Alternative and Complementary Health Practices
Section Newsletter
Fall 2005

Salute

We salute those who are providing rescue and relief to individuals affected by Hurricane Katrina. These efforts are based on and inspire public health at its essence. To the survivors of this tragedy, we wish peace and healing.




Letter from the Co-Chairs

This has been a dramatic year for complementary and alternative medicine (CAM) and alternative health practices nationally. These concepts and therapies are becoming an increasingly significant part of consumer health behavior. Recently published results of the National Health Interview Survey, based on interviews with more than 31,000 adults, found that 36 percent of the respondents used one or more forms of CAM. Use rose to 62 percent if prayer for health purposes was included. Another report published by the Institute of Medicine on CAM similarly reported use to be widespread, and described the evidence of CAM’s role in both disease treatment and prevention as significant. At the same time new studies call into question the efficacy of some widely accepted CAM therapies, such as recent studies on echinacea and acupuncture, while other major studies provide solid evidence of clinical benefit.

Conventional medicine has initiated important changes in response to this growing consumer demand, with many medical schools now offering CAM courses, and larger managed care systems integrating CAM into their services. Public health is also joining this cultural transformation with CAM offerings in schools of public health, and CAM integration into clinical and community-based HIV treatment programs for HIV and addiction.

The Alternative and Complementary Health Practices (ACHP) SPIG is excited to be in the midst of this cultural evolution, working to contribute positively to the unfolding of a more pluralistic, ethnically and culturally representative, innovative, evidence-based, preventative lifestyle-oriented health care system and a healthier country (in every sense of the word). After all, one medicine does not cure all ills. To move forward in this arena we need the help of our members. Here is what you can do:

  • Tell other APHA members to become ACHP SPIG affiliates.
  • Tell your CAM-oriented colleagues who are not APHA members that APHA has a progressive SPIG they should join.
  • Attend our business meeting at the Philadelphia Annual Meeting: Monday, Dec. 12 at 6:30 p.m.; room TBA.
  • Visit our booth at the Annual Meeting, send your colleagues over to meet us, attend ACHP talks at the conference.
  • Send us your success stories of using ACHP’s in your work context or in your life.
  • Let us know how we can help you to integrate CAM into your curriculum, clinics and community programs.

Let us work together to create a more creative health care system and build more progressive attitudes about health and healing in our country. The time to do things differently is here right now! We invite you to be a part of this exciting journey.

References are available on request:
aburke@sfsu.edu.

2005 ACHP SPIG Program at a Glance

Due to the devastating impact of Katrina, the 133rd APHA Annual Meeting has been moved to Philadelphia (Dec. 10-14, 2005). We hope you will join us in Philadelphia this year. Our group has planned a wide range of high quality sessions and sessions around the theme, Evidence Based Policy and Practice, to meet your professional interests. As it was in the past, we received many high quality abstracts this year. Thanks to our volunteer reviewers, we were able to select the best abstracts and plan this year’s program successfully. Speakers from the United States and around the world will share their ACHP research and experience with conference participants.

To assist you in scheduling your time, following is the tentative session schedule with session overviews for the 133rd APHA Annual Meeting:

Monday, 12/12/05
8:30-10:00 a.m. Evidence Based ACHP Research (Scientific Oral)
This session presents evidence-based studies in ACHP, including issues related to ACHP research and the effectiveness of alternative and complementary health practices in dealing with various health problems.

10:30 a.m.-12:00 p.m. Evidence Based ACHP Practices and Policies (Scientific Oral)
The need to incorporate economic research, policies and procedures in patient recruitment in CAM clinical trials, and other CAM related policies and procedures will be discussed in this session.

12:30 p.m.-2:00 p.m. Body, Mind, and Spirit in Public Health: Caring for the Whole Person (Scientific Oral)
This session presents a study that examines the relationship between spiritual well-being and eating disorders; the feasibility of offering yoga classes as an adjunctive therapy in the treatment of hypertension; the possible mechanisms that may account for the relationship between spirituality and depression; and insight in the evaluation of haptonomic massage and its effects on the well-being of cancer patients treated with chemotherapy.

2:30-4:00 p.m. ACHP: Professional Education Issues (Scientific Oral)
Considering how diabetes, cancer, heart disease and other major illnesses are so strongly related to lifestyle, teaching ACHP may prove to be another invaluable resource for health promotion and disease prevention. To ensure adequate preparation in this area, public health and related healthcare preparation programs need to integrate these concepts and methods into both the undergraduate and graduate curricula. Panel participants will discuss the possibilities and challenges of building this new competency area.

4:30-6:00 p.m. ACHP among Women and Minority Populations (Scientific Oral)
This session will provide the participants with an overview of CAM use among women and various minority populations. Participants will learn how to identify data sources available for analyzing CAM use among racial and ethnic populations and understand the significance of exploring the concept of spirituality and spiritual strategies utilized by African-Americans to promote health.

Tuesday, 12/13/05
8:30-10:00 a.m. ACHP around the World (Scientific Oral)
This session will provide the participants with an overview of several perspectives relating to Alternative and Complementary Health Practices around the world.

12:30-2:00 p.m. ACHP and Public Health (Poster session)
This poster session will present an array of current ACHP application, education, and research by scholars and practitioners from various settings. You will have the opportunity to interact with our presenters directly. Do not miss this session.

2:30-4:00 p.m. Growing Prevalence of ACHP: Challenges and Opportunities for Professionals and Consumers (Scientific Oral)
This session will address issues of the frequency and type of CAM use and attitudes toward CAM use among different populations, the value of loving kindness meditation in promoting civic engagement, and the role of institutional programmatic reform and academic collaboration in creating a system to conduct effective outcomes-oriented research in CAM to best meet defined public health agenda

4:30-6:00 p.m. ACHP and Chronic Diseases (Scientific Oral)
This session addresses several aspects of ACHP applied in chronic disease care. Topics include the feasibility and potential effectiveness of a massage intervention aimed at enhancing the well-being of family caregivers and their loved ones receiving hospice care; predictors of CAM use in children with asthma and whether CAM use predicts asthma medication regimen the relationship between obesity and selected CAM modalities; and insight into acupuncture use in the US with implications relevant to public health research and policy.

8:30-10:00 a.m. ACHP in Cancer Treatment (Scientific Oral)
This session addresses various issues related to CAM therapies and cancer care, including the examination of using representative population-based data to study issues related to the limitations of existing studies of CAM use among cancer patients, the use of CAM modalities in treating cancer, the experience of using the New Beginnings Cancer Care Program to improve quality of life for cancer patients, Internet-based self-help group for women with breast cancer, and the physiological and psychological effects of massage therapy on children with cancer and blood diseases.

Lastly, but most importantly, we would like to invite you to attend our ACHP Business Meeting scheduled on Monday, Dec. 12 at 6:30 p.m. Please bring your ideas and suggestions of how to move our SPIG forward and continue to gain momentum within APHA.

Acupuncturists Without Borders Organizes Hurricane Relief Efforts

Hurricane Katrina and its aftermath have elicited an unprecedented response from acupuncturists and supporters throughout the country. Acupuncturists Without Borders (AWB), an organization that has mobilized to provide care and services for individuals affected by the storm and related tragedy, has been active in September doing fund-raising, organizing logistics, and assembling trained personnel. Teams of acupuncturists will travel to Houston and other areas in order to provide relief efforts.

Diana Fried, AWB director, says the organization has been “absolutely awestruck by the outpouring of response in the acupuncture community to our call for help with the relief effort. The caliber of the replies, the offers, the thoughtful and gracious words, the extraordinary mix of skills and experience, have given us huge inspiration to carry this vision forward.”

Community responses of this type were first mounted after Sept. 11 in New York and other cities on the East Coast. Using ear acupuncture and National Acupuncture Detoxification Association (NADA) approaches, treatment has been provided to thousands of individuals. Focus of treatment is on minimizing physical and psychological stress related to disaster or tragedy.

Fried explained that AWB has a team approach to disaster relief, and has been in discussions with the American Red Cross, the Federal Emergency Management Agency, and other local agencies to coordinate response. “Getting food, water, and shelter to survivors are primary goals. Once these are established, providing acupuncture treatment makes sense. We’ve been working to create the infrastructure and logistics to support ongoing service.”

One of the main challenges to a seamless roll-out of services on the national level is the issue of reciprocity; acupuncture licenses are issued on a state by state basis and, unlike licenses for medical doctors, do not yet have the tradition of being honored across states in times of crisis. A longer-term goal of AWB is to work with Congressional representatives, state licensing boards, and the legal system to create new precedents for allowing reciprocal privileges. Education is the key to promoting understanding about the training, experience, and scope of acupuncture practice.

Acupuncturists who are interested in volunteering are encouraged to do so. Individuals already certified as NADA trainers can automatically join the group. For acupuncturists who are NADA certified or without previous NADA training, AWB has created a screening process that is pending approval by the Texas State Licensing Board.

“Our goal is to have team members stay for a minimum of one week, and preferably for two weeks or longer,” Fried explained.

In the short-term AWB is working on obtaining organizational 501(c)3 non-profit status. Because the group does not yet have this formal standing, AWB is currently unable to directly accept donations.

“Organizations such as the AOM Alliance and NADA have graciously offered to serve as conduits for donations,” Fried said. The AOM Alliance and NADA will earmark 100 percent of all donations to AWB for AWB; no overhead or other charges will be directed for processing or administrative costs. (Contact information for these groups will be provided at the end of this article).

The long-term plan of AWB is to “create a world-class organization of acupuncturists who provide community-style acupuncture in the U.S. as well as internationally.” Fried further envisions that the group will “focus on regions where there has been war and conflict, including U.S. inner cities, or disaster. Our group hopes to support local indigenous efforts at dealing with trauma.”

For further information, individuals can contact AWB at
www.acuwithoutborders.org or e-mail info@acuwithoutborders.org.

American Red Cross Funds Available for Auricular Acupuncture

A mental health and substance abuse program in Hudson County, New York has been funded by the American Red Cross; services are available to those who were affected by 9/11 and their family members. The September 11 Recovery Program has provided treatment to more than 8,000 individuals since its launch in August, 2002.

Officials say the program is currently enrolling approximately 50 people per week, but they expect the numbers to rise as the time nears the anniversary of the attacks. People continue to experience a variety of symptoms in relation to the trauma of 9/11. Mental health professionals working in the Hudson County area claim that many individuals continue to experience effects related to Post-Traumatic Stress Disorder.

The September 11 Recovery Program includes a comprehensive set of services including mental health treatment for individuals, families or groups, auricular acupuncture, and medication. Because the program wants to increase access to care, services are covered in part by the Red Cross. Assistance is provided for:
  • up to 32 sessions of outpatient mental health counseling or auricular acupuncture.
  • up to 32 sessions of outpatient substance abuse counseling or auricular acupuncture.
  • up to $1,500 for psychotropic medications and substance abuse screenings.
  • up to 30 days of partial or inpatient hospitalization for mental health conditions.
  • up to 30 days of partial or inpatient hospitalization for substance abuse conditions.
  • up to 8 hours of psychological evaluation and testing for young people through the age of 21.

Participation is open to the following individuals who, as a result of the attacks:

  • lost a family member
  • sustained serious injuries
  • worked south of Chambers St.
  • lost a job or at least 30 percent of their income
  • attended school close to the World Trade Center
  • officially deployed for rescue or recovery

Information also available from the Mental Health Association of New York City at (800)LIFE-NET.

Report on the 3rd International AIDS Society Conference: CAM High-lights

The International AIDS Society (IAS) held its third conference on HIV pathogenesis and treatment in Rio de Janeiro, Brazil, from July 24 to 27. Six thousand delegates attended from more than 130 countries. The purpose of the conference was to present and discuss clinical and scientific advances in all aspects of HIV/AIDS – prevention, diagnostics, and treatment.

The conference was organized by a coalition consisting of the IAS, the Federal University of Rio de Janeiro, and the Brazilian Society of Infectious Diseases. IAS President and Co-chair Helene Gayle, MD, MPH, is the director of the HIV, TB, and Reproductive Health Programme of the Bill and Melinda Gates Foundation.

More than 1,300 abstracts were presented that focused on issues that included new medications, vaccine development, and current status of microbicide research. Of particular interest were presentations dealing with manufacture and use of generic medications, an area in which Brazil has recently acquired resources and expertise. Although a minority of presenters discussed topics related to complementary and alternative health practices, there was interest and enthusiasm on the part of delegates to hear about these areas as well. Topics of interest in this realm included acupuncture and Traditional Chinese medicine (TCM), nutritional factors, and exercise.

Several presentations will be of particular interest to ACHP readers: research on the use of reishi mushrooms to affect immunomodulation and the effects of acupuncture to moderate digestive side-effects of HIV-medications.

Jessica Leonard, a naturopathic physician and licensed acupuncturist, has been studying the effects of Reishi mushrooms (Ling Zhi) on immune function. Dr. Leonard is a post-doctoral research fellow sponsored by the National Institutes of Health and the National Center for Complementary and Alternative Medicine; she works at Bastyr University in Seattle. In addition to volunteering at the Kang Wen Clinic in Seattle since 1999, Dr. Leonard supervises acupuncture treatment at the Immune Wellness Clinic at the Bastyr Center for Natural Health.

Leonard described the next steps of their research: “We have an ongoing pilot trial at Bastyr that is evaluating the effects of Reishi in HIV-positive participants who are not currently using antiretroviral therapy; we are evaluating Reishi’s safety and efficacy in this population of immune-compromised individuals”.

How does Leonard envision the role of Asian medicine and CAM in treating people with HIV/AIDS? “There are two main areas where I think TCM and CAM can be beneficial," she said. "The first is in treating side-effects of antiretroviral medications. Acupuncture and nutritional supplementation can be effective in reducing many of the side-effects of the medications, including but not limited to nausea and other digestive issues, fatigue, myalgia, and neuropathy. By decreasing the side-effects of the medications, we may be influencing compliance, or a patient’s ability to tolerate the medications over time.

“The other area is treating patients before they initiate antiretroviral therapy. Through the use of diet, lifestyle modification, and certain CAM therapies such as nutritional supplementation and Chinese herbal medicine, it may be possible to extend the amount of time that individuals living with HIV can stay healthy and postpone antiretroviral therapy.”

The conference’s other presentation on Asian medicine focused on the role of acupuncture in managing digestive side-effects of medications. Researchers at Pathways to Wellness in Boston conducted a cross-over clinical trial that evaluated the use of acupuncture to control digestive side-effects related to the use of highly active antiretroviral therapy. This pilot study recruited more than 50 participants who received acupuncture treatment for six weeks. Two types of treatment were compared; a set of four points known for their effective control of digestive problems (called the symptom-specific group) was compared to a set of four nearby points that are thought to have little or no value for influencing digestive disorders (called the comparison group). Each set of points was used for 3 weeks, with the order of treatment randomly assigned. Study participants and data analysts were blinded to the order of treatment.

Although improvement in symptoms resulted from both sets of treatment, a greater degree of efficacy was related to treatment in the symptom-specific group for the following conditions: loss of appetite, abdominal cramping, and bloating. The trial determined that a carry-over effect can result from administration of the set of symptom-specific points, as well as that acupuncture treatment seemed to improve adherence to medication among those individuals whose adherence was sub-optimal at the beginning of the study.

Each year conferences on treatment for people with HIV/AIDS include greater numbers of studies about the value of CAM approaches such as acupuncture and Chinese herbal medicine. Researchers, clinicians and most importantly, people who are HIV-positive, are benefiting from the increasing interest, availability, and integration of integrative techniques. As professionals in this field, our task is to be knowledgeable about and support these efforts.

References:
Leonard J, Majd I, McGann M, Novack J, Wenner C. Reishi: a novel inhibitor of TNF production and NFkB activation in HIV infection. International AIDS Society 2005. 3rd IAS Conference on HIV Pathogenesis and Treatment. Abstract WePe12.8.C04.
Sommers E, Porter K. Acupuncture trial: managing digestive side-effects of antiretroviral treatment. International AIDS Society 2005. 3rd IAS Conference on HIV Pathogenesis and Treatment. Abstract WePe6.2.C01.
http://my.webmd.com/content/article/109/109217 Accessed 8/22/05.

Conference abstracts can be accessed via the following site:
www.ias-2005.org.

U.S. Department of Defense and CAM

The Department of Defense and the Veterans Administration Hospital system put out a call last spring for CAM-related research projects to address the issue of post-traumatic stress disorder (PTSD) among U.S. veterans. Six projects throughout the country were funded, including one in Boston proposed by APHA member Bei Chang, ScD. Her study, submitted in collaboration with Boston University School of Public Health and Pathways to Wellness, will evaluate the efficacy of acupuncture and relaxation in treating physical and emotional symptoms related to PTSD. We wish Bei and her team the best with their work and look forward to hearing what is learned from the study.

Congratulations to an ACHP member!

Katherine (Kate) Irvine completed a doctorate in April 2005 from the University of Michigan's School of Natural Resources and Environment. Her thesis, "Work Breaks and Well-Being: The Effect of Nature on Hospital Nurses," explored the benefits of spending time in nature while at work on psychological and spiritual health. Kate accepted a two-year post-doctoral research fellow at De Montfort University's Institute for Energy and Sustainable Development in Leicester, England to research the health benefits of parks and green space for urban residents.

Survey of Interest to Acupuncturists and Chinese Herbal Providers

A new survey research study will be under way soon examining practice characteristics and experiences of acupuncturists/Oriental medicine practitioners who treat HIV-positive patients as a significant portion of practice (at least 20 percent). Practitioners from throughout the United States will be invited to participate. The study will involve completing a mailed survey, which should take approximately 30 minutes. You will be eligible to win a $250 gift certificate at amazon.com. Please check this newsletter for future announcements, or contact Adam Burke, PhD, MPH, LAC, at aburke@sfsu.edu for more information.

Positions Available

  1. The Institute for Holistic Healing Studies, Department of Health Education, at San Francisco State University, is pleased to announce a new Tenure Track position in Holistic Health. The ideal candidate will have expertise in holistic health/alternative health/complementary and alternative medicine with an emphasis in Eastern cultures and their healing traditions. Details of the position will be available in October. For information please contact the chair of the search committee, Adam Burke, aburke@sfsu.edu.
  2. San Francisco State University is searching for a director of its new Health Equity Initiative (HEI) who will develop, coordinate, and lead related research and grant seeking activities within the Office of Research and Sponsored Programs. Contact Mary Beth Love for more information at love@sfsu.edu.

Interested in providing guidance for curriculum development?

Holistic Health/Alternative Health Curriculum Task Force
If you are interested in working to help define the competencies for undergraduate/graduate Holistic Health/Alternative Health curricula please contact Adam Burke at
aburke@sfsu.edu.

Call for submissions – ACHP wants your stories!

Send us your success stories, job announcements, conference announcements, relevant links or resource ideas related to Alternative Health Practices in public health so we can inform our community. Updates about work you’re doing, projects you’re designing or implementing, or any other reports on your activities are of interest to our large and growing community. Please send submissions of any length (maximum 1,500 words) to ACHP Newsletter Editor Beth Sommers at esommers@bu.edu. If you have an idea for the newsletter and want feedback, Beth will be delighted to discuss it. Our SPIG is dedicated to creating a forum for ongoing dialogue about innovative integrative care and practice. Thanks in advance for your input!

Telephone, Telegraph, Tell Your Friends. . .

Tell your friends and colleagues to become members of the ACHP SPIG. Let's bring the preventive power of alternative health practices into APHA to better serve the public and our constituencies.







INTEGRATED HEALTH CARE IS A RIGHT, NOT A PRIVILEGE.