BackgroundNausea and vomiting during pregnancy (NVP) affects two-thirds of pregnant women to varying degrees and over the years many modalities have been used to try to alleviate this often debilitating condition. There is a paucity of information in the literature about the use or efficacy of complementary and alternative medicine (CAM) for the treatment of this condition that affects so many women. Our primary objective was to examine the prevalence of CAM usage by women suffering from NVP. Our secondary objective was to ascertain if women had any supervision in the use of these treatments.MethodsWomen who called The Motherisk NVP helpline, were asked after the counseling session to complete a questionnaire, which included demographic data as well as information about their CAM use.ResultsSeventy women completed the questionnaire. 61% reported using CAM therapies, of which the three most popular were: ginger, vitamin B6 and acupressure. 21% of those who reported using CAM, had consulted CAM practitioners, 8% their physicians or pharmacists and 71% discussed the usage with family, friends and other allied health professionals. Women who did not use CAM stated they would probably use these modalities if there was more information about the safety in pregnancy.ConclusionPregnant women with NVP are mirroring the trend in the general population of the use of CAM. They are also using CAM therapies with little supervision from practitioners experienced in the use of these modalities.

Complementary and alternative medicine (CAM) education is at a crossroads and has been an area of increasing debate. Public use of CAM has risen dramatically since 1997, with initial reports ranging from 30% to a possible 60% in the United States. Much attention has been directed to the education of the public regarding CAM, with respect to efficacy, potential harm, and integration. Far less attention has been paid to the education of CAM practitioners. In the current climate of integrative health settings, CAM practitioners should be trained to interact with conventional physicians, the public, and policy makers in an evidence-based format. In order to create communication effectively, an evidence-based approach may provide the common ground required for all schools of thought.

Background: The effectiveness of teaching critical appraisal to students of Complementary and Alternative Medicine (CAM) has not been studied. In this study we attempt to determine if a workshop for final year students at a naturopathic college improved their ability to utilize critical appraisal concepts.

One of the most common questions that arise in clinical practice is whether a causal relationship exists between two factors. In order to answer this question three steps need to be taken: First an association needs to be demonstrated between treatment/exposure and effect. Next, the possibility of this association being the result of error needs to be determined. Finally additional evidence to support a cause-and-effect relationship needs to be identified. Part 1 of this two-part paper describes how a complementary and alternative medicine provider goes through the first two steps when confronted with the question of whether silicone breast implants cause arthritis to develop. Also covered are the need for a control group when attempting to establish whether an association exists, the potential for systematic error (bias) or unsystematic error (chance) to distort an association, and the susceptibility of different study designs to systematic error.

As noted in Part 1, of this two-part paper, one of the most common questions that arise in clinical practice is whether a causal relationship exists between two factors. In order to answer this question we noted in Part 1 that three steps need to be taken: First an association needs to be demonstrated between treatment/exposure and effect. Next, the possibility of this association being the result of error needs to be determined. Finally, additional evidence to support a cause-and-effect relationship needs to be identified. Part 1 covered the first two steps and now Part 2 describes how a complementary and alternative medicine provider goes through the last step of this process when confronted with the question of whether silicone breast implants cause the development of arthritis. Part 3 examines the importance of answering the following questions: Did the cause precede the effect? How strong was the association observed? Is increasing exposure more likely to lead to disease? Is there evidence from several different studies showing the same association? Does withdrawal of the cause result in loss of the effect? Is there a biologic model that can explain the causal relationship?