Professor Jon Adams

Biography

Jon is Professor of Public Health and Director of the Australian Research Centre in Complementary and Integrative Medicine (ARCCIM) at the Faculty of Health, University of Technology Sydney. He is also Executive Director of the Network of Researchers in the Public Health of Complementary and Alternative Medicine, NORPHCAM (opens an external site) – an international network with over 250 members promoting and conducting rigorous public health investigation of the practice and use of complementary and alternative medicine (CAM), traditional medicine and integrative health care. Jon is also National Convenor of the Public Health Association of Australia Special Interest Group in Evidence, Research and Policy in Complementary Medicine. Jon currently holds a prestigious NHMRC Career Development Fellowship (2011-2015) in CAM and women's health.

He is also Senior Fellow on the prestigious Oxford International Leadership Program, Department of Primary Health Care, University of Oxford. Jon also holds a number of visiting and honorary titles. He is Adjunct Professor at the School of Health Sciences, RMIT University, Honorary Professor in Health Social Science at the School of Population Health, University of Queensland, Honorary Professor in Health Sociology at the School of Social Science, University of Queensland and Visiting Professor in Health Services Research at the London South Bank University, UK.

Jon's program of public health and health services research is focused upon CAM in relation to primary health care, rural health, women's health, chronic illness and care, ageing and education/policy amongst other topics. Jon is leading a national team of researchers examining CAM use and provision for women’s health in Australia. Drawing upon data from the Australian Longitudinal Study on Women’s Health (ALSWH), this ground-breaking work includes examining CAM use and practice for pregnancy, back pain, cancer care, allergies and in relation to urban and rural health care and constitutes the largest longitudinal analysis of CAM use in the world to date, n=>40,000 women). jon is also a member of the Sax Institute and has recently analysed CAM data from the 45 and Up Study.

Jon is Associate Editor of four international peer-reviewed CAM journals, Complementary Therapies in Medicine (opens an external site), Journal of Acupuncture and Meridian Studies (opens an external site), European Journal of Integrative Medicine (Regional Editor) and BMC Complementary and Alternative Mediine. He also sits on the International Editorial Advisory Board for the Journal of Manipulative and Physiological Therapeutics and is regular reviewer for a wide range of international peer-reviewed health and medical research journals. He has produced over 210 peer reviewed academic publications since 2000 and has edited/co-edited 6 international research books including Editor-in-Chief of the first International Reader in Traditional, Complementary and Integrative Medicine (Palgrave MacMillan, 2013).

Jon has extensive training in qualitative health research methods, health social science and mixed-method design. He is currently holds 8 national and international grants including 3 ARC and 3 NHMRC-funded projects. He has been researching numerous aspects of CAM and conventional primary health care for over 10 years and has attracted in excess of AUD$7M in external funding in the past five years alone. He has also been supervisor for 14 completed PhD students (6 in CAM) and is currently supervising/co-supervising 10 more students to completion.

Professional

Director, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM)

Executive Director, NORPHCAM

Associate Editor, Complementary Therapies in Medicine,

Associate Editor, European Journal of Integrative Medicine,

Associate Editor, BMC Complementary and Alternative Medicine 

NHMRC Career Development Fellow

Senior Fellow, Oxford International Leadership Program, Department of Primary Health Care, University of Oxford

National Convenor, PHAA SIG Evidence, Research and Policy in CM

Image of Jon Adams
Professor of Public Health, Faculty of Health
Director, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM)
Core Member, Health Services and Practice Research Strength
BA Honors, Master of Arts, Degree of Doctor Of Philosophy
 
Phone
+61 2 9514 4821
Fax
+61 2 9514 4835
Room
CB10.07.216
Can supervise: Yes

Book Chapters

Wardle, J., Adams, J., Broom, A. & Sibbritt, D. 2013, 'Examining the relationship between complementary and integrative medicine and rural general practice: A focus upon health services research' in Jon Adams, Parker Magin, Alex Broom (eds), Primary Health Care and Complementary and Integrative Medicine, Imperial College Press, London, pp. 115-132.
Recent research has revealled that complementary and integrative medicine (CIM) is particularly popular amongst rural populations, with a growing body of literature supporting this interpretation
Adams, J., Hollenberg, D., Broom, A., Steel, A.E., Sibbritt, D. & Lui, C. 2013, 'Integration in Primary Health Care: A focus upon practice and education and the importance of a critical social science perspective' in Adams, J, Magin, P, Broom, A (eds), Primary Health Care and Complementary and Integrative Medicine, Imperial College Press, London, pp. 203-228.
In this chapter we argue that the mainstream work and commentary around integrative health care and education has often lacked a critical social science perspective
Steel, A.E., Frawley, J.E., Adams, J., Sibbritt, D. & Broom, A. 2013, 'Primary Health Care, Complementary and Alternative Medicine and Women's Health: A Focus Upon Menopause' in Adams, J, Magin, P, Broom, A (eds), Primary Health Care and Complementary and Integrative Medicine, Imperial College Press, London, pp. 11-34.
Australian Women are integrating primary health care and complementary and alternative medicine to alleviate a range of symptoms and conditions. This chapter introduces the use of CAM for women's health in general and more particularly, explores the integration of CAM alongside mainstream primary health care
Magin, P. & Adams, J. 2013, 'Complementary and Alternative Medicine and Skin Disease in General Practice' in Adams, J, Magin, P, Broom, A (eds), Primary Health Care and Complementary and Integrative Medicine, Imperial College Press, London, pp. 51-70.
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We explore the relationship between general practice, CAM, and skin disease
Adams, J. 2013, 'Naturopaths: Their central role in primary health care delivery' in Adams, J, Magin, P, Broom, A (eds), Primary Health Care and Complementary and Integrative Medicine, Imperial College Press, London, pp. 73-92.
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This chapter will explore the potential role that naturopaths may play in public health care, where appropriate, and discuss relevant practice, regulatory, and legislative developments that should be part of any naturopathic role in public health care delivery
Adams, J., Lui, C., Sibbritt, D., Broom, A., Wardle, J., Homer, C.S., Steel, A.E. & Beck, S. 2012, 'Women's use of complementary and alternative medicine during pregnancy: A critical review of the literature' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 35-43.
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The use of complementary and alternative medicine has attracted much attention and debate in recent years. The objective of this critical review is to examine the evidence base on use of complementary products and therapies during pregnancy. It examines an important but neglected issue in maternity care. Methods: A database search was conducted in MEDLINE, CINAHL, AMED, and Maternity and Infant Care. A total of 24 papers published between 1999 and 2008 met the selection criteria and were included in the review. Results: Findings of these 24 papers were extracted and reported under four themes: "user prevalence and profile," "motivation and condition of use," "perception and self-reported evaluation," and "referral and information sources." Conclusions: This review highlights four research gaps in the literature, a lack of: large representative samples; in-depth understanding of user experiences and risk perceptions; research comparing consumption patterns across cultures and over time; and work exploring the nature of the therapeutic encounter with complementary practitioners in this area of women's health care.
Wardle, J. & Adams, J. 2012, 'Indirect risks of complementary and alternative medicine: Promises and problems' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 212-219.
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A discussion of issues of safety and risk around complementary and alternative medicine (CAM) has primarily revolved around issues of direct risk, including adverse events (such as the potential hepatotoxicity of CAM products or potential CAM-drug interactions) and the monitoring of these events (pharmacovigilance). Yet the development of a broader public health agenda for CAM (Adams, 2008) provides an opportunity for a new focus on the inherent indirect health risks associated with these medicines - representing a novel, innovative approach to the consideration of risk and safety in CAM.
Adams, J., Sibbritt, D., Broom, A., Wardle, J., Steel, A.E., Murthy, V. & Daley, J. 2012, 'Research capacity building in traditional, complementary and integrative medicine: Grass-roots action towards a broader vision' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 275-282.
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Developing capacity to undertake health research effectively is an integral component of national and global health research systems (Lansang and Dennis, 2004) and is essential to producing a sound evidence base for decision making in policy and practice (Cooke, 2005). Moreover, research capacity building (RCB) - nurturing and producing sustainable increased capacity for future research endeavours - is important fOr all health research fields and TCIM is no exception (Andrews, 2006; Adams, 2007). There is currently a great opportunity to embrace RCB in relation to TCIM in order to help develop an evidence base and a stronger and more robust research culture among scholars and practitioners alike.
Sibbritt, D. & Adams, J. 2012, 'Utilising existing data sets to investigate CAM consumption: cohort studies and longitudinal analyses.' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 32-39.
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Adams, J., Andrews, G.J., Barnes, J., Broom, A. & Magin, P. 2012, 'Introduction' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 1-5.
No one paradigm of medicine or system of health care hold a monopoly anywhere in the world and cultures have invariably developed pluralistic ways of understanding health, ill-health, approaches to well-being and forms of treatment. Not only does the social cartography of health and medical care differ across cultures and history, but within such a fluid landscape the borders of what constitutes the 'official', 'legitimate', 'authentic' and 'effective' are also prone to flux. As any rigorous review of contemporary health and health care trends illustrates, what may only recently have been ordained fringe or marginal can soon be seen to occupy a mainstream position.
Andrews, G.J., Adams, J., Segrott, J. & Lui, C. 2012, 'The profile of complementary and alternative medicine users and reasons for complementary and alternative medicine use' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 11-17.
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The use of complementary and alternative medicine (CAM) has become a mainstream health care activity in many countries. The rise in prevalence of CAM use over the past decade reflects an epidemilogical transition of disease patterns as well as profound transformations in health belief and practices in contemporary societies.
Magin, P., Adams, J., Pond, D. & Smith, W. 2012, 'Chapter 7 Topical and oral complementary and alternative medicine in acne: A consideration of context' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 63-70.
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Acne is one of the commonest diseases to afflict humanity. Anecdotally, the use of CAM in acne is widespread. In this review the empirical evidence for the efficacy of CAM modalities is examined and the context for their use discussed.
Tovey, P. & Adams, J. 2012, 'Chapter 17 Nostalgic and nostophobic referencing and the authentication of nurses' use of complementary therapies' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 150-156.
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Andrews, G.J., Segrott, J., Lui, C. & Adams, J. 2012, 'The geography of complementary and alternative medicine' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 231-236.
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Adams, J., Andrews, G.J., Barnes, J., Broom, A. & Magin, P. 2012, 'Part A Section 1: Introduction' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 9-10.
Profile, demographics and motivations for complementary and alternative medicine use
Adams, J., Andrews, G.J., Barnes, J., Broom, A. & Magin, P. 2012, 'Part A Section 2: Introduction' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 33-34.
Complementary and alternative medicine through the life cycle
Adams, J., Andrews, G.J., Barnes, J., Broom, A. & Magin, P. 2012, 'Part A Section 3: Introduction' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 61-62.
Traditional, complementary and integrative medicine and disease context
Adams, J., Andrews, G.J., Barnes, J., Broom, A. & Magin, P. 2012, 'Part B Section 4: Introduction' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 105-106.
Traditional medicine in context
Adams, J., Andrews, G.J., Barnes, J., Broom, A. & Magin, P. 2012, 'Part B Section 5: Introduction' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 133-134.
Exploring the complementary and alternative medicine-conventional medicine interface
Adams, J., Andrews, G.J., Barnes, J., Broom, A. & Magin, P. 2012, 'Part B Section 6: Introduction' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 157-158.
Integrative Medicine
Adams, J., Andrews, G.J., Barnes, J., Broom, A. & Magin, P. 2012, 'Part C Section 7: Introduction' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 185-186.
Evidence, safety and regulation
Adams, J., Andrews, G.J., Barnes, J. & Broom, A. 2012, 'Part C Section 8: Introduction' in Adams J, Andrews G, Barnes J, Broom A, Magin P (eds), Traditional, Complementary and Integrative Medicine, Palgrave Macmillan, Basingstoke, pp. 229-230.
Traditional, complementary and integrative medicine in perspective
Broom, A. & Adams, J. 2012, 'A Critical Social Science of Evidence-Based Healthcare' in Alex Broom and Jon Adams (eds), Evidence-Based Healthcare in Context: Critical Social Science Perspectives, Ashgate, Farnham, Surrey, UK, pp. 1-19.
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In many respects evidence-based healthcare is neither new nor are its philosophical underpinnings unique. Getting the best knowledge to the right people in a timely fashion is commonsense. Yet, this basic principle reflects a broader social movement in knowledge production and dissemination that has been emerging for centuries. Scientific inquiry, as it were, has become more systematic, globally connected and protocol driven over the course of the twentieth century. While scientific discoveries in the nineteenth and early twentieth centuries still often occurred in the context of a sole or renegade researcher/practitioner, the latter part of the twentieth century witnessed the global streamlining, enhanced connectivity and dramatic institutionalisation of scientific knowledge production.
Broom, A. & Adams, J. 2012, 'The Histories and Cultures of Evidence Utilisation: The Cases of Medical Oncology and Haematology' in Alex Broom and Jon Adams (eds), Evidence-Based Healthcare in Context: Critical Social Science Perspectives, Ashgate, Farnham, Surrey, UK, pp. 97-114.
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As outlined in our introduction to this book, the idea of EBM or EBP for biomedical clinicians, is to apply the best evidence to the clinical condition the are presented with. However, while EBM may seem to be mere commonsense, in actuality, and partcularly in the context of specialties like medical oncology and haematology, it presents a plethora of ideological, epistemological and practical issues. We argue here that for oncology clinicians operating at a grassroots level there is often a disconnection between EBM (and processes of standardisation) and the actual character of contemporary oncological work (De Vries and Lemmens 2006). Furthermore, the very value judgements and subjectivities that often go unrecognised in an EBM framework are actually critically important skills in oncology and haematology practice (Tredaniel et al, 2005). In oncology such disjunctions are accentuated with the constant development of new interventions (Joannidis, Schmid and Lau 2000) combined with the ommpresent need to 'try new things' with potentially terminal patients where standard treatments do not work.
Adams, J., Andrews, G.J. & Segrott, J. 2010, 'Complementary and Alternative Medicine (CAM): Production, Consumption, Research' in Tim Brown, Sara McLafferty, Graham Moon (eds), A Companion to Health and Medical Geography, Wiley-Blackwell, Oxford, pp. 587-603.
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Adams, J. & Broom, A. 2009, 'The status of complementary and alternative medicine (CAM) in biomedical education: towards a critical engagement' in Caragh Brosnan and Bryan S Turner (eds), Handbook of the Sociology of Medical Education, Routledge, Oxon, pp. 1-296.
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Complementary and alternative medicine (CAM) has become increasingly prominent over the last three decades with more individuals using CAM in combination with, or as an alternative to, biomedical treatments. In addition to this resurgence in consumer interest in CAM modalities, health-insurance companies in the US, Britain, Australia and New Zealand now fund selected CAM therapies such as chiropractic, osteopathy, acupuncture, homoeopathy and healing-touch therapy for certain medical conditions (Cassileth 1999). While there is still only limited and sporadic provision of CAM in mainstream western medical contexts, consumer interest, health-insurance rebates and political impetus have provided some degree of momentum toward the development of 'integrative' approaches to patient care. Progress has been slow in terms of actual mainstream integration of CAM practices, yet doctors are increasingly faced with patients wanting to discuss CAM-related issues. In areas such as cancer care or the treatment of other chronic illness, CAM use is traditionally high (Thome et at. 2002) and discussions about non-biomedical options are frequent and are valued by patients (Tovey and Broom 2007). However, the skill and knowledge base of practising clinicians in relation to CAM is generally limited and paradigmatic divergences between CAM and biomedicine can complicate patient-doctor discussions regarding what constitutes 'effectiveness', 'evidence' and 'risk' (Broom and Tovey 2007b).
Tovy, P. & Adams, J. 2008, 'The authentication of CAM in nursing' in Jon Adams and Philip Tovey (eds), Complementary and Alternative Medicine in Nursing and Midwifery: Towards a critical social science, Routledge, Oxon, pp. 73-92.
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Membership figures for the UK Royal College of Nursing (RCN) Complementary Therapies Forum illustrate the surge of interest in complementary and alternative medicine (CAM) within the profession: 1,600 in 1997; rising to 11,400 in 2000 (House of Lords 2000) and the activities of similar representative bodies in other developed countries have confirmed this trend on the international stage (Fox-Young 1998; ReNA 1997). This is occurring at an interesting time in the development of nursing more broadly, given the ongoing attention to an enhanced nursing role, and continuing debate about the profession's most appropriate form and content (Barton 1999), It is a debate in which the essence of nursing is contested and recourse to history frequently undertaken in an attempt to legitimise specific conceptions of nursing (Hall and Allan 1994; Hisama 1996; Rinker 2000; Salmore 1998; Snyder and Lindquist 2001; Watson 1998; Wilson 2000).
Adams, J. & Tovey, P. 2008, 'Introduction: Towards a critical social science of CAM in nursing and midwifery' in Jon Adams and Philip Tovey (eds), Complementary and Alternative Medicine in Nursing and Midwifery: Towards a critical social science, Routledge, Oxon, pp. 1-178.
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Within the last decade there have been significant developments in the relationship between complementary and alternative medicine (CAM)1 and biomedical provision. Rhetorics of integration have become increasingly commonplace and an air of consensus, about the incorporation of CAM, as an accompaniment or supplement to conventional treatments, has become apparent. Regardless of the potential barriers to successful integration (Barrett 2003; Hughes 2004; Coulter 2004) the rising tide of popularity of these medicines amongst both providers and consumers has helped cement CAM as a key public health and health care/provision issue (Bodeker and Kronenberg 2002; Giordano et a1. 2003). But with the emergence of consensus comes the potential for a less critical and distanced analysis of the integrative process. This is a tendency, we argue, that should be resisted.
Adams, J. 2007, 'Introduction' in Adams, Jon (eds), Researching Complementary and Alternative Medicine, Routledge, Oxon, pp. xiii-xx.
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de Barros, N.F., Tovey, P. & Adams, J. 2005, 'Using qualitative methods to explore complementary medicine' in de Barros, N. F., Cecatti, J. G., Turato, E. R (eds), Qualitative Health Research: International Perspectives, Unicamp University Press, Sao Paulo, Brazil, pp. 219-233.
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Books

Adams, J., Magin, P. & Broom, A. 2013, Primary Health Care and Complementary and Integrative Medicine: Practice and Research, 1, Imperial College Press, London.
Outlines core issues, challenges and opportunities facing the CIM-primary health care interface and its study will provide insight and inspiration for those practising, studying and researching the contemporary relations between CIM and primary health care
Adams, J., Andrews, G.J., Barnes, J., Broom, A. & Magin, P. 2012, Traditional, Complementary and Integrative Medicine: An International Reader, 1st, Palgrave Macmillan, Hampshire UK.
A ground-breaking collection of contemporary TCIM literature featuring respected research articles alongside fresh material. Bringing together the perspectives of a diverse range of international practitioners and academics, it provides essential guidance, insight and inspiration for those embarking upon study, practice or research in this field.
Broom, A. & Adams, J. 2012, Evidence-Based Healthcare in Context: Critical Social Science Perspectives, Ashgate, Farnham, Surrey, UK.
With new methods of treatment standardisation resulting in various benefits for patient outcomes, evidence-based practice have emerged as defining features of wester healthcare provision in recent years. Most health professions are now adoptig some sort of 'evidence based' framework for clinical training and practice. However, the rise of evidence-based healthcare has drawn sustained critisism regarding the limits of trial based evidence, the reductive character of epidemiological study designs, and the potential for an erosion of the importance of lay perspectives and clinical judgement.
Adams, J. & Tovy, P. 2008, Complementary and Alternative Medicine in Nursing and Midwifery: towards a critical social science, Routledge, Oxon.
Adams, J. 2007, Researching Complementary and Alternative Medicine, Routledge, Oxon.

Conference Papers

Dean, S.J. & Adams, J. 2012, '"Talk to them"; an exploratory study of the challenges of teaching communication skills.', The International Institute of Social and Economic Sciences, Dubrovnik, Croatia, June 2012.
Communication skills are fundamental in therapeutic communication and there is overwhelming evidence that communication is a key element in producing positive outcomes for health care workers and patients (Anderson et al. 2007). Potential barriers to effective therapeutic communication include poor communication skills on the part of the health care professional (Greenburg et al.2006). This paper reports on the first stage of a larger study and assessed an educational initiative that teaches communication skills to students in a Traditional Chinese Medical degree program (TCM). A pre course survey was completed by 37 of 41 students enrolled in a communication subject in the first year of their 4 year degree program. A further survey will be completed at the end of the course where students will be asked about their course experience and the data will be evaluated for parallel responses to determine what students thought about the teaching and learning of communication skills before and after the course. Further, communication competence is assessed using the Kalamazoo Consensus Statement (KCS) (Acad Med. 2004) and patient feedback data is collected. This is then evaluated against the pre and post course surveys completed by the students. A limitation of this study is that it was conducted in one TCM program but it is a preliminary study and will serve as a basis for further studies to increase the valuing of teaching communication skills and how to ensure the skills taught in the first year of a prgram can be applied and evaluated in clinical practice during the program and beyond. The use of complementary medicine is said to be increasing worldwide (White. 2000) and one of the reasons proposed for patients using complementary therapists instead of conventional doctors is they believe complementary therapists are better communicators (White. 2000). A challenge for faculty is to evaluate the effect of curricular innovations such as the teaching of communication skills and to ensure that students see the relevance to positive outcomes for patients and health care providers and continue to apply the skills in clinical practice and beyond.

Journal Articles

Murthy, V., Sibbritt, D., Adams, J., Broom, A., Kirby, E. & Refshauge, K.M. 2014, 'Consultations with complementary and alternative medicine practitioners amongst wider care options for back pain: a study of a nationally representative sample of 1,310 Australian women aged 60-65 years', Clinical Rheumatology, pp. 1-10.
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Back pain is a significant health service issue in Australia and internationally. Back pain sufferers can draw upon a range of health care providers including complementary and alternative medicine (CAM) practitioners. Women are higher users of health services than men and tend to use CAM frequently for musculoskeletal conditions. However, there remain important gaps in our understanding of women+s consultation patterns with CAM practitioners for back pain. The objective of this study is to examine the prevalence of use and characteristics of women who use CAM practitioners for back pain. The method used was a survey of a nationally representative sample of women aged 60+65 years from the Australian Longitudinal Study on Women+s Health. Women consulted a massage therapist (44.1 %, n?=?578) and a chiropractor (37.3 %, n?=?488) more than other CAM practitioners for their back pain. Consultations with a chiropractor for back pain were lower for women who consulted a General Practitioner (GP) (OR, 0.56; 95 % CI 0.41, 0.76) or a physiotherapist (OR, 0.53; 95 % CI 0.39, 0.72) than for those who did not consult a GP or a physiotherapist. CAM practitioner consultations for back pain were greater for women who visited a pharmacist (OR, 1.99; 95 % CI 1.23, 3.32) than for women who did not visit a pharmacist. There is substantial use of CAM practitioners alongside conventional practitioners amongst women for back pain, and there is a need to provide detailed examination of the communication between patients and their providers as well as across the diverse range of health professionals involved in back pain care.
Steel, A.E., Adams, J., Sibbritt, D., Broom, A., Frawley, J.E. & Gallois, C. 2014, 'The Infuence of Complementary and Alternative Medicine Use in Pregnancy on Labor Pain Management Choices: Results from a Nationally Representative Sample of 1,835 Women', Journal of Alternative and Complementary Medicine, vol. epub, pp. 1-11.
Objectives: This study examines involvement with a range of complementary and alternative medicine (CAM) during pregnancy on the use of pharmacologic (PPMT) and nonpharmacologic (NPMT) pain management techniques for labor and birth. Design: Longitudinal analysis of survey data. Participants: A substudy (n=2445) of the ``young++ cohort of the nationally representative Australian Longitudinal Study on Women+s Health was conducted. Outcome measures: Use of PPMT and NPMT during labor and birth. Results: The survey was completed by 1835 women (response rate, 79.2%). Most respondents used either intrapartum PPMT (81.9%) or NPMT (74.4%). Many (60.7%) used some form of CAM during pregnancy and also used PPMT during birth. More than two thirds of women (66.7%) who used NPMT used CAM during pregnancy. There was a general trend of increased likelihood of NPMT use by women who applied CAM during pregnancy. There was an inverse effect on use of epidural analgesia for women who consumed herbal teas during pregnancy (odds ratio, 0.60).
Steel, A.E., Wardle, J., Diezel, H.M., Johnstone, K. & Adams, J. 2014, 'Educating for collaboration: The outcomes of an interprofessional education workshop for complementary and alternative maternity care providers', Advances in Integrative Medicine, vol. 1, no. 1, pp. 17-24.
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Objectives: Despite high community use of complementary and alternative medicine (CAM) poor collaboration between conventional and CAM practitioners have been identified in many health sectors including maternity care. This is in part associated with a deficit in the formal training of CAM practitioners which overlooks collaborative practice skills and guidelines. This study evaluates the outcomes of an interprofessional education workshop which endeavours to improve the collaborative practice of CAM practitioners providing care to pregnant women. Methods: A pre-workshop and post-workshop questionnaire which evaluated the participants' perception of self-proficiency and their interprofessional practice behaviours when providing maternity care. Descriptive and inferential statistical analysis of the data was undertaken. Results: CAM practitioners (n = 30) providing care to pregnant women participated in the project. Prior to taking part in the workshop a low level of confidence in pregnancy-specific physiology and psychology knowledge more broadly but also poor confidence in engaging with conventional maternity care providers and understanding conventional models of maternity care was identified amongst participants. Participants who felt more positive about their knowledge of pregnancy and birth physiology were more likely to enquire about women's conventional care and discuss safety issues with women in their care. Following workshop involvement the participant's awareness of the models of maternity care available to Australian women improved alongside participants' knowledge of the scope and role of obstetricians and midwives. There was a reduced need by participants to have their role acknowledged by conventional care providers as important to enable effective collaboration after workshop completion. Conclusions: Interprofessional education is argued to be a valuable tool to promote interprofessional collaboration and communication. It may be employed as a useful tool to encourage stronger links and improved integration between CAM and conventional health professionals
Broom, A., Meurk, C., Adams, J. & Sibbritt, D. 2014, 'Networks of knowledge or just old wives' tales?: A diarybased analysis of women's selfcare practices and everyday lay expertise', Health: an interdisciplinary journal for the social study of health, illness and medicine, vol. epub, no. 0.
Complementary and alternative medicine is increasingly popular in Australia and particularly among women. While existing research provides some understanding of women's engagement with complementary and alternative medicine and biomedicine, there has been comparatively little examination of the day-to-day character of their experiences. In this study, we utilise solicited diaries with women aged 60 -65 years drawn from the 1946-1951 cohort of the Australian Longitudinal Study on Women's Health to capture the temporal dimension of their therapeutic engagement. Focusing on 30 active complementary and alternative medicine users, we explore women+s experiences of managing their health, illness and well-being over a 1-month period.
Boughtwood, D.L., Shanley, C., Adams, J., Santalucia, Y., Kyriazopoulos, H., Rowland, J. & Pond, D. 2013, 'The role of the bilingual/ bicultural worker in dementia education, support and care', Dementia, vol. 12, no. 1, pp. 7-21.
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Members of minority populations often have difficulty knowing about and accessing dementia services. One of the strategies used to promote access is the employment of bilingual/bicultural workers (sometimes referred to as multicultural, link or outreach workers). This study involved interviews with 24 bilingual/bicultural workers in south western Sydney, Australia to gain a better understanding of their role within the dementia field. Seven themes emerged: importance of working with family; process of building trust when moving between two cultures; importance of understanding the culture; self-care and culture; flexibility of their role; linking community members; and linking communities to mainstream services. Bilingual/bicultural workers play a significant and complex role in supporting individuals and families within their community who are affected by dementia.
Siobhan, C., Broom, A., Adams, J. & Sibbritt, D. 2013, 'Bodies of knowledge: Nature, holism and women's plural health practices', Health: an interdisciplinary journal for the social study of health, illness and medicine, vol. 17, no. 3, pp. 300-318.
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The proliferation of complementary and alternative medicine (CAM), and women's high level of engagement with these practices, has presented sociology with a range of questions regarding gender, embodiment and identity work in the context of contemporary medical pluralism. The current study, drawing on 60 qualitative interviews with women from the Australian Longitudinal Study on Women's Health (ALSWH), examines how a group of Australian women negotiate CAM and biomedicine in a range of health and illness contexts. Selected from the mid-aged cohort of this national study, here we explore their accounts of engagement with CAM and biomedicine, unpacking their logics underpinning, and rhetorical practices surrounding, their therapeutic engagement. The results provide significant insight into: the importa nce of ideas about nature, holism and strengthening; perceptions of the harshness and softness of medicines for women's bodies; and, the relative importance of scientific proof vis-a-vis individual subjectivities. Ultimately, their accounts illustrate gendered and embodied strategies of strategic integration, and importantly, border crossing. We conclude that while women's engagement with CAM and biomedicine may be indeed be gendered in character, we suggest a rethinking of gender-based resistance (to biomedicine) or gender-alignment (to CAM) arguments; the notion of women as designers would more adequately capture the landscapes of contemporary medical pluralism.
Wardle, J., Adams, J. & Sibbritt, D. 2013, 'Acupuncture in Australian general practice: trends in reimbursed acupuncture services from 1995 to 2011', Acupuncture in Medicine, vol. 31, no. 1, pp. 45-50.
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Objectives: To ascertain the extent of and trends in the use of acupuncture in Australian general practice and the characteristics of patients receiving publicly subsidised acupuncture services from general practitioners (GPs). Design: Secondary analysis of national patient Medicare data for claims by all non-specialist medical practitioners for Medicare Benefits Schedule items for an attendance where acupuncture was performed by a medical practitioner from 1995 to 2011. Main outcome measures: Use of acupuncture by GPs, patients sex and age and the socioeconomic disadvantage index of GPs practice. Results: There has been a 47.7% decline in the number of acupuncture claims by GPs per 100 000 population in the period from 1995 to 2011. Acupuncture claims were made by 3.4% of GPs in 2011. Women were almost twice as likely to receive acupuncture from a GP as men, and patients in urban areas were more than twice as likely to receive acupuncture from a GP as patients in rural areas. Acupuncture claims were highest in areas that were socioeconomically advantaged. Conclusions: Claims for reimbursement for acupuncture by GPs have declined significantly in Australian general practice even though the use of acupuncture by the Australian public has increased. This may be due to increased use of referrals or use of non-medical practitioners, barriers to acupuncture practice in general practice or non-specificf actors affecting reimbursement for non-vocationally registered GPs.
Wardle, J., Adams, J., Lui, C. & Steel, A.E. 2013, 'Current challenges and future directions for naturopathic medicine in Australia: a qualitative examination of perceptions and experiences from grassroots practice', BMC Pregnancy Childbirth, vol. 13, no. 15, pp. 1-10.
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Naturopaths are an increasingly significant part of the healthcare sector in Australia, yet despite their significant role there has been little research on this practitioner group. Currently the naturopathic profession in Australia is undergoing a period of rapid professional growth and change. However, to date most research exploring the perceptions of naturopaths has been descriptive in nature and has focused on those in leadership positions rather than grassroots practitioners. This article explores the perceptions and experiences of practising naturopaths on the challenges and future directions of their profession.
Wardle, J., Sibbritt, D. & Adams, J. 2013, 'Referrals to chiropractors and osteopaths: a survey of general practitioners in rural and regional New South Wales, Australia', Chiropractic & Manual Therapies, vol. 21, no. 5, p. Online.
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Chiropractic and osteopathy form a significant part of the healthcare setting in rural and regional Australia, with national registration of practitioners, public subsidies for services and high utilisation by the Australian public. However, despite their significant role in rural and regional Australia, there has been little exploration of the interface between chiropractic and osteopathy and conventional primary health care practitioners in this area. The study aim was to examine the referral practices and factors that underlie referral to chiropractors and osteopaths by rural and regional Australian general practitioners (GPs), by drawing on a sample of GPs in rural and regional New South Wales.
Adams, J., Barbery, G. & Lui, C. 2013, 'Complementary and Alternative Medicine Use for Headache and Migraine: A Critical Review of the Literature', Headache, vol. 53, no. 3, pp. 459-473.
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Contexts.An evidence base for complementary and alternative medicine (CAM) consumption within general populations is emerging. However, research data on CAM use for headache disorders remain poorly documented. This paper, constituting the first critical review of literature on this topic, provides a synopsis and evaluation of the research findings on CAM use among patients with headache and migraine.
Meurk, C., Broom, A., Adams, J. & Sibbritt, D. 2013, 'Rurality, mobility, identity: Women's use of complementary and alternative medicine in rural Australia', Health & Place, vol. 20, no. Online, pp. 75-80.
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This article explores why women in rural and remote areas of Australia use complementary and alternative medicine (CAM) at higher rates than their counterparts in urban areas. Drawing on qualitative interviews with 60 women 60-65 years of age, currently living in rural Australia, we explore the possibility that CAM use in rural areas may be embedded in processes of spatialised identity-building and the health-creating practices of mobile, ex-urban, individuals who drive this process. We problematise previous explanations which suggest CAM use in rural areas is principally derived from a lack of biomedical service provision and enhanced community ties showing instead how and why identity and mobility are useful additional variables for understanding CAM use in rural areas.
Wardle, J., Sibbritt, D. & Adams, J. 2013, 'Referral to Chinese medicine practitioners in Australian primary care: a survey of New South Wales rural and regional general practitioners', Chinese Medicine, vol. 8.
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Background: Chinese medicine practitioners (CMPs) play an important part in rural and regional Australian healthcare. A survey was conducted to investigate referral practices between Chinese medicine (CM) and conventional primary health care practitioners in this region. Methods: A 27-item questionnaire was sent to all 1486 general practitioners (GPs) currently practising in rural and regional Divisions of General Practice in New South Wales, Australia. This survey explored GP opinions, perceptions and practices in relation to complementary and alternative medicine or Chinese medicine specifically. Results: A total of 585 GPs completed the questionnaire. Forty-nine were returned as 'no longer at this address', resulting in an adjusted response rate of 40.7%. One in ten GPs (9.9%) had referred their patients to CMPs at least a few times over the past 12 months, one in five GPs (17.4%) could not locate a CMP to refer to in their local area, and over one-third of GPs (37.7%) stated they would not refer to a CMP under any circumstances. GPs that had graduated from an Australian medical college (OR = 3.71; CI: 1.22, 11.23), GPs observing positive responses previously in patients using CM (OR = 2.53; 95% CI: 1.12, 8.58), GPs perceiving a lack of other options for patients (OR = 3.10; 95% CI: 1.12, 8.58), GPs reporting satisfactory or higher levels of CM knowledge (OR = 15.62; 95% CI: 5.47, 44.56), and GPs interested in increasing their complementary and alternative medicine knowledge (OR = 3.28; 95% CI: 1.17, 9.21) referred to CMPs more frequently than did other groups of GPs amongst the rural GPs included in this study. Conclusion: There has been little interaction between CMPs and Australian rural and regional GPs.
Poulsen, E., Sibbritt, D., McLaughlin, D., Adams, J. & Pachana, N.A. 2013, 'Predictors of Complementary and Alternative Medicine (CAM) use in two cohorts of Australian women', International Psychogeriatrics, vol. 25, no. 1, pp. 168-170.
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Complementary and Alternative Medicine (CAM) use has been researched widely; however, studies with older adults and Australian populations are limited. The profile of Australian women CAM users has been mapped using the 1996 data from the ALSWH (Adams et al., 2003).
Broom, A., Kirby, E., Good, P., Wootton, J. & Adams, J. 2013, 'The art of letting go: Referral to palliative care and its discontents', Social Science & Medicine, vol. 78, no. 1, pp. 9-16.
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Accompanying patients from active treatment towards specialist palliative care is a complex sphere of clinical practice that can be fraught with interpersonal and emotional challenges. While medical specialists are expected to break `bad news+ to their patients and ease their transitions to specialist palliative care if required, few have received formal training in such interpersonal complexities.
Adams, J., Sibbritt, D., Broom, A., Loxton, D., Wardle, J., Pirotta, M. & Lui, C. 2013, 'Complementary And Alternative Medicine Consultations In Urban And Nonurban Areas: A National Survey Of 1427 Australian Women', Journal Of Manipulative And Physiological Therapeutics, vol. 36, no. 1, pp. 12-19.
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Objectives: The purpose of this study was to evaluate survey data from a national cross-sectional sample of 1427 urban and nonurban Australian women focusing on the relationship between the use of specific complementary and alternative medicine (CAM) pra
Kirby, E., Broom, A., Sibbritt, D., Adams, J. & Refshauge, K. 2013, 'A National Cross-sectional Survey Of Back Pain Care Amongst Australian Women Aged 60-65', European Journal of Integrative Medicine, vol. 5, no. 1, pp. 36-43.
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Aim of the study To analyse the use of complementary and alternative medicine (CAM), allied health and biomedicine for back pain amongst Australian women aged 60+65. Methodology Self-completion postal survey in 2011/2012 of 1310 women who reported seeking help for back pain from the mid-age cohort of the Australian Longitudinal Study on Women's Health (ALSWH). Questions asked about their use of, and attitudes towards, CAM, allied health and biomedicine for the treatment of back pain. Results Intensity of back pain was greater for those who consulted biomedical and allied health practitioners. Women reported seeking help from biomedical and allied health practitioners more quickly after onset of pain than CAM practitioners but the longer their pain persisted the more likely they were to consult CAM practitioners. Use of CAM reflected less perceived benefit of biomedicine and allied health. The perceived differences in approach of CAM practitioners (e.g. more time in consultation, more equal relationship, more holistic approach) may be influential in their use and perceived benefit. Ease of access/availability may also influence use of CAM in particular. Some communication limitations were reported regarding discussing the use of other practitioner groups with biomedical and CAM practitioners.
Singer, J. & Adams, J. 2013, 'An Exploratory Study Of The Health Service Managers Role In Providing Effective Integrative Health Care', European Journal of Integrative Medicine, vol. 5, no. 1, pp. 27-35.
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Introduction Emerging health service research on integrative health care (IHC) has predominantly focused on the experiences and perceptions of patients and practitioners. To date no work has focused attention upon health service managers (HSMs) and their involvement in IHC service provision. In this paper we report on the first exploratory investigation of the perspectives of HSMs regarding their role in facilitating effective IHC practice. Methods Semi-structured interviews were conducted with a purposive sample of eight HSMs. Six were responsible for community-based programmes (drug and alcohol rehabilitation, refugee mental health and women's health) and two were responsible for hospital-based specialist programmes dealing with chronic conditions. Results Findings reveal that HSMs in this study perceive their role as important in the establishment and the continuity of strategies to enable effective IHC practice. HSMs recognised the clinical relevance of CAM within their services and proactively instigated appropriate supportive organisational structures to facilitate inter-disciplinary respect and collegiality between practitioners. The current study suggests CAM champions, co-location, educational and communication strategies, clear and respectful boundaries between disciplines, well informed referral practices and shared values are all seen by HSMs to be important to ensure the sustainability and efficacy of IHC practice.
Shanley, C., Boughtwood, D.L., Santalucia, Y., Adams, J., Ferrerosa-rojas, J., Kourouche, F., Gava, S. & Wu, Y. 2013, 'Qualitative Research On Dementia In Ethnically Diverse Communities: Fieldwork Challenges And Opportunities', American Journal of Alzheimer's Disease & Other Dementias, vol. 28, no. 3, pp. 278-283.
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Australia, like other ethnically diverse societies, needs to provide culturally appropriate health care to all its citizens. One way of facilitating this is to ensure that health services research adequately reflects the circumstances and needs of culturally and linguistically diverse (CALD) communities within the population. This article discusses the fieldwork phase of a qualitative research project on dementia caregiving in 4 CALD communities in south west Sydney, Australia. Rather than focusing on the study results+which have been published elsewhere+this article presents and discusses crucial fieldwork issues that arose in the conduct of the project, particularly regarding participant recruitment and facilitation of focus groups. In being transparent about some of the difficulties encountered and how these were managed, we offer suggestions for other researchers wanting to include CALD communities in a meaningful way in their research projects
Sibbritt, D., Adams, J. & Murthy, V. 2013, 'The Prevalence And Determinants Of Chinese Medicine Use By Australian Women: Analysis Of A Cohort Of 10,287 Women Aged 56-61 Years', American Journal Of Chinese Medicine, vol. 41, no. 2, pp. 281-291.
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This study aimed to examine the factors associated with Chinese medicine use amongst a sample of 10,287 Australian women aged 56+61 years. Data was obtained from a cross-sectional postal questionnaire conducted in 2007, this being the fifth survey of the Australian Longitudinal Study on Women's Health. This representative sample of 10,287 women was randomly selected from the Health Insurance Commission (Medicare) database. The outcome measure was the use of Chinese medicine in the previous 12 months. The predictive factors included demographics, health status measures and health service utilization measures. Statistical analyses included univariate chi-square and ANOVA tests and backward stepwise multiple logistic regression modelling. The use of Chinese medicine amongst women aged 56+61 years appears to be strongly influenced by their country of birth, consultation with a range of CAM practitioners, and the use of some self-prescribed CAM. Interestingly, severe tiredness was the only symptom or diagnosis that predicted Chinese medicine use. Given the substantial prevalence of Chinese medicine use and the finding that the use of Chinese medicine is heavily integrated alongside the use of many other CAM and conventional treatments, it is imperative for the safety of patients that health professionals (across complementary and conventional healthcare) fully recognise the possible Chinese medicine use amongst their practice populations. In order to help inform relevant practice and policy development it is also important that future research further examining women's decision-making, motivations and evaluations regarding Chinese medicine use considers such issues within the context of broader CAM and conventional health care utilization.
Homer, C.S., Besley, K.J., Bell, J.E., Davis, D.L., Adams, J., Porteous, A., Foureur, M. 2013, 'Does continuity of care impact decision making in the next birth after a caesarean section(VBAC)? A randomised controlled trial', BMC Pregnancy Childbirth, vol. 13, no. 140, pp. 1-6.
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Background: Caesarean section (CS) has short and long-term health effects for both the woman and her baby. One of the greatest contributors to the CS rate is elective repeat CS. Vaginal birth after caesarean (VBAC) is an option for many women; despite this the proportion of women attempting VBAC remains low.
Solomon, D., Adams, J. & Graves, N. 2013, 'Economic Evaluation Of St. John's Wort (hypericum Perforatum) For The Treatment Of Mild To Moderate Depression', Journal Of Affective Disorders, vol. 148, no. 2-3, pp. 228-234.
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Background: The burden of rising health care expenditures has created a demand for information regarding the clinical and economic outcomes associated with Complementary and Alternative Medicines. Clinical controlled trials have found St. John's wort to
Wardle, J., Adams, J. & Sibbritt, D. 2013, 'Homeopathy in rural Australian primary health care: a survey of general practitioner referral and practice in rural and regional New South Wales, Australia', Homeopathy, vol. 102, no. 3, pp. 199-206.
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Introduction: Homeopathy has attracted considerable recent attention from the Australian conventional medical community. However, despite such increased attention there has been little exploration of the interface between homeopathy and Australian conventional medical practice. This article addresses this research gap by exploring homeopathic practice and referral by rural and regional Australian general practitioners (GPs).
Adams, J., Sibbritt, D., Lui, C., Broom, A. & Wardle, J. 2013, '-3 fatty acid supplement use in the 45 and Up Study Cohort', BMJ Open, vol. 2013, no. 3, pp. e002292-1-e002292-7.
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Objective: There has been a dramatic increase in the use of dietary supplements in Western societies over the past decades. Our understanding of the prevalence of O-3 fatty acid supplement consumption is of significance for future nutrition planning, health promotion and care delivery. However, we know little about O-3 fatty acid supplement consumption or users. This paper, drawing upon the largest dataset with regard to O-3 fatty acid supplement use (n=266 848), examines the use and users of this supplement among a large sample of older Australians living in New South Wales.
Steel, A.E., Frawley, J.E., Sibbritt, D. & Adams, J. 2013, 'A preliminary profile of Australian women accessing doula care: Findings from the Australian Longitudinal Study on Women's Health', Australian and New Zealand Journal of Obstetrics & Gynaecology, vol. 53, no. 6, pp. 589-592.
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Despite growing interest and controversy regarding the value of doulas in contemporary maternity care, little is known about the profile of women who choose to involve a doula in their care team. This preliminary analysis indicates that women's attitudes towards maternity care may influence their use of a doula more so than demographic factors. Further research examining these
Adams, J. 2013, 'Providing leadership in complementary medicine research: Introducing the Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney', Australian Journal of Herbal Medicine, vol. 25, no. 2, pp. 54-56.
Abstract: An integral component of national and global health research systems is the development of the capacity to undertake health research effectively (Lansang and Dennis 2004). Such research capacity building is also essential for producing a sound evidence base that is relevant to, and of benefit for, practice and policy decision-making (Cooke 2005). This is as important for complementary medicine (CM), including herbal medicine, as for conventional medicine (Adams et al 2012a).
Thompson, R., Lee, C. & Adams, J. 2013, 'Imagining Fatherhood: Young Australian Men's Perspectives on Fathering', International Journal of Men's Health, vol. 12, no. 2, pp. 150-165.
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Cultural norms that view men as peripheral to family life and to decision-making about parenthood have shaped mainstream research agendas and underlie the relative lack of research on men's perspectives on fatherhood. This semi-structured interview study explored the subjective meaning of having children and being a father in the imagined future lives of 16 male university students in Australia.
Frawley, J.E., Adams, J., Sibbritt, D., Steel, A.E., Broom, A. & Gallois, C. 2013, 'Prevalence and determinants of complementary and alternative medicine use during pregnancy: Results from a nationally representative sample of Australian pregnant women', Australian and New Zealand Journal of Obstetrics & Gynaecology, vol. 53, no. 4, pp. 347-352.
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Background: Pregnant women have been identi?ed as high users of complementary and alternative medicine (CAM). However, no research to date has provided a detailed analysis of the prevalence and determinants of CAM consumption amongst pregnant women. Aim: To examine the prevalence and determinants of CAM use by pregnant women, utilising a national representative sample. Methods: The study sample was obtained via the Australian Longitudinal Study on Women+s Health. This paper is based on a sub-study of 1,835 pregnant women, administered in 2010. The women answered questions about CAM use, demographics, pregnancy-related health concerns and health service utilisation. Results: Complementary and alternative medicine use was found to be high with 48.1% (n = 623) of pregnant women consulting a CAM practitioner and 52.0% (n = 842) of women using CAM products (excluding vitamins and minerals) during pregnancy. CAM practitioner visits were more likely for selected pregnancy-related health concerns, namely back pain or back ache, neck pain and labour preparation. Women were less likely to consult a CAM practitioner if they suffered with headaches/migraines. Employment was also found to be predictive of pregnant women+s visits to a CAM practitioner. Signi?cant health history and demographic predictors of CAM product use were tiredness and fatigue, embarking on preparation for labour and having a university education. Conclusion: Most pregnant women are utilising CAM products and/or services as part of their maternity care and obstetricians, general practitioners and midwives need to enquire with women in their care about possible CAM use to help promote safe, effective coordinated maternity care.
Adams, J. & Robinson, N. 2013, 'Public health and health services research in integrative medicine: An emerging, essential focus', European Journal of Integrative Medicine, vol. 5, no. 1, pp. 1-3.
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The empirical investigation of integrative medicine (IM) and complementary medicine (CM) has grown exponentially over recent years. The focus of this increasing body of work incorporates many different perspectives and approaches but as yet the vast majority of research energy has been dedicated to examining clinical efficacy [1].
Kirby, E., Broom, A.K., Sibbritt, D., Refshauge, K. & Adams, J. 2013, 'Health Care Utilisation and Out-of-Pocket Expenditure Associated with Back Pain: A Nationally Representative Survey of Australian Women', Plos One, vol. 8, no. 12, pp. e83559-1-e83559-7.
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Background: Back pain impacts on a significant proportion of the Australian population over the life course and has high prevalence rates among women, particularly in older age. Back pain care is characterised by multiple practitioner and self-prescribed
Wardle, J., Sibbritt, D. & Adams, J. 2013, 'Acupuncture referrals in rural primary healthcare: a survey of general practitioners in rural and regional New South Wales, Australia', Acupuncture In Medicine, vol. 31, no. 4, pp. 375-382.
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Background Acupuncture services form a significant part of the Australian healthcare setting, with national registration of acupuncture practitioners, public subsidies for acupuncture services and high use of acupuncture by the Australian public. Despite
Wardle, J. & Adams, J. 2013, 'Are the CAM professions engaging in high-level health and medical research? Trends in publicly funded complementary medicine research grants in Australia', Complementary Therapies In Medicine, vol. 21, no. 6, pp. 746-749.
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Introduction: Developing research capacity is an essential part of professional development in the health professions, as well as essential to improving health care delivery. CAM is one area in which the importance of research capacity has been previousl
Wardle, J., Sibbritt, D. & Adams, J. 2013, 'Referral To Massage Therapy In Primary Health Care: A Survey Of Medical General Practitioners In Rural And Regional New South Wales, Australia', Journal Of Manipulative And Physiological Therapeutics, vol. 36, no. 9, pp. 595-603.
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Objectives: Massage therapists are an important part of the health care setting in rural and regional Australia and are the largest complementary and alternative medicine (CAM) profession based on both practitioner numbers and use. The purpose of this st
Adams, J., Sommers, E. & Robinson, N. 2013, 'Public health and health services research in integrative medicine: An emerging, essential focus', European Journal Of Integrative Medicine, vol. 5, no. 1, pp. 1-3.
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Beatty, L., Adams, J., Sibbritt, D. & Wade, T.D. 2012, 'Evaluating the impact of cancer on complementary and alternative medicine use, distress and health related QoL among Australian women: A prospective longitudinal investigation', Complementary Therapies In Medicine, vol. 20, no. 1-2, pp. 61-69.
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Objectives: While several cross-sectional studies have examined psychological correlates of complementary and alternative medicine (CAM) use and cancer, few prospective longitudinal investigations have been reported. This study examined whether CAM use moderated distress and quality of life (HRQoL) from pre- to post-cancer.
Ider, B., Adams, J., Morton, A.E., Whitby, M., Muugolog, T., Lundeg, G. & Clements, A. 2012, 'Using a checklist to identify barriers to compliance with evidence-based guidelines for central line management: a mixed methods study in Mongolia', International Journal of Infectious Diseases, vol. 16, no. 7, pp. E551-E557.
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This study aimed to determine the extent to which a checklist has potential for identifying barriers to compliance with central line management guidelines, to evaluate the potential utility of checklists to improve the management of central lines in Mongolia, and to define the gap between current and best practices. Methods: A 22-item checklist was developed based on the Centers for Disease Control and Prevention (CDC, USA) guidelines and existing central line-associated bloodstream infection (CLABSI) checklists. The checklist was used to observe 375 central line procedures performed in the intensive care units of four tertiary hospitals of Mongolia between July and December 2010. In parallel, 36 face-to-face interviews were conducted in six other tertiary hospitals to explain practice variations and identify barriers. Results: The baseline compliance level across all components of the checklist was 68.5%. The main factors explaining low levels of compliance were outdated local standards, a lack of updated guidelines, poor control over compliance with existing clinical guidelines, poor supply of medical consumables, and insufficient knowledge of contemporary infection control measures among health care providers. Conclusions: The health authorities of Mongolia need to adequately address the prevention and control of CLABSIs in their hospitals. Updating local standards and guidelines and implementing adequate multifaceted interventions with behavioral, educational, and logistical components are required. Use of a checklist as a baseline evaluation tool was feasible. It described current practice, showed areas that need urgent attention, and provided important information needed for future planning of CLABSI interventions.
Sibbritt, D., Adams, J., Lui, C. & Broom, A. 2012, 'Health services use among young Australian women with allergies, hayfever and sinusitis: A longitudinal analysis', Complementary Therapies In Medicine, vol. 20, no. 3, pp. 135-142.
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The existing knowledge base on the use of complementary and alternative medicine among patients with allergies is built upon findings of cross-sectional surveys and there is a lack of longitudinal data. There is also a lack of studies that examine both the use of conventional medicine and complementary and alternative medicine among allergy patients. This paper reports the findings of the first ever longitudinal study of the use of conventional providers, practitioners of complementary and alternative medicine, and self-prescribed modalities amongst women with allergies, hayfever and sinusitis from a large nationally representative sample. Analysis focused upon data from 7538 women from the younger cohort of the Australian Longitudinal Study on Women's Health collected between 1996 and 2006. Chi-square tests were employed to compare the groups across consultations and self-prescribed treatments and one-way analysis of variance was used to compare the groups across health status. A modified Bonferroni test was used to correct for multiple comparisons. The study identified that women who sought help for their allergic disorder were more likely to consult a range of practitioners and self-prescribed complementary and alternative medicine than women who either did not seek help or did not have allergic disorders. The analysis shows that many women with allergic disorders use complementary and alternative medicine alongside or as a complement to conventional healthcare services. The frequent use of a range of conventional providers and practitioner-based and self-prescribed complementary and alternative medicine amongst women with allergic disorders warrants further investigation.
McLaughlin, D., Lui, C. & Adams, J. 2012, 'Complementary And Alternative Medicine Use Among Older Australian Women - A Qualitative Analysis', Bmc Complementary And Alternative Medicine, vol. 12, no. 34, pp. 1-8.
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In line with increasing complementary medicine (CAM) use, the Australian government has committed considerable resources to the training of CAM practitioners. However, it has generally failed to complement this support with regulation or accountability measures.
Wardle, J., Steel, A. & Adams, J. 2012, 'A Review Of Tensions And Risks In Naturopathic Education And Training In Australia: A Need For Regulation', Journal Of Alternative And Complementary Medicine, vol. 18, no. 4, pp. 363-370.
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In line with increasing complementary medicine (CAM) use, the Australian government has committed considerable resources to the training of CAM practitioners.
Adams, J., Sibbritt, D. & Lui, C. 2012, 'Health Service Use Among Persons With Self-Reported Depression: A Longitudinal Analysis Of 7,164 Women', Archives of Psychiatric Nursing, vol. 26, no. 3, pp. 181-191.
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Depression is a common mental disorder and a leading contributor to the global burden of disease. In Australia, depression is reportedly the leading cause of morbidity for young women. In addition to conventional treatments, there is also some evidence that there is common use of complementary and alternative medicine (CAM) among people with depressive symptoms. However, there has been little research focus upon broad health care and practitioner use (including consumption of both conventional and CAM practitioners as well as self-prescribed care) among young adults with depression. This article aims specifically to address this knowledge gap by providing the first longitudinal analysis of the use of health service among women with self-reported depression. Methods: Data from a longitudinal cohort study (Australian Longitudinal Study on Women's Health) conducted over a 3-year period on 7,164 young Australian women were analyzed. Information on health status, health service use, and self-prescribed treatments was obtained from two questionnaires mailed to study participants in 2003 and 2006.
Wardle, J., Lui, C. & Adams, J. 2012, 'Complementary and Alternative Medicine in Rural Communities: Current Research and Future Directions', Journal of Rural Health, vol. 28, no. 1, pp. 101-112.
The consumption of complementary and alternative medicine (CAM) in rural areas is a significant contemporary health care issue. An understanding of CAM use in rural health can provide a new perspective on health beliefs and practice as well as on some of the core service delivery issues facing rural health care generally. Purpose: This article presents the first review and synthesis of research findings on CAM use and practice in rural communities. A comprehensive search of literature from 1998 to 2010 in CINAHL, MEDLINE, AMED, and CSA Illumina (social sciences) was conducted. The search was confined to peer-reviewed articles published in English reporting empirical research findings on the use or practice of CAM in rural settings. Research findings are grouped and examined according to 3 key themes: "prevalence of CAM use and practice," "user profile and trends of CAM consumption," and "potential drivers and barriers to CAM use and practice." Evidence from recent research illustrates the substantial prevalence and complexity of CAM use in rural regions. A number of potential gaps in our understanding of CAM use and practice in rural settings are also identified.
Broom, A., Kirby, E., Sibbritt, D., Adams, J. & Refshauge, K. 2012, 'Back pain amongst mid-age Australian women: A longitudinal analysis of provider use and self-prescription treatments.', Complementary Therapies In Medicine, vol. 20, no. 5, pp. 275-282.
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To analyse use of conventional and complementary and alternative (CAM) practitioners and self-prescribed CAM amongst mid-age Australian women with back pain.
Sibbritt, D., Adams, J., Lui, C., Broom, A. & Wardle, J. 2012, 'Who uses glucosamine and why? A study of 266,848 Australians aged 45 years and older', PLoS One, vol. 7, no. 7, pp. 1-6.
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Objectives: There has been a dramatic increase in the use of complementary medicines over recent decades. Glucosamine is one of the most commonly used complementary medicines in Western societies. An understanding of glucosamine consumption is of significance for public health and future health promotion. This paper, drawing upon the largest dataset to date with regards to glucosamine use (n = 266,844), examines the use and users of glucosamine amongst a sample of older Australians.
Broom, A., Kirby, E., Sibbritt, D., Adams, J. & Refshauge, K. 2012, 'Use of complementary and alternative medicine by mid-age women with back pain: A national cross-sectional survey', BMC Complementary and Alternative Medicine, vol. 12, no. 98, pp. 1-15.
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The use of complementary and alternative medicine (CAM) has increased significantly in Australia over the past decade. Back pain represents a common context for CAM use, with increasing utilisation of a wide range of therapies provided within and outside conventional medical facilities. We examine the relationship between back pain and use of CAM and conventional medicine in a national cohort of mid-aged Australian women.
Ider, B., Adams, J., Morton, A., Whitby, M. & Clements, A. 2012, 'Infection control systems in transition: the challenges for post-Soviet Bloc countries', Journal Of Hospital Infection, vol. 80, no. 4, pp. 277-287.
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Background: Just two decades ago, 30 of today's countries in Europe and Asia had socialist governments under Soviet dominance or direct administration. Intensive health system reforms have altered infection control in many of these countries. However, much of the literature from these countries is difficult to access by international scientists. Aim: To summarize existing infection control policies and practices in post-Soviet Bloc countries. Methods: In addition to PubMed and Google search engines, we explored local websites and grey literature. In total, 192 references published in several languages were reviewed. Findings: Infection control in these countries is in the midst of transition. Three groups of countries were identified. First, Eastern European and Baltic countries building surveillance systems for specific pathogens and antibiotic use; second, European post-Soviet Bloc countries focusing on the harmonization of recently established infection control infrastructure with European surveillance programmes; third, countries such as those formerly in the Union of Soviet Socialist Republics, Mongolia and post-conflict Eastern European countries that are in the first stages of reform. Poor commitment, resource scarcity and shortages of expertise were identified. Underreporting of official infection control statistics is widespread. Conclusions: Guidance from international organizations has been crucial in initiating and developing contemporary infection control programmes. More support from the international community will be needed for the third group of countries, where infection control has remained a neglected issue.
Ford, E., Adams, J. & Graves, N. 2012, 'Development of an economic model to assess the cost-effectiveness of hawthorn extract as an adjunct treatment for heart failure in Australia', BMJ Open, vol. 2, pp. 1-10.
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Objective: An economic model was developed to evaluate the cost-effectiveness of hawthorn extract as an adjunctive treatment for heart failure in Australia. Methods: A Markov model of chronic heart failure was developed to compare the costs and outcomes of standard treatment and standard treatment with hawthorn extract. Health states were defined by the New York Heart Association (NYHA) classification system and death. For any given cycle, patients could remain in the same NYHA class, experience an improvement or deterioration in NYHA class, be hospitalised or die. Model inputs were derived from the published medical literature, and the output was quality-adjusted life years (QALYs). Probabilistic sensitivity analysis was conducted. The expected value of perfect information (EVPI) and the expected value of partial perfect information (EVPPI) were conducted to establish the value of further research and the ideal target for such research.
Adams, J. & Steel, A.E. 2012, 'Editorial: Investigating complementary and alternative medicine in maternity care: The need for further public health/health services research', Complementary Therapies in Clinical Practice, vol. 18, pp. 73-74.
The relationship between complementary and alternative medicine (CAM) and maternity care has attracted much attention over recent years and there has been a movement towards developing and promoting an evidence-base to help understand the interface between CAM, midwifery and wider mainstream maternity care.
Hay, A.D., Rortveit, G., Purdy, S., Adams, J., Sanci, L.A., Schermer, T.R. & van der Windt, D.A. 2012, 'Primary care research- an international responsibility', Family Practice, vol. 29, no. 5, pp. 499-500.
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The provision of primary care secures equitable and cost-effective health care. Academic primary care is strong in countries where substantial levels of research funding are available3 with quality outputs achieved. Despite this, many high- and low-income countries do not have a comprehensive primary health care system, much less one built on scientific evidence.
Ider, B., Adams, J., Morton, A., Whitby, M. & Clements, A. 2012, 'Perceptions of healthcare professionals regarding the main challenges and barriers to effective hospital infection control in Mongolia: a qualitative study', BMC Infectious Diseases, vol. 12, no. 170, pp. 1-18.
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It is not fully understood why healthcare decision-makers of developing countries often give low priority to infection control and why they are unable to implement international guidelines. This study aimed to identify the main perceived challenges and barriers that hinder the effective implementation of infection control programmes in Mongolia.
Broom, A., Kirby, E., Good, P., Wootton, J. & Adams, J. 2012, 'Specialists' Experiences and Perspectives on the Timing of Referral to Palliative Care: A Qualitative Study', Journal Of Palliative Medicine, vol. 15, no. 11, pp. 1-6.
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Background: Specialist referral practices regarding palliative care are variable and their decision-making practices regarding timing and communication remains an under-researched issue. More effective referral practices have been shown to enhance patient and carer experiences at the end of life, reduce the burden on pre-palliative care services, and even extend life expectancy in some cases.
Steel, A.E., Adams, J., Sibbritt, D., Broom, A., Gallois, C. & Frawley, J.E. 2012, 'Utilisation of complementary and alternative medicine (CAM) practitioners within maternitycare provision: results from a nationally representative cohort study of 1,835 pregnant women', BMC Pregnancy Childbirth, vol. 12, no. 146, pp. 1-8.
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Background: There is little known about women's concurrent use of conventional and complementary health care during pregnancy, particularly consultation patterns with complementary and alternative medicine (CAM). This study examines health service utilisation among pregnant women including consultations with obstetricians, midwives, general practitioners (GPs) and CAM practitioners.
Boughtwood, D.L., Shanley, C., Adams, J., Santalucia, Y., Kyriazopoulos, H., Pond, D. & Rowland, J. 2012, 'Dementia Information For Culturally And Linguistically Diverse Communities: Sources, Access And Considerations For Effective Practice', Australian Journal of Primary Health, vol. 18, no. 3, pp. 190-196.
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Providing information about dementia has been shown to produce immense benefits for people living with dementia and their carers. The dementia information needs of culturally and linguistically diverse (CALD) families have not been comprehensively invest
Shanley, C., Boughtwood, D.L., Adams, J., Santalucia, Y., Kyriazopoulos, H., Pond, D. & Rowland, J. 2012, 'A Qualitative Study Into The Use Of Formal Services For Dementia By Carers From Culturally And Linguistically Diverse (CALD) Communities', BMC Health Services Research, vol. 12, no. NA, pp. 0-0.
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Background: People with dementia and their family carers need to be able to access formal services in the community to help maintain their wellbeing and independence. While knowing about and navigating one's way through service systems is difficult for m
Broom, A., Meurk, C., Adams, J. & Sibbritt, D. 2012, 'My health, my responsibility? Complementary medicine and self (health) care', Journal of Sociology, vol. epub, pp. 1-16.
People are increasingly compelled to take responsibility for their health and illness trajectories. The existing literature on what may be termed self-care points to the ways that public health initiatives have instigated the transfer of governance onto the individual through campaigns promoting physical activity and diet among other things.
Steel, A.E. & Adams, J. 2012, 'Developing midwifery and complementary medicine collaboration: The potential of interprofessional education?', Complementary Therapies in Clinical Practice, vol. 18, pp. 261-264.
A higher percentage of referrals to complementary and alternative medicine (CAM) by midwives can be linked to their af?nity with CAM. However, midwifery education does not commonly include CAM as part of the curriculum leaving potential for misinformation and unsafe practice. An approach to CAM education which encourages collaboration between all care providers is needed to ensure safe, womancentred maternity care. Whilst a number of models have been considered in health education they are not without their limitations when aiming to promote interprofessional collaboration.
Steel, A.E., Diezel, H.M., Johnstone, K., Sibbritt, D., Adams, J. & adair, r. 2012, 'The Value of Care Provided by Student Doulas: An Examination of the Perceptions of Women in Their Care', Journal of Perinatal Education, vol. 22, no. 1, pp. 39-48.
This study provides an examination of women's perceptions of care provided by student doulas undertaking a formal qualification in doula support services. Feedback forms completed by women attended by student doulas undertaking a formal qualification in doula support services were analyzed. The women (N = 160) consistently rated the student doulas' contribution to their experience of birth favorably. Qualitative analysis revealed that women value the presence of their student doulas highly with reference to the student doulas' demeanor, support provided to family, interface with other health professionals, and learned skills. Within the Australian context, this study suggests that the support provided by student doulas that have completed a formal training course is held in positive regard by the women receiving their care.
Sibbritt, D., Adams, J. & Van Der Riet, P. 2011, 'The Prevalence And Characteristics Of Young And Mid-Age Women Who Use Yoga And Meditation: Results Of A Nationally Representative Survey Of 19,209 Australian Women', Complementary Therapies In Medicine, vol. 19, no. 2, pp. 71-77.
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Objective: To determine the characteristics of yoga and meditation users and non-users amongst young and mid-aged Australian women. Design and setting: The research was conducted as part of the Australian Longitudinal Study on Womens Health (ALSWH) which
Steel, A. & Adams, J. 2011, 'The Application And Value Of Information Sources In Clinical Practice: An Examination Of The Perspective Of Naturopaths', Health Information And Libraries Journal, vol. 28, no. 2, pp. 110-118.
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Background: The approach of evidence-based medicine (EBM), providing a paradigm to validate information sources and a process for critiquing their value, is an important platform for guiding practice. Researchers have explored the application and value o
Sibbritt, D., Adams, J. & Lui, C. 2011, 'A Longitudinal Analysis Of Complementary And Alternative Medicine Use By A Representative Cohort Of Young Australian Women With Asthma, 1996-2006', Journal Of Asthma, vol. 48, no. 4, pp. 380-386.
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Background. There is evidence of asthma patients using complementary and alternative medicine (CAM). This article reports the findings of the first ever longitudinal study of CAM use among women with asthma from a large nationally representative sample.
Johnson, C., Paul, C., Girgis, A., Adams, J. & Currow, D. 2011, 'Australian General Practitioners And Oncology Specialists Perceptions Of Barriers And Facilitators Of Access To Specialist Palliative Care Services', Journal Of Palliative Medicine, vol. 14, no. 4, pp. 429-435.
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Purpose: Doctors in Australia play an important role in facilitating access to specialist palliative care (SPC) services for people with advanced cancer. This study aimed to describe doctors perceptions of barriers to referring patients for SPC, and to i
Adams, J., Lui, C., Sibbritt, D., Broom, A., Wardle, J., Homer, C.S. 2011, 'Attitudes And Referral Practices Of Maternity Care Professionals With Regard To Complementary And Alternative Medicine: An Integrative Review', Journal of Advanced Nursing, vol. 67, no. 3, pp. 472-483.
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Aim. This paper presents an integrative literature review examining the attitudes and referral practices of midwives and other maternity care professionals with regard to complementary and alternative treatment and its use by pregnant women. Background.
Johnson, C., Girgis, A., Paul, C., Currow, D., Adams, J. & Aranda, S. 2011, 'Australian Palliative Care Providers Perceptions And Experiences Of The Barriers And Facilitators To Palliative Care Provision', Supportive Care in Cancer, vol. 19, no. 3, pp. 343-351.
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People with advanced cancer who may benefit from specialised palliative care (SPC) do not necessarily access such services. To obtain a deeper understanding of issues affecting access to SPC, five focus groups were undertaken with nurses (35), physicians
Solomon, D., Ford, E., Adams, J. & Graves, N. 2011, 'Potential Of St John's Wort For The Treatment Of Depression: The Economic Perspective', Australian And New Zealand Journal Of Psychiatry, vol. 45, no. 2, pp. 123-130.
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The burden of rising health care expenditures has created a demand for information regarding the clinical and economic outcomes associated with complementary and alternative medicines. Meta-analyses of randomized controlled trials have found Hypericum pe
Magin, P., May, J., Mcelduff, P., Goode, S., Adams, J. & Cotter, G. 2011, 'Occupational Violence In General Practice: A Whole-Of-Practice Problem. Results Of A Cross-Sectional Study', Australian Health Review, vol. 35, no. 1, pp. 75-80.
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Objective. To examine the experiences of occupational violence in general practitioner (GP) and non-GP staff. Further objectives were to compare prevalence of violence in GP and non-GP staff and to examine levels of apprehension and perceptions of contro
Adams, J., Sibbritt, D. & Lui, C. 2011, 'The Urban-Rural Divide In Complementary And Alternative Medicine Use: A Longitudinal Study Of 10,638 Women', BMC Complementary And Alternative Medicine, vol. 11, no. 2, pp. 1-7.
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Background: Research has identified women in rural and remote areas as higher users of complementary and alternative medicine (CAM) practitioners than their urban counterparts. However, we currently know little about what influences womens CAM consumptio
McLaughlin, D., Adams, J., Vagenas, D. & Dobson, A. 2011, 'Factors Which Enhance Or Inhibit Social Support: A Mixed-Methods Analysis Of Social Networks In Older Women', Ageing & Society, vol. 31, no. Part 1, pp. 18-33.
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Evidence suggests that people with strong social support have lower mortality and morbidity and better self-rated health in later life, but few studies have used longitudinal data to examine the factors that inhibit or enhance social support. This study
Adams, J., Sibbritt, D., Broom, A., Loxton, D., Pirotta, M., Humphreys, J. & Lui, C. 2011, 'A comparison of complementary and alternative medicine users and use across geographical areas: A national survey of 1,427 women', BMC Complementary And Alternative Medicine, vol. 11, no. 85, pp. 1-8.
Background: Evidence indicates that people who reside in non-urban areas have a higher use of complementary and alternative medicine (CAM) than people who reside in urban areas. However, there is sparse research on the reasons for such differences. This paper investigates the reasons for geographical differences in CAM use by comparing CAM users from four geographical areas (major cities, inner regional, outer region, rural/remote) across a range of health status, healthcare satisfaction, neighbourhood and community factors. A cross-sectional survey of 1,427 participants from the Australian Longitudinal Study on Women's Health (ALSWH) conducted in 2009.
Magin, P. & Adams, J. 2011, 'Occupational Violence', Australian Family Physician, vol. 40, no. 11, pp. 893-893.
Research into occupational violence in Australia commenced in the Discipline of General Practice at the University of Newcastle (New South Wales) with quantitative and qualitative work in rural general practice led by Dr Helen Tolhurst in the late 1990s. Her team developed definitions of types of occupational violence, which have been used in our subsequent research and in other Australian studies.
Janz, S. & Adams, J. 2011, 'Acupuncture by Another Name: Dry Needling in Australia', Australian journal of acupuncture and Chinese medic, vol. 6, no. 2, pp. 3-11.
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Like acupuncture, dry needling involves the insertion of acupuncture needles into specific points on the body to improve health. Unlike acupuncture, the practice of dry needling is unregulated in Australia. This paper challenges the notion that dry needling is not a part of acupuncture practice and also examines the risks associated with the practice of dry needling from a public health perspective. The practice of acupuncture and dry needling are first examined and compared to identify commonalities. A review into the incidence of risks of dry needling reveals very limited literature with only one case report and no review articles identified. Based on the similarities between acupuncture and dry needling, the extensive literature on the serious risks of acupuncture is extrapolated to evaluate the risks of dry needling. Dry needling is not a new or separate practice to acupuncture; rather it is a subsystem of musculoskeletal acupuncture which has been practised continuously for at least 1 400 years. Dry needling is a pseudonym for a brief course of study in myofascial acupuncture also known as ashi acupuncture and trigger point acupuncture. Dry needling is likely to result in an increased incidence of serious risks, particularly pneumothorax, due to the short training courses and deep needling techniques which typify the practice. In the interest of public health and safety, the practice of dry needling should be restricted to suitably qualified practitioners.
Boughtwood, D.L., Adams, J., Shanley, C., Santalucia, Y. & Kyriazopoulos, H. 2011, 'Experiences and Perceptions of Culturally and Linguistically Diverse Family Carers of People With Dementia', American Journal of Alzheimer's Disease & Other Dementias, vol. 26, no. 4, pp. 290-297.
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Dementia incidence rates are rapidly increasing among culturally and linguistically diverse (CALD) Australians, and there is very little local research to inform practice. In response, a qualitative study employing focus group methods was undertaken with carers from 4 CALD communities - Arabic-speaking, Chinese - speaking, Italian - speaking and, Spanish - speaking. The study examined the experiences and perceptions of these family carers with regard to their caregiving for a person living with dementia (PLWD). Analysis revealed that while considerable similarities exist across the experiences and perceptions of carers from all 4 CALD communities, there were nevertheless some important distinctions across the different groups. These study findings have significant implications for those working with CALD communities.
Janz, S. & Adams, J. 2011, 'Acupuncture Education Standards in Australia: A Critical Review', Australian journal of acupuncture and Chinese medic, vol. 6, no. 1, pp. 3-15.
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The implementation of the National Registration and Accreditation Scheme for the Health Professions incorporates the registration of acupuncturists under the Chinese Medicine Board of Australia from 1 July 2012. Other registered health professionals will still be able to use the title acupuncturist if their board determines that they are suitably qualified to have their registration endorsed for acupuncture. This paper aims to identify the various education and training standards underpinning the practice of acupuncture among the health professions in Australia and create a reference point to determine the impact of registration on future acupuncture education standards. A literature search was conducted to identify scholarly works on acupuncture education standards as well as a search of standard setting bodies and course providers. Results were tabulated for comparison. There is very little literature on acupuncture education standards in Australia despite its practice by a diverse range of health professions.
Adams, J. 2011, 'Growing popularity of complementary and alternative medicine during pregnancy and implications for healthcare providers', Expert Review of Obstetrics & Gynecology, vol. 6, no. 4, pp. 365-366.
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The last few decades have seen increasing interest in complementary and alternative medicine (CAM); a wide range of practices and products including acupuncture, chiropractic, aromatherapy, naturopathy and reflexology that are not traditionally associated with mainstream practitioners nor traditionally taught as part of the medical curriculum, across most developed countries.
McLaughlin, D., Adams, J., Sibbritt, D. & Lui, C. 2011, 'Sex differences in the use of complementary and alternative medicine in older men and women', Australasian Journal on Ageing, vol. 31, no. 2, pp. 78-82.
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Aim: The aim of this study was to examine sex differences in complementary and alternative medicine (CAM) use among older adults. Methods: Cross-sectional analysis of data from two cohort studies of community-dwelling women (n=5399) and men (n=3188) aged 82-87 and 77-91 years, respectively. The main outcome measure was self-report of consultations with an alternative health practitioner.
Steel, A.E. & Adams, J. 2011, 'The role of naturopathy in pregnancy, labour and post-natal care: Broadening the evidence-base', Complementary Therapies in Clinical Practice, vol. 17, no. 4, pp. 189-192.
It is known that women are high users of complementary and alternative medicine (CAM) including naturopathy and that CAM is frequently used by pregnant women. However, we still know little about the consumption, practice and role of naturopathy in pregnancy, labour and post-natal care. With this in mind, this paper proposes a possible framework for advancing further research on this topic. The framework is divided into issues associated with three core stakeholder groups-pregnant women, naturopaths/herbalists and other maternity health professionals including obstetricians, midwives and general practitioners. The development of a rigorous health services research agenda around this topic has much to offer maternity-care users, practitioners and policy makers and the framework outlined here is offered with the hope of inspiring further inquiry into this significant issue in women's health.
Wardle, J., Adams, J., Magalh+es, R.J. & Sibbritt, D. 2011, 'Distribution of complementary and alternative medicine (CAM) providers in rural New South Wales, Australia: A step towards explaining high CAM use in rural health?', Australian Journal of Rural Health, vol. 19, pp. 197-204.
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Objective: Complementary and alternative medicine (CAM) use is high in rural health and an agenda for research in the geography of CAM has been outlined. Unfortunately, no studies to date have mapped the geographic distribution of CAM practitioners in rural areas. For the first time we investigate CAM practitioner distributions across a large district/region in rural Australia.
Magin, P., Adams, J., Heading, G. & Pond, D. 2011, ''Perfect skin', the media and patients with skin disease: a qualitative study of patients with acne, psoriasis and atopic eczema', Australian Journal of Primary Health, vol. 17, pp. 181-185.
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Abstract. The relationship of skin disease with societal ideals of beauty, and the role of the media in this relationship, has not previously been researched. The overall objective of this study was to explore the psychological effects of skin disease. The theme of the ideal of perfect skin and the role of the media in generating this ideal arose via an inductive study methodology and was explored in the context of respondents' psychological morbidity. A qualitative study, 62 semistructured interviews were conducted with respondents with acne, eczema or psoriasis recruited from both general practice and specialist dermatology practice in an Australian regional city. Interviews were audiotaped, transcribed and subjected to thematic analysis employing a process of constant comparison in which data collection and analysis were cumulative and concurrent. The themes of perfect skin, societal ideals and media influence emerged from this iterative process. Respondents identified a societal ideal of flawless skin, largely mediated by media portrayals of perfection. Failure to meet this ideal precipitated psychological morbidity in female, but not male, respondents. An appreciation of the pervasive pressures of society and media upon females with skin disease may inform management strategies, particularly psychological management strategies, in patients with skin disease.
Steel, A.E. & Adams, J. 2011, 'The Interface Between Tradition and Science:Naturopaths' Perspectives of Modern Practice', Journal of Alternative and Complementary Medicine, vol. 17, no. 10, pp. 967-972.
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Objectives: Although there has been much international commentary, little is known about the interface between traditional knowledge and scientific research in modern naturopathic practice. This study aimed to explore this interface from the perspective of naturopaths. Design: Semistructured interviews were conducted with naturopaths in current practice. The participants were selected using purposive sampling, and the data from the interviews were interpreted using thematic analysis. Settings/location: Interviews were conducted in a place suitable to each participant. Subjects: Twelve (12) naturopaths in current clinical practice were interviewed. The participants represented a diversity of characteristics including gender, time in practice, level of qualification, and clinical contact hours per week.
McLaughlin, D., Adams, J., Almeida, O.P., Brown, W., Byles, J.E., Dobson, A., Flicker, L., Hankey, G.J., Jamrozik, K., McCaul, K.A., Norman, P.E. & Pachana, N.A. 2011, 'Are the national guidelines for health behaviour appropriate for older Australians? Evidence from the Men, Women and Ageing project', Australasian Journal on Ageing, vol. 30, no. 2, pp. 13-16.
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Aim: To review findings from the Men, Women and Ageing (MWA) longitudinal studies and consider their implications for national health guidelines. Methods: Guidelines for good health for older adults in the areas of body mass index (BMI), physical activity, alcohol consumption and smoking behaviours are compared with MWA findings.
Adams, J., Sibbritt, D. & Lui, C. 2011, 'The use of complementary and alternative medicine during pregnancy: A longitudinal study of Australian women', Birth: issues in perinatal care, vol. 38, no. 3, pp. 200-206.
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Background: The use of complementary and alternative medicine is increasingly prevalent in contemporary Western societies. The objective of this study was to explore trends and patterns in complementary and alternative medicine practitioner consultations and the use of complementary and alternative medicine consumption before, during, and after pregnancy and between pregnancies. Methods: Analysis focused on data from 13,961 women from the younger cohort of the Australian Longitudinal Study on Women++s Health collected between 1996 and 2006. Chi-square tests were employed for the cross-sectional analysis of categorical variables and t tests for continuous variables. Generalized estimating equations were used to conduct multivariate longitudinal analysis.
Ider, B., Adams, J., Morton, A., Whitby, M. & Clements, A. 2011, 'Gaming in infection control: A qualitative study exploring the perceptions and experiences of health professionals in Mongolia', American Journal of Infection Control, vol. 39, no. 7, pp. 587-594.
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Background: This study aimed to gain insight into the extent to which gaming is responsible for the underreporting of hospital acquired infections (HAIs) in Mongolian hospitals, to identify gaming strategies used by health professionals, and to determine how gaming might be prevented. Methods: Eighty-seven health professionals, including policy- and hospital-level managers, doctors, nurses, and infection control practitioners, were recruited for 55 interviews and 4 group discussions in Mongolia in 2008.
Sibbritt, D., Adams, J. & Moxey, A. 2011, 'Mid-Age Women's Consultations with Acupuncturists: A Longitudinal Analysis of 11,200 Women, 2001-2007', Journal of Alternative and Complementary Medicine, vol. 17, no. 8, pp. 735-740.
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Objectives: The objectives of this study were to chart the patterns and determine the factors associated with acupuncture consultations among a large cohort of mid-aged women in Australia over a 6-year period. Design: A longitudinal analysis of questionnaires completed in 2001, 2004, and 2007 as part of the Australian Longitudinal Study on Women's Health. Statistical analyses included Generalized Estimating Equations. Subjects: Mid-aged women (n = 11,200) were randomly selected from the Australian Medicare database, with oversampling of women from rural and remote areas. Outcome measure: The outcome measure was consultation with an acupuncturist in the 12 months prior to each survey.
Lawler, S., Spathonis, K., Masters, J., Adams, J. & Eakin, E. 2011, 'Follow-up care after breast cancer treatment: experiences and perceptions of service provision and provider interactions in rural Australian women', Supportive Care In Cancer, vol. 19, no. 12, pp. 1975-1982.
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Purpose This study aims to explore and examine experiences and perceptions of follow-up care (medical and psychosocial) after active treatment for breast cancer among women living outside major Australian cities. Method Twenty-five semi-structured telephone interviews were conducted. Participants also completed a brief questionnaire to collect demographic, diagnosis, and treatment information. Interviews were audio-recorded, transcribed, independently coded, and then thematically analysed.
Sibbritt, D. & Adams, J. 2011, 'Developing and promoting public health methods for integrative medicine: examples from the field in Australia', Journal of Chinese Integrative Medicine, vol. 9, no. 3, pp. 233-236.
Integrative medicine (IM) research in China has largely focused on clinical and experimental research , which is critical to determining the efficacy of treatments and enhancing the standing of IM. Nevertheless, there is also a need to extend research activities to include methods and research perspectives from public health , which will provide a greater understanding of clinical practice and assist government and professional organizations to shape policies and directives in IM. In this article we outline the public health research methods we have used in relation to our program of research on complementary and alternative medicine use and area of residence geography, to highlight the usefulness of these methods in IM.
Boughtwood, D.L., Shanley, C., Adams, J., Santalucia, Y., Kyriazopoulos, H., Pond, D. & Rowland, J. 2011, 'Culturally And Linguistically Diverse (CALD) Families Dealing With Dementia: An Examination Of The Experiences And Perceptions Of Multicultural Community Link Workers', Journal of Cross-Cultural Gerontology, vol. 26, no. 4, pp. 365-377.
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Dementia is a chronic illness involving increasing levels of care, often provided by family members, particularly in culturally and linguistically diverse (CALD) communities. Multicultural community link workers are often the primary service providers as
Sibbritt, D., Adams, J. & Lui, C. 2011, 'Health service utilisation by pregnant women over a 7 year period', Midwifery, vol. 27, pp. 474-476.
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To examine the use of complementary and alternative medicine during pregnancy using data from a longitudinal cohort study. The research was conducted as part of the Australian Longitudinal Study on Women's Health which was designed to investigate multiple factors affecting the health and well-being of women over a 20-year period. The younger cohort of the Australian Longitudinal Study on Women's Health who had completed four surveys in 1996, 2000, 2003 and 2006.
Steel, A.E., Adams, J. & Sibbritt, D. 2011, 'Complementary and Alternative Medicine in Pregnancy: a Systematic Review', Journal of the Australian Traditional-Medicine Society, vol. 17, no. 4, pp. 205-209.
A systematic review of recent peer-reviewed literature exploring women++s use of complementary and alternative medicine (CAM) in pregnancy, birth and postnatal care.
Steel, A.E. & Adams, J. 2011, 'Approaches to clinical decision-making: A qualitative study of naturopaths', Complementary Therapies in Clinical Practice, vol. 17, pp. 81-84.
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The type of information used and its application in clinical practice has generated interest due to its relationship to evidence-based medicine (EBM). However, it is also acknowledged that the principles of EBM place less value on practitioners' experience and intuitive insights when making clinical decisions.
Pirotta, M., Kotsirilos, V., Brown, J., Adams, J., Morgan, T. & Williamson, M. 2010, 'Complementary Medicine In General Practice A National Survey Of Gp Attitudes And Knowledge', Australian Family Physician, vol. 39, no. 12, pp. 946-950.
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Background Integrative medicine is a holistic approach to patient care that utilises both conventional and complementary therapy. This article compares the demographics of Australian general practitioners who do, and those who do not, practise integrativ
Ford, E., Solomon, D., Adams, J. & Graves, N. 2010, 'The Use Of Economic Evaluation In CAM: An Introductory Framework', BMC Complementary And Alternative Medicine, vol. 10, no. 1, pp. 1-9.
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Background: For CAM to feature prominently in health care decision-making there is a need to expand the evidence-base and to further incorporate economic evaluation into research priorities. In a world of scarce health care resources and an emphasis on e
Magin, P., Joyce, T., Adams, J., Goode, S. & Cotter, G. 2010, 'General Practice As a Fortress Occupational Violence and General Practice Receptionists', Australian Family Physician, vol. 39, no. 11, pp. 854-856.
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Background Occupational violence is well documented among general practice receptionists, who are singularly vulnerable because they are placed in the general practice frontline. One response to this threat has been to physically isolate reception staff
Magin, P., Heading, G., Adams, J. & Pond, D. 2010, 'Sex And The Skin: A Qualitative Study Of Patients With Acne, Psoriasis And Atopic Eczema', Psychology, Health & Medicine, vol. 15, no. 4, pp. 454-462.
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Quantitative questionnaire-based research has suggested a considerable effect of skin disease on the sexual life of sufferers. In this study, we explored the effects of acne, psoriasis and atopic eczema upon sexual functioning and sexual relationships in the context of a wider exploration of the psychological sequelae of these diseases. We employed a qualitative methodology employing in-depth semistructured interviews and involving thematic analysis and constant comparison. Participants were patients with currently active acne, psoriasis or atopic eczema. Purposive sampling aimed to obtain a sample reflecting a wide range of participant characteristics including skin disease severity, age, sex, and care by general practitioner or dermatologist. Sixty-two semi-structured interviews were conducted. Acne had adverse effects on participants+ self-perceived sexual attractiveness and self-confidence, as did psoriasis and eczema. But psoriasis and eczema also had marked effects on sexual well-being and on capacity for intimacy. These were related to issues of self-esteem and sexual self-image and were often pervasive, resulting in marked behavioural avoidance of intimate situations and continuing effects on sexual well-being even in long-established sexual relationships. Effects of psoriasis and eczema on sexual well-being and sexual relationships were mediated more by appearance and texture of nongenital skin than by involvement of genital skin. We conclude that, while recognising the distressing effects of acne on self-perceived sexual attractiveness, clinicians should be especially aware of the capacity of psoriasis and eczema to profoundly affect patients+ psychological and sexual well-being.
Wardle, J., Adams, J. & Lui, C. 2010, 'A Qualitative Study Of Naturopathy In Rural Practice: A Focus Upon Naturopaths Experiences And Perceptions Of Rural Patients And Demands For Their Services', BMC Health Services Research, vol. 10, no. 1, pp. 1-8.
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Background: Complementary and alternative medicine (CAM) use - of which naturopathy constitutes a significant proportion - accounts for approximately half of all health consultations and half of out-of-pocket expenditure in Australia. Data also suggest C
Ider, B., Clements, A., Adams, J., Whitby, M. & Muugolog, T. 2010, 'Organisation Of Hospital Infection Control In Mongolia', Journal Of Hospital Infection, vol. 75, no. 3, pp. 209-213.
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As with other areas of the public sector in Mongolia, the healthcare system has undergone significant structural and policy reforms since the early 1990s. The previous infection control system, characterised as a sanitary-epidemiological network, was dis
Ider, B., Clements, A., Adams, J., Whitby, M. & Muugolog, T. 2010, 'Prevalence Of Hospital-Acquired Infections And Antibiotic Use In Two Tertiary Mongolian Hospitals', Journal Of Hospital Infection, vol. 75, no. 3, pp. 214-219.
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Health statistics of Mongolia indicate that hospital-acquired infections (HAIs) occur in 0.01-0.05% of all hospital admissions. This is considerably lower than internationally reported rates. A one-day survey was conducted in two tertiary hospitals of Ul
Broom, A., Wijewardena, K., Sibbritt, D., Adams, J. & Nayar, K. 2010, 'The Use Of Traditional, Complementary And Alternative Medicine In Sri Lankan Cancer Care: Results From A Survey Of 500 Cancer Patients', Public Health, vol. 124, no. 4, pp. 232-237.
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Objectives: While the introduction of biomedicine within the Sri Lankan healthcare system has resulted in reduced reliance on traditional, complementary and alternative medicine (TCAM) over the last century in Sri Lanka, treatment modalities such as Ayur
Steinsbekk, A., Adams, J., Sibbritt, D. & Johnsen, R. 2010, 'Complementary And Alternative Medicine Practitioner Consultations Among Those Who Have Or Have Had Cancer In A Norwegian Total Population (Nord-Tr Circle Divide Ndelag Health Study): Prevalence, Socio-Demographics And Health Perceptions', European Journal of Cancer Care, vol. 19, no. 3, pp. 346-351.
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The aim of the study was to identify the use of complementary and alternative medicine (CAM) practitioners among current and previous cancer patients in a total population. A secondary analysis of data from the Nord-Tr circle divide ndelag Health Study (
Broom, A. & Adams, J. 2010, 'The reconfiguration of expertise in oncology: The practice of prediction and articulation of indeterminacy in medical consultations', Qualitative Health Research, vol. 20, no. 10, pp. 1433-1445.
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Evidence-based medicine has enhanced the predictive capacity of biomedicine in population terms, but it has also introduced new challenges for patient care and biomedical expertise. In this article we examine the negotiation of prediction and indeterminacy by oncology clinicians, exploring the ways in which they report delivering prognosis and engaging with indeterminacy in conversation with their patients. We examine oncologists+ strategies for delivering +news,+ the technological mediation of uncertainty, and reported conversational turns toward a focus on indeterminacy and individual response. Drawing from these accounts, we argue that, although predictive capacity remains central to oncological expertise, notions of individualism, subjectivity, and self-determination are being heavily drawn on by clinicians. Rather than presenting a challenge, such ideas might be becoming increasingly central to oncological expertise. Interviews with cancer nurses illustrate their precarious relationship with evidence, uncovering tensions in their approach to patients and in their attempts to traverse diverse paradigms of care. We argue for an understanding of oncological expertise as evolving within the context of potentially competing contemporary cultural shifts, and against a simplistic notion of indeterminacy as necessarily eroding expertise.
Adams, J., Lui, C., Sibbritt, D., Broom, A., Wardle, J., Homer, C.S. & Beck, S. 2009, 'Women's Use of Complementary and Alternative Medicine During Pregnancy: : A Critical Review Of The Literature', Birth: issues in perinatal care, vol. 36, no. 3, pp. 237-245.
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Background: The use of complementary and alternative medicine has attracted much attention and debate in recent years. The objective of this critical review is to examine the evidence base on use of complementary products and therapies during pregnancy. It examines an important but neglected issue in maternity care. Methods: A database search was conducted in MEDLINE, CINAHL, AMED, and Maternity and Infant Care. A total of 24 papers published between 1999 and 2008 met the selection criteria and were included in the review. Results: Findings of these 24 papers were extracted and reported under four themes: "user prevalence and profile,""motivation and condition of use,""perception and self-reported evaluation," and "referral and information sources." Conclusions: This review highlights four research gaps in the literature, a lack of: large representative samples; in-depth understanding of user experiences and risk perceptions; research comparing consumption patterns across cultures and over time; and work exploring the nature of the therapeutic encounter with complementary practitioners in this area of women's health care.
Adams, J., Mackenzie, A., Mclaughlin, R., Burke, N., Bennett, S., Mobbs, R. & ellis, N. 2009, 'Australian Military Primary Care Practitioners Do Not Believe Clinical Practice Guidelines Are Needed For Postdeployment Medically Unexplained Symptoms', Military Medicine, vol. 174, no. 4, pp. 392-397.
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In Australia, little research has been undertaken on the development of clinical practice guidelines (CPGs) to assist with the impact of postdeployment ill-health including medically unexplained symptoms (MUS) and it has been unclear whether such a devel
Adams, J., Hollenberg, D., Lui, C. & Broom, A. 2009, 'Contextualizing Integration: A Critical Social Science Approach To Integrative Health Care', Journal Of Manipulative And Physiological Therapeutics, vol. 32, no. 9, pp. 792-798.
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This article argues for the importance of examining the phenomenon of integrative health care in broader social and historical contexts. The authors examine mainstream approaches to identify patterns of integrative medicine and criticize them for their n
Magin, P., Adams, J., Heading, G., Pond, D. & Smith, W. 2009, 'The Psychological Sequelae Of Psoriasis: Results Of A Qualitative Study', Psychology, Health & Medicine, vol. 14, no. 2, pp. 150-161.
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Psoriasis is a common condition with recognised psychological comorbidity in specialist practice. The objective of this study was to investigate the psychological comorbidities in psoriasis in patients from general (family) practices and specialist dermatology practices, using a qualitative methodology. This was a qualitative study, utilising semi-structured interviews and thematic analysis. Twenty-nine patients with psoriasis were recruited from general practices and specialist dermatology practices in an Australian non-capital city. Respondents represented a broad range of ages and psoriasis severities. The principle study finding was that psychological morbidity in psoriasis is considerable. Though mood and anxiety symptoms were present in participants, and were occasionally severe, more prominent sequelae of psoriasis were embarrassment, shame, impaired self-image, low self-esteem, self-consciousness and stigmatisation. Psoriasis was associated with behavioural avoidance and effects on respondents+ sexuality. The perception of psoriasis as an incurable disease beyond respondents+ control, with consequent pessimism regarding prognosis and treatment efficacy, was a contributor to psychological morbidity. Some respondents reported psoriasis having permanently and adversely affected their personality + avoidant personality traits were ascribed to the experience of living with psoriasis. Our conclusion is that the psychological effects of psoriasis can be considerable and long-lasting and are evident across a broad range of psoriasis severities. Clinicians should be aware that psychological sequelae are complex and encompass a range of psychological morbidities beyond conventional psychiatric diagnoses.
Magin, P., Joyce, T., Adams, J., Goode, S. & Cotter, G. 2009, 'Receptionists Experiences Of Occupational Violence In General Practice: A Qualitative Study', British Journal of General Practice, vol. 59, no. 565, pp. 578-583.
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Background The significance of occupational violence in general practice is well established, but research has focused almost exclusively on the experiences of GPs. Only limited research has examined the role of general practice receptionists despite the
Sarris, J., Kavanagh, D., Byrne, G., Bone, K., Adams, J. & Deed, G. 2009, 'The Kava Anxiety Depression Spectrum Study (KADSS): A Randomized, Placebo-Controlled Crossover Trial Using An Aqueous Extract Of Piper Methysticum', Psychopharmacology, vol. 205, no. 3, pp. 399-407.
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Rationale Piper methysticum (Kava) has been withdrawn in European, British, and Canadian markets due to concerns over hepatotoxic reactions. The WHO recently recommended research into aqueous extracts of Kava. Objective The objective of this study was to
Sarris, J., Kavanagh, D., Adams, J., Bone, K. & Byrne, G. 2009, 'Kava Anxiety Depression Spectrum Study (KADSS): A Mixed Methods Rct Using An Aqueous Extract Of Piper Methysticum', Complementary Therapies In Medicine, vol. 17, no. 3, pp. 176-178.
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Objectives: To report on the design, significance and potential impacts of the first documented human clinical trial assessing the anxiolytic and thymoleptic efficacy of an aqueous mono-extract of Piper methysticum (kava). The significance of the qualita
Outram, S., Hansen, V., Macdonell, G., Cockburn, J. & Adams, J. 2009, 'Still Living In A War Zone: Perceived Health And Wellbeing Of Partners Of Vietnam Veterans Attending Partners Support Groups In New South Wales, Australia', Australian Psychologist, vol. 44, no. 2, pp. 128-135.
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Post-traumatic stress disorder (PTSD) in veterans is well documented, less so the long-term impact on the health of their partners and families. The perceived health and wellbeing of women partners of Australian Vietnam veterans who were members of partn
Broom, A. & Adams, J. 2009, 'Oncology Clinicians Accounts Of Discussing Complementary And Alternative Medicine With Their Patients', Health: an interdisciplinary journal for the social study of health, illness and medicine, vol. 13, no. 3, pp. 317-336.
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The profile of complementary and alternative medicine (CAM) has risen dramatically over recent years, with cancer patients representing some of the highest users of any patient group. This article reports the results from a series of in-depth interviews
Magin, P., Adams, J., Heading, G. & Pond, C. 2009, 'Patients With Skin Disease And Their Relationships With Their Doctors: A Qualitative Study Of Patients With Acne, Psoriasis And Eczema', Medical Journal of Australia, vol. 190, no. 2, pp. 62-64.
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Objective: To explore the experiences of patients with acne, psoriasis or atopic eczema in their relationships with their treating doctors. Design: Qualitative study, using semi-structured interviews conducted between January 2004 and April 2005, themati
Broom, A., Adams, J. & Tovey, P. 2009, 'Evidence-Based Healthcare In Practice: A Study Of Clinician Resistance, Professional De-Skilling, And Inter-Specialty Differentiation In Oncology', Social Science & Medicine, vol. 68, no. 1, pp. 192-200.
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Evidence-based medicine (EBM) is strongly shaping the nature and direction of biomedical practice and organisational culture. Clinicians are now expected to adopt the principles of EBM and evidence-based practice (EBP) whilst also maintaining such things
Adams, J., Sibbritt, D. & Young, A.F. 2009, 'A Longitudinal Analysis Of Older Australian Women's Consultations With Complementary And Alternative Medicine (CAM) Practitioners, 1996-2005', Age And Ageing, vol. 38, no. 1, pp. 93-99.
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Objective: to determine the factors associated with complementary and alternative medicine (CAM) use among older Australian women over time. Methods: a longitudinal analysis of postal questionnaires completed in 1996, 1999, 2002 and 2005 as part of the A
Adams, J. & Wardle, J. 2009, 'Engaging practitioners in research', Journal of Complementary Medicine, vol. Sept/Oct, pp. 5-5.
The CM field needs to further enhance a positive role for practitioners in research Public-health and health-services research in CM is needed to supplement and contextualise clinical trials and related designs A new research network will help address such challenges
Sarris, J., Adams, J. & Wardle, J. 2009, 'Time for a reassessment of the use of Kava in anxiety?', Complementary Therapies In Medicine, vol. 17, no. 3, pp. 121-122.
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Seven years after the ongoing ban of Piper methysticum (Kava) by the EU, UK and Canada: Where are we at? In December 2008, articles by the Fiji Times reported that the Kava ban was over-turned. This statement was subsequently revealed to be erroneous and is indicative of the controversy and confusion sometimes surrounding regulatory, safety and efficacy issues associated with Kava. Cases of hepatotoxicity purportedly caused by European Kava products may have been due to a commercial costmotivated preference for injudicious Kava cultivars or plant parts, and the use of non-traditional solvents (ethanol and acetone).1 Conversely, traditional use of Kava (<100 g per week) is associated with remarkably few adverse effects in Pacific Island communities,2 and public health concerns instead centre on issues of abuse by heavy users.2 5
Sibbritt, D. & Adams, J. 2009, 'Back pain amongst 8,910 young Australian women: a longitudinal analysis of the use of conventional providers, complementary and alternative medicine (CAM) practitioners and self-prescribed CAM', Clinical Rheumatology, vol. 29, no. 1, pp. 25-32.
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Back problems and back pain are amongst the most prevalent conditions afflicting Australians and carry high direct and indirect costs for the health care systems of all developed countries. A major gap in the research literature on this topic is the longitudinal analysis of health seeking behaviour for people with back pain. All studies to date have been cross-sectional and it is important that the use of different providers (both conventional and complementary and alternative medicine, CAM) is examined over time. This study analysed data from a longitudinal study conducted over a 3-year period on 8,910 young Australian women. Information on health service use, self-prescribed treatments, and health status was obtained from two questionnaires mailed to study participants in 2003 and 2006. We found that there is little difference in the consultation practises or use of self-prescribed CAM between women who recently sought help for back pain and women who had longer-term back pain; the only difference being that women with longer-term back pain consulted more with chiropractors. We conclude that women who seek help for their back pain are frequent visitors to a range of conventional and CAM practitioners and are also high users of self-prescribed CAM treatments. The frequent use of a range of conventional providers and practitioner-based and self-prescribed CAM amongst women with back pain warrants further investigation.
Adams, J., Lui, C. & McLaughlin, D. 2009, 'The use of complementary and alternative medicine in later life', Reviews in Clinical Gerontology, vol. 19, no. 4, pp. 227-236.
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The increasing prevalence of complementary and alternative medicine (CAM) use is a significant health care issue in contemporary societies and researchers have identified CAM as holding potential for treating and coping with chronic illness and other conditions experienced in later life. This paper focuses upon contemporary research literature to provide a critical review of the prevalence, correlates, conditions, perceptions and communication of CAM use in later life. Evidence from recent research illustrates the substantial prevalence and complexity of CAM use amongst older people and such ++community++ use requires all providers, regardless of their experience or perception of the worth of CAM, to at least acknowledge and enquire with their older patients about the potential use of these other medicines.
Senarathna, L., Adams, J., De Silva, D., Buckley, N. & Dawson, A. 2008, 'Personal And Professional Challenges In The Management Of Deliberate Self-Poisoning Patients In Rural Sri Lanka: A Qualitative Study Of Rural Hospital Doctors Experiences And Perceptions', BMC Public Health, vol. 8, pp. 1-7.
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Background: Deliberate self-poisoning is a major public heath issue in developing countries. In rural Sri Lanka deliberate self-poisoning is one of the leading causes of hospital death. The majority of patients with poisoning present to rural hospitals f
Magin, P., Adams, J., Joy, E., Ireland, M., Heaney, S. & Darab, S. 2008, 'Violence In General Practice - Perceptions Of Cause And Implications For Safety', Canadian Family Physician, vol. 54, no. 9, pp. 1278-1284.
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OBJECTIVE To explore GPs opinions about the causes of occupational violence in general practice. DESIGN A cross-sectional qualitative study. SETTING Three urban divisions of general practice in New South Wales, Australia. PARTICIPANTS A total of 172 GPs:
Adams, J., Broom, A. & Jennaway, M. 2008, 'Qualitative Methods In Chiropractic Research: One Framework For Future Inquiry', Journal Of Manipulative And Physiological Therapeutics, vol. 31, no. 6, pp. 455-460.
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Qualitative research holds potential for helping understand core aspects of chiropractic. Nevertheless, these methods remain underused in the field. This article overviews a qualitative perspective, introduces qualitative methods, and offers one possible
Magin, P., Adams, J., Heading, G., Pond, D. & Smith, W. 2008, 'Experiences Of Appearance-Related Teasing And Bullying In Skin Diseases And Their Psychological Sequelae: Results Of A Qualitative Study', Scandinavian Journal of Caring Sciences, vol. 22, no. 3, pp. 430-436.
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Acne, psoriasis and atopic eczema are common diseases and have been consistently associated with adverse psychological sequelae including stigmatization. Being teased on the basis of appearance has been associated with psychiatric morbidity in children a
Casey, M., Adams, J. & Sibbritt, D. 2008, 'An Examination Of The Clinical Practices And Perceptions Of Professional Herbalists Providing Patient Care Concurrently With Conventional Medical Practice In Australia', Complementary Therapies In Medicine, vol. 16, no. 4, pp. 228-232.
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Objective: To examine the clinical practices and perceptions of herbalists providing patient care concurrently with conventional medical practice. Method: A postal survey was sent to all full members of the National Herbalists Association of Australia (N
Steinsbekk, A., Adams, J., Sibbritt, D., Jacobsen, G. & Johnsen, R. 2008, 'Socio-demographic characteristics and health perceptions among male and female visitors to CAM practitioners in a total population study', Forschende Komplementarmedizin, vol. 15, no. 3, pp. 146-151.
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Background: The aim was to explore the prevalence of visitors to CAM practitioners in a total population with reference to sex, self-rated health status and socio-demographic characteristics. Methods: The paper reports findings from the Nord-Trondelag He
Magin, P., Adams, J., Joy, E., Ireland, M., Heaney, S. & Darab, S. 2008, 'General practitioners' assessment of risk of violence in their practice: results from a qualitative study', Journal Of Evaluation In Clinical Practice, vol. 14, no. 3, pp. 385-390.
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Rationale, aims and objectives Clinicians means of stratification of risk of violence has been previously studied in health settings, but not in general practice. This study aimed to investigate the means by which general practitioners (GPs) assess risk
Magin, P., Adams, J., Sibbritt, D., Joy, E. & Ireland, M. 2008, 'Effects of occupational violence on Australian general practitioners provision of home visits and after-hours care: a cross-sectional study', Journal Of Evaluation In Clinical Practice, vol. 14, no. 2, pp. 336-342.
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Occupational violence is increasingly recognized as a problem in general practice, and has been suggested as adversely affecting general practitioners (GPs) provision of services to patients. The aim of this study was to investigate the association of ex
Adams, J. 2008, 'Utilising and promoting public health and health services research in complementary and alternative medicine: The founding of NORPHCAM', Complementary Therapies In Medicine, vol. 16, no. 5, pp. 245-246.
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Promoting CAM research: Encouraging a wider context: The exponential growth in the use and practice of CAM has fuelled a drive to advance the evidence-base for these medicines to allow consumers to make informed choices about their health. Indeed, we are currently witnessing an exciting expansion in complementary and alternative medicine research and any reader who has conducted mainstream database searches over the last few years to locate literature on the broad topic of CAM will no doubt be familiar with this expansion - every year seems to produce an even greater number of newly published papers in the area.
Pham, K., Le Thi, Q., Petrie, D., Adams, J. & Doran, C. 2008, 'Households' willingness to pay for a motorcycle helmet in Hanoi, Vietnam', Applied Health Economics and Health Policy, vol. 6, no. 2-3, pp. 137-144.
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Background: Injuries caused by both non-use of and substandard helmets in motorcycle accidents place a substantial cost on both the Vietnamese Government and on victims and their families who are unfortunate enough to experience such an event.
Magin, P., Adams, J. & Joy, E. 2007, 'Occupational Violence In General Practice', Australian Family Physician, vol. 36, no. 11, pp. 955-957.
The risk of occupational violence is a cause for considerable concern in Australian general practice. Emerging evidence from Australian general practice is consistent with evidence from the United Kingdom that occupational violence is common and has impo
Adams, J., Sibbritt, D. & Young, A.F. 2007, 'Consultations With A Naturopath Or Herbalist: The Prevalence Of Use And Profile Of Users Amongst Mid-Aged Women In Australia', Public Health, vol. 121, no. 12, pp. 954-957.
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Broom, A. & Adams, J. 2007, 'Current Issues And Future Directions In Complementary Medicine (Cam) And Alternative Research', Complementary Therapies In Medicine, vol. 15, no. 3, pp. 217-220.
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This paper examines the topics discussed over the course of the Complementary Therapies in Medicine (CAM) research methods series and looks ahead at research methods that either have not been discussed so far in the series or are currently emerging as po
Steinsbekk, A., Adams, J., Sibbritt, D., Jacobsen, G. & Johnsen, R. 2007, 'The Profiles Of Adults Who Consult Alternative Health Practitioners And Or General Practitioners', Scandinavian Journal Of Primary Health Care, vol. 25, no. 2, pp. 86-92.
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Objective. To compare the profiles of people visiting only a general practitioner ( GP), those visiting only a practitioner of complementary and alternative medicine ( CAM), and those visiting both ( GP& CAM). Design. A comparative total population healt
Casey, M., Adams, J. & Sibbritt, D. 2007, 'An examination of the prescription and dispensing of medicines by Western herbal therapists: A national survey in Australia', Complementary Therapies In Medicine, vol. 15, no. 1, pp. 13-20.
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Objective: To describe the patterns of prescription and dispensing of herbal medicines employed by Western herbal practitioners in Australia. Design: A national postal survey sent to all full members of the National Herbalist Association of Australia (NH
Adams, J. 2007, 'Restricting CAM consumption research: Denying insights for practice and policy', Complementary Therapies In Medicine, vol. 15, no. 2, pp. 75-76.
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Empirical study, often employing but not restricted to survey work, has illuminated exponential growth in CAM use around the world.1 In fact, this subfield of CAM inquiry has so rapidly burgeoned over recent years that CAM use (amongst other topics) may appear irrelevant to some research tastes.2 Having established levels and trends of consumption, some CAM researchers are perhaps tempted to focus attention upon what may be seen as ++higher++ order research questions. However, we should perhaps not be too hasty in casting CAM use and CAM user research aside. In fact, as I argue here, an appropriate appreciation of this subfield not only reveals how further investigation on CAM use and users is necessary but also helps illustrate how such work is essential to the wider enterprise of CAM research and the development of relevant CAM policy and practice.
Sibbritt, D., Adams, J. & Young, A.F. 2007, 'The characteristics of middle aged Australian women who consult acupuncturists', Acupuncture in Medicine, vol. 25, no. (1-2), pp. 22-28.
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Background Although an increase in the use of acupuncture in recent years has been identified, there are few studies that focus attention upon the characteristics of acupuncture users. This survey aimed at providing a first step towards addressing this significant research gap. Methods This study was conducted as part of the Australian Longitudinal Study on Women++s Health, and examined the characteristics of acupuncture users among middle aged Australian women between 50 and 55 years old. Data were collected on demographic measures, health status and health service use.
Magin, P. & Adams, J. 2007, 'Complementary and alternative medicines: use in skin diseases', Expert Review of Dermatology, vol. 2, no. 1, pp. 41-49.
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There is a plethora of complementary and alternative medicines (CAM) used by sufferers of skin diseases. For the most part, the use of these therapies is based on anecdotal evidence or on traditional patterns of use. Relatively little empirical evidence exists for the use of CAM therapies in skin diseases. Those studies that have examined CAM skin disease therapies have often been flawed methodologically. A small number of CAM therapies have been accepted or are on the cusp of acceptance in dermatological practice. Even here, the evidence for CAM use is often limited or equivocal. Equally, issues of poorly documented adverse effect profiles, quality control of preparations and product adulteration and contamination hamper the integration of CAM therapies into orthodox dermatology practice. Thus, it may be more appropriate to consider `pluralism' rather than `integration' in the relationship of CAM and conventional medicine.
Sibbritt, D., Adams, J. & Young, A.F. 2006, 'A profile of middle-aged women who consult a chiropractor or osteopath: Findings from a survey of 11,143 Australian women', Journal Of Manipulative And Physiological Therapeutics, vol. 29, no. 5, pp. 349-353.
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Purpose: The aim of this study is to examine the prevalence of chiropractic and osteopathy use and the profile of chiropractor/osteopath users among middle-aged Australian women. Methods: This article reports on research conducted as part of the Australi
Magin, P., Adams, J., Pond, C. & Smith, W. 2006, 'Topical and oral CAM in acne: A review of the empirical evidence and a consideration of its context', Complementary Therapies In Medicine, vol. 14, no. 1, pp. 62-76.
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Introduction: Acne is one of the commonest diseases to afflict humanity. Anecdotally, the use of CAM in acne is widespread. In this review the empirical evidence for the efficacy. of CAM modalities is examined and the context for their use discussed. Met
Magin, P., Adams, J., Heading, G., Pond, C. & Smith, W. 2006, 'Complementary and alternative medicine therapies in acne, psoriasis, and atopic eczema: results of a qualitative study of patients experiences and perceptions', Journal Of Alternative And Complementary Medicine, vol. 12, no. 5, pp. 451-457.
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Objectives: The aim of this study was to explore the use of complementary and alternative medicine (CAM) therapies in patients with acne, psoriasis, or atopic eczema and the attitudes about CAM of these patients. Design: This was a qualitative study, uti
Magin, P., Adams, J., Ireland, M., Joy, E., Heaney, S. & Darab, S. 2006, 'The response of general practitioners to the threat of violence in their practices: results from a qualitative study', Family Practice, vol. 23, no. 3, pp. 273-278.
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Background. Violence directed towards GPs has been recognized as a significant problem in the UK. In Australian urban general practice, no study has previously examined this topic. Objective. The objective of this study was to investigate the responses o
Adams, J. 2006, 'An exploratory study of complementary and alternative medicine in hospital midwifery: Models of care and professional struggle', Complementary Therapies in Clinical Practice, vol. 12, no. 1, pp. 40-47.
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Complementary and alternative medicine (CAM) is increasingly popular amongst midwives in Australia. A growing number of hospital midwives are personally integrating one or a range of CAM within their midwifery practice. Despite this trend we still know little about CAM in midwifery, particularly at a grass-roots level. This paper reports findings from one section of a larger exploratory study examining grass-root practitioners++ understandings and experiences of complementary therapies in nursing and midwifery. Thirteen in-depth interviews were conducted with midwives working in New South Wales public hospitals and currently integrating CAM within their general midwifery practice. Analysis illustrates how midwives++ explanations of, and affinity claims regarding, CAM feed into wider ongoing issues relating to professional autonomy and the relationship between midwifery and obstetrics.
Tolhurst, H., Adams, J. & Stewart, S. 2006, 'An exploration of when urban background medical students become interested in rural practice', Rural and Remote Health, vol. 6, no. 1, pp. 452-462.
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While it is well recognized that rural background medical students are more likely to enter rural practice than urban background, students' research shows that 34% to 67% of rural doctors have urban backgrounds. This article explores the factors influencing urban background medical students' interest in rural practice. The study used a qualitative design employing focus groups and semi-structured interviews. Data were collected at three Australian universities and a national student rural health conference, and the participants were 82 first and final year medical students who participated in focus groups, and 49 who were interviewed individually. Data were analysed using the N6 computer package to manage the data. Forty-three urban background students indicated an interest in rural practice and the data presented in this article relate to this group of students. This article presents an analysis of data from one part of a larger project conducted from 2002 to 2004 investigating medical student career choice. The students' level of interest in rural practice depends on an interaction between student and location factors and other external influences with students seeking to match their needs and interests with locations. Some are 'predisposed' to develop interest in rural practice via their familiarity with rural areas, level of altruism, interest in generalist work, and interest in certain leisure activities. Exposure to rural locations provides knowledge about different places. Students recognize differences between rural locations in relation to the size of town and the remoteness of the town, and they seek specific rural locations which will match their values and interests. Existing social relationships can be enabling or limiting factors in the student's ability to follow through their interest in rural practice and to enter rural practice, and are important in the students finding a match between themselves and an appropriate location.
Magin, P., Adams, J., Heading, G., Pond, D. & Smith, W. 2006, 'Psychological sequelae of acne vulgaris: Results of a qualitative study', Canadian Family Physician, vol. 52, no. 8, pp. 978-985.
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OBJECTIVE To investigate the psychological sequelae of acne vulgaris. DESIGN Qualitative study using a grounded-theory approach. SETTING General practices and specialty dermatology practices in Newcastle, Australia. PARTICIPANTS Patients with current acne recruited from the practices. METHOD We used semistructured interviews and recorded participants++ comments verbatim. Data analysis was cumulative and concurrent throughout the data-collection period. Coding and analysis was done in the inductive tradition. MAIN FINDINGS Interviews were conducted with 26 subjects who represented a range of ages and acne severity. Psychological morbidity was considerable. Though participants had mood and anxiety symptoms, these symptoms tended to be subsyndromal and evanescent. More prominent symptoms were embarrassment, impaired self-image, low self-esteem, self-consciousness, frustration, and anger. Some subjects thought that acne had affected their personalities permanently and adversely. Psychological sequelae were attributed to the effects of facial acne on appearance. CONCLUSION The psychological effects of acne can be considerable. The psychological morbidity is complex and often does not conform to standard psychiatric disease criteria. Recognition and management of the psychological sequelae of acne by general practitioners is of considerable importance.
Knight, A., Usherwood, T. & Adams, J. 2006, 'Increasing EBM learning in training GPs: a qualitative study of supervisors', Australian family physician, vol. 35, no. 4, pp. 268-269.
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Successful strategies for increasing the use of evidence based medicine (EBM) by general practitioners remain elusive. One important approach may b e to target general practice registrars early in their vocational training when their experiences and attitudes are still forming. Modelling by supervisors can have powerful effects on early career practitioners when supervisor beliefs and practices are most influential on the registrar. For this reason wee decided to examine the attitudes, beliefs and teaching practices of GP supervisors with respect to EBM in the hope that this might inform strategies to deepen and embed the practice of EBM of early career GPs.
Magin, P., Adams, J., Heading, G., Pond, D. & Smith, W. 2006, 'The causes of acne: A qualitative study of patient perceptions of acne causation and their implications for acne care', Dermatology Nursing, vol. 18, no. 4, pp. 344-370.
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The roles of diet, dirt, and sunshine in acne causation and management were examined in this qualitative study and found central to patients++ understanding of, and responses to, acne. These perceptions have considerable health and therapeutic implications.
Tovey, P. & Adams, J. 2006, 'Comment on: "Conceptualizing mainstream health care providers behaviours in relation to complementary and alternative medicine"', Social Science & Medicine, vol. 63, no. 3, pp. 563-565.
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In a recent article in Social Science & Medicine, Hirschkorn and Bourgeault (2005) set out a comparative conceptual framework developed to help make sense of the wealth of atheoretical, descriptive data on the attitudes and behaviours of health care providers in relation to complementary and alternative medicine (CAM).
Chatwin, J., Adams, J. & Tovey, P. 2006, 'Formal and informal processes in an Australian cancer support group: An exploratory case study', Austral-Asian Journal of Cancer, vol. 5, no. 3, pp. 125-130.
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Complementary and alternative medicine (CAM) has continued to achieve an ever higher place on healthcare agendas in western countries - including Australia - over the last decade. This is evident in the extensive interest in, and use by, patients. Recent estimates suggest that Australians spend $2.3 billion a year on CAM, a figure in line with those identified in other western countries. There has also been extensive growth in the number of CAM service providers both within and beyond orthodox biomedicine. Indeed, during the course of the last decade, the tone of discourse on CAM has gradually hifted away from paradigmatic confrontation, and towards a position grounded in talk of integration and integrative practice. These trends are perhaps most evident in cancer care, where there is considerable evidence that interest, use, and the rhetoric of integration are most pronounced. In terms of provision and integrative trends, and in terms of cancerspecific activity, the situation in Australia illustrates these wider trends well.
Adams, J., Sibbritt, D. & Young, A.F. 2005, 'Naturopathy/herbalism consultations by mid-aged Australian women who have cancer', European Journal of Cancer Care, vol. 14, no. 5, pp. 443-447.
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Complementary and alternative medicine (CAM) is now a significant practice issue for those delivering cancer care with a range of CAM being utilized by a significant number of patients with cancer. While various studies have explored the prevalence of CA
Magin, P., Adams, J., Sibbritt, D., Joy, E. & Ireland, M. 2005, 'Experiences of occupational violence in Australian urban general practice: a cross-sectional study of GPs', Medical Journal of Australia, vol. 183, no. 7, pp. 352-356.
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Objective: To establish the prevalence and characteristics of occupational violence in Australian urban general practice, and examine practitioner correlates of violence. Design, setting and participants: Cross-sectional questionnaire survey mailed to al
Girgis, A., Adams, J. & Sibbritt, D. 2005, 'The use of complementary and alternative therapies by patients with cancer', Oncology Research, vol. 15, no. 5, pp. 281-289.
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The aim of this research was to assess the prevalence and predictors of complementary and alternative therapy (CAT) use among cancer patients in Australia. A total of 1492 cancer patients attending nine major public cancer treatment centers in New South
Magin, P., Adams, J., Ireland, M., Heaney, S. & Darab, S. 2005, 'After-hours care: a qualitative study of GPs' perceptions of risk of violence and effect on service provision', Australian family physician, vol. 34, no. 1-2, pp. 91-92.
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Workplace violence in general practice has been found to be an important problem in the United Kingdom. No research has been undertaken in this area in Australian urban practice. Four focus groups involved 18 urban general practitioners and over 9 hours of taped responses were transcribed. The transcripts were coded and subjected to thematic analysis. General practitioners expressed a wide range of risks relating to the provision of after hours care. This makes them apprehensive about participating in it. Those who had experienced violence, or perceived its risk, had limited their participation in after hours care; sometimes completely. Structures may be needed to support provision of after hours general practice services.
Magin, P., Adams, J., Heading, G., Pond, D. & Smith, W. 2005, 'Patients' perceptions of isotretinoin, depression and suicide: results from a qualitative study', Australian family physician, vol. 34, no. 9, pp. 795-797.
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BACKGROUND Isotretinoin is an effective acne medication. The evidence for it causing depression and suicide, although widely publicised, remains uncertain. METHODS Twenty-six semi-structured interviews with patients with acne were coded and subjected to thematic analysis. RESULTS Isotretinoin was perceived to be effective but dangerous. The most well known adverse effects were depression and suicide.
Adams, J., Easthope, G. & Sibbritt, D. 2003, 'Exploring the relationship between womens health and the use of complementary and alternative medicine', Complementary Therapies In Medicine, vol. 11, no. 3, pp. 156-158.
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In this paper we identify the need for further research exploring the relationship between complementary and alternative medicine (CAM) use and womens health. We offer our personal thoughts on the direction such future research might take outlining a num
Adams, J., Sibbritt, D., Easthope, G. & Young, A.F. 2003, 'The profile of women who consult alternative health practitioners in Australia', Medical Journal of Australia, vol. 179, no. 6, pp. 297-300.
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Objectives: To compare the characteristics of complementary and alternative medicine (CAM) users and non-users among Australian women. Design: Cross-sectional postal questionnaire conducted during 1996, forming the baseline survey of the Australian Longi
Sibbritt, D., Adams, J., Easthope, G. & Young, A.F. 2003, 'Complementary and alternative medicine (CAM) use among elderly Australian women who have cancer', Supportive Care in Cancer, vol. 11, no. 8, pp. 548-550.
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The use of complementary and alternative medicine (CAM) in the general population has grown considerably in recent years. However, little is known about the prevalence of CAM use amongst women with cancer. Our research provides the first step in addressi
Tovey, P. & Adams, J. 2003, 'Nostalgic and nostophobic referencing and the authentication of nurses use of complementary therapies', Social Science & Medicine, vol. 56, no. 7, pp. 1469-1480.
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In recent years what can loosely be described as a sociology of complementary and alternative medicine (CAM) has begun to emerge. Although work has been conducted with lay therapists, orthodox practitioners, and consumers, overall, research in this area
Adams, J. & Tovey, P. 2001, 'Nurses' use of professional distancing in the appropriation of CAM: a text analysis', Complementary Therapies In Medicine, vol. 9, no. 3, pp. 136-140.
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Despite the depth of interest in complementary and alternative medicines (CAM) within the nursing community, the intersection between nurses, nursing and CAM has largely avoided sociological analysis. This paper presents findings from one part of an ongo
Tovey, P. & Adams, J. 2001, 'Primary care as intersecting social worlds', Social Science & Medicine, vol. 52, no. 5, pp. 695-706.
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An enhanced role for primary health care (PHC) is currently a matter of political priority in the UK. This higher profile is drawing attention to a range of unresolved challenges and issues, relating to both the structure and content of provision, which currently permeate the system. Running in parallel with this is a recognition that: to date, PHC has been under-researched: that, as a result, our understanding of it is frequently poor: and that, as a consequence, fresh perspectives are needed in order to effectively research this uncertain, evolving and increasingly important healthcare sector. In this paper we argue that social worlds theory (SWT) provides, albeit in a suitably modified form, an ideal conceptual framework for the analysis of contemporary primary care. SWT is an approach which assumes complexity and constant evolution, and its core concepts are directed towards unravelling the consequences of encounters between different interest groups - something which is of particular utility at this time given the increasing attention to user participation, and an ongoing questioning of established patterns of professional authority.

Other research activity

Kirby, E., Broom, A., Good, P., Wootton, J. & Adams, J. 2014, 'Medical specialists' motivations for referral to specialist palliative care: a qualitative study', BMJ supportive & palliative care, BMJ Publishing Group, London.
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Objectives The decision to refer a patient to palliative care is complex and often highly variable between medical specialists. In this paper, we examine medical specialists+ motivations and triggers underpinning decisionmaking around referral to palliative care in order to facilitate improvements in referral practices.
Adams, J. 2010, '', Research Committee - NHMRC.

Reports

Rohr, Y., Young, L. & Adams, J. 2009, 'Understanding palliative care patients' experience of oral discomfort', DEPARTMENT OF PALLIATIVE CARE, Sydney, pp. 1-27.
Poor oral health, ultimately manifesting as oral problems is commonplace for cancer and palliative care patients (Sweeney & Bagg, 2000; Lee et al 2001). Aldred et al (1991) argue that many terminally ill patients suffer from substantial oral and dental problems which clearly impact quality of life. According to Honnor & Law (2002) complications associated with various types of cancer treatment may have devastating effects on the oral cavity . Graham et al (1993) (cited in Borbasi et al, 2002) suggest cyto-toxic effects of chemotherapeutic drugs and radiotherapy can lead to severe oral mucositis in about 40% of patients receiving standard-dose chemotherapy.
Brown, J., Morgan, T., Adams, J., Grunseit, A., Toms, M., Roufogalis, B.D., Kotsirilos, V., Pirotta, M. & Williamson, M. 2008, 'Complementary medicines information use and needs of health professionals: general practitioners and pharmacists', Australian Government Department of Health and Ageing, Sydney, pp. 1-146.
There is an increasing interest in complementary and alternative medicines and therapies in Australia and overseas. Many consumers purchase a wide range of complementary medicines (CMs) and consult a wide range of complementary and alternative practitioners including naturopaths, acupuncturists and Chinese herbal medicine practitioners who may also directly supply CMs.
Magin, P., Joyce, T., Adams, J., Goode, S., Cotter, G. & May, J. 2008, 'Experiences of occupational violence of general practice reception, administration and nursing staff: results of a qualitative study', unpublished, Australia, pp. 1-98.
Workplace violence is recognised as a significant problem in general Practice. Studies in the UK, Ireland and Australia have established a relatively high prevalence of violence in the work experience of GPs. Violence in these studies has included not only assault or physical injury to the GP but also verbal abuse, threatening behaviour, sexual harassment, and property damage. In some of these studies GPs have acknowledged the vulnerable position of non-GP staff regarding Occupational violence ++ especially in the ++front-line+ role of eceptionists. But specific research of this issue is sparse.