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1.  World Congress Integrative Medicine & Health 2017: Part one 
Brinkhaus, Benno | Falkenberg, Torkel | Haramati, Aviad | Willich, Stefan N. | Briggs, Josephine P. | Willcox, Merlin | Linde, Klaus | Theorell, Töres | Wong, Lisa M. | Dusek, Jeffrey | Wu, Darong | Eisenberg, David | Haramati, Aviad | Berger, Bettina | Kemper, Kathi | Stock-Schröer, Beate | Sützl-Klein, Hedda | Ferreri, Rosaria | Kaplan, Gary | Matthes, Harald | Rotter, Gabriele | Schiff, Elad | Arnon, Zahi | Hahn, Eckhard | Luberto, Christina M. | Martin, David | Schwarz, Silke | Tauschel, Diethard | Flower, Andrew | Gramminger, Harsha | Gupta, Hedwig H. | Gupta, S. N. | Kerckhoff, Annette | Kessler, Christian S. | Michalsen, Andreas | Kessler, Christian S. | Kim, Eun S. | Jang, Eun H. | Kim, Rana | Jan, Sae B. | Mittwede, Martin | Mohme, Wiebke | Ben-Arye, Eran | Bonucci, Massimo | Saad, Bashar | Breitkreuz, Thomas | Rossi, Elio | Kebudi, Rejin | Daher, Michel | Razaq, Samaher | Gafer, Nahla | Nimri, Omar | Hablas, Mohamed | Kienle, Gunver Sophia | Samuels, Noah | Silbermann, Michael | Bandelin, Lena | Lang, Anna-Lena | Wartner, Eva | Holtermann, Christoph | Binstock, Maxwell | Riebau, Robert | Mujkanovic, Edin | Cramer, Holger | Lauche, Romy | Michalsen, Andres | Ward, Lesley | Cramer, Holger | Irnich, Dominik | Stör, Wolfram | Burnstock, Geoffrey | Schaible, Hans-Georg | Ots, Thomas | Langhorst, Jost | Lauche, Romy | Sundberg, Tobias | Falkenberg, Torkel | Amarell, Catherina | Amarell, Catherina | Anheyer, Melanie | Eckert, Marion | Eckert, Marion | Ogal, Mercedes | Eckert, Marion | Amarell, Catherina | Schönauer, Annette | Reisenberger, Birgit | Brand, Bernhard | Anheyer, Dennis | Dobos, Gustav | Kroez, Matthias | Martin, David | Matthes, Harald | Ammendola, Aldo | Mao, Jun J. | Witt, Claudia | Yang, Yufei | Dobos, Gustav | Oritz, Miriam | Horneber, Markus | Voiß, Petra | Reisenberger, Birgit | von Rosenstiel, Alexandra | Eckert, Marion | Ogal, Mercedes | Amarell, Catharina | Anheyer, Melanie | Schad, Friedemann | Schläppi, Marc | Kröz, Matthias | Büssing, Arndt | Bar-Sela, Gil | Matthes, Harald | Schiff, Elad | Ben-Arye, Eran | Arnon, Zahi | Avshalomov, David | Attias, Samuel | Schönauer, Annette | Haramati, Aviad | Witt, Claudia | Brinkhaus, Benno | Cotton, Sian | Jong, Miek | Jong, Mats | Scheffer, Christian | Haramati, Aviad | Tauschel, Diethard | Edelhäuser, Friedrich | AlBedah, Abdullah | Lee, Myeong Soo | Khalil, Mohamed | Ogawa, Keiko | Motoo, Yoshiharu | Arimitsu, Junsuke | Ogawa, Masao | Shimizu, Genki | Stange, Rainer | Kraft, Karin | Kuchta, Kenny | Watanabe, Kenji | Bonin, D | Büssing, Arndt | Gruber, Harald | Koch, Sabine | Gruber, Harald | Pohlmann, Urs | Caldwell, Christine | Krantz, Barbara | Kortum, Ria | Martin, Lily | Wieland, Lisa S. | Kligler, Ben | Gould-Fogerite, Susan | Zhang, Yuqing | Wieland, Lisa S. | Riva, John J. | Lumpkin, Michael | Ratner, Emily | Ping, Liu | Jian, Pei | Hamme, Gesa-Meyer | Mao, Xiaosong | Chouping, Han | Schröder, Sven | Hummelsberger, Josef | Wullinger, Michael | Brodzky, Marc | Zalpour, Christoff | Langley, Julia | Weber, Wendy | Mudd, Lanay M. | Wayne, Peter | Witt, Clauda | Weidenhammer, Wolfgang | Fønnebø, Vinjar | Boon, Heather | Steel, Amie | Bugarcic, Andrea | Rangitakatu, Melisa | Steel, Amie | Adams, Jon | Sibbritt, David | Wardle, Jon | Leach, Matthew | Schloss, Janet | Dieze, Helene | Boon, Heather | Ijaz, Nadine | Willcox, Merlin | Heinrich, Michael | Lewith, George | Flower, Andrew | Graz, Bertrand | Adam, Daniela | Grabenhenrich, Linus | Ortiz, Miriam | Binting, Sylvia | Reinhold, Thomas | Brinkhaus, Benno | Andermo, Susanne | Sundberg, Tobias | Falkenberg, Torkel | Nordberg, Johanna Hök | Arman, Maria | Bhasin, Manoj | Fan, Xueyi | Libermann, Towia | Fricchione, Gregory | Denninger, John | Benson, Herbert | Berger, Bettina | Stange, Rainer | Michalsen, Andreas | Martin, David D. | Boers, Inge | Vlieger, Arine | Jong, Miek | Brinkhaus, Benno | Teut, Michael | Ullmann, Alexander | Ortiz, Miriam | Rotter, Gabriele | Binting, Sylvia | Lotz, Fabian | Roll, Stephanie | Canella, Claudia | Mikolasek, Michael | Rostock, Matthias | Beyer, Jörg | Guckenberger, Matthias | Jenewein, Josef | Linka, Esther | Six, Claudia | Stoll, Sarah | Stupp, Roger | Witt, Claudia M. | Chuang, Elisabeth | Kligler, Ben | McKee, Melissa D. | Cramer, Holger | Lauche, Romy | Klose, Petra | Lange, Silke | Langhorst, Jost | Dobos, Gustav | Chung, Vincent C. H. | Wong, Hoi L. C. | Wu, Xin Y. | Wen, Grace Y. G. | Ho, Robin S. T. | Ching, Jessica Y. L. | Wu, Justin C. Y. | Coakley, Amanda | Flanagan, Jane | Annese, Christine | Empoliti, Joanne | Gao, Zishan | Liu, Xugang | Yu, Shuguang | Yan, Xianzhong | Liang, Fanrong | Hohmann, Christoph D. | Steckhan, Nico | Ostermann, Thomas | Paetow, Arion | Hoff, Evelyn | Michalsen, Andreas | Hu, Xiao-Yang | Wu, Ruo-Han | Logue, Martin | Blonde, Clara | Lai, Lily Y. | Stuart, Beth | Flower, Andrew | Fei, Yu-Tong | Moore, Michael | Liu, Jian-Ping | Lewith, George | Hu, Xiao-Yang | Wu, Ruo-Han | Logue, Martin | Blonde, Clara | Lai, Lily Y. | Stuart, Beth | Flower, Andrew | Fei, Yu-Tong | Moore, Michael | Liu, Jian-Ping | Lewith, George | Jeitler, Michael | Zillgen, Hannah | Högl, Manuel | Steckhan, Nico | Stöckigt, Barbara | Seifert, Georg | Michalsen, Andreas | Kessler, Christian | Khadivzadeh, Talat | Bashtian, Maryam Hassanzadeh | Aval, Shapour Badiee | Esmaily, Habibollah | Kim, Jihye | Kim, Keun H. | Klocke, Carina | Joos, Stefanie | Koshak, Abdulrahman | Wie, Li | Koshak, Emad | Wali, Siraj | Alamoudi, Omer | Demerdash, Abdulrahman | Qutub, Majdy | Pushparaj, Peter | Heinrich, Michael | Kruse, Sigrid | Fischer, Isabell | Tremel, Nadine | Rosenecker, Joseph | Leung, Brenda | Takeda, Wendy | Liang, Ning | Feng, Xue | Liu, Jian-ping | Cao, Hui-juan | Luberto, Christina M. | Shinday, Nina | Philpotts, Lisa | Park, Elyse | Fricchione, Gregory L. | Yeh, Gloria | Munk, Niki | Zakeresfahani, Arash | Foote, Trevor R. | Ralston, Rick | Boulanger, Karen | Özbe, Dominik | Gräßel, Elmar | Luttenberger, Katharina | Pendergrass, Anna | Pach, Daniel | Bellmann-Strobl, Judit | Chang, Yinhui | Pasura, Laura | Liu, Bin | Jäger, Sven F. | Loerch, Ronny | Jin, Li | Brinkhaus, Benno | Ortiz, Miriam | Reinhold, Thomas | Roll, Stephanie | Binting, Sylvia | Icke, Katja | Shi, Xuemin | Paul, Friedemann | Witt, Claudia M. | Rütz, Michaela | Lynen, Andreas | Schömitz, Meike | Vahle, Maik | Salomon, Nir | Lang, Alon | Lahat, Adi | Kopylov, Uri | Ben-Horin, Shomron | Har-Noi, Ofir | Avidan, Benjamin | Elyakim, Rami | Gamus, Dorit | NG, Siew | Chang, Jessica | Wu, Justin | Kaimiklotis, John | Schumann, Dania | Buttó, Ludovica | Langhorst, Jost | Dobos, Gustav | Haller, Dirk | Cramer, Holger | Smith, Caroline | de Lacey, Sheryl | Chapman, Michael | Ratcliffe, Julie | Johnson, Neil | Lyttleton, Jane | Boothroyd, Clare | Fahey, Paul | Tjaden, Bram | van Vliet, Marja | van Wietmarschen, Herman | Jong, Miek | Tröger, Wilfried | Vuolanto, Pia | Aarva, Paulina | Sorsa, Minna | Helin, Kaija | Wenzel, Claudia | Zoderer, Iris | Pammer, Patricia | Simon, Patrick | Tucek, Gerhard | Wode, Kathrin | Henriksson, Roger | Sharp, Lena | Stoltenberg, Anna | Nordberg, Johanna Hök | Xiao-ying, Yang | Wang, Li-qiong | Li, Jin-gen | Liang, Ning | Wang, Ying | Liu, Jian-ping | Balneaves, Lynda | Capler, Rielle | Bocci, Chiara | Guffi, Marta | Paolini, Marina | Meaglia, Ilaria | Porcu, Patrizia | Ivaldi, Giovanni B. | Dragan, Simona | Bucuras, Petru | Pah, Ana M. | Badalica-Petrescu, Marius | Buleu, Florina | Hogea-Stoichescu, Gheorghe | Christodorescu, Ruxandra | Kao, Lan | Cho, Yumin | Klafke, Nadja | Mahler, Cornelia | von Hagens, Cornelia | Uhlmann, Lorenz | Bentner, Martina | Schneeweiss, Andreas | Mueller, Andreas | Szecsenyi, Joachim | Joos, Stefanie | Neri, Isabella | Ortiz, Miriam | Schnabel, Katharina | Teut, Michael | Rotter, Gabriele | Binting, Sylvia | Cree, Margit | Lotz, Fabian | Suhr, Ralf | Brinkhaus, Benno | Rossi, Elio | Baccetti, Sonia | Firenzuoli, Fabio | Monechi, Maria V. | Di Stefano, Mariella | Amunni, Gianni | Wong, Wendy | Chen, Bingzhong | Wu, Justin | Amri, Hakima | Haramati, Aviad | Kotlyanskaya, Lucy | Anderson, Belinda | Evans, Roni | Kligler, Ben | Marantz, Paul | Bradley, Ryan | Booth-LaForce, Cathryn | Zwickey, Heather | Kligler, Benjamin | Brooks, Audrey | Kreitzer, Mary J. | Lebensohn, Patricia | Goldblatt, Elisabeth | Esmel-Esmel, Neus | Jiménez-Herrera, Maria | Ijaz, Nadine | Boon, Heather | Jocham, Alexandra | Stock-Schröer, Beate | Berberat, Pascal O. | Schneider, Antonius | Linde, Klaus | Masetti, Morgana | Murakozy, Henriette | Van Vliet, Marja | Jong, Mats | Jong, Miek | Agdal, Rita | Atarzadeh, Fatemeh | Jaladat, Amir M. | Hoseini, Leila | Amini, Fatemeh | Bai, Chen | Liu, Tiegang | Zheng, Zian | Wan, Yuxiang | Xu, Jingnan | Wang, Xuan | Yu, He | Gu, Xiaohong | Daneshfard, Babak | Nimrouzi, Majid | Tafazoli, Vahid | Alorizi, Seyed M. Emami | Saghebi, Seyed A. | Fattahi, Mohammad R. | Salehi, Alireza | Rezaeizadeh, Hossein | Zarshenas, Mohammad M. | Nimrouzi, Majid | Fox, Kealoha | Hughes, John | Kostanjsek, Nenad | Espinosa, Stéphane | Lewith, George | Fisher, Peter | Latif, Abdul | Lefeber, Donald | Paske, William | Öztürk, Ali Ö. | Öztürk, Gizemnur | Boers, Inge | Tissing, Wim | Naafs, Marianne | Busch, Martine | Jong, Miek | Daneshfard, Babak | Sanaye, Mohammad R. | Dräger, Kilian | Fisher, Peter | Kreitzer, Mary J. | Evans, Roni | Leininger, Brent | Shafto, Kate | Breen, Jenny | Sanaye, Mohammad R. | Daneshfard, Babak | Simões-Wüst, Ana P. | Moltó-Puigmartí, Carolina | van Dongen, Martien | Dagnelie, Pieter | Thijs, Carel | White, Shelley | Wiesener, Solveig | Salamonsen, Anita | Stub, Trine | Fønnebø, Vinjar | Abanades, Sergio | Blanco, Mar | Masllorens, Laia | Sala, Roser | Al-Ahnoumy, Shafekah | Han, Dongwoon | He, Luzhu | Kim, Ha Yun | In Choi, Da | Alræk, Terje | Stub, Trine | Kristoffersen, Agnete | von Sceidt, Christel | Michalsen, Andreas | Bruset, Stig | Musial, Frauke | Anheyer, Dennis | Cramer, Holger | Lauche, Romy | Saha, Felix J. | Dobos, Gustav | Anheyer, Dennis | Haller, Heidemarie | Lauche, Romy | Dobos, Gustav | Cramer, Holger | Azizi, Hoda | Khadem, Nayereh | Hassanzadeh, Malihe | Estiri, Nazanin | Azizi, Hamideh | Tavassoli, Fatemeh | Lotfalizadeh, Marzieh | Zabihi, Reza | Esmaily, Habibollah | Azizi, Hoda | Shabestari, Mahmoud Mohammadzadeh | Paeizi, Reza | Azari, Masoumeh Alvandi | Bahrami-Taghanaki, Hamidreza | Zabihi, Reza | Azizi, Hamideh | Esmaily, Habibollah | Baars, Erik | De Bruin, Anja | Ponstein, Anne | Baccetti, Sonia | Di Stefano, Mariella | Rossi, Elio | Firenzuoli, Fabio | Segantini, Sergio | Monechi, Maria Valeria | Voller, Fabio | Barth, Jürgen | Kern, Alexandra | Lüthi, Sebastian | Witt, Claudia | Barth, Jürgen | Zieger, Anja | Otto, Fabius | Witt, Claudia | Beccia, Ariel | Dunlap, Corina | Courneene, Brendan | Bedregal, Paula | Passi, Alvaro | Rodríguez, Alfredo | Chang, Mayling | Gutiérrez, Soledad | Beissner, Florian | Beissner, Florian | Preibisch, Christine | Schweizer-Arau, Annemarie | Popovici, Roxana | Meissner, Karin | Beljanski, Sylvie | Belland, Laura | Rivera-Reyes, Laura | Hwang, Ula | Berger, Bettina | Sethe, Dominik | Hilgard, Dörte | Heusser, Peter | Bishop, Felicity | Al-Abbadey, Miznah | Bradbury, Katherine | Carnes, Dawn | Dimitrov, Borislav | Fawkes, Carol | Foster, Jo | MacPherson, Hugh | Roberts, Lisa | Yardley, Lucy | Lewith, George | Bishop, Felicity | Al-Abbadey, Miznah | Bradbury, Katherine | Carnes, Dawn | Dimitrov, Borislav | Fawkes, Carol | Foster, Jo | MacPherson, Hugh | Roberts, Lisa | Yardley, Lucy | Lewith, George | Bishop, Felicity | Holmes, Michelle | Lewith, George | Yardley, Lucy | Little, Paul | Cooper, Cyrus | Bogani, Patrizia | Maggini, Valentina | Gallo, Eugenia | Miceli, Elisangela | Biffi, Sauro | Mengoni, Alessio | Fani, Renato | Firenzuoli, Fabio | Brands-Guendling, Nadine | Guendling, Peter W. | Bronfort, Gert | Evans, Roni | Haas, Mitch | Leininger, Brent | Schulz, Craig | Bu, Xiangwei | Wang, J. | Fang, T. | Shen, Z. | He, Y. | Zhang, X. | Zhang, Zhengju | Wang, Dali | Meng, Fengxian | Büssing, Arndt | Baumann, Klaus | Frick, Eckhard | Jacobs, Christoph | Büssing, Arndt | Grünther, Ralph-Achim | Lötzke, Désirée | Büssing, Arndt | Jung, Sonny | Lötzke, Désirée | Recchia, Daniela R. | Robens, Sibylle | Ostermann, Thomas | Berger, Bettina | Stankewitz, Josephin | Kröz, Matthias | Jeitler, Mika | Kessler, Christian | Michalsen, Andreas | Cheon, Chunhoo | Jang, Bo H. | Ko, Seong G. | Huang, Ching W. | Sasaki, Yui | Ko, Youme | Cheshire, Anna | Ridge, Damien | Hughes, John | Peters, David | Panagioti, Maria | Simon, Chantal | Lewith, George | Cho, Hyun J. | Han, Dongwoon | Choi, Soo J. | Jung, Young S. | Im, Hyea B | Cooley, Kieran | Tummon-Simmons, Laura | Cotton, Sian | Luberto, Christina M. | Wasson, Rachel | Kraemer, Kristen | Sears, Richard | Hueber, Carly | Derk, Gwendolyn | Lill, JR | An, Ruopeng | Steinberg, Lois | Rodriguez, Lourdes Diaz | la Fuente, Francisca García-de | De la Vega, Miguel | Vargas-Román, Keyla | Fernández-Ruiz, Jonatan | Cantarero-Villanueva, Irene | Rodriguez, Lourdes Diaz | García-De la Fuente, Francisca | Jiménez-Guerrero, Fanny | Vargas-Román, Keyla | Fernández-Ruiz, Jonatan | Galiano-Castillo, Noelia | Diaz-Saez, Gualberto | Torres-Jimenez, José I. | Garcia-Gomez, Olga | Hortal-Muñoz, Luis | Diaz-Diez, Camino | Dicen, Demijon | Diezel, Helene | Adams, Jon | Steel, Amie | Wardle, Jon | Diezel, Helene | Steel, Amie | Frawley, Jane | Wardle, Jon | Broom, Alex | Adams, Jon | Dong, Fei | Yu, He | Liu, Tiegang | Ma, Xueyan | Yan, Liyi | Wan, Yuxiang | Zheng, Zian | Gu, Xiaohong | Dong, Fei | Yu, He | Wu, Liqun | Liu, Tiegang | Ma, Xueyan | Ma, Jiaju | Yan, Liyi | Wan, Yuxiang | Zheng, Zian | Zhen, Jianhua | Gu, Xiaohong | Dubois, Julie | Rodondi, Pierre-Yves | Edelhäuser, Friedrich | Schwartze, Sophia | Trapp, Barbara | Cysarz, Dirk
doi:10.1186/s12906-017-1782-4
PMCID: PMC5498855
2.  World Congress Integrative Medicine & Health 2017: part two 
Ee, Carolyn | Thuraisingam, Sharmala | Pirotta, Marie | French, Simon | Xue, Charlie | Teede, Helena | Kristoffersen, Agnete E. | Sirois, Fuschia | Stub, Trine | Engler, Jennifer | Joos, Stefanie | Güthlin, Corina | Felenda, Jennifer | Beckmann, Christiane | Stintzing, Florian | Evans, Roni | Bronfort, Gert | Keefe, Daniel | Taberko, Anna | Hanson, Linda | Haley, Alex | Ma, Haiwei | Jolton, Joseph | Yarosh, Lana | Keefe, Francis | Nam, Jung | Evans, Roni | Ojala, Liwanag | Kreitzer, Mary J. | Hanson, Linda | Fink, Careen | Kraft, Karin | Flower, Andrew | Lewith, George | Harman, Kim | Stuart, Beth | Bishop, Felicity L. | Frawley, Jane | Füleki, Lilla | Kiss, Eva | Vancsik, Tamas | Krenacs, Tibor | Funabashi, Martha | Pohlman, Katherine A. | Mior, Silvano | Thiel, Haymo | Hill, Michael D. | Cassidy, David J. | Westaway, Michael | Yager, Jerome | Hurwitz, Eric | Kawchuk, Gregory N. | O’Beirne, Maeve | Vohra, Sunita | Gaboury, Isabelle | Morin, Chantal | Gaertner, Katharina | Torchetti, Loredana | Frei-Erb, Martin | Kundi, Michael | Frass, Michael | Gallo, Eugenia | Maggini, Valentina | Comite, Mattia | Sofi, Francesco | Baccetti, Sonia | Vannacci, Alfredo | Di Stefano, Mariella | Monechi, Maria V. | Gori, Luigi | Rossi, Elio | Firenzuoli, Fabio | Mediati, Rocco D. | Ballerini, Giovanna | Gardiner, Paula | Lestoquoy, Anna S. | Negash, Lily | Stillman, Sarah | Shah, Prachi | Liebschutz, Jane | Adelstein, Pamela | Farrell-Riley, Christine | Brackup, Ivy | Penti, Brian | Saper, Robert | Sampedro, Isabel Giralt | Carvajal, Gilda | Gleiss, Andreas | Gross, Marie M. | Brendlin, Dorothea | Röttger, Jonas | Stritter, Wiebke | Seifert, Georg | Grzanna, Noelle | Stange, Rainer | Guendling, Peter W. | Gu, Wen | Lu, Yan | Wang, Jie | Zhang, Chengcheng | Bai, Hua | He, Yuxi | Zhang, Xiaoxu | Zhang, Zhengju | Wang, Dali | Meng, Fengxian | Hagel, Alexander | Albrecht, Heinz | Vollbracht, Claudia | Dauth, Wolfgang | Hagel, Wolfgang | Vitali, Francesco | Ganzleben, Ingo | Schultis, Hans | Konturek, Peter | Stein, Jürgen | Neurath, Markus | Raithel, Martin | Hagel, Alexander | Vollbracht, Claudia | Raithel, Martin | Konturek, Peter | Krick, Bianka | Haller, Heidemarie | Klose, Petra | Dobos, Gustav | Kümmel, Sherko | Cramer, Holger | Haller, Heidemarie | Saha, Felix J. | Kowoll, Anna | Ebner, Barbara | Berger, Bettina | Dobos, Gustav | Choi, Kyung-Eun | He, Lisha | Wang, Han | He, X. | Gu, C. | Zhang, Y. | Zhao, Linhua | Tong, Xiaolin | He, Lisha | Wang, Han | He, Xinhui | Gu, Chengjuan | Zhang, Ying | Zhao, Linhua | Tong, Xiaolin | He, Lisha | Wang, Han | He, Xinhui | Gu, Chengjuan | Zhang, Ying | Zhao, Linhua | Tong, Xiaolin | Ho, Robin S. T. | Chung, Vincent C. H. | Wu, Xinyin | Wong, Charlene H. L. | Wu, Justin C. Y. | Wong, Samuel Y. S. | Lau, Alexander Y. L. | Sit, Regina W. S. | Wong, Wendy | Holmes, Michelle | Bishop, Felicity | Calman, Lynn | Holmes, Michelle | Bishop, Felicity | Lewith, George | Newell, Dave | Field, Jonathan | Htut, Win L. | Han, Dongwoon | Choi, Da I. | Choi, Soo J. | Kim, Ha Y. | Hwang, Jung H. | Huang, Ching W. | Jang, Bo H. | Chen, Fang P. | Ko, Seong G. | Huang, Wenjing | Jin, De | Lian, Fengmei | Jang, Soobin | Kim, Kyeong H. | Lee, Eun K. | Sun, Seung H. | Go, Ho Y. | Ko, Youme | Park, Sunju | Jang, Bo H. | Shin, Yong C. | Ko, Seong G. | Janik, Hubert | Greiffenhagen, Natalie | Bolte, Jürgen | Kraft, Karin | Jaworski, Mariusz | Adamus, Miroslawa | Dobrzynska, Aleksandra | Jeitler, Michael | Jaspers, Jessica | von Scheidt, Christel | Koch, Barbara | Michalsen, Andreas | Steckhan, Nico | Kessler, Christian | Jin, De | Huang, Wen-jing | Pang, Bing | Lian, Feng-Mei | Jong, Miek | Baars, Erik | Glockmann, Anja | Hamre, Harald | Kainuma, Mosaburo | Murakami, Aya | Kubota, Toshio | Kobayashi, Daisuke | Sumoto, Yasuhiro | Furusyo, Norihiro | Ando, Shin-Ichi | Shimazoe, Takao | Kelber, Olaf | Verjee, S. | Gorgus, Eva | Schrenk, Dieter | Kemper, Kathi | Hill, Ellie | Kemper, Kathi | Rao, Nisha | Gascon, Gregg | Mahan, John | Kienle, Gunver | Dietrich, Jörg | Schmoor, Claudia | Huber, Roman | Kim, Weon H. | Han, Dongwoon | Ahmed, Mansoor | He, Luzhu | Hwang, Jung Hye | Kiss, Eva | Vancsik, Tamas | Meggyeshazi, Nora | Kovago, Csaba | Krenacs, Tibor | Klaus, Anne K. | Zerm, Roland | Pranga, Danilo | Ostermann, Thomas | Reif, Marcus | von Laue, Hans Broder | Brinkhaus, Benno | Kröz, Matthias | Klaus, Anne K. | Zerm, Roland | Pranga, Danilo | Recchia, Daniela Rodrigues | Ostermann, Thomas | Reif, Marcus | von Laue, Hans B. | Brinkhaus, Benno | Kröz, Matthias | Klein-Laansma, Christien T. | Jong, Mats | von Hagens, Cornelia | Jansen, Jean P. | van Wietmarschen, Herman | Jong, Miek C. | Ko, Youme | Sun, Seung-Ho | Go, Ho-Yeon | Jeon, Chan-Yong | Song, Yun-Kyung | Ko, Seong-Gyu | Koch, Anna K. | Rabsilber, Sybille | Lauche, Romy | Kümmel, Sherko | Dobos, Gustav | Langhorst, Jost | Cramer, Holger | Koch, Anna K. | Trifunovic-Koenig, Milena | Klose, Petra | Cramer, Holger | Dobos, Gustav | Langhorst, Jost | Koster, Evi | Baars, Erik | Delnoij, Diana | Kroll, Lena | Weiss, Kathrin | Kubo, Ai | Hendlish, Sarah | Altschuler, Andrea | Connolly, Nancy | Avins, Andy | Lauche, Romy | Recchia, Daniela Rodrigues | Cramer, Holger | Wardle, Jon | Lee, David | Sibbritt, David | Adams, Jon | Ostermann, Thomas | Lauche, Romy | Sibbritt, David | Park, Crystal | Mishra, Gita | Adams, Jon | Cramer, Holger | Lechner, Johann | Lee, Inseon | Chae, Younbyoung | Lee, Jisu | Cho, Seung H. | Choi, Yujin | Lee, Jee Y. | Ryu, Han S. | Yoon, Sung S. | Oh, Hye K. | Hyun, Lyun K. | Kim, Jin O. | Yoon, Seong W. | Lee, Ju-Yeon | Shin, Sang-Hoon | Jang, Min | Müller, Indra | Park, So-Hyun Janson | Lestoquoy, Anna S. | Laird, Lance | Negash, Lily | Mitchell, Suzanne | Gardiner, Paula | Li, Xiaofei | Wang, Yunhui | Zhen, Jianhua | Yu, He | Liu, Tiegang | Gu, Xiaohong | Liu, Hui | Ma, Weiguo | Zhang, Chengcheng | Shang, Xuezheng | Bai, Yu | Meng, Fengxian | Liu, Wei | Rooney, Collin | Smith, Amos | Lopes, Shirlene | Demarzo, Marcelo | do Patrocínio Nunes, Maria | Lorenz, Peter | Gründemann, Carsten | Heinrich, Miriam | Garcia-Käufer, Manuel | Grunewald, Franziska | Messerschmidt, Silke | Herrick, Anja | Gruber, Kim | Beckmann, Christiane | Knödler, Matthias | Huber, Roman | Steinborn, Carmen | Stintzing, Florian | Lu, Taoying | Wang, Lixin | Wu, Darong | Luberto, Christina M | Hall, Daniel L. | Chad-Friedman, Emma | Lechner, Suzanne | Park, Elyse R. | Luberto, Christina M. | Park, Elyse | Goodman, Janice | Luer, Sonja | Heri, Matthias | von Ammon, Klaus | Frei-Erb, Martin | Ma, Weiguo | Meng, Fengxian | Maggini, Valentina | Gallo, Eugenia | Landini, Ida | Lapucci, Andrea | Nobili, Stefania | Mini, Enrico | Firenzuoli, Fabio | McDermott, Clare | Lewith, George | Richards, Selwyn | Cox, Diane | Frossell, Sarah | Leydon, Geraldine | Eyles, Caroline | Raphael, Hilly | Rogers, Rachael | Selby, Michelle | Adler, Charlotte | Allam, Jo | Meng, Fengxian | Gu, Wen | Zhang, Chengcheng | Bai, Hua | Zhang, Zhengju | Wang, Dali | Bu, Xiangwei | Zhang, Honghong | Zhang, Jianpeng | Liu, Hui | Mikolasek, Michael | Berg, Jonas | Witt, Claudia | Barth, Jürgen | Miskulin, Ivan | Lalic, Zdenka | Miskulin, Maja | Dumic, Albina | Sebo, Damir | Vcev, Aleksandar | Mohammed, Nasr A. A. | Han, Dongwoon | Ahmed, Mansoor | Choi, Soo Jeung | Im, Hyea Bin | Hwang, Jung Hye | Mukherjee, Anwesha | Kandhare, Amit | Bodhankar, Subhash | Mukherjee, Anwesha | Kandhare, Amit | Thakurdesai, Prasad | Bodhankar, Subhash | Munk, Niki | Evans, Erica | Froman, Amanda | Kline, Matthew | Bair, Matthew J. | Musial, Frauke | Kristoffersen, Agnete E. | Alræk, Terje | Hamre, Harald J. | Stub, Trine | Björkman, Lars | Fønnebø, Vinjar M. | Pang, Bing | Lian, Feng-mei | Ni, Qing | Tong, Xiao-lin | Li, Xin-long | Liu, Wen-ke | Feng, Shuo | Zhao, Xi-yan | Zheng, Yu-jiao | Zhao, Xue-min | Lin, Yi-qun | Pang, Bing | Lian, Feng-mei | Tong, Xiao-lin | Zhao, Tian-yu | Zhao, Xi-Yan | Phd, Hui Che | Zhang, Chen | Pang, Bing | Liu, Feng | Tong, Xiao-lin | Zhao, Lin-hua | Zhao, Xue-min | Ye, Ru | Gu, Cheng-juan | Pang, Bing | Ni, Qing | Tong, Xiao-lin | Lian, Feng-mei | Zhao, Xi-yan | Jin, De | Zhao, Xue-min | Zheng, Yu-jiao | Lin, Yi-qun | Peng, Wenbo | Lauche, Romy | Sibbritt, David | Adams, Jon | Peng, Wenbo | Wardle, Jon | Cramer, Holger | Mishra, Gita | Lauche, Romy | Pohlman, Katherine A. | Mior, Silvano | Funabashi, Martha | De Carvalho, Diana | El-Bayoumi, Mohamed | Haig, Bob | Kelly, Kimbalin | Wade, Darrell J. | O’Beirne, Maeve | Vohra, Sunita | Portalupi, Emanuela | Gobo, Giampietro | Bellavita, Luigi | Guglielmetti, Chiara | Raak, Christa | Teuber, Myriam | Molsberger, Friedrich | von Rath, Ulrich | Reichelt, Ulrike | Schwanebeck, Uta | Zeil, Sabine | Vogelberg, Christian | Veintimilla, Dolores Rodríguez | Vollbracht, Claudia | Mery, Guerrero Tapia | Villavicencio, Marisol Maldonado | Moran, Sandra Herrera | Sachse, Christian | Gündlin, Peter W | Stange, Rainer | Sahebkarkhorasani, Monirsadat | Azizi, Hoda | Schumann, Dania | Lauche, Romy | Sundberg, Tobias | Leach, Matthew J. | Cramer, Holger | Seca, Susana | Greten, Henry | Selliah, Sugir | Shakya, Anu | Han, Dongwoon | Kim, Ha Yun | Choi, Da I. | Im, Hyea B. | Choi, Soo J. | Sherbakova, Anna | Ulrich-Merzenich, Gudrun | Kelber, Olaf | Abdel-Aziz, Heba | Sibinga, Erica | Webb, Lindsey | Ellen, Jonathan | Skrautvol, Kari | Nåden, Dagfinn | Song, Rhayun | Grabowska, Weronika | Osypiuk, Kamila | Diaz, Gloria V. | Bonato, Paolo | Park, Moonkyoung | Hausdorff, Jeffrey | Fox, Michael | Sudarsky, Lewis R. | Tarsy, Daniel | Novakowski, James | Macklin, Eric A. | Wayne, Peter M. | Song, Rhayun | Hwang, Inok | Ahn, Sukhee | Lee, Myung-Ah | Wayne, Peter M. | Sohn, Min K. | Sorokin, Oleg | Steckhan, Nico | Heydeck, Dagmar | Borchert, Astrid | Hohmann, Christoph-Daniel | Kühn, Harmut | Michalsen, Andreas | Kessler, Christian | Steckhan, Nico | Hohmann, Christoph-Daniel | Cramer, Holger | Michalsen, Andreas | Dobos, Gustav | von Scheidt, Christel | Kirschbaum, Clemens | Stalder, Tobias | Stöckigt, Barbara | Teut, Michael | Suhr, Ralf | Sulmann, Daniela | Brinkhaus, Benno | Streeter, Chris | Gerbarg, Patrica | Silveri, Marisa | Brown, Richard | Jensen, John | Stritter, Wiebke | Rutert, Britta | Eggert, Angelika | Längler, Alfred | Seifert, Georg | Holmberg, Christine | Sun, Jin | Deng, Xin | Li, Wen-Yuan | Wen, Bin | Robinson, Nicola | Liu, Jian-Ping | Sung, Hyun K. | Yang, Narae | Go, Ho Y. | Shin, Seon M. | Jung, Hee | Kim, Young J. | Jung, Woo S. | Park, Tae Y. | Suzuki, Kiyoshi | Ito, Toshinori | Uchida, Seiya | Kamohara, Seika | Ono, Naoya | Takamura, Mitsuyuki | Yokochi, Ayumu | Maruyama, Kazuo | Tapia, Patricio | Thabaut, Katarzyna | Brinkhaus, Benno | Stöckigt, Barbara | Thronicke, Anja | Kröz, Matthias | Steele, Megan | Matthes, Harald | Herbstreit, Cornelia | Schad, Friedemann | Tian, Jiaxing | Lian, Fengmei | Yang, Libo | Tong, Xiaolin | Tian, Tian | Zhang, Hewei | Tian, Xia | Wang, CongCong | Chai, Qian Yun | Zhang, Lijuan | Xia, Ruyu | Huang, Na | Fei, Yutong | Liu, Jianpin | Trent, Natalie | Miraglia, Mindy | Dusek, Jeffrey | Pasalis, Edi | Khalsa, Sat B. | Trifunovic-König, Milena | Klose, Petra | Cramer, Holger | Lauche, Romy | Koch, Anna | Dobos, Gustav | Langhorst, Jost | Uebelacker, Lisa | Tremont, Geoffrey | Gillette, Lee | Epstein-Lubow, Gary | Strong, David | Abrantes, Ana | Tyrka, Audrey | Tran, Tanya | Gaudiano, Brandon | Miller, Ivan | Ullmann, Gerhild | Ullmann, Gerhild | Li, Yuhua | Vaidya, Sujata | Marathe, Vinod | Vale, Ana C. | Motta, Jacquelyne | Donadão, Fabíola | Valente, Angela C. | Valente, Luana C. Carvalho | Ghelman, Ricardo | Vesovic, Dusan | Jevdic, Dragan | Jevdic, Aleksandar | Jevdic, Katarina | Djacic, Mihael | Letic, Dragica | Bozic, Drago | Markovic, Marija | Dunjic, Slobodan | Vesovic, Dusan | Jevdic, Dragan | Jevdic, Aleksandar | Jevdic, Katarina | Djacic, Mihael | Letic, Dragica | Bozic, Drago | Markovic, Marija | Ruscuklic, Gordana | Baksa, Dezire | Dunjic, Slobodan | Vesovic, Dusan | Jevdic, Dragan | Jevdic, Aleksandar | Jevdic, Katarina | Djacic, Mihael | Letic, Dragica | Bozic, Drago | Markovic, Marija | Ruscuklic, Gordana | Baksa, Dezire | Dunjic, Slobodan | Vesovic, Dusan | Jevdic, Dragan | Jevdic, Aleksandar | Jevdic, Katarina | Djacic, Mihael | Letic, Dragica | Bozic, Drago | Markovic, Marija | Ruscuklic, Gordana | Baksa, Dezire | Dunjic, Slobodan | Vesovic, Dusan | Jevdic, Dragan | Jevdic, Aleksandar | Jevdic, Katarina | Djacic, Mihael | Letic, Dragica | Bozic, Drago | Markovic, Marija | Vrca, Kenan | Dunjic, Slobodan | Vincent, Ann | Wahner-Roedler, Dietlind | Whipple, Mary | Vogelius, Maria M. | Vollbracht, Claudia | Friesecke, Iris | Gündling, Peter W. | Wahner-Roedler, Dietlind | Mahapatra, Saswati | Hynes, Rebecca | Van Rooy, Kimberly | Looker, Sherry | Ghosh, Aditya | Bauer, Brent | Cutshall, Susanne | Walach, Harald | Flores, Ana Borges | Walach, Harald | Ofner, Michael | Kastner, Andreas | Schwarzl, Gerhard | Schwameder, Hermann | Alexander, Nathalie | Strutzenberger, Gerda | Wang, Jie | Lu, Yan | Gu, Wen | Zhang, Chengcheng | Bu, Xianwei | Zhang, Honghong | Zhang, Jianping | He, Yuxi | Zhang, Xiaoxu | Meng, Fengxian | Wang, Shang | Yu, He | Shi, Jinfeng | Hao, Yu | Liu, Tiegang | Wu, Jun | Qiu, Zeji | Gu, Xiaohong | Wang, Yuh-Hai | Lou, Chi-Jung | Watts, Sam | Wayne, Peter | Osypiuk, Kamila | Vergara-Diaz, Gloria | Bonato, Paolo | Gow, Brian | Hausdorff, Jeffrey | Miranda, Jose | Sudarsky, Lewis | Tarsy, Daniel | Fox, Michael | Macklin, Eric | Wode, Kathrin | Bergqvist, Jenny | Bernhardsson, Britt-Marie | Nordberg, Johanna Hök | Kienle, Gunver | Sharp, Lena | Henriksson, Roger | Woo, Yeonju | Hyun, Min K. | Wu, Hao | Wang, Tian-Fang | Zhao, Yan | Wei, Yu | Tian, Lei | He, Lei | Wang, Xue | Wu, Ruohan | Feng, Shuo | Han, Mei | Caldwell, Patrina H. Y. | Liu, Shigang | Zhang, Jing | Liu, Jianping | Xia, Ruyu | Chai, Qianyun | Fei, Yutong | Guo, Zhongning | Wang, Congcong | Liu, Zhijun | Li, Xun | Zhang, Ying | Liu, Jianping | Yang, I. J. | Lincha, V. Ruberio | Ahn, S. H. | Lee, D. U. | Shin, H. M. | Yang, Lu | Sibbritt, David | Peng, Wenbo | Adams, Jon | Yang, N. | Sung, H. | Shin, S. M. | Go, H. Y. | Jung, H. | Kim, Y. | Park, T. Y. | Yap, Angela | Kwan, Yu H. | Tan, Chuen S. | Ibrahim, Syed | Ang, Seng B. | Yayi, Alfred | Han, Dongwoon | Im, Hyea Bin | Hwang, Jung Hye | Choi, Soo Jeung | Yoo, Jeong E. | Yoo, Ho R. | Jang, Sae B. | Lee, Hye L. | Youssef, Ala’a | Ezzat, Shahira | Motaal, Amira Abdel | El-Askary, Hesham | Yu, Xiaotong | Cui, Yashan | Zhang, Ying | Lian, Fengmei | Yun, Younghee | Ko, Youme | Ahn, Jin-Hyang | Jang, Bo-Hyung | Kim, Kyu-Seok | Ko, Seong-Gyu | Choi, Inhwa | Zerm, Roland | Glinz, Augustina | Pranga, Danilo | Berger, Bettina | ten Brink, Fadime | Reif, Marcus | Büssing, Arnd | Gutenbrunner, Christoph | Kröz, Matthias | Zerm, Roland | Helbrecht, Bert | Pranga, Danilo | Brinkhaus, Benno | Michalsen, Andreas | Kröz, Matthias | Zhang, Honghong | Fang, Tiesheng | Wang, Jie | Zhang, Chengcheng | He, Yuxi | Zhang, Xiaoxu | Zhang, Zhengju | Wang, Dali | Meng, Fengxion | Zhang, Jianping | Zhang, Chengcheng | Bai, Hua | Shen, Zhiming | Ma, Weiguo | Liu, Hui | Bai, Yu | Shang, Xuezheng | Meng, Fengxian | Zhang, Ruixin | Wu, Fan | Li, Ming | Xuan, Xinyun | Shen, Xueyong | Ren, Ke | Berman, Brian | Zhen, Jianhua | Li, Xiaofei | Gu, Xiaohong | Yu, He | Zheng, Zian | Wan, Yuxiang | Wang, Yunhui | Ma, Xueyan | Dong, Fei | Liu, Tiegang | Zhen, Jianhua | Li, Xiaofei | Gu, Xiaohong | Yu, He | Zheng, Zian | Wan, Yuxiang | Wang, Yunhui | Ma, Xueyan | Dong, Fei | Liu, Tiegang | Zick, Suzie | Harris, Richard | Bae, Go E. | Kwon, Jung N. | Lee, Hye Y. | Nam, Jong K. | Lee, Sang D. | Lee, Dong H. | Han, Ji Y. | Yun, Young J. | Lee, Ji H. | Park, Hye L. | Park, Seong H. | Bocci, Chiara | Ivaldi, Giovanni B. | Vietti, Ilaria | Meaglia, Ilaria | Guffi, Marta | Ruggiero, Rubina | Gualea, Marita | Longa, Emanuela | Bonucci, Massimo | Croke, Sarah | Rodriguez, Lourdes Diaz | Caracuel-Martínez, Juan C. | Fajardo-Rodríguez, Manuel F. | Ariza-García, Angélica | la Fuente, Francisca García-De | Arroyo-Morales, Manuel | Estrems, Maria S. | Gómez, Vicente G. | Estrems, Maria S. | Sabater, Mónica Valero | Ferreri, Rosaria | Bernardini, Simonetta | Pulcri, Roberto | Cracolici, Franco | Rinaldi, Massimo | Porciani, Claudio | Firenzuoli, Fabio | Baccetti, Sonia | Di Stefano, Mariella | Monechi, Maria V. | Gallo, Eugenia | Maggini, Valentina | Gori, Luigi | Rossi, Elio | Fisher, Peter | Hughes, John | Mendoza, Ariadna | MacPherson, Hugh | Witt, Claudia | Filshie, Jacqueline | Lewith, George | Di Francesco, Antonia | Bernardini, Alberto | Messe, Monica | Primitivo, Vincenzo | Iasella, Piera A. | Ghelman, Ricardo | Taminato, Monica | Alcantara, Jaqueline Do Carmo | De Oliveira, Katia R. | Rodrigues, Debora C. De Azevedo | Mumme, Juliana R. Campana | Sunakozawa, Olga K. Matsumoto | Filho, Vicente Odone | Seifert, Georg | Goldenberg, Joshua | Day, Andrew | Sasagawa, Masa | Ward, Lesley | Cooley, Kieran | Gunnarsdottir, Thora | Hjaltadottir, Ingibjorg | Hajimonfarednejad, Mahdie
doi:10.1186/s12906-017-1783-3
PMCID: PMC5498867
3.  A Comparison of the Characteristics of Acupuncture- and Non–Acupuncture-Preferred Consumers: A Secondary Analysis of NHIS 2012 Data 
Abstract
Objectives: To determine whether acupuncture use, sociodemographic characteristics, and existing health conditions differ between acupuncture-preferred consumers (i.e., those who deem acupuncture to be one of the three most important complementary and alternative medicine [CAM] modalities used) and non–acupuncture-preferred consumers who used acupuncture in the past 12 months
Methods: This is a secondary analysis of the National Health Interview Survey Sample Adult File and Adult Alternative Medicine datasets collected by the Centers for Disease Control and Prevention during 2012. The sample was drawn from the noninstitutionalized civilian population of the United States. The datasets yielded 34,525 respondents aged 18 years and older. Measures included in the analysis were acupuncture use in the past 12 months, sociodemographic characteristics, and existing health conditions. Analyses were performed by using Stata software, version 9.0 (Stata Corp., College Station, TX).
Results: Of the 10,158 adults who responded to the question regarding the “three most important” CAM modalities used, 572 (5.6%) had used acupuncture in the past 12 months. Of these, 456 (79.7%) chose acupuncture as one of the top three CAM modalities most important to their health. Acupuncture-preferred consumers reported significantly more visits to acupuncturists (7.46 versus 3.99 visits; p < 0.001), as well as higher out-of-pocket costs ($342.8 versus $246.4; p < 0.001), compared with non–acupuncture-preferred consumers. The logistic regression model revealed that with every additional CAM modality used, the likelihood of deeming acupuncture as one of the three CAM modalities most important to one's health decreased by 39% (odds ratio, 0.61; 95% confidence interval, 0.52–0.71; p < 0.001). Health conditions were not statistically significant predictors.
Conclusions: A consumer's preference for acupuncture appeared not to be driven by health conditions but rather was related to sociodemographic factors. This suggests that health education regarding acupuncture may need to be tailored to certain consumer groups, such as those residing in the South, and could provide more information on the comparative effectiveness of acupuncture for various health conditions.
doi:10.1089/acm.2015.0244
PMCID: PMC4827296  PMID: 27003512
4.  Predicting adherence to acupuncture appointments for low back pain: a prospective observational study 
Background
Acupuncture is a popular form of complementary and alternative medicine (CAM), but it is not clear why patients do (or do not) follow acupuncturists’ treatment recommendations. This study aimed to investigate theoretically-derived predictors of adherence to acupuncture.
Methods
In a prospective study, adults receiving acupuncture for low back pain completed validated questionnaires at baseline, 2 weeks, 3 months, and 6 months. Patients and acupuncturists reported attendance. Logistic regression tested whether illness perceptions, treatment beliefs, and treatment appraisals measured at 2 weeks predicted attendance at all recommended acupuncture appointments.
Results
Three hundred twenty-four people participated (aged 18–89 years, M = 55.9, SD = 14.4; 70% female). 165 (51%) attended all recommended acupuncture appointments. Adherence was predicted by appraising acupuncture as credible, appraising the acupuncturist positively, appraising practicalities of treatment positively, and holding pro-acupuncture treatment beliefs. A multivariable logistic regression model including demographic, clinical, and psychological predictors, fit the data well (χ 2 (21) = 52.723, p < .001), explained 20% of the variance, and correctly classified 65.4% of participants as adherent/non-adherent.
Conclusions
The results partially support the dynamic extended common-sense model for CAM use. As hypothesised, attending all recommended acupuncture appointments was predicted by illness perceptions, treatment beliefs, and treatment appraisals. However, experiencing early changes in symptoms did not predict attendance. Acupuncturists could make small changes to consultations and service organisation to encourage attendance at recommended appointments and thus potentially improve patient outcomes.
doi:10.1186/s12906-016-1499-9
PMCID: PMC5209924  PMID: 28049527
Acupuncture; Adherence; Back pain; Health knowledge, Attitudes, Practice; Illness perceptions; Treatment beliefs
5.  Assessing knowledge about acupuncture: A survey of people with back pain in the UK 
Highlights
•202 adults with back pain completed a survey assessing knowledge of acupuncture.•More than 80% correctly answered questions on efficacy, side-effects, and styles.•Fewer people knew about public sector provision, regulation, or electro-acupuncture.•Addressing these knowledge gaps would improve public awareness of acupuncture.
Objectives
Despite the prevalence of acupuncture treatment in the UK, and the increasing evidence of safety and effectiveness, the information presented to patients by practitioners frequently contains inaccuracies. As knowledge of treatment affects both patient decision-making and treatment outcomes, this study aimed to establish what is known about acupuncture in a sample of people who had, and had not, previously experienced acupuncture.
Design
A 15-item questionnaire was constructed to assess knowledge of acupuncture.
Setting
Online survey of people with a history of back pain.
Results
202 participants completed the questionnaire. 66.8% of the sample was female and 33.2% male, with a mean age of 35 years (range 18–74 years). 87.6% had back pain in the past six months, 44.1% currently. 21.8% had previously received acupuncture, and 69.8% had previously read or heard information about acupuncture. On average participants answered 11.03 of 15 questions about acupuncture correctly (SD = 2.64). Items relating to common concerns about acupuncture, acupuncture efficacy, and types of acupuncture were correctly answered by ≥80% of participants. Participants possessed less knowledge of accessibility, Government legislation, and methods of administration.
Conclusions
The study identified key gaps in knowledge about acupuncture among patients. In particular, many participants were unaware that acupuncture is available from the UK National Health Service and that acupuncturists are not subject to statutory regulation in the UK. These knowledge gaps should be addressed in order to increase people’s understanding of and access to acupuncture.
doi:10.1016/j.ctim.2016.10.005
PMCID: PMC5139617  PMID: 27912942
Acupuncture; Health knowledge; Attitudes; Practice; Statutory regulation; Survey; Back pain
6.  The impact of patient-reported outcome measures in clinical practice for pain: a systematic review 
Quality of Life Research  2016;26(2):245-257.
Purpose
Patient-reported outcome measures (PROMs) have increasingly been incorporated into clinical practice. Research suggests that PROMs could be viewed as active components of complex interventions and may affect the process and outcome of care. This systematic review examines PROMs in the context of treatment for non-malignant pain.
Methods
An electronic search on: MEDLINE, EMBASE, PsycINFO, PsycARTICLES, Cochrane Library and Web of Science identified relevant papers (February 2015). The inclusion criteria were: focused on implementing PROMs into clinical practice, adults, and primary data studies. Critical interpretive synthesis was used to synthesise qualitative and quantitative findings into a theoretical argument.
Results
Thirteen eligible studies were identified. Synthesis suggested that PROMs may be included in the initial consultation to assess patients and for shared decision-making regarding patient care. During the course of treatment, PROMs can be used to track progress, evaluate treatment, and change the course of care; using PROMs may also influence the therapeutic relationship. Post-treatment, using PROMs might directly influence other outcomes such as pain and patient satisfaction. However, although studies have investigated these areas, evidence is weak and inconclusive.
Conclusion
Due to the poor quality, lack of generalisability and heterogeneity of these studies, it is not possible to provide a comprehensive understanding of how PROMs may impact clinical treatment of non-malignant pain. The literature suggests that PROMs enable pain assessment, decision-making, the therapeutic relationship, evaluation of treatment and may influence outcomes. Further research is needed to provide better evidence as to whether PROMs do indeed have any effects on these domains.
doi:10.1007/s11136-016-1449-5
PMCID: PMC5288411  PMID: 27815820
Patient-reported outcome measures; PROMs; Clinical practice; Pain
7.  Altruism, personal benefit, and anxieties: a phenomenological study of healthy volunteers' experiences in a placebo‐controlled trial of duloxetine 
Human Psychopharmacology  2016;31(4):332-340.
Objective
The objective of this study was to develop an in‐depth understanding of healthy volunteers' experiences of mental health trials.
Methods
A qualitative study was nested within a healthy volunteer placebo‐controlled trial of duloxetine, a psychotropic drug used for treating patients with major depression and generalized anxiety disorder. Eight participants were interviewed, and data were analyzed using interpretative phenomenological analysis.
Results
Interviewees described volunteering for the trial because they were interested in research, wanted the monetary incentive, wanted to help researchers, and wanted to be part of something. On entering the trial, participants considered the possible risks and described feeling anxious, excited, and determined; they had some clear expectations and some loosely held hopes about what would happen. During the trial, participants were curious about whether they were taking duloxetine or placebo, self‐monitored their bodies' reactions, and guessed which treatment they received. On being un‐blinded to treatment allocation after completing the trial, some participants' guesses were confirmed, but others were surprised, and a few were disappointed.
Conclusions
Small changes to advertising/consent materials to reflect volunteers' motivations could improve recruitment rates to similar trials; “active” placebos might be particularly useful for maintaining blinding in healthy volunteer trials; and sensitive procedures are needed for un‐blinding participants to treatment allocation. © 2016 The Authors. Human Psychopharmacology: Clinical and Experimental published by John Wiley & Sons, Ltd.
doi:10.1002/hup.2543
PMCID: PMC4988510  PMID: 27378326
placebo effect; qualitative research; healthy volunteers; psychopharmacology; mental health
8.  Using psychological theory and qualitative methods to develop a new evidence-based website about acupuncture for back pain 
Introduction
Potential acupuncture patients seek out information about acupuncture from various sources including websites, many of which are unreliable. We aimed to create an informative, scientifically accurate and engaging website to educate patients about acupuncture for back pain and modify their beliefs in a way that might enhance its clinical effects.
Methods
We used psychological theory and techniques to design an evidence-based website, incorporating multimedia elements. We conducted qualitative “think aloud” audio-recorded interviews to elicit user views of the website. A convenience sample of ten participants (4 male; aged 21–64 years from the local community) looked at the website in the presence of a researcher and spoke their thoughts out loud. Comments were categorised by topic.
Results
The website comprises 11 main pages and addresses key topics of interest to potential acupuncture patients, including beneficial and adverse effects, mechanisms of action, safety, practicalities, and patients’ experiences of acupuncture. It provides information through text, evidence summaries and audio-clips of four patients’ stories and two acupuncturists’ descriptions of their practice, and three short films. Evidence from the think aloud study was used to identify opportunities to make the website more informative, engaging, and user-friendly.
Conclusions
Using a combination of psychological theory and qualitative interviews enabled us to produce a user-friendly, evidence-based website that is likely to change patients’ beliefs about acupuncture for back pain. Before using the website in clinical settings it is necessary to test its effects on key outcomes including patients’ beliefs and capacity for making informed choices about acupuncture.
doi:10.1016/j.eujim.2016.05.006
PMCID: PMC5078494  PMID: 27807469
Acupuncture; Back pain; Patient education; Digital intervention; Internet; Qualitative research
9.  Standardised Chinese herbal treatment delivered by GPs compared with individualised treatment administered by practitioners of Chinese herbal medicine for women with recurrent urinary tract infections (RUTI): study protocol for a randomised controlled trial 
Trials  2016;17:358.
Background
In the UK, urinary tract infections (UTIs) are the most common bacterial infection presented by women in primary care. Recurrent urinary tract infections (RUTIs) are defined as three episodes of UTI in the last 12 months, or two episodes in the last 6 months. Between 20 and 30 % of women who have had one episode of UTI will have an RUTI, and approximately 25 % of these will develop subsequent recurrent episodes. RUTIs can have a significant negative effect on the quality of life, and have a high impact on health care costs as a result of outpatient visits, diagnostic tests and prescriptions. Chinese herbal medicine (CHM) has a recorded history of treatments for the symptoms of UTIs for more than 2000 years. More recent clinical research in China has provided some preliminary evidence that CHM can alleviate the symptoms of UTIs and reduce the rate of recurrence, but more rigorous investigation is required.
Methods/design
The RUTI trial is a double-blind, randomised, placebo-controlled, feasibility trial. A total of 80 women will be randomised to ‘individualised’ herbs prescribed by a Chinese herbal practitioner or to ‘standardised’ herbs provided by primary care clinicians. Both arms will have herbs for prevention of UTIs and treatment of acute episodes. Treatment duration is for 16 weeks.
The primary outcomes are the number of episodes of recurrent UTIs during the trial period and in the 6 months of follow-up, and the number of days of symptoms rated moderately bad or worse based on patient diaries. Secondary outcomes will assess participant expectations and beliefs, adherence to the treatment, adverse events and health economics and provide quantitative and qualitative assessments of the impact of recurrent infections on the lives of women.
Discussion
The RUTI trial is the first instance of CHM delivered as a clinical trial of an investigatory medicinal product in the UK. This study provides important information regarding the feasibility and acceptability of researching and using CHM in Primary care. Once completed, it will provide provisional estimates of the variance of change in continuous outcomes to inform a power calculation for a larger, more definitive trial.
Trial registration
EudraCT, 2013-004657-24. Registered on 5 September 2014. 
Electronic supplementary material
The online version of this article (doi:10.1186/s13063-016-1471-5) contains supplementary material, which is available to authorized users.
doi:10.1186/s13063-016-1471-5
PMCID: PMC4962349  PMID: 27460108
Urinary tract infection; Chinese herbal medicine; Primary care; feasibility
10.  Informing Patients About Placebo Effects: Using Evidence, Theory, and Qualitative Methods to Develop a New Website 
JMIR Research Protocols  2016;5(2):e106.
Background
According to established ethical principles and guidelines, patients in clinical trials should be fully informed about the interventions they might receive. However, information about placebo-controlled clinical trials typically focuses on the new intervention being tested and provides limited and at times misleading information about placebos.
Objective
We aimed to create an informative, scientifically accurate, and engaging website that could be used to improve understanding of placebo effects among patients who might be considering taking part in a placebo-controlled clinical trial.
Methods
Our approach drew on evidence-, theory-, and person-based intervention development. We used existing evidence and theory about placebo effects to develop content that was scientifically accurate. We used existing evidence and theory of health behavior to ensure our content would be communicated persuasively, to an audience who might currently be ignorant or misinformed about placebo effects. A qualitative ‘think aloud’ study was conducted in which 10 participants viewed prototypes of the website and spoke their thoughts out loud in the presence of a researcher.
Results
The website provides information about 10 key topics and uses text, evidence summaries, quizzes, audio clips of patients’ stories, and a short film to convey key messages. Comments from participants in the think aloud study highlighted occasional misunderstandings and off-putting/confusing features. These were addressed by modifying elements of content, style, and navigation to improve participants’ experiences of using the website.
Conclusions
We have developed an evidence-based website that incorporates theory-based techniques to inform members of the public about placebos and placebo effects. Qualitative research ensured our website was engaging and convincing for our target audience who might not perceive a need to learn about placebo effects. Before using the website in clinical trials, it is necessary to test its effects on key outcomes including patients’ knowledge and capacity for making informed choices about placebos.
doi:10.2196/resprot.5627
PMCID: PMC4920960  PMID: 27288271
placebo effect; informed consent; qualitative research; health attitudes; consumer health information
11.  Non-specific mechanisms in orthodox and CAM management of low back pain (MOCAM): theoretical framework and protocol for a prospective cohort study 
BMJ Open  2016;6(5):e012209.
Introduction
Components other than the active ingredients of treatment can have substantial effects on pain and disability. Such ‘non-specific’ components include: the therapeutic relationship, the healthcare environment, incidental treatment characteristics, patients’ beliefs and practitioners’ beliefs. This study aims to: identify the most powerful non-specific treatment components for low back pain (LBP), compare their effects on patient outcomes across orthodox (physiotherapy) and complementary (osteopathy, acupuncture) therapies, test which theoretically derived mechanistic pathways explain the effects of non-specific components and identify similarities and differences between the therapies on patient–practitioner interactions.
Methods and analysis
This research comprises a prospective questionnaire-based cohort study with a nested mixed-methods study. A minimum of 144 practitioners will be recruited from public and private sector settings (48 physiotherapists, 48 osteopaths and 48 acupuncturists). Practitioners are asked to recruit 10–30 patients each, by handing out invitation packs to adult patients presenting with a new episode of LBP. The planned multilevel analysis requires a final sample size of 690 patients to detect correlations between predictors, hypothesised mediators and the primary outcome (self-reported back-related disability on the Roland-Morris Disability Questionnaire). Practitioners and patients complete questionnaires measuring non-specific treatment components, mediators and outcomes at: baseline (time 1: after the first consultation for a new episode of LBP), during treatment (time 2: 2 weeks post-baseline) and short-term outcome (time 3: 3 months post-baseline). A randomly selected subsample of participants in the questionnaire study will be invited to take part in a nested mixed-methods study of patient–practitioner interactions. In the nested study, 63 consultations (21/therapy) will be audio-recorded and analysed quantitatively and qualitatively, to identify communication practices associated with patient outcomes.
Ethics and dissemination
The protocol is approved by the host institution's ethics committee and the NHS Health Research Authority Research Ethics Committee. Results will be disseminated via peer-reviewed journal articles, conferences and a stakeholder workshop.
doi:10.1136/bmjopen-2016-012209
PMCID: PMC4885467  PMID: 27235304
COMPLEMENTARY MEDICINE; PAIN MANAGEMENT; PRIMARY CARE; RHEUMATOLOGY
12.  Assessing Cognitive behavioural Therapy in Irritable Bowel (ACTIB): protocol for a randomised controlled trial of clinical-effectiveness and cost-effectiveness of therapist delivered cognitive behavioural therapy and web-based self-management in irritable bowel syndrome in adults 
BMJ Open  2015;5(7):e008622.
Introduction
Irritable bowel syndrome (IBS) affects 10–22% of the UK population, with England's annual National Health Service (NHS) costs amounting to more than £200 million. Abdominal pain, bloating and altered bowel habit affect quality of life, social functioning and time off work. Current treatment relies on a positive diagnosis, reassurance, lifestyle advice and drug therapies, but many people suffer ongoing symptoms. Cognitive behaviour therapy (CBT) and self-management can be helpful, but availability is limited.
Methods and analysis
To determine the clinical- and cost-effectiveness of therapist delivered cognitive behavioural therapy (TCBT) and web-based CBT self-management (WBCBT) in IBS, 495 participants with refractory IBS will be randomised to TCBT plus treatment as usual (TAU); WBCBT plus TAU; or TAU alone. The two CBT programmes have similar content. However, TCBT consists of six, 60 min telephone CBT sessions with a therapist over 9 weeks, at home, and two ‘booster’ 1 hour follow-up phone calls at 4 and 8 months (8 h therapist contact time). WBCBT consists of access to a previously developed and piloted WBCBT management programme (Regul8) and three 30 min therapist telephone sessions over 9 weeks, at home, and two ‘booster’ 30 min follow-up phone calls at 4 and 8 months (2½ h therapist contact time). Clinical effectiveness will be assessed by examining the difference between arms in the IBS Symptom Severity Score (IBS SSS) and Work and Social Adjustment Scale (WASAS) at 12 months from randomisation. Cost-effectiveness will combine measures of resource use with the IBS SSS at 12 months and quality-adjusted life years.
Ethics and dissemination
This trial has full ethical approval. It will be disseminated via peer reviewed publications and conference presentations. The results will enable clinicians, patients and health service planners to make informed decisions regarding the management of IBS with CBT.
Trial registration number
ISRCTN44427879.
doi:10.1136/bmjopen-2015-008622
PMCID: PMC4513538  PMID: 26179651
PRIMARY CARE
13.  How women manage recurrent urinary tract infections: an analysis of postings on a popular web forum 
BMC Family Practice  2014;15:162.
Background
Recurrent urinary tract infections (RUTIs) are commonly presented by women in primary care. In order to explore the poorly described experience of women with RUTIs a qualitative study was conducted that analysed data from a publically accessible internet-based self-help forum.
Methods
Qualitative Description was used to analyse the text with an emphasis on using the naturalistic language of the informants to portray their perceptions and experiences of RUTIs. Individual codes were identified inductively and grouped according to common ideas into related categories, before being incorporated into five main themes.
Results
Women of diverse ages and geographical location contributed to the website. Themes were identified that vividly explored the atypical symptomatology of RUTIs, the serious impact it had on many aspects of women’s lives, different attitudes to treatments options such as antibiotics, the use of unorthodox approaches such as complementary and alternative medicines (CAM) and contrasting experiences of medical practitioners.
Conclusion
A web-based analysis can vividly capture the views of a diverse population. RUTIs can have a disabling effect on women’s health, their intimate and social relationships, self-esteem, and capacity for work. Further research is required to clarify the wider relevance of the qualitative themes identified, to identify key elements of good practice, and to provide a more rigorous assessment of CAM interventions.
doi:10.1186/1471-2296-15-162
PMCID: PMC4262982  PMID: 25260870
14.  When and Why Placebo-Prescribing Is Acceptable and Unacceptable: A Focus Group Study of Patients' Views 
PLoS ONE  2014;9(7):e101822.
Background
Surveys of doctors suggest that they use placebos and placebo effects clinically to help patients. However, patients' views are not well-understood. We aimed to identify when and why placebo-prescribing in primary care might be acceptable and unacceptable to patients.
Methods
A purposive diverse sample of 58 English-speaking adults (18 men; aged 19–80 years) participated in 11 focus groups. Vignettes describing doctors prescribing placebos in primary care were used to initiate discussions. Data were analyzed inductively.
Results
Participants discussed diverse harms and benefits of placebo-prescribing for individual patients, carers, healthcare providers, and society. Two perspectives on placebo-prescribing were identified. First, the “consequentialist” perspective focused on the potential for beneficial outcomes of placebo-prescribing. Here, some participants thought placebos are beneficial and should be used clinically; they often invoked the power of the mind or mind-body interactions. Others saw placebos as ineffective and therefore a waste of time and money. Second, the “respecting autonomy” perspective emphasized the harms caused by the deceptive processes thought necessary for placebo-prescribing. Here, participants judged placebo-prescribing unacceptable because placebo-prescribers deceive patients, thus a doctor who prescribes placebos cannot be trusted and patients' autonomy is compromised. They also saw placebo-responders as gullible, which deterred them from trying placebos themselves. Overall, the word “placebo” was often thought to imply “ineffective”; some participants suggested alternative carefully chosen language that could enable doctors to prescribe placebos without directly lying to patients.
Conclusions
Negative views of placebos derive from beliefs that placebos do not work and/or that they require deception by the doctor. Positive views are pragmatic in that if placebos work then any associated processes (e.g. mechanisms, deception) are deemed unimportant. Public education about placebos and their effects is warranted and research to identify optimal ways of harnessing placebo effects in clinical practice is needed.
doi:10.1371/journal.pone.0101822
PMCID: PMC4089920  PMID: 25006673
15.  Mixed Methods in CAM Research: A Systematic Review of Studies Published in 2012 
Background. Mixed methods research uses qualitative and quantitative methods together in a single study or a series of related studies. Objectives. To review the prevalence and quality of mixed methods studies in complementary medicine. Methods. All studies published in the top 10 integrative and complementary medicine journals in 2012 were screened. The quality of mixed methods studies was appraised using a published tool designed for mixed methods studies. Results. 4% of papers (95 out of 2349) reported mixed methods studies, 80 of which met criteria for applying the quality appraisal tool. The most popular formal mixed methods design was triangulation (used by 74% of studies), followed by embedded (14%), sequential explanatory (8%), and finally sequential exploratory (5%). Quantitative components were generally of higher quality than qualitative components; when quantitative components involved RCTs they were of particularly high quality. Common methodological limitations were identified. Most strikingly, none of the 80 mixed methods studies addressed the philosophical tensions inherent in mixing qualitative and quantitative methods. Conclusions and Implications. The quality of mixed methods research in CAM can be enhanced by addressing philosophical tensions and improving reporting of (a) analytic methods and reflexivity (in qualitative components) and (b) sampling and recruitment-related procedures (in all components).
doi:10.1155/2013/187365
PMCID: PMC3881584  PMID: 24454489
16.  Exploring Patients' Views of a Cognitive Behavioral Therapy-Based Website for the Self-Management of Irritable Bowel Syndrome Symptoms 
Background
Cognitive behavioral therapy (CBT) has been shown to have positive effects on the management of irritable bowel syndrome (IBS) symptoms. A factorial pilot randomized placebo-controlled trial (called MIBS) tested the potential effectiveness of a self-management CBT-based website alongside two medications: methylcellulose and mebeverine, and a placebo. The results showed no significant differences in quality of life or symptom severity measures, but enablement and participant’s global assessment of relief was higher in the website groups.
Objective
To conduct a qualitative study nested within this trial, in order to explore patients’ views and experiences of using the CBT-based website to facilitate self-management of IBS.
Methods
Semistructured interviews were carried out with patients who had used the website with one session of nurse support (n=16) or the website alone (n=15) while participating in the MIBS trial. An inductive thematic analysis was conducted.
Results
We identified three types of engagement with the CBT-based website. One group of participants, mostly in the website-only condition, had limited or no engagement with the website. One group engaged with the content and advice on practical lifestyle changes. The final group of participants engaged with the content and advice on psychological aspects related to IBS. Similarities and differences between these three groups are explored.
Conclusions
Teaching self-management techniques through a Web intervention was received positively by most of the participants. Concepts linked to cognitive aspects of CBT appeared to be harder for participants to engage with. Participants who received nurse support rated the cognitive aspects more positively, suggesting that some therapy support alongside the website should be considered. However, the Web format was preferred by some who favored anonymity as well as those who appreciated the accessibility and ease of use of this type of management. Suggestions on how to encourage engagement with Web interventions are discussed.
doi:10.2196/jmir.2672
PMCID: PMC3785978  PMID: 24001787
irritable bowel syndrome; cognitive behaviour therapy; Internet; primary care; qualitative research
17.  Participants’ Experiences of Being Debriefed to Placebo Allocation in a Clinical Trial 
Qualitative health research  2012;22(8):1138-1149.
Participants in placebo-controlled clinical trials give informed consent to be randomized to verum or placebo. However, researchers rarely tell participants which treatment they actually received. We interviewed four participants in a trial of acupuncture for irritable bowel syndrome, before, during, and after they received a course of placebo treatments over six weeks. During the final interview, we informed participants that they had received a course of placebo treatments. We used an idiographic phenomenological approach based on the Sheffield School to describe each participant’s experiences of being blinded to and then debriefed to placebo allocation. Our participants’ experiences of blinding and debriefing were embodied, related to their goals in undertaking the study, and social (e.g., embedded in trusting and valued relationships with acupuncturists). We suggest ways in which debriefing to placebo allocation can be managed sensitively to facilitate positive outcomes for participants.
doi:10.1177/1049732312448544
PMCID: PMC3645341  PMID: 22673094
ethics/moral perspectives; Giorgi; health care; alternative and complementary; interviews; semistructured; phenomenology; research participation; research; quantitative
18.  Identifying patients’ beliefs about treatments for chronic low back pain in primary care: a focus group study 
The British Journal of General Practice  2013;63(612):e490-e498.
Background
Current evidence-based guidelines for low back pain (LBP) recommend multiple diverse approaches to treatment and suggest considering patient preferences when formulating a treatment plan.
Aim
To explore patient preferences and to identify patients’ beliefs about LBP treatments.
Design and setting
Qualitative study using focus groups in primary care in South-West England.
Method
Thirteen focus groups were organised with a purposive sample of 75 adults with LBP. Group discussions of LBP treatments were facilitated, audiorecorded, and the verbatim transcripts thematically analysed.
Results
Eight themes were identified, four related to treatment beliefs and four to seeking treatment. Treatment beliefs comprised participants’ expectations and appraisals of specific treatments, which were underpinned by four distinct dimensions: credibility, effectiveness, concerns and individual fit. Treatment beliefs were expressed in the broader context of treatment seeking: participants’ primary concern was to obtain a clear explanation of their LBP which went beyond a diagnostic label and provided an understanding of the cause(s) of their LBP. They described engaging in self-management activities and claimed they were willing to try anything if it might help them. Participants wanted an empathic and expert practitioner who could deliver a suitable treatment (or refer them on to someone else) and help them to negotiate the challenges of the healthcare system.
Conclusion
These findings highlight the importance of helping patients develop coherent illness representations about their LBP before trying to engage them in treatment-decisions, uptake, or adherence. Addressing patients’ illness and treatment perceptions in clinical practice could improve shared decision making and patient outcomes.
doi:10.3399/bjgp13X669211
PMCID: PMC3693806  PMID: 23834886
back pain; health knowledge, attitudes, practice; illness behaviour; patient preference; primary health care; qualitative research
19.  Patients’ preconceptions of acupuncture: a qualitative study exploring the decisions patients make when seeking acupuncture 
Background
Like any other form of healthcare, acupuncture takes place in a particular context which can enhance or diminish treatment outcomes (i.e. can produce contextual effects). Patients’ expectations of acupuncture might be an important component of contextual effects, but we know relatively little about the origins and nature of patients’ expectations or wider preconceptions about acupuncture. Our aim was to identify the processes the underpin patients’ decisions to try acupuncture and thus begin to tease out the origins and nature of patients’ preconceptions.
Methods
One-off semi-structured interviews were conducted with a purposive, varied sample of 35 adults who had tried acupuncture for various conditions. Interviews explored people’s experiences of acupuncture treatment and techniques from framework and inductive thematic analysis were used to relate the data to the research question.
Results
We identified four distinct processes within participants’ accounts of deciding to try acupuncture: establishing a need for treatment, establishing a need for a new treatment, deciding to try acupuncture, and finding an acupuncturist. Family, friends and health care professionals played a role in these processes, providing support, advice, and increasing people’s general familiarity with acupuncture. When they came to their first acupuncture appointment, participants had hopes, concerns, and occasionally concrete expectations as to the nature of acupuncture treatment and its likely effects.
Conclusions
Existing theories of how context influences health outcomes could be expanded to better reflect the psychological components identified here, such as hope, desire, optimism and open-mindedness. Future research on the context of acupuncture should consider these elements of the pre-treatment context in addition to more established components such as expectations. There appears to be a need for accessible (i.e. well-disseminated), credible, and individualised, patient-centred materials that can allay people’s concerns about the nature of acupuncture treatment and shape realistic hopes and expectations.
doi:10.1186/1472-6882-13-102
PMCID: PMC3658911  PMID: 23664032
Placebo; Context; Acupuncture; Health care utilisation; Complementary medicine; Expectations; Health knowledge attitudes practice; Illness behaviour; Qualitative research; Patient preference; Treatment seeking
20.  Placebo Use in the United Kingdom: Results from a National Survey of Primary Care Practitioners 
PLoS ONE  2013;8(3):e58247.
Objectives
Surveys in various countries suggest 17% to 80% of doctors prescribe ‘placebos’ in routine practice, but prevalence of placebo use in UK primary care is unknown.
Methods
We administered a web-based questionnaire to a representative sample of UK general practitioners. Following surveys conducted in other countries we divided placebos into ‘pure’ and ‘impure’. ‘Impure’ placebos are interventions with clear efficacy for certain conditions but are prescribed for ailments where their efficacy is unknown, such as antibiotics for suspected viral infections. ‘Pure’ placebos are interventions such as sugar pills or saline injections without direct pharmacologically active ingredients for the condition being treated. We initiated the survey in April 2012. Two reminders were sent and electronic data collection closed after 4 weeks.
Results
We surveyed 1715 general practitioners and 783 (46%) completed our questionnaire. Our respondents were similar to those of all registered UK doctors suggesting our results are generalizable. 12% (95% CI 10 to 15) of respondents used pure placebos while 97% (95% CI 96 to 98) used impure placebos at least once in their career. 1% of respondents used pure placebos, and 77% (95% CI 74 to 79) used impure placebos at least once per week. Most (66% for pure, 84% for impure) respondents stated placebos were ethical in some circumstances.
Conclusion and implications
Placebo use is common in primary care but questions remain about their benefits, harms, costs, and whether they can be delivered ethically. Further research is required to investigate ethically acceptable and cost-effective placebo interventions.
doi:10.1371/journal.pone.0058247
PMCID: PMC3604013  PMID: 23526969
21.  Scientific tools, fake treatments, or triggers for psychological healing: How clinical trial participants conceptualise placebos 
Social science & medicine (1982)  2012;74(5):767-774.
Placebos are an essential tool in randomised clinical trials, where they are used to control for contextual healing effects. Placebos and their effects are also studied from multiple diverse perspectives, but the perspectives of placebo recipients are seldom considered. Research shows that people form cognitive and affective representations of active treatments such as medicines, and that they use these representations to guide their behaviour; it seems reasonable to suggest that people might also think about and develop representations of placebos. We adopted a qualitative approach to examine in detail how participants in one RCT, conducted in the USA, conceptualised placebos. 12 people were interviewed 3 times each, at the start, middle, and end of a trial of placebo effects and acupuncture for Irritable Bowel Syndrome (IBS). The interview data were analysed inductively and we identified four ways in which the participants conceptualised placebos: placebos are necessary for research; placebo effects are fake; placebo acupuncture is not real acupuncture; placebos have real effects mediated by psychological mechanisms. Participants’ conceptualisations of placebos were dynamic and situated in a broader psychological and socio-cultural context. Seeing placebo effects as legitimate seemed to be facilitated by having more holistic models of healing, viewing IBS as psychological, and seeing treatment as multifactorial. However, some participants maintained a negative view of placebo effects (e.g. as illusions) that was apparently inconsistent with their other beliefs (e.g. in mind-body healing mechanisms). This may indicate a dominance of negative discourses around placebos at a socio-cultural level. Negative views of placebos are inconsistent with evidence that placebo treatments can have positive effects on symptoms. RCT participants should be informed about potential benefits of placebo treatments to avoid misunderstandings and unease. Future work should improve methods of providing participants with full accurate information about placebos and their effects.
doi:10.1016/j.socscimed.2011.11.020
PMCID: PMC3288621  PMID: 22285289
USA; placebo; placebo effect; illness cognition; informed consent; acupuncture; health knowledge; attitudes; practice; IBS
22.  Informed Consent and Placebo Effects: A Content Analysis of Information Leaflets to Identify What Clinical Trial Participants Are Told about Placebos 
PLoS ONE  2012;7(6):e39661.
Background
Placebo groups are used in randomised clinical trials (RCTs) to control for placebo effects, which can be large. Participants in trials can misunderstand written information particularly regarding technical aspects of trial design such as randomisation; the adequacy of written information about placebos has not been explored. We aimed to identify what participants in major RCTs in the UK are told about placebos and their effects.
Methods and Findings
We conducted a content analysis of 45 Participant Information Leaflets (PILs) using quantitative and qualitative methodologies. PILs were obtained from trials on a major registry of current UK clinical trials (the UKCRN database). Eligible leaflets were received from 44 non-commercial trials but only 1 commercial trial. The main limitation is the low response rate (13.5%), but characteristics of included trials were broadly representative of all non-commercial trials on the database. 84% of PILs were for trials with 50∶50 randomisation ratios yet in almost every comparison the target treatments were prioritized over the placebos. Placebos were referred to significantly less frequently than target treatments (7 vs. 27 mentions, p<001) and were significantly less likely than target treatments to be described as triggering either beneficial effects (1 vs. 45, p<001) or adverse effects (4 vs. 39, p<001). 8 PILs (18%) explicitly stated that the placebo treatment was either undesirable or ineffective.
Conclusions
PILs from recent high quality clinical trials emphasise the benefits and adverse effects of the target treatment, while largely ignoring the possible effects of the placebo. Thus they provide incomplete and at times inaccurate information about placebos. Trial participants should be more fully informed about the health changes that they might experience from a placebo. To do otherwise jeopardises informed consent and is inconsistent with not only the science of placebos but also the fundamental rationale underpinning placebo controlled trials.
doi:10.1371/journal.pone.0039661
PMCID: PMC3384614  PMID: 22761859
23.  Integrated medicine in the management of chronic illness: a qualitative study 
Background
Complementary and alternative medicine (CAM) is popular with patients, yet how patients use CAM in relation to orthodox medicine (OM) is poorly understood.
Aim
To explore how patients integrate CAM and OM when self-managing chronic illness.
Design of study
Qualitative analysis of interviews.
Method
Semi-structured interviews were conducted with individuals attending private CAM practices in the UK, who had had a chronic benign condition for 12 months and were using CAM alongside OM for more than 3 months. Patients were selected to create a maximum variation sample. The interviews were analysed using framework analysis.
Results
Thirty five patient interviews were conducted and seven categories of use were identified: using CAM to facilitate OM use; using OM to support long-term CAM use; using CAM to reduce OM; using CAM to avoid OM; using CAM to replace OM; maximising relief using both CAM and OM; and returning to OM. Participants described initiating CAM use following a perceived lack of suitable orthodox treatment. Participants rejecting OM for a specific condition never totally rejected OM in favour of CAM.
Conclusion
Patients utilise CAM and OM in identifiably different ways, individualising and integrating both approaches to manage their chronic conditions. To support patients and prevent potential adverse interactions, open dialogue between patients, OM practitioners, and CAM practitioners must be improved.
doi:10.3399/bjgp11X556254
PMCID: PMC3026175  PMID: 21276333
complementary medicine; chronic disease; qualitative
24.  Predictors for Adolescent Visits to Practitioners of Complementary and Alternative Medicine in a Total Population (the Young-HUNT Studies) 
PLoS ONE  2011;6(10):e25719.
Aim
To investigate the factors predicting adolescent visits to practitioners of complementary and alternative medicine (CAM).
Methods
A longitudinal cohort study conducted in an adolescent total population in Central Norway (The Nord-Trøndelag Health Studies (HUNT)). In Young-HUNT 1, all inhabitants aged 13 to 19 years (N = 8944, 89% response rate) were invited to participate, and the youngest group (13 to 15 year olds) was surveyed again 4 years later (Young-HUNT 2, N = 2429, 82% response rate). The participants completed a comprehensive questionnaire on health and life style which included a question regarding visits to a CAM practitioner in the last 12 months.
Results
One in eleven (8.7%, 95%CI 7.6-9.8%) had visited a CAM practitioner, an increase of 26% in 4 years (1.8% points). The final multivariable analysis predicted increased odds of an adolescent becoming a CAM visitor four years later (p<0.05) if she or he had previously visited a CAM practitioner (adjOR 3.4), had musculoskeletal pain (adjOR 1.5), had migraine (adjOR 2.3), used asthma medicines (adjOR 1.8) or suffered from another disease lasting more than three months (adjOR 2.1). Being male predicted reduced odds of visiting a CAM practitioner in the future (adjOR 0.6).
Conclusion
We can conclude from this study that future visits to a CAM practitioner are predicted by both predisposing factors (being female, having visited a CAM practitioner previously) and medical need factors (having had musculoskeletal pain, migraine, used asthma medicines or experienced another disease lasting more than three months). None of the specific variables associated with CAM visits were predictive for CAM visits four years later.
doi:10.1371/journal.pone.0025719
PMCID: PMC3189196  PMID: 22003404
25.  Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK 
Background
The aim of this study was to compare patients' experiences of public and private sector healthcare, using acupuncture as an example. In the UK, acupuncture is popular with patients, is recommended in official guidelines for low back pain, and is available in both the private sector and the public sector (NHS). Consumerism was used as a theoretical framework to explore patients' experiences.
Methods
Semi-structured face-to-face interviews were conducted in 2007-8 with a purposive sample of 27 patients who had recently used acupuncture for painful conditions in the private sector and/or in the NHS. Inductive thematic analysis was used to develop themes that summarised the bulk of the data and provided insights into consumerism in NHS- and private practice-based acupuncture.
Results
Five main themes were identified: value for money and willingness to pay; free and fair access; individualised holistic care: feeling cared for; consequences of choice: empowerment and vulnerability; and "just added extras": physical environment. Patients who had received acupuncture in the private sector constructed detailed accounts of the benefits of private care. Patients who had not received acupuncture in the private sector expected minimal differences from NHS care, and those differences were seen as not integral to treatment. The private sector facilitated consumerist behaviour to a greater extent than did the NHS, but private consumers appeared to base their decisions on unreliable and incomplete information.
Conclusions
Patients used and experienced acupuncture differently in the NHS compared to the private sector. Eight different faces of consumerist behaviour were identified, but six were dominant: consumer as chooser, consumer as pragmatist, consumer as patient, consumer as earnest explorer, consumer as victim, and consumer as citizen. The decision to use acupuncture in either the private sector or the NHS was rarely well-informed: NHS and private patients both had misconceptions about acupuncture in the other sector. Future research should evaluate whether the differences we identified in patients' experiences across private and public healthcare are common, whether they translate into significant differences in clinical outcomes, and whether similar faces of consumerism characterise patients' experiences of other interventions in the private and public sectors.
doi:10.1186/1472-6963-11-129
PMCID: PMC3127982  PMID: 21619572

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