Questions and answers about using magnets to treat pain

The National Center for Complementary and Alternative Medicine of the National Institutes of Health has published a detailed set of questions and answers about using magnets to treat pain. This resource cites the relevant scientific literature and addresses the following questions. What are magnets? Is the use of magnets considered conventional medicine or complementary and alternative medicine? What is the history of the discovery and use of magnets to treat pain? How common is the use of magnets to treat pain? What are some examples of theories and beliefs about magnets and pain? How are static magnets used in attempts to treat pain? How are electromagnets used in attempts to treat pain? What is known from the scientific evidence about the effectiveness of magnets in treating pain? Are there scientific controversies associated with using magnets for pain? Have any side effects or complications occurred from using magnets for pain? What should consumers know if they are considering using magnets to treat pain? Is the National Center for Complementary and Alternative Medicine (NCCAM) funding research on magnets for pain and other diseases and conditions? The report also includes definitions and three appendices that address the following issues: Research on Theories and Beliefs On How Magnets Might Relieve Pain, General and Systematic Reviews on CAM Magnetic Therapy for Pain Published From August 1999 to August 2003, and Reports on Randomized Clinical Trials of Magnetic Therapy for Pain from January 1997 to March 2004.     

Financial support for research training and career development in complementary and alternative medicine from the National Institutes of Health

Research careers are a relatively new reality for complementary and alternative medicine (CAM) practitioners (eg, chiropractors, naturopaths, doctors of oriental medicine, etc). Before the establishment in 1998 of the National Center for Complementary and Alternative Medicine (NCCAM) as part of the National Institutes of Health (NIH), there were few funding resources available for those interested in a CAM research career and fewer still feasible paths. Now, however, NCCAM provides a broad array of research training and career development awards for those seeking a long-term career in CAM research. These awards include predoctoral and postdoctoral fellowships, individual career development awards, and institutional training awards. The goal of this article is to provide information about current research training funding opportunities from NCCAM and NIH as a whole that are available to CAM practitioners in the context of the historical challenges of transitioning from a clinical career in CAM practice to a CAM research career.     

Blending the boundaries: steps toward an integration of complementary and alternative medicine into mainstream practice

Complementary and alternative medicine (CAM) is growing in popularity among patients traditionally seen in an allopathic setting. A literature review and information search was conducted to determine the trend in demand for and the availability of CAM in the United States. The results of major surveys show that there is an increase in the use of CAM in the United States. The best predictor of CAM use is higher level of education. In addition, findings reveal that the field of CAM is poorly researched. Many studies in CAM therapies have flaws, such as insufficient statistical power, poor controls, inconsistent treatment, and lack of comparisons. The National Center for Complementary and Alternative Medicine of the National Institutes of Health, has declared their top strategic priority to be investing in research. Currently, more than 70 medical schools offer some type of training in alternative medicine, although there are few guidelines for curriculum and there is considerable heterogeneity in content, format, and requirements among CAM courses. As patients have greater access to information, their needs and values change. They become more involved in their overall health care and are taking a more natural and holistic approach to achieving well-being. Health care practitioners, both allopathic and alternative, must be well informed. There is an imperative to make CAM research a high priority. Valid and reliable empirical data must document the clinical efficacy and safety of CAM practices. In order to integrate CAM into the mainstream, there must be a coordinated effort among all the entities involved. Physicians need to be familiar with proven CAM therapies in order to advise patients about these modalities and the potential benefits and limitations. CAM practitioners should be licensed and regulated in scope of practice to provide a high standard of care, and be sufficiently educated in conventional medical science(s) in order to recognize how, where, and why their respective complementary practice is most effective for integration.     

Research methodology: implications for CAM pain research

The National Cancer Institute's Office of Cancer Complementary and Alternative Medicine established a series of expert panels to develop the state of the science in research methodologies in CAM cancer research. Panelists from both conventional and CAM research draw on their expertise in their relative fields to apply their knowledge and expertise to specific topic areas within cancer CAM. The first panel is focused on cancer symptom research. The discussion and conclusions raised by this panel primarily address pain research but are applicable to other symptoms as well. This article will focus on the panel presentations that are most applicable to CAM pain research in both cancer and noncareer pain populations, identifying the major challenges and conclusions offered by the panelists.     

American Adult Use of Complementary and Alternative Medicine

Editor's Note: In 2004, a study of usage of complementary and alternative medicine among 31,000 American adults revealed that 36% of the population now uses CAM. CAM is defined and usage patterns are described. The survey instrument was developed by the National Center for Complementary and Alternative Medicine and the Center for Disease Control and Prevention National Center for Health Statistics.     

Conceptualization and analysis of mechanistic studies

Much recent attention has been given to the priority for doing "mechanistic studies" of complementary and alternative medicine (CAM) modalities. A preference for such studes has been clearly indicated by the National Center for Complementary and Alternative Medicine program of funding for CAM research. It is, however, difficult to find canons by which "mechanistic" studies should be analyzed, and even harder to find a good definition of "mechanism." Social scientists have well-developed ways of approaching these issues, but their methods suffer from a fatal flaw, the ecologic mechanistic fallacy. Basic scientists fare even worse, often conducting mechanistic studies that may have no plausible mechanistic content, and that also commit the ecologic mechanistic fallacy. More methodological work on the concept of mechanism is needed at a fundamental level.     

Nurse Practitioners’ Role in Complementary and Alternative Medicine: Active or Passive?

Complementary and alternative medical (CAM) therapies are emerging as a significant force that is shaping the delivery of health care in the United States. The physician-scientists of conventional medicine are slowly easing into the process of evaluating and integrating CAM therapies. After all factors are considered, should the role of NPs in this process be active or passive? This article explores reasons why NPs should or should not take an active role in evaluating and integrating CAM therapies. It proposes a role that NPs could have in determining the influence of complementary and alternative medicine on their clinical practice. Key words: Alternative medicine, complementary medicine, nurse practitioners     

The spectrum of therapeutic influences and integrative health care: classifying health care practices by mode of therapeutic action

The growing popularity of complementary and alternative medicine (CAM) and integrative medicine (IM) highlight the need for a clinically relevant system for classifying health care practices. All systems, modalities, and techniques of health care (conventional, complementary, alternative, and traditional) can be organized in categories of "primary mode of therapeutic action." This results in six categories: biochemical; biomechanical; mind-body; energy; psychological (symbolic); and nonlocal. In each category, there are subdivisions. Organizing health care by primary mode of therapeutic action has numerous benefits: (1) conventional and CAM practitioners, and the public, can readily see some of the general similarities and differences among practices; (2) health care educators gain a common foundation and shared language for explaining CAM and IM; (3) professionals and the public, wishing to combine dissimilar practices, gain a common framework for evaluating the meaning of integration; and (4) the crossover problem can be understood as a natural occurrence in health care, not a confusing intellectual dilemma. The National Center for Complementary and Alternative Medicine (NCCAM) system of categories for CAM is briefly critiqued.     

Complementary and alternative medicine research initiatives in the Children's Oncology Group and the role of the pediatric oncology nurse.

Complementary and alternative medicine (CAM) has emerged as a new area of investigation in cancer research and treatment. CAM modalities are widely used, but little is known about their efficacy. The Children's Oncology Group has made a major commitment to CAM research in childhood and adolescent cancer, beginning with studies of CAM in the area of supportive care. Pediatric oncology nurses, as implementing clinicians and collaborating researchers, are critical to the success of these studies.     

The polarized debate over complementary and alternative medicine

Debate about the place and scientific of complementary and alternative medicine (CAM) has increased markedly in 2002 following the release of the report of the White House Commission on Alternative and Complementary Medicine Policy. Arguments for and against the integration of CAM into mainstream medicine that have been made are discussed. Positions taken by organizations opposed to CAM are described as are arguments to study the place of CAM further.     

FRIEND OF THE FAMILY: A HOSPICE VOLUNTEER’S EXPERIENCE/SALLY E. LEBOWITZ. By Mary-Alice Herbert

Debate about the place and scientific of complementary and alternative medicine (CAM) has increased markedly in 2002 following the release of the report of the White House Commission on Alternative and Complementary Medicine Policy. Arguments for and against the integration of CAM into mainstream medicine that have been made are discussed. Positions taken by organizations opposed to CAM are described as are arguments to study the place of CAM further.     

Complementary and Alternative Treatments for Chronic Pelvic Pain

Chronic pelvic pain (CPP) is a significant clinical entity that affects both men and women alike. The etiologies of CPP are multifactorial, and treatments are myriad. Complementary and Alternative Medicine (CAM) refers to non-allopathic health systems, and its use is popular in the United States. In particular, several recent studies have investigated the efficacy of various CAM practices in the treatment of CPP. The authors systematically evaluated recent literature in this area by searching the PubMed database for English-language studies published between January 2007 and August 2012.     

Integrative Medicine in Family Medicine Residency

Background

As specialists who care for families and communities, family physicians have a responsibility to respond to evolving views of healthcare among their patients. Americans are using complementary and alternative medicine (CAM) with increasing frequency and family physicians are well suited to becoming the guides for ensuring the safe and effective integration of conventional and complementary approaches to healthcare.

Methods

US National Institutes of Health National Centers for Complementary and Alternative Medicine funding was used to design, implement and evaluate an educational intervention for residents and faculty members in our family medicine residency programme at the Maine Medical Center (Portland, ME, USA). Key components of the project were a series of half-day workshops, faculty development and a resident curriculum. The resident curriculum includes experiences designed to address physician Wellness, communication with patients and coordination of care with community CAM providers. The project engaged community CAM practitioners as teachers and in patient care.

Results

Faculty members and residents reported an increase in knowledge and confidence in discussing and utilising CAM modalities. They reported improvement in their ability to find reliable information on CAM and a dramatic increase in level of comfort discussing CAM with patients.

Conclusions

Our experience suggests that family physicians are well suited to becoming patient guides for the safe and effective integration of conventional and complementary approaches to healthcare.     

Response to a proposal for an integrative medicine curriculum

BACKGROUND: A paper entitled "Core Competencies in Integrative Medicine for Medical School Curricula: A proposal," published in Academic Medicine, stimulated a broad discussion among complementary and alternative medicine (CAM) educators. This discussion led to a formal process for responding to the issues raised by the paper. METHODS: Representatives from the Academic Consortium for Complementary and Alternative Health Care (ACCAHC) and the Oregon Collaborative for Complementary and Integrative Medicine (OCCIM) formed the ACCAHC/OCCIM Task Force to participate in a Delphi process of consultation and deliberation. This process led to a broad, cross-discipline agreement on important points to include in a response to the integrative medicine (IM) curriculum proposal. RESULTS: Five key areas of concern emerged: (1) the definition of IM as presented in the paper; (2) lack of clarity about the goals of the proposed IM curriculum; (3) lack of recognition of the breadth of whole systems of health care; (4) omission of competencies related to collaboration between MDs and CAM professionals in patient care; and (5) omission of potential areas of partnership in IM education. CONCLUSIONS: A major overall theme emerging from the Delphi process was a desire for closer collaboration between conventional medical schools and CAM academic institutions in developing IM curricula. Several cross-disciplinary venues for addressing the Delphi Task Force themes include the National Center for Complementary and Alternative Medicine's R-25 Initiatives, and the National Education Dialogue. OCCIM is presented as an example of a successful lateral integration approach.     

The National Cancer Institute's perspective and agenda for promoting awareness and research on alternative therapies for cancer

The widespread use of a variety of nutritional, psychologic, and natural medical approaches, collectively termed complementary and alternative medicine (CAM), has been well documented. Recent surveys demonstrate that between 9% and 91% of U.S. patients with cancer use CAM therapies at some time after their diagnosis. However, there is a paucity of data available to indicate whether these CAM practices are efficacious and safe. Despite, or possibly because of, this controversy there has been considerable growth of interest in CAM by the American public. This interest has also resulted in a growth of research resources. Concurrently there has been an expansion of interest in the conventional medical establishment manifested by the creation of Departments of CAM or Integrative Medicine in respected conventional medical institutions, privately funded research centers and the National Institutes of Health (NIH) Office of Alternative Medicine (OAM)/National Center for Complementary and Alternative Medicine (NCCAM). Communication between conventional and unconventional practitioners is beginning. These changes are leading to a conversion of the dialogue about CAM from a focus on "quackery" to an exploration of the potential for novel therapeutics and the beginnings of focused, rigorous research. The National Cancer Institute is establishing programs to increase the amount and quality of CAM cancer research, support the production of high-quality CAM cancer information, and facilitate the dialogue between CAM practitioners and cancer researchers.     

Complementary and alternative medicine (CAM) and supportive care in cancer: a synopsis of research perspectives and contributions by an interdisciplinary team

Goals of work The purpose of this short review is to provide a commonly accepted definition of complementary and alternative medicine (CAM), to illustrate the widespread use of CAM by people affected by cancer around the world, and to highlight the research contributions of the Cancer Complementary and Alternative Medicine (CCAM) research team and its colleagues. Methods Based on research conducted by CCAM and several European colleagues, a collection of articles was compiled, reviewed, and edited. Main results CAM modalities play a role in supportive care and cancer. Because of the high CAM utilization, it is critical to help cancer patients make safe, informed, evidence-based decisions for their care. In addition, advances in research methodology, outcomes, and measurement in CAM studies are suggested to better account for individual and collective experiences. Conclusion This special issue provides clinicians with a summary of information about CAM and perspectives for better responding to cancer patient’s needs.     

What's cooking with garlic: is this complementary and alternative medicine for hypertension?

PURPOSE: To define complementary and alternative medicine (CAM); describe one type of CAM, garlic (Allium sativum L); and discuss its effects on blood pressure as a treatment for hypertension. DATA SOURCES: Literature review from professional journals, abstracts, natural therapy books, and the World Wide Web (Internet). Information from the following professional organizations and agencies: The World Health Organization, Agency of Healthcare Research and Quality, National Cancer Institute, National Center for Complementary and Alternative Medicine, American Botanical Council, and Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. CONCLUSION: Garlic is widely used throughout the world as a CAM. It is one of the most popular herbal products sold in the United States. However, while some studies have shown small positive effects in reducing blood pressure, there are insufficient scientific data to draw conclusions regarding its efficacy on clinical blood pressure outcomes. Thus, healthcare providers should be cautious in recommending this herbal product as an antihypertensive CAM. IMPLICATIONS FOR PRACTICE: CAMs may be used by clients for a variety of conditions including hypertension. Healthcare providers must be cognizant of the use, efficacy, adverse affects, and scientific evidence concerning CAM in order to provide safe and effective practice as well as appropriate and accurate information to their clients.