From the conventional to the alternative: exploring patients' pathways of cancer treatment and care.

Background: Complementary and alternative medicine (CAM) use is widespread and on the increase among cancer patients. Most research to date has involved a cross-sectional snapshot of CAM use rather than an exploration into the longitudinal, nonlinear treatment trajectories that cancer patients develop. Our aim is to explore and describe different treatment and decision-making pathways that individuals develop after receipt of a diagnosis of either breast, colorectal, or prostate cancer.

The professional role of massage therapists in patient care in Canadian urban hospitals--a mixed methods study.

Background: Massage therapy (MT) is becoming established as a recognized health care profession in Canada. It has been integrated as a core service in settings such as health spas, private integrative health centers, and there is indication that MT is starting to be integrated into hospitals. Research in the area of hospital-based MT has primarily focused on the efficacy, effectiveness, and increasingly, the safety of MT.

Negotiating consent: exploring ethical issues when therapeutic massage bodywork practitioners are trained in multiple therapies.

Introduction: Obtaining informed consent from competent patients is essential to the ethical delivery of health care, including therapeutic massage and bodywork (TMB). The informed consent process used by TMB practitioners has not been previously studied. Little information is available about the practice of informed consent in a treatment-focused environment that may involve multiple decision points, use of multiple TMB therapies, or both.

Exclusive use of alternative medicine as a positive choice: a qualitative study of treatment assumptions among people with multiple sclerosis in denmark.

Background: A survey of members of the Danish MS Society revealed that a minority of MS patients choose to forgo all types of conventional treatment and use complementary and alternative medicine (CAM) exclusively. A qualitative follow-up study was performed to elucidate the choice of exclusive CAM use by exploring treatment assumptions among a group of exclusive CAM users.

Methods: The study was based on a phenomenological approach.

Decision-making about complementary and alternative medicine by cancer patients: integrative literature review.

Background: Patients with cancer consistently report conflict and anxiety when making decisions about complementary and alternative medicine (CAM) treatment. To design evidence-informed decision-support strategies, a better understanding is needed of how the decision-making process unfolds for these patients during their experience with cancer. We undertook this study to review the research literature regarding CAM-related decision-making by patients with cancer within the context of treatment, survivorship, and palliation.

The Living Well Lab: a community-based HIV/AIDS research initiative.

Background: Complementary and Alternative Medicine (CAM) is becoming a pillar in the rehabilitative efforts for many living with HIV/AIDS. A community-based research program called the Living Well Lab (LWL) was established in 2007, operating out of Friends For Life (FFL), a non-profit wellness center in Vancouver, Canada offering free CAM therapies to people living with HIV/AIDS. Therapies range from naturopathy to yoga.

Retrospective case analyses of two people with cancer who followed the Bill Henderson Protocol.

Objective: To provide a retrospective case analyses of Bill Henderson Protocol adherence, a dietary cancer treatment regimen.

Design: Case study analysis based on the National Cancer Institute's Best Case Series approach.

Subjects: Using Mr Henderson's listserv (N = 31,000), members meeting certain criteria were invited to submit case documentation (diagnostic, treatment, outcome information).

Use of bodily sensations as a risk assessment tool: exploring people with Multiple Sclerosis' views on risks of negative interactions between herbal medicine and conventional drug therapies.

Background: Most users of complementary and alternative medicine (CAM) combine it with conventional medicine. Recent risk assessment studies have shown risks of negative interactions between CAM and conventional medicine, particularly when combining herbal medicine and conventional drug therapies (CDT). Little is known about the way users consider such risks.

Developing an operational model for an integrative oncology program: a qualitative descriptive feasibility study.

Purpose: We describe a descriptive qualitative study with the purpose of assessing the feasibility of developing an integrative oncology program in our region.

Methods: We conducted 39 interviews and two focus groups (n = 20) with cancer patients, their caregivers and complementary and conventional (n = 15) healthcare professionals.

Results: One primary theme emerged, acceptance or tolerance of an integrative oncology program, which represents concepts within four emergent categories: (1) operational model; (2) values to guide an integrative oncology program; (3) physical location and design; and (4) facilitators and barriers to establishing an integrative oncology program.

Dragon boat racing and health-related quality of life of breast cancer survivors: a mixed methods evaluation.

Background: Breast cancer survivors who participate in physical activity (PA) are reported to experience improved health-related quality of life (HRQOL). However, the quantitative research exploring the relationship between the team-based activity of dragon boat racing and the HRQOL of breast cancer survivors is limited. Given the rising number of breast cancer survivors, and their growing attraction to dragon boating, further exploration of the influence of this activity on HRQOL is warranted.

Differences between users and non-users of complementary and alternative medicine among people with multiple sclerosis in Denmark: a comparison of descriptive characteristics.

Aims: The aim of this study was to investigate differences in socio-economic characteristics between CAM users and CAM non-users among people with MS in Denmark as well as differences in characteristics related to the use of CAM among CAM users and the use of conventional treatments among CAM non-users.

Methods: An internet-based questionnaire was used to collect data from 3361 patient members of the Danish MS society. A letter with a personal code was sent to all respondents, asking them to fill out the questionnaire online.

Exploring the nature of therapeutic massage bodywork practice.

Background: Research on therapeutic massage bodywork (TMB) continues to expand, but few studies consider how research or knowledge translation may be affected by the lack of uniformly standardized competencies for most TMB therapies, by practitioner variability from training in different forms of TMB, or from the effects of experience on practice.

Purpose: This study explores and describes how TMB practitioners practice, for the purpose of improving TMB training, practice, and research. PARTICIPANTS SETTING: 19 TMB practitioners trained in multiple TMB therapies, in Alberta, Canada.

The flexner report of 1910 and its impact on complementary and alternative medicine and psychiatry in north america in the 20th century.

America experienced a genuinely vast development of biomedical science in the early decades of the twentieth century, which in turn impacted the community of academic psychiatry and changed the way in which clinical and basic research approaches in psychiatry were conceptualized. This development was largely based on the restructuring of research universities in both of the USA and Canada following the influential report of Johns Hopkins-trained science administrator and politician Abraham Flexner (1866-1959). Flexner's report written in commission for the Carnegie Foundation for the Advancement of Teaching in Washington, DC, also had a major influence on complementary and alternative medicine (CAM) in psychiatry throughout the 20th century.

*Abstracts - 7th IN-CAM Research Symposium, Evaluating CAM Practices: Effectiveness, Integration, Economics & Safety - November 2012.

Abstract The following are abstracts of oral and poster presentations given at the 7th IN-CAM Research Symposium - Evaluating CAM Practices: Effectiveness, Integration, Economics & Safety, and the 4th HomeoNet Research Forum, a pre-Symposium event. The IN-CAM Research Symposium was held November 2 to 4, 2012 at the Leslie Dan Faculty of Pharmacy, University of Toronto, in Toronto, Ontario, Canada. For more information, please visit: www.

A qualitative study on the term CAM: is there a need to reinvent the wheel?

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.

The healing experience-how can we capture it?

Background: The Integrative Medicine (I-MED) Index, designed to be a universal instrument to assess the 5 levels of healing (physical, energetic, emotional, subconscious, spiritual) among individuals who use complementary therapies, is based on the hypothesis of healing (HH), which considers healing as a dynamic process towards wholeness generally following the same steps. When we pilot-tested the instrument, it became clear that the way participants experience healing in their lives was not as the HH suggested. This led us to ask how patients experience healing and what outcomes they identify as key to their journey.

Whole complementary and alternative medical systems and complexity: creating collaborative relationships.

In recent years, investigators have discovered significant limitations in applying biomedical cause-effect assumptions and using conventional efficacy study designs to assess the clinical outcomes of whole systems of complementary and alternative medicine (WS-CAM). A group of WS-CAM researchers has been working collaboratively since 2001 to address the limitations of studies evaluating WS-CAM and discern ways to conduct research that would capture the complexity of such systems and the synergistic effects between the various elements of the system and would take into account treatment individualization and/or the patient-centered nature of treatment systems. In 2009, 14 complexity scientists from systems biology, psychology and the social sciences were invited to attend a workshop with these CAM scientists to (a) identify and discuss analytical techniques that can be used to study phenomena from a complex/nonlinear dynamical sciences perspective, (b) establish working relationships with these researchers, and (c) develop working research projects/ protocols to collaboratively study patient-centered responses to CAM treatments.

The Complementary Medicine Education and Outcomes (CAMEO) program: a foundation for patient and health professional education and decision support programs.

Objective: This paper describes the background, design and evaluation of a theory-informed education and decision support program for cancer patients considering complementary medicine (CM).

Methods: The program was informed by the Shared Decision Making theory, the Ottawa Decision Support Framework and the Supportive Care Framework. Previous empirical evidence and baseline research were used to identify patients' and health professionals' (HPs) information and decision support needs related to CM.

Components of an anticancer diet: dietary recommendations, restrictions and supplements of the Bill Henderson Protocol.

The use of complementary and alternative medicines including dietary supplements, herbals and special diets to prevent or treat disease continues to be popular. The following paper provides a description of an alternative dietary approach to the self-management and treatment of cancer, the Bill Henderson Protocol (BHP). This diet encourages daily intake of raw foods, a combination of cottage cheese and flaxseed oil and a number of supplements.

Developing a patient-centered outcome measure for complementary and alternative medicine therapies I: defining content and format.

Background: Patients receiving complementary and alternative medicine (CAM) therapies often report shifts in well-being that go beyond resolution of the original presenting symptoms. We undertook a research program to develop and evaluate a patient-centered outcome measure to assess the multidimensional impacts of CAM therapies, utilizing a novel mixed methods approach that relied upon techniques from the fields of anthropology and psychometrics. This tool would have broad applicability, both for CAM practitioners to measure shifts in patients' states following treatments, and conventional clinical trial researchers needing validated outcome measures.

Meaning and challenges in the practice of multiple therapeutic massage modalities: a combined methods study.

Background: Therapeutic massage and bodywork (TMB) practitioners are predominantly trained in programs that are not uniformly standardized, and in variable combinations of therapies. To date no studies have explored this variability in training and how this affects clinical practice.

Methods: Combined methods, consisting of a quantitative, population-based survey and qualitative interviews with practitioners trained in multiple therapies, were used to explore the training and practice of TMB practitioners in Alberta, Canada.

Practitioners' validation of framework of team-oriented practice models in integrative health care: a mixed methods study.

Background: Biomedical and Complementary and Alternative Medicine (CAM) academic and clinical communities have yet to arrive at a common understanding of what Integrative healthcare (IHC) is and how it is practiced. The Models of Team Health Care Practice (MTHP) framework is a conceptual representation of seven possible practice models of health care within which teams of practitioners could elect to practice IHC, from an organizational perspective. The models range from parallel practice at one end to integrative practice at the other end.

Use of complementary and alternative medicine by patients with inflammatory bowel disease.

In this review article we provide a broad overview of complementary and alternative medicine (CAM) use in inflammatory bowel diseases (IBDs), including prevalence of use, common therapies used, and reasons for and factors associated with CAM use. CAM is commonly used by those suffering from IBD. Multiple forms of CAM are used to treat IBD, and often patients use multiple CAM therapies and continue to use conventional medical therapies.

Identifying the barriers to conducting outcomes research in integrative health care clinic settings--a qualitative study.

Background: Integrative health care (IHC) is an interdisciplinary blending of conventional medicine and complementary and alternative medicine (CAM) with the purpose of enhancing patients' health. In 2006, we designed a study to assess outcomes that are relevant to people using such care. However, we faced major challenges in conducting this study and hypothesized that this might be due to the lack of a research climate in these clinics.

The use of mixed methods for therapeutic massage research.

Mixed methods research is the integration of quantitative and qualitative components in a research project. Whether you are reading or designing a mixed methods research project, it is important to be familiar with both qualitative and quantitative research methods and the specific purposes for which they are brought together in a study: triangulation, complementarity, expansion, initiation, or development. In addition, decisions need to be made about the sequencing and the priority or importance of each qualitative and quantitative component relative to the other components, and the point or points at which the various qualitative and quantitative components will be integrated.