Characteristics of global naturopathic education, regulation, and practice frameworks: results from an international survey.

BACKGROUND: This descriptive study provides the first examination of global naturopathic education, regulation and practice frameworks that have potential to constrain or assist professional formation and integration in global health systems. Despite increasing public use, a significant workforce, and World Health Organization calls for national policy development to support integration of services, existent frameworks as potential barriers to integration have not been examined. METHODS: This cross-sectional survey utilized purposive sampling of 65 naturopathic organisations (educational institutions, professional associations, and regulatory bodies) from 29 countries. Organizational representatives completed an on-line survey, conducted between Nov 2016 - Aug 2019. Frequencies and cross-tabulation statistics were analyzed using SPSSv.25. Qualitative responses were hand-coded and thematically analysed where appropriate. RESULTS: Sixty-five of 228 naturopathic organizations completed the survey (29% response rate) from 29 of 46 countries (63% country response rate). Most education programs (68%) were delivered via a national framework. Higher education qualifications (60%) predominated. Organizations influential in education were professional associations (75.4%), particularly where naturopathy was unregulated, and accreditation bodies (41.5%) and regulatory boards (33.8%) where regulated. Full access to controlled acts, and to health insurance rebates were more commonly reported where regulated. Attitude of decision-makers, opinions of other health professions and existing legislation were perceived to most impact regulation, which was globally heterogeneous. CONCLUSION: Education and regulation of the naturopathic profession has significant heterogeneity, even in the face of global calls for consistent regulation that recognizes naturopathy as a medical system. Standards are highest and consistency more apparent in countries with regulatory frameworks.

S-carboxymethylcysteine in the fluidification of sputum and treatment of chronic airway obstruction.

The clinical results and changes in sputum found in both a short-term inpatient trial and a subsequent long-term outpatient investigation (three-month double-blind controlled study) of 82 patients with chronic bronchitis treated with a new mucolytic agent, S-carboxymethylcysteine (Mucodyne), are reported. Fluidification of sputum with reduction in certain measurements of the viscosity of morning sputum aliquots, associated with improvement in the ability to cough up bronchial secretions, significant increase in sputum volume output, and improvement in ventilation (as estimated by the forced expiratory volume in one second), were observed in both trials as dose-related responses, with an increase in the ease of expectoration and a reduction in cough frequency and dyspnea. Therapy with S-carboxymethylcysteine was well tolerated, and there were no serious adverse effects, either immediate or delayed. We suggest that the effect of the drug in fluidifying sputum may be due to a mucoregulatory mechanism which reverses the sputum macromolecular disturbances seen in chronic bronchitis.

Stool microscopy in screening for steatorrhoea.

A prospective study is described comparing microscopy of random faecal specimens for the presence of neutral and split fat by a relatively simple, cheap, and rapid methods with standard chemical estimation of faecal fat. The method of microscopy was found to be reliable in excluding steatorrhoea in children over the age of 3 months.

The Leeds regional quality control scheme for clinical biochemistry: a progress report.

The results from a regional quality control scheme for clinical biochemistry are analysed. Comparison with results from an earlier period shows that the quality of several of the 15 routine analyses has improved. The methods by which the sera are produced and distributed, and the weekly results are analysed, are described. Each of the 25 laboratories receives an individual weekly computer printout within 24 hours of the deadline for the receipt of results. At the end of each six-month period a printout is produced ranking each laboratory for ;accuracy' and ;precision' for each test.

Mucopolysaccharide in the blood of a patient with neuroblastoma.

In a case of neuroblastoma the presence of an abnormal blood constituent was suspected from the raised erythrocyte sedimentation rate, sludging of the red cells, marked rouleaux formation, an atypical Leishman stain, increased plasma viscosity, and a distorted protein electrophoresis pattern. The abnormal constituent was shown to be a mucopolysaccharide which was either hyaluronic acid or chondroitin sulphate.

Satisfactory screening for cystic fibrosis with the BM meconium procedure.

The Boehringer Mannheim test (BM test) for cystic fibrosis has been applied to 15 734 neonates. A positive result occurred in 130, seven of whom were subsequently shown to have the disease. To our knowledge no cases have been missed. Tests have been performed centrally by experienced laboratory staff and the false-positive rate of 0.83% is considered acceptable. It is important to follow up weak as well as strongly positive reactions to the BM test strip.

Transient hyperphosphatasaemia of infancy following rotavirus infection.

A child with transient hyperphosphatasaemia of infancy is reported. The syndrome followed rotavirus infection. Reports of transient hyperphosphatasaemia of infancy are reviewed.

Concentrated milk feeds and their relation to hypernatraemic dehydration in infants.

The composition of milks usually fed to 25 infants admitted to hospital with a dehydrating illness was studied. 15 hypernatraemic babies had been given feeds of greater sodium concentration and osmolality than those fed to the 10 infants whose plasma sodium was below 150 mEq/l. Hypernatraemic dehydration may be followed by death or permanent brain damage. Most infants in the survey were receiving milk with a sodium content greater than that advised by the manufacturers. Suggestions are made for reducing the sources of error commonly made in the reconstitution of dried milk formulae.