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Biomedical subjects

Mary Koithan

Publications and source records attributed to Mary Koithan.

6 recordsLinked to original sources
PubMed2006

Developing CAM Research Capacity for Complementary Medicine.

This article describes initiatives that have been central to the development of complementary and alternative medicine (CAM) research capacity in the United Kingdom, Canada and the United States over the last decade. While education and service delivery are essential parts of the development of CAM, this article will focus solely on the development of research strategy. The development of CAM research has been championed by both patients and politicians, primarily so that we may better understand the popularity and apparent effectiveness of these therapies and support integration of safe and effective CAM in health care. We hope that the perspective provided by this article will inform future research policy.

Journal Article↗
PubMed2006

The integrative family medicine program: an innovation in residency education.

The Integrative Family Medicine (IFM) Program is a four-year combined family medicine residency program and integrative medicine fellowship. It was created in 2003 to address the needs of four constituencies: patients who desire care from well trained integrative physicians, physicians who seek such training, the health care system which lacks a conventional integrative medicine training route, and educational leaders in family medicine who are seeking new strategies to reverse the declining interest in family medicine amongst U.S. graduates. The program was designed jointly by the University of Arizona Program in Integrative Medicine (PIM) and family medicine residency programs at Beth Israel/Albert Einstein College of Medicine (AECOM), Maine Medical Center, Middlesex Hospital, Oregon Health & Science University, and the Universities of Arizona and Wisconsin. One or two residents from each of these institutions may apply, and when selected, commit to extending their training by a fourth year. They complete their family medicine residencies at their home sites, enroll in the distributed learning associate fellowship at PIM, and are mentored by local faculty members who have training in integrative medicine. To date three classes totaling twenty residents have entered the program. Evaluation is performed jointly: PIM evaluates the residents during residential weeks and through online modules and residency faculty members perform direct observation of care and review treatment plans. Preliminary data suggest that the program enhances interest amongst graduating medical students in family medicine training. The Accreditation Council of Graduate Medical Education Family Medicine residency review committee has awarded the pilot experimental status.

Complementary Therapies↗
PubMed2006

Models for the study of whole systems.

This article summarizes a network and complex systems science model for research on whole systems of complementary and alternative medicine (CAM) such as homeopathy and traditional Chinese medicine. The holistic concepts of networks and nonlinear dynamical complex systems are well matched to the global and interactive perspectives of whole systems of CAM, whereas the reductionistic science model is well matched to the isolated local organ, cell, and molecular mechanistic perspectives of pharmaceutically based biomedicine. Whole systems of CAM are not drugs with specific actions. The diagnostic and therapeutic approaches of whole systems of CAM produce effects that involve global and patterned shifts across multiple subsystems of the person as a whole. For homeopathy, several characteristics of complex systems, including the probabilistic nature of attractor patterns, variable sensitivity of complex systems to initial conditions, and emergent behaviors in the evolution of a system in its full environmental context over time, could help account for the mixed basic science and controlled clinical trial research findings, in contrast with the consistently positive outcomes of observational studies in the literature. Application of theories and methods from complex systems and network science can open a new era of advances in understanding factors that lead to good versus poor individual global outcome patterns and to rational triage of patients to one type of care over another. The growing reliance on complex systems thinking and systems biology for cancer research affords a unique opportunity to bridge between the CAM and conventional medical worlds with some common language and conceptual models.

Acupuncture Therapy↗
PubMed2003

Homeopathic practitioner views of changes in patients undergoing constitutional treatment for chronic disease.

OBJECTIVES: To identify areas that classical homeopathic practitioners would want to see evaluated in a patient self-report questionnaire sensitive to change during constitutional treatment. DESIGN: Open-ended, written practitioner questionnaire, analyzed using inductive content analysis. SETTINGS/LOCATION: Two classical homeopathic meetings held in the western United States. SUBJECTS: Homeopathic practitioners attending the above professional meetings and volunteering to complete the questionnaire in response to announcements prior to sessions. DATA COLLECTION METHODS: Practitioners completed a demographic questionnaire and answered an open-ended question inquiring for changes about which to ask people undergoing classical homeopathic constitutional treatment. RESULTS: The categories that the 38 homeopaths identified included changes in: (1) emotions; (2) mentation; (3) specific physical functioning; (4) general physical changes; (5) perception of self; (6) relationships; (7) spirituality; (8) lifestyle; (9) energy; (10) dream content and tone; (11) well-being; (12) perceptions by others; (13) life relationships; (14) a sense of freedom or feeling less "stuck"; (15) sleep; (16) coping; (17) ability to adapt; (18) creativity; and (19) recall of past experiences. Sixteen percent (16%) of participants added more in-depth description of the nature of changes across categories (i.e., a rhythmical process of innovation and flux). CONCLUSIONS: The findings are consistent with the systemic orientation of classical homeopathic philosophy to evaluate and treat the patient as a whole. Taken together, the results support the need for development of new, multidimensional outcome measures for clinical research in homeopathy beyond the disease-specific and health-related quality-of-life scales available from conventional medical research.

Activities of Daily Living↗
PubMedDate not supplied

Alternative medicine or "alternative" patients: a qualitative study of patient-oriented decision-making processes with respect to complementary and alternative medicine.

BACKGROUND: Theory and clinical practice suggest that complementary and alternative medicine (CAM) decision-making processes may differ from those used in conventional medicine. If so, understanding the differences could improve patient-provider communication around treatment options. OBJECTIVES: To examine patient-oriented decision-making processes relative to CAM use. POPULATION: Adults with chronic rheumatological disorders who utilize allopathic medicine only, CAM only, or both. METHOD: An exploratory, cross-sectional naturalistic design with thematic and content analyses. RESULTS: Three distinct decision paths were developed, differing substantially on the importance of provider trust, disease severity/prognosis, willingness to experiment, intuitive/spiritual factors, and outcomes evidence. CONCLUSIONS: These divergent decision paths indicate the possibility of "alternative patients," not just "alternative therapies." Since informed decisions, tailored to the patient, would likely lead to sustainable improvements in health care outcomes, the findings may facilitate providers' capacity to effectively advise patients about treatment alternatives and CAM use.

Adult↗