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Integrative medicine is a comprehensive and holistic approach to health care in which all health care professionals work collaboratively, in an equal and respectful manner, to better meet the needs of the patient and community. Despite concerns about clinical evidence, practitioner competence and health care philosophy, such an approach is likely to increase health care choice, improve treatment outcomes, and allow patients to more effectively navigate through the range of available treatment options. An integrative health care model may also be of benefit in addressing the many limitations of the current health care system.

Complementary and alternative medicine (CAM) is widely used around the world for cancer. Preliminary research indicates that cultural factors influence cancer patients’ decisions to use, with significant associations seen between ethnicity and prevalence and type of CAM use. To enhance a culturally-appropriate understanding of CAM use in Chinese cancer patients in BC, this study explored a sample of Chinese cancer patients to gain: (1) the general conceptualization of CAM use; (2) the meaning of CAM use in relation to cancer; (3) the patterns of CAM use prior to and after cancer diagnosis; (4) the reasons for CAM use; and (5) the socio-cultural process in making decision about CAM use. A naturalistic, descriptive study design was used that incorporated semi-structural ethnographic interviewing and qualitative data analysis. The results of this study provide insights about the pattern, reasons, meaning, as well as cultural and socioeconomic factors underpinning the use of CAM. The CAM decision-making (DM) process was found to be nonlinear and comprised of four distinct phases: fitting with the cultural belief framework/lifestyle, seeking information and clarification, evaluating the effectiveness of CAM use, and balancing the cost and benefits of CAM use.

The use of herbal medicines or natural health products as alternative medicines for public health use continues to expand rapidly around the world. Pre-clinical assays are essential to guarantee the efficacy and safety of natural products and are commonly requested by regulatory agencies to approve marketing of these products. Different animal models are used to evaluate the pharmacological effects of natural health products and herbal medicines in particular. The main toxicological assays and pharmacological activities to be tested in the evaluation of natural products will be discussed in this presentation. Common pharmacological effects of herbal medicines are: anti inflammatory, antioxidative, hepatoprotective, laxative and analgesic. The importance of using positive and negative controls will be explained and examples will be provided. Animal models currently used in the evaluation of herbal medicines will be presented and the importance of selecting the right model to reproduce human disorders will be highlighted.

For several reasons one may suggest a connection between spirituality and religiosity (SpR) and the usage of CAM. It is suggested that patients with severe diseases which use CAM have more active coping strategies and a higher religious involvement than patients which do not use these treatments. We thus investigated basic attitudes of 313 patients with chronic diseases attending a CAM outpatient clinic towards SpR and their adjustment to their illness, and relevant adaptive coping strategies. All test instruments were extensively (re)validated before usage, particularly the AKU questionnaire which measures adaptive coping styles. The main important strategies were “Search for information and medical help” and “Positive arrangement of life,” while “Religious support” and “Positive interpretation of illness” were less important. Among those with an interest in SpR, "Support of life through SpR" was highly relevant. "Search for alternative ways of healing" did not correlate with any of the SpR scales, but strongly with "Search for information and medical help" and "Positive arrangement of life." We conclude that interest in CAM is not a unique pattern of SpR, but of an adaptive and active coping. Nevertheless, we confirm SpR is of high importance in patients with life-threatening diseases such as cancer.

We interviewed 1072 people interested in medicinal plants and phytotherapy living in Belo Horizonte and its immediate surrounding areas, in Minas Gerais, Brazil. The questionnaire was designed to document patterns of use of herbal remedies in a metropolitan area and to identify the plants most commonly used by this population. The interest in this theme is higher among women, particularly among housewives. People aged 41 to 50 years old also reported higher rates of use. One of the main reasons for the interest in herbal remedies was the belief that plants are more effective than conventional therapies and are associated with lower incidence of side effects. This population uses a total of 316 different plants and one third of them are indigenous to Brazil. The results suggest that there is a strong interest in using herbal remedies by this population and special efforts are thus required to improve the access and quality of such products in Brazil and other larger cities in Latin America.

A decoction of leaves and unripe fruits prepared from C. aronia syn. azarolus (L) (Rosaceae), the indigenous Israeli hawthorn, is used to treat diabetes in Arab traditional medicine. There is a growing body of evidence reporting the presence of systemic oxidative stress in insulin-dependent and non-insulin dependent diabetes. We have already reported that this decoction has antioxidant properties in vitro. In this report, we extended these in vitro observations to study its antioxidant action in the streptozotocin (STZ)-induced diabetic rat in which we measured its effect on plasma and tissue indices of oxidative stress, as well as blood glucose levels. In an experiment lasting 24 days, 30 diabetic and 30 control rats were each subdivided into three separate groups. Group 1 rats drank tap water, group 2 rats drank the decoction containing 50 mg grounded dried plant/mL and group 3 rats drank the decoction containing 350 mg grounded dried plant/mL. Upon completion of the treatment period, the rats were anesthetized and blood glucose was measured using a drop of blood obtained by tail vein puncture. The abdomen was opened and aortic blood was withdrawn for measurement of the plasma levels of lipid peroxides, glutathione, cholesterol and triglycerides and the livers were harvested for determination of the extent of lipid peroxidation. The results of these experiments show that a decoction prepared from the leaves and unripe fruits of C. aronia normalizes plasma lipid peroxide levels and lowers blood glucose levels in diabetic rats. These findings indicate that the therapeutic benefit of the decoction could be due to these two actions, thereby providing a basis for its use in treating diabetes in traditional Arab medicine.

The oxidative hemolysis of rat erythrocytes induced by 2,2’-azobis–(2-amidinopropane) (AAPH) and its inhibition by silymarin studied. Different concentrations of silymarin showed no significant hemolysis compared with phosphate buffer solution. AAPH (25 mM and 50 mM) induced hemolysis in a time-dependent manner. Silymarin inhibited AAPH (25 mM)-induced hemolysis concentration-dependently. However, in the presence of 50 mM of AAPH, only the two higher concentrations of silymarin inhibited hemolysis. Addition of silymarin 3h after incubation with AAPH (25 mM), had no significant effects on the time course of cell lysis. It is concluded that, in addition to its well-established antioxidant effects, silymarin displays cytoprotective properties.

The following are abstracts of oral and poster presentations given at the third annual IN-CAM Research Symposium: "Integrating CAM Research and Practice: A Focus on Outcome Measures" that was held on November 4th & 5th, 2005 at the University of Calgary, Calgary, Canada. For more information on the symposium, please visit: www.incamresearch.ca.