scientists, psychometricians, medical sociologists, policy analysts, and statisticians.

ENZCAM Newsletter TM/CAM Update April 2012 Page 3

“RAND conducts evidence‐based research on alternative approaches to illness prevention and treatment as well as studies aimed at understanding the place of complementary and alternative medicines within the health care system.”

Integrated Healthcare Policy Consortium http://ihpc.info/about/about.shtml

“The Integrated Healthcare Policy Consortium (IHPC) is a broad coalition of healthcare professionals, patients and organizations driving public policy ….”

4. CAM Research ‐ Citation Classics: 50 frequently cited articles

Citation classics in the integrative and complementary medicine literature: 50 frequently cited articles

By Wilson W.S. Tam, Eliza L.Y. Wong ∗, Faye C.Y. Wong, Annie W.L. Cheung European Journal of Integrative Medicine Volume 4, Issue 1, March 2012 http://www.sciencedirect.com/science/article/pii/S187638201100179X

Aim of the study: The objective of the current study is to characterise the most frequently cited articles published in integrative and complementary medicine (ICM) journals.

Materials and methods: We utilised the ISI Journal Citation Reports: Science Edition 2009 database in May 2011 to determine the most frequently cited published articles. The top 50 most cited articles were selected and evaluated according to the type of journal, country of publication, topic, study design, and year of publication.

Results: The 50 selected articles were published in 7 out of 16 journals between 1980 and 2009, the majority of which originated from the US.

The most common study design was literature and systematic reviews. The efficacy of ICM on pain was the most common topic, followed by the anti‐inflammatory effect of ICM, prevalence of ICM utilisation, questionnaire development for pain, adverse effects of ICM, discussion of study design in ICM, chemical component of ICM, animal model testing, and obesity.

Conclusions: The findings provide a historical perspective on the scientific progress in integrative and alternative medicine. We revealed that majority papers (∼60%) were published between 1995 and 2004, suggesting that ICM has gained increasing attention since 1995. In terms of study design, review‐type and questionnaire‐related studies constituted approximately 60% of the articles. The actual number of citations from these articles was lower than the articles from the citation classics in other medical fields. The review of the articles having the greatest public recognition could help to establish and expand the role of ICM.

ENZCAM Newsletter TM/CAM Update April 2012 Page 4 5. Consumer Integration of TM/CAM

Complementary and alternative medicine use among older Australian women ‐ a qualitative analysis

By Deirdre McLaughlin, Chi‐Wai Lui and Jon Adams BMC Complementary and Alternative Medicine 2012 http://www.biomedcentral.com/1472‐6882/12/34/abstract

Background

The use of complementary and alternative medicines (CAM) among older adults is an emerging health issue, however little is known about older people's experiences of using CAM and the cultural, geographical and other determinants of CAM use in this population. This study used qualitative methods to explore older women's views of CAM and reasons for their use of CAM. Participants for the project were drawn from the Australian Longitudinal Study on Women's Health (ALSWH) 1921‐1926 birth cohort. …

Results

The women expressed a range of views on CAM which fell into three broad themes: "push" factors such as dissatisfaction with conventional health services, "pull" factors which emphasised the positive aspects of choice and self‐care in health matters, and barriers to CAM use. Overall, the "push' factors did not play a major role in the decision to use CAM, rather this was driven by "pull" factors related to health care self‐responsibility and being able to source positive information about types of CAM. A number of barriers were identified such as access difficulties associated with increased age, limited mobility and restricted transport options, as well as financial constraints.

6. Books

Evidence‐based Healthcare in Context: Critical Social Science Perspectives Edited by Alex Broom and Jon Adams Publication: January 2012 http://www.amazon.co.uk/Evidence‐Based‐Healthcare‐Context‐Alex‐Broom/dp/0754679810 http://www.fishpond.co.nz/Books/Evidence‐based‐Healthcare‐Context‐Alex‐Broom‐Jon‐ Adams/9780754679813

“With new methods of treatment standardisation resulting in various benefits for patient outcomes, evidence‐based medicine and evidence‐based practice have emerged as defining features of western healthcare provision in recent years. Most health professions are now adopting some form of 'evidence‐based' framework for clinical training and practice. However, the rise of evidence based healthcare has drawn sustained criticism regarding the limits of trial based evidence, the reductive character of epidemiological study designs, and the potential for an erosion of the importance of lay perspectives and clinical judgement.

"Evidence Based Healthcare in Context" introduces readers to the social, cultural and historical underpinnings of 'evidence' in healthcare, critically examining questions about what constitutes 'evidence' and 'effectiveness' from perspectives outside medicine, including those of patients, complementary medicine and midwifery.

ENZCAM Newsletter TM/CAM Update April 2012 Page 5

It focuses on the application of contemporary theoretical debates around the nature of medical and health knowledge, providing readers with a series of critical analyses of the production, application and translation of 'evidence' in a range of healthcare contexts. Featuring cutting edge work from leading social scientists in the UK, US, Canada, Norway, Australia and New Zealand, this volume draws on the latest empirical research to provide a thorough critical overview of this important field of health research.”

7. Journals

African Journal of Traditional, Complementary and Alternative medicines (AJTCAM) [First listed in ENZCAM Newsletter October 2011] Volume 9, Number 3, 2012 http://journals.sfu.ca/africanem/index.php/ajtcam

Selected articles:  Histological changes in male accessory reproductive organs in rats exposed to cigarette smoke and the protective effect of honey supplementation  Medicinal plants and formulations used by the Soren clan of the Santal tribe in Rajshahi district, Bangladesh for treatment of various ailments  Survey and scientific evaluation of medicinal plants used by the Pahan and Teli tribal communities of Natore district, Bangladesh  Medicinal plants used for treatment of diabetes by the Marakh sect of the Garo tribe living in Mymensingh district, Bangladesh  Radical scavenging activity of selected medicinal plants from Limpopo province of South Africa  Qualitative content analysis of complementary topical therapies used to manage diabetic foot in Jordan

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 2: April 2012 http://online.liebertpub.com/toc/act/18/2

Selected articles:  Neurodegenerative Disease: Part 2—Top Herbs and Supplements for Addressing Alzheimer’s and Parkinson’s Disease  What Every Clinician Should Know About Herb–Supplement–Drug Interactions  Current Controversies in Nutrition: Which Fat Do We Denigrate? Dietary Fat and the Follies of History  Herbal Formulas for Alleviating Symptoms of Tinnitus

ENZCAM Newsletter TM/CAM Update April 2012 Page 6

 Therapeutic Gardens and Horticultural Therapy: Growing Roles in Health Care  From Herbs to Medicines: Cocoa–Food and Medicine of the Gods  Data Support Antioxidant Use During Chemotherapy: An Interview with Keith I. Block, MD  Hops (Humulus lupulus): An Evidence‐Based Systematic Review by the Natural Standard Research Collaboration  Clinical Roundup: Selected Treatment Options for Female Infertility

Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] Published in April 2012 http://www.hindawi.com/journals/ecam/contents/

Selected articles:  Traditional Chinese Herbal Products for Coronary Heart Disease: An Overview of Cochrane Reviews  Safety and Efficacy of Tien‐Hsien Liquid Practical in Patients with Refractory Metastatic Breast Cancer: A Randomized, Double‐Blind, Placebo‐Controlled, Parallel‐Group, Phase IIa Trial  The Efficacy of Gelam Honey Dressing towards Excisional Wound Healing  Natural Product Nitric Oxide Chemistry: New Activity of Old Medicines  Sulfotanshinone Sodium Injection for Unstable Angina Pectoris: A Systematic Review of Randomized Controlled Trials  Atherosclerosis: An Integrative East‐West Medicine Perspective  Management of Hepatic Encephalopathy by Traditional Chinese Medicine  Efficacy and Safety of a Chinese Herbal Medicine Formula (RCM‐104) in the Management of Simple Obesity: A Randomized, Placebo‐Controlled Clinical Trial  Current Situation and Perspectives of Clinical Study in Integrative Medicine in China  A Systematic Review of Xuezhikang, an Extract from Red Yeast Rice, for Coronary Heart Disease Complicated by Dyslipidemia  Manual and Electroacupuncture for Labour Pain: Study Design of a Longitudinal Randomized Controlled Trial  Integrative Laser Medicine and High‐Tech Acupuncture at the Medical University of Graz, Austria, Europe  Biomedical Teleacupuncture between China and Austria Using Heart Rate Variability—Part 2: Patients with Depression  Complementary and Integrative Oncology in the Cross‐Cultural Region of the Middle East and South Asia  Astragalus Injection for Hypertensive Renal Damage: A Systematic Review

Journal of Evidence‐Based Complementary & Alternative Medicine [First listed in ENZCAM Newsletter April 2011] Volume 17, Number 2: April 2012 http://chp.sagepub.com/content/17/2.toc?etoc

Selected articles:  Role of Yoga in Preventing and Controlling Type 2 Diabetes Mellitus  Meditation for Quality Improvement of Medical Encounters: Single‐Intervention, Vedanta‐ Based Meditation Effects on Vital Signs and Mood Indices  Lovastatin Content of Commercially Available Red Yeast Rice Supplements

ENZCAM Newsletter TM/CAM Update April 2012 Page 7

 Treating Type 2 Diabetes: A Cross‐sectional Audit of Naturopathic Standards of Care Using the Naturopathic Patient Database  A Novel N of 1 Trial Design and Proposed Utility in Complementary and Alternative Medicine Research  Myofascial Structural Integration: A Promising Complementary Therapy for Young Children With Spastic Cerebral Palsy

Journal of Holistic Nursing [First listed in ENZCAM Newsletter April 2011] Volume 30, Number 1: March 2012 http://jhn.sagepub.com/content/30/1.toc

Selected articles:  A Concept Analysis of Person‐Centered Care  Becoming Whole: The Role of Story for Healing  T.R.U.S.T.: An Affirming Model for Inclusive Spiritual Care  Continuing Nursing Education for “T.R.U.S.T.: An Affirming Model for Inclusive Spiritual Care”  Soothability and Growth in Preterm Infants  Use of Creative Arts as a Complementary Therapy by Rural Women Coping With Chronic Illness  Mind Magic: A Pilot Study of Preventive Mind‐Body‐Based Stress Reduction in Behaviorally Inhibited and Activated Children

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 4: April 2012 http://online.liebertpub.com/toc/acm/18/4

Selected articles:  Stress‐Reducing Effects of Real and Artificial Nature in a Hospital Waiting Room  Reduction in Nausea and Vomiting in Children Undergoing Cancer Chemotherapy by Either Appropriate or Sham Auricular Acupuncture Points with Standard Care  Clinical Effects of Scalp Electrical Acupuncture in Stroke: A Sham‐Controlled Randomized Clinical Trial  Chiropractic or Osteopathic Manipulation for Children in the United States: An Analysis of Data from the 2007 National Health Interview Survey  A Model of Integrative Care for Low‐Back Pain  A Review of Tensions and Risks in Naturopathic Education and Training in Australia: A Need for Regulation  Policy Implications of Complementary and Alternative Medicine Use in Australia: Data from the National Health Survey  The Pulse Spectrum Analysis at Three Stages of Pregnancy  Chinese Herbal Medicine Danshen Formulations for Preventing Renal Disease in Henoch‐ Schönlein Purpura: A Systematic Review and Meta‐Analysis  Hypertonic Dextrose Injections (Prolotherapy) for Knee Osteoarthritis: Results of a Single‐Arm Uncontrolled Study with 1‐Year Follow‐Up  Urut Melayu, the Traditional Malay Massage, as a Complementary Rehabilitative Care in Postpartum Stroke  Low‐Back Pain, Leg Pain, and Chronic Idiopathic Testicular Pain Treated with Chiropractic Care

ENZCAM Newsletter TM/CAM Update April 2012 Page 8 8. NCCAM Clinical Digest

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

April 2012: Asthma and Complementary Health Practices http://nccam.nih.gov/health/providers/digest/asthma

“Asthma is a chronic lung disease that affects people of all ages. It causes episodes of wheezing, coughing, shortness of breath, and chest tightness. Although there is no cure, most people with asthma are able to manage the disease with medications and behavioral changes.

Researchers also are studying various complementary health approaches for asthma relief. This issue provides information on "what the science says" about complementary health practices for asthma, including acupuncture, breathing exercises, and herbs and other dietary supplements.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

4 May 2012

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update May 2012

1. CAM in Germany

“Every fifth MD uses CAM” and “about 30% of the German MDs providing outpatient treatment are using alternative therapies”

This article is reproduced from the CAMbrella newsletter, Spring 2012 http://www.cambrella.eu/home.php?il=174&l=deu

“Many German MDs are practising CAM, quite often they attend postgraduate courses related to CAM, and the citizens benefit from good reimbursement options.

In Germany the citizens have quite a lot of choices regarding health care, and there is a tradition of homeopathy, anthroposophic medicine and herbal medicine in the German context. Also, Chinese and Indian systems such as acupuncture and to a lesser extent Ayurveda have become part of the picture. Both medical doctors (MDs) and others practise CAM in Germany.

The German citizens have been given better possibilities for reimbursement. Since the beginning of 2012 a new German law (GKV‐Versorgungsstrukturgesetz) became effective. It allows the health insurances to offer additional benefits to its customers, and e. g. the Techniker Krankenkasse (TK), decided to reimburse up to 100€ per year and insured person for Homeopathic, Phytotherapeutically and Anthroposophic Medicinal Products which are obtainable only in pharmacies but without a prescription. Besides, there are also minor health insurances, so‐called Company Health Insurance Funds, reimbursing costs for CAM.

Among German MD’s there is a trend towards seeking an additional postgraduate qualification related to CAM, e.g. acupuncture, homeopathy, manual therapy/chirotherapy and naturopathic medicine. Among the 141,500 MDs, more than 40,000 held such a qualification in 2010. Please note that some doctors might have more than one of these additional qualifications, meaning that the number of these doctors is less than 40,000.

Despite of the publication of articles suggesting that clinical effects of homeopathy are placebo effects, the number of medical practitioners in Germany with additional qualification in Homeopathy is still increasing. In five years, from 2005 to 2010, the number increased from 4,528 to 5,070.

Every fifth MD uses CAM.

Within the same period, the number of MDs with additional qualification in acupuncture increased from 1,781 to 10,675, but this high increase might partly be explained by changes in qualification

ENZCAM Newsletter TM/CAM Update May 2012 Page 2 requirements. The MDs, though, have been involved in acupuncture since the 1950s, and today, the German Medical Association for Acupuncture, DÄGfA, has around 10,000 members, and the organisation has developed into a major professional society, working in all areas of Chinese medicine, including research, teaching and medical practice.

Besides that, about one out of ten MDs providing outpatient treatment are practicing under the title Naturheilverfahren in 2010. They have taken a broad training in areas such nutrition, homeopathy, herbal medicine and acupuncture.

All in all it means that about 30% of the German MDs providing outpatient treatment are using alternative therapies in his/her work. But it is unclear on which scientific basis they use it – whether for example, acupuncture is used from its original holistic approach or whether you just use the mechanical “Western” part of it.

Moreover, there are more than 10,000 “Heilpraktiker” practitioners. This is a specifically German phenomenon, as they have been included in the German health system by law for about 100 years. They are not doctors, but are trained in both – conventional medicine and alternative therapies, typical acupuncture and homeopathy.

Recently, Deutsche Krebshilfe (German Cancer Aid) has established a funding programme with focus on CAM: Priority Programme “Complementary Medicine in Oncology”. The aim is to increase transparency and objectivity in the area of unconventional treatments, on which cancer patients are continuously seeking advice.

The programme will generate high‐quality information on existing practices and evidence‐based studies, and this information should be made easily accessible for health care professionals and advisors, researchers, patients and the general public.

German Cancer Aid will support a network of competence, consisting of experienced institutions inside and outside universities. This interdisciplinary consortium should be led by a clinical oncologist with proven expertise in complementary methods.”

Original Text: Jesper Odde Madsen

Links: German Medical Association (Bundesärztekammer): http://www.bundesaerztekammer.de/page.as... Federal Statistical Office (Federal Health Monitoring): http://www.gbe‐bund.de German Cancer Aid: http://www.krebshilfe.de/english.html

2. Integration of CAM for Cancer Treatment in the EU

This article is summarised from the CAMbrella newsletter, Spring 2012 http://www.cambrella.eu/home.php?il=173

“Two groups of MEP’s are encouraging the European Commission and the European Parliament to support integration of CAM into the healthcare of EU citizens. A Round Table Meeting of the two European Parliament Interest Groups “MEPs Against Cancer” and “MEPs for CAM” took place on Tuesday 27th March 2012 in the European Parliament [in a meeting entitled] “Cancer and the contribution of Complementary and Alternative Medicine”.

ENZCAM Newsletter TM/CAM Update May 2012 Page 3

A European survey has shown that more than a third of cancer patients in Europe use CAM to increase their body’s ability to fight the disease, to enhance their health and well‐being, to feel empowered, and to alleviate physical and/or psychological distress. Emerging evidence from clinical trials suggests that several CAM therapies may address pain, fatigue, and psychological distress and improve quality of life in cancer patients. Because of the growing interest in CAM by patients, academic cancer centres are exploring ways to integrate such care into a conventional cancer treatment system. ….

[The MEPs] concluded the meeting with a call to the European Commission and the European Parliament to actively support the greater integration of CAM into the healthcare of EU citizens, particularly with regards to the prevention and treatment of cancer including empowerment of patients in self‐care and to iron out inequalities in the use of CAM across Europe. They also called for greater investment in research into an integrated approach into the care and treatment of patients with cancer.

Original Text: Jesper Odde Madsen Source: www.europeancancerleagues.org

3. CAM Research Approaches

This article is summarised from the CAMbrella newsletter, Spring 2012 http://www.cambrella.eu/home.php?il=176&l=deu

“Health research is much more than a question of efficacy, and as many CAM therapies are not single component based, this is more complex compared to the investigation of a single pharmaceutical…. Other approaches and other questions are also important …. The prioritisation between these approaches, though, vary a lot throughout the world, and exploring the prioritisations and the background for those is an indispensable part of preparing the future research roadmap.

CAMbrella Work Package 6 are using a division in the following five types of research areas (based on Fønnebø et al, 2007 – see at end): 1) Context, paradigms, philosophical understanding and utilization; 2) Safety status 3) Comparative effectiveness 4) Component efficacy and 5) Biological mechanisms

While conventional research on pharmaceuticals often starts out with research on biological mechanisms followed by studies on component efficacy, the study of CAM needs to be different, according to an increasing number of researchers. Since the CAM movement is driven by its users rather than by research, CAM research looks different compared to research on conventional pharmaceuticals. Instead CAM research has many similarities to research on other complex interventions, for example nursing care or psychological interventions.

Considering the fact that CAM is used by a large percentage of the population regardless of the current research situation, an important focus for CAM research is to understand how CAM is perceived by its users and the motivations that lie behind the use. Moreover, the safety of specific CAM therapies is an important research focus in order to assure user safety. Given the popularity of CAM, these two kinds of questions are often more urgent and significant to investigate than the efficacy. …

ENZCAM Newsletter TM/CAM Update May 2012 Page 4

However, an important focus of CAM research is of course also to investigate whether something works or not. Since many CAM therapies are not single component based this is more complex compared to the investigation of a single pharmaceutical.

Here the knowledge about whether or not a CAM intervention works in an authentic clinical setting (i.e. comparative effectiveness) becomes a more important focus than to know if it works in a controlled environment (i.e. component efficacy).

To know about the specific biological mechanisms of a certain CAM intervention may very well be useful, but not as crucial as for a new drug, that may or may not make its way into the market.”

Original text: Johanna Hök and Jesper Odde Madsen

Comment: The 2007 paper by Fønnebø and colleagues is a critical one for understanding why CAM research methods need to differ from pharmaceutical research:

Fønnebø, V., Grimsgaard, S., Walach, H., Ritenbaugh, C., Norheim, A. J., MacPherson, H., et al. (2007). Researching complementary and alternative treatments‐‐the gatekeepers are not at home. BMC medical research methodology, 7, 7. URL: http://www.ncbi.nlm.nih.gov/pubmed/17291355

Figure 1 from Fønnebø et al, 2007: Research strategies in drug trials and CAM (proposed). Phases that contrast the proposed phased research strategy in CAM (dark arrows) with that conventionally used in drug trials (light arrows).

ENZCAM Newsletter TM/CAM Update May 2012 Page 5

4. TCM in World Health Organization's ICD‐11 Codes

By John Weeks http://theintegratorblog.com/index.php?option=com_content&task=view&id=812&Itemid=189

“A note recently from Stacy Gomes, … of Pacific College of Oriental Medicine shared this: "Marilyn Allen's quiet but steadfast work as the U.S. liaison for the WHO ICD‐11 [International Classification of Diseases, 11th edition] codes … has not been publicized well and it only effects a limited 'traditional' medicine. It is a VERY promising direction for diagnostic coding for Chinese medicine." Gomes' note accompanied news that a new "ICD Alpha Browser" of the coding strategy is presently available on a WHO site. The TCM portion is here for review and comment by those who register.

Marilyn Allen … has led the charge for years now to raise funds to get the U.S. acupuncture community into the room to help develop these codes with counterparts and colleagues in China, Korea and Japan.”

WHO: Traditional medicine conditions originating from Chinese medicine

This [WHO ICD‐11] chapter refers to disorders and patterns which originated in ancient Chinese Medicine and are commonly used in China, Japan, Korea, and elsewhere around the world. This list represents a union set of harmonized traditional medicine conditions of the Chinese, Japanese, and Korean classifications. For an extended list of traditional medicine conditions, please refer to the International Classification of Traditional Medicine (ICTM).

A disorder in traditional medicine, disorder (TM)*a, refers to a set of dysfunctions in any of the body systems which presents with associated manifestations, i.e. a single or a group of specified signs, symptoms, or findings. Each disorder (TM) may be defined by its symptomology, etiology, course and outcome, or treatment response. In defining a disorder (TM), symptomology and etiology are required. Course and outcome, and treatment response are optional.

1. Symptomology: signs, symptoms or unique findings by traditional medicine diagnostic methods, including the taking of the pulse, examining the tongue or any tongue coating, abdominal examination, and other methods.

2. TM Etiology: the underlying traditional medicine explanatory style, such as weather factors (historically known in TM translations as the external contractions), emotional factors (historically known in TM translations as the seven emotions), or other pathological factors, processes, and products.

3. Course and outcome: a unique path of development of the disorder (TM) over time

4. Treatment response: known response to traditional medicine interventions

A pattern in traditional medicine, pattern (TM), refers to the complete clinical presentation of the patient at a given moment in time including all findings. Findings may include symptomology or patient constitution, among other things. a * The (TM) designation is used throughout this chapter for every traditional medicine term which uses the same word as a conventional medicine concept, but which has a different meaning in traditional medicine. For example, "liver (TM)" represents a different concept than "liver" in the other chapters of ICD.

ENZCAM Newsletter TM/CAM Update May 2012 Page 6

Constitution: the characteristics of an individual, including structural and functional characteristics, temperament, ability to adapt to environmental changes, or susceptibility to various health conditions. This is relatively stable, being in part genetically determined while partially acquired.

Comment: This is a very significant development as lack of ICD coding can be a hindrance to funders accepting a complementary medicine modality.

Useful links: http://www.who.int/mediacentre/news/notes/2010/trad_medicine_20101207/en/ http://www.who.int/classifications/icd/en/ http://www.who.int/classifications/icd/revision/en/index.html http://apps.who.int/classifications/icd11/browse/f/en

5. Books

Law and Ethics in Complementary Medicine A handbook for practitioners in Australia and New Zealand By Michael Weir Publication Date: Fourth Edition, 2011 http://www.michaelweir.com.au/book.htm http://www.allenandunwin.com/default.aspx?page=94&book=9781742374055

“Established as the most widely used reference in the field, Law and Ethics in Complementary Medicine is a comprehensive handbook for professionals, students and researchers. Covering a wide range of complementary modalities, it deals with legal and ethical issues in clinical relationships and provides practical guidelines for setting up and running a professional practice. Michael Weir systematically outlines the various aspects of the law which impact on clinical practice, including legal obligations to clients, consumer legislation and complaints processes, and professional boundaries. He explains how to navigate professional indemnity insurance, and the steps you need to take in setting up a professional practice from establishing a business name to dealing with employees. He also outlines the role of codes of ethics, and explores how to deal with tricky ethical issues in daily practice.

This fourth edition is fully updated and addresses recent changes in regulation and case law, including the introduction of national boards to cover each registered health profession in Australia. For the first time it also covers aspects of regulation of complementary medicine modalities in New Zealand.”

6. Journals

ENZCAM Newsletter TM/CAM Update May 2012 Page 7 BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] Volume X, Number X: Month 2012 http://www.biomedcentral.com/bmccomplementalternmed/

Selected articles:  Natural resistance to ascorbic acid induced oxidative stress is mainly mediated by catalase activity in human cancer cells and catalase‐silencing sensitizes to oxidative stress  Antipyretic, analgesic and anti‐inflammatory activity of Viola betonicifolia whole plant  Development and Implementation of an Herbal and Natural Product Elective in Undergraduate Medical Education  The use of complementary and alternative medicine (CAM) in children: a telephone‐based survey in Korea  Adjunctive naturopathic care for type 2 diabetes: patient‐reported and clinical outcomes after one year  Phytochemical studies and antioxidant activity of two South African medicinal plants traditionally used for the management of opportunistic fungal infections in HIV/AIDS patients  Knowledge about complementary, alternative and integrative medicine (CAM) among registered health care providers in Swedish surgical care: a national survey among university hospitals  Consumers' experiences and values in conventional and alternative medicine paradigms: a problem detection study (PDS)  Complementary and alternative medicine use among older Australian women ‐ a qualitative analysis  Acupuncture with manual and low frequency electrical stimulation as experienced by women with polycystic ovary syndrome: a qualitative study

Complementary Therapies in Clinical Practice [First listed in ENZCAM Newsletter June 2011] Volume 18, Number 2: May 2012 http://www.ctcpjournal.com/issues

Selected articles:  Investigating complementary and alternative medicine in maternity care: The need for further public health/health services research  Short‐ and long‐term effects of a lactose‐restricted diet and probiotics in children with chronic abdominal pain: A retrospective study  Therapeutic effects of calcium & vitamin D supplementation in women with PCOS  The effects of deep breathing on ‘tension–anxiety’ and fatigue in cancer patients undergoing adjuvant chemotherapy  How Natural Therapists enhance positive expectations of patients  Guided visualization interventions on perceived stress, dyadic satisfaction and psychological symptoms in highly stressed couples  Fusion of western and traditional medicine for heart patients  The College of Medicine in the UK welcomes Government announcement that practitioners of herbal medicine are to be statutorily regulated

ENZCAM Newsletter TM/CAM Update May 2012 Page 8 Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] Published in May 2012 http://www.hindawi.com/journals/ecam/aims/

Selected articles:  Outcome Measures of Chinese Herbal Medicine for Coronary Heart Disease: An Overview of Systematic Reviews  Chinese Medicine Shenfu Injection for Heart Failure: A Systematic Review and Meta‐Analysis  Electroacupuncture Pretreatment as a Novel Avenue to Protect Brain against Ischemia and Reperfusion Injury  Technical Parameters for Laser Acupuncture to Elicit Peripheral and Central Effects: State‐of‐the‐ Art and Short Guidelines Based on Results from the Medical University of Graz, the German Academy of Acupuncture, and the Scientific Literature  Lipid‐Regulating Effect of Traditional Chinese Medicine: Mechanisms of Actions  Quality of Life and Functional Health Status of Long‐Term Meditators  Korean Red Ginseng Improves Blood Pressure Stability in Patients with Intradialytic Hypotension  Developing Policy for Integrating Biomedicine and Traditional Chinese Medical Practice Using Focus Groups and the Delphi Technique  Effect of Auricular Acupressure on Peri‐ and Early Postmenopausal Women with Anxiety: A Double‐Blinded, Randomized, and Controlled Pilot Study  Sino‐European Transcontinental Basic and Clinical High‐Tech Acupuncture Studies—Part 4: “Fire of Life” Analysis of Heart Rate Variability during Acupuncture in Clinical Studies  Combining ZHENG Theory and High‐Throughput Expression Data to Predict New Effects of Chinese Herbal Formulae  Centella asiatica (L.) Urban: From Traditional Medicine to Modern Medicine with Neuroprotective Potential, Ilkay Erdogan Orhan  Exploration of New Electroacupuncture Needle Material  Chinese Medicine Injection Qingkailing for Treatment of Acute Ischemia Stroke: A Systematic Review of Randomized Controlled Trials  Applications of New Technologies and New Methods in ZHENG Differentiation  Prescription Pattern of Chinese Herbal Products for Breast Cancer in Taiwan: A Population‐Based Study

Explore: The Journal of Science and Healing [First listed in ENZCAM Newsletter May 2011] Volume 8, Number 3: May 2012 http://www.explorejournal.com/issues

Selected articles:  Tibetan Medicine and Integrative Health: Validity Testing and Refinement of the Constitutional Self‐Assessment Tool and Lifestyle Guidelines Tool  Religious Coping and Mental Health Outcomes: An Exploratory Study of Socioeconomically Disadvantaged Patients  Time, Touch, and Compassion: Effects on Autonomic Nervous System and Well‐Being  Emergence of a Signal from Background Noise in the “Memory of Water” Experiments: How to Explain It?

ENZCAM Newsletter TM/CAM Update May 2012 Page 9

 Feasibility of a Brief Yoga Intervention During Chemotherapy for Persistent or Recurrent Ovarian Cancer  Effects of Myofascial Release and Other Advanced Myofascial Therapies on Children With Cerebral Palsy: Six Case Reports  Evidence‐Based Integrative Medicine Updates  Innovations in Integrative Healthcare Education

Integrative Cancer Therapies [First listed in ENZCAM Newsletter April 2011] Volume 11, Number 1: March 2012 (notified May 2012) http://ict.sagepub.com/content/11/1.toc?etoc

Selected articles:  Systems Modeling in Integrative Oncology  Medicinal Plants as Antiemetics in the Treatment of Cancer: A Review  An Extract of Agaricus blazei Murill Administered Orally Promotes Immune Responses in Murine Leukemia BALB/c Mice In Vivo  Co‐Inhibition of HSP70/HSP90 Synergistically Sensitizes Nasopharyngeal Carcinoma Cells to Thermotherapy  Tumor Growth Inhibitory Effect of Juglone and Its Radiation Sensitizing Potential: In Vivo and In Vitro Studies

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 5: May 2012 http://online.liebertpub.com/toc/acm/18/5

Select articles:  Editorial: The Mismatch Between Personal Experience of Healing (in Patient or Therapist) and Currently Accepted Forms of Evidence  Effects of Acupuncture on the Outcomes of In Vitro Fertilization: A Systematic Review and Meta‐ Analysis  Zingiber officinale (Ginger) as an Anti‐Emetic in Cancer Chemotherapy: A Review  Multiweek Resting EEG Cordance Change Patterns from Repeated Olfactory Activation with Two Constitutionally Salient Homeopathic Remedies in Healthy Young Adults  Implementation and Acceptability of Mindful Awareness in Body‐Oriented Therapy in Women's Substance Use Disorder Treatment  Effects of an Integrated Approach of Hatha Yoga Therapy on Functional Disability, Pain, and Flexibility in Osteoarthritis of the Knee Joint: A Randomized Controlled Study  Yoga Breathing for Cancer Chemotherapy–Associated Symptoms and Quality of Life: Results of a Pilot Randomized Controlled Trial  Effects of Physical Therapy on Pain and Mood in Patients with Terminal Cancer: A Pilot Randomized Clinical Trial  Portrayal of Complementary and Alternative Medicine for Cancer by Top Online News Sites  Effects of Transcutaneous Electrical Nerve Stimulation on Motion Sickness Induced by Rotary Chair: A Crossover Study  Anti‐Inflammatory Effect of Keigai‐rengyo‐to Extract and Acupuncture in Male Patients with Acne Vulgaris: A Randomized Controlled Pilot Trial

ENZCAM Newsletter TM/CAM Update May 2012 Page 10

 Decontextualized Versus Lived Worlds: Critical Thoughts on the Intersection of Evidence, Lifeworld, and Values  Book Review: Review of The Medical War Against Chiropractors: The Untold Story from Persecution to Vindication

7. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

May 2012: Spinal Manipulation for Low‐Back Pain http://nccam.nih.gov/health/providers/digest/backpain

“Back pain is one of the most common health complaints, affecting 8 out of 10 people at some point during their lives. The lower back is the area most often affected. For many people, back pain goes away on its own after a few days or weeks. But for others, the pain becomes chronic and lasts for months or years. Low‐back pain can be debilitating, and it is a challenging condition to diagnose, treat, and study. The total annual costs of low‐back pain in the United States, including lost wages and reduced productivity, are more than $100 billion.

Spinal manipulation, sometimes called spinal manipulative therapy, is practiced by health care professionals such as chiropractors, osteopathic physicians, naturopathic physicians, physical therapists, and some medical doctors. Practitioners perform spinal manipulation by using their hands or a device to apply a controlled force to a joint of the spine. The amount of force applied depends on the form of manipulation used. The goal of the treatment is to relieve pain and improve physical functioning. This issue provides the state of the science about spinal manipulation for low‐ back pain.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

7 June 2012

ENZCAM Newsletter TM/CAM Update May 2012 Page 11

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update June 2012

1. WHO Policy and Strategy

The World Health Organization (WHO) has embarked on planning meetings for the new WHO 2014‐ 2023 Strategic Plan for Traditional Medicines (TM/CAM).

John Weeks wrote about the planning meeting held in Hong Kong in May 2012, saying: “The work will update WHO 2002‐2005 Traditional Medicine Strategy. A major shift in the current work is that TM/CAM has a new home inside WHO. During the first plan process, TM/CAM was in a division related only to medicines. Now it resides in a division with a charge related to health systems, delivery and primary care. … “The 2014‐2023 version of the plan is expected to focus more on the role of TM/CAM providers. … The WHO TM/CAM strategic plan has a number of steps prior to going before the General Assembly for approval in 2014.”

The full article by John Weeks is at: http://theintegratorblog.com/index.php?option=com_content&task=view&id=822&Itemid=189

2. Registration of Traditional Chinese Medicine Practitioners in Australia

With effect from 1 July 2012, Chinese Medicine practitioners will join the national practitioner registration system in Australia. The Australian Health Practitioner Regulation Agency (AHPRA) AHPRA “is the organisation responsible for the implementation of the National Registration and Accreditation Scheme across Australia. … AHPRA's operations are governed by the Health Practitioner Regulation National Law Act 2009, as in force in each state and territory, which came into effect on 1 July 2010. This law means that for the first time in Australia, 10 health professions are regulated by nationally consistent legislation.” The first ten professions were chiropractic, dental, medical, nursing and midwifery, optometry, osteopathy, pharmacy, physiotherapy, podiatry and psychology.

“From 1 July 2012, four new professions will join the National Registration and Accreditation Scheme.” These are Aboriginal and Torres Strait Islander health practice, Chinese medicine, Medical radiation practice and Occupational therapy.

ENZCAM Newsletter TM/CAM Update June 2012 Page 2

“This means that practitioners must meet nationally consistent registration standards and be adequately qualified to be able to practise. In some states and territories, this will be the first time that these professions are regulated.”

Under the National Scheme, there is a National Board for each profession, which is supported by the Australian Health Practitioner Regulation Agency (AHPRA). These boards set the professional standards that each practitioner must meet to be registered.”

“The purpose of health practitioner regulation is to protect the public by ensuring that only health practitioners who have the skills, qualifications and knowledge to provide safe care are registered. Under the National Scheme, practitioners register once, renew yearly, and can practice anywhere in Australia (within the scope of their registration).”

The Chinese Medicine Board of Australia http://www.chinesemedicineboard.gov.au/

The four protected titles under Chinese Medicine become: Chinese medicine practitioner; acupuncturist; Chinese herbal medicine practitioner; Chinese herbal dispenser; and Oriental medicine practitioner.

Australian Acupuncture & Chinese Medicine Association Ltd (AACMA) http://www.acupuncture.org.au/

AACMA “is the leading national professional association of acupuncture and Traditional Chinese Medicine (TCM) practitioners. … AACMA members are bound to a high standard of ethical and professional conduct through adherence to our national practitioner accreditation standards, Code of Ethics and Standards of Practice.”

AACMA played a leading role in developing TCM in Australia and preparing the profession to transition to formal regulation. As formal licencing by AHPRA takes over, so AACMA will remain a professional body for TCM practitioners.

Australian Journal of Acupuncture and Chinese Medicine (AJACM) http://ajacm.com.au/

“The AJACM is the official journal of the Australian Acupuncture and Chinese Medicine Association Ltd. It is Australia's paramount peer‐reviewed journal for the acupuncture and Chinese medicine profession. … Its primary focus is the publication of peer‐reviewed articles that enhance quality and diversity in acupuncture and Chinese medicine clinical practice and research, and stimulate the exchange of ideas about clinical practice and the role of acupuncture and Chinese medicine in contemporary health care. AJACM publishes original research articles, general papers, reviews, case reports and case series and also includes general articles that are relevant to the Journal's objectives. The first issue of AJACM was published in 2006 and it has been published biannually since 2007.”

ENZCAM Newsletter TM/CAM Update June 2012 Page 3 3. CAM in Denmark

The summer edition of the CAMbrella newsletter has material on the status of complementary medicine in Denmark. An extract from the article is provided below. http://www.cambrella.eu/home.php?il=185&l=deu

“In general, CAM is provided outside the public health system, and CAM practitioners and physicians are two separated categories. There are some overlaps, but they are exceptions to the rule. Within Danish mainstream medicine CAM methods are regarded as non‐scientific, not being recognised by medical doctors, researchers or public health authorities. The debate about CAM has been characterized by extreme and biased views, but over the last decade, the tone has become more rational and constructive. Acupuncture is the CAM method most often practised by medical doctors, as an increasing number of medical doctors since the 1970s have adopted it into their daily practice”

“One out of four Danes have been using CAM within the last year, and more than half of them have had a CAM treatment at least once in their lifetime. The most frequently used CAM methods within the last year are: massage, osteopathy or other manual techniques (19%); Acupuncture (7%); and Reflexology (5%).”

“In 2004, The National Board of Health launched a registration system for CAM practitioners. The registration system is administered by the associations of CAM practitioners, and the objective is to enhance the safety of CAM users. Associations for CAM practitioners can apply the Danish National Board of Health for an approval to become responsible for registration. Once an association has been appointed, its members can apply for permission to use the protected title “Registered Alternative Practitioner” (RAB). This does not imply any form of validation from the Danish National Board of Health neither of the alternative therapies nor of the practitioners.”

4. CAMbrella Research Project in Europe draws to an end

CAMbrella Final Conference Brussels, November 29, 2012 http://www.cambrella.eu/home.php

“The conference will bring together all the CAMbrella researchers, policy makers on a European, national and regional level, members of the European Parliament as well as CAM and non‐CAM stakeholders. The focus of the event will be the presentation of the project's results including a proposal for a roadmap for future CAM research.”

CAMbrella has been a pan‐European research network for complementary and alternative medicine (CAM). “The goal of this collaboration is to develop a roadmap for future European research in CAM that is appropriate for the health care needs of EU citizens, and acceptable to the EU Parliament as well as national research funders and healthcare providers. We will enable meaningful, reliable comparative research and communication within Europe and create a sustainable structure and policy. CAMbrella is focused on academic research groups which do not advocate specific treatments.” The project was established in January 2010 and was intended to run for three years. http://www.cambrella.eu/home.php?il=8&l=deu

ENZCAM Newsletter TM/CAM Update June 2012 Page 4 5. Research Organisations

The Society for Medicinal Plant and Natural Product Research http://www.ga‐online.org/about_en.html

“The Society for Medicinal Plant and Natural Product Research is an international, neutral and independent association of scientists from research institutions of universities and companies as well as other interested people engaged in the advancement of research and science in the field of medicinal plants, natural bioactive compounds and phytotherapy.

Specifically, this purpose is achieved by:  the organization of scientific meetings  support of the scientific journal "Planta Medica: Natural Products and Medicinal Plant Research" as organ of the society  cooperation with organizations pursuing similar aims  the scientific counselling of public institutions  the financial support of research work”

See the extensive list of conferences worldwide on this research area: http://www.ga‐online.org/events_en.php

Planta Medica: Journal of Medicinal Plant and Natural Product Research http://www.ga‐online.org/planta_medica.html http://www.thieme.de/SID‐34D752DD‐8091FB29/fz/plantamedica.html

“Planta Medica is one of the leading international journals in the field of medicinal plants and natural products with original research papers, letters, rapid communications, reviews, mini reviews and perspectives from researchers worldwide. Planta Medica publishes 18 issues per year. ‐ The following areas of medicinal plants and natural products research are covered:  Biological and Pharmacological Activity  Pharmacokinetic and Clinical Studies  Natural Product Chemistry  Analytical Studies”

6. Conferences and Research Abstracts

Scientific Abstracts Presented at the International Research Congress on Integrative Medicine and Health 2012

BMC Complementary and Alternative Medicine has published a supplement containing abstracts of the meeting held in Portland, Oregon, in the USA in May 2012. Volume 12 Supplement 1 contains some 139 pages of abstracts of posters and papers presented. Edited by Robert Saper, Ama Boah and David Eisenberg. http://www.biomedcentral.com/bmccomplementalternmed/supplements/12/S1

ENZCAM Newsletter TM/CAM Update June 2012 Page 5

5th European Congress for Integrative Medicine (ECIM)

Florence, Italy on September 21‐22, 2012. http://www.cambrella.eu/home.php?il=182&l=deu

“The event titled “The Future of Comprehensive Patient Care. Promoting health and developing an integrated and sustainable treatment in acute and chronic diseases” is organized by the Local Health Authority of Florence in cooperation with the Local Health Authority of Lucca.”

“ECIM 2012 represents the premier international event for physicians, healthcare and wellness practitioners, researchers, and sponsors, seeking to evaluate and integrate Complementary/Alternative Medicine with mainstream practice.”

7. Journals

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 3: June 2012 http://online.liebertpub.com/toc/act/18/3

Selected articles:  Insomnia: The Impact on Health and Interventions to Improve Sleep  The Integrative Approach to Psychiatry: A Comprehensive View  Current Controversies in Nutrition: Homocysteine Reduction and the B‐Vitamin Controversy  New Perspectives on the Placebo Effect: Implications for Research and Clinical Practice  Sleep…Naturally: A Review of the Efficacy of Herbal Remedies for Managing Insomnia  Herbal Sunscreens and Ultraviolet Protectants  Moving Through Loss: Addressing Grief in Our Patients  Primary Biliary Cirrhosis  Liver Toxicity: An Integrative Approach: A Natural Standard Monograph  Clinical Roundup: Selected Treatment Options for Chemotherapy‐Induced Nausea and Vomiting

BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] May and June 2012 http://www.biomedcentral.com/bmccomplementalternmed/

Selected articles:  The effect of yoga on women with secondary arm lymphoedema from breast cancer treatment.  Rhodiola rosea for physical and mental fatigue: a systematic review

ENZCAM Newsletter TM/CAM Update June 2012 Page 6

 Randomized Pilot Trial of a Synbiotic Dietary Supplement in Chronic HIV‐1 Infection  Chemical Composition of 8 Eucalyptus species' Essential Oils and the Evaluation of Their Antibacterial, Antifungal and Antiviral activities  Enzyme inhibitory and antioxidant activities of traditional medicinal plants: potential application in the management of hyperglycemia  Health economic evaluation of acupuncture along meridians for treating migraine in China: results from a randomized controlled trial  Construction of a Traditional Chinese Medicine syndrome‐specific outcome measure: The Kidney Deficiency Syndrome questionnaire (KDSQ)  Inhibition of melanogenesis and antioxidant properties of Magnolia grandiflora L. flower extract

Chinese Journal of Integrative Medicine http://www.springer.com/medicine/journal/11655

“Chinese Journal of Integrative Medicine, originally entitled "Chinese Journal of Integrated Traditional and Western Medicine" (English Edition), was founded in 1995, and changed formally its name in 2003. This journal is supervised by State Administration of Traditional Chinese Medicine, sponsored by Chinese Association of Integrative Medicine and China Academy of Chinese Medical Sciences. It is the first international peer‐reviewed monthly journal on integrative medicine included in Science Citation Index Expanded (SCI‐E).”

Volume 18, Number 5: May 2012  Fighting against cancer by integrative medicine  Cancer complementary and alternative medicine research at the US national cancer institute  Diagnosis and treatment of malignant tumors using integrated traditional and western medicine: Progress, challenges and reflections  Clinical study on Tongyan Spray (通咽喷雾剂 ) for post‐stroke dysphagia patients: A randomized controlled trial  Tumor interstitial fluid and gastric cancer metastasis: An experimental study to verify the hypothesis of “tumor‐phlegm microenvironment”  Lateral epicondylitis successfully treated with fire needle therapy: A case report  Fuzheng Huayu Capsule (扶正化瘀胶囊 ) in the treatment of liver fibrosis: Clinical evidence and mechanism of action

Chinese Medicine http://www.cmjournal.org/

“Chinese Medicine is an open access, online journal publishing evidence‐based, scientifically justified, and ethical research into all aspects of Chinese medicine.”

“Areas of interest include recent advances in herbal medicine, clinical nutrition, clinical diagnosis, acupuncture, pharmaceutics, biomedical sciences, epidemiology, education, informatics, sociology, and psychology that are relevant and significant to Chinese medicine. Examples of research approaches include biomedical experimentation, high‐throughput technology, clinical trials, systematic reviews, meta‐analysis, sampled surveys, simulation, data curation, statistics, omics, translational medicine, and integrative methodologies”.

Chinese Medicine is the official journal of The International Society for Chinese Medicine (ISCM).

ENZCAM Newsletter TM/CAM Update June 2012 Page 7

Sample of articles:  Evaluation of the anticancer potential of six herbs against a hepatoma cell line  Effects of transcutaneous electric acupoint stimulation on drug use and responses to cue‐ induced craving: a pilot study  A combination extract of ginseng, epimedium, polygala, and tuber curcumae increases synaptophysin expression in APPV717I transgenic mice  Inquiry diagnosis of coronary heart disease in Chinese medicine based on symptom‐syndrome interactions  NMR evaluation of total statin content and HMG‐CoA reductase inhibition in red yeast rice (Monascus spp.) food supplements

Complementary Therapies in Medicine [First listed in ENZCAM Newsletter May 2011] Volume 20, Number 3: June 2012 http://www.complementarytherapiesinmedicine.com/issues

 A comprehensive yoga programs improves pain, anxiety and depression in chronic low back pain patients more than exercise: An RCT  Dietary selenium and major depression: a nested case‐control study  Effect of collagen hydrolysate in articular pain: A 6‐month randomized, double‐blind, placebo controlled study  Acupuncture for symptoms of Gaucher disease  Health services use among young Australian women with allergies, hay fever and sinusitis: A longitudinal analysis  Clinical efficacy and safety of Chinese herbal medicine for Wilson's disease: A systematic review of 9 randomized controlled trials  Could ginseng‐based medicines be better than nitrates in treating ischemic heart disease? A systematic review and meta‐analysis of randomized controlled trials

European Journal of Integrative Medicine [First listed in ENZCAM Newsletter May 2011] Volume 4, Number 2: June 2012 http://www.europeanintegrativemedicinejrnl.com/issues

Selected articles:  The Fundamental Study for the Standardization and Objectification of Pattern Identification in Traditional Korean Medicine for Stroke (SOPI‐Stroke): An overview of phase I  Acupuncture for dysphagia following stroke: A systematic review  Acupuncture for Whiplash‐associated disorder: A randomized, waiting‐list controlled, pilot trial  Relation between body mass index and resting metabolic rate, cardiorespiratory fitness and insulin sensitivity in Sasang typology for young male persons: An observational study  Effects of Stachys tibetica essential oil in anxiety  Why do cancer patients use Chinese Medicine?—A qualitative interview study in China  Comparing two questionnaires for eliciting CAM use in a multi‐ethnic US population of older adults  Quality of life and assessment after local application of sulphurous water in the home environment in patients with psoriasis vulgaris: A randomised placebo‐controlled pilot study

ENZCAM Newsletter TM/CAM Update June 2012 Page 8 Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] June 2012 http://www.hindawi.com/journals/ecam/contents/

Selected Articles:  Molecular Mechanisms of Same TCM Syndrome for Different Diseases and Different TCM Syndrome for Same Disease in Chronic Hepatitis B and Liver Cirrhosis  Development and Validation of an Instrument for Measuring Attitudes and Beliefs about Complementary and Alternative Medicine (CAM) Use among Cancer Patients  Plectranthus amboinicus and Centella asiatica Cream for the Treatment of Diabetic Foot Ulcers  Relationship between Blood Stasis Syndrome Score and Cardioankle Vascular Index in Stroke Patients  Mathematical Reflections on Acupoint Combinations in the Traditional Meridian Systems  Traditional Chinese Medicine in Cancer Care: A Review of Case Series Published in the Chinese Literature  Ficus deltoidea: A Potential Alternative Medicine for Diabetes Mellitus  Epigenetic Changes in Response to Tai Chi Practice: A Pilot Investigation of DNA Methylation Marks  Traditional Chinese Medicine Zheng in the Era of Evidence‐Based Medicine: A Literature Analysis  Clinical Data Mining of Phenotypic Network in Angina Pectoris of Coronary Heart Disease  Temperature and Safety Profiles of Needle‐Warming Techniques in Acupuncture and Moxibustion  Application of Metabolomics in Traditional Chinese Medicine Differentiation of Deficiency and Excess Syndromes in Patients with Diabetes Mellitus  The Potential Benefit of Complementary/Alternative Medicine in Cardiovascular Diseases  Evaluation of the Effects of Acupuncture on Blood Flow in Humans with Ultrasound Color Doppler Imaging  The Effects of Clinical Hypnosis versus Neurolinguistic Programming (NLP) before External Cephalic Version (ECV): A Prospective Off‐Centre Randomised, Double‐Blind, Controlled Trial  Anti‐Infective and Antiproliferative Potential of African Medicinal Plants

Integrative Cancer Therapies [First listed in ENZCAM Newsletter April 2011] Volume 11, Number 2: June 2012 http://ict.sagepub.com/content/11/2.toc?etoc

Selected articles:  Prevalence and Correlates of Vitamin and Supplement Usage Among Men With a Family History of Prostate Cancer  An Exploratory Study on the Quality of Life and Individual Coping of Cancer Patients During Mistletoe Therapy  A Critical Review of the Effects of Medical Qigong on Quality of Life, Immune Function, and Survival in Cancer Patients  Effects of Sweet Bee Venom Pharmacopuncture Treatment for Chemotherapy‐Induced Peripheral Neuropathy: A Case Series  Induction of Apoptosis of Tumor Cells by Some Potentiated Homeopathic Drugs: Implications on Mechanism of Action

ENZCAM Newsletter TM/CAM Update June 2012 Page 9 Journal of Holistic Nursing [First listed in ENZCAM Newsletter April 2011] Volume 30, Number 2: June 2012 http://jhn.sagepub.com/content/30/2.toc?etoc

Selected articles:  Sacred Healing Stories Told at the End of Life  Self‐Compassion: A Concept Analysis  Examination of the Effectiveness of Peppermint Aromatherapy on Nausea in Women Post C‐ Section  Spiritual Expressions of African Americans and Whites in Cancer Pain  Call for Submissions: Nurse‐Herbalism—Global Tradition: A Special Issue of Journal of Holistic Nursing

8. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

There was no clinical digest published in June 2012.

Produced for ENZCAM by Heather McLeod and Ray Kirk

11 July 2012

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update July 2012

1. Research Organisations

Canadian Interdisciplinary Network for CAM Research (IN‐CAM) The IN‐CAM Outcomes Database www.outcomesdatabase.org IN‐CAM “have developed a database of outcome measures of particular importance to Complementary and Alternative Medicine (CAM) and Integrative Health Care (IHC) effectiveness and efficacy research in order to facilitate and support the assessment of CAM interventions through high quality research, and thus, to improve clinical practice and inform policy.”

“Although important in research on CAM and IHC interventions, the outcomes included in this Database are not limited or exclusive to CAM or IHC research; rather they are useful for the study of health interventions framed within a whole person perspective and focused on health and well‐ being”.

“Our goals are to: 1) include practical information on outcome measures within a framework of domains that makes them easily accessible, and 2) assist researchers and practitioners in framing their approach (research or clinical) within a whole person perspective and/or a wellness orientation.”

Tools to measure outcomes are listed under the following domains:  Context of the Intervention  Process of the intervention  Holistic  Health‐related quality of life  Spiritual  Psychological  Physical  Social  Individualized

Anyone contemplating a research project in CAM or IM will find this an invaluable resource.

ENZCAM Newsletter TM/CAM Update July 2012 Page 2 RAND Meeting on Integrative Medicine

RAND held a meeting on 18 July 2012 with some of the leading thinkers on integrative medicine. The speakers were:  Ian Coulter, Samueli Institute Chair in Policy for Integrative Medicine, and Senior Health Policy Analyst, RAND Corporation  Wayne Jonas, President and Chief Executive Officer, Samueli Institute  David Eisenberg, Executive Vice President for Health Research and Education, Samueli Institute  Allen Fremont, Natural Scientist, RAND Corporation"

The audio podcast of the meeting is available on: http://www.rand.org/multimedia/audio/2012/07/18/integrative‐health‐care‐medicine.html "Integrative medicine combines the strengths of conventional medicine with effective and safe approaches in complementary and alternative medicine. In the past decade, the number of hospitals offering complementary therapies has more than doubled to over 20 percent; and, among Americans, 38 percent use integrative practices in their daily lives. Join us for a discussion on how hospitals, universities, and the U.S. military are using and teaching these methods, what research has found on the effectiveness of integrative practices, and the future of integrative medicine in the United States.

2. Responses in Medical Journal of Australia to the “Friends of Science”

Medicine and science must oppose intolerance and censorship Paul A Komesaroff, Amber Moore and Ian H Kerridge Med J Aust 2012; 197 (2): 82‐83. https://www.mja.com.au/journal/2012/197/2/medicine‐and‐science‐must‐oppose‐intolerance‐and‐ censorship Friends of Science in Medicine should avoid threatening their own values “Science has always been — and should be — a battleground for contending views on what is true. Because of the close connection between knowledge and power, however, the risk is always present that those who command the dominant theories or ideologies will rely on their positions of influence to overcome those who oppose them. It is important that those who treasure tolerance and the value of open, unfettered discourse remain sensitive to these risks and — even when they personally disagree — to protect and foster the expression of contrary viewpoints.” “When the nature of science and medicine is at stake, the importance of this task is especially pressing. We believe that the views promoted in a commissioned editorial in the Journal, by the Friends of Science in Medicine (FSM), exceed the boundaries of reasoned debate and risk compromising the values that FSM claims to support.” “In its own words, the key objective of FSM is “countering the growth of pseudoscience in medicine”, where true science is defined as a set of practices characterised by “an experimental, evidence‐based approach”. The strategy of the group — which deliberately and forcefully relies on the unquestioned eminence of its members — is to apply pressure on governments and educational

ENZCAM Newsletter TM/CAM Update July 2012 Page 3 institutions to withdraw or prohibit funding for health practices referred to in a general sense as “complementary medicines”. The organisation models itself on similar groups in the United States and the United Kingdom and proudly refers to the success of these groups in having had funding removed from certain alternative medicine courses. It is clear that FSM aims to emulate this success in Australia through a campaign to influence public opinion and apply pressure on government and educational institutions.” “We do not write to advocate complementary medicines. Indeed, two of us are physicians who practise exclusively in the field of Western medicine and are actively engaged in “conventional” laboratory and clinical research.” … “We feel that the appropriate response to these problems is not to seek to suppress all approaches to health care which we cannot understand or with which we do not agree. Rather, it should be to establish a system of safeguards that minimise risk, while continuing to protect the rights of consumers to choose their own health care practices. Such safeguards should include legal, professional and conceptual criteria and target specific rogue practices while protecting and regulating others. We believe that any approach other than this would run the risk of threatening the core values and practices of science and medicine.” [Article continues] See also the interview with Paul Komesaroff: http://www.abc.net.au/worldtoday/content/2012/s3546523.htm

The legitimacy of academic complementary medicine Stephen P Myers, Charlie C Xue, Marc M Cohen, Kerryn L Phelps and George T Lewith Med J Aust 2012; 197 (2): 69‐70. https://www.mja.com.au/journal/2012/197/2/legitimacy‐academic‐complementary‐medicine

Standing up for common sense “Science sets out to rigorously eliminate bias, not to assert it. The arguments mounted for the closure of complementary medicine courses in Australian universities by the Friends of Science in Medicine in a recent editorial in the Journal are highly emotive and, while having a gloss of superficial reasonableness, they do not stand up to critical review.” … “Complementary medicine is a broad field in which generalisations have little value. The major professional and university‐based disciplines of traditional Chinese medicine, chiropractic, osteopathy and naturopathy need to be differentiated from fringe practices, and the actions of rogue or unqualified practitioners should be viewed separately from the competence of the wider profession.” … “The call for removal of complementary medicine courses from universities raises deeper issues. It has been argued that the purpose of universities is to conserve the diversity of ideas in the community, and that this is as important to the survival of knowledge as genetic diversity is to the survival of species.” … “Science does not occur in a vacuum; it is a social phenomenon, a practice that is embedded in wider cultural values and power relationships in society. The debate on whether complementary medicine should be a university discipline, when seen from a sociological perspective, says much less about good science and much more about control and power.” … “This controversy is simply the latest episode in a long‐contested battle between orthodox and divergent views.”

ENZCAM Newsletter TM/CAM Update July 2012 Page 4

“Complementary medicine, like conventional medicine, is riddled with poor scientific methodology and lacks a comprehensive evidence base. The BMJ compiles and updates the evidence for medical interventions (3000 to date) and currently considers that 51% of medical treatment is of unknown effectiveness and that only 11% is definitively beneficial, with another 23% probably beneficial.” … “Voltaire wrote in an essay on tolerance: “Think for yourselves and let others enjoy the privilege to do so too.” The dialogue about complementary medicine and its legitimacy as an academic discipline needs to be patient centred, evidence‐based, mindful of culture, enabling of safe professional practice, and grounded in mutual respect and common sense. There is no sustainable rationale to support the removal of complementary medicine courses from a university environment. These courses clearly develop critical thinking and fulfil the criteria for legitimate university disciplines. We can see great danger for the public if complementary medicine practice is allowed to develop outside mainstream education.” [See original article for references]

3. Conferences

Forthcoming conferences

31 August ‐ 2 September 2012 AIMA 18th International Integrative Medicine Conference Melbourne, AUSTRALIA https://www.aima.net.au/

21‐ 22 September 2012 Mechanism‐Based Natural Product Development Whistler, British Columbia, CANADA Conference 2012 http://www.naturalproductswhistler.com/ 21‐22 September 2012 5th European Congress for Integrative Medicine (ECIM) Florence, ITALY http://www.ecim‐congress.org/

24‐26 October 2012 International Congress for Educators in Complementary and Washington DC, USA Integrative Medicine 2012 http://www.icecim.org/

2‐4 November 2012 7th IN‐CAM Research Symposium Toronto, CANADA http://www.incamresearch.ca/index.php?id=19,544,0,0,1,0

29 November 2012 CAMbrella Final Conference Brussels, BELGIUM http://www.cambrella.eu/home.php

11‐13 April 2013 8th International Congress on Complementary Medicine London, UNITED KINGDOM Research http://www.iccmr2013.org/ 9‐13 September 2013 8th International Congress on Traditional Asian Medicine Sancheong, KOREA http://www.iastam.org/

ENZCAM Newsletter TM/CAM Update July 2012 Page 5 4. Books

Traditional, Complementary and Integrative Medicine: An International Reader By Jon Adams, Gavin Andrews, Joanne Barnes, Alex Broom and Parker Magin (Editors) Publication Date: June 2012, to be launched in August 2012 http://www.amazon.com/Traditional‐Complementary‐Integrative‐Medicine‐ International/dp/0230232655

“A ground‐breaking collection of contemporary TCIM literature featuring respected research articles alongside fresh material. Bringing together the perspectives of a diverse range of international practitioners and academics, it provides essential guidance, insight and inspiration for those embarking upon study, practice or research in this field.” http://www.palgrave.com/products/title.aspx?pid=356267

“Contributions come from practitioners and academics drawn from a diverse range of disciplines and professions across the globe. From perspectives on the significance of TCIM within public health policy to discourses on its influence in fields such as psychiatry and sociology, discrete chapters come together to provide an international map of the contemporary research, key debates and core issues which shape the field.”

“[The] reader is divided into three parts: Part A focuses on the consumption of TCIM, including chapters on its use through the life‐cycle and within the context of disease and health management; Part B covers considerations for practitioners across the world, taking in issues over ethics, communication and education; Part C features chapters on the role of evidence, research and knowledge production in TCIM and looks at what lies ahead for the field.”

5. Journals

African Journal of Traditional, Complementary and Alternative medicines (AJTCAM) [First listed in ENZCAM Newsletter October 2011] Volume 9, Number 4: Month 2012 http://journals.sfu.ca/africanem/index.php/ajtcam

Selected articles:  Acupuncture in treating hepatic fibrosis: a review with recommendation for future studies  Aromatherapy as an adjuvant treatment in cancer care – a descriptive systematic review

ENZCAM Newsletter TM/CAM Update July 2012 Page 6

 Prevalence and predictors of traditional medicine utilization among persons living with AIDS (PLWA) on antiretroviral (ARV) and prophylaxis treatment in both rural and urban areas in South Africa  Why HIV positive patients on antiretroviral treatment and/or cotrimoxazole prophylaxis use traditional medicine: perceptions of health workers, traditional healers and patients: a study in two provinces of South Africa  Phytomedicine versus gonorrhoea: the Bapedi experience  Development and evaluation of a novel four‐electrode device system for monitoring skin impedance

BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] July 2012 http://www.biomedcentral.com/bmccomplementalternmed/content

Selected articles:  Immunity to melanin and to tyrosinase in melanoma patients, and in people with vitiligo  In vitro and in vivo anti‐colon cancer effects of Garcinia mangostana xanthones extract  Use of complementary and alternative medicine by mid‐age women with back pain: a national cross‐sectional survey  A homeopathic remedy from arnica, marigold, St. John’s wort and comfrey accelerates in vitro wound scratch closure of NIH 3T3 fibroblasts  Acupuncture for the treatment of tinnitus: a systematic review of randomized clinical trials  A six‐month Crossover Chemoprevention Clinical Trial of Tea in Smokers and Non‐smokers: Study Design and Methodological Issues  Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial  Development of an acupuncture treatment protocol by consensus for women undergoing Assisted Reproductive Technology (ART) treatment  Antioxidant and acetylcholinesterase‐inhibitory properties of long‐term stored medicinal plants

The EPMA Journal [First listed in ENZCAM Newsletter December 2011] Published in 2012 http://www.epmajournal.com/

Selected articles:  Expert recommendations to personalization of medical approaches in treatment of Multiple Sclerosis: an overview of family planning and pregnancy  Time for new guidelines in advanced healthcare: the mission of The EPMA Journal to promote an integrative view in predictive, preventive and personalized medicine  Behavior, nutrition and lifestyle in a comprehensive health and disease paradigm: skills and knowledge for a predictive, preventive and personalized medicine  Methods for analysis of the cancer microenvironment and their potential for disease prediction, monitoring and personalized treatments  Personalization of prostate cancer prevention and therapy: are clinically qualified biomarkers in the horizon?

ENZCAM Newsletter TM/CAM Update July 2012 Page 7 Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] Published in July 2012 http://www.hindawi.com/journals/ecam/aims/

Selected articles:  Local and Systemic Cardiovascular Effects from Monochromatic Infrared Therapy in Patients with Knee Osteoarthritis: A Double‐Blind, Randomized, Placebo‐Controlled Study  Uncaria tomentosa—Adjuvant Treatment for Breast Cancer: Clinical Trial  The Role of Acupuncture in Assisted Reproductive Technology  Breast Milk Jaundice and Maternal Diet with Chinese Herbal Medicines  How to Design the Control Group in Randomized Controlled Trials of Acupuncture?  Long‐Term Consumption of Platycodi Radix Ameliorates Obesity and Insulin Resistance via the Activation of AMPK Pathways  Clinical Distribution and Molecular Basis of Traditional Chinese Medicine ZHENG in Cancer  Cancer, Inflammation, and Insights from Ayurveda  Neuroendocrine Mechanisms of Acupuncture  Auricular Acupressure for Managing Postoperative Pain and Knee Motion in Patients with Total Knee Replacement: A Randomized Sham Control Study  Green Tea Polyphenols for the Protection against Renal Damage Caused by Oxidative Stress  Effectiveness of Mentha piperita in the Treatment of Infantile Colic: A Crossover Study  Emerging Glycolysis Targeting and Drug Discovery from Chinese Medicine in Cancer Therapy  A Longitudinal Follow‐Up Study of Saffron Supplementation in Early Age‐Related Macular Degeneration: Sustained Benefits to Central Retinal Function  Reflexology versus Swedish Massage to Reduce Physiologic Stress and Pain and Improve Mood in Nursing Home Residents with Cancer: A Pilot Trial  Medical Ethnobotany in Europe: From Field Ethnography to a More Culturally Sensitive Evidence‐Based CAM  Classification of Insomnia Using the Traditional Chinese Medicine System: A Systematic Review,  Isolation of Antidiabetic Principle from Fruit Rinds of Punica granatum  Vitamin E as an Antiosteoporotic Agent via Receptor Activator of Nuclear Factor Kappa‐B Ligand Signaling Disruption: Current Evidence and Other Potential Research Areas

Explore: The Journal of Science and Healing [First listed in ENZCAM Newsletter May 2011] Volume 8, Number 4: July–August 2012 http://www.sciencedirect.com/science/issue/273308‐1‐s2.0‐S1550830711X00101

Selected articles:  A Calculation of National Wellness  Distant Healing of Surgical Wounds: An Exploratory Study  The Healing Experience—How Can We Capture It?  Comparing Individual Preferences for Four Meditation Techniques: Zen, Vipassana (Mindfulness), Qigong, and Mantra  You Cannot Wash Off Blood With Blood: Entering the Mind Through the Body  Say Your Prayers, But Make ‘Em Quick: Replicating the Effects of Three Minutes of Prayer on Forgiveness

ENZCAM Newsletter TM/CAM Update July 2012 Page 8

 Evidence‐Based Integrative Medicine Updates: Tai Chi, Myofascial Release, Tetanic Electrical Stimulation, Omega‐3 Fatty Acid Supplementation, Antioxidant Supplements  Integrative Healthcare for the Military: A Samueli Institute/Department of Defense Partnership  Innovations in Integrative Healthcare Education: Georgetown University's Graduate Program in Complementary and Alternative Medicine: Training Future Practitioners of Integrative Healthcare

Journal of Medicinal Food [First listed in ENZCAM Newsletter Q1 2011] Volume 15, Number 7: July 2012 http://online.liebertpub.com/toc/jmf/15/7

Selected articles:  Efficacy and Safety of Mixed Oriental Herbal Medicines for Treating Human Obesity: A Systematic Review of Randomized Clinical Trials  Olive Leaf Extract as a Hypoglycemic Agent in Both Human Diabetic Subjects and in Rats  Korean Mistletoe (Viscum album coloratum) Extract Improves Endurance Capacity in Mice by Stimulating Mitochondrial Activity  Proteomic Analysis of Terminalia chebula Extract‐Dependent Changes in Human Lymphoblastic T Cell Protein Expression

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 6: June 2012 (received in July 2012) http://online.liebertpub.com/toc/acm/18/6

Selected articles:  Can We Help Just by Good Intentions? A Meta‐Analysis of Experiments on Distant Intention Effects  A Brief Review of Current Scientific Evidence Involving Aromatherapy Use for Nausea and Vomiting  A Review on Citrullus colocynthis Schrad.: From Traditional Iranian Medicine to Modern Phytotherapy  Western Acupuncture in a NHS General Practice: Anonymized 3‐Year Patient Feedback Survey  Utilization of Group‐Based, Community Acupuncture Clinics: A Comparative Study with a Nationally Representative Sample of Acupuncture Users  The Effect of Qigong on Menopausal Symptoms and Quality of Sleep for Perimenopausal Women: A Preliminary Observational Study  The Effect of TJ‐15 Plus TJ‐17 on Atopic Dermatitis: A Pilot Study Based on the Principle of Pattern Identification  Influence of a Specific Ginger Combination on Gastropathy Conditions in Patients with Osteoarthritis of the Knee or Hip  Development of a Chinese Medicine Pattern Severity Index for Understanding Eating Disorders  Therapeutic Effectiveness of Ageratina pichinchensis on the Treatment of Chronic Interdigital Tinea Pedis: A Randomized, Double‐Blind Clinical Trial  Clinical Efficacy of Manasamitra Vataka (an Ayurveda Medication) on Generalized Anxiety Disorder with Comorbid Generalized Social Phobia: A Randomized Controlled Study  Capacity for Clinical Research on Herbal Medicines in Africa

ENZCAM Newsletter TM/CAM Update July 2012 Page 9 The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 7: July 2012 http://online.liebertpub.com/toc/acm/18/7

 Qigong Exercise for the Treatment of Fibromyalgia: A Systematic Review of Randomized Controlled Trials  The Cognitive‐Enhancing Effects of Bacopa monnieri: A Systematic Review of Randomized, Controlled Human Clinical Trials  Relaxation Practice and Physiologic Regulation in a National Sample of Older Taiwanese  Effects of Auricular Acupuncture on Anthropometric, Lipid Profile, Inflammatory, and Immunologic Markers: A Randomized Controlled Trial Study  Feasibility of a Nutritional Supplement as Treatment for Pediatric Bipolar Spectrum Disorders  Long‐Term Effect of Acupuncture for Treatment of Tinnitus: A Randomized, Patient‐ and Assessor‐Blind, Sham‐Acupuncture‐Controlled, Pilot Trial  Chia Seed Supplementation and Disease Risk Factors in Overweight Women: A Metabolomics Investigation  A Complex, Nonlinear Dynamic Systems Perspective on Ayurveda and Ayurvedic Research  Case Report: Ayurvedic Intervention in Metastatic Liver Disease  Emerging Economies' Need for Cheap, Efficient Health Care Makes Western Anti‐Homeopathy Rhetoric Irrelevant: Observations from the Canadian Homeopathy Conference, October 2011

6. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

July 2012: Chronic Pain and Complementary Health Practices http://nccam.nih.gov/health/providers/digest/chronicpain.htm

“Pain is the most common health problem for which adults use complementary health practices. Many people with conditions causing chronic pain turn to these practices to supplement other conventional medical treatment, or when their pain is resistant or in an effort to advert side effects of medications. Despite the widespread use of complementary health practices for chronic pain, scientific evidence on efficacy and mechanisms whether the therapies help the conditions for which they are used and, if so, how is, for the most part, limited. However, the evidence base is growing, especially for several complementary health practices most commonly used by people to lessen pain.

This issue highlights the research status for several therapies used for common kinds of pain, including arthritis, fibromyalgia, headache, low‐back pain, and neck pain.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

6 August 2012

ENZCAM Newsletter TM/CAM Update July 2012 Page 10

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update August 2012

1. Policy and Legislation

New Zealand: Review of the Health Practitioners Competence Assurance Act http://www.health.govt.nz/publication/2012‐review‐health‐practitioners‐competence‐assurance‐ act‐2003‐discussion‐document

We reported in the ENZCAM update of August 2011 about the proposal that Traditional Chinese Medicine (TCM) become a regulated profession under the Health Practitioners Competence Assurance Act of 2003. At the time we also provided a link to material from the Ministry of Health on the criteria for assessing applications for regulation of CAM practitioners.

It seems that while the application by TCM was favourably received, there is a reluctance to set up another regulatory body under the Act. There are currently 16 regulatory authorities under the Act and it is understood that the Ministry is eager to see the number reduced or for services to be shared in order to save costs. This would either require consolidation of some authorities or the establishment of a body similar to the Australian Health Practitioner Regulation Agency (AHPRA), which we reported on in the ENZCAM update of June 2012.

The Ministry of Health in New Zealand is thus undertaking a strategic review of the Health Practitioners Competence Assurance Act 2003. “The review will assess how the operation of the Act can be improved, including how it continues to protect public safety in a changing health environment, and how it supports the development of New Zealand's health workforce now and in the future. As part of this review, Health Workforce New Zealand will be undertaking a full public consultation, beginning on 31 August 2012. The Discussion Document and submission form are now available. The closing date for submissions is Friday, October 26, 2012.”

While the questions for the review do not specifically discuss the registration of complementary medicine, the discussion document provides examples of practice in other countries where some complementary therapies have been included.

Complementary medicine practitioner associations are urged to take this opportunity to help shape the future direction of health practitioner registration by making submissions.

See also: Registering a new profession http://www.health.govt.nz/our‐work/regulation‐health‐and‐disability‐system/health‐practitioners‐ competence‐assurance‐act/registering‐new‐profession

ENZCAM Newsletter TM/CAM Update August 2012 Page 2 2. Journal Article on Terminology: CAM or Integrative Health Care?

A qualitative study on the term CAM: is there a need to reinvent the wheel? By Isabelle Gaboury, Karine Toupin April and Marja Verhoef BMC Complementary and Alternative Medicine 2012 http://www.biomedcentral.com/1472‐6882/12/131/abstract Published: 21 August 2012

Abstract (provisional)

Background: As complementary and alternative medicine (CAM) has developed extensively, uncertainty about the appropriateness of the terms CAM and other CAM‐related terms has grown both in the research and practice communities. Various terms and definitions have been proposed over the last three decades, highlighting how little agreement exits in the field. Contextual use of current terms and their respective definitions needs to be discussed and addressed.

Methods: Relying upon the results of a large international Delphi survey on the adequacy of the term CAM, a focus group of 13 international experts in the field of CAM was held. A forum was also set up for 28 international experts to discuss and refine proposed definitions of both CAM and integrative healthcare (IHC) terms. Audio recordings of the meeting and forum discussion threads were analyzed using interpretive description.

Results: Multiple terms to describe the therapies, products, and disciplines often referred to as CAM, were considered. Even though participants generally agreed there is a lack of optimal definitions for popular CAM‐related umbrella terms and that all terms that have so far been introduced are to some extent problematic, CAM and IHC remained the most popular and accepted terms by far. The names of the specific disciplines were also deemed adequate in certain contexts. Focus group participants clarified the context in which those three terms are appropriate. Existing and emergent definitions of both CAM and integrative healthcare terms were discussed.

Conclusions: CAM and other related terms could be used more effectively, provided they are used in the proper context. It appears difficult for the time being to reach a consensus on the definition of the term CAM due to the uncertainty of the positioning of CAM in the contemporary healthcare systems. While umbrella terms such as CAM and IHC are useful in the context of research, policy making and education, relevant stakeholders should limit the use of those terms.

3. Standards for Patient‐Centered Outcomes Research

Patient‐Centered Outcomes Research Institute (PCORI) Draft Methodology Report http://www.pcori.org/get‐involved/opportunities‐for‐public‐comment/methodology/

“The Patient‐Centered Outcomes Research Institute (PCORI) is an independent, non‐profit organization authorized by Congress [in the USA]. Its mission is to fund research that will provide patients, their caregivers and clinicians with the evidence‐based information needed to make better‐ informed health care decisions. PCORI is committed to continuously seeking input from a broad range of stakeholders to guide its work.”

ENZCAM Newsletter TM/CAM Update August 2012 Page 3

“PCORI has a Methodology Committee whose role is to advise the PCORI Board of Governors on defining methodological standards and creating a translation table to guide health care stakeholders towards the best methods for patient‐centered outcomes research (PCOR).”

“This first draft PCORI Methodology Report focuses on the patient’s perspective. Future reports will address clinicians’, healthcare purchasers’ and policy‐makers’ perspectives in more detail.”

Material below sourced from Health Affairs: www.healthaffairs.org

PCORI “is accepting public comment on its landmark draft Methodology Report, which proposes methodological standards for the conduct of patient‐centered outcomes research (PCOR). The feedback received during the comment period, closing at 11:59 p.m. ET on Friday, September 14, will be considered for incorporation into the final report before it is considered for adoption by the PCORI Board of Governors at its November public meeting in Boston.”

“The draft report proposes a set of 60 methodological standards and recommendations for the conduct of PCOR that will help patient and clinicians better identify credible information that can lead to better health decisions.”

“The report was produced by PCORI's 17‐member Methodology Committee, an expert panel of research methodology specialists appointed by the U.S. Government Accountability Office. The draft report is the first step toward a building comprehensive guide for conducting patient‐centered research.”

4. Journal Papers on Health System Integration of TM/CAM

Use of Complementary and Alternative Medicine in Residential Aged Care Michael Bauer and Jo‐Anne Rayner. The Journal of Alternative and Complementary Medicine. Published ahead of print. doi:10.1089/acm.2011.0582. http://online.liebertpub.com/doi/abs/10.1089/acm.2011.0582

Abstract

Objectives: There is increasing evidence of the use of complementary and alternative medicine (CAM) by older people living in the community; however, little is known about the use of CAM in residential aged‐care facilities (RACF). This review examined the literature on the use of CAM in RACF, focusing on prevalence, motivations, and support for use.

Methods: A search of multiple databases between 2000 and 2010 was conducted. Articles were analyzed under five key themes: prevalence of CAM use, CAM user profile, motivations for use, expectations for and satisfaction with CAM use, and institutional and/or staff support for CAM use.

Results: Only five articles were found that met the inclusion criteria. The review highlights the absence of evidence regarding the use of CAM by older people in RACF.

Conclusions: To inform policy and improve clinical practice in line with the aging of the population, nationally representative, population‐based studies are required.

ENZCAM Newsletter TM/CAM Update August 2012 Page 4 Management of Influenza‐Like Illness by Homeopathic and Allopathic General Practitioners in France During the 2009–2010 Influenza Season Stéphane Vincent, Antoine Demonceaux, Didier Deswarte, Daniel Scimeca, and Marie‐France Bordet. The Journal of Alternative and Complementary Medicine, Published ahead of print. doi:10.1089/acm.2011.0706. http://online.liebertpub.com/doi/full/10.1089/ACM.2011.0706

Abstract

Objective: This study was done to determine characteristics and management of patients in France visiting allopathic general practitioners (AGPs) and homeopathic general practitioners (HGPs) for influenza‐like illness (ILI).

Design: This was a prospective observational study. Settings/location: It was conducted in metropolitan France during the 2009–2010 influenza season. Subjects: Sixty‐five HGPs and 124 AGPs recruited a total of 461 patients with ILI. Interventions: Patients were treated for ILI by their GPs. GPs and patients completed questionnaires recording demographic characteristics and patient symptoms when patients were included in the study. Patients reported satisfaction with treatment on day 4. Prescriptions were recorded by the GPs. Outcome measures: Outcome measures were patient characteristics, demographics, and symptoms at baseline; medications prescribed by type of physician; and satisfaction with treatment by type of physician and medication.

Results: Most AGPs (86%), and most patients visiting them (58%) were men; whereas most HGPs (57%; p<0.0001), and most patients visiting them (56%; p=0.006) were women. Patients visiting AGPs were seen sooner after the appearance of symptoms, and they self‐treated more frequently with cough suppressants or expectorants (p=0.0018). Patients visiting HGPs were seen later after the appearance of symptoms and they self‐treated with homeopathic medications more frequently (p<0.0001). At enrollment, headaches (p=0.025), cough (p=0.01), muscle/joint pain (p=0.049), chills/shivering (p<0.001), and nasal discharge/congestion (p=0.002) were more common in patients visiting AGPs. Of these patients, 37.1% visiting AGPs were prescribed at least one homeopathic medication, and 59.6% of patients visiting HGPs were prescribed at least one allopathic medication. Patient satisfaction with treatment did not differ between AGPs and HGPs but was highest for patients treated with homeopathic medications only.

Conclusions: In France, homeopathy is widely accepted for the treatment of ILI and does not preclude the use of allopathic medications. However, patients treated with homeopathic medications only are more satisfied with their treatment than other patients.

5. New Academic Courses at Middlesex University

Middlesex University Education and Training in Western Herbal Medicine, Chinese Herbal Medicine, Ayurvedic Medicine or Acupuncture http://www.mdx.ac.uk/courses/postgraduate/complementary_health

“Middlesex University was the first University in the UK to offer degree level education and training in complementary health. “

ENZCAM Newsletter TM/CAM Update August 2012 Page 5

“These new and innovative programmes at Middlesex University provide an opportunity for graduate to gain a professional qualification in Western Herbal Medicine, Chinese Herbal Medicine, Ayurvedic Medicine or Acupuncture.

The programmes are designed to meet the requirements of the Core Curriculum of the European Herbal and Traditional Medicine Practitioners Association (EHTPA) or the British Acupuncture Accreditation Board. These taught Professional Practice programmes combine classroom theoretical learning with significant opportunities to develop clinical skills.

Extensive clinical practice for students is provided at the Asante Academy of Chinese Medicine or the Archway Clinic of Herbal Medicine and in addition, for acupuncture students, via collaborations with nearby NHS hospitals, including the Royal Free, Whittington and North Middlesex.

Length and mode of Study: 1 to 4 years depending on mode of study (full or part time) and prior learning. Students who already possess a healthcare science qualification (e.g. GPs, physiotherapists, chiropractors, osteopaths, midwives, nurses, and complementary practitioners) can apply for accreditation of prior learning.” Courses offered:

 Chinese Medicine, MSc  Integrated Masters in Complementary Medicine (Ayurvedic Medicine), MCM  Professional Practice in Herbal Medicine, MSc  Professional Practice in Chinese Herbal Medicine, MSc  Professional Practice in Ayurvedic Medicine, MSc  Professional Practice in Acupuncture, Msc

“Overseas placements in India form part of the final year of the Integrated Masters in Complementary Medicine (Ayurvedic Medicine). Placement opportunities with our overseas partners in China and in India are also available to students on other courses of study in both Chinese Medicine and Ayurvedic Medicine and students can negotiate to access these in addition to their prescribed course.”

6. Conferences

Conference Presentations and Webcasts Webcasts are now freely available of the plenary speakers at the Third International Research Congress on Integrative Medicine and Health, Portland USA, 15‐18 May 2012. http://imconsortium‐congress2012.org/speakers.html

Forthcoming conferences

A new conference added is the ISCMR Research Methodology Training in March 2013. There will be three modules offered: 1) Basic Study Design and Basic Statistics, 2) Designing Pragmatic Trials for Comparative Effectiveness Research and 3) Systematic Reviews and Meta‐Analysis. See below for details.

ENZCAM Newsletter TM/CAM Update August 2012 Page 6

The International Research Congress on Integrative Medicine and Health (IRCIMH) is moving to a two‐yearly schedule and the next congress will be in May 2014 in Miami, Florida.

24‐26 October 2012 International Congress for Educators in Complementary and Washington DC, USA Integrative Medicine 2012 http://www.icecim.org/

2‐4 November 2012 7th IN‐CAM Research Symposium Toronto, CANADA http://www.incamresearch.ca/index.php?id=19,544,0,0,1,0

29 November 2012 CAMbrella Final Conference Brussels, BELGIUM http://www.cambrella.eu/home.php

18 – 24 March 2013 ISCMR Research Methodology Training in cooperation with Baltimore, USA the Institute for Integrative Health. http://tiih.org/research‐methods 11‐13 April 2013 8th International Congress on Complementary Medicine London, UNITED KINGDOM Research http://www.iccmr2013.org/ 9‐13 September 2013 8th International Congress on Traditional Asian Medicine Sancheong, KOREA http://www.iastam.org/

13‐16 May 2014 International Research Congress on Integrative Medicine Miami, Florida, USA and Health (IRCIMH)

7. Journals

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 4: August 2012 http://online.liebertpub.com/toc/act/18/4

ENZCAM Newsletter TM/CAM Update August 2012 Page 7

 Roundoc Rx: What Should Clinicians Look for in a Supplement?  Building Resiliency: A Strategy to Cope with Stress  Animal‐Assisted Group Therapy in Mental Health Settings: An Initial Model  Exercise to Promote Mind—Body Health in Patients with Cancer  Potential of Herbs as Clinical Photosensitizers  Current Controversies in Nutrition: Fermented Wheat Germ Extract—An Adjunct Treatment for Cancer?  The Functional Medicine Movement—Global and Growing: An Interview with Kristi Hughes, ND  Sea Buckthorn (Hippophae rhamnoides): An Evidence‐Based Systematic Review by the Natural Standard Research Collaboration  Clinical Roundup: Selected Treatment Options for Lyme Disease no access

BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] August 2012 http://www.biomedcentral.com/bmccomplementalternmed/

Selected articles:  Multi‐center randomized double‐blind controlled clinical study of chemotherapy combined with or without traditional Chinese medicine on quality of life of postoperative non‐small cell lung cancer patients  Knowledge and attitudes towards complementary and alternative medicine among medical students in Turkey  Immunity to melanin and to tyrosinase in melanoma patients, and in people with vitiligo  Effect of Alpinia zerumbet components on antioxidant and skin diseases‐related enzymes  Wound healing activities of different extracts of Centella asiatica in incision and burn wound models: an experimental animal study  A homeopathic remedy from arnica, marigold, St. John’s wort and comfrey accelerates in vitro wound scratch closure of NIH 3T3 fibroblasts  Use of complementary and alternative medicine by mid‐age women with back pain: a national crosssectional survey  Acupuncture for the treatment of tinnitus: a systematic review of randomized clinical trials  A six‐month Crossover Chemoprevention Clinical Trial of Tea in Smokers and Non‐smokers: Study Design and Methodological Issues  Usage and appraisal of educational media by homeopathic therapists ‐ A cross sectional survey  Effect of Zingiber officinale R. rhizomes (ginger) on pain relief in primary dysmenorrhea: a placebo randomized trial  Development of an acupuncture treatment protocol by consensus for women undergoing Assisted Reproductive Technology (ART) treatment  Antioxidant and acetylcholinesterase‐inhibitory properties of long‐term stored medicinal plants  Acupressure for persistent cancer‐related fatigue in breast cancer survivors (AcuCrft): a study protocol for a randomized controlled trial  A qualitative study on the term CAM: is there a need to reinvent the wheel?  Screening and identification of dietary oils and unsaturated fatty acids in inhibiting inflammatory prostaglandin E  Herbal medicine: a survey of use in Nigerian presurgical patients booked for ambulatory anaesthesia  Prevalence and determinants of complementary and alternative medicine use among infertile patients in Lebanon: a cross sectional study

ENZCAM Newsletter TM/CAM Update August 2012 Page 8

 Application of orange essential oil as an antistaphylococcal agent in a dressing model  A PET‐CT study on the specificity of acupoints through acupuncture treatment in migraine patients  Suggestion of new possibilities in approaching individual variability in appetite through constitutional typology: a pilot study

Chinese Medicine August 2012 [First listed in ENZCAM Newsletter June 2012] http://www.cmjournal.org/content

Selected articles:  East meets West: current issues relevant to integrating Chinese medicine  PlantID ‐ DNA‐based identification of multiple medicinal plants in complex mixtures

Complementary Therapies in Clinical Practice [First listed in ENZCAM Newsletter June 2011] Volume 18, Number 3: August 2012 http://www.sciencedirect.com/science/journal/17443881/18

Selected articles:  The rise and fall of complementary medicine in National Health Service hospitals in England  Patient experience of acupuncture provision in a GP practice  Reported treatment strategies for reflexology in cardiac patients and inconsistencies in the location of the heart reflex point: An online survey  Diaphragmatic breathing exercise as a therapeutic intervention for control of oxidative stress in type 2 diabetes mellitus  Complementary and alternative treatment use for autism spectrum disorders  The effects of clinical aromatherapy for anxiety and depression in the high risk postpartum woman – A pilot study  Comparing the effects of ice massage and acupressure on labor pain reduction  Do spiritual ceremonies affect participants' quality of life? A pilot study  A randomised controlled pilot feasibility study of the physical and psychological effects of an integrated support programme in breast cancer  Effect of a combined nutraceutical containing Orthosiphon stamineuseffect on blood pressure and metabolic syndrome components in hypertensive dyslipidaemic patients: A randomized clinical trial

Complementary Therapies in Medicine [First listed in ENZCAM Newsletter May 2011] Volume 20, Number 4: August 2012 http://www.sciencedirect.com/science/issue/272589‐1‐s2.0‐S0965229912X00049

Selected articles:  Efficacy of acupressure for non‐pharmacological stress reduction in college students  Acupuncturist perceptions of serving as a clinical trial practitioner

ENZCAM Newsletter TM/CAM Update August 2012 Page 9

 Multiple interacting factors corresponding to repetitive use of complementary and alternative medicine  Use of complementary and alternative medicine in recurrent vulvovaginal candidiasis—Results of a practitioner survey  An investigation of the possible interaction between the use of Vitamin C and highly active antiretroviral therapy (HAART) adherence and effectiveness in treated HIV+ women  Cervical epidural abscess after cupping and acupuncture  Spinal manipulations for tension‐type headaches: A systematic review of randomized controlled trials  The efficacy of Chinese herbal medicine as an adjunctive therapy for colorectal cancer: A systematic review and meta‐analysis  Defining Pilates exercise: A systematic review

Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] August 2012 http://www.hindawi.com/journals/ecam/contents/

Selected articles:  Patterns and Determinants of Complementary and Alternative Medicine Practitioner Use among Adults with Diabetes in Queensland, Australia  Systematic Review of Yoga for Pregnant Women: Current Status and Future Directions  Frequency of Yoga Practice Predicts Health: Results of a National Survey of Yoga Practitioners  Chinese Medicine in Diabetic Peripheral Neuropathy: Experimental Research on Nerve Repair and Regeneration  Effects of Electroacupuncture at Head Points on the Function of Cerebral Motor Areas in Stroke Patients: A PET Study  Can Combination Therapy of Conventional and Oriental Medicine Improve Poststroke Aphasia? Comparative, Observational, Pragmatic Study  Development of a Biocrystallisation Assay for Examining Effects of Homeopathic Preparations Using Cress Seedlings  Complementary Medicine, Exercise, Meditation, Diet, and Lifestyle Modification for Anxiety Disorders: A Review of Current Evidence  Chinese Herbal Medicine in Treating Primary Sjögren’s Syndrome: A Systematic Review of Randomized Trials

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 8: August 2012 http://online.liebertpub.com/toc/acm/18/8

Selected articles:  Use of Mind–Body Complementary Therapies (MBCTs) in Patients with Cancer  Oral Chinese Herbal Medicine for Improvement of Quality of Life in Patients with Stable Chronic Obstructive Pulmonary Disease: A Systematic Review  A Pilot Study Exploring the Effects of a 12‐Week T'ai Chi Intervention on Somatic Symptoms of Depression in Patients with Heart Failure  Yoga Training Improves Quality of Life in Women with Asthma

ENZCAM Newsletter TM/CAM Update August 2012 Page 10

 Mindfulness‐Based Cognitive Therapy Versus Psycho‐Education for Patients with Major Depression Who Did Not Achieve Remission Following Antidepressant Treatment: A Preliminary Analysis  Pranic Meditation Affects Phagocyte Functions and Hormonal Levels of Recent  Effect of a Home‐Based Simple Yoga Program in Child‐Care Workers: A Randomized Controlled Trial  Cerebrovascular Response in Migraineurs During Prophylactic Treatment with Acupuncture: A Randomized Controlled Trial  A Preliminary Study of the Effects of Repeated Massage on Hypothalamic–Pituitary–Adrenal and Immune Function in Healthy Individuals: A Study of Mechanisms of Action and Dosage  Effect of Sweet Orange Aroma on Experimental Anxiety in Humans  Elderly Deaths Associated with Balneotherapy in Denizli, Turkey Province: Three Autopsy Cases  Management of Chickenpox with Frozen Mother's Milk

8. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

August 2012: Spotlight on Modality: Yoga for Health http://nccam.nih.gov/health/providers/digest/yoga

“Yoga is a mind and body practice with historical origins in ancient Indian philosophy. Like other meditative movement practices used for health purposes, various styles of yoga typically combine physical postures, breathing techniques, and meditation or relaxation.

Many people who practice yoga do so to maintain their health and well‐being, improve physical fitness, relieve stress, and enhance quality of life. In addition, yoga is also used to address specific health conditions, such as back pain, neck pain, arthritis, and anxiety. This issue summarizes the scientific research on effectiveness and safety of yoga for health.”

The Clinical Digest contains sections on:  Time to Talk Tips: 5 Things You Should Know About  Read more about what the science says  Featured Clinical Guidelines  The Scientific Literature  Systematic Reviews/Reviews/Meta‐analysis  Randomized Controlled Trials  NCCAM Research Spotlights  Information for Your Patients

Produced for ENZCAM by Heather McLeod and Ray Kirk

10 September 2012

ENZCAM Newsletter TM/CAM Update August 2012 Page 11

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update September 2012

1. Ethics of Traditional Medicine

The International Bioethics Committee of UNESCO Draft Report on Traditional Medicine and its Ethical Implications Published August 2012 http://unesdoc.unesco.org/images/0021/002174/217457e.pdf

“The International Bioethics Committee [IBC] of UNESCO had included the issue of traditional medicine in its 2010‐2011 work programme. A working group was established and entrusted with focusing on the ethical implications of these widespread and very different practices, avoiding duplication of the investigation carried out by other United Nations agencies and institutions. At the same time, internal as well as external sources were consulted and engaged. … This Report is presented to the 19th session of the IBC (UNESCO Headquarters, Paris, 11‐12 September 2012) for further consideration.”

“Traditional medicine is at the crossroads of two different clusters of competences, values and responsibilities.

As medicine, the activity of traditional practitioners has to comply with the requirements which are appropriate to this practice, starting in the first place with those of safety, efficacy and quality. This system of knowledge, skills and practices is supposed to contribute to improve health outcomes, which include physical as well as mental and social well‐being.

As a practice embedded in theories, beliefs and experiences which belong to different peoples, traditional medicine has been used in some communities for hundreds or even thousands of years. It can be perceived as a fundamental feature of their own identity and is often closely intertwined with lifestyles, cultural frameworks and social regulations, as well as domestic legislation.”

“The consideration by IBC of the ethical implications of traditional medicine is directly linked to UNESCO’s mandate to promote cultural diversity. The Universal Declaration on Cultural Diversity (2001), the Convention for the Safeguarding of the Intangible Cultural Heritage (2003) and the Convention on Biological Diversity (2003), as well as the United Nations Declaration on the Rights of Indigenous peoples (2007) establish the parameters within which traditional medicine should be understood and dealt with.”

ENZCAM Newsletter TM/CAM Update September 2012 Page 2

“Governments are called upon to adopt appropriate legislations for assessing, licensing and accrediting traditional practices and drugs and to cooperate to strengthen internationally agreed regulations. Governments and the academia are also called upon to study, elaborate and adopt appropriate educational methods and tools for the teaching of traditional practices, and to strengthen communication, capacities and solidarity. International agencies, non‐governmental organizations and research institutions on modern and traditional medicines are important pillars of this commitment, and collaboration should be encouraged and improved.”

2. Healthcare Research in Australia

The Strategic Review of Health and Medical Research ‐ The McKeon Review www.mckeonreview.org.au

“The Strategic Review of Health and Medical Research in Australia was established by the Australian Government in late 2011. The Review is to report by the end of 2012 and recommend a 10‐year strategic health and medical research plan for the nation.“ The Panel is chaired by Mr Simon McKeon. The Consultation Paper is now available on the website and is open for public comment until 31 October.

“The Panel's vision for health and medical research (HMR) is ‘Better Health Through Research’. Better health encompasses population health outcomes, such as increased life expectancy, as well as social goals such as equity, affordability and quality of life. HMR is the R&D arm of Australia’s $130bn health sector, so investment in research is vital to support innovation, performance improvement, and curtail escalating healthcare costs. The vision is for a high quality and efficient health system, where a defined proportion of the health budget is invested in research in the health system and where all research activity is well managed to deliver health impact. Initially, the focus should be on spending current investment more effectively. Within the next ten years, an additional $2–3bn p.a. should be invested in research to deliver a better health system ….”

While the report does not mention complementary medicine research, the direction taken will influence future CAM and integrative medicine research. The Health Services Research Association Australia and New Zealand (HSRAANZ) produced a summary reproduced below. http://www.hsraanz.org/news/news/12‐10‐03/McKeon_Review_Consultation_Paper.aspx

“The Panel has developed a draft ten‐year strategy that has 21 recommendations, including:  Investing at least 3% of Australian and state and territory government health expenditure (an additional A$2bn to A$3bn per year by mid 2023) to drive research activity within the health system as an embedded component of the Australian government’s health reforms  Establishing “Integrated Health Research Centres” combining hospital networks, universities and medical research institutes to create globally relevant centres of excellence and drive translation of research into clinical practice  Creating up to 1,000 competitive practitioner fellowships for leading clinicians that protects 50% of their time to further embed research within patient care  Providing increased sector leadership by a rejuvenated NHMRC  Supporting focused research based on priorities of immediate clinical relevance to Australians, and in key areas such as Indigenous health, rural and remote health, and application of genomics to personalised medicine

ENZCAM Newsletter TM/CAM Update September 2012 Page 3

 Maintaining research excellence by making research a more attractive career path with improvements in people support, career flexibility and granting processes, and by strategic investment in infrastructure such as biobanks and data linkage networks  Advancing clinical trials, public health research and health services research  Providing clear pathways to translate research evidence into clinical practice, including a matching Translational Development Fund for early stage development and commercialisation  Incentivising high end philanthropy to invest in identified health priorities.”

3. Conferences

Conference Presentations and Webcasts European Journal of Integrative Medicine Volume 4, Supplement 1, September 2012 http://www.sciencedirect.com/science/journal/18763820/4/supp/S1

The 5th European Congress for Integrative Medicine was held in Italy from September 21–22, 2012. There is a special supplement to the European Journal of Integrative Medicine that provides all the papers presented. The supplement of 216 pages has 491 papers on CAM and integrative medicine topics.

“The central topics of the Congress are the efficacy of complementary medicines and practices, their integration with orthodox medicine and the future development of integrative medicine.”

Forthcoming conferences

24‐26 October 2012 International Congress for Educators in Complementary and Washington DC, USA Integrative Medicine 2012 http://www.icecim.org/ 2‐4 November 2012 7th IN‐CAM Research Symposium Toronto, CANADA http://www.incamresearch.ca/index.php?id=19,544,0,0,1,0

29 November 2012 CAMbrella Final Conference: Brussels, BELGIUM The Roadmap for European CAM Research http://www.cambrella.eu/home.php 18 – 24 March 2013 ISCMR Research Methodology Training in cooperation with Baltimore, USA the Institute for Integrative Health. http://tiih.org/research‐methods 11‐13 April 2013 8th International Congress on Complementary Medicine London, UNITED KINGDOM Research http://www.iccmr2013.org/ 9‐13 September 2013 8th International Congress on Traditional Asian Medicine Sancheong, KOREA http://www.iastam.org/

13‐16 May 2014 International Research Congress on Integrative Medicine Miami, Florida, USA and Health (IRCIMH)

ENZCAM Newsletter TM/CAM Update September 2012 Page 4 4. Books

Textbook of Natural Medicine, 4th Edition By Joseph E. Pizzorno Jr. ND and Michael T. Murray ND Publication Date: September 2012 http://www.amazon.com/Textbook‐Medicine‐TEXTBOOK‐MEDICINE‐PIZZORNO/dp/1437723330

This is the fourth edition of the seminal work by Murray and Pizzorno. It is an expensive book but well worth‐having on your shelves, whether you are a researcher, a clinician or a funder. This textbook is frequently described as “the gold standard in natural medicine”.

“Covering preventive, non‐invasive, and natural treatments, Textbook of Natural Medicine, 4th Edition … promotes an integrated practice that can utilize natural medicine, traditional Western medicine, or a combination of both …. Based on a combination of philosophy and clinical studies, [the book] helps you provide health care that identifies and controls the underlying causes of disease, is supportive of the body's own healing processes, and is considerate of each patient's unique biochemistry.”

“Internationally known authors Joseph Pizzorno and Michael Murray [and more than 90 expert contributors ] include detailed pharmacologic information on herbs and supplements, plus evidence‐ based coverage of diseases and conditions …”

 “Coverage of pharmacology of natural medicines includes the uses and potential dangers of nearly 80 herbal medicines, special nutrients, and other natural agents, addressing topics such as general information, chemical composition, history, pharmacology, clinical applications dosage, and toxicology.  In‐depth, evidence‐based coverage of 73 diseases and conditions includes key diagnostic criteria, pathophysiology of diseases, and therapeutic rationales.  Coverage of potential interactions between drugs, herbs, and supplements ensures the safest possible use for each of 79 herbs and supplements.  Diagnostic procedures include … descriptions of evidence‐based techniques plus discussions of clinical application of diet analysis, food allergy testing, immune function assessment, fatty acid profiling, hair mineral analysis, and other diagnostic approaches.  Common therapeutic modalities are described and reviewed, including botanical medicine, nutritional therapy, therapeutic fasting, exercise therapy, hydrotherapy, counseling, acupuncture, homeopathy, and soft tissue manipulation.  Coverage of syndromes and therapies helps in understanding the underlying causes of diseases by discussing topics such as food reactions, functional toxicology, sports nutrition, stress management, and breathing pattern disorders.  Coverage of the philosophy of natural medicine includes its history and background, with discussions of toxicity, detoxification, and scientific documentation of the healing actions of nature and natural substances.  More than 10,000 research literature citations …  13 appendices offer quick lookup of frequently used charts, handouts, and information.  New chapters are included on topics such as female infertility, medicinal mushrooms, natural products and quality control, pregnancy health and primary prevention, and Vitamin K; new appendices include a supplier certification questionnaire and cervical escharotics treatment.  Tabs in Specific Health Problems section [cover some] 70 … diseases/conditions.” Sourced from publisher at Amazon.com

ENZCAM Newsletter TM/CAM Update September 2012 Page 5

The previous edition had additional summaries available that included a clinician's handbook and naturopathic instructions for patients. At the time of release, the first additional product available is the general audience version of the book:

The Encyclopedia of Natural Medicine Third Edition By Michael T. Murray and Joseph E. Pizzorno Published July 2012 http://www.amazon.com/Encyclopedia‐Natural‐Medicine‐Third‐Edition/dp/1451687346

5. Journals

BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] September 2012 http://www.biomedcentral.com/bmccomplementalternmed/content

Selected articles:  Efficacy of acupuncture for chronic knee pain: protocol for a randomised controlled trial using a Zelen design  Dosing study of massage for chronic neck pain: protocol for the dose response evaluation and analysis of massage [DREAM] trial  Effectiveness guidance document (EGD) for acupuncture research ‐ a consensus document for conducting trials  Quality of life, immunomodulation and safety of adjuvant mistletoe treatment in patients with gastric carcinoma ‐‐ a randomized, controlled pilot study  Homeopathy for mental fatigue: lessons from a randomized, triple blind, placebo‐controlled cross‐over clinical trial  Prevalence and patterns of prenatal use of traditional medicine among women at selected Harare clinics: a cross‐sectional study  Mindfulness‐based stress reduction for low back pain. A systematic review  Evaluation of a multi‐herb supplement for erectile dysfunction: a randomized double‐blind, placebo‐controlled study  The Red flag! risk assessment among medical homeopaths in Norway: a qualitative study  Lessons learned from a double‐blind randomised placebo‐controlled study with a iota‐ carrageenan nasal spray as medical device in children with acute symptoms of common cold  Utilization pattern of traditional chinese medicine for liver cancer patients in Taiwan

Chinese Journal of Integrative Medicine. [First listed in ENZCAM Newsletter September 2011] Volume 18 Number 9, September 2012 http://link.springer.com/journal/11655/18/9/page/1

ENZCAM Newsletter TM/CAM Update September 2012 Page 6

Selected articles:  The Western model of integrative oncology — the contribution of Chinese medicine  Integrative oncology meets immunotherapy: New prospects for combination therapy grounded in Eastern medical knowledge  The treatment of non‐small cell lung cancer by interstitial I‐125 seeds implantation combined with chemotherapy and Chinese medicine

European Journal of Integrative Medicine [First listed in ENZCAM Newsletter May 2011] Volume 4, Number 3: September 2012 http://www.europeanintegrativemedicinejrnl.com/current

Selected articles:  Does acupuncture improve the outcome of in vitro fertilization? Guidance for future trials  Incorporation of traditional Chinese medicine pattern diagnosis in the management of rheumatoid arthritis  Bee venom acupuncture for chronic low back pain: A randomised, sham‐controlled, triple‐blind clinical trial  Inpatient satisfaction with TCM medication counseling services provided by pharmacists  The impact of eurythmy therapy on fatigue in healthy adults—A controlled trial  Randomized controlled trial of Sajabalssuk (Artemisia princeps Pampanini) to treat pre‐diabetes  Modified Ling‐Gui‐Zhu‐Gan decoction combined with short‐term fasting improves therapeutic response in type 2 diabetic patients  Clinical efficacy of a Unani formulation ‘Safoof Habis’ in menorrhagia: A randomized controlled trial  The impact of Ephedra and green tea combination mesotherapy on localized fat: A randomized‐ controlled clinical trial  Pounds, shillings and pence: Ways to Cost NHS complementary therapy services – The SEAT and BISCUIT studies  Action research, critical realism and new knowledge for delivering integrative medicine: Sharing research results  A pragmatic observational cohort study to evaluate treatments for musculoskeletal disorders provided by the Royal London Hospital for Integrated Medicine  Prevalence of complementary and alternative medicine (CAM) use by UK patients/consumers: A systematic review of surveys

Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] Published September 2012 http://www.hindawi.com/journals/ecam/2012/

Selected articles:  Role of Medicinal Plants and Natural Products on Osteoporotic Fracture Healing  Nigella sativa: A Potential Antiosteoporotic Agent  Effects of Yoga Interventions on Fatigue: A Meta‐Analysis  Herbal Products: Benefits, Limits, and Applications in Chronic Liver Disease

ENZCAM Newsletter TM/CAM Update September 2012 Page 7

 The Evolution of Mindfulness‐Based Physical Interventions in Breast Cancer Survivors  Effects of Yoga on Mental and Physical Health: A Short Summary of Reviews  Chinese Herbal Medicine Paratherapy for Parkinson's Disease: A Meta‐Analysis of 19 Randomized Controlled Trials  Safety and Efficacy Profile of Echinacea purpurea to Prevent Common Cold Episodes: A Randomized, Double‐Blind, Placebo‐Controlled Trial  The Molecular Basis of Wound Healing Processes Induced by Lithospermi Radix: A Proteomics and Biochemical Analysis  Medicinal Plants in the Prevention and Treatment of Chronic Diseases  Clinical Studies on Treatment of Earthquake‐Caused Posttraumatic Stress Disorder Using Electroacupuncture

Explore: The Journal of Science and Healing [First listed in ENZCAM Newsletter May 2011] Volume 8, Number 5: September 2012 http://www.explorejournal.com/current Selected articles:  Evidence and Potential Mechanisms for Mindfulness Practices and Energy Psychology for Obesity and Binge‐Eating Disorder  Retrolective Studies on the Survival of Cancer Patients Treated With Mistletoe Extracts: A Meta‐ analysis  Altars and Icons: The Surgical Suite as a Sacred Ritual

Integrative Cancer Therapies [First listed in ENZCAM Newsletter April 2011] Volume 11, Number 3: September 2012 http://ict.sagepub.com/content/11/3?etoc

Selected articles:  How Many Cancer Patients Use Complementary and Alternative Medicine: A Systematic Review and Metaanalysis  Effect of Ginger on Acute and Delayed Chemotherapy‐Induced Nausea and Vomiting: A Pilot, Randomized, Open‐Label Clinical Trial  The Role of Religion and Spirituality in Psychological Distress Prior to Surgery for Urologic Cancer  Use of Chinese Medicine Among Survivors of Nasopharyngeal Carcinoma in Taiwan: A Population‐Based Study  Practices, Attitudes, and Beliefs Associated With Complementary and Alternative Medicine (CAM) Use Among Cancer Patients

Journal of Ayurveda and Integrative Medicine

“The Journal of Ayurveda and Integrative Medicine (J‐AIM) is a peer reviewed, open access international circulating professional journal led by the Institute of Ayurveda and Integrative Medicine (www.iaim‐frlht.org ). As a trans‐disciplinary platform for integrative health sciences, J‐AIM aims to explore the relationships between Ayurveda, biomedicine and other contemporary health

ENZCAM Newsletter TM/CAM Update September 2012 Page 8 sciences, encouraging meaningful collaboration to promote effective, safe and affordable global health.”

Volume 3, Number 3: July‐September 2012 http://www.jaim.in/currentissue.asp?sabs=n

Selected articles:  Exploratory study to evaluate tolerability, safety, and activity of Ashwagandha (Withania somnifera) in healthy volunteers  The ontological status of western science and medicine  Adjunct therapy of Ayurvedic medicine with anti‐tubercular drugs on the therapeutic management of pulmonary tuberculosis  Association of constitutional type of Ayurveda with cardiovascular risk factors, inflammatory markers and insulin resistance

Journal of Holistic Nursing [First listed in ENZCAM Newsletter April 2011] Volume 30, Number 3: September 2012 http://jhn.sagepub.com/content/30/3.toc?etoc

Selected articles:  The Self‐Transcendence Scale: An Investigation of the Factor Structure Among Nursing Home Patients  Singapore Nursing Students’ Perceptions and Attitudes About Spirituality and Spiritual Care in Practice: A Qualitative Study  A Pilot Study Evaluating the Effect of Mindfulness‐Based Stress Reduction on Psychological Status, Physical Status, Salivary Cortisol, and Interleukin‐6 Among Advanced‐Stage Cancer Patients and Their Caregivers  The Six Dimensions of Wellness and Cognition in Aging Adults  Using a Healing Touch Intervention in Older Adults With Persistent Pain: A Feasibility Study

Journal of Medicinal Food [First listed in ENZCAM Newsletter Q1 2011] Volume 15, Number 9: September 2012 http://online.liebertpub.com/toc/jmf/15/9

Selected articles:  Resveratrol in Cholesterol Metabolism and Atherosclerosis  Ginkgo biloba Extract and Bilberry Anthocyanins Improve Visual Function in Patients with Normal Tension Glaucoma  Evaluation of the Efficacy of Flaxseed Meal and Flaxseed Extract in Reducing Menopausal Symptoms

ENZCAM Newsletter TM/CAM Update September 2012 Page 9 Medical Acupuncture http://www.liebertpub.com/acu “Medical Acupuncture is an essential, peer‐reviewed journal written for physicians, by physicians. The Journal delivers authoritative, evidence‐based clinical papers, case reports, and research findings that integrate concepts from traditional and modern forms of acupuncture with conventional medical training.” Medical Acupuncture coverage includes: pain relief; stroke; neurological disorders; digestive disorders; respiratory disorders; urinary, menstrual, and reproductive problems; nausea and vomiting from oncological therapies; and dermatological conditions.

Volume 24, Number 3: September 2012 http://online.liebertpub.com/toc/acu/24/3

Selected articles:  Combining Acupuncture with Western and Chinese Nutritional Treatment in Obesity  Electroacupuncture Effects on the Disintegration of Beta Amyloid Sheets: Its Application to Alzheimer's Disease  The Brain Effects of Laser Acupuncture in Depressed Individuals: An fMRI Investigation  Electroacupuncture Treatment in Osteoarthritis Pain of the Knee for Geriatric Patients  Holistic Acupuncture  How Do You Treat Bell's Palsy in Your Practice?

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 9: September 2012 http://online.liebertpub.com/toc/acm/18/9

Selected articles:  Epidemiology, Quality, and Reporting Characteristics of Systematic Reviews of Acupuncture Interventions Published in Chinese Journals  Acupuncture for Shoulder Pain After Stroke: A Systematic Review  Integrating Complementary Medicine and Supportive Care: Patients' Perspectives Toward Complementary Medicine and Spirituality  The Benefits of Yoga for Women Veterans with Chronic Low Back Pain  The ADDOPT Study (Acupuncture to Decrease Disparities in Outcomes of Pain Treatment): Feasibility of Offering Acupuncture in the Community Health Center Setting  Prevalence and Correlates of Complementary and Alternative Medicine Services Use in Low‐ Income African Americans and Whites: A Report from the Southern Community Cohort Study  Preliminary Trial of Aloe Vera Gruel on HIV Infection  S‐Adenosyl‐l‐Methionine (SAMe) for Smoking Abstinence: A Randomized Clinical Trial  Complementary and Alternative Medicine in the Undergraduate Medical Curriculum: A Survey of Korean Medical Schools  Qi, Acupuncture, and the Fascia: A Reconsideration of the Fundamental Principles of Acupuncture

ENZCAM Newsletter TM/CAM Update September 2012 Page 10 6. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

September 2012: Children and Dietary Supplements http://nccam.nih.gov/health/providers/digest/children

“Research has shown that many children use herbs and other dietary supplements. However, there are little data available on their safety and effectiveness in children. The 2007 National Health Interview Survey (NHIS) gathered information on use of complementary health practices among more than 9,000 children younger than 18. Nearly 12 percent of the children had used some form of a complementary health practice during the past 12 months. In addition to herbs and dietary supplements, children use a wide range of complementary health approaches, including spinal manipulation and yoga.

Further, a 2001 survey of 745 members of the American Academy of Pediatrics found that 87 percent of pediatricians had been asked about complementary health practices by a patient or a parent in the 3 months prior to the survey. The pediatricians in the survey were asked most often about herbs and dietary supplements.

This issue provides information about scope of use of complementary health practices by children, safety, and how to discuss complementary health approaches with your patients.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

8 October 2012

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update October, November 2012

1. Policy and Legislation

Progress on the New Zealand Natural Health Products Bill The bill was introduced in parliament by the Minister of Health in September 2011. After the first reading, it was referred to the Health Committee and submissions were due by 24 February 2012. The Select Committee report was published on 31 October 2012.

A press release from the Minister of Health said:

The Natural Health Products Bill has been reported back to Parliament with the support of all parties on the Health Select Committee. Health Minister Tony Ryall is pleased with progress on the bill, which will provide regulation of commercial natural health products, such as vitamin supplements, Echinacea and fish oil.

“New Zealanders can continue to support and manage their own health as they do now, but the bill will ensure the natural health products they buy are safe, the labels are accurate and the claims the products make, such as ‘will improve your immunity’, are true,” Mr Ryall said. “This low cost, low bureaucracy regulation will give the public greater confidence about the safety and integrity of natural health products.”

Mr Ryall acknowledged the cooperation of the Green Party in the development of the Bill which was reported back unanimously. Green Party Natural Health spokesperson Mojo Mathers said, “The Bill brings in a good balance between light handed regulation and protecting consumers. The schedule of approved pharmacopeia in the Bill will make the process of approving traditional claims very straightforward for many natural health products. “I’m pleased that products prepared as part of traditional medicine practice such as Rongoa are exempted.”

Only commercial products will be affected – people can continue to prepare home remedies. The Government and the Green Party also acknowledged the support of the Labour Party. The detailed regulatory work will be undertaken in consultation with the industry, and public. As part of the memorandum of understanding agreement, the Government has also agreed the Green Party will be involved at every stage of the development of these regulations.

Background from the Ministry of Health: http://www.health.govt.nz/about‐ministry/legislation‐and‐regulation/regulatory‐impact‐ statements/development‐natural‐health‐products‐bill

ENZCAM Newsletter TM/CAM Update October, November 2012 Page 2

The legislative progress can be followed at: http://www.parliament.nz/en‐NZ/PB/Legislation/Bills/b/c/8/00DBHOH_BILL11034_1‐Natural‐ Health‐Products‐Bill.htm

Text of the Natural Health Products bill: http://www.legislation.govt.nz/bill/government/2011/0324/latest/DLM3984610.html

2. CAMbrella Project Final Reports

European Policy Brief: The Roadmap for European CAM Research The Roadmap for European CAM Research: An Explanation of the CAMbrella Project and its Key Findings http://www.cambrella.eu/home.php?il=203&l=deu

“CAMbrella is an EU funded project that looks into the situation of Complementary and Alternative Medicine (CAM) in Europe as it presents itself in 2012. The acronym brings together the terms ‘CAM’ and ‘umbrella’ to stress the project’s effort both to harmonize existing knowledge and to determine the knowledge gaps in this field. Both parts come together in recommendations to the European Commission and the European Parliament on the way forward in Europe for research into CAM …”.

The Roadmap for European CAM research “describes a strategic approach to research for the field of CAM. It is based on past experiences in CAM research and designed to address future European healthcare challenges. It takes the findings of all the CAMbrella work packages into account.

CAMbrella´s vision for 2020 is that an evidence base is established which enables European citizens, healthcare providers and other stakeholders to make informed decisions about CAM. Currently, there is too little general knowledge about the state of CAM in Europe, especially on  the prevalence of use of CAM  the needs and attitudes of EU citizens, patients and providers  regarding CAM  the types and modes of CAM provision.

Past research with its focus on the underlying mechanisms of CAM hasn’t met the more pressing questions about CAM as possible reasonable treatment options in addition or alternative to routine care protocols. Furthermore, the considerable heterogeneity within CAM in the EU has hampered the development of pan‐European research efforts. The challenges now are to:  address the needs and attitudes of EU citizens, patients and providers  get essential information about the real situation as regards provision and use of CAM in all countries of Europe  create a valid knowledge data base on CAM effectiveness, costs and safety  establish scientific knowledge that enables all stakeholders including citizens, healthcare providers, policy makers and researchers to make informed decisions about CAM.”

The policy brief and the “Roadmap” documents have been published. CAMbrella says that “between December 2012 and April 2013 we still will upload reports and documents generated in the work‐ packages of CAMbrella.” These are expected to contain much useful information on CAM in Europe for researchers, funders and providers.

ENZCAM Newsletter TM/CAM Update October, November 2012 Page 3

There were eight work packages: 1) Terminology and definitions of CAM methods 2) Legal status and regulations 3) Needs and attitudes of citizens 4) CAM use – the patients’ perspective 5) CAM use – the providers’ perspective 6) The global perspective 7) The Roadmap for CAM research in Europe 8) Communication and dissemination

These documents will be able to be accessed at: http://www.cambrella.eu/home.php?il=203&l=deu

3. Thesis on Rongoā Māori (traditional Māori healing)

Rongoā Māori (traditional Māori healing) through the eyes of Māori healers : sharing the healing while keeping the tapu A thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychology at Massey University, Albany, New Zealand by Glenis Mark http://mro.massey.ac.nz/handle/10179/4064

Abstract:

“This research explores the underlying philosophies of rongoa Maori, the traditional healing system of the indigenous Maori of Aotearoa/New Zealand. The research is set within the context of worldwide traditional healing systems that involves discussion of the embedded nature of indigenous cultural values and beliefs within traditional healing practices. Parallels are drawn between the traditional healing practices of Maori and other indigenous healing traditions.

The research was conducted in adherence to the principles of Kaupapa Maori research to ensure the use of Maori cultural values throughout the research process. Narrative interviews were conducted with seventeen Maori healers about their understandings of rongoa Maori. Data analysis was conducted in a three‐step process using an approach created specifically for the research entitled the rourou Maori method of analysis. The analysis was inclusive of the contributions of each individual healer and the researcher to the collective story on rongoa Maori across all participants in the research.

The analysis revealed nine underlying philosophies of rongoa Maori. These showed that rongoa Maori: healing is a continuous process of life; is a co‐construction of healing through the healer/client relationship; includes collaborative whakawhanaungatanga (family‐like) relationships in healing; involves the synergy of the alliance between people and plants; utilises the tipuna (ancestors) as the wairua (spirits) that conduct the healing; focuses on diagnosing illness through past generations; identifies the power of emotions to create or destroy health, illness and healing; aims to facilitate change for the client; and aspires to heal Maori of colonisation and keep Maori knowledge sovereign.

In this research, Maori healers indicated that aspects of Maori knowledge and wisdom have been purposely kept tapu (sacred). However, there are three major contributions to knowledge about traditional healing systems. First, new insights were presented on rongoa Maori, such as the relationship between healers and plants. Second, the contribution of rongoa Maori to the greater

ENZCAM Newsletter TM/CAM Update October, November 2012 Page 4 advancement of Maori tino rangatiratanga was discussed. Third, additional conceptualisations about traditional healing systems, such as aroha (love) in the relationship between the healer and client, were found. Rongoa Maori was shown to share several healing concepts with other traditional healing systems.

4. Australian Indigenous HealthInfoNet http://www.healthinfonet.ecu.edu.au/

“The Australian Indigenous HealthInfoNet is an innovative internet resource that aims to inform practice and policy in Indigenous health by making research and other knowledge readily accessible. In this way, we contribute to 'closing the gap' in health between Indigenous and other Australians.

We are an academic unit of Edith Cowan University (ECU), Western Australia’s oldest tertiary education institution and newest university. … Our work in the area of translational research with a population health focus – in which we are a world leader – makes research and other information available in a form that has immediate, practical utility for practitioners and policy‐makers in the area of Indigenous health, enabling them to make decisions based on the best available evidence.

We also encourage and support information‐sharing among practitioners, policy‐makers and others working to improve Indigenous health. Our 'yarning places' (electronic networks) allow people with common interests and purposes to share information, knowledge and experience from different states, territories, regions and sectors. Our core functions are made possible by grants (particularly from the Australian Department of Health and Ageing's Office for Aboriginal and Torres Strait Islander Health). Specific research activities are supported by funds from a variety of sources.”

While the Australian Indigenous HealthInfoNet deals with health issues for Aboriginal and Torres Strait Islander people from largely a western perspective, there are a significant number of links to material on traditional medicines. Use “traditional medicines” in the search facility.

5. Macquarie University's Indigenous Bioresources Research Group (IBRG) http://www.science.mq.edu.au/news_and_events/news/bush_medicine

“Researchers from Macquarie University's Indigenous Bioresources Research Group (IBRG) have worked closely with the Yaegl people in northern NSW to document their medicinal plant knowledge, and have also begun phase two of their study ‐ examining the chemical and biological properties of the plants. Bioorganic and Medicinal Chemist Associate Professor Joanne Jamie said the research aim was to conserve customary Aboriginal knowledge, and apply this to the discovery of new evidence‐based alternative medicines.”

Jamie said: "In Australia we are only now beginning to regard traditional knowledge as a significant medicinal resource ‐ the increase in microbial resistance, emergence of new diseases, side effects of medicines and high cost of drug development have forced us to take a fresh look."

“Central to the success of the bush medicine research is the strong relationship between the researchers and the Elders, which has been forged over many years and has culminated in a collaborative partnership agreement to work together on the study. …”

ENZCAM Newsletter TM/CAM Update October, November 2012 Page 5

“The Macquarie University study has become a model for collaboration between Australian Aboriginal communities and research scientists. The University has worked closely with the Elders involved to identify ways that their communities can gain real benefit from the partnership ‐ such as creating educational opportunities for Aboriginal high school students. The IBRG's bush medicine study is funded by a grant from the National Health and Medical Research Council, awarded to the Macquarie University team …”.

6. Book on Arrernte Traditional Healing

Arelhe‐Kenhe Merrethene: Arrernte Traditional Healing By Veronica Dobson http://iadpress.com/shop/arrernte‐traditional‐healing/

This book “is a comprehensive overview of the different methods of healing used by the Arrernte people of Central Australia. ‘Dreaming of the healing power comes from, to your Altyerre Aknganentye or totem and country.’ Starting with the spiritual and cultural basis of Arrernte healing, Veronica explains the source of the Angangkeres’ healing powers and their use of singing and touch. Then follows a comprehensive list of plants, insects and other methods used in traditional healing, with explanations and comprehensive illustrations of how the remedies are prepared.

The author, Veronica Dobson, is a widely respected elder who is also a noted translator, interpreter and teacher of the Arrernte language. She has drawn on her own cultural knowledge and supplemented it by interviewing other elders and senior healers in the Arrernte community. The author shares the various medicinal plants and how they are processed into washes and ointments; the use of hot earth and ashes, and the treatments for various conditions such as toothache, snakebite and flu.”

7. Paper: International Classification of Traditional Medicine

In the ENZCAM newsletter of May 2012 we reported on the inclusion of ICD codes for traditional medicine derived from Chinese medicine in the forthcoming WHO International Classification of Diseases, 11th edition (ICD‐11). The academic paper below deals with this topic in greater detail. It also has a useful summary of the WHO’s traditional medicine efforts and the three phases of the oriental traditional medicine project. International Classification of Traditional Medicine By William Morris, Stacy Gomes and Marilyn Allen Global Advances in Health and Medicine, September 2012, Volume 1, Number 4 http://www.gahmj.com/doi/abs/10.7453/gahmj.2012.1.4.005

“The ramifications of the ICD project are far‐reaching and complex. At the minimum, there is recognition of TM models. More importantly, given the rate of TM use worldwide, there is a large knowledge gap about the patterns of TM use, which this project would address in part. The development of acupuncture and Oriental medicine disease classification codes has implications for education, research, insurance reimbursement, medical integration, individual practitioners, international recognition, and professional identity.”

ENZCAM Newsletter TM/CAM Update October, November 2012 Page 6 8. Conferences

Forthcoming conferences

13‐16 May 2014 International Research Congress on Integrative Medicine Miami, Florida, USA and Health (IRCIMH)

9. Journals

African Journal of Traditional, Complementary and Alternative medicines (AJTCAM) [First listed in ENZCAM Newsletter October 2011] Volume 10, Number 1: 2013 (October 2012) http://journals.sfu.ca/africanem/index.php/ajtcam

Selected articles:  Complementary and Alternative Medicine Usage in Cancer Patients in Southeast of Turkey  Tribal Formulations for Treatment of Pain: A Study of the Bede Community Traditional Medicinal Practitioners of Porabari Village in Dhaka District, Bangladesh  The Effects of Pranayama, Hatha and Raja Yoga on Physical Pain and the Quality of Life of Women with Multiple Sclerosis

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 5: October 2012 http://online.liebertpub.com/toc/act/18/5

ENZCAM Newsletter TM/CAM Update October, November 2012 Page 7

Selected articles:  Roundoc Rx: Environmental Toxins and Children’s Health: Part 1—Why Children Are at Risk  Integrative Strategies for Treating Pediatric Asthma  Neurofeedback Therapy in Clinical Applications and for Cognitive Enhancement  Neuroimaging and Pain: Matching Brain Function to Targeted Treatments  Current Concepts in Nutrition: The Science and Art of the Elimination Diet  Cilantro—Culinary Herb or Miracle Medicinal Plant?  Medicate and Meditate—A Broader View of Heart Disease: An Interview with Erminia “Mimi” Guarneri, MD, FACC  Herpes: An Integrative Approach—A Natural Standard Monograph  Clinical Roundup: Selected Treatment Options for Urticaria

BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] October 2012 http://www.biomedcentral.com/bmccomplementalternmed/

Selected articles:  CAM practitioners in the Australian health workforce: an underutilized resource  A model for homeopathic remedy effects: low dose nanoparticles, allostatic cross‐adaptation, and time‐dependent sensitization in a complex adaptive system  Impact of electroacupuncture on quality of life for patients with Relapsing‐Remitting Multiple Sclerosis under treatment with immunomodulators: A randomized study  Current status of Kampo medicine curricula in all Japanese medical schools  Understanding the role of scientific evidence in consumer evaluation of natural health products for osteoarthritis an application of the means end chain approach  Effects of comprehensive therapy based on traditional Chinese medicine patterns in stable chronic obstructive pulmonary disease: a four‐center, open‐label, randomized, controlled study  Disease severity is associated with the use of complementary medicine to treat or manage type‐ 2 diabetes: data from the 2002 and 2007 National Health Interview Survey  Pulsatile dry cupping in patients with osteoarthritis of the knee ‐‐ a randomized controlled exploratory trial  Factors affecting pharmacists' recommendation of complementary medicines ‐‐ a qualitative pilot study of Australian pharmacists  Confidence in the efficacy and safety of dietary supplements among United States active duty army personnel  Antioxidant and anti‐inflammatory activities of selected Chinese medicinal plants and their relation with antioxidant content

Complementary Therapies in Clinical Practice [First listed in ENZCAM Newsletter June 2011] Volume 18, Number 4: November 2012 http://www.ctcpjournal.com/current

Selected articles:  Enhanced external counterpulsation: A novel therapy for angina  Reflexology has an acute (immediate) haemodynamic effect in healthy volunteers: A double‐ blind randomised controlled trial

ENZCAM Newsletter TM/CAM Update October, November 2012 Page 8

 Feasibility and effect of chair massage offered to nurses during work hours on stress‐related symptoms: A pilot study  Acupuncture and Chinese herbs as treatments for depression: An Australian pilot study  Mindfulness‐based stress reduction in breast cancer: A qualitative analysis  The effectiveness of Swedish massage and traditional Thai massage in treating chronic low back pain: A review of the literature  Mindfulness yoga during pregnancy for psychiatrically at‐risk women: Preliminary results from a pilot feasibility study  Pilot study of yoga for breast cancer survivors with poor quality of life  Complementary and alternative medicines (CAM) disclosure to the health care providers: A qualitative insight from Malaysian cancer patients  Developing midwifery and complementary medicine collaboration: The potential of interprofessional education?

Complementary Therapies in Medicine [First listed in ENZCAM Newsletter May 2011] Volume 20, Number 5: October 2012 http://www.complementarytherapiesinmedicine.com/issues

Selected articles:  The effect of olive oil on prevention of striae gravidarum: A randomized controlled clinical trial  Back pain amongst mid‐age Australian women: A longitudinal analysis of provider use and self‐ prescribed treatments  Prognosis following the use of complementary and alternative medicine in women diagnosed with breast cancer  Physiological changes in energy healers during self‐practice  Faith and use of complementary and alternative medicine among heart attack patients in a secular society  Substitutes or complements? An exploration of the effect of wait times and availability of conventional care on the use of alternative health therapies in Canada  Status of complementary and alternative medicine in the curricula of health colleges in Saudi Arabia  Safety protocols for Gua sha (press‐stroking) and Baguan (cupping)  Defining research priorities in complementary medicine in oncology  Acupoint stimulation intervention for people with primary dysmenorrhea: Systematic review and meta‐analysis of randomized trials  Costs and consequences of acupuncture as a treatment for chronic pain: A systematic review of economic evaluations conducted alongside randomised controlled trials

The EPMA Journal [First listed in ENZCAM Newsletter December 2011] Volume 3, October and November 2012

Articles:  Evidence‐based pain management: is the concept of integrative medicine applicable?  Predictive and preventive strategies to advance the treatments of cardiovascular and cerebrovascular diseases: the Ukrainian context

ENZCAM Newsletter TM/CAM Update October, November 2012 Page 9

 Opinion controversy to chromium picolinate therapy's safety and efficacy: ignoring 'anecdotes' of case reports or recognising individual risks and new guidelines urgency to introduce innovation by predictive diagnostics?  General Report & Recommendations in Predictive, Preventive and Personalised Medicine 2012: White Paper of the European Association for Predictive, Preventive and Personalised Medicine  Introduction into PPPM as a new paradigm of public health service: an integrative view  Traditional, complementary and alternative medical systems and their contribution to personalisation, prediction and prevention in medicine‐‐‐person‐centred medicine

Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] Published October and November 2012 http://www.hindawi.com/journals/ecam/2012/

Selected articles:  Iyengar Yoga for Distressed Women: A 3‐Armed Randomized Controlled Trial  The Traditional Chinese Medicine Prescription Pattern of Endometriosis Patients in Taiwan: A Population‐Based Study  Guidelines for Developing Yoga Interventions for Randomized Trials  Prescription Patterns of Chinese Herbal Products for Osteoporosis in Taiwan: A Population‐Based Study  Changing Academic Medicine: Strategies Used by Academic Leaders of Integrative Medicine—A Qualitative Study  Utilization of and Attitudes towards Traditional Chinese Medicine Therapies in a Chinese Cancer Hospital: A Survey of Patients and Physicians  Use of Chinese Medicine and Subsequent Surgery in Women with Uterine Fibroid: A Retrospective Cohort Study  Vitamin E and Bone Structural Changes: An Evidence‐Based Review  Therapeutic Approaches to Neuroprotective Activity by Complementary and Alternative Medicines  Yoga & Cancer Interventions: A Review of the Clinical Significance of Patient Reported Outcomes for Cancer Survivors  Systems Biology of Meridians, Acupoints, and Chinese Herbs in Disease  Training Self‐Administered Acupressure Exercise among Postmenopausal Women with Osteoarthritic Knee Pain: A Feasibility Study and Lessons Learned  Traditional Medicine in China, Korea, and Japan: A Brief Introduction and Comparison  A Review of Acupoint Specificity Research in China: Status Quo and Prospects  Effectiveness of Yoga for Menopausal Symptoms: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials  Chinese Patent Medicine Liu Wei Di Huang Wan Combined with Antihypertensive Drugs, a New Integrative Medicine Therapy, for the Treatment of Essential Hypertension: A Systematic Review of Randomized Controlled Trials  Yoga as a Therapeutic Intervention  Systematic Review of Chinese Traditional Exercise Baduanjin Modulating the Blood Lipid Metabolism  Chinese Massage Combined with Herbal Ointment for Athletes with Nonspecific Low Back Pain: A Randomized Controlled Trial  Pomegranate Protection against Cardiovascular Diseases

ENZCAM Newsletter TM/CAM Update October, November 2012 Page 10

Explore: The Journal of Science and Healing [First listed in ENZCAM Newsletter May 2011] Volume 8, Number 6: November 2012 http://www.explorejournal.com/current

Selected articles:  Meaning as a Healing Agent  Nonlocality, Near‐Death Experiences, and the Challenge of Consciousness  Thought Field Therapy (TFT) as a Treatment for Anxiety Symptoms: A Randomized Controlled Trial  Entangled in the Womb? A Pilot Study on the Possible Physiological Connectedness Between Identical Twins with Different Embryonic Backgrounds  Patients Seek Integrative Medicine for Preventive Approach to Optimize Health  Energy Therapies: Focus on Spirituality  Medical and Psychology Students' Knowledge of and Attitudes Towards Mindfulness as a Clinical Intervention  Interprofessional Student Education: Exchange Program Between Albert Einstein College of Medicine and Pacific College of Oriental Medicine

Journal of Evidence‐Based Complementary & Alternative Medicine [First listed in ENZCAM Newsletter April 2011] Volume 17, Number 3: October 2012 http://chp.sagepub.com/content/17/3.toc?etoc

Selected articles:  Effect of Serum Vitamin D Levels on Cardiovascular Mortality and Cardiovascular Disease Risk  Spiritual Well‐Being May Buffer Psychological Distress in Patients With Implantable Cardioverter Defibrillators  Yoga as an Alternative and Complementary Treatment for Hypertensive Patients: A Systematic Review  The Effect of Regular Exercise and Yoga on Health‐Related Quality of Life Among Ovarian Cancer Survivors  Effects of Reiki, Yoga, or Meditation on the Physical and Psychological Symptoms of Chemotherapy‐Induced Peripheral Neuropathy: A Randomized Pilot Study  Yoga as an Alternative and Complementary Treatment for Asthma: A Systematic Review  Racial and Ethnic Profiles of Complementary and Alternative Medicine Use Among Young Adults in the United States: Findings From the National Longitudinal Study of Adolescent Health  The Importance of Complementary and Alternative Medicine Education in Medical School  The Free Radical Theory of Aging and Antioxidant Supplements: A Systematic Review

Journal of Medicinal Food [First listed in ENZCAM Newsletter Q1 2011] Volume 15, Number 11: November 2012 http://online.liebertpub.com/toc/jmf/15/11

ENZCAM Newsletter TM/CAM Update October, November 2012 Page 11

Selected articles:  Anti‐Inflammatory Activity of Sulfur‐Containing Compounds from Garlic  Anti‐Inflammatory and Anti‐Ulcer Activities of Carvacrol, a Monoterpene Present in the Essential Oil of Oregano  A Meta‐Analysis of Clinical Improvements of General Well‐Being by a Standardized Lycium barbarum  Effects of Ecklonia cava Polyphenol in Individuals with Hypercholesterolemia: A Pilot Study

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 10: October 2012 http://online.liebertpub.com/toc/acm/18/10

Selected articles:  On Contradictions Between Chinese and Tibetan Pulse Diagnosis  Adverse Events Following Acupuncture: A Systematic Review of the Chinese Literature for the Years 1956–2010  The Effects of Yoga on Physical Functioning and Health Related Quality of Life in Older Adults: A Systematic Review and Meta‐Analysis  Can Acupuncture Affect the Circadian Rhythm of Blood Pressure? A Randomized, Double‐Blind, Controlled Trial  Aromatherapy and Massage Intrapartum Service Impact on Use of Analgesia and Anesthesia in Women in Labor: A Retrospective Case Note Analysis  An Integrative Medicine Approach to Asthma: Who Responds?  The Effect of Interactive Neurostimulation Therapy on Myofascial Trigger Points Associated with Mechanical Neck Pain: A Preliminary Randomized, Sham‐Controlled Trial  Rehabilitation of Stroke Patients Using Yamamoto New Scalp Acupuncture: A Pilot Study  Evaluation of the Effect of Progressive Relaxation Exercises on Fatigue and Sleep Quality in Patients with Multiple Sclerosis

Volume 18, Number 11: November 2012 http://online.liebertpub.com/toc/acm/18/11

Selected articles:  Use of Complementary and Alternative Medicine in Residential Aged Care  Effects of Yoga on Psychologic Function and Quality of Life in Women with Breast Cancer: A Meta‐Analysis of Randomized Controlled Trials  Black Pepper Essential Oil to Enhance Intravenous Catheter Insertion in Patients With Poor Vein Visibility: A Controlled Study  The Challenges of Establishing an Integrative Medicine Primary Care Clinic in Sydney, Australia  Complementary and Alternative Medicine Use in Radiotherapy: What Are Patients Using?  Acupuncture for Irritable Bowel Syndrome: Diagnosis and Treatment of Patients in a Pragmatic Trial  Use of Complementary and Alternative Medicine by Patients with Cancer in Saudi Arabia  Safety and Tolerability of Panax ginseng Root Extract: A Randomized, Placebo‐Controlled, Clinical Trial in Healthy Korean Volunteers

ENZCAM Newsletter TM/CAM Update October, November 2012 Page 12 10. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

October 2012: St. John’s Wort and Depression http://nccam.nih.gov/health/providers/digest/depression

St. John’s wort, a plant that grows in the wild, has been used for centuries for mental health conditions and is widely prescribed for depression in Europe. There is public interest in the United States as well, and many people come to NCCAM’s Web site seeking information on St. John’s wort for depression, consistently making it one of the top five search terms every month. However, current evidence for using St. John’s wort for depression is not conclusive, and the herb can have serious side effects. It is also important to note that in the United States, the Food and Drug Administration has not approved its use as an over‐the‐counter or prescription medicine for depression.

This issue provides information on what the science says about St. John’s wort for depression, including scientific evidence, side effects and cautions, and tips for talking with your patients.

November 2012: Omega‐3 Supplements for Heart Disease http://nccam.nih.gov/health/providers/digest/omega3

According to the 2007 National Health Interview Survey, which included a comprehensive survey on the use of complementary health practices by Americans, fish oil/omega‐3/DHA supplements are the natural product (excluding vitamins and minerals) most commonly taken by adults, and the second most commonly taken by children.

There has been a substantial amount of research on omega‐3 supplements and heart disease. Experts agree that fish rich in omega‐3 fatty acids should be included in a heart‐healthy diet. However, omega‐3s in supplement form have not been shown to protect against heart disease.

Omega‐3s are being extensively studied for other conditions, such as rheumatoid arthritis and cognitive decline. Current evidence‐based information is available from NCCAM at http://nccam.nih.gov/health/omega3

This issue provides information on omega‐3 supplements for heart disease, including what the science says, safety information, and tips for talking with your patients.

Produced for ENZCAM by Heather McLeod and Ray Kirk

4 December 2012

ENZCAM Newsletter TM/CAM Update October, November 2012 Page 13

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM) ENZCAM Newsletter TM/CAM Update December 2012

1. Call for Action for CAM in Europe http://www.homeopathyeurope.org/media/news/newsletter‐16‐january‐2013/unprecedented‐cam‐ conference‐in‐the‐european‐parliament

The call for action follows the European Parliament Conference on Complementary and Alternative Medicine, held in Bruxelles, October 9th 2012. “The organising CAM associations of patients, practitioners and doctors call on the European Commission  to promote equitable access by citizens to Complementary and Alternative Medicine (CAM) in Member States,  to promote harmonization of information on CAM methods and CAM providers within the EU Member States is order to facilitate cross border movement for citizens and providers using CAM modalities,  to include CAM in all possible Community Actions dealing with health education and promotion, prevention and treatment of chronic disease, health inequalities, and active and healthy ageing,  to encourage Member States to explore the ways in which CAM can contribute to sustainable healthcare systems in Europe including its role in health maintenance, health education, self‐ responsibility for health, motivation for healthy lifestyle change and less invasive and more cost‐ effective treatment of illness,  to propose the requisite draft directives, or amendments to existing directives, to ensure freedom of establishment and freedom to provide services for providers of CAM,  to initiate a process for the appropriate regulation of providers of CAM across the Union taking into account the full extent of the scope of action of CAM modalities across the healthcare spectrum from health maintenance and education to complementary treatment of illness,  to start a new initiative, in cooperation with the stakeholders concerned, for the regulations on the licensing and use of CAM medicinal products in Europe …[see original for detail]  to take up, following consultation with the CAM stakeholders, the recommendations of the CAMbrella Seventh Framework Programme (FP7) Research Project on the funding of future research into CAM in Europe,  to ensure that the management of the programmes of the Commission – such as the Health for Growth, Horizon 2020, European Innovation Partnership on Healthy and Active Aging and other relevant programmes – gives an equitable opportunity to CAM projects to participate.

The organising CAM associations also called on EU Member States to honour the WHO “Beijing Declaration”, formulated at the WHO Congress on Traditional Medicine, Beijing, China, 8 November 2008.

ENZCAM Newsletter TM/CAM Update December 2012 Page 2

2. New National Coordinating Center for Integrative Medicine (NccIM) in Preventive Medicine http://www.prweb.com/releases/2012/10/prweb9976040.htm

In the USA, the American College of Preventive Medicine (ACPM) “has received a cooperative agreement award from the Health Resources and Services Administration (HRSA) to create a National Coordinating Center for Integrative Medicine (NccIM) in Preventive Medicine. The purpose of the coordinating center, which ACPM will call the Integrative Medicine in Preventive Medicine Education (IMPriME) Coordinating Center, is to provide technical support for Preventive Medicine Residency and other health professions training programs interested in incorporating evidence‐ based integrative medicine content into their training.”

“The centerpiece of ACPM’s approach to the NccIM, or IMPriME, is to create, convene, administer and sustain a Community of Learning for integrative medicine (IM) and preventive medicine that includes partners in Preventive Medicine training, primary care, other health professions such as nursing, dentistry, and pharmacy, and complementary and alternative medicine (CAM) practitioners from a wide variety of practice modalities. The learning community will form the basis for sharing practices, creating and validating evaluation instruments, and disseminating shared experiences to the wider integrative medicine, Preventive Medicine, primary care, other health professions, and CAM practitioner audiences.”

3. A Standard Questionnaire for Measurement of the Prevalence of CAM Use: I‐CAM‐Q and I‐CAM‐G

Translation and adaptation of an international questionnaire to measure usage of complementary and alternative medicine (I‐CAM‐G)

By Meike Lo Re, Stefan Schmidt and Corina Güthlin BMC Complementary and Alternative Medicine 2012, 12:259 Published: 20 December 2012 http://www.biomedcentral.com/1472‐6882/12/259/abstract

“The growing body of data on prevalence of complementary and alternative medicine (CAM) usage means there is a need to standardize measurement on an international level. An international team has published a questionnaire (I‐CAM‐Q), but no validation has yet been provided. The aim of the present study was to provide a German measurement instrument for CAM usage (I‐CAM‐G) which closely resembles the original English version, and to assess its performance in two potential samples for measuring CAM usage.”

“Following methodologically sound and comprehensive translation, adaptation and assessment processes using recognized translation procedures, cognitive interviews, and studying the performance of the questionnaire in two samples, we arrived at a German questionnaire for measuring CAM use which is comparable with the international (English) version. The questionnaire appropriately measures CAM use, with some items being more appropriate than others. We recommend the development of a short version.”

ENZCAM Newsletter TM/CAM Update December 2012 Page 3

The paper described the development and contents of the original English version, saying:

“As a result of a complete lack of measurement standardization for CAM usage, the National Research Center in Complementary and Alternative Medicine (NAFKAM) in Norway carried out a workshop with the aim of developing a standardized questionnaire for measuring international CAM usage. Participants represented different countries (United States, Canada, Great Britain, Australia, Norway, Germany, Sweden and Denmark), came from a wide range of backgrounds (anthropology, sociology, nursing, health services, medicine, public health and pharmacy) and were specialists in different fields (survey design, cross‐cultural research), and thus were able to develop a measurement instrument which covered both the most prominent types of CAM, as well as application methods in different countries, the I‐CAM‐Q.”

“The I‐CAM‐Q contains four sections. Section 1 asks about “Visiting health care providers”, section 2 about “Complementary treatments received from physicians (MDs)”, section 3 about the “Use of herbal medicine and dietary supplements” and section 4 about “Self‐help practices”.”

“The treatment modalities are presented in the form of a list, and respondents have to provide information on their usage over the previous 12 months (yes/no) and give details on the number of times the practitioner was seen/the treatment was received over the previous 3 months …. Respondents are also asked to indicate whether the CAM therapy was used on account of an acute illness/condition, a long‐term illness, to improve general well‐being, or for other reasons (if necessary). Finally, respondents are asked to indicate how helpful the CAM treatment had been.”

See the original paper from 2009 on I‐CAM‐Q: Development of an International Questionnaire to Measure Use of Complementary and Alternative Medicine (I‐CAM‐Q) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3189003/

ENZCAM Newsletter TM/CAM Update December 2012 Page 4 4. Strategic Framework for Comparative Effectiveness Research in CAM

Building a Strategic Framework for Comparative Effectiveness Research in Complementary and Integrative Medicine By Claudia M. Witt, Margaret Chesney, Richard Gliklich, Lawrence Green, George Lewith, Bryan Luce, Anne McCaffrey, Shelly Rafferty Withers, Harold C. Sox, Sean Tunis and Brian M. Berman Evidence‐Based Complementary and Alternative Medicine, Volume 2012 http://www.hindawi.com/journals/ecam/2012/531096/

“Drug research follows a clear hierarchical research strategy that establishes efficacy before effectiveness is evaluated. Because of its long history, complementary medicine treatments are often in widespread use before clinical research has been conducted. For complementary and integrative medicine, a reverse research strategy was recommended. Using a strategy that generates evidence on comparative effectiveness before determining component efficacy will help to focus on treatments that have relevance for practice and a potential for integration into health care while saving research resources. Because studies in Comparative Effectiveness Research (CER) are designed to be carried out in settings that reflect usual care, they have considerable potential to help health care providers as well as patients and clinicians to choose among currently available therapeutic options in complementary and integrative medicine.” “The Institute of Medicine defines CER as “the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. The purpose of CER is to assist consumers, clinicians, purchasers, and policy makers to make informed decisions that will improve health care at both the individual and population levels”. (“Alternative” does not refer to “alternative medicine” but to “best care” options.) … “ The current movement in conventional medicine towards more CER places strong emphasis on the evaluation of different treatment options by including more heterogeneous patients and by using less standardized treatment protocols and more patient‐centered outcomes. …..The aim of this project was to provide recommendations for a strategic framework for CER in the field of complementary and integrative medicine.” “The following recommendations for future research in complementary and integrative medicine were developed: (1) Because Gaps in Evidence for Clinical and Health Policy Decision‐Making Are Significant, CER Studies Should Be Made a Priority (2) CER Should Engage Stakeholders at Every Stage of Research (3) CER Study Designs Should Highlight Effectiveness over Efficacy to Support Clinical and Health Policy Decision‐Making (4) Well‐Defined Research Questions Are Prerequisites for Selecting Appropriate CER Study Designs (5) The Complementary and Integrative Medicine Community Should Cultivate Widely Shared Understandings, Discourse, Tools, and Technologies to Support the Use and Validity of CER Methods (6) Effectiveness Guidance Documents (EGDs) Should Be Developed to Shape Future CER Studies”.

Note to readers: There is much useful discussion of research methodologies for CAM in the original article.

ENZCAM Newsletter TM/CAM Update December 2012 Page 5 5. Interprofessional Collaboration in Integrative Health Care

Organizational Determinants of Interprofessional Collaboration in Integrative Health Care: Systematic Review of Qualitative Studies

By Vincent C. H. Chung, Polly H. X. Ma, Lau Chun Hong, and Sian M. Griffiths http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0050022

“Interprofessional collaboration (IPC) between biomedically trained doctors (BMD) and traditional, complementary and alternative medicine practitioners (TCAMP) is an essential element in the development of successful integrative healthcare (IHC) services. This systematic review aims to identify organizational strategies that would facilitate this process.

Findings: Thirty‐seven studies of acceptable quality were included. The main driver for developing integrative healthcare was the demand for holistic care from patients. Integration can best be led by those trained in both paradigms. Bridge‐building activities, positive promotion of partnership and co‐ location of practices are also beneficial for creating bonding between team members. In order to empower the participation of TCAMP, the perceived power differentials need to be reduced. Also, resources should be committed to supporting team building, collaborative initiatives and greater patient access. Leadership and funding from central authorities are needed to promote the use of condition‐specific referral protocols and shared electronic health records. More mature IHC programs usually formalize their evaluation process around outcomes that are recognized both by BMD and TCAMP.

Conclusions: The major themes emerging from our review suggest that successful collaborative relationships between BMD and TCAMP are similar to those between other health professionals, and interventions which improve the effectiveness of joint working in other healthcare teams with may well be transferable to promote better partnership between the paradigms. However, striking a balance between the different practices and preserving the epistemological stance of TCAM will remain the greatest challenge in successful integration.”

6. Forthcoming Conferences

13‐16 May 2014 International Research Congress on Integrative Medicine Miami, Florida, USA and Health (IRCIMH)

ENZCAM Newsletter TM/CAM Update December 2012 Page 6 7. CAM included in New Medical Terminology Textbook

Mastering Medical Terminology: Australia and New Zealand Elsevier Australia http://www.prweb.com/releases/Mastering/MedicalTerminology/prweb10148836.htm

“A new textbook from Elsevier Australia is set to delight Australian and New Zealand students contending with the often‐difficult vocabulary of medicine. The newly published 'Mastering Medical Terminology: Australia and New Zealand' is a comprehensive suite of learning tools, which work together to simplify and demystify medical terminology. The ….suite comprises: a full‐colour textbook; a practical workbook with the option of a hard copy or online version packed with a variety of questions and activities; and extensive online resources. All components of this suite are available for separate purchase to enable you to pick and choose the right package for your learning requirements. A mobile phone app is also available ….

“The textbook contains over 20 chapters devoted to individual body systems and systemic diseases. These feature each area’s associated vocabulary, key concepts and pronunciation guides as well as review activities for self‐testing.” [The book] also breaks new ground by including two chapters addressing contemporary areas not normally covered in medical terminology texts: Complementary and Alternative Therapies and Public Health, Epidemiology and Research Terms.” [emphasis added]

8. Journals

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 6: December 2012 http://www.liebertonline.com/toc/act/18/6 Selected articles:  Roundoc Rx: Environmental Toxins and Children’s Health: Part 2—Reduce Exposure and Detoxify  GERD as a Motility Disorder: A New Way of Thinking  Wave Motion as a Stress Intervention Method for Stage II and Stage III Breast‐Cancer Survivors  Healing Touch, Therapeutic Touch, and Reiki: Energy Medicine Advances in the Medical Community  CAM and the Aging Population: Trends and Clinical Implications  Caffeine Clinical Bottom Line: An Evidence‐Based Systematic Review by the National Standard Research Collaboration  Clinical Roundup: Selected Treatment Options for Attention‐Deficit Hyperactivity Disorder

ENZCAM Newsletter TM/CAM Update December 2012 Page 7 BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] November and December 2012 http://www.biomedcentral.com/bmccomplementalternmed/content Selected articles:  Commentary on Mathie RT et al. Method for appraising model validity of randomised controlled trials of homeopathic treatment: multi‐rater concordance study  The effect of acupuncture on stroke recovery: study protocol for a randomized controlled trial  A protocol for a trial of homeopathic treatment for irritable bowel syndrome  Mindfulness‐and body‐psychotherapy‐based group treatment of chronic tinnitus: a randomized controlled pilot study  Complementary and alternative medicine (CAM) providers' views of chronic low back pain patients' expectations of CAM therapies: a qualitative study  Effect of electroacupuncture in postanesthetic shivering during regional anesthesia: a randomized controlled trial  The clinical use of Kampo medicines (traditional Japanese herbal treatments) for controlling cancer patients' symptoms in Japan: a national cross‐sectional survey  The use of complementary and alternative medicine for patients with traumatic brain injury in Taiwan  Translation and adaptation of an international questionnaire to measure usage of complementary and alternative medicine (I‐CAM‐G)

Complementary Therapies in Medicine [First listed in ENZCAM Newsletter May 2011] Volume 20, Number 6: December 2012 http://www.complementarytherapiesinmedicine.com/current

Selected articles:  One year study on the integrative intervention of acupressure and interactive multimedia for visual health in school children  Clinical utility of paced breathing as a concentration meditation practice  The feasibility of aromatherapy massage to reduce symptoms of Idiopathic Environmental Intolerance: A pilot study  Monochord sounds and progressive muscle relaxation reduce anxiety and improve relaxation during chemotherapy: A pilot EEG study  The effect of acupressure on sleep quality in hemodialysis patients  Effect of integrated Yoga on neurogenic bladder dysfunction in patients with multiple sclerosis— A prospective observational case series  Traditional Chinese medicine speeds‐up humerus fracture healing: Two case reports  A pilot study to evaluate nutritional influences on gastrointestinal symptoms and behavior patterns in children with Autism Spectrum Disorder  Complementary and alternative medicine use in Turkish children with epilepsy  Acupuncture for cancer patients suffering from hiccups: A systematic review and meta‐analysis  A systematic review to evaluate the clinical benefits of craniosacral therapy  The effect of red yeast rice (Monascus purpureus) in dyslipidemia and other disorders

ENZCAM Newsletter TM/CAM Update December 2012 Page 8 European Journal of Integrative Medicine [First listed in ENZCAM Newsletter May 2011] Volume 4, Number 4: December 2012 http://www.europeanintegrativemedicinejrnl.com/current

Selected articles:  Oriental and traditional medicine – Supporting the vision for integrated health  Acupuncture for tension‐type headache in pregnancy: A prospective, randomized, controlled study  Thermotherapy self‐treatment for neck pain relief—A randomized controlled trial  Influence of combined administration of herbal complexes and warfarin on international normalized ratio in stroke and anoxic brain damage patients: A retrospective study  A prospective case series exploring the role of Chinese herbal medicine in the treatment of recurrent urinary tract infections  A mixed methods feasibility study of mindfulness meditation for fatigue in women with metastatic breast cancer  Lavender and sleep: A systematic review of the evidence  An Integrative Day Care Clinic for chronically ill patients: Concept and case presentation

Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] Published December 2012 http://www.hindawi.com/journals/ecam/2012/

Selected articles:  First Nationwide Attitude Survey of Japanese Physicians on the Use of Traditional Japanese Medicine (Kampo) in Cancer Treatment  Preventive and Protective Properties of Zingiber officinale (Ginger) in Diabetes Mellitus, Diabetic Complications, and Associated Lipid and Other Metabolic Disorders: A Brief Review  Tai‐Chi for Residential Patients with Schizophrenia on Movement Coordination, Negative Symptoms, and Functioning: A Pilot Randomized Controlled  A Systems Biology Approach to Uncovering Pharmacological Synergy in Herbal Medicines with Applications to Cardiovascular Disease  Application of Complementary and Alternative Medicine on Neurodegenerative Disorders: Current Status and Future Prospects  Depression, Comorbidities, and Prescriptions of Antidepressants in a German Network of GPs and Specialists with Subspecialisation in Anthroposophic Medicine: A Longitudinal Observational Study  Vitamin E and the Healing of Bone Fracture: The Current State of Evidence  Effect of Combining Therapy with Traditional Chinese Medicine‐Based Psychotherapy and Herbal Medicines in Women with Menopausal Syndrome: A Randomized Controlled Clinical Trial  Traditional Oriental Herbal Medicine for Children and Adolescents with ADHD: A Systematic Review  Complementary and Alternative Medicine and Cancer Survivorship  The Relationship between Complementary and Alternative Medicine Use and Breast Cancer Early Detection: A Critical Review  Outcome Measures of Chinese Herbal Medicine for Hypertension: An Overview of Systematic Reviews

ENZCAM Newsletter TM/CAM Update December 2012 Page 9

 Predictors of Complementary and Alternative Medicine Use in Cancer Care: Results of a Nationwide Multicenter Survey in Korea  Building a Strategic Framework for Comparative Effectiveness Research in Complementary and Integrative Medicine  The Flexner Report of 1910 and Its Impact on Complementary and Alternative Medicine and Psychiatry in North America in the 20th Century

Integrative Cancer Therapies [First listed in ENZCAM Newsletter April 2011] Volume 11, Number 4: December 2012 http://ict.sagepub.com/content/11/4?etoc

Selected articles:  Melatonin as Adjuvant Cancer Care With and Without Chemotherapy: A Systematic Review and Meta‐analysis of Randomized Trials  The Chiropractic Care of Patients With Cancer: A Systematic Review of the Literature  Impact of Yoga on Functional Outcomes in Breast Cancer Survivors With Aromatase Inhibitor– Associated Arthralgias  Alteration of Hypothalamic–Pituitary–Thyroid Axis Function in Non‐Small‐Cell Lung Cancer Patients  Mechanisms of Cardioprotective Effect of Aged Garlic Extract Against Doxorubicin‐Induced Cardiotoxicity

Journal of Holistic Nursing [First listed in ENZCAM Newsletter April 2011] Volume 30, Number 4: December 2012 http://jhn.sagepub.com/content/30/4.toc?etoc

Selected articles:  Creation of an American Holistic Nurses Association Research Consultation Program  Effects of Therapeutic Touch on Anxiety, Vital Signs, and Cardiac Dysrhythmia in a Sample of Iranian Women Undergoing Cardiac Catheterization: A Quasi‐Experimental Study  Holistic Wellness Assessment for Young Adults: Psychometric Analysis  Loneliness as Experienced by Women Living With Chronic Illness in Rural Areas  The Effects of Slow‐Stroke Back Massage on Minutes of Nighttime Sleep in Persons With Dementia and Sleep Disturbances in the Nursing Home: A Pilot Study  The Use of Simulation to Instruct Students on the Provision of Spiritual Care: A Pilot Study

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 18, Number 2: December 2012 http://online.liebertpub.com/toc/acm/18/12

Selected articles:  Chinese Herbal Medicine for Infertility with Anovulation: A Systematic Review  Collections of Traditional Chinese Medical Literature as Resources for Systematic Searches

ENZCAM Newsletter TM/CAM Update December 2012 Page 10

 Evaluation of Impact on Health‐Related Quality of Life and Cost Effectiveness of Traditional Chinese Medicine: A Systematic Review of Randomized Clinical Trials  The Integrative Medicine Team—Is Biomedical Dominance Inevitable?  HIV/AIDS‐Related Attitudes and Practices Among Traditional Healers in Zambézia Province, Mozambique  The Benefits of Giving a Massage on the Mental State of Massage Therapists: A Randomized, Controlled Trial  Recourse to Alternative Medicine During Pregnancy: Motivations of Women and Impact of Research Findings  Effect of Yoga on Cognitive Abilities In Schoolchildren from a Socioeconomically Disadvantaged Background: A Randomized Controlled Study  Effects of Tai Chi Exercise on Glucose Control, Neuropathy Scores, Balance, and Quality of Life in Patients with Type 2 Diabetes and Neuropathy

9. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

December 2012: Stress and Relaxation Techniques http://nccam.nih.gov/health/providers/digest/relaxation.htm

“Stress is a physical and emotional reaction that people experience as they encounter changes in life. Occasional stress is a normal coping mechanism. However, long‐term stress may contribute to or worsen a range of health problems including digestive disorders, headaches, sleep disorders, and other symptoms. Stress may worsen asthma and has been linked to depression, anxiety, and other mental illnesses.”

“Some people use various relaxation techniques to induce the relaxation response, which helps release tension and may counteract the ill effects of stress. Relaxation techniques often combine breathing exercises and focused attention to calm the mind and the body. Some examples of relaxation response techniques are autogenic training, biofeedback, deep breathing, guided imagery, progressive relaxation, and self‐hypnosis.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

18 January 2013

ENZCAM Newsletter TM/CAM Update December 2012 Page 11

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

Integrative Medicine Newsletter January February 2013

The purpose of this update on integrative medicine is to inform healthcare professionals, researchers, funders and policy‐makers about developments in traditional medicine (TM), complementary medicine (CAM) and integrative medicine (IM). The update provides links to new material published or released as well as links to classic resources on these topics.

1. CAM in Europe: Findings of the CAMbrella Project

A special edition of the journal “Forschende Komplementärmedizin / Research in Complementary Medicine” has been published, containing reports from the CAMbrella project.

Insights into the Current Situation of CAM in Europe: Major Findings of the EU Project CAMbrella Forschende Komplementärmedizin / Research in Complementary Medicine Vol. 19, Suppl. 2, 2012 Issue release date: November 2012 http://www.karger.com/Journal/Issue/257354

Table of Contents:  Editorial: CAMbrella – Complementary Medicine Research in Europe  Guest Editorial: CAMbrella – a Pan‐European Research Network for Complementary and Alternative Medicine: From the Beginnings up to First Results  Towards a Pan‐European Definition of Complementary and Alternative Medicine – a Realistic Ambition?  What Attitudes and Needs Do Citizens in Europe Have in Relation to Complementary and Alternative Medicine?  A Systematic Literature Review of Complementary and Alternative Medicine Prevalence in EU  Legal Status and Regulation of Complementary and Alternative Medicine in Europe  Complementary and Alternative Medicine Provision in Europe – First Results Approaching Reality in an Unclear Field of Practices  International Development of Traditional Medicine / Complementary and Alternative Medicine Research – What Can Europe Learn?  Key Issues in Clinical and Epidemiological Research in Complementary and Alternative Medicine – a Systematic Literature Review  Building a Sustainable Complementary and Alternative Medicine Research Network in Europe

The paper on developing a pragmatic definition of CAM in Europe, “Towards a Pan‐European Definition of Complementary and Alternative Medicine in Europe”, is a very useful read. See http://www.karger.com/Article/Abstract/343812

ENZCAM Integrative Medicine Newsletter January February 2013 Page 2 2. CAM to be integrated in public hospital care in Paris

Source: CAMbrella: http://www.cambrella.eu/home.php?il=214

“The Paris hospitals have adopted a strategic plan to include, evaluate and integrate CAM in their services. … Dr. Catherine Viens‐Bitker, [brought] the news from France that the „Assistance Publique – Hospitaux de Paris (AP‐HP) will include CAM services in their routine care programmes.”

“Dr. Catherine Viens‐Bitker was in charge of the report and is now heading the implementation process. …. While many patients, especially those with chronic conditions use CAM in private practices in the city, the hospitals have no structured knowledge about the possible benefits of these treatments. And while many health professionals have included CAM practices in their personal professional portfolio, the public hospital system does not profit from this expertise. The plan is to develop CAM in the Parisian hospitals along four lines: best practices, research, TCM and occupational health.”

The “Assistance Publique – Hospitaux de Paris” is the organisational body for the public hospitals of the City of Paris. It is the largest hospital system in Europe, about 90,000 health professionals work in it and receive about 4.5 million patients visits per year.”

3. US Spending on CAM Plateaued in the Period 2002–08

US Spending On Complementary and Alternative Medicine During 2002–08 Plateaued, Suggesting Role In Reformed Health System By Matthew A. Davis, Brook I. Martin, Ian D. Coulter and William B. Weeks Health Affairs, January 2013 vol. 32 no. 1, pages 45‐52 http://content.healthaffairs.org/content/32/1/45.abstract?ct

Abstract:

“Complementary and alternative medicine services in the United States are an approximately $9 billion market each year, equal to 3 percent of national ambulatory health care expenditures. Unlike conventional allopathic health care, complementary and alternative medicine is primarily paid for out of pocket, although some services are covered by most health insurance.

Examining trends in demand for complementary and alternative medicine services in the United States reported in the Medical Expenditure Panel Survey during 2002–08, we found that use of and spending on these services, previously on the rise, have largely plateaued. The higher proportion of out‐of‐pocket responsibility for payment for services may explain the lack of growth.

Our findings suggest that any attempt to reduce national health care spending by eliminating coverage for complementary and alternative medicine would have little impact at best. Should some forms of complementary and alternative medicine—for example, chiropractic care for back pain—be proven more efficient than allopathic and specialty medicine, the inclusion of complementary and alternative medicine providers in new delivery systems such as accountable care organizations could help slow growth in national health care spending.”

ENZCAM Integrative Medicine Newsletter January February 2013 Page 3 4. Prince of Wales on Integrated Health and Post‐modern Medicine

The Journal of the Royal Society of Medicine featured an editorial by HRH, The Prince of Wales. It is the first time the Prince of Wales has had an article published in a medical journal.

Integrated health and post‐modern medicine By HRH, The Prince of Wales Journal of the Royal Society of Medicine Published online before print 21 December 2012 http://jrsm.rsmjournals.com/content/105/12/496.full

An extract from the beginning of the paper:

“For many years, I have advocated an integrated approach to medicine and health. By integrated medicine, I mean the kind of care that integrates the best of new technology and current knowledge with ancient wisdom. More specifically, perhaps, it is an approach to care of the patient which includes mind, body and spirit and which maximizes the potential of conventional, lifestyle and complementary approaches in the process of healing.” [emphasis added]

“Integrated health, on the other hand, represents an approach to individual and population health which respects and includes all health‐related areas, such as the physical and social environment, education, agriculture and architecture. I know that this is a somewhat wider definition of integration than commonly used, but I want to argue that a successful health service needs to embrace this broader and more complex concept of integration.” [emphasis added]

“I hasten to say that the point of this article is not to confront accepted medical wisdom, but merely to suggest that there is a case for reaching beyond it ….”

“Exactly 30 years ago, in a speech to the British Medical Association (BMA), I quoted George Engel, who wrote ‘A Modern Science of medicine still tends to be based on the notion of the body as a machine, of disease as the consequence of breakdown of the machine, and of the doctor's task as repair of the machine’.”

“I fear that what was true 30 years ago remains equally true today. It is why for a rather long time now, and not without criticism from some quarters, I have been attempting to suggest that it might be beneficial to develop truly integrated systems of providing health and care. That is, not simply to treat the symptoms of disease, but actively to create health and to put the patient at the heart of this process by incorporating those core human elements of mind, body and spirit.”

5. African Traditional Health Practitioners Council Inaugurated

“The inauguration of the Interim Traditional Health Practitioners Council [on 11 February 2013] is a historic occasion and a significant milestone towards integrating African Traditional Medicine into the National Health System in South Africa.”

See http://www.doh.gov.za/show.php?id=3919

ENZCAM Integrative Medicine Newsletter January February 2013 Page 4

It is unusual to find journal articles on the practice of traditional medicine. This one is particularly useful for those who wish to understand more about African Traditional Medicine. The article is written by David Cumes, MD, who received his surgical training in Johannesburg and has taught at Stanford Medical Center. He spent time with the Bushmen and shamans in Peru and South Africa and was initiated as a sangoma in South Africa in 2002.

South African Indigenous Healing: How It Works Explore: The Journal of Science and Healing Volume 9, Issue 1 , Pages 58‐65, January 2013 http://www.explorejournal.com/article/S1550‐8307%2812%2900225‐X/fulltext

Abstract:

“Sangomas or inyangas are shamans, healers, priests, and prophets that have been the backbone of Bantu communities, especially in the rural areas of Southern Africa for eons. …. Indigenous knowledge has always been transmitted orally, and there is little written down about the secret traditions of initiation. …

Most sub‐Saharan African peoples believe in the importance of the ancestors being able to guide events, and they revere them because they have this power. … Since sangoma wisdom is an oral tradition the individual's initiation will depend on the mentor and the spirit guides involved. That particular sangoma's healing repertoire will be somewhat different to another though the principles remain the same. The ancestors find the most efficient way to impart the information so that the healer can do the work. The way in which they transmit the knowledge will be unique to that person's receptivity and talents.

…. One has to put cognitive, left‐brained intellect aside. … The sangoma or inyanga has a lot to teach the West about the spirit world and our ancestral roots. Science has put us in touch with a magical universe of technology. We may be technically advanced, but when it comes to psychospiritual wizardry we are really only beginners.”

6. IBIS Database Made Freely Available

Source: John Weeks http://theintegratorblog.com/index.php?option=com_content&task=view&id=860&Itemid=189

“One of the earliest clinician‐oriented electronic databases, IBIS (Integrative BodyMind Information System) has been made available free to all interested parties. The program has been updated from its founding 20 years ago in the dark ages of the internet by a visionary team at MedicineWorks.com led by Mitchell Stargrove, ND, LAc, co‐author of Herb, Nutrient and Drug Interactions. A multidisciplinary team of 74 contributors, weighted toward naturopathic doctors, participated in content development.”

“Comment [by John Weeks]t: Stargrove was given the Vis Medicatrix Naturae award by his national professional association in 2012, signifying his contributions to enhancing respect for the healing power of nature, the core precept in naturopathic philosophy. Stargrove and his clinician wife and partner Lori Beth Stargrove, ND, LAc, have been remarkable in the database world for their clinician‐ centric and patient‐centric approaches. They were among the first, for instance, to shape content around the clinical experience that many "interactions" are not, in fact, negative. …."

The software can be obtained from: http://www.ouribis.com/

ENZCAM Integrative Medicine Newsletter January February 2013 Page 5 7. Forthcoming Conferences

A new conference added is the 6th European Congress for Integrative Medicine, to be held in October 2013 in Berlin. Later the same month, the inaugural International Congress for Clinicians in Complementary and Integrative Medicine will be held in Chicago in the USA. More information is now available on the conference planned for May 2014 in Florida.

4‐5 October 2013 6th European Congress for Integrative Medicine Berlin, GERMANY http://www.ecim‐congress.org/general‐information.html

29‐31 October 2013 Inaugural International Congress for Clinicians in Chicago, Illinois, USA Complementary and Integrative Medicine (ICC‐CIM 2013) http://www.icccim.org/ 13‐16 May 2014 4th International Research Congress on Integrative Miami, Florida, USA Medicine and Health (IRCIMH) 9th annual International Congress on Complementary Medicine Research (ICCMR) http://www.ircimh.org/2014

8. Books

Integrative Medicine, Third Edition Expert Consult Premium Edition with Enhanced Online Features By Dr. David Rakel Publication Date: May 2012 http://www.amazon.com/Integrative‐Medicine‐Consult‐Enhanced‐Features/dp/1437717934/

“Integrative Medicine, by Dr. David Rakel, provides the practical, evidence‐based guidance you need to safely and effectively integrate complementary and alternative medical treatments into your practice. This medical reference book lays the framework for making the best use of these therapeutic modalities and understanding the mechanisms by which these interventions work, keeping you at the forefront of the trend toward integrative health care. … Access the full text, image bank, downloadable Patient Education Guides, and video collections online at www.expertconsult.com.”

ENZCAM Integrative Medicine Newsletter January February 2013 Page 6 9. Journals

African Journal of Traditional, Complementary and Alternative medicines (AJTCAM) [First listed in ENZCAM Newsletter October 2011] Volume 10, Number 2: January 2013 http://journals.sfu.ca/africanem/index.php/ajtcam/issue/view/77

Selected articles:  Temperament Determination for Melatonin: a bridge From Iranian traditional to modern sleep medicine  Medicinal Formulations of a Kanda Tribal Healer – a tribe on the verge of disappearance in Bangladesh  Herbal therapies used by hypertensive patients in Turkey  Medicinal plants used for the treatment of tuberculosis by Bapedi Traditional Healers in three districts of the Limpopo province, South Africa  A randomized, double‐blind, placebo‐controlled trial of a Chinese herbal Sophora flower formula in patients with symptomatic haemorrhoids: a preliminary study  Ethnobotanical study of medicinal plants used by Kurd Tribe in Dehloran and Abdanan districts, Ilam province, Iran

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter Q1 2011] Volume 19, Number 1: February 2013 http://online.liebertpub.com/toc/act/19/1

Selected articles:  Roundoc Rx: Using Nutraceuticals to Complement Drug Treatments  Natural Approaches for Postpartum Support  Complementary Therapy Use Among Australians with Type 2 Diabetes or Cardiovascular Disease  Night Sweats in Perimenopause and Beyond  Sugar Alternatives and Their Effects on Health  Making the Case for Corporate Wellness: Interventions Benefit Employees and Bottom Line  An Integrative Approach to Colon Cancer: A Natural Standard Monograph  Clinical Roundup: Selected Treatment Options for Chronic Musculoskeletal Pain

BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] January and February 2013 http://www.biomedcentral.com/bmccomplementalternmed/content

ENZCAM Integrative Medicine Newsletter January February 2013 Page 7

Selected articles:  The prevalence of traditional herbal medicine use among hypertensives living in South African communities  Complementary and alternative medicine utilization by a sample of infertile couples in Jordan for infertility treatment: Clinics‐Based Survey  The eCALM Trial‐eTherapy for cancer applying mindfulness: online mindfulness‐based cancer recovery program for underserved individuals living with cancer in Alberta: protocol development for a randomized wait‐list controlled clinical trial  Efficacy and safety of Suanzaoren decoction for primary insomnia: a systematic review of randomized controlled trials  Characteristics of users and implications for the use of complementary and alternative medicine in Ghanaian cancer patients undergoing radiotherapy and chemotherapy: a cross‐ sectional study  Current challenges and future directions for naturopathic medicine in Australia: a qualitative examination of perceptions and experiences from grassroots practice  The biomechanical demands of standing yoga poses in seniors: The Yoga empowers seniors study (YESS)

Complementary Therapies in Clinical Practice [First listed in ENZCAM Newsletter June 2011] Volume 19, Number 1: February 2013 http://www.ctcpjournal.com/issues

Selected articles:  Acupuncture and in vitro fertilization: Critique of the evidence and application to clinical practice  Tai chi/yoga reduces prenatal depression, anxiety and sleep disturbances  Is craniosacral therapy effective for migraine? Tested with HIT‐6 Questionnaire  Effects of honey, sucrose and glucose on blood glucose and C‐peptide in patients with type 1 diabetes mellitus  Integrative medicine outcomes: What should we measure?  Neuromuscular electrical stimulation for muscle strengthening in elderly with knee osteoarthritis – A systematic review  A comparison of decision‐making processes for conventional and complementary medicine in cancer patients  A narrative review of maternal physical activity during labour and its effects upon length of first stage  Reiki training for caregivers of hospitalized pediatric patients: A pilot program

Complementary Therapies in Medicine [First listed in ENZCAM Newsletter May 2011] Volume 21, Number 1: February 2013 http://www.complementarytherapiesinmedicine.com/issues

Selected articles:  Strain–counterstrain to treat restrictions of the mobility of the cervical spine in patients with neck pain—A sham‐controlled randomized trial  Efficacy of cranial electric stimulation for the treatment of insomnia: A randomized pilot study

ENZCAM Integrative Medicine Newsletter January February 2013 Page 8

 “More than I expected”: Perceived benefits of yoga practice among older adults at risk for cardiovascular disease  How patients choose osteopaths: A mixed methods study  Naturopaths and Western herbalists’ attitudes to evidence, regulation, information sources and knowledge about popular complementary medicines  The role of acupuncture in emergency department settings: A systematic review  Looking outside the square: The use of qualitative methods within complementary and alternative medicine—The movement towards rigour  Conference Report: Complementary therapies for treating alcoholism

The EPMA Journal [First listed in ENZCAM Newsletter December 2011] January and February 2013 http://www.epmajournal.com/

Selected articles:  Can we prevent or treat multiple sclerosis by individualised vitamin D supply?  Targeted therapies in colorectal cancer‐‐‐an integrative view by PPPM  Multi‐parameter systematic strategies for predictive, preventive and personalised medicine in cancer  Women's higher health risks in the obesogenic environment: a gender nutrition approach to metabolic dimorphism with predictive, preventive, and personalised medicine  Pitfalls and limitations in translation from biomarker discovery to clinical utility in predictive and personalised medicine  Risk assessment, disease prevention and personalised treatments in breast cancer: is clinically qualified integrative approach in the horizon?

Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] Published January and February 2013 http://www.hindawi.com/journals/ecam/2013/

Selected articles:  Blinding Measured: A Systematic Review of Randomized Controlled Trials of Acupuncture  Acupuncture or Acupressure at the Sanyinjiao (SP6) Acupoint for the Treatment of Primary Dysmenorrhea: A Meta‐Analysis  Massage Therapy for Neck and Shoulder Pain: A Systematic Review and Meta‐Analysis  A Randomized Clinical Trial of Auricular Point Acupressure for Chronic Low Back Pain: A Feasibility Study  Electroacupuncture Modulates Reproductive Hormone Levels in Patients with Primary Ovarian Insufficiency: Results from a Prospective Observational Study  Metabolic Syndrome and Inflammation: A Critical Review of In Vitro and Clinical Approaches for Benefit Assessment of Plant Food Supplements  Ethnopharmacological Approaches to Wound Repair  Medical Yoga for Patients with Stress‐Related Symptoms and Diagnoses in Primary Health Care: A Randomized Controlled Trial  Ginkgo biloba Extract for Patients with Early Diabetic Nephropathy: A Systematic Review

ENZCAM Integrative Medicine Newsletter January February 2013 Page 9

 A Systematic Review of the Efficacy of Centella asiatica for Improvement of the Signs and Symptoms of Chronic Venous Insufficiency  Replacements of Rare Herbs and Simplifications of Traditional Chinese Medicine Formulae Based on Attribute Similarities and Pathway Enrichment Analysis  Integrating Traditional Chinese Medicine Services in Community Health Centers: Insights into Utilization Patterns in the Pearl River Region of China  Botulinum Toxin for the Treatment of Myofascial Pain Syndromes Involving the Neck and Back: A Review from a Clinical Perspective  Effects of Aromatherapy on the Anxiety, Vital Signs, and Sleep Quality of Percutaneous Coronary Intervention Patients in Intensive Care Units  Acupuncture for Spinal Cord Injury and Its Complications: A Systematic Review and Meta‐ Analysis of Randomized Controlled Trials  Use of Herbal Dietary Supplement Si‐Wu‐Tang and Health‐Related Quality of Life in Postpartum Women: A Population‐Based Correlational Study  Chinese Herbal Medicine and Depression: The Research Evidence  Use of Medicinal Plants and Natural Products for Treatment of Osteoporosis and Its Complications, Ima Nirwana Soelaiman  Acupuncture for Posttraumatic Stress Disorder: A Systematic Review of Randomized Controlled Trials and Prospective Clinical Trials  Cost Analysis of Integrative Inpatient Treatment Based on DRG Data: The Example of Anthroposophic Medicine  Effects of Aroma Massage on Home Blood Pressure, Ambulatory Blood Pressure, and Sleep Quality in Middle‐Aged Women with Hypertension  The Effects of Integrative In‐Patient Treatment on Patients’ Quality of Life: A Meta‐Analysis,  The Effects of Qigong on Anxiety, Depression, and Psychological Well‐Being: A Systematic Review and Meta‐Analysis  Add‐On Effect of Chinese Herbal Medicine on Mortality in Myocardial Infarction: Systematic Review and Meta‐Analysis of Randomized Controlled Trials  Objectifying Specific and Nonspecific Effects of Acupuncture: A Double‐Blinded Randomised Trial in Osteoarthritis of the Knee

Explore: The Journal of Science and Healing [First listed in ENZCAM Newsletter May 2011] Volume 9, Number 1: January 2013 http://www.explorejournal.com/issues

Selected articles:  Unbroken Wholeness: The Emerging View of Human Interconnection  American College of Preventive Medicine Named as National Coordinating Center for Integrative  Further Possible Physiological Connectedness Between Identical Twins: The London Study  A Randomized, Controlled, Double‐Blind Pilot Study of the Effects of Cranial Electrical Stimulation on Activity in Brain Pain Processing Regions in Individuals with Fibromyalgia  Treating Pediatric Psychogenic Dizziness with a Japanese Herbal Medicine  Qualitative and Quantitative Evaluation of a Pilot Integrative Coping and Resiliency Program for Healthcare Professionals  An Integrative Approach to Interstitial Cystitis  South African Indigenous Healing: How It Works

ENZCAM Integrative Medicine Newsletter January February 2013 Page 10 Integrative Cancer Therapies [First listed in ENZCAM Newsletter April 2011] Volume 12, Number 1: January 2013 http://ict.sagepub.com/content/12/1?etoc

Selected articles:  Significance of Natural Product Interactions in Oncology  Green Tea and Lung Cancer: A Systematic Review  The Impact of Healing Touch on Pediatric Oncology Patients  Increased Mindfulness Is Related to Improved Stress and Mood Following Participation in a Mindfulness‐Based Stress Reduction Program in Individuals With Cancer  Influence of Chinese Medicine on Weight Loss and Quality of Life During Radiotherapy in Head and Neck Cancer  Evidence That Naturopathic Therapy Including Cordyceps sinensis Prolongs Survival of Patients With Hepatocellular Carcinoma  Religion, Spirituality, and Cancer: The Question of Individual Empowerment

Journal of Evidence‐Based Complementary & Alternative Medicine [First listed in ENZCAM Newsletter April 2011] Volume 18, Number 1: January 2013 http://chp.sagepub.com/content/18/1.toc

Selected articles:  Yoga as an Alternative and Complementary Therapy for Patients Suffering From Anxiety: A Systematic Review  Yoga as an Alternative and Complementary Treatment for Patients With Low Back Pain: A Systematic Review  Tai Chi as an Alternative or Complementary Therapy for Patients With Depression: A Systematic Review  Role of Dietary Advanced Glycation End Products in Diabetes Mellitus  Traditional Medicinal Plants: A Source of Phytotherapeutic Modality in Resource‐Constrained Health Care Settings  Evidence‐Based Practice and Chiropractic Care

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 19, Number 1: January 2013 http://online.liebertpub.com/toc/acm/19/1

Selected articles:  Adoption in China of Clinical Practice Guidelines for Hypertension Using Traditional Chinese Medical Approaches: A Literature Review Based on Clinical Studies  Effect of Acute Acupuncture Treatment on Exercise Performance and Postexercise Recovery: A Systematic Review  Tension Tamer: Delivering Meditation With Objective Heart Rate Acquisition for Adherence Monitoring Using a Smart Phone Platform

ENZCAM Integrative Medicine Newsletter January February 2013 Page 11

 Effect of Yoga on Serum Homocysteine and Nitric Oxide Levels in Adolescent Women With and Without Dysmenorrhea  Changes in Autonomic Variables Following Two Meditative States Described in Yoga Texts  Analysis of Data from a Multicenter, Randomized, Controlled Trial for Primary Dysmenorrhea  Development and Validation of the Yin Deficiency Scale  A New Insight into Estrogen Signaling: Yin–Yang Perspective  Effect of Inhaled Essential Oils on Mental Exhaustion and Moderate Burnout: A Small Pilot Study

Volume 19, Number 2: February 2013 http://online.liebertpub.com/toc/acm/19/2

Selected articles:  Use of Assistance and Therapy Dogs for Children with Autism Spectrum Disorders: A Critical Review of the Current Evidence  Pain Research in Complementary and Alternative Medicine in Australia: A Critical Review  A Pilot Study of Qigong for Reducing Cocaine Craving Early in Recovery  Earthing (Grounding) the Human Body Reduces Blood Viscosity—a Major Factor in Cardiovascular Disease  Expert Consensus on the Treatment of Rheumatoid Arthritis with Chinese Patent Medicines  Homeopathic Treatment of Migraine in Children: Results of a Prospective, Multicenter, Observational Study  Evaluation of Biofield Treatment Dose and Distance in a Model of Cancer Cell Death  Prevalence and Predictors of Selenium and Vitamin E Supplementation in a Urology Population  Indirect Moxibustion (CV4 and CV8) Ameliorates Chronic Fatigue: A Randomized, Double‐Blind, Controlled Study  Management of Influenza‐Like Illness by Homeopathic and Allopathic General Practitioners in France During the 2009–2010 Influenza Season  Effects of a Holistic Yoga Program on Endocrine Parameters in Adolescents with Polycystic Ovarian Syndrome: A Randomized Controlled Trial  Effects of a Homeopathic Combination Remedy on the Acute Stress Response, Well‐Being, and Sleep: A Double‐Blind, Randomized Clinical Trial

10. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

January 2013: Five Most Searched‐For Herbs of 2012 http://nccam.nih.gov/health/providers/digest/topsupplements

“In 2012, over 3 million visitors came to NCCAM’s Web site seeking information on complementary health approaches. Though many people were looking for information on particular health topics or specific modalities like acupuncture, yoga, and meditation, the majority was seeking information on specific herbs and botanicals.” The five most searched‐for herbs were:  Evening Primrose Oil  St. John’s Wort  Fenugreek  Echinacea  Aloe Vera.

ENZCAM Integrative Medicine Newsletter January February 2013 Page 12

February 2013: High Cholesterol and Complementary Health Practices http://nccam.nih.gov/health/providers/digest/cholesterol

“Approximately 13 percent of U.S. adults has high total cholesterol. Lowering cholesterol levels can slow down, reduce, or even stop plaque from building up in the walls of arteries and may decrease the chance of having a heart attack. Mainstays in treating high cholesterol include diet, weight loss, physical activity, and when necessary, drug treatment.

According to the 2007 National Health Interview Survey, high blood cholesterol is one of the top 10 conditions prompting use of complementary health practices among adults. This issue provides information on "what the science says" about the effectiveness and safety of several dietary supplements reportedly used by people with high cholesterol, including red yeast rice, flaxseed and flaxseed oil, and garlic.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

5 March 2013

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

Integrative Medicine Newsletter March April 2013

1. Policy and Legislation in New Zealand

Review of Health Practitioners Competence Assurance Act 2003 “The Ministry of Health has been undertaking a strategic review of the Health Practitioners Competence Assurance Act 2003. A discussion document was released in August 2012. A total of 145 submissions were received.” The summary of submissions received and individual submissions were released on 9 May 2013: http://healthworkforce.govt.nz/node/553

Several complementary medicine organisations made submissions as this is the act that could be used to extend registration to other CAM professions.

Natural Health and Supplementary Products Bill “This bill establishes a system for the regulation of low‐risk natural health products in New Zealand.” The bill had its second reading in parliament in March 2013: http://www.parliament.nz/en‐NZ/PB/Legislation/Bills/b/c/8/00DBHOH_BILL11034_1‐Natural‐ Health‐and‐Supplementary‐Products‐Bill.htm

The Ministry of Health has advertised for the post of an Establishment Manager to oversee the creation of the new regulator that would be established when this bill is enacted: https://jobs.health.govt.nz/Job/Establishment‐Manager‐New‐Regulators/Wellington/138

2. The Placebo Effect and its Ramifications for Clinical Practice and Research

Complementary Therapies in Medicine Volume 21, Number 2: April 2013 http://www.complementarytherapiesinmedicine.com/issues

From the Editorial: The placebo revisited: What we do, don’t and maybe won’t know

“This Special Issue reports on the outcomes of an expert workshop on the placebo effect and its ramifications. …For a long time I have held the opinion that the negative association with the placebo phenomenon is not justified. This is because from a more holistic point of view, the placebo

ENZCAM Integrative Medicine Newsletter March April 2013 Page 2 effect is to be considered part of the ‘self‐healing response’. This was confirmed by several of the experts who emphasised the importance of the ‘meaning response’ and that giving a medicine to patients cannot be dissociated from the meaning of the personal interaction and cultural context in which this takes place. The latter was also confirmed by the expert on the role of empathy in medicine who observed in an extensive research program that perceived empathy has a significant and real effect on outcomes in the treatment of chronic diseases.”

“… for me a number of clear messages transpired. One of these is that the placebo debate is not more, or less, of an issue in CAM as compared to conventional medicine. It is linked to any kind of medical intervention. … Another important message is the complexity as well as high relevance of the placebo issue. On the one hand, it can greatly complicate the evaluation of treatments in clinical trials; on the other hand, better understanding the placebo phenomenon can contribute to improvements in clinical practice.”

“To a certain extent, the placebo effect has become more an ‘issue’ since the dominance of the Randomised Controlled Trial (RCT) as a research method after World War II. This was accompanied by the emergence of a regulatory framework that strongly hinges on the placebo controlled RCT as a proof of efficacy for single molecules with highly specific effects on single molecular targets. This framework is still largely in place today and it represents a reductionist, mono‐causal, ‘linear’ way of approaching disease and its treatment, in which the concept of separating and simply adding up the specific and the non‐specific effects of pharmacological agents seems to make sense.”

“ Whilst this approach has been very successful, particularly in the treatment of acute diseases, advances in medicine have increasingly demonstrated the limitations of this model, particularly in the treatment of chronic diseases. The genomic revolution in biology has demonstrated that single cause disease pathways are the exception rather than the rule, and in fact the majority of the major chronic diseases are multi‐factorial diseases, in which a ‘multi‐component, multi‐target’ approach is likely to be more applicable. …. So the question could be asked if the dominance of a reductionist, mono‐causal disease model has led to the creation of a ‘false dichotomy’ between ‘specific’ and ‘non‐specific’ effects, and resulted in a regulatory model that is not optimally appropriate for most CAM treatments which have a ‘whole systems’ approach to the patient.” …

“I am of the opinion that we should keep questioning the appropriateness of the placebo‐controlled research design and keep looking for improved and/or alternative research designs for the rigorous evaluation of treatments. Some initial and positive steps in this direction are also reflected in this Special Issue. Further efforts in this direction should not only explore what is ultimately ‘knowable’, but also what will remain ‘unknowable’ due to methodological, ethical and/or legal reasons. The latter will help to map limitations and remaining knowledge gaps associated with clinical trial designs.” …

Articles in the Special Issue:  The placebo revisited: What we do, don’t and maybe won’t know  The placebo effect and its ramifications for clinical practice and research. Villa La Collina at Lake Como, Italy, 4–6 May 2012  The early history of the placebo  The placebo response in clinical trials—the current state of play  The placebo effect revisited: Lessons learned to date

ENZCAM Integrative Medicine Newsletter March April 2013 Page 3

 Trial designs and exploration of the placebo response  The use of placebo interventions in clinical practice  The gap between results from sham‐controlled trials and trials using other controls in acupuncture research—The influence of context  Veterinary Clinical Research Database for Homeopathy: Placebo‐controlled trials  Implications of the ‘placebo effect’ for CAM research  Against the “placebo effect”: A personal point of view

3. Public Health and Health Services Research in Integrative Medicine

European Journal of Integrative Medicine Volume 5, Number 1: February 2013 http://www.europeanintegrativemedicinejrnl.com/issues

“This special issue brings together a flavour of some of the international research currently undertaken as part of this expanding interest in PH/HSR questions relating to IM/CM. There is an international recognition of the timeliness as evidenced by the submissions EUJIM has received from North America, Europe, and Australia. The manuscripts included here in this special issue similarly reflect international research activity and scholarship as well as a suite of perspectives and approaches.”

“Authors address a variety of topics related to models of integration. Kadetz discusses the World Health Organization's approach and related challenges in China, Cuba, and the Philippines. Particular stake‐holders were questioned in order to assess their impressions concerning optimal clinical and organisational practice and patterns. It also provides a critical review of the literature and explores the meaning of health care integration and how it is being practised in different contexts. Singer and Adams carried out semi structured interviews with health service managers to identify their recommendations and key requirements for those wishing to design and maintain effective integrative health services. Willis and Rayner interviewed physicians who practice integrative medicine and conceptualise this work very differently from a biomedical approach. Stake‐holders including patients, clinicians and providers of IM/CM informed the work by Welch et al. and offered perspectives relevant to both clinical and organisational issues.”

“Health concerns of specific populations are also described by several authors. Midwives’ perspectives on IM/CM approaches for pregnant women are discussed by Hall et al. Of specific interest is the context of their professional work and how this affects their beliefs and knowledge, and how this is balanced with the demands and expectations of woman in the midwifery setting. Kirby et al. use survey data to assess the use of IM/CM by mid‐age women with back pain and suggest that the longer pain persists the more likely the women were to consult CAM practitioners and that there were different perceived differences in approach between CAM and conventional biomedical practitioners. Roles for providers of IM/CM in rural Canada are qualitatively assessed in Hollenberg et al.’s paper however inter‐professional education appears to be a major barrier.

Other salient public health issues include use of polypharmacy by ageing populations and how CAM interventions could provide opportunities. Defining public health ethics for IM/CM is highlighted as a result of work carried out by CAMBRELLA, a EU funded project. Spinks et al. address the topics of cost and inter‐professional communication in the context of diabetes and cardiovascular care and

ENZCAM Integrative Medicine Newsletter March April 2013 Page 4 that concurrent chronic conditions appear to be strong independent predictors and key motivators of CAM use. This is likely influenced or associated with lower quality of life.

“We are pleased that in this special issue of the EUJIM our goals of promoting international and multi‐disciplinary dialogue and advancing the understanding of the intersections between public health and IM/CM have been addressed with such rich and diverse scholarship.”

Articles:  Public health and health services research in integrative medicine: An emerging, essential focus  Polypharmacy, multimorbidity and the value of integrative medicine in public health  Integrative medical doctors—Public health practitioner or lifestyle coach?  Addressing provider shortage in underserviced areas: The role of traditional, complementary and alternative medicine (TCAM) providers in Canadian rural healthcare  An exploratory study of the health service managers role in providing effective integrative health care  A national cross‐sectional survey of back pain care amongst Australian women aged 60–65  Costs and drivers of complementary and alternative medicine (CAM) use in people with type 2 diabetes or cardiovascular disease  Challenging a universal approach to health care integration: China, Cuba, and the Philippines  Public health ethics for complementary and alternative medicine  Contextual factors that mediate midwives’ behaviour towards pregnant women's use of complementary and alternative medicine  Working at the coalface: Using action research to study ‘integrative medicine’ in the NHS

4. Conferences

Conference Papers 8th Annual International Congress of Complementary Medicine Research, ICCMR 2013. London, 11‐13 April, 2013

The abstracts and indices of papers and posters presented are published as a special 142 page supplement to “Forschende Komplementärmedizin / Research in Complementary Medicine”.

Vol. 20, Suppl. 1, 2013, Issue release date: March 2013 Complementary Medicine Research, ICCMR 2013 http://www.karger.com/Journal/Issue/259791

Forthcoming conferences

9‐13 September 2013 8th International Congress on Traditional Asian Medicine Sancheong, KOREA http://www.iastam.org/

4‐5 October 2013 6th European Congress for Integrative Medicine Berlin, GERMANY http://www.ecim‐congress.org/general‐information.html

ENZCAM Integrative Medicine Newsletter March April 2013 Page 5

5. Books

An Integrated View of Health and Well‐being. Bridging Indian and Western Knowledge By Morandi, Antonio; Nambi, A.N.Narayanan (Eds.) Springer Verlag Series: Cross‐Cultural Advancements in Positive Psychology, Vol. 5 Publication Date: 2013 http://www.springer.com/psychology/book/978‐94‐007‐6688‐4

“Concepts like Health and Well‐being are not exclusive products of the Western culture. Research has widely demonstrated that the representation of the body and of its pathologies, as well as treatment and healing practices vary across cultures in relation to social norms and beliefs. The culture of India is a melting pot of nine main Darshanas, or philosophical systems, that share the common core of a realization of the self in society. India’s traditional health system, Ayurveda, is a result of the practical application of the Darshanas to the observation of human nature and behavior. Ayurveda conceptualizes health, disease and well‐being as multidimensional aspects of life, and it seeks to preserve a balance in individuals among their biological features, their psychological features and their environmental demands.”

“The Ayurveda approach to health is remarkably similar to the eudaimonic conceptualization of well‐ being proposed by positive psychology, and the basic tenets of Ayurveda are deeply consistent with the latest developments of modern physics, which stresses the substantial interconnectedness among natural phenomena and their substrates. This text shows how the approach to health developed in Ayurveda can be fruitfully integrated in a general view of health and well‐being that encompasses cultural and ideological boundaries. Specifically, it details the conceptualization of health as an optimal and mindful interaction between individuals and their environment.”

Chapters:  Introduction.‐  Part I. Health and Well‐Being in the Western Tradition.‐  Chapter 1. Well‐Being in the West: Hygeia Before and After the Demographic Transition; Corey L.M. Keyes.‐  Chapter 2. The Psychosomatic View; Giovannni Fava.‐  Part II. Health and Well‐Being in Indian Traditions.‐  Chapter 3. The Perspectives on Reality in Indian Traditions and their Implications for Health and Well‐Being; Kiran Kumar K. Salagame.‐  Chapter 4. Concepts of Health and the Paradigm of Ayurveda; P. Ram Manohar.‐  Chapter 5. The Determinants of Health and Well‐Being; A.N. Narayanan Nambi.‐  Chapter 6. The Role of Social Rituals in Well‐Being; P.R. Krishnakumar.‐

ENZCAM Integrative Medicine Newsletter March April 2013 Page 6

 Chapter 7. Health and Well‐Being in Indian Local Health Traditions; Unnikrishnan Payyapallimana.‐  Part III. Bridging the Worlds.‐  Chapter 8. Quantum Logic in Ayurveda; Rama Jayasundar.‐  Chapter 9. The Psychological Roots of Health Promotion; Antonella Delle Fave.‐  Chapter 10. The Emergence of Health in Complex Adaptive Systems: A Common Ground for Ayurveda and Western Science; Antonio Morandi and Antonella Delle Fave.‐  Conclusions; joining Knowledge Traditions: Towards an Integrated Approach to Health and Well‐ Being; Antonio Morandi, A.N. Narayanan Nambi, and Antonella Delle Fave.‐

6. Call for Papers

Evidence‐Based Complementary and Alternative Medicine Special Issue on Research Methodology: Choices, Logistics, and Challenges

“The role, benefits, challenges and appropriate use of research methods in the basic and applied social and clinical sciences have been debated extensively in recent years. The fields of clinical research and health services research in particular, have benefited from insightful, comprehensive debates and discussions of research methods and their appropriate use. We invite empirical, methodological, and theoretical articles discussing complementary and alternative medicine (CAM) methods research across the social, behavioral, health, technological, and human sciences. We encourage contributors to focus on the pragmatic aspects of research methodology in addition to conceptual and validity issues, and to foster dialogue and comparisons among different approaches as applied in CAM research in comparison to conventional therapies research.”

“We invite investigators to contribute original research and methods articles as well as review articles that will stimulate continuing efforts to identify the advantages and disadvantages of various research methods. We are especially interested in articles offering guidance in selecting and applying appropriate methods, avoiding potential pitfalls, and suggestions for diagnosing and correcting methods‐related problems. The aim of this special issue is to increase synergies between CAM and conventional therapy approaches around research methodology.”

“Potential topics include, but not limited to:  Meta‐analysis / systematic review methods  Methods for rapid review and related assessments and syntheses of the literature  Qualitative research methodology, quantitative research methodology and mixed methods  Systems approaches  Validity methodology  Methods of modeling and simulation  Optimal study design and design tradeoffs (e.g., internal vs. external validity)  Health services research methods  Efficacy vs. Effectiveness  Comparative effectiveness research, patient‐centered outcomes research methodology for practice‐based and pragmatic studies  Methods for partnered research, engaged research and practice‐based research

ENZCAM Integrative Medicine Newsletter March April 2013 Page 7

Prior to submission authors should carefully review the journal's Author Guidelines, which are located at http://www.hindawi.com/journals/ecam/guidelines/ . Prospective authors should submit an electronic copy of their complete manuscript through the journal Manuscript Tracking System at http://mts.hindawi.com/ according to the following timetable:

Manuscript Due July 26, 2013 First Round of Reviews October 18, 2013 Publication Date December 13, 2013

Guest Editors: Raheleh Khorsan, Ian D. Coulter, Brian Mittman, Cheryl Hawk, George Lewith, Evan Willis and Ray Kirk.

7. Journals

Selected articles:  Quercetin: a potential natural drug for adjuvant treatment of rheumatoid arthritis  Comparison of efficacy of neural therapy and physical therapy in chronic low back pain  Evaluation of anti‐bacterial and wound healing activity of the fruits of Amorpha Fruticosa l.  Analysis on 85 case reports of adverse drug reactions

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter Q1 2011] Volume 19, Number 2: April 2013 http://online.liebertpub.com/toc/act/19/2

Selected articles:  Roundoc Rx: Natural Interventions to Prevent Hypertension: Part 1—Six Things to Avoid  Integrative Urology and Prevention of Prostate Cancer  Nutrition in Pain Modulation  Antifibrotic Herbs: Indications, Mechanisms of Action, Doses, and Safety Information  Fecal Microbiotic Transplantation: A Novel Way to Treat Gastrointestinal Disorders  Yoga as an Adjunctive Therapy in the Clinical Setting  Ginger as an Adjunctive Treatment for Cyclic Vomiting Syndrome

ENZCAM Integrative Medicine Newsletter March April 2013 Page 8

 Raspberry Ketone: An Evidence‐Based Systematic Review by the Natural Standard Research Collaboration  Clinical Roundup: Selected Treatment Options for Polycystic Ovary Syndrome

BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] February, March and April 2013 http://www.biomedcentral.com/bmccomplementalternmed/content

Selected articles:  The eCALM Trial‐eTherapy for cancer applying mindfulness: online mindfulness‐based cancer recovery program for underserved individuals living with cancer in Alberta: protocol development for a randomized wait‐list controlled clinical trial  The effectiveness of fermented turmeric powder in subjects with elevated alanine transaminase levels: a randomised controlled study  Acupuncture for ankle sprain: systematic review and meta‐analysis  Capsaicin induces cell cycle arrest and apoptosis in human KB cancer cells  Physicochemical and antioxidant properties of Malaysian honeys produced by Apis cerana, Apis dorsata and Apis mellifera  The prevalence of traditional herbal medicine use among hypertensives living in South African communities  Moxibustion for treating knee osteoarthritis: study protocol of a multicentre randomised controlled trial  Is acupuncture “stimulation” a misnomer? A case for using the term “blockade”  Nutrient‐ and non‐nutrient‐based natural health product (NHP) use in adults with mood disorders: prevalence, characteristics and potential for exposure to adverse events  Anti‐hyperglycemic effects of three medicinal plants in diabetic pregnancy: modulation of T cell proliferation  Consultations with complementary and alternative medicine practitioners by older Australians: results from a national survey  Thai traditional massage increases biochemical markers of bone formation in postmenopausal women: a randomized crossover trial  Potential effectiveness of traditional Chinese medicine for cardiac syndrome X (CSX): a systematic review and meta‐analysis

Chinese Medicine [First listed in ENZCAM Newsletter June 2012] http://www.cmjournal.org/content

Selected articles:  Key considerations for conducting Chinese medicine clinical trials in hospitals  Referral to Chinese medicine practitioners in Australian primary care: a survey of New South Wales rural and regional general practitioners

Complementary Therapies in Medicine See section 2 in this newsletter

ENZCAM Integrative Medicine Newsletter March April 2013 Page 9 The EPMA Journal [First listed in ENZCAM Newsletter December 2011] March and April 2013 http://www.epmajournal.com/

Selected articles:  The EPMA Journal introduces a new type of research article dedicated to predictive, preventive and personalised medicine

European Journal of Integrative Medicine

Volume 5, Number 1: February 2013 See section 3 in this newsletter

Volume 5, Number 2: April 2013 http://www.europeanintegrativemedicinejrnl.com/current

Selected articles:  Integrative medicine, integrative acupuncture  Scalp acupuncture for stroke recovery: A systematic review and meta‐analysis of randomized controlled trials  Acupuncture for neurogenic bladder after spinal cord injury: A systematic review and meta‐ analysis  Sulphurous medicinal waters increase somatostatin release: It is a possible mechanism of anti‐ inflammatory effect of balneotherapy in psoriasis  Effectiveness of MORA electronic homeopathic copies of remedies for allergic rhinitis: A short‐ term, randomized, placebo‐controlled PILOT study  Advances in integrative nanomedicine for improving infectious disease treatment in public health  “Effects of Tactile Touch on pain, sleep and health related quality of life in Parkinson's disease with chronic pain”: A randomized, controlled and prospective study  Changes in chronically ill patients’ self‐management skills and resources following 14 days of inpatient treatment in a Department for Integrative Medicine: An observational pilot study  Introduction of the German case tariff fee system and its effects on patient satisfaction in inpatient naturopathy

Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] Published March and April 2013 http://www.hindawi.com/journals/ecam/2013/

Selected articles:  Effects of Qigong on Depression: A Systemic Review  Cardiovascular Protective Effects of Adjunctive Alternative Medicine (Salvia miltiorrhiza and Pueraria lobata) in High‐Risk Hypertension  Chinese Medicinal Herbs for Childhood Pneumonia: A Systematic Review of Effectiveness and Safety

ENZCAM Integrative Medicine Newsletter March April 2013 Page 10

 Noninvasive Characterisation of Foot Reflexology Areas by Swept Source‐Optical Coherence Tomography in Patients with Low Back Pain  Syndrome Differentiation in Chinese Herbal Medicine for Irritable Bowel Syndrome: A Literature Review of Randomized Trials  Objectifying Acupuncture Effects by Lung Function and Numeric Rating Scale in Patients Undergoing Heart Surgery  Active Student Participation May Enhance Patient Centeredness: Patients' Assessments of the Clinical Education Ward for Integrative Medicine  Systematic Review and Meta‐Analysis of 16 Randomized Clinical Trials of Radix Astragali and Its Prescriptions for Diabetic Retinopathy  Complementary and Alternative Medicine Use among Physicians in Oriental Medicine Hospitals in Vietnam: A Hospital‐Based Survey  Pomegranate Extracts in the Management of Men's Urologic Health: Scientific Rationale and Preclinical and Clinical Data  Effect of GutGard in the Management of Helicobacter pylori: A Randomized Double Blind Placebo Controlled Study  Efficacy of Myofascial Trigger Point Dry Needling in the Prevention of Pain after Total Knee Arthroplasty: A Randomized, Double‐Blinded, Placebo‐Controlled Trial  Complementary and Alternative Medicine Use among Norwegian Cancer Survivors: Gender‐ Specific Prevalence and Associations for Use  Research and Development for Botanical Products in Medicinals and Food Supplements Market  Expert Consensus on the Treatment of Hypertension with Chinese Patent Medicines  Validity of a Diagnostic Scale for Acupuncture: Application of the Item Response Theory to the Five Viscera Score  Control Group Design: Enhancing Rigor in Research of Mind‐Body Therapies for Depression  Why Urban Citizens in Developing Countries Use Traditional Medicines: The Case of Suriname  Emerging Roles of Propolis: Antioxidant, Cardioprotective, and Antiangiogenic Actions  The European Heritage of Folk Medicines and Medicinal Foods: Its Contribution to the CAMs of Tomorrow  Astragalus in the Prevention of Upper Respiratory Tract Infection in Children with Nephrotic Syndrome: Evidence‐Based Clinical Practice  Effects of Flower and Fruit Extracts of Melastoma malabathricum Linn. on Growth of Pathogenic Bacteria: Listeria monocytogenes, Staphylococcus aureus, Escherichia coli, and Salmonella typhimurium  Tibetan Medicine: A Systematic Review of the Clinical Research Available in the West  The Effect of Aromatherapy Abdominal Massage on Alleviating Menstrual Pain in Nursing Students: A Prospective Randomized Cross‐Over Study  Topical Treatment of Nonhealing Venous Leg Ulcer with Propolis Ointment  Role of Garlic Usage in Cardiovascular Disease Prevention: An Evidence‐Based Approach  A Yoga and Compassion Meditation Program Reduces Stress in Familial Caregivers of Alzheimer's Disease Patients  Acupressure Improves the Weaning Indices of Tidal Volumes and Rapid Shallow Breathing Index in Stable Coma Patients Receiving Mechanical Ventilation: Randomized Controlled Trial  Use of Complementary and Alternative Medicine among Patients with End‐Stage Renal Disease  Shoulder Mobility, Muscular Strength, and Quality of Life in Breast Cancer Survivors with and without Tai Chi Qigong Training

ENZCAM Integrative Medicine Newsletter March April 2013 Page 11 Forschende Komplementärmedizin / Research in Complementary Medicine http://www.karger.com/Journal/Home/224242

International journal for clinical research and practice in complementary medicine, with articles published in German and English.

“Aims and Scope: 'Forschende Komplementärmedizin / Research in Complementary Medicine' is an international journal that aims to bridge the gap between traditional and complementary/alternative medicine (CAM) on a sound scientific basis, promoting their mutual integration. Accordingly, experts of both traditional and CAM medicine cooperate on the journal‘s editorial board, which accepts papers only after a rigorous peer‐review process in order to maintain a high standard of scientific quality.”

Volume 20, Number 1: March 2013 http://www.karger.com/Journal/Issue/259777

Selected articles in English:  Anti‐Hyperglycemic Effect of Vaccinium arctostaphylos in Type 2 Diabetic Patients: A Randomized Controlled Trial  The Evolution of Complementary and Alternative Medicine (CAM) in the USA over the Last 20 Years

Volume 20, Number 2: April 2013 http://www.karger.com/Journal/Issue/259855

Selected articles in English:  Role of Reflexology and Antiepileptic Drugs in Managing Intractable Epilepsy ‐ a Randomized Controlled Trial  Stress Management and Mind‐Body Medicine: A Randomized Controlled Longitudinal Evaluation of Students' Health and Effects of a Behavioral Group Intervention at a Middle‐Size German University (SM‐MESH)  Ayurvedic Management of Ulcerative Colitis ‐ a Non‐Randomized Observational Clinical Study  Italy and the Dialogue on Human Health between Traditional Chinese Medicine Culture and Western Medicine

Integrative Cancer Therapies [First listed in ENZCAM Newsletter April 2011] Volume 12, Number 2: March 2013 http://ict.sagepub.com/content/12/2?etoc

Selected articles:  Quercetin in Cancer Prevention and Therapy  Investigating the Perceived Feasibility of Integrative Medicine in a Conventional Oncology Setting: Yoga Therapy as a Treatment for Breast Cancer Survivors  Examining a Therapeutic Yoga Program for Prostate Cancer Survivors  Can We Demonstrate That Breast Cancer "Integrative Oncology" Is Effective? A Methodology to Evaluate the Effectiveness of Integrative Oncology Offered in Community Clinics  Effectiveness of 3‐Week Intervention of Shi Quan Da Bu Tang for Alleviating Hematotoxicity Among Patients With Breast Carcinoma Receiving Chemotherapy

ENZCAM Integrative Medicine Newsletter March April 2013 Page 12

Journal of Evidence‐Based Complementary & Alternative Medicine [First listed in ENZCAM Newsletter April 2011] Volume 18, Number 2: April 2013 http://chp.sagepub.com/

Selected articles:  Patterns of Complementary Therapy Use for Symptom Management for Older Rural Adults With Diabetes  A Sociobehavioral Model of Use of Complementary and Alternative Medicine Providers, Products, and Practices: Findings From the 2007 National Health Interview Survey  Comparison of Vitamin D Label Dosing Recommendations to North American National Guidelines  Preventative and Therapeutic Role of Probiotics in Various Allergic and Autoimmune Disorders: An Up‐to‐Date Literature Review of Essential Experimental and Clinical Data  Clinical Significance of Leech Therapy in Indian Medicine  Book/Media Review: Connecting With Socially Isolated Seniors—A Service Provider’s Guide  Book/Media Review: The Validation Breakthrough—Simple Techniques for Communicating With People With Alzheimer’s and Other Dementias  Book/Media Review: Seeking Sickness: Medical Screening and the Misguided Hunt for Disease

Journal of Holistic Nursing [First listed in ENZCAM Newsletter April 2011] Volume 31, Number 1: March 2012 http://jhn.sagepub.com/content/30/3.toc?etoc

Selected articles:  Creative Power of Metaphorical Expression  Translation and Focus Group Testing of the WHOQOL Spirituality, Religiousness, and Personal Beliefs Module in Norway  Nursing’s Role in Courage Development in Patients Facing Complications of Diabetes  Comparative Analysis of Two Musical Genres Within a Multisensory Environmental Intervention

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 19, Number 3: March 2013 http://online.liebertpub.com/toc/acm/19/3

Selected articles:  The Effects of Regular Yoga Practice on Pulmonary Function in Healthy Individuals: A Literature Review  Effect of Naturopathic and Nutritional Supplement Treatment on Tumor Response, Control, and Recurrence in Patients with Prostate Cancer Treated with Radiation Therapy  The Journal of Alternative and Complementary Medicine. March 2013, 19(3  Adding Integrative Meditation with Ear Acupressure to Outpatient Treatment of Cocaine Addiction: A Randomized Controlled Pilot Study  Effects of Spiritual Healing for Women Undergoing Long‐Term Hormone Therapy for Breast Cancer: A Qualitative Investigation

ENZCAM Integrative Medicine Newsletter March April 2013 Page 13

 Has the Use of Complementary and Alternative Medicine Therapies by U.S. Adults with Chronic Disease‐Related Functional Limitations Changed from 2002 to 2007?  Spectrum of Antimicrobial Activity Associated with Ionic Colloidal Silver  A Proposed Reductionist Solution to Address the Methodological Challenges of Inconsistent Reflexology Maps and Poor Experimental Controls in Reflexology Research: A Discussion Paper  Effect of Aromatherapy Massage on Elderly Patients Under Long‐Term Hospitalization in Japan  Effect of Risk Adjustment Method on Comparisons of Health Care Utilization Between Complementary and Alternative Medicine Users and Nonusers

Volume 19, Number 4: April 2013 http://online.liebertpub.com/toc/acm/19/4

Selected articles:  Factors Associated with Conflicting Findings on Acupuncture for Tension‐Type Headache: Qualitative and Quantitative Analyses  Music's Use for Anesthesia and Analgesia  Tapping‐in Method (Skin Penetration Technique) with a Placebo Needle for Double‐Blind Acupuncture Trials  Auricular Acupressure for Pain Relief in Adolescents with Dysmenorrhea: A Placebo‐Controlled Study  Is There a Specific Hemodynamic Effect in Reflexology? A Systematic Review of Randomized Controlled Trials  Open‐Label, Randomized, Parallel‐Group Controlled Clinical Trial of Massage for Treatment of Depression in HIV‐Infected Subjects  Nutmeg Extracts for Painful Diabetic Neuropathy: A Randomized, Double‐Blind, Controlled Study  Medical Students' Knowledge, Perceptions, and Interest in Complementary and Alternative Medicine  Blinding in Clinical Trials: A Practical Approach  Insights on Personalized Medicine from Ayurveda

8. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

March 2013: Irritable Bowel Syndrome and Complementary Health Practices http://nccam.nih.gov/health/providers/digest/IBS

“Irritable bowel syndrome (IBS) is a chronic disorder that interferes with the normal functions of the colon. IBS is characterized by symptoms such as abdominal pain, cramping, bloating, constipation, and diarrhea. IBS is challenging to study because its symptoms vary, are non‐specific, can be episodic, may resolve for long periods, and there are no definitive diagnostic tests.

This issue summarizes research on some of the most popular complementary and health practices people try to treat symptoms of IBS. Overall, although there is some emerging evidence suggesting that some complementary health practices may be helpful for IBS, there have been few large well‐ designed studies, and most of the studies have had methodological flaws. Systematic reviews generally conclude that more well‐designed studies are needed to firmly establish whether complementary health practices are helpful treatments for IBS.”

ENZCAM Integrative Medicine Newsletter March April 2013 Page 14

April 2013: Seasonal Allergies and Complementary Health Practices http://nccam.nih.gov/health/providers/digest/allergies

“Seasonal allergies, also called ‘hay fever’, are a common chronic medical problem. At least 17.7 million American adults (7.8 percent of the adult population) and 7 million children (about 9 percent of children) have seasonal allergies.

People manage seasonal allergies by taking medication, avoiding exposure to the substances that trigger their allergic reactions, having a series of ‘allergy shots’ (a form of immunotherapy) or using various complementary approaches. According to the 2007 National Health Interview Survey, ‘respiratory allergy’ is among the 15 conditions for which children in the United States use complementary approaches most frequently. This issue of the Digest provides information on what the science says about several complementary health approaches for seasonal allergies, such as saline nasal irrigation, butterbur, honey, acupuncture, and other practices.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

10 May 2013

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

Integrative Medicine Newsletter May June 2013

1. Policy and Legislation

Consultation in New Zealand on Rongoā Tikanga Standard The Ministry of Health and Standards New Zealand have released a draft standard for the provision of traditional Māori healing services. The document should be of interest to other jurisdictions as it shows how the world‐view of indigenous healing practices has been incorporated in the standards typical of the bio‐medical health system. http://www.health.govt.nz/our‐work/populations/maori‐health/rongoa‐maori‐traditional‐maori‐ healing‐0/rongoa‐tikanga‐standards‐panui‐public‐consultation

A copy of the document is available from the Standards New Zealand website during the Public Comment phase from 1 July 2013. Closing date for comments is 23 August 2013. http://shop.standards.co.nz/default.htm?action=viewDraft&mod=drafts&draftId=DZ%2013901

“Standards NZ are seeking feedback on a draft Rongoā Tikanga Standard that describes guidelines for the provision of safe and quality rongoā [Māori traditional healing] services. This standard provides clear requirements for service providers to attain, and guidance on how these can be achieved.”

“This discussion document encourages and supports consistency of quality rongoā care, and the ongoing development of the rongoā workforce. It also provides information which:  sets out the rights and mana [authority, status, spiritual power], of tūroro [client, patient]  highlights management systems to assist rongoā providers  supports a traditional integrated rongoā Māori service  promotes health and safety  proposes a framework to validate, verify and endorse the integrity of the rongoā service.”

“Rongoā Māori is informed by a body of knowledge that has as its core the enhancement of Māori well‐being including that of the pūtaiao [science]. In this way, Rongoā Māori is a healing orientated practice. It is a specialty based on a body of knowledge accumulated by tupuna Māori [ancestors] that is applied in totality to bring about wholeness or interconnectedness of body, mind, emotion, spirituality, energy, society, culture, relationships and environment. It is a way of being in the world and sharing the appropriate knowledge to help restore balance. “It is not a medical modality in which components can be selected or ignored as one chooses. It is a process that combines healing tradition, environment and matauranga [knowledge, wisdom, understanding, skill]. As such it differs significantly from a western medical paradigm which has at its heart the identification, management and/or elimination of disease.”

ENZCAM Integrative Medicine Newsletter May June 2013 Page 2

The draft document provides a way to think of the provider‐patient relationship in Rongoā Māori by drawing on cultural symbols and understanding, for example (p18 and p24):

“This diagram illustrates that the tūroro [client, patient] is the centre of rongoā [Māori traditional healing] services. The rongoā service focuses on looking at treating the overall health of the tūroro in a holistic way in contrast to treating the disease or the illness that a tūroro may have.

The total well‐being of the tūroro is paramount and that true healing puts the mind, body, and spirit in harmony. There are other dimensions of well‐being to be considered when caring for a tūroro. These include te taha wairua [spirit, soul], waiora [health, soundness], hinengaro [mind, intellect, consciousness], tinana [physical], whenua [land], whakapapa [genealogy, lineage] and te reo [language].

The interactions between tūroro and practitioner are imperative in the process of achieving orangatanga [wholeness and wellness]. The tūroro needs to be involved in their orange [health] journey.”

“This diagram embraces the principles of service delivery and the mauri [life principle] of rongoā to ensure the tūroro [client, patient] is provided with a high quality and safe rongoā service.

Successful development and implementation of rongoā tikanga [patterns of appropriate behaviour including customs and rites] requires rohe [area authorities for Māori healing services] to take responsibility of the rongoā services. Specifically, the initial steps rohe need to take are to: (a) Collectively articulate and agree their rongoā tikanga; and (b) Plan and implement the tikanga. For example structures, strategy, systems, policies, and procedures should be developed to ensure the implementation of rongoā tikanga in each rohe.”

ENZCAM Integrative Medicine Newsletter May June 2013 Page 3 Australian Concerns with TGA reforms with direct detrimental impact for complementary medicine health professionals http://www.theartofhealing.com.au/news_important_industry_notice.html

“The Complementary Healthcare Council of Australia (the CHC), the [association] committed to a vital and sustainable complementary medicines industry, has been engaging with the Therapeutic Goods Administration (TGA) on appropriate regulatory reform for complementary medicines (CMs) as part of the Governments’ Blueprint Reforms.

The Australian Society of Bioregulatory Medicine (ASBRM) … have asked us to draw to your attention to a number of regulatory changes and proposals impacting the CM industry that, if approved, will have direct detrimental impact for complementary medicine health professionals.

Of particular importance are the regulatory changes that will mean as of July 2014, practitioners will have reduced access to tools of the trade such as In‐Vitro Diagnostic devices for example, bio‐ impedance analysis, live blood analysis, urine analysis and other in‐clinic testing and monitoring devices or tools.

Additionally, the proposed changes to advertising of therapeutic goods means that practitioners will not be able to access advertising and educational material from Practitioner‐Only complementary medicine companies. In effect, the proposed changes mean that all healthcare professionals would be treated as if they were consumers.”

Practitioners were asked to engage in a campaign against the proposed changes.

2. Integration of Spirituality into the Medical Curriculum

The Whanganui Chronicle reported on Associate Professor Kellie Bennett’s presentation at the Compassion, Spirituality and Health Conference held in Adelaide, Australia. http://www.wanganuichronicle.co.nz/news/would‐you‐like‐spirituality‐to‐be‐integrated‐into‐ /1964338/

“Dr Bennett works in the School of Psychiatry and Clinical Neurosciences at the University of Western Australia [UWA].” “She’s the recipient of a Templeton Foundation research grant awarded to her to survey spirituality content in medical education in Australian universities nationally, as she also gauges the attitudes of Deans, teachers, students, and practitioners to the use of spirituality in patient care.

“UWA has made some progress, offering elective units that include a spiritual approach to healthcare. But Dr Bennett is looking towards an integrated model where spirituality would be embedded into the curriculum.”

“With the Association of American Colleges, Joint Commission on Accreditation of Health Organisations and the World Health Organisation all on board as to the importance of the recognition of spirituality in healthcare, and the majority of US and UK medical schools already providing it in the curriculum, the Australian / New Zealand medical scene is poised to start considering the complexities of how, what , who, how much, when: that is, how to move to a biopsychosocial‐spiritual model of treatment.”

ENZCAM Integrative Medicine Newsletter May June 2013 Page 4

“Coming from a genetics background, Dr Bennett now does some research in mindfulness‐based cognitive therapy and is dedicated to evidence‐based medicine. … She feels that the fact that meditation is found to be beneficial, has very low harm associated with it, and that there’s a significant body of corroborating literature, needs to be communicated to people.”

“Dr Bennett was as ready to talk about the benefits of prayer as she was meditation. She’d done some work with it through the Cancer Council. Research focusing on the power of prayer and meditation in healing nearly doubled in the 1990s and continues today, providing documented MRI brain scans of the physical changes that take place in the body when someone meditates.”…

“Spirituality, emphasising the healing of the whole person …. not just the disease, promotes trust in a higher power and often results in a more buoyant disposition, self‐forgiveness, self‐forgetfulness, a sense of peace and certainty, hope, optimism, increased kindness and compassion, along with a decrease in pain and depression.”

3. Subtle Energies & Energy Medicine Journal Archives

Journal of Subtle Energies and Energy Medicine archive available free on‐line http://journals.sfu.ca/seemj/index.php/seemj/index

The International Society for the Study of Subtle Energies & Energy Medicine [ISSSEEM] was established in 1989:  “To explore the application of subtle energies to the experience of consciousness, healing, and human potential. It is designed as a bridging organization for scientist, clinicians, therapists, healers, and lay people.  To study systems and energies that interact with the human psyche and physiology, either enhancing or perturbing health.  To interconnect persons who work with or conduct research about subtle energies.  To encourage an exchange of information through conferences, seminars, and workshops.  To cooperate with other organizations that have common interests and goals, enhancing the use of available resources.  To interface with the broader scientific community through Bridges, a quarterly magazine, and Subtle Energies and Energy Medicine, a peer‐reviewed, scientific journal.”

ISSSEEM has, from June 2013, become a division of Holos University Graduate Seminary. http://www.issseem.org/about.cfm

ISSSEEM announced in May 2013 that the full archive of the peer‐reviewed Journal of Subtle Energies and Energy Medicine (SEEMJ) would be made available freely on‐line. SEEMJ is a “scholarly journal concerning consciousness, healing, and human potential addressing the study of subtle energies and informational systems interacting with the human psyche and physiology.”

The website features:  free public access full‐text to every item published in the 21 years of its publication;  full‐text search capabilities;  full‐text indexing and access via Google Scholar.

ENZCAM Integrative Medicine Newsletter May June 2013 Page 5 4. Conferences

Forthcoming conferences

A new conference added is the 19th International Integrative Medicine Conference, to be held in Australia in October 2013. It is being hosted by the Australasian Integrative Medicine Association (AIMA).

9‐13 September 2013 8th International Congress on Traditional Asian Medicine Sancheong, KOREA http://www.iastam.org/

4‐5 October 2013 6th European Congress for Integrative Medicine Berlin, GERMANY http://www.ecim‐congress.org/general‐information.html

18‐20 October 2013 19th International Integrative Medicine Conference Surfer’s Paradise, Queensland, https://www.aima.net.au/ Australia

5. Books

Traditional healers of Central Australia: ngangkari. Ngaanyatjarra Pitjantjatjara Yankunytjatjara Women’s Council Aboriginal Corporation, compilers. Broome, Western Australia: Magabala Books Publication Date: 2013 http://www.magabala.com/traditional‐healers‐of‐the‐central‐desert‐ngangkari.html

From the book review: “Traditional healers help close the gap”, by Robert M Parker, Med J Aust 2013; 199 (1): 45. https://www.mja.com.au/journal/2013/199/1/traditional‐healers‐help‐close‐gap

“Traditional healers of Central Australia celebrates the important work done by [ngangkari (traditional healers) Andy Tjilari and Rupert Langkatjukur Peter] and other ngangkari. It is a rich compilation of stories told by the ngangkari themselves along with artwork and photographs of Central Australia.

ENZCAM Integrative Medicine Newsletter May June 2013 Page 6

The tales told by a number of male and female ngangkari reflect their life and cultural experience with respect to their careers as traditional healers within their Aboriginal family and community. The book includes a general discussion of the work of the ngangkari as well as specifics on how they approach topics such as grief, death and dying, substance abuse, mental illness, and the way they work with conventional health services. The services the ngangkari offer to these communities are often conducted in coordination with formal clinical mental health service provision.

This beautiful and insightful work will give the interested reader a window into a cultural experience of healing that is a continuing vital element of the health of the Aboriginal communities in Central Australia. In the ongoing efforts to Closing the Gap, this book is a reminder that solutions to health may be assisted through the wisdom of local people and communities in coordination with the “evidence” that is so prominent in the discussions about health service delivery today.”

6. Journals

Selected articles:  The view of patients with chronic obstructive pulmonary disease (COPD) on complementary and alternative medicine (CAM) in Eastern Turkey  African mistletoes (Loranthaceae); ethnopharmacology, chemistry and medicinal values: an update

Alternative and Complementary Therapies [First listed in ENZCAM Newsletter Q1 2011] Volume 19, Number 3: June 2013 http://online.liebertpub.com/toc/act/19/3

Selected articles:  Treating Veterans’ Chronic Pain and Mental Health Disorders: An Integrative, Patient‐Centered Approach  Effects of Meditation on Symptoms of Knee Osteoarthritis: A Pilot Study  Insect Bites: An Integrative Approach: A Natural Standard Monograph  Clinical Roundup: Selected Treatment Options for Peripheral Neuropathy

ENZCAM Integrative Medicine Newsletter May June 2013 Page 7 BMC Complementary and Alternative Medicine [First listed in ENZCAM Newsletter September 2011] May and June 2013 http://www.biomedcentral.com/bmccomplementalternmed/content

Selected articles:  CamMedNP: Building the Cameroonian 3D structural natural products database for virtual screening  Simultaneous transcutaneous electrical nerve stimulation mitigates simulator sickness symptoms in healthy adults: a crossover study  Prevalence and factors associated with the use of alternative (folk) medicine practitioners in 8 countries of the former Soviet Union  How to locate and appraise qualitative research in complementary and alternative medicine  A screening for antimicrobial activities of Caribbean herbal remedies  Individualised medicine from the perspectives of patients using complementary therapies: a meta‐ethnography approach  Patients’ expectations of private osteopathic care in the UK: a national survey of patients  In‐vitro evaluation of selected Egyptian traditional herbal medicines for treatment of Alzheimer’s disease  Histone modifications and traditional Chinese medicinals  Effects of a Brief Qigong‐based Stress Reduction Program (BQSRP) in a distressed Korean population: a randomized trial  Opinions on Kampo and reasons for using it – results from a cross‐sectional survey in three Japanese clinics  Patients’ preconceptions of acupuncture: a qualitative study exploring the decisions patients make when seeking acupuncture  Chinese herbal medicine for impaired glucose tolerance: a randomized placebo controlled trial  Evaluation of pharmacological activities, cytotoxicity and phenolic composition of four Maytenus species used in southern African traditional medicine to treat intestinal infections and diarrhoeal diseases  The quest for modernisation of traditional Chinese medicine  Characteristics and quality of life of patients presenting to cancer support centres: Patient rated outcomes and use of complementary therapies  A randomised controlled trial of the use of aromatherapy and hand massage to reduce disruptive behaviour in people with dementia  Antibacterial activities of selected edible plants extracts against multidrug‐resistant Gram‐ negative bacteria  The role of natural health products (NHPs) in dietetic practice: results from a survey of Canadian dietitians  Prevalence of herbal and dietary supplement usage in Thai outpatients with chronic kidney disease: a cross‐sectional survey  Complementary alternative medicine use among patients with type 2 diabetes mellitus in the primary care setting: a cross‐sectional study in Malaysia  Cameroonian medicinal plants: a bioactivity versus ethnobotanical survey and chemotaxonomic classification  The BraveNet prospective observational study on integrative medicine treatment approaches for pain  Acupuncture and physical exercise for affective symptoms and health‐related quality of life in polycystic ovary syndrome: secondary analysis from a randomized controlled trial

ENZCAM Integrative Medicine Newsletter May June 2013 Page 8

Chinese Medicine [First listed in ENZCAM Newsletter June 2012] May and June 2013 http://www.cmjournal.org/content

Selected articles:  Chemical changes of Angelicae Sinensis Radix and Chuanxiong Rhizoma by wine treatment: chemical profiling and marker selection by gas chromatography coupled with triple quadruple mass spectrometry  Developing a diagnostic checklist of traditional Chinese medicine symptoms and signs for psoriasis: a Delphi study

Complementary Therapies in Clinical Practice [First listed in ENZCAM Newsletter June 2011] Volume 19, Number 2: May 2013 http://www.ctcpjournal.com/issues

Selected articles:  An exploration of Traditional Chinese Medicine practitioners' perceptions of Evidence Based Medicine  Working with the labyrinth. Paths for exploration  Perception and attitude of Jordanian physicians towards complementary and alternative medicine (CAM) use in oncology  The impact of Yoga upon young adult cancer survivors  Effect of daily supplementation of fruits on oxidative stress indices and glycaemic status in type 2 diabetes mellitus  Rheumatoid arthritis in upper limbs benefits from moderate pressure massage therapy  Reconditioning the stress response with hypnosis CD reduces the inflammatory cytokine IL‐6 and influences resilience: A pilot study  A qualitative analysis of beginning mindfulness experiences for women with post‐traumatic stress disorder and a history of intimate partner violence  Mindful‐Veteran: The implementation of a brief stress reduction course

Complementary Therapies in Medicine [First listed in ENZCAM Newsletter May 2011] Volume 21, Number 3: June 2013 http://www.complementarytherapiesinmedicine.com/issues

Selected articles:  The effects of Panax notoginseng on delayed onset muscle soreness and muscle damage in well‐ trained males: A double blind randomised controlled trial  Evaluation of the effect of omega‐3 fatty acids in the treatment of premenstrual syndrome: “A pilot trial”  Effect of Turkish classical music on blood pressure: A randomized controlled trial in hypertensive elderly patients

ENZCAM Integrative Medicine Newsletter May June 2013 Page 9

 Bee venom acupuncture point injection for central post stroke pain: A preliminary single‐blind randomized controlled trial  The effect of aromatherapy massage on the psychological symptoms of postmenopausal Iranian women  The clinical efficacy of a bovine lactoferrin/whey protein Ig‐rich fraction (Lf/IgF) for the common cold: A double blind randomized study  A phase II randomised double‐blind placebo‐controlled clinical trial investigating the efficacy and safety of ProstateEZE Max: A herbal medicine preparation for the management of symptoms of benign prostatic hypertrophy  A pilot study investigating the effect of Caralluma fimbriata extract on the risk factors of metabolic syndrome in overweight and obese subjects: a randomised controlled clinical trial  A randomised double‐blind comparability study of a placebo for Individualised Western Herbal Medicine  Inpatient treatment for severe atopic dermatitis in a Traditional Korean Medicine hospital: Introduction and retrospective chart review  Utilization of traditional Chinese medicine in patients treated for depression: A population‐based study in Taiwan  Prevalence of complementary and alternative medicine (CAM)‐use in UK paediatric patients: A systematic review of surveys  Syzygium cumini (L.) Skeels., a novel therapeutic agent for diabetes: Folk medicinal and pharmacological evidences  A narrative review of yoga and mindfulness as complementary therapies for addiction  Systems biology approach opens door to essence of acupuncture  Prevalence of complementary and alternative medicine use in a community‐based population in South Korea: A systematic review  Filling the gap between traditional Chinese medicine and modern medicine, are we heading to the right direction?

The EPMA Journal [First listed in ENZCAM Newsletter December 2011] May and June 2013 http://www.epmajournal.com/

Selected articles:  The primary vascular dysregulation syndrome: implications for eye diseases  Personalized medicine: myth or reality? The position of Russian clinical pharmacologists  Position paper of the EPMA and EFLM: a global vision of the consolidated promotion of an integrative medical approach to advance health care

European Journal of Integrative Medicine [First listed in ENZCAM Newsletter May 2011] Volume 5, Number 3: June 2013 http://www.europeanintegrativemedicinejrnl.com/current

Selected articles:  Personal budgets for patient centred care  Patient questionnaires for use in the integrative medicine primary care setting—A systematic

ENZCAM Integrative Medicine Newsletter May June 2013 Page 10

 The effectiveness of honey for the management of radiotherapy‐induced oral mucositis in head and neck cancer patients: A systematic review of clinical trials  Phytothermotherapy in fibromyalgia and osteoarthritis: Between tradition and modern medicine  Comparative clinical evaluation of leech therapy in the treatment of knee osteoarthritis  ‘New Homeopathic Medicines’ database: A project to employ conventional drugs according to  Influence of general self‐efficacy as a mediator in Taiji‐induced stress reduction – Results from a randomized controlled trial

Evidence‐Based Complementary and Alternative Medicine (eCAM) [First listed in ENZCAM Newsletter July 2011] Published May and June 2013 http://www.hindawi.com/journals/ecam/2013/

Selected articles:  Stan Scheller: The Forerunner of Clinical Studies on Using Propolis for Poor and Chronic Nonhealing Wounds  Historical Aspects of Propolis Research in Modern Times  Recent Progress of Propolis for Its Biological and Chemical Compositions and Its Botanical Origin  Predicting the Drug Safety for Traditional Chinese Medicine through a Comparative Analysis of Withdrawn Drugs Using Pharmacological Network  A Meta‐Analysis of Randomized Controlled Trials on Acupuncture for Amblyopia  A Promise in the Treatment of Endometriosis: An Observational Cohort Study on Ovarian Endometrioma Reduction by N‐Acetylcysteine  Treating Type 2 Diabetes Mellitus with Traditional Chinese and Indian Medicinal Herbs  The History of Inpatient Care in German Departments Focussing on Natural Healing  The Effects of Xuefu Zhuyu and Shengmai on the Evolution of Syndromes and Inflammatory Markers in Patients with Unstable Angina Pectoris after Percutaneous Coronary Intervention: A Randomised Controlled Clinical Trial  Chinese Herbal Medicine (Zi Shen Qing) for Mild‐to‐Moderate Systematic Lupus Erythematosus: A Pilot Prospective, Single‐Blinded, Randomized Controlled Study  A Network Pharmacology Approach to Evaluating the Efficacy of Chinese Medicine Using Genome‐Wide Transcriptional Expression Data  Understanding Central Mechanisms of Acupuncture Analgesia Using Dynamic Quantitative Sensory Testing: A Review  Psychoneuroimmunology‐Based Stress Management during Adjuvant Chemotherapy for Early Breast Cancer  Neurobiological Foundations of Acupuncture: The Relevance and Future Prospect Based on Neuroimaging Evidence  Amyloidosis in Alzheimer’s Disease: The Toxicity of Amyloid Beta (Aβ), Mechanisms of Its Accumulation and Implications of Medicinal Plants for Therapy  Effect of Siguan Acupuncture on Gastrointestinal Motility: A Randomized, Sham‐Controlled, Crossover Trial  Overview of Systematic Reviews: Yoga as a Therapeutic Intervention for Adults with Acute and Chronic Health Conditions  The Effect of Qigong on Depressive and Anxiety Symptoms: A Systematic Review and Meta‐ Analysis of Randomized Controlled Trials  Inpatient Treatment of Community‐Acquired Pneumonias with Integrative Medicine  Positive Effect of Propolis on Free Radicals in Burn Wounds

ENZCAM Integrative Medicine Newsletter May June 2013 Page 11

 Affect and Mindfulness as Predictors of Change in Mood Disturbance, Stress Symptoms, and Quality of Life in a Community‐Based Yoga Program for Cancer Survivors  Yoga and Mindfulness as Therapeutic Interventions for Stroke Rehabilitation: A Systematic Review  Sleep Ameliorating Effects of Acupuncture in a Psychiatric Population  Lessons Learnt from Evidence‐Based Approach of Using Chinese Herbal Medicines in Liver Cancer  Historical Review about Research on “Bonghan System” in China  Quality of Life and Mental Health in Patients with Chronic Diseases Who Regularly Practice Yoga and Those Who Do Not: A Case‐Control Study  Placebo Acupuncture Devices: Considerations for Acupuncture Research  A Randomized Controlled Pilot Study of the Triple Stimulation Technique in the Assessment of Electroacupuncture for Motor Function Recovery in Patients with Acute Ischemic Stroke  Herbal Medicine and Acupuncture for Breast Cancer Palliative Care and Adjuvant Therapy  Efficacy and Safety of Acupuncture in Preterm and Term Infants  Adjunct Methods of the Standard Diabetic Foot Ulceration Therapy  Role of Complementary and Alternative Medicine in Cardiovascular Diseases  Botanical Compounds: Effects on Major Eye Diseases  Spiritual Dryness as a Measure of a Specific Spiritual Crisis in Catholic Priests: Associations with Symptoms of Burnout and Distress  Effect of Eucalyptus Oil Inhalation on Pain and Inflammatory Responses after Total Knee Replacement: A Randomized Clinical Trial  Chinese Herbal Medicine for the Treatment of Obesity‐Related Hypertension  Significance of Kampo, Traditional Japanese Medicine, in Supportive Care of Cancer Patients  Indian Traditional Ayurvedic System of Medicine and Nutritional Supplementation  Whole‐Systems Research in Integrative Inpatient Treatment  Prevalence and Correlates of Discomfort and Acceptability of Acupuncture among Outpatients in Chinese Acupuncture and Moxibustion Departments: A Cross‐Sectional Study  Chinese Herbal Medicine Qi Ju Di Huang Wan for the Treatment of Essential Hypertension: A Systematic Review of Randomized Controlled Trials  Trends in the Treatment of Hypertension from the Perspective of Traditional Chinese Medicine

Explore: The Journal of Science and Healing [First listed in ENZCAM Newsletter May 2011] Volume 9, Number 3: May 2013 http://www.explorejournal.com/issues

Selected articles:  Bravenet Launches Patient‐Reported Outcomes Registry  False Equivalencies and the Mediocrity of Nonlocal Consciousness Research Criticism  On Mind Wandering, Attention, Brain Networks, and Meditation  Qigong as a Novel Intervention for Service Members With Mild Traumatic Brain Injury  Taking Spiritual History in Clinical Practice: A Systematic Review of Instruments  Nutritional Deficiency in Healthcare Education

ENZCAM Integrative Medicine Newsletter May June 2013 Page 12 Integrative Cancer Therapies [First listed in ENZCAM Newsletter April 2011] Volume 12, Number 3: May 2013 http://ict.sagepub.com/content/12/3?etoc

Selected articles:  The Preventive and Therapeutic Effect of Acupuncture for Radiation‐Induced Xerostomia in Patients With Head and Neck Cancer: A Systematic Review  Cancer‐Specific Concerns and Physical Activity Among Recently Diagnosed Breast and Prostate  Safety and Feasibility of an Exercise Intervention for Patients Following Lung Resection: A Pilot Randomized Controlled Trial  Predictors of Use of Complementary and Alternative Medicine by Non‐Hodgkin Lymphoma Survivors and Relationship to Quality of Life

Journal of Holistic Nursing [First listed in ENZCAM Newsletter April 2011] Volume 31, Number 2: June 2013 http://jhn.sagepub.com/content/31/2.toc?etoc

Selected articles:  An Early Introduction to Holistic Nursing  The Role of Transcendence in a Holistic View of Successful Aging: A Concept Analysis and Model of Transcendence in Maturation and Aging  Acute Care Nurses’ Spiritual Care Practices  Mastery: A Comparison of Wife and Daughter Caregivers of a Person With Dementia  Postpartum Weight Loss: Weight Struggles, Eating, Exercise, and Breast‐Feeding  Relaxation Practice for Health in the United States: Findings From the National Health Interview Survey

The Journal of Alternative and Complementary Medicine [First listed in ENZCAM Newsletter Q1 2011] Volume 19, Number 5: May 2013 http://online.liebertpub.com/toc/acm/19/5

Selected articles:  The Effect of T'ai Chi Exercise on Immunity and Infections: A Systematic Review of Controlled Trials  Systematic Assessment of the Representativeness of Published Collections of the Traditional Literature on Chinese Medicine  A Prospective Patient‐Centered Data Collection Program at an Acupuncture and Oriental Medicine Teaching Clinic  A Comparative Study of Three Aloe Species Used to Treat Skin Diseases in South African Rural Communities  Do Outcomes of Acupuncture for Back Pain Differ According to Varying Sociocultural Contexts? The View from China  Acupuncture for Cerebral Vasospasm After Subarachnoid Hemorrhage: A Retrospective Case– Control Study  Acupuncture Helps Regain Postoperative Consciousness in Patients with Traumatic Brain Injury: A Case Study

ENZCAM Integrative Medicine Newsletter May June 2013 Page 13

Volume 19, Number 6: June 2013 http://online.liebertpub.com/toc/acm/19/6

Selected articles:  Medicinal Plants Used by Traditional Practitioners of the Kole and Rai Tribes of Bangladesh  Integration of Traditional Chinese Medicines and Western Medicines for Treating Diabetes Mellitus with Coronary Heart Disease: A Systematic Review  Military Report More Complementary and Alternative Medicine Use than Civilians  Efficacy of an Eight‐Week Yoga Intervention on Symptoms of Restless Legs Syndrome (RLS): A Pilot Study  Osteopathic Treatment of Patients with Long‐Term Sequelae of Whiplash Injury: Effect on Neck Pain Disability and Quality of Life  Acupuncture‐Associated Pneumothorax  Discrimination in Health Care and CAM Use in a Representative Sample of U.S. Adults  Combined Nutraceutical Approach to Postmenopausal Syndrome and Vascular Remodeling Biomarkers

7. Clinical Integration of TM/CAM

NCCAM Clinical Digest Produced by the National Center for Complementary and Alternative Medicine (NCCAM) in the USA.

May 2013: Hepatitis C and Dietary Supplements http://nccam.nih.gov/health/providers/digest/hepatitisC

“Hepatitis C, a contagious liver disease, is caused by the hepatitis C virus. People can get hepatitis C through contact with blood from a person who is already infected or, less commonly, through having sex with an infected person. The infection usually becomes chronic. Chronic hepatitis C often is treated with drugs that can eliminate the virus. This may slow or stop liver damage, but the drugs may cause side effects, and for some people, treatment is ineffective.

Some people with hepatitis C also try complementary health approaches, especially dietary supplements. Several herbal supplements have been studied for hepatitis C, and substantial numbers of people with hepatitis C have tried herbal supplements. For example, a survey of 1,145 participants in the HALT‐C (Hepatitis C Antiviral Long‐Term Treatment against Cirrhosis) trial, a study supported by NIH, found that 23 percent of the participants were using herbal products. Although participants reported using many different herbal products, silymarin (milk thistle) was by far the most common. However, no dietary supplement has been shown to be effective for hepatitis C.

This issue provides information on what the science says about the safety and effectiveness of milk thistle and some of the other dietary supplements studied for hepatitis C.”

ENZCAM Integrative Medicine Newsletter May June 2013 Page 14

June 2013: Weight Loss and Complementary Health Practices http://nccam.nih.gov/health/providers/digest/weightloss

“More than two‐thirds of adults and one‐third of children in the United States are overweight or obese. Achieving a healthy weight, eating a healthy diet, and being physically active can help lower cholesterol, blood pressure, and blood sugar—and may also help prevent weight‐related diseases, such as heart disease and type 2 diabetes, as you know.

Your patients may ask you about complementary health approaches for losing weight, such as dietary supplements marketed for weight loss, which are available in supermarkets, pharmacies, health food stores, and the Internet. Although patients may be tempted by the “quick fix” claims of these products, most of these products haven’t been proven safe or effective. Two important safety concerns about dietary supplements for weight loss are the possibilities of drug interactions and product contamination. This issue provides information on “what the science says” about a few popular dietary supplements marketed for weight loss, including acai, bitter orange, ephedra, and green tea, as well as several mind and body practices that are being studied for weight loss.”

Produced for ENZCAM by Heather McLeod and Ray Kirk

28 July 2013

New Zealand Centre for Evidence‐based Research into Complementary and Alternative Medicine (ENZCAM)

http://www.hsci.canterbury.ac.nz/enzcam/

http://creativecommons.org/licenses/by‐nc‐sa/3.0/nz/deed.en