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Special Issue "Complementary and Integrative Medicine"

A special issue of Medicina (ISSN 1010-660X).

Deadline for manuscript submissions: 1 September 2019.

Special Issue Editor

Guest Editor
Dr. Jon Wardle

University of Technology Sydney, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Sydney, Australia
Website | E-Mail
Interests: complementary medicine; integrative medicine; primary health care; public health; health policy; health law

Special Issue Information

Dear Colleagues,

Complementary medicine, which includes a range of self-directed and practitioner-directed health practices (e.g., meditation and yoga, chiropractics, naturopathy) and products (e.g., herbal medicine, homeopathy, nutritional supplements), forms an increasingly significant component of the contemporary health sector in many countries. Combining complementary and conventional medical approaches to health care (also called integrative medicine) is also increasingly common. Complementary medicine is somewhat unique among recognized health specializations in that its definition is based solely on exclusion, rather than on a set of unified professional traits. It is a field of tremendous heterogeneity, encompassing evidence-based yet hitherto non-adopted treatments performed by licensed and qualified practitioners, to fringe, unorthodox and non-scientific therapies that are performed by unqualified and sometimes unscrupulous practitioners. Complementary and integrative medicine is also unique in that it is one of the truly patient-driven phenomena of health care, with significant and growing utilization often occurring despite barriers to its incorporation in more readily accessible generic health systems. This can be the result of cultural factors (such as the high use of traditional medicines in communities where those traditions are indigenous) as well as social factors (such as the push and pull factors associated with patient desire for more holistic and patient-focused care). In addition to questions of evidence and efficacy, the high utilization and presence of traditional and complementary medicine also has direct relevance for diverse research fields such as public health (e.g., does higher complementary medicine use place the public at risk of harm), policy (e.g., can—or should—complementary medicines be incorporated into regulatory regimes), and sociology (e.g., what drives people to use complementary medicine even when conventional medicine is freely accessible). In light of the growing utilization and presence of complementary and integrative medicine globally there is a need for multi-disciplinary, critical and rigorous examination of complementary and integrative medicine. This Special Issue aims to examine complementary and integrative medicine from a variety of different disciplinary experiences. By inviting submissions from multiple research fields, this Special Issue will cast a critical eye on the field of complementary and integrative medicine.

Dr. Jon Wardle
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • complementary medicine
  • traditional medicine
  • integrative medicine
  • public health
  • patient-centered care
  • health behaviors

Published Papers (8 papers)

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Research

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Open AccessArticle
Utilisation of and Attitude towards Traditional and Complementary Medicine among Ebola Survivors in Sierra Leone
Medicina 2019, 55(7), 387; https://doi.org/10.3390/medicina55070387
Received: 5 June 2019 / Revised: 27 June 2019 / Accepted: 12 July 2019 / Published: 18 July 2019
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Abstract
Background and objectives: In addition to conventional healthcare, Ebola survivors are known to seek traditional and complementary healthcare (T&CM) options to meet their healthcare needs. However, little is known about the general beliefs of Ebola survivors regarding T&CM and the impact of these [...] Read more.
Background and objectives: In addition to conventional healthcare, Ebola survivors are known to seek traditional and complementary healthcare (T&CM) options to meet their healthcare needs. However, little is known about the general beliefs of Ebola survivors regarding T&CM and the impact of these beliefs in influencing their decisions around T&CM use. This study examines Ebola survivors’ attitudes towards T&CM use in Sierra Leone. Materials and Methods: We conducted a nationwide quantitative cross-sectional study of 358 Ebola survivors in Sierra Leone between January and August 2018. We used descriptive analysis, chi-square tests and backward stepwise binary logistic regression for data analysis. Results: Close to half of the survivors (n = 163, 45.5%) had used T&CM since their discharge from an Ebola treatment centre. Survivors who viewed T&CM as boosting their immune system/resistance were 3.89 times (95%CI: 1.57–9.63, p = 0.003) more likely to use T&CM than those who did not view T&CM as boosting their immune system/resistance. Additionally, survivors who viewed T&CM as having fewer side effects than conventional medicine were more likely to use T&CM [OR = 5.03 (95%CI: 1.92–13.19, p = 0.001)]. Ebola survivors were more influenced to use T&CM based on their personal experience of the effectiveness of T&CM than by clinical evidence [OR = 13.72 (95%CI: 6.10–30.84, P < 0.001)]. Ebola survivors who perceived T&CM as providing them with more control than conventional medicine over their health/body were more likely to use T&CM [OR = 4.15 (95%CI: 1.74–9.89, p = 0.001)] as opposed to those who did not perceive T&CM in this way. Conclusions: Considering the widespread use of T&CM, an understanding of Ebola survivors’ attitudes/beliefs towards T&CM is useful to healthcare providers and policymakers with regard to public education and practitioner–survivors communication, T&CM regulation and research in Sierra Leone. Ebola survivors appear to turn to T&CM not only for treatment, but also to fill gaps in conventional health care services. Full article
(This article belongs to the Special Issue Complementary and Integrative Medicine)
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Open AccessArticle
“I’ve Only Just Heard About It”: Complementary and Alternative Medicine Knowledge and Educational Needs of Clinical Psychologists in Indonesia
Medicina 2019, 55(7), 333; https://doi.org/10.3390/medicina55070333
Received: 18 April 2019 / Revised: 25 June 2019 / Accepted: 2 July 2019 / Published: 3 July 2019
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Abstract
Background and objectives: The inadequate knowledge of complementary and alternative medicine (CAM) among health professionals may put their clients at risk because clients would then find information about CAM from unreliable sources. Clinical psychologists (CPs), as health professionals, also have the opportunity to [...] Read more.
Background and objectives: The inadequate knowledge of complementary and alternative medicine (CAM) among health professionals may put their clients at risk because clients would then find information about CAM from unreliable sources. Clinical psychologists (CPs), as health professionals, also have the opportunity to provide psychoeducation on the latest scientific CAM research for their clients. The current study aimed to explore knowledge and educational needs regarding CAM among CPs in Indonesia because previous studies on exploring CAM knowledge and educational needs regarding CAM were primarily conducted in Western countries. Materials and Methods: Data were collected through semi-structured face-to-face interviews with 43 CPs in public health centers (PHCs) in Indonesia. Most interviews were conducted at the PHCs where the participants worked and lasted for 55 minutes on average. The interview recordings were transcribed and were analyzed using deductive thematic analysis. Results: Five main themes emerged within participants’ responses regarding CAM knowledge and educational needs. First (CAM understanding), participants’ responses ranged from those with little or no prior knowledge of CAM treatments and uses, to those with much greater familiarity. Second (source of knowledge), participants’ access ranged widely in terms of references, from popular to scientific literature. Third (why is it important?), participants identified CAM as an essential part of Indonesian culture and considered it therefore crucial to have this cultural knowledge. Fourth (the challenges and what is needed?), the challenges for improving participants’ knowledge came from personal and institutional levels. Fifth (what and how to learn?), participants advised that only CAM treatments that fit in brief psychotherapy sessions should be introduced in professional training. Conclusions: This qualitative study discovered that CAM was neither well-known nor understood widely. Participants advised that professional associations and health institutions should work together in enhancing knowledge of CAM and incorporating CAM education into psychology education. Full article
(This article belongs to the Special Issue Complementary and Integrative Medicine)
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Open AccessArticle
In Vitro Antioxidant and Bactericidal Efficacy of 15 Common Spices: Novel Therapeutics for Urinary Tract Infections?
Medicina 2019, 55(6), 289; https://doi.org/10.3390/medicina55060289
Received: 19 February 2019 / Revised: 15 May 2019 / Accepted: 15 May 2019 / Published: 19 June 2019
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Abstract
Background and Objectives: Bacterial urinary tract infection (UTI) is the most common ailment affecting all age groups in males and females. The commercial antibiotics usage augments antibiotics resistance and creates higher recurrence rates of such communal infections. Hence, this study is aimed [...] Read more.
Background and Objectives: Bacterial urinary tract infection (UTI) is the most common ailment affecting all age groups in males and females. The commercial antibiotics usage augments antibiotics resistance and creates higher recurrence rates of such communal infections. Hence, this study is aimed at investigating the antibacterial and antioxidant potentials of 15 common spices against 11 UTI-causing bacterial pathogens. Materials and Methods: The antioxidant potential of the methanolic extracts was analyzed as contents of total phenols and flavonoids; radical scavenging, total reducing power, the ferric reducing power assay. Urinary pathogens were subjected to spice extracts to investigate antibacterial assays. Results: Preliminary phytochemical study of spices was performed to find those containing alkaloids, flavonoids, phenolic compounds, and steroids that can be recognized for their noteworthy bactericidal effects. The outcome of the antioxidative potential from the four methods demonstrated the sequence of potent antioxidant activity: Acorus calamus > Alpinia galanga > Armoracia rusticana > Capparis spinosa > Aframomum melegueta. The total polyphenols and flavonoids in the studied species positively correlated with their antioxidant properties. The four most effective spices (A. calamus, A. galanga, A. rusticana, and C. spinosa) had a zone of inhibition of at least 22 mm. A. calamus, A. melegueta, and C. spinosa had the lowest minimum inhibitory concentration (MIC) value against Enterobacter aerogenes, Staphylococcus aureus and Proteus mirabilis. All 15 spices had the lowest minimum bactericidal concentration (MBC) value against most of the pathogenic bacteria. Conclusion: The four highly potent and unique spices noted for the in vitro control of UTI-causing pathogens could be pursued further in the development of complementary and alternative medicine against UTI-causing pathogens. Full article
(This article belongs to the Special Issue Complementary and Integrative Medicine)
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Open AccessArticle
GC-MS Chemical Characterization and In Vitro Evaluation of Antioxidant and Toxic Effects Using Drosophila melanogaster Model of the Essential Oil of Lantana montevidensis (Spreng) Briq.
Medicina 2019, 55(5), 194; https://doi.org/10.3390/medicina55050194
Received: 14 March 2019 / Revised: 27 March 2019 / Accepted: 15 May 2019 / Published: 23 May 2019
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Abstract
Background and objectives: Natural products such as essential oils with antioxidant potential can reduce the level of oxidative stress and prevent the oxidation of biomolecules. In the present study, we investigated the antioxidant potential of Lantana montevidensis leaf essential oil (EOLM) in chemical [...] Read more.
Background and objectives: Natural products such as essential oils with antioxidant potential can reduce the level of oxidative stress and prevent the oxidation of biomolecules. In the present study, we investigated the antioxidant potential of Lantana montevidensis leaf essential oil (EOLM) in chemical and biological models using Drosophila melanogaster. Materials and methods: in addition, the chemical components of the oil were identified and quantified by gas chromatography coupled to mass spectrometry (GC-MS), and the percentage compositions were obtained from electronic integration measurements using flame ionization detection (FID). Results: our results demonstrated that EOLM is rich in terpenes with Germacrene-D (31.27%) and β-caryophyllene (28.15%) as the major components. EOLM (0.12–0.48 g/mL) was ineffective in scavenging DPPH radical, and chelating Fe(II), but showed reducing activity at 0.24 g/mL and 0.48 g/mL. In in vivo studies, exposure of D. melanogaster to EOLM (0.12–0.48 g/mL) for 5 h resulted in 10% mortality; no change in oxidative stress parameters such as total thiol, non-protein thiol, and malondialdehyde contents, in comparison to control (p > 0.05). Conclusions: taken together, our results indicate EOLM may not be toxic at the concentrations tested, and thus may not be suitable for the development of new botanical insecticides, such as fumigants or spray-type control agents against Drosophila melanogaster. Full article
(This article belongs to the Special Issue Complementary and Integrative Medicine)
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Open AccessArticle
Use of Complementary and Alternative Medicine by Patients with Irritable Bowel Syndrome According to the Roma IV Criteria: A Single-Center Italian Survey
Received: 19 December 2018 / Revised: 25 January 2019 / Accepted: 8 February 2019 / Published: 13 February 2019
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Abstract
Aim: This study was conducted to evaluate the impact of complementary and alternative medicine (CAM) in patients with irritable bowel syndrome (IBS) as assessed by the Rome IV criteria. Methods: Consecutive patients referring for IBS were re-evaluated according to the Rome IV criteria. [...] Read more.
Aim: This study was conducted to evaluate the impact of complementary and alternative medicine (CAM) in patients with irritable bowel syndrome (IBS) as assessed by the Rome IV criteria. Methods: Consecutive patients referring for IBS were re-evaluated according to the Rome IV criteria. Demographic features and characteristics potentially associated with the use of CAM were collected. A validated, self-administered, survey questionnaire dealing with CAM and patients’ level of knowledge, motivation, perception, and information seeking-behavior toward the use of CAM was analyzed. Multivariate logistic regression analysis was performed in order to identify predictors of CAM use among participants. Results: Among 156 patients claiming IBS, 137 (88%) met the Rome IV criteria, and 62 of them (45%) were CAM users. Biologically based therapy was the most chosen CAM (78%). Significant risk factors (adjusted odds ratio, 95% confidence interval) for the use of CAM were female gender (7.22, 2.31–22.51), a higher BMI (1.16, 1.02–1.33), and a good knowledge of CAM (4.46, 1.73–11.45), while having children was a protective factor (0.25, 0.07–0.95). Only 19% of patients used CAM due to medical advice and over half (51%) thought it was a “more natural” approach. Although a minority of patients (16%) had full satisfaction from CAM, 81% of users would repeat the CAM experience for their IBS symptoms. Conclusions: The widespread use of CAM in IBS, the patients’ belief in its safety, and their willingness to re-use it suggest that knowledge of health-care providers and patient education should be improved. Full article
(This article belongs to the Special Issue Complementary and Integrative Medicine)
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Review

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Open AccessReview
Drimia indica: A Plant Used in Traditional Medicine and Its Potential for Clinical Uses
Medicina 2019, 55(6), 255; https://doi.org/10.3390/medicina55060255
Received: 22 March 2019 / Revised: 5 June 2019 / Accepted: 5 June 2019 / Published: 7 June 2019
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Abstract
Drimia indica (Roxb.) Jessop (Asparagaceae) is a reputed Ayurvedic medicine for a number of therapeutic benefits, including for cardiac diseases, indigestion, asthma, dropsy, rheumatism, leprosy, and skin ailments. The present work aimed to critically and extensively review its traditional uses, phytochemistry, pharmacology, toxicology, [...] Read more.
Drimia indica (Roxb.) Jessop (Asparagaceae) is a reputed Ayurvedic medicine for a number of therapeutic benefits, including for cardiac diseases, indigestion, asthma, dropsy, rheumatism, leprosy, and skin ailments. The present work aimed to critically and extensively review its traditional uses, phytochemistry, pharmacology, toxicology, and taxonomy together with the mechanisms of action of selected extracts of D. indica. A systematic literature survey from scientific databases such as PubMed, Scopus, and Web of Science as well as from some textbooks and classical texts was conducted. The plant, mainly its bulb, contains various bioactive constituents, such as alkylresorcinols, bufadienolides, phytosterols, and flavonoids. Various scientific studies have proven that the plant has anthelmintic, anticancer, antidiabetic, antimicrobial, antioxidant, and wound healing activities. The present work concludes that D. indica has the potential to treat various diseases, mainly microbial infections. This review also suggests that bufadienolides, flavonoids, and steroids might be responsible for its bioactive potential. Full article
(This article belongs to the Special Issue Complementary and Integrative Medicine)
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Open AccessReview
A Systematic Review of the Role of Prebiotics and Probiotics in Autism Spectrum Disorders
Medicina 2019, 55(5), 129; https://doi.org/10.3390/medicina55050129
Received: 21 February 2019 / Revised: 25 March 2019 / Accepted: 7 May 2019 / Published: 10 May 2019
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Abstract
Background: Autism spectrum disorder (ASD) is a complex developmental condition typically characterized by deficits in social and communicative behaviors as well as repetitive patterns of behaviors. Despite its prevalence (affecting 0.1% to 1.8% of the global population), the pathogenesis of ASD remains [...] Read more.
Background: Autism spectrum disorder (ASD) is a complex developmental condition typically characterized by deficits in social and communicative behaviors as well as repetitive patterns of behaviors. Despite its prevalence (affecting 0.1% to 1.8% of the global population), the pathogenesis of ASD remains incompletely understood. Patients with ASD are reported to have more frequent gastrointestinal (GI) complaints. There is some anecdotal evidence that probiotics are able to alleviate GI symptoms as well as improve behavioral issues in children with ASD. However, systematic reviews of the effect of prebiotics/probiotics on ASD and its associated symptoms are lacking. Methods: Using the keywords (prebiotics OR probiotics OR microbiota OR gut) AND (autism OR social OR ASD), a systematic literature search was conducted on PubMed, EMBASE, Medline, Clinicaltrials.gov and Google Scholar databases. The inclusion criteria were original clinical trials, published in English between the period 1st January 1988 and 1st February 2019. Results: A total of eight clinical trials were systematically reviewed. Two clinical trials examined the use of prebiotic and/or diet exclusion while six involved the use of probiotic supplementation in children with ASD. Most of these were prospective, open-label studies. Prebiotics only improved certain GI symptoms; however, when combined with an exclusion diet (gluten and casein free) showed a significant reduction in anti-sociability scores. As for probiotics, there is limited evidence to support the role of probiotics in alleviating the GI or behavioral symptoms in children with ASD. The two available double-blind, randomized, placebo-controlled trials found no significant difference in GI symptoms and behavior. Conclusion: Despite promising preclinical findings, prebiotics and probiotics have demonstrated an overall limited efficacy in the management of GI or behavioral symptoms in children with ASD. In addition, there was no standardized probiotics regimen, with multiple different strains and concentrations of probiotics, and variable duration of treatments. Full article
(This article belongs to the Special Issue Complementary and Integrative Medicine)
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Open AccessReview
The Beneficial Effects of Traditional Chinese Exercises for Adults with Low Back Pain: A Meta-Analysis of Randomized Controlled Trials
Medicina 2019, 55(5), 118; https://doi.org/10.3390/medicina55050118
Received: 12 March 2019 / Revised: 24 April 2019 / Accepted: 24 April 2019 / Published: 29 April 2019
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Abstract
Objective: The aim of this meta-analytic review was to quantitatively examine the effects of traditional Chinese exercises (TCE) on pain intensity and back disability in individuals with low back pain (LBP). Methods: Potential articles were retrieved using seven electronic databases (Medline, Embase, [...] Read more.
Objective: The aim of this meta-analytic review was to quantitatively examine the effects of traditional Chinese exercises (TCE) on pain intensity and back disability in individuals with low back pain (LBP). Methods: Potential articles were retrieved using seven electronic databases (Medline, Embase, Cinahl, Web of Science, Cochrane library, China National Knowledge Infrastructure, and Wanfang). The searched period was from inception to 1 March 2019. Randomized controlled trials (RCTs) assessing the effect of TCE on pain intensity and back disability in LBP patients were included. Pooled effect sizes were calculated using the random-effects models and 95% confidence interval (95% CI). Results: Data from eleven RCTs (886 individuals with LBP) meeting the inclusion criteria were extracted for meta-analysis. Compared with the control intervention, TCE induced significant improvements in the visual analogue scale (VAS) (Hedge’s g = −0.64, 95% CI −0.90 to −0.37, p < 0.001), Roland–Morris Disability Questionnaire (RMDQ) (Hedge’s g = −0.41, 95% CI −0.79 to −0.03, p = 0.03), Oswestry Disability Index (ODI) (Hedge’s g = −0.96, 95% CI −1.42 to −0.50, p < 0.001), and cognitive function (Hedge’s g = −0.62, 95% CI −0.85 to −0.39, p < 0.001). In a meta-regression analysis, age (β = 0.01, p = 0.02) and total exercise time (β = −0.0002, p = 0.01) were associated with changes in the VAS scores, respectively. Moderator analyses demonstrated that Tai Chi practice (Hedge’s g = −0.87, 95% CI −1.38 to −0.36, p < 0.001) and Qigong (Hedge’s g = −0.54, 95% CI −0.86 to −0.23, p < 0.001) reduced VAS scores. Interventions with a frequency of 1–2 times/week (Hedge’s g = −0.53, 95% CI −0.98 to −0.07, p = 0.02) and 3–4 times/week (Hedge’s g = −0.78, 95% CI −1.15 to −0.42, p < 0.001) were associated with reduced VAS scores, but this significant reduction on this outcome was not observed in the weekly training frequency of ≥5 times (Hedge’s g = −0.54, 95% CI −1.16 to 0.08, p = 0.09). Conclusions: TCE may have beneficial effects for reducing pain intensity for individuals with LBP, regardless of their pain status. Full article
(This article belongs to the Special Issue Complementary and Integrative Medicine)
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