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Vaccine. 2010 Feb 17;28 (7):1709-16
20045099
Cit:2
Department of Anthropology, Chester New Hall, McMaster University, 1280 Main St. W, Hamilton, Ontario L8S 4L8, Canada. aniakata@gmail.com
The Internet plays a large role in disseminating anti-vaccination information. This paper builds upon previous research by analyzing the arguments proffered on anti-vaccination websites, determining the extent of misinformation present, and examining discourses used to support vaccine objections. Arguments around the themes of safety and effectiveness, alternative medicine, civil liberties, conspiracy theories, and morality were found on the majority of websites analyzed; misinformation was also prevalent. The most commonly proposed method of combating this misinformation is through better education, although this has proven ineffective. Education does not consider the discourses supporting vaccine rejection, such as those involving alternative explanatory models of health, interpretations of parental responsibility, and distrust of expertise. Anti-vaccination protestors make postmodern arguments that reject biomedical and scientific "facts" in favour of their own interpretations. Pro-vaccination advocates who focus on correcting misinformation reduce the controversy to merely an "educational" problem; rather, these postmodern discourses must be acknowledged in order to begin a dialogue.
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Vaccine. 2012 May 28;30 (25):3778-89
22172504
McMaster University, Psychiatry and Behavioural Neurosciences, 555 Sanatorium Road Hamilton, Ontario, Canada L9C 1C4.
Websites opposing vaccination are prevalent on the Internet. Web 2.0, defined by interaction and user-generated content, has become ubiquitous. Furthermore, a new postmodern paradigm of healthcare has emerged, where power has shifted from doctors to patients, the legitimacy of science is questioned, and expertise is redefined. Together this has created an environment where anti-vaccine activists are able to effectively spread their messages. Evidence shows that individuals turn to the Internet for vaccination advice, and suggests such sources can impact vaccination decisions - therefore it is likely that anti-vaccine websites can influence whether people vaccinate themselves or their children. This overview examines the types of rhetoric individuals may encounter online in order to better understand why the anti-vaccination movement can be convincing, despite lacking scientific support for their claims. Tactics and tropes commonly used to argue against vaccination are described. This includes actions such as skewing science, shifting hypotheses, censoring dissent, and attacking critics; also discussed are frequently made claims such as not being "anti-vaccine" but "pro-safe vaccines", that vaccines are toxic or unnatural, and more. Recognizing disingenuous claims made by the anti-vaccination movement is essential in order to critically evaluate the information and misinformation encountered online.
Healthc Q. 2009 ;12 (4):54-62
20057230
Cit:1
Hamilton Health Sciences, Hamilton, Ontario. frolic@hhsc.ca
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University of Florida, College of Veterinary Medicine, Gainesville, FL, USA.
Complementary and alternative medicine can be defined as the diagnosis, treatment, and/or prevention that complements mainstream medicine, satisfying a demand not met by orthodoxy and diversifying the conceptual framework of medicine. Acupuncture is being used much more commonly now as a sole or integrative modality in veterinary medicine and can play a large role in management of inflammation and chronic pain. Western medical etiology, pathophysiology, diagnosis, and treatment should be considered before applying acupuncture. This article describes the evolving biomedical basis of acupuncture analgesia and gives the practitioner an overview of how acupuncture can be performed in a medical setting.
School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, Hawaii, USA. kealohab@hawaii.edu
Nurses require current information about popular complementary and alternative medicine for pediatric asthma. This integrative review searched scientific literature in PubMed and WEB of Science from 2004 to 2009 via key terms: asthma complementary medicine, nursing complementary pediatric asthma, asthma herbal, and herbal pediatric asthma. Nine journal articles met the inclusion criteria of containing data collection and analysis for biologically based therapies for pediatric asthma. Evidenced-based research on this focus topic is still in its initial stages. Two themes of maximizing the diet and augmenting conventional therapy with Traditional Chinese Medicine may serve as conduits of patient education.
J Cancer Educ. 2009 ;24 (4):249-53
19838879
Cit:2
Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
BACKGROUND The use of complementary and alternative medicine (CAM) among cancer patients has increased substantially during the last decade. The purpose of this investigation is to summarize CAM content of comprehensive cancer control (CCC) plans in the United States, territories, and tribes. METHODS Sixty-six CCC plans, including all the states, most of the territories, and nearly all the Native American tribes were analyzed for content of CAM, and predominant thematic areas were summarized. RESULTS Thirty-nine plans (59.1%) included CAM content. The predominant themes identified included increased education of CAM practices (46.2%), followed by utilization of existing CAM providers (28.2%), increasing CAM research efforts (18%), encouraging patient and provider communication about CAM use (18%), establishment of CAM baseline data (10.3%), and CAM as a barrier to treatment (10.3%). CONCLUSION CAM is an emerging area in cancer care. The increasing inclusion of various themes of CAM into CCC plans indicate that many US cancer coalitions are taking steps to include the education and promotion of safe and efficacious CAM therapies for cancer patients.
University of Alberta, Edmonton, Alberta.
Complementary and alternative medicine (CAM) use, including paediatric use, is common. The Hospital for Sick Children Foundation organized a priority-setting forum regarding paediatrics and the use of CAM/natural health products in November 2001. Four priority areas were identified: the creation of a national paediatric research network and/or centre of excellence in CAM; support for experiential learning, education, and training; completion of a needs/use assessment; and facilitation of knowledge transfer. These priority areas are discussed in the context of research, education, knowledge transfer and health systems. The present article represents a call for action for Canadian funding agencies to support the development of an evidence base in paediatric CAM.
Belief in complementary and alternative medicine is related to age and paranormal beliefs in adults.
Leuven School for Mass Communication Research, Katholieke Universiteit Leuven, Parkstraat 45, Box 3603, 3000 Leuven, Belgium. jan.vandenbulck@soc.kuleuven.be
BACKGROUND The use of complementary and alternative medicine (CAM) is widespread, even among people who use conventional medicine. Positive beliefs about CAM are common among physicians and medical students. Little is known about the beliefs regarding CAM among the general public. Among science students, belief in CAM was predicted by belief in the paranormal. METHODS In a cross-sectional study, 712 randomly selected adults (>18 years old) responded to the CAM Health Belief Questionnaire (CHBQ) and a paranormal beliefs scale. RESULTS CAM beliefs were very prevalent in this sample of adult Flemish men and women. Zero-order correlations indicated that belief in CAM was associated with age (r = 0.173 P < 0.001) level of education (r =-0.079 P = 0.039) social desirability (r =-0.119 P = 0.002) and paranormal belief (r = 0.365 P < 0.001). In a multivariate model, two variables predicted CAM beliefs. Support for CAM increased with age (regression coefficient: 0.01; 95% confidence interval (CI): 0.006 to 0.014), but the strongest relationship existed between support for CAM and beliefs in the paranormal. Paranormal beliefs accounted for 14% of the variance of the CAM beliefs (regression coefficient: 0.376; 95%: CI 0.30-0.44). The level of education (regression coefficient: 0.06; 95% CI:-0.014-0.129) and social desirability (regression coefficient:-0.023; 95% CI:-0.048-0.026) did not make a significant contribution to the explained variance (<0.1%, P = 0.867). CONCLUSION Support of CAM was very prevalent in this Flemish adult population. CAM beliefs were strongly associated with paranormal beliefs.
University of Miami, Coral Gables, FL 33146, USA. ohsin@psy.miami.edu
OBJECTIVE To assess whether family involvement and acculturation were related to adherence and glycemic control among Hispanic youth with type 1 diabetes (T1D). METHODS Hispanic youth with T1D (n = 111; M age = 13.33; 53% female) and parents completed questionnaires that assessed diabetes-related family involvement (distribution of responsibility for diabetes, family support for diabetes), acculturation (linguistic acculturation, generational status), and adherence. HbA1c levels indexed glycemic control. RESULTS Better adherence was associated with less adolescent independent responsibility, more family support for diabetes, and more recent immigration (fewer generations of the family living in US). Family support mediated the relationship between responsibility and adherence. Better glycemic control was associated with higher levels of parental education and adherence. CONCLUSIONS Family support for diabetes is important for adherence among Hispanic youth with T1D. Research should examine aspects of recent immigration that contribute to better adherence and the impact of supportive interventions on diabetes care.
University of Sydney, Lidcombe NSW 2141, Australia. afbroom@gmail.com
The profile of complementary and alternative medicine (CAM) has risen dramatically over recent years, with cancer patients representing some of the highest users of any patient group. This article reports the results from a series of in-depth interviews with oncology consultants and oncology nurses in two hospitals in Australia. Analysis identifies a range of self-reported approaches with which oncology clinicians discuss CAM, highlighting the potential implications for patient care and inter-professional dynamics. The interview data suggest that, whilst there are a range of consultant approaches to CAM,;risk' is consistently deployed rhetorically as a key regulatory strategy to frame CAM issues and potentially direct patient behaviour. Moreover,;irrationality',;seeking control', and ;desperation' were viewed by consultants as the main drivers of CAM use, presenting potential difficulties for effective doctor-patient dialogue about CAM. In contrast, oncology nurses appear to perceive their role as that of CAM and patient advocate - an approach disapproved of by the consultants on their respective teams, presenting implications for oncology teamwork. CAM education emerged as a contentious and crucial issue for oncology clinicians. Yet, while viewed as a key barrier to clinician-patient communication about CAM, various forms of individual and organizational resistance to CAM education were evident. A number of core issues for clinical practice and broader work in the sociology of CAM are discussed in light of these findings.
Division of Palliative Medicine, Shizuoka Cancer Center Hospital, Shizuoka, Japan. i.osaka@scchr.jp
Complementary and alternative medicine (CAM) might enhance the quality of life of patients with cancer. The aim of this study was to investigate the current practice of CAM in Japanese palliative care units. A 17-item questionnaire was mailed to all 150 certified palliative care units in Japan, 80% of which responded. In total, 75 institutions (64%) provided at least one modality of CAM. Only 33% of the palliative care units surveyed had any regulations about patient usage of CAM, and 42% rejected some types of CAM because they caused difficulties for other patients (34%), required medical procedures (26%), used fire (5%), or required outside practitioners (4%). In total, 92% of surveyed palliative care units had no regulation and actually provided CAM. The obstacles to the use of CAM included the availability of certified practitioners, costs, added responsibilities for staff members, and insufficient evidence of efficacy. We concluded that Japanese palliative care units generally had a positive attitude toward CAM, and were willing to provide this type of therapy to patients.
Division of Adolescent Medicine, Department of Pediatrics, Children's Hospital of Michigan, Wayne State University School of Medicine, 3901 Beaubien Boulevard, Detroit, MI 48301, USA. asawni@med.wayne.edu
The use of complementary and alternative medicine (CAM) for treatment of attention-deficit/hyperactivity disorder (ADHD) has increased both by parents and health care providers. Despite scientific evidence supporting the effectiveness of stimulants in the treatment of ADHD, the use of stimulants has received negative publicity and, for many parents, is worrisome. Concerns regarding adverse effects and the prospect of long-term use of pharmacologic treatments make many parents uncomfortable thus they seek "alternative treatments." With the information explosion produced by the Internet, marketing for alternative therapies such as herbal remedies, elimination diets, and food supplements for ADHD has increased. Many people use CAM because they are attracted to the CAM philosophies and health beliefs, dissatisfied with the process or results of conventional treatments, or concerned about adverse effects of stimulants. Although some scientific evidence exists regarding some CAM therapies, for most there are key questions regarding safety and efficacy of these treatments in children. The aim of this article is to provide a general overview and focus on the evidence-based studies of CAM modalities that are commonly used for ADHD.
Department of Pediatrics, University of Pennsylvania School of Medicine, The Children's Hospital of Philadelphia, 3405 Civic Center Boulevard, Philadelphia, PA 19104, USA. levys@email.chop.edu
Complementary and alternative medical (CAM) treatments are commonly used for children with autism spectrum disorders. This review discusses the evidence supporting the most frequently used treatments, including categories of mind-body medicine, energy medicine, and biologically based, manipulative, and body-based practices, with the latter two treatments the most commonly selected by families. Clinical providers need to understand the evidence for efficacy (or lack thereof) and potential side effects. Some CAM practices have evidence to reject their use, such as secretin, whereas others have emerging evidence to support their use, such as melatonin. Most treatments have not been adequately studied and do not have evidence to support their use.
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