Naturopaths and Western herbalists' attitudes to evidence, regulation, information sources and knowledge about popular complementary medicines.

BACKGROUND: The practice of naturopathy and Western herbal medicine (WHM) was built on traditional evidence but may be undergoing change with the advent of scientific evidence. The aims of this research were to provide a better understanding of practitioners' attitudes towards evidence, information sources, professional regulation and their knowledge about the evidence of commonly used complementary medicines (CMs). METHOD: Naturopaths and WHM practitioners were invited to participate in an anonymous, self-administered, on-line survey. Participants were recruited using the mailing lists and websites of CM manufacturers and professional associations. RESULTS: Four hundred and seventy nine practitioners participated; 95% currently in practice. The majority (99%) thought well documented traditional evidence was essential or important, 97% patient reports and feedback, 97% personal experience, 94% controlled randomised trials and 89% published case reports. Significantly more recent graduates (less than 5 years) rated randomised trials as essential compared to others. Most (82%) respondents want information sources containing both traditional and scientific evidence. They currently use several resources; 74% CM textbooks, 67% conferences/seminars, 57% CM journals, 48% databases and 40% manufacturers' information. The mean knowledge score was 61.5% with no significant differences between respondents with diploma or degree level education or by graduating year. Eighty-five percent of practitioners strongly agreed or agreed that practitioners should be formally registered to safeguard the public, 8% were unsure and 8% disagreed or strongly disagreed. CONCLUSION: Naturopaths and WHM practitioners accept the importance of scientific evidence whilst maintaining the importance and use of traditional evidence. The majority are in favour of professional registration.

The role of permanent income and family structure in the determination of child health in Canada.

We use data from the Ontario Child Health Study (OCHS) to provide the first Canadian estimates of how the empirical association between child health and both low-income and family status (lone-mother versus two-parent) changes when we re-estimate the model with pooled data. Two waves of data provide a better indication of the family's long-run level of economic resources than does one wave. Our measures of health status include categorical indicators and the health utility score derived from the Health Utilities Index Mark 2 (HUI2) system. Consistent with findings from other countries, we find that most outcomes are more strongly related to low-average income (in 1982 and 1986) than to low-current income in either year. Unlike some previous research, we find the quantitative impact of low-income on child health to be modest to large. Lone-mother status is negatively associated with most outcomes, but the lone-mother coefficients did not change significantly when we switched from low-current income to low-average income. This implies that the lone-mother coefficient in single cross-sections is not just a proxy for low-permanent income.

Neural and behavioral teratological evaluation of rats exposed to ultra-wideband electromagnetic fields.

Several investigators have reported teratologic effects of electromagnetic field exposure. The majority of these studies have been performed at levels of exposure that could produce substantial heating of the animals. New and unique sources of ultra-wideband (UWB) electromagnetic fields are currently being developed and tested that are capable of generating nonthermalizing, high-peak-power, microwave (MW) pulses with nanosecond (ns) pulse widths, picosecond (ps) rise times, and an UWB of frequencies. Our study was performed to determine if teratological changes occur in rat pups as a result of (i) daily UWB exposures during gestation days 3-18, or (ii) as a result of both prenatal and postnatal (10 days) exposures. Dams were exposed either to (i) UWB irradiation from a Kentech system that emitted a 55 kV/m-peak E field, 300 ps rise time, and a 1.8 ns pulse width, average whole-body specific absorption rate 45 mW/kg; (ii) sham irradiation; or (iii) a positive control, lead (Pb) acetate solution (2000 microg/ml) continuously available in the drinking water. Offspring were examined for ontogeny (litter size, sex-ratios, weights, coat appearance, tooth-eruption, eye-opening, air-righting, and ultrasonic stress vocalizations). Male pups were tested on various performance measures (locomotor, water-maze learning, and fertilization capabilities). The pups postnatally exposed were examined for hippocampal morphology and operant behavior. Behavioral, functional, and morphological effects of UWB exposure were unremarkable with these exceptions: (i) The UWB-exposed pups emitted significantly more stress vocalizations than the sham-exposed pups; (ii) the medial-to-lateral length of the hippocampus was significantly longer in the UWB-exposed pups than in the sham-exposed animals; (iii) male offspring exposed in utero to UWB mated significantly less frequently than sham-exposed males, but when they did mate there was no difference in fertilization and offspring numbers from the sham group. There does not appear to be a unifying physiological or behavioral relationship among the significant differences observed, and our findings could be due to the expected spurious results derived when a large number of statistical comparisons are made. Significant effects found between our positive-controls and other groups on numerous measures indicates that the techniques used were sensitive enough to detect teratological effects. Bioelectromagnetics 21:524-537, 2000. Published 2000 Wiley-Liss, Inc.

The use of role-play in teaching medical students obstetrics and gynaecology.

There is a great need to review and critically assess medical education. Role-play has seen increasing use as an educational tool. We investigated its role in a 'conventional speciality', Obstetrics and Gynaecology. This is a part of the medical curriculum where communication skills are particularly important, but difficult to learn in practice. Twenty-one medical students took part in three role-play case studies. An innovation we implemented was the use of 'time outs' which could be called at any time through a session. After the exercise students were required to complete a questionnaire designed to probe their attitudes towards the experience. The results indicate that this technique can be successfully used in teaching a conventional speciality. Unlike some previous studies we also found this to be a satisfactory tool in teaching the factual part of the course. We found the 'time out' innovation to be an important aid. We argue that there is an important niche for role-play in medical education.

Comparative clinical trial of fenticonazole ovule (600 mg) versus clotrimazole vaginal tablet (500 mg) in the treatment of symptomatic vaginal candidiasis.

A multi-centre, randomized, single-blind, parallel-group clinical trial was undertaken in 50 patients (26 fenticonazole, 24 clotrimazole) with symptomatic vaginal candidiasis to compare the antifungal efficacy and tolerability of single-dose intra-vaginal treatment with a fenticonazole ovule (600 mg) or a clotrimazole vaginal tablet (500 mg). Assessment was by laboratory mycological investigation and symptomatic assessments for a period of 3 weeks from the day of treatment. Of the 50 patients, 43 (23 fenticonazole, 20 clotrimazole) returned for assessment 1 week after drug administration and 32 (17 fenticonazole, 15 clotrimazole) were re-assessed 3 weeks after drug administration. Both treatments resulted in very similar and highly significant improvements in symptoms, associated with disappearance of detectable Candida in approximately 70% of patients. There were no significant differences between treatments and no appreciable incidence of relapse during the 3-week period of observation. At the end of this period, 10 (59%) of 17 fenticonazole patients were totally disease-free, as compared with 10 (67%) of 15 patients after clotrimazole treatment. The cure rate observed was somewhat less than that previously seen when intra-vaginal cream formulations of the same two drugs were given on a multiple-dose basis. Both drugs were very well tolerated, with no reports of appreciable local or systemic adverse reactions to either drug.