ATMS Journal Autumn 2016

Journal of the

Australian Traditional Medicine Society

Volume 22 | Number 1 | Autumn 2016

Dark Field Microscopy of Human Blood Acid Base Balance in Health – From Past to Present

Mindfulness

is more than a buzz word

Towards a sustainable model of health care

CAM Use

by Poor Rural Victorian Consumers Brief Interventions for Clients with Drug and Alcohol Issues ISSN 1326-3390

Health Fund News | New Research | Book Reviews

VLA

Vitality Longevity and Healthy Ageing Program

AT VLA YOU WILL DISCOVER HOW TO: •

•

Use Bioelectrical Impedance Analysis (BIA) to identify key biological markers - providing a snapshot of how your patient’s body is functioning at a cellular level.

Utilise scientic protocols and procedures that will help you promote longevity and healthy ageing in your patients.

Improve patient outcomes.

•

Better assist patients with weight management, integrated care and diet selection.

•

Integrate the use of VLA in a clinical situation.

•

Effectively market VLA.

Increase patient compliance.

Grow your repeat business.

“It doubled my client base within the rst 3 months and I haven’t looked back. VLA has given me a tool that empowers clients. It allows me to create thorough care plans and gives me a tool for education at every appointment to empower my clients to be wellness based, rather than symptom based, in their thinking and living.”

VENUES & DATES

Pullman Melbourne on the Park 192 Wellington Street, Melbourne

Sydney

Friday 11th – Sunday 13th Nov 2016 Rydges Sydney Central 28 Albion Street, Surry Hills, Sydney

metagenics.com.au

Wellington

Friday 5th – Sunday 7th Aug 2016 Intercontinental Wellington 2 Grey Street, Pipitea, Wellington

MET4488 - 02/16

Melbourne

Friday 6th – Sunday 8th May 2016

Journal of the

Australian Traditional Medicine Society Volume 22 | Number 1

Contents AUTUMN 2016

05

32

PRESIDENT’S MESSAGE

COMMEMORATION OF SIMON SCHOT LEGACY P.LEWIS

B. TANNOUS

06 CEO’S REPORT

C. WURF

20 ARTICLES

CAM USE BY POOR RURAL VICTORIAN CONSUMERS T. HOLMES

34 PRACTITIONER PROFILE R. BALBI

REPORTS

07 MINDFULNESS IS MORE THAN A BUZZ WORD M.MARS & M. OLIVER

12

36

26

LAW REPORT

BRIEF INTERVENTIONS FOR CLIENTS WITH DRUG AND ALCOHOL ISSUES K. ALEXANDER

BOOK REVIEWS

39 42

ACID BASE BALANCE IN HEALTH – FROM PAST TO PRESENT R. ARTHUR

RECENT RESEARCH

NEWS

46 HEALTH FUND UPDATE

16 DARK FIELD MICROSCOPY OF HUMAN BLOOD W.G. REILLY

47

30

HEALTH FUND NEWS

A ROLE FOR HOMOEOPATHY IN URINARY TRACT INFECTION R. MEDHURST

PRODUCTS & SERVICES GUIDE

56 58 EDUCATION & TRAINING

JATMS | Autumn 2016 | 3

The Australian Traditional-Medicine Society Limited (ATMS) was incorporated in 1984 as a company limited by guarantee ABN 46 002 844 233.

ATMS HAS THREE CATEGORIES OF MEMBERSHIP Accredited member Associate member

LIFE MEMBERS

Student membership (free)

Dorothy Hall* - bestowed 11/08/1989

MEMBERSHIP AND GENERAL ENQUIRIES

Simon Schot* - bestowed 11/08/1989

ATMS, PO Box 1027 Meadowbank NSW 2114

Alan Jones* - bestowed 21/09/1990

Tel: 1800 456 855 Fax: (02) 9809 7570

Catherine McEwan - bestowed 09/12/1994

info@atms.com.au

Garnet Skinner - bestowed 09/12/1994

www.atms.com.au

Phillip Turner - bestowed 16/06/1995 Nancy Evelyn - bestowed 20/09/1997

PRESIDENT Betty Tannous | betty.tannous@atms.com.au

Leonie Cains - bestowed 20/09/1997 Peter Derig* - bestowed 09/04/1999

VICE PRESIDENTS

Sandi Rogers - bestowed 09/04/1999

Stephen Eddey | stephen.eddey@atms.com.au

Maggie Sands - bestowed 09/04/1999

Peter Berryman | peter.berryman@atms.com.au

Freida Bielik - bestowed 09/04/1999 Marie Fawcett - bestowed 09/04/1999

TREASURER Christine Pope | christine.pope@atms.com.au DIRECTORS

Roma Turner - bestowed 18/09/1999 Bill Pearson - bestowed 07/08/2009 * deceased

Antoinette Balnave | antoinette.balnave@atms.com.au Sandra Grace | sandra.grace@atms.com.au

HALL OF FAME

Robert Medhurst | robert.medhurst@atms.com.au

Dorothy Hall - inducted 17/09/2011

Alexandra Middleton | alexandra.middleton@atms.com.au

Marcus Blackmore - inducted 17/09/2011

Greg Morling | greg.morling@atms.com.au

Peter Derig - inducted 17/09/2011

Maggie Sands | maggie.sands@atms.com.au

Denis Stewart - inducted 23/09/2012

Jesse Sleeman | jesse.sleeman@atms.com.au

Garnet Skinner - inducted 22/09/2013

Daniel Zhang | daniel.zhang@atms.com.au

Simon Schot - inducted 10/12/2015

ATMS JOURNAL EDITORS

ADVERTISING SALES Yuri Mamistvalov - Portside Media Tel: 0419 339 865 www.portsidemedia.com.au

Editor: Sandra Grace Assistant Editor: Stephen Clarke

PEER REVIEWERS Manuela Boyle

Robert Medhurst

Patrick de Permentier

Bill Pearson

Stephen Eddey

Wayne Reilly

Thomas Harris

Ann Vlass

Brad McEwen

Daniel Zhang

4 | vol22 no1 | JATMS

GRAPHIC DESIGN & PRODUCTION Annette Epifanidis - Uber Creative Tel: 0416 087 412 www.ubercreative.com.au Copyright 2015. All rights reserved. The opinions expressed in this journal are those of each author. Advertisements are solely for general information and not necessarily endorsed by ATMS.

President’s Report Betty Tannous | ATMS President

Welcome to the first issue of the Journal for 2016. The Board are back, refreshed after the holiday break, ready to continue the work of our strategic plan.

We ended 2015 on a positive note with the new CEO, Charles Wurf, taking the reins just prior to the ATMS AGM day.

Thank you to over 200 members who attended and we look forward to seeing you all at the next. It was a worthwhile day for many members. The theme of our presentations was skin. Patrick De Permentier started the day by reminding us of the anatomy of the largest organ in the body and continued by explaining what could go wrong with it. Brad McEwen followed up with nutritional advice to keep the skin healthy and Denis Stewart finished the day by adding his own gems with regard to herbal medicine treatment of the skin.

The end of the year also signalled the removal of the Advanced Diplomas of Naturopathy, Western Herbal Medicine, Nutritional Medicine and Homoeopathy from the Health Training Package.

The potential of this change cannot be underestimated. It is a reminder to all members to ensure that they keep their membership up to date. This includes renewing your membership by the due date, keeping your Professional Indemnity Insurance and First Aid certificate current and completing your

continuing education points. I cannot stress enough the importance of keeping these current, not only to maintain your membership with this professional association, but also to continue to receive health fund rebates for your clients. The ATMS Board and CEO will be heavily involved with education decision-makers and key stakeholders for reform of education in our sector.

We will also be increasing our focus on the five key strategic agendas. A working group, headed by our CEO, Charles Wurf, has been set up to further enhance ATMS’s relationships with the Health Funds. The Executive Directors of ATMS are in communication with the Executive Directors of the other associations within our sector. The calendar of events for the first half of the year is available on the website. The CEO and Directors are participating in meetings and seminars with external committees and government officials to raise the profile of natural medicine, and our PR and marketing campaigns are in full swing.

Make sure you check out the CPE events and review any gaps you have in your professional development and choose an event that meets those needs.

Also, if you are not already one of our connections on LinkedIn, if you haven’t ‘liked’ us on Facebook, or followed us

on Twitter, please do so. Keep your eye out for the Wise-n-Well during the year that will keep you up to date with all the marketing and PR campaigns that will be happening this year.

Phase 1 of the Website and Database is completed and the new format has been well received. Phase 2 will be implemented in the next three months with enhancements to the Find a Practitioner section and the member site. I would like to thank our members for their patience and we will certainly keep you updated on our progress.

If you have not transferred your insurance to the ATMS preferred insurer GSA, now is the time as they have a great offer for our members - 14 months for the price of 12. Check out their ad in this journal and make the change.

The ATMS Board of Directors take seriously their role in representing our members and advocating for our professions. We are committed to the strategy for the next two years and are focussed on meeting the agendas set.

I am looking forward to a year filled with positive outcomes for our members.

Betty Tannous President

JATMS | Autumn 2016 | 5

CEO’s Report Charles Wurf | ATMS CEO

Thank you for the encouraging welcome!

Thank you to members of ATMS for the warm and encouraging welcome that I have received since commencing in midNovember.

There are challenges aplenty for ATMS and individual practitioners at this time, and with those challenges come wonderful opportunities for natural medicine in the years ahead. There is a solid plan in place to position ATMS and its members as the leaders of the natural medicine industry.

This is a vision and an outcome that I am inspired by, and I look forward to working with the Board and members as we realise this ambition and confirm natural medicine as a natural partner of choice for the health and wellness of all Australians.

and universities providing training to future practitioners.

The ongoing success and growth of natural medicine will attract the attention and potential scrutiny of government and health funds as the overall size of consumer spending continues to increase – this is the opportunity for constructive engagement with government and funding agencies to cement natural medicine as a natural partner of choice.

A key component of supporting practitioners is to sustain and expand the research base underpinning practice – and the Journal will continue to support this essential task.

Internal auditing of accreditation Advocacy and Standards At its core the strategic plan of ATMS includes a solid operational plan to focus on advocacy for members based on our professional standards. For ATMS to succeed, it must stand on the solid foundation of the professional standards of our practitioners, and this is a key operational workload of ATMS. In our relationships with the key stakeholders who regulate or fund or critique our industry, the key to our advocacy is to set, monitor and enforce the professional standards of accredited members, across all modalities. This includes great attention to detail in the educational standards of existing accredited members and the colleges

6 | vol22 no1 | JATMS

A key commitment of ATMS accredited practitioners is to accept the professional obligation to regularly update clinical skills and professional knowledge.

This commitment is reflected in the ATMS Continuing Education Policy, requiring that Accredited Members must accumulate 20 CPE points per annum, commencing and ending in the financial year (1 July to 30 June).

The Policy notes for all members: The ATMS CPE Policy is designed to ensure its accredited members regularly update their clinical skills and professional knowledge. One of the chief roles of CPE is to bridge the gap between the skills and knowledge

gained as a student, and the skills and knowledge actually required in clinical practice.

The accrual of 20 CPE points is essential to maintain accredited status with ATMS, and is also an essential requirement to remain recognised with health funds.

As part of the maturing relationship with the health funds, ATMS conducts an internal sample audit of our CPE program with Accredited Members and will do so again from 1 March. Our sample audit process randomly selects 5% of the total Accredited Members, and we track compliance with evidence of successful completion of the 20 CPE points. This audit assists ATMS to fulfil our contractual obligations with the health funds, and assists us in our ongoing advocacy on behalf of Accredited Members.

We look forward to working with the selected members on the successful completion of the sample audit, on behalf of all members of ATMS.

Supporting members in practice I look forward to working with the Board and staff at ATMS through 2016, as we continue to focus on the operational aspects of our Strategic Plan, all designed to sustain and support Members in their practice of natural medicine.

Charles Wurf CEO

ARTICLE

Mindfulness is more than a buzz word: Towards a sustainable model of health care

Dr Michelle Mars PhD, MPhil | GradDipSocSci, BBS, Senior Lecturer Endeavour College of Natural Health Meeghan Oliver | GradDipAppSci LIM, BA, Librarian Endeavour College of Natural Health

Abstract In this article the health benefits of mindfulness in the workplace, in education, and in the practice of natural medicine are discussed. With reference to recent literature, mindfulness is located as a self-development tool in the context of a rapidly changing and increasingly complex social environment. Mindfulness is a much used and little understood concept. The discussion begins with a definition placing mindfulness in a contemporary health context, leading into an examination of its workplace and educational applications and its potential benefits for the sustainability of the health care system. The discussion is informed by the authors’ experience of working in a College of Natural Health where weaving together the philosophy and practice of mindfulness is part of our strategic plan.

Introduction Mindfulness: we hear the word often but do we know what it means? Most of us would recognise mindfulness as a potential tool for self-development, and while self-development is not a new phenomenon best practice strategies have certainly changed. In the past few decades our understandings have moved beyond behaviourism and self-management strategies, stress management and time management to deeper understandings of the human psyche. Spirituality is no longer intrinsically linked to religion, and spiritual experience is understood to be a key to wellbeing. Over the same time span psychological understandings have progressed from analysis of personal history to an emphasis on making change in the here and now. Positive psychology shifts the focus from what is clinically wrong to the promotion of wellbeing and

the creation of a satisfying life filled with meaning, pleasure, engagement, positive relationships and accomplishment.1 It is about being more aware of ourselves, our capacity for gratitude, how we interact with others and being in the here and now, and yes, mindfulness. In this article we discuss the benefits of mindfulness in the health care environment with particular reference to the workplace, education, and the practice of natural medicine.

The demographic ratio is changing in Australia. Between 2004 and 2014 the percentage of the population aged over 85 years increased by 150% and that of those aged 50-70 by approximately 75%.2 This trend will continue to accelerate in the short and medium term before declining. There will be fewer young people to care for an ageing population and at

JATMS | Autumn 2016 | 7

ARTICLE

the same time ageing and life style trends mean that chronic illness will increase. The burden of chronic disease threatens to overwhelm the health budget, the capacity of health services and the health workforce.3 We will see increasing pressure on the health care system and those who work in it. A sustainable health care system requires individual and systemic change. In this article we argue that mindfulness practice has a part to play in the creation of a sustainable health care system.

Definition of Mindfulness Mindfulness is the art of paying attention to the present moment with intention, openness and curiosity, and without judgment – there is no good and there is no bad. It is a willingness to accept what is. It is experiencing each moment as it unfolds in its purest form without judgment and without colouring it with our own biases and perceptions – it’s letting go of past regrets and the worries of what the future might bring. It is learning the practice of being in the present moment, consciously being aware, and giving our full, focused attention without judging.

The benefits are profound. With regular practice, mindfulness is a powerful tool that can help you improve your overall wellbeing.4 Mindfulness is more than a buzz word. It can be understood as a practice, a mental state, or a personal trait.5 As a practice it is distinct from meditation. In the Buddhist tradition mindfulness and meditation are two distinct limbs of the eightfold path and anyone who has practised both can testify to the difference. However, the amount of time living mindfully can be increased by meditation practice. Mindfulness may be, but is not necessarily, a religious or spiritual practice.6 As a mental state there is receptive and open attention to present moment experience and awareness of bodily sensations and mental states.7 As a trait it naturally varies in dispositional manner8 and is characterised by increased capacity in the brain to regulate, learn and return to more positive mental states.9 Put simply, the evidence suggests that mindfulness practice increases our openness to the present moment and over time the neuroplasticity of the brain allows those who practise it to interact more mindfully with others.

Mindfulness is a relatively new player in the western medical and psychological literature however, and over the past three decades its popularity and a corresponding body of empirical evidence has continued to grow. Over the past 15 years mindfulness has moved from the margins to the mainstream and more recently GPs in the UK have begun prescribing mindfulness meditation for a host of physical and mental ills.10 Mindfulness is a technique often used by natural health care practitioners. It is a practice that has the potential to effect change in people’s ways of being in the world. In this article we argue the need to embed mindfulness practice throughout the natural health care environment, from the workplace to

8 | vol22 no1 | JATMS

teaching, to practice, and in leadership training. Mindfulness is now mainstream in the corporate world and the benefits of its practice are readily observable.

Mindfulness in the workplace Corporate Australia continues to embrace mindfulness, with new techniques constantly emerging. Hewlett-Packard Co. and GlaxoSmithKline PLC set up laughter yoga clubs in the early 2000’s and IBM Australia and New Zealand were early adopters of programs teaching staff about mindfulness, meditation, clarity of thought and focus.11,12 Mindfulness practice has been linked to emotional intelligence, productivity and innovation. Late Apple co-founder Steve Jobs introduced a 30-minute ‘meditate at work’ routine, providing classes on meditation and yoga on-site. Google has been working hard to bring meditation into the workplace. One of Google’s original software engineers and now head of personal growth, Chade-Meng Tan, spearheaded a program at Google in 2007 called ‘Search Inside Yourself’, which has helped more than 500 employees learn how to breathe mindfully, listen to their coworkers, and improve their emotional intelligence.13 It’s not just the tech giants who are embracing the mindfulness trend. In 2012 management firm McKinsey & Co. started embracing meditation as part of their HR strategy aimed at keeping employees happy and healthy, developing meditation and self-analysis programs not only for their own employees but for other multi-million dollar corporations as well. In one case, a meditation program developed by McKinsey for an Australian client saved the business more than $20 million.14 The program, designed to help staff find meaning in their work, helped stem the attrition of customers who were picking up ‘bad vibes’ from the company staff.15 Mindfulness can be cultivated through formal meditation.

However, formal meditation encompasses a range of practice: ‘it’s not really about sitting in the full lotus, like pretending you’re a statue in a British museum … it’s about living your life as if it really mattered, moment by moment by moment by moment’.16 Mindfulness can be cultivated through simply changing the focus of attention. Some simple practical suggestions include: • Pay close attention to your breathing, especially when you’re feeling intense emotions • Notice - really notice - what you’re sensing in a given moment, the sights, sounds, and smells that ordinarily slip by without reaching your conscious awareness • Recognize that your thoughts and emotions are fleeting and do not define you, an insight that can free you from negative thought patterns

• Tune into your body’s physical sensations, from the water hitting your skin in the shower to the way your body rests in your office chair.17 Mindfulness practice is a form of personal development. Making this part of a corporate strategy enables the development of a mindful corporate culture. At the College we extend this practice to the classroom, enabling student learning and developing future practice skills.

Mindfulness in natural health education Beyond the corporate work environment mindfulness practice can also improve educational outcomes. The calm stability fostered by mindfulness practice positively affects cognitive functions like attention and working memory, leading toward understanding and wisdom.18 Mindfulness meditation is increasingly used in classrooms around the world as a tool to improve student wellbeing and enhance academic performance.19 A wide variety of mindfulness techniques has been put into practice across disciplines from architecture and economics to poetry and law. Mindfulness complements traditional third-person learning, encouraging critical analysis, the ability to observe at a distance, emotional intelligence and the cultivation of compassionate connection with the perspectives of others.18 Not only does mindfulness practice enhance ability to learn, but it also improves abilities that are vital to good practice in natural health settings, such as listening skills. In a recent study20 students were challenged to pay attention to and unlearn bad habits, such as multi-tasking, that inhibit deep listening. This moves learning beyond a set of cognitive skills learned in the classroom to a place where students were motivated to change based on their own expanded awareness.

Mindfulness practice has proven educational benefits in terms of more productive and stable work environments. Its potential also extends to innovative leadership and ultimately the sustainability of health care in Australia.

Mindfulness in the health care workplace, innovative leadership and sustainability Australia fares well across a range of OECD health statistics, with high life expectancy, lower than average health care expenditure and good levels of self-reported health.21 However, we are aware that the current system will not be sustainable in the future and that the future health care workplace is likely to be a high pressure environment. Mindfulness measures have been proven to reduce stress and promote positive leadership, wellbeing and resilience.5,7,9,11,17 The theory is that if staff are trained to recognise signs of stress, anxiety and mental illness, mindfulness techniques can help overcome these issues and promote an overall positive experience.

How do we enable our health workforce in the face of coming scenarios? Research suggests that innovative leadership requires the development of higher order cognitive skills and habits of reflection, mindfulness and self-correction.22 In a report on Leadership for the Sustainability of the Australian Healthcare System mindfulness is identified as an element of transformational learning.23 However, experts suggests that much of the multiÂŹmillion dollar expenditure on traditional organisational and leadership programs is wasted because people are not taught to concentrate.24 Paying attention, concentrating on work and having clear thoughts are obviously beneficial; the more people focus on their work the more they can achieve. That includes people responding productively in meetings rather than allowing their minds to wander.

While there will always be a call for higher methodological quality, strong biomedical and traditional evidence to support mindfulness exists.10 A study led by Davidson and Kabat – Zinn in the US measured brain activity in workers and found that undertaking eight weeks of mindfulness meditation, was associated with their immune systems coping better with the influenza vaccine than those of subjects who had not practised

Immediate and precise heavy metal and trace element analysis at your desk

t t t t t t

/P XBJUJOH EFUFDU DVSSFOU CJP BWBJMBCJMJUZ JO TFDPOET /P IBJS TBNQMF OFFEFE 1PSUBCMF EFWJDF "GGPSEBCMF FDPOPNJDBM QSPGJUBCMF 'VMM USBJOJOH QSPWJEFE 1$ PS .BD

The cutting edge OligoScan enables you to make, in real time, a precise analysis of the mineral status of your patients for very specific prescription.

The OligoScan device uses Spectrophotometry to measure the optical density of the trace elements and heavy metals currently present in the tissues. e jon@karunahealthcare.com.au w www.oligoscan.net.au

OligoScan

JATMS | Autumn 2016 | 9

ARTICLE

mindfulness meditation . It has been proved time and again that mindfulness meditation and stress reduction improve wellbeing.16 The population is ageing and at the same time obesity and a host of lifestyle-related chronic diseases are on the rise. One of the simplest and most effective changes we can make as a population toward future sustainability of health care is to make wiser choices about our health and live healthier lives.

But to facilitate change at the level of the individual systemic, cultural, and institutional change is required. This is where mindfulness practice, embedded throughout the health care environment from education to the workplace, to leadership and to practice has the potential to initiate change. Mindfulness can be understood as a vital component in the drive towards health care reform as it promotes lifestyle change, ‘leveraging the body’s innate capacity to heal itself’, and may indeed be ‘the key to creating a sustainable healthcare system for the 21st century’.25

Conclusion Years of working in the health professions makes one weary of the latest buzz words. Is mindfulness just a sticking plaster when what we need is trauma counselling to deal with the savagery of life from the playground to corporate life? Perhaps the answer to that question is yes, but nonetheless mindfulness works and it doesn’t need to be complicated. The old adage ‘take a breath’ is a good clue to the fact that we know a pause, a breath and a moment or two of silence can make a huge difference to our perception of something. Introducing mindfulness practice to students, embedding it in workplace practice and training leaders in mindfulness practice has the potential to engender a shift inside and outside the health care workplace.

Mindfulness has hit the mainstream and it works. It opens up real possibilities for sustainability and change and we ignore it at our peril.

REFERENCES 1. Gable SL, Haidt J. What ( and Why ) Is Positive Psychology ? 2005;9(2):103– 10.

2. Statistics AB of. 3101 . 0 ­Australian Demographic Statistics , Jun 2014. ­Aust Demogr Stat [Internet]. 2014;June:1–8. Available from: http://www.abs. gov.au/ausstats/abs@.nsf/0/1CD2B1952AFC5E7ACA257298000F2E76?Ope nDocument# 3. Willcox S, Collaboration TAHP. Chronic diseases in Australia : the case for changing course October 2014 Chronic diseases in Australia : the case for changing course Background and policy paper [Internet]. Policy paper No. 2014-02. 2014 [cited 2016 Jan 12]. Available from: https://www.vu.edu.au/ sites/default/files/AHPC/pdfs/Chronic-diseases-in-Australia-the-case-forchanging-course-sharon-willcox.pdf 4. Krishna RM. Mindfulness: the untapped innate catalyst for healing, happiness and health. J Oklahoma State Med Assoc [serial Internet].

2014;107(12):649–51.

5. Garland EL. Mindfulness research in social work: Conceptual and methodological recommendations. Soc Work Res. 2013;37:439–48.

10 | vol22 no1 | JATMS

6. Grossman P, Van Dam NT. Mindfulness, by any other name…: trials and tribulations of sati in western psychology and science. Contemp Buddhism [Internet]. 2011;12(1):219–39. Available from: http://www.tandfonline.com/ doi/abs/10.1080/14639947.2011.564841 7. Hardy S. Mindfulness: Enhancing physical and mental wellbeing.

2015;26(9).

8. Baer RA et al. Kentucky Inventory of Mindfulness Skills. October.

2006;11(October):80–1.

9. Krishnakumar S, Robinson MD. Maintaining an even keel: An affectmediated model of mindfulness and hostile work behavior. Emotion 2015;15(5):579–89.

10. Dimidjian S SZ. Prospects for a clinical science of mindfulness-based intervention. Am Psychol. 2015;70(7):593–620.

11. Voigt K. Companies’ Antidote to Workplace Stress: Yoga, Meditation, More Soothing Laughter. Wall Str J [Internet]. 2002 [cited 2015 Dec 8];1–6.

Available from: http://www.wsj.com/articles/SB1014330982990372760 12. Edwards V. How IBM , NAB and other companies are encouraging mindfulness among staff. Aust. 2015;(March 15):1–4.

13. Baer D. ‘Search Inside Yourself’ Google’s life changing Mindfulness course.

Bus Insid [Internet]. Business Insider; 2014 [cited 2015 Dec 8];8. Available from: http://www.businessinsider.com.au/search-inside-yourself-googleslife-changing-mindfulness-course-2014-8 14. Onlinemba.com. 10 Big Companies That Promote Employee Meditation.

Online MBA; 2012;2. Available from: http://www.onlinemba.com/blog/10big-companies-that-promote-employee-meditation/ 15. Voight K. Companies’ Antidote to Workplace Stress: Yoga, Meditation, More Soothing Laughter. Wall Streeet J [Internet]. 2002;February(22).

Available from: http://www.wsj.com/articles/SB1014330982990372760 16. Kabat-Zinn, Jon Williams JMG. Mindfulness: diverse perspectives on its meaning, origins, and multiple applications at the intersection of science and dharma. Contemp Buddhism. 2011;12(1):1–18.

17. Kabat-Zinn J. How can mindfulness change your life. YouTube. 2015.

18. Bush M. Mindfulness in higher education. Contemp Buddhism.

2011;12(1):183–97.

19. Ricci C. Mindfulness very gently moving around the world’s classrooms.

The Age. 2015; 20. Goh ECL. Integrating Mindfulness and Reflection in the Teaching and Learning of Listening Skills for Undergraduate Social Work Students in Singapore. 2012;31(5):587–604.

21. OECD. How does Australia compare ? 2014;2012–4.

22. Levy L, Carrol B. Aspiring to lead: hard-wired to manage. Univ Auckl Bus Sch Rev. 2008;10(2):17–21.

23. Health Workforce Australia. Leadership for the Sustainability of the Health System. Part 1 - A Lit Rev. 2012;1–89.

24. Edwards V. Mindfulness: bringing your head and your heart into the office. The Australian [Internet]. Adelaide; 2015 Oct 10; Available from: http://www.theaustralian.com.au/business/mindfulnessbringing-your-head-and-your-heart-into-the-office/news-story/ ede950691a0d2c3f32446e218391e305 25. McCabe Ruff K, Mackenzie ER. The Role of Mindfulness in Healthcare Reform: A Policy Paper. Explor J Sci Heal [Internet]. Elsevier Inc.; 2009;5(6):313–23, pp.321 . Available from: http://dx.doi.org/10.1016/j. explore.2009.10.002

Tai Chi and Qigong in Risdon Prison, Hobart In 2014 Risdon Prison minimum security in Hobart introduced Health Expos for male prisoners and I was invited to hold a Tai Chi workshop. This was repeated in 2015. During these Expos many inmates approached me to enquire as to the benefits of Tai Chi and Qigong but also asked me whether I would be interested in going to the prison to regularly conduct classes. The number of men enquiring grew and I told them that I would start the process of trying to obtain permission to work with them in Risdon.

Late last year the classes started and it was soon very obvious that the area designated for us to conduct the classes wasn’t going to be large enough so another area was found which gave us the freedom to perform Tai Chi and Qigong.

I am concentrating on two different areas during the sessions:

1. Yang Style Long Form 108 Tai Chi. This is one of the oldest forms of Tai Chi. I had notes of the entire form written up and these were printed at the prison and the participants now have copies with many spares left over for newcomers. I also donated an early video I made of the Yang Style 108 which I gave to the participants.

2. Health Qigong. Qigong preceded Tai Chi by many years and this form concentrates on a style which mainly focuses on balance, physical and emotional stability, pain reduction, support, trust and many other areas.

The men have taken to the classes with great enthusiasm and contributed the comments shown below to a report I wrote when the classes finished for 2015.

“For physical, spiritual and mental health. Promotes a sense of peace beyond the session. Really good for

physical balance and a sense of wellbeing to the whole body. Improves the suppleness of the joints and overall flexibility. A very important activity in the negative and often difficult environment of the prison.”

“I really enjoy Tai Chi and find it very relaxing. It has also helped with my chronic shoulder pain. I have also noticed a pacifying effect on myself and others on the course. It seems to have an overall beneficial effect on the whole body."

I am hoping that the prison authorities agree to continue the classes indefinitely and as I wrote this story (early 2016) discussions and negotiations were continuing.

Bill Pearson Dip.TCM Life Member ATMS, Principal Jian Shen School of Tai

ATMS Research Grants ATMS invites applications for small grants of up to $5000 for natural medicine research that supports the goals of its strategic plan.

The applicant must: 1. be the Chief Investigator of the project 2. be an Australian citizen, or have permanent resident status 3. currently reside in Australia 4. be a financial member of ATMS Application forms can be downloaded from the ATMS website. Applications close on Friday 15 May at 5pm, Please direct enquiries to research@atms.com.au

ARTICLE

Acid Base Balance in Health – From Past to Present Rachel Arthur | BHSc BNat (Hons)

Abstract Much has been made of the mismatch between our modern diet and our stone age genes. However, recurrent attempts to recreate the Paleo Diet in a time and food context which bears little resemblance to that era appear fraught with problems and potential unintended outcomes.

Perhaps there is an argument instead to consume a diet that attempts to align as closely as possible with the actual nutritional composition and subsequent physiological norms characteristic of Paleolithic diets generally. One of the most consistent scientific findings in this regard is the alkaline nature of most preagricultural diets compared with the acid-producing modern diet. The eating behaviours and food choices that produced an alkaline dietary load historically have been clearly articulated, and current research in this area suggests that the cost of a chronic dietary acid load is substantial and may be implicated in the aetiology of many chronic health conditions. Therefore it is arguable that a more meaningful objective of modern dietary approaches would be to ensure a net alkaline yield.

12 | vol22 no1 | JATMS

M

uch has been made of the mismatch between our modern diet and our stone age genes which has resulted in a significant amount of attention being awarded to recreating a modern version of the Paleo Diet. Our current food, health and environmental contexts, however, bear little resemblance to the Paleolithic era and therefore modern attempts at imitation appear fraught with problems and potential unintended outcomes.

Perhaps there is an argument instead to consume a diet that aligns as closely as possible with the actual nutritional composition and subsequent physiological norms characteristic of Paleolithic diets generally. One of the most consistent scientific findings in this regard is the alkaline nature of most pre-agricultural diets compared with the acid-producing modern diet.

Personally I don’t subscribe to the currently popularised notion of the Paleo Diet. The Paleo Diet purports to emulate a diet eaten by our ancestors, in spite of

Pre-agricultural Diets 85% Alkaline

Alkaline mineral rich plants: ↑ Potassium ↑ Magnesium ↑ Calcium ↑ HCO Moderate Protein

Alkaline

Neutral

Acid

a complete lack of congruency in terms of food availability, quantity and quality.

For example, wild boar that we had to hunt ourselves can hardly compare nutritionally with the highly preserved slice of bacon picked up from the deli, the result of high intensity farming and synthetic feed, antibiotics etc. The Paleo Diet is vulnerable to dangerous oversimplification and misinterpretation.1, 2 Perhaps, given the differences between the food choices, levels of physical activity and environments of the two eras, the initial error lies in the myth that there was a ‘one size fits all’ diet consumed during the Upper Paleolithic period, which spanned approximately 2.6 million years. This of course has been shown to be incorrect, the diets of Homo Sapiens during this era being profoundly influenced by geography, season and specific features of the period.2, 3 While I feel an attempt to turn back dietary time to a bygone era is essentially impossible for modern man and unlikely to reap the benefits we anticipate, I am compelled by the notion that instead we should find a diet in the modern food-setting that attempts to provide as much as possible the nutritional composition and subsequent physiological norms characteristic of pre-agricultural diets. On this topic, there has been and continues to be extensive high quality scientific research published.

I clearly recall the first paper I ever read of this type over ten years ago, Paleolithic vs. modern diets--selected pathophysiological implications,4 which

Standard Australian Diet (SAD) Primarily acid-forming

Low alkaline minerals: ↑ Sodium ↑ Chloride ↓ Vegetable intake ↑ Protein ↑ EDNP (energy-dense, nutrient-poor)

struck me most of all because of its bold claim that what we consider ‘normal’ or ‘healthy’ in the contemporary medical context, in terms of blood pressure, fasting glucose etc., is in fact a distortion caused by modern diet: its reversed sodium to potassium intake ratio and other dramatic nutritional disparities. While perhaps this seems a very straightforward assertion, for me it had a big impact and a light went on somewhere in my brain that I haven’t been able to switch off since!

Many people have articulated this argument eloquently: ‘From an evolutionary nutritional perspective, contemporary humans are Stone Agers habitually ingesting a diet discordant with their genetically determined metabolic machinery and integrated organ physiology’.5 One tangible example takes the perspective of the kidneys, whose function is thought to be adapted and well suited to our traditional diet, which was characterised by intermittent high potassium intake along with other anions (bicarbonate, magnesium, calcium), thanks to the consumption of fruits and berries with negligible intake of sodium and chloride. As a result, our kidneys are single-mindedly geared towards renal conservation of sodium and elimination of potassium.6 So what happens when our diet has changed so radically but our kidneys remain the same? This has been coined the ‘diet-kidney mismatch’ by some.5 The physiological norms of preagricultural Homo Sapiens have been determined by detailed analyses of hundreds of documented Paleolithic diets and have produced a surprising level of consensus among researchers.

In particular the majority agree that the net endogenous acid production (NEAP), also referred to as the net acid dietary load, of most pre-agricultural diets (85%) was alkaline with an average NEAP of 82mEq/d.7 While the degree of alkalinity varied significantly across the various Paleolithic diets, this still contrasts starkly with the standard American diet (SAD), which has been consistently shown to be net acid-producing.

JATMS | Autumn 2016 | 13

ARTICLE

In simple terms this is thought to be the result of: 1) reduced bicarbonate consumption due to lower fruit and vegetable intake2, 3, 5; 2) the reversed ratio of sodium to potassium intake that has seen our average daily sodium exposure increase by a factor of ten and our potassium intake reduced by 75% 3, 5, 8; along with 3) the enormous increase in chloride intake3; and finally 4) the large dietary contribution from ‘energy-dense, nutrient-poor foods’ (e.g., separated fats, refined sugars, and vegetable oils), which have no capacity to buffer the net acid producing foods of the modern diet, such as meat, dairy and grains.7 Interestingly, one study found that those few pre-agricultural diets that were net acid-producing were consumed by populations living at higher latitudes (e.g. > 40◦).2 Ethnographic data tells us that while the contribution of hunted animal foods remains relatively constant across latitudes, plant food intake notably declines and fished animal food typically replaces hunted animal food with increasing latitude. Effectively, these diets had a higher animal to plant food ratio.

Some advocates of the current Paleo Diet acknowledge the need to be mindful of acid-base balance in theory, yet the example diets and actual execution of the Paleo Diet principles appear do little to ensure that a net alkaline diet is achieved (http://thepaleodiet.com/what-to-eat-onthe-paleo-diet/). Even modern popularised ‘alkalising diets’ can unfortunately lead us astray, with consumers exposed to conflicting and inaccurate messages about how to ‘alkalise’, from simply drinking alkaline water to removing all grains, avoiding refined sugars and abstaining from perfectly alkaline producing vegetables such as the ‘deadly’ (sic) nightshades!

Some researchers have attempted to scientifically answer the question of how modern diet could be changed to restore an alkaline NEAP and conclude that the substitution of ‘greens for grains’, as frequently put forward by Paleo and alkaline proponents alike, would fail to resolve the issue.7

14 | vol22 no1 | JATMS

WHAT DO WE RISK IF WE DON’T SOLVE THIS MODERN DIET MALADY OF ACIDITY? AT A POPULATION AND PUBLIC HEALTH LEVEL, THERE IS INCREASING EVIDENCE OF A BROAD MULTISYSTEM BURDEN SECONDARY TO THE ‘CHRONIC MILD METABOLIC ACIDOSIS’ PRODUCED FROM A NET ACID-PRODUCING DIET, NEGATIVELY AFFECTING THE RENAL, IMMUNE, ADRENAL AND MUSCULOSKELETAL SYSTEMS.

What do we risk if we don’t solve this modern diet malady of acidity? At a population and public health level, there is increasing evidence of a broad multi-system burden secondary to the ‘chronic mild metabolic acidosis’ produced from a net acid-producing diet, negatively affecting the renal, immune, adrenal and musculoskeletal systems.2, 5, 9-11 Consequently there is significant speculation about the potential causative role chronic mild metabolic acidosis and an acid-producing diet may play in a range of chronic diseases that dominate our modern medical landscape, such as diabetes type 2, renal impairment and osteoporosis.12-14, However, more research is needed to establish causality and clarify the full magnitude of its contribution.

Closer to home, working in integrative nutrition for over 20 years, I know that best patient outcomes typically are the result of identifying and addressing the underpinning determinants of health and disease and, in particular, of individuals’ nutritional imbalances. In human nutrition we can draw parallels with agriculture: the more we attend to the overall health of the soil, the fewer direct interventions (fertilisers, added

nutrients, pesticides) the plant will need.

Similarly, in nutritional practice, if we fail to address the ‘soil’ of our clients, then our prescriptions risk being superficial and so tend to become longer and longer lists of supplements and interventions, in response to which the patient manages to keep their head above water, but not to swim unaided. A relatively simple analogy I use with my clients is this: when we consume an acid-producing diet long-term, it’s like having a leaking tap in your house, not just creating a constant drain on your overall water levels but also on many of your nutrients (all the alkaline minerals K, Ca, Mg), your endocrine system, your immune system and finally your wallet!)

We could run around and top you up again with these nutrients, address each consequence individually, or … we could fix the leaking tap!

Is acid base balance an important determinant of the health of ‘human soil’, in addition to other well recognised contributors such as adequate sleep, emotional wellbeing, sufficient hydration, eubiosis and adequate sun exposure?

It is my opinion, both from a research and clinical perspective, that it is. That light that I can’t switch off in my brain

since I read that Eaton & Eaton paper ten years ago tells me that the physiological norms scientifically demonstrated to be true of our ancestors do have something essential to teach us about what we should aspire to in terms of our food choices and nutritional intake today, and achieving an alkaline NEAP is central to this.

REFERENCES 1. Turner BL, Thompson AL. Beyond the Paleolithic prescription: incorporating diversity and flexibility in the study of human diet evolution. Nutr Rev. 2013;71(8):501-10.

2. Strohle A, Hahn A, Sebastian A. Latitude, local ecology, and hunter-gatherer dietary acid load: implications from evolutionary ecology.

Am J Clin Nutr. 2010;92(4):940-5.

3. Eaton SB, Konner MJ, Cordain L. Dietdependent acid load, Paleolithic [corrected] nutrition, and evolutionary health promotion.

Am J Clin Nutr. 2010;91(2):295-7.

4. Eaton SB, Eaton SB, 3rd. Paleolithic vs. modern diets--selected pathophysiological implications. Eur J Nutr. 2000;39(2):67-70.

5. Frassetto L, Morris RC, Jr., Sellmeyer DE, Todd K, Sebastian A. Diet, evolution and aging--the pathophysiologic effects of the post-agricultural inversion of the potassiumto-sodium and base-to-chloride ratios in the human diet. Eur J Nutr. 2001;40(5):200-13.

6. Kamel KS, Schreiber M, Halperin ML. Integration of the response to a dietary potassium load: a paleolithic perspective.

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 2014;29(5):982-9.

7. Sebastian A, Frassetto LA, Sellmeyer DE, Merriam RL, Morris RC, Jr. Estimation of the net acid load of the diet of ancestral preagricultural Homo sapiens and their hominid ancestors. Am J Clin Nutr.

2002;76(6):1308-16.

8. Sebastian A, Frassetto LA, Sellmeyer DE, Morris RC, Jr. The evolution-informed optimal dietary potassium intake of human beings greatly exceeds current and recommended intakes.

Semin Nephrol. 2006;26(6):447-53.

9. Wiederkehr M, Krapf R. Metabolic and endocrine effects of metabolic acidosis in humans. Swiss Med Wkly. 2001;131(9-10):12732.

10. Bushinsky DA. Acid-base imbalance and the skeleton. Eur J Nutr. 2001;40(5):238-44.

11. Chan R, Leung J, Woo J. Association Between Estimated Net Endogenous Acid Production and Subsequent Decline in Muscle Mass Over Four Years in Ambulatory Older Chinese People in Hong Kong: A Prospective Cohort Study. J Gerontol A Biol Sci Med Sci. 2015;70(7):905-11.

12. Jew S, AbuMweis SS, Jones PJ. Evolution of the human diet: linking our ancestral diet to modern functional foods as a means of chronic disease prevention. Journal of medicinal food. 2009;12(5):925-34.

13. Lindeberg S. Paleolithic diets as a model for prevention and treatment of Western disease.

Am J Hum Biol. 2012;24(2):110-5.

14. Cordain L, Eaton SB, Miller JB, Mann N, Hill K. The paradoxical nature of hunter-gatherer diets: meat-based, yet non-atherogenic. Eur J Clin Nutr. 2002;56 Suppl 1:S42-52.

Basica

速

Bio-Practica

www.biopractica.com.au

Active

Comprehensive Alkalising Formula

5

KEY

Benefits of Basica速 Active

1

Acid-alkaline balance*

2

Improves stress response

3

Bone mineral density

4

Detoxification* and liver health

5

Energy production

*Claims based on a dosage of 10g twice daily

For more information on Basica Active and Acid/ Base Balance contact Bio-Practica 1300 551 077.

Based on the original formulations of the world renowned Acid-alkaline nutritional expert, Dr Ragner Berg.

Basica速 Active contains mineral citrates and is: Gluten and wheat free Yeast free Vegan formula No added sugar, naturally sweetened with Stevia Egg, dairy and lactose free Copper free Nut and soy free Purine free Practitioner Only Product.

References available upon request

ARTICLE

Dark Field Microscopy of Human Blood: The history of dark field microscopy in human blood analysis.

Wayne G Reilly | BSc, MSc (Hons) Biochemistry, Diploma Health Science (Western Herbal Medicine, Diploma Clinical Nutrition, Certificate of Pathology.

In 1916, Dr Gunter Enderlein began his investigations of human blood under the microscope using phase contrast and dark field microscopy. These methods enabled him to observe both stained dried blood and live blood preparations from healthy and sick animals and humans. His investigations identified numerous morphological objects in the blood that he correlated to illnesses.

As he was a proponent of biological pleomorphism he developed a theory of disease and a terminology that described his observations in his live blood samples.

Terms such as protits, symprotits, makrosymprotits and spermite were used to described objects that supposedly identified the transformation of a viruses to bacteria or to fungi, and these all originated in his observed live blood cells.

Enderlein published his findings in a book entitled Bacterien Cyklogenie (The Life Cycle of Bacteria) in 1925.1 Due to the limited understanding of cell biology at the time it is not too surprising that many of his observations were artefacts. In the late 1990’s further research conducted

16 | vol22 no1 | JATMS

by Dr Christopher Gerner, a biochemist at the University of Vienna, Austria, identified that many of the cellular forms observed by Dr Enderlein were primarily composed of cellular debris from degenerating red blood cells, and were in fact molecules of globulin and albumin.2 The Enderlein method of Live Blood Analysis is still being taught in Europe and the USA today, but it is important to differentiate this from other methods of Live Blood Analysis using dark field microscopy that allow point-of-care examination of a patient’s blood during a complementary medicine consultation. At the International Pleo-Sanum Conference, held in San Diego in February 2011, a number of Enderlein practitioners from around the world assembled to discuss Enderlein Live Blood Analysis.

They included Dr Thomas Rau MD, the Chief Medical Director and partowner of the Paracelsus Klinik, Center for Paracelsus Biological Medicine and Dentistry in Lustmuhle, Switzerland. Dr Rau is considered a leading expert in Enderlein therapy, dark field microscopy, and biologic tumour treatments. This

meeting demonstrated that the Enderline technique is strongly associated with biologic medicine. Yet many of the adverse responses from the medical profession relating to live blood analysis that have been reported in the media and the internet have been directed mainly at the Enderlein method and other similar practices. This method of live blood analysis does have some merit in its own right; however, it is substantially different to the dark field examination of human blood practised in Australia and New Zealand by trained practitioners of the now unsupported Hemaview technique.

This method closely resembles standard haematological blood film analysis and endeavours to interpret the same cellular observations on the wet mount as seen in a stained blood film.3 Various screening tests are currently used by complementary and alternative health practitioners in Australia. The analysis of wet prep blood using dark field microscopy live blood analysis examines non-anticoagulant-treated capillary blood. This technique has been in use for more than 20 years under the name of

Hemaview and can be performed rapidly at the point-of-care, allowing for fast and effective patient treatment.

One of the advantages of this technique is the ability to examine leukocyte motility. Leukocyte movement is easily observed with dark field microscopy, with neutrophils displaying the highest levels of activity.4 Chylous material (chylomicrons and chylomicron remnants) are also clearly visible using dark field microscopy, as are platelets.

The morphology of all the cellular components in a dark field live blood analysis can easily be examined with this technique, and inferences can be made based on the observed shifts in the morphological state of red and white blood cells and precipitated plasma proteins. These can then be examined in relation to the patient's presenting symptoms 5,6 and used to suggest a therapy.

THE HUMAN BODY CONSISTS OF 75 TRILLION CELLS, OF WHICH 25 TRILLION ARE RED BLOOD CELLS, SO IT IS NOT SURPRISING THAT RED CELL MORPHOLOGY IS SO STRONGLY INDICATIVE OF HOMEOSTATIC CHANGE.

These observations can then be used to assess inflammation, oxidative stress, certain nutritional deficiencies and possible dysfunctions in the gastrointestinal tract.7-9 These observations are indicative of homeostatic change and suggestive of pathological change. in his book Diagnostic Haematology5 Norman Beck notes that a haematological reference range and a patient’s level within this in a full blood cell count (FBC), even within the so called normal range, may indicate a preclinical homeostatic change.

His example is that a woman’s having a normal range mean corpuscular volume (MCV) of 85fl could in fact be a sign of a preclinical process toward the development of hypothyroidism. It then becomes imperative to look at haematological outliers in the reference range as suggestive of preclinical indicators.

More people in health and community services choose HESTA for their super Supports your industry | Low fees | A history of strong returns

WORKPLACE SUPER PRODUCT OF THE YEAR - VALUE CHOICE

WINNER

2015 RAINMAKER EXCELLENCE AWARDS

Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL 235249, the Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. Investments may go up or down. Past performance is not a reliable indicator of future performance. Product ratings are only one factor to be considered when making a decision.

See hesta.com.au for more information. Before making a decision about HESTA products you should read the relevant Product Disclosure Statement (call 1800 813 327 or visit hesta.com.au for a copy), and consider any relevant risks (hesta.com.au/understandingrisk)

ARTICLE

Measurement of red blood cell count (RBC) size in dark field microscopy live blood analysis is used in this way and research has shown this approach to be an accurate indicator of such change.10-12

Dark field examination of human blood Dark field microscopy makes possible the examination of blood cell morphology in regard to shape, size and motility.

It affords a greater degree of visual enhancement of the image based on the absorption of light. This enhanced visibility is seen in all components of the blood - red blood cells, white blood cells and other inclusions, such as fibrin, platelet aggregation and red cell inclusion bodies (i.e. Heinz bodies).9, 10 Red blood cell size can easily be determined through dark field microscopy, with small cells (microcytosis) indicative of iron deficiency and large cells (macrocytosis) of vitamin B12 or folate deficiency.

Norman Beck also states that anaemia is so common in an FBC that it is often overlooked during diagnosis, and yet this is often important to treatment.5 Hence, simply by looking at the size and shape of red blood cells or by identifying increased numbers of immature neutrophilic metamyelocytes in the dark field preparation, one could identify a leukemoid reaction or myelodysplasia6 and then send the patient on to their general practitioner for further assessment.

Effects of iron, folate and/or vitamin B12 deficiencies on the blood The human body consists of 75 trillion cells, of whiech 25 trillion are red blood cells 5, so it is not surprising that red cell morphology is so strongly indicative of homeostatic change. A red cell matures for eight days in the bone marrow and is then released into the circulation, to develop as a reticulocyte into a mature red blood cell over the next 24 hours.

Once mature, a red blood cell can have a life span of 120 days.

18 | vol22 no1 | JATMS

Large oval red blood cells with a raised MCV are the first clinical sign of B12 and/ or folate deficiency. Increased numbers of hypersegmented neutrophils with five or six lobes can appear in the peripheral circulation several weeks before frank B12 deficiency is observed. A recent study at Southern Cross University showed a similar accuracy in the identification of these parameters between standard pathology analysis and dark field live blood analysis.11,12 Aggregation and rouleaux of red blood cells and platelets have been shown to be indicative of impending cardiovascular disease or thrombosis.13-15 Erythrocyte sedimentation rate (ESR), a non-specific inflammatory marker commonly measured in pathology tests, is a measure of acute phase reactants.15 Dark field live blood analysis can also identify an increase in these features.12 Increased numbers of eosinophils and basophils, when observed in dark field live blood analysis, can also be correlated to a similar response seen in allergies.8 Dark field live blood analysis has been shown to accurately differentiate the white cell population without differential staining, using a haematological stain.16 For example, Wright-Giemsa stain, with its combination of acidic and basic dyes, will differentially stain the granules, cytoplasm, and nuclei of various white blood cell types.17, 18 Each white blood cell has a different illumination under dark field microscopy, which allows accurate differentiation of the white cell population on the prepared wet mount slide used in live blood analysis.19 Once a differential percentage is established the

neutrophil to lymphocyte ratio (the N/L ratio) can be calculated.20 This ratio is now widely accepted in haematology as an indicator of altered immune function and disease.21 There is a definite need for continued research into dark field live blood analysis, as it is only through these efforts that greater acceptance of this technique as a general tool in complementary medicine will occur.

Wayne Reilly is a practising western herbalist and nutritionist and has a clinic in Coorparoo in Brisbane. He has been teaching Advanced Hemaview (Live Blood Analysis) for Metagenics since 2006 and is a member of the ATMS Research Committee.

REFERENCES 1. Enderlein G. Bakterien-Cyclogenie. Berlin: Verlag de Gruyter & Co; 1925.

2. Gerner C. Biochemische Analyse endobiontischer Strukturen aus dem menschlichen Blut. Curr. Onkol. 1997; 6:12.

3. Reilly W, Mannionf P, et al. HemaviewTM: A Clinical Useful Tool for the Evaluation of Red Blood Cell Parameters in Preclinical States.

5th AH&MR Congress, 2010. Melbourne Convention Centre: abs#630.

4. Elgefors B, Olling S. Random locomotion in dark-field microscopy of single granulocytes from venous blood, tissue and exudate.

Methodological considerations and clinical applications. Acta Pathologica, Microbiologica, Et Immunologica Scandinavica. Section C, Immunology. 1984; 92(2): 113-119.

5. Beck N. Diagnostic Haematology. Berlin: Springer Verlag; 2009.

6. Reilly W. Identification of Myelodysplasia during routine screening using HemaviewTM, a live blood analysis technique. 15th International Holistic Health Conference of the Australasian Integrative Medicine Association, 2009. Novotel St Kilda, Melbourne VIC. 7. Hansen-Pruss O. The circulating blood cells as seem by dark-ground illumination. American Journal of Clinical Pathology, 1936; 6: 423.

8. Vitetta L, Sali H. et al. The Live Blood Analysis Technique. Journal of the Australasian Integrative Medicine Association, 2005; 24: 16-20.

9. Trivieri L. Monitoring the river of life: doctors use Dark Field microscopy to detect early signs of disease in the blood - but its use as a tool to educate and motivate patients can be of even more value. Alternative Medicine Magazine, 2002; (48): 90.

10. Vigar V. Inter-rater and intra-rater reliability of live blood analysis using Dark Field microscopy. Honours thesis. Southern Cross University, Lismore (NSW), 2009.

11. Andersson-McConnell L. The correlation of

Available exclusively in Health Food Stores Australia wide.

inflammatory markers in fresh capillary blood observed with Dark Field microscopy with inflammatory markers determined by other tests in a population with gastrointestinal symptoms. Honours thesis. Southern Cross University, Lismore (NSW), 2013.

12. Watts Q. The validity of live blood analysis using Dark Field microscopy in screening for oxidative stress.Honours thesis. Southern Cross University, Lismore (NSW), 2013.

13. Moriarty PM. Gibson CA. Association between hematological parameters and high-density lipoprotein cholesterol. Current Opinion In Cardiology, 2005; 20(4): 318-323.

14. Pusl T, Broedl UC, et al. Long-term LDL apheresis does not stably improve hemorheology in hypercholesterolemic patients with coronary artery disease. Clinical Hemorheology and Microcirculation, 2009; 41(2): 137-142.

15. Voeĭkov VL. The physicochemical and physiological aspects of the erythrocyte sedimentation reaction. Uspekhi Fiziologicheskikh Nauk. 1998; 29(4): 55-73.

16. Petric V. 2009. Atlas of Live Blood through Dark Field Microscopy: The Morphology of Blood in Live Hematology. New Zealand: Vlatko Petric; 2009.

17. Bauer JD. Clinical Laboratory Methods. 9th ed.

St Louis: Mosby, 1982.

18. Wintrobe MEA. Clinical Hematology.

Philadelphia: Lea & Febiger; 1981.

19. Zigmond SH, Lauffenburger DA. Assays of leukocyte chemotaxis. Annual Review Of Medicine, 1986; 37: 149-155.

20. Reeve K, Gruner T, Arellano J, Reilly W. Differential white blood cell counts: A comparison between automated pathology and Dark Field microscopic fresh capillary blood analysis. The International Congress on Natural Medicine, Melbourne, June 8th -10th, 2013.

21. de Jager CP, Wever PC, Gemen EF, Kusters R, van Gageldonk-Lafeber AB, van der Poll T, Laheij RJ. The neurtrophil-lymphocyte count ratio in patients with community-acquired pneumonia. PLoS One, 2012; 7(10):e46561 doi: 10.1371/journal.pone.0046561.

Bio Curcumin 4800+ Bio Curcumin 4800+ contains Meriva® curcumin, an extract of Turmeric that may help reduce joint swelling and inflammation and increase joint mobility associated with mild arthritis.

Herbs of Gold – Producing herbal and nutritional supplements since 1989.

herbsofgold.com.au Always read the label. Use only as directed.

CHC 71276-02/16

JATMS | Autumn 2016 | 19

ARTICLE

CAM Use By Poor Rural Victorian Consumers Tass Holmes | PhD (Anthropology, University of Melbourne)

Following from previous JATMS papers,1,2 this article describes complementary and alternative medicine (CAM) use among low-income consumers in a rural community in Victoria, Australia. It refers to ethnographic documentation and interview narratives, using pseudonyms, from an anthropological research project in the composite fictitious town, ‘Sephirah’. The particular focus is on differing CAMs selected, and experiential aspects of CAM use. Consumer descriptions of their unconventional healthcare practices emphasise the ongoing popularity and commonality of non-biomedical approaches to wellbeing. A diverse group of welfare recipients consumed CAM, despite usually being unable to afford private-sector fees.

Formal or semi-formal CAM provider treatments and ‘folk healing’ methods were both favoured by those with alternative worldviews or beliefs about the value of holism in health. A connection may be tentatively drawn between a preference for CAM and the evolution of non-mainstream opinions and beliefs, or conversely, between extant alternative viewpoints and development of a preference for CAM.

Rural CAM consumers Central topics of the research were poverty and limited consumer access to professional CAM. There is a paucity of literature discussing the nexus between non-medical healing and poverty in Australia and other firstworld countries. Some research suggests CAM consumption is higher in rural than urban areas, both in Australia3-5 and elsewhere.cf.6-8 In developing countries traditional medicine and CAM may support cultural knowledge preservation and resistance against inroads of capitalist development,9,10 further to providing needed healthcare services, although one study found a

20 | vol22 no1 | JATMS

positive correlation between retained herbal knowledge and both ‘commercial occupation’ and ‘consumerism’.11 Aside from recent work to alleviate food insecurity,12 Australian CAM research often prioritises practitionerprovided treatments,13-15 rather than considering all the ways that consumers use CAM.but:16,17 Exceptions may portray supplement use as poorly informed ‘self-medication’. Surveys often omit respondents’ beliefs and reasons for CAM consumption, thereby overlooking emic perspectives such as distinguishing unique rural challenges from those of urban locations.

Methodology Documentary research aims required ethnographic data collection, mainly participant observation and in-depth interviews. University of Melbourne HREC ethics clearance (June 2011) permitted immersive fieldwork for over two years. I joined in numerous community activities, events and networks, staged many purposeful informal conversations, and conducted, recorded and transcribed 54 in-depth interviews.

Consumer interviewees were over 18, and of low-income status. They were recruited by a snowball method,

using inclusion criteria that stipulated ‘intensive’ personal involvement with CAM rather than superficial use. Further to pragmatic description of preferred therapies, this approach yielded detail about consumer understandings of CAM paradigms, and insight into sociocultural contexts. I interviewed 23 nonpractitioner CAM consumers (and several student-practitioners, such as Louisa and Danielle, included below). Consumers were: seven single men, six of whom were receiving welfare benefits, two who were in part-time or self-employment; and 16 women, of whom 5 were married/defacto, 11 were single, 15 were receiving welfare payments, and only 3 (each of these with a partner) had any type of paid employment.

Impoverished circumstances Despite poverty being relatively hidden in contemporary urban middle-class Australia, a substantial sub-population survives for years to decades on an income at or below the poverty line.

For rural residents, difficult financial circumstances and reduced availability of health services can limit access to private healthcare, including virtually all CAM consultations. Medicare funding does not extend to CAM practitioner services, except a restricted number (5 per year, current at 2014) of chiropractic, osteopathic, psychological and other allied health visits, for referred medical patients.18 Poverty is a reality for many rural residents.1 Association between rurality and compromised health is described elsewhere.cf.19 In this study long-term poverty was common and extensive. Those ‘living poor’ included unemployed,20 caravan park residents,21 and sole parents struggling to afford children’s education, or living alone after their kids moved out. While many locals owned their homes, most sole parents, with the lowest incomes per number of household members and longest periods spent living in poverty, were paying relatively expensive private rental costs.

Sephireans do not generally have ‘rural’ lifestyles, but reside in small houses

in township communities, forming enmeshed social networks among financially and culturally disadvantaged familiar folk.22 Several interviewees described low-income circumstances.

Fifty-eight year-old Louisa lives alone in an isolated low-energy bush home, ‘five kilometres from the bitumen’, on a Centrelink widow’s pension (equals Newstart). Her young adult children had left home. Louisa described years of yoga and mindfulness practice, long-term sole-parenting, and recent attempts to start a small kinesiology business. Her worldview reflects deep investment in alternative doctrines linked to eastern lifestyle practices (self-directed yoga and meditation) that are inherently cost free, ‘low-footprint’ and accessible to selfmotivated people of any income.

Fifty-four year old George, single and unemployed, with vision problems, is a typical low-income local, battling without hope of improving his financial lot. George joked about not affording private health insurance, saying, ‘I’m only on the dole, only got that insurance!’ As a former farm labourer, George’s wage for three months fulltime work during the 2007 summer amounted to four thousand dollars, less than a third of average taxable income (then $57,000 per annum23). George was ‘very healthy’ despite frequent smoking, and he cited his Icelandic father’s strong resistance to disease. He sees a medical doctor about every three years, selfmedicating occasionally according to need, especially with aloe vera juice applied topically for eye inflammation,24 and Friar’s Balsam for injuries. George’s view, that professional healthcare services are mostly not required, is one definite means of reducing health costs.

Overall, women displayed considerable interest in healing and CAM, while men frequently expressed no interest, seeking conventional medical treatment only. Some men thought CAM pointless; they believed it couldn’t help them, as they preferred an unhealthy lifestyle, smoking and beer-drinking.

Folk healing and traditional herbal medicine Although most interviewees purchased branded CAM products for selfmedicating, old-fashioned home remedies and folk healing methods were also popular as free or low-cost selfprescribed treatment. Eighty year-old Wilhemina James, known as Willie, recalling her ‘dirt poor’ rural childhood in South Australia and New Zealand, described folk health knowledge as informal, taught as an oral tradition, and without much ‘herbal medicine’ of the type now generally recognised.

She conceptualised folk medicine as a stand-alone pluralistic tradition25,26 that persisted through necessity, independent of medicine. She stated matter-of-factly: Although sometimes you need validation and a bit of guidance, I think in this world you’re supposed to be grown up and think for yourself.

Willie remembered taking castor oil weekly as a laxative, and using iodine as disinfectant, kerosene on sugar for sore throats, sulfur powder for skin problems, and a sugar-soap mixture to draw splinters or boils. Willie’s friend Suzie emphasised contemporary folk medicine’s familiarity and the value of straightforward time-honoured remedies, as applied un-medical learning. She listed aloe vera for minor burns, flower essences for anxiety, Scheussler tissue salts for chronic complaints, bi-carb soda for indigestion, home-made calamine lotion for mozzie bites, Epsom salts for pain, warmed tea cups to draw breast-milk, and cabbage leaves for mastitis or sore nipples. Suzie enthused about placebo effect, and the idea that home remedies offer a means of side-stepping a reliance on the world of ‘products’ and profit-making.

Another interviewee self-treated for recurrent vulval thrush and cystitis using acidophilus yoghurt, herbal ointments, and eventually ti-tree oil ‘applied neat’, which ‘raised a shout’ but was curative.

Plant essential oils, including ti-tree oil

JATMS | Autumn 2016 | 21

ARTICLE

(Melaleuca alternifolia), eucalyptus and other oils from essential oil-bearing plants, have been shown effective against infective pathogens.27-29 Sole parent Danielle dealt with her four children’s illnesses, for the most part without visits to medical practitioners.

She allowed them to rest during sickness, and during fevers, cooled their feet and forehead with lavender water, and fed them lemon water as a food cure.

Forty year-old Layla took St John’s wort (Hypericum perforatum) 30-33 in lieu of medical drugs, which she refused despite clinical depression.

She consumed other foods and herbs as ‘simples’, including saffron to improve energy, valerian for sleep and overcoming anxiety, and bananas, SAMe, and vitamin B-complex to improve mood.

Homebirth mum Abelle obtained advice over the phone from a Queensland herbalist for treatment of severe pain with kidney stones that consisted of a very hot bath for one hour, followed by a crushed soaked linseed poultice over the kidneys and painful parts, renewed three-hourly. Abelle experienced kidney pains as ‘worse than childbirth’, but found the bath and linseed method an effective analgesic, anti-inflammatory, anti-oedema cure that reduced peripheral pain.34-36 Flax (Linum usitatissimum, syn. linseed) has a long and fascinating cultural history of association with suffering and pain,37 which informs a doctrine of signatures suggestive of pain-relief. The doctrine of signatures is an old-fashioned method of intuiting healing properties of herbal plants by virtue of their resemblance to the form, appearance or behaviour of parts of the body.

Some interviewees grew herbs at home, or practised wildcrafting common plants to procure old-fashioned medicinal herbs at very low cost.38 Almost all described self-motivated use of western herbs as medicines, without practitioner advice.

22 | vol22 no1 | JATMS

Some interviewees grew herbs at home, or practised wildcrafting common plants to procure oldfashioned medicinal herbs at very low cost. Almost all described self-motivated use of western herbs as medicines, without practitioner advice.

They looked up information in books or libraries, on the internet, or from people they knew. Some recalled folk remedies used by their mothers or grandmothers that had piqued their interest.

Sixty-four year-old Ryan, a part-time cabinet-maker who classes himself as ‘one of the working poor’, self-medicates experimentally with herbs for common ailments, favouring ‘whatever works’. He explained that the effectiveness of herbs arose from long traditions of western and eastern cultural knowledge, despite finding herbal results unpredictable and believing placebo effect was real.30 Ryan enjoys self-sourcing herbs ‘from the nature strip’ for political reasons, because they ‘don’t appeal to drug companies’, which can’t profit from them. He takes lemon and honey to ward off flu and cold symptoms, and wildcrafts locally grown medicinal plants such as aromatic indigenous sassafras from bush gullies where he walks, following the Indigenous tradition of using these leaves to prepare tea or inhalations for relief of sinus congestion and pain.

Sixty-two year-old Marie Walder was a sole parent for many years. Recently

retired from full-time work, through stress, tiredness, and a dearth of employment for her age-group, she moved from a long-term rental home in Sephirah township to the bush, as her meagre savings evaporated supplementing high rental costs for a single person. She enjoys using western folk-herbal healing in a way she calls ‘being a witch’, grows garden herbs, and regularly wildcrafts ‘about a dozen’ other medicinal herbs that are freely and widely available[1]39-42 from yards, footpaths and her neighbourhood.

Occasionally, Marie ‘cures’ family members and friends of chronic conditions using wildcrafted herbs. She recalled a friend’s relief from hayfever and spring allergies after drinking a strong brew of wildcrafted herbs she collected from his backyard.

Unable to afford naturopaths, Marie often self-medicates with herbs, preferring to avoid expensive professional treatments, while still able ‘to get to the root cause of things’, consistent with her beliefs, rather than suppressing illness with conventional medications. She sources information from books, and is interested in interpreting herb properties according to the doctrine

of signatures.43 Favourite herbs include sow thistle, ribwort, clover flowers, and wild lettuce, in tea, salads or stews, and lungwort (Pulmonaria spp.) for short-term use during coughs or chest infection (although cautious not to overuse herbs, she sidesteps warnings about pyrrolizidine alkaloid content precluding all internal use). Marie experienced improvements in her overall health from regularly taking wildcrafted herbs, which appeared to ward off sickness, hasten recovery when ill, and promote increased energy.

Homeopathic holism and naturopathic supplements

NE W

Consumers who favoured homoeopathic treatment emphasised the philosophical holism, safety and ‘naturalness’ of this system of medicine, believing it addressed disturbances that originate in energetic and spiritual aspects of human life. Homeopathic consumers

appeared knowledgeable about homoeopathy’s mode of action, offering detailed explanations of ‘likes cure likes’ and ‘stimulation of the vital force’, and linking homoeopathy to all-encompassing life philosophies or a purpose for humanity, such as that espoused by Rudolf Steiner. Marissa justified choosing homoeopathy for her family’s healthcare on the basis of making choices that develop a sense of conscious freedom, human identity, and not having to be restricted by routinised systems and an expected reliance on mainstream ‘usual care’.

While homoeopathic remedies are very low in cost, consumers of homoeopathy in this study mainly visited professional homoeopaths for advice and to obtain remedies, only infrequently selfmedicating with homeopathic ‘first aid’, usually arnica pills or creams.

Desiring naturopathic treatment, several other low-income consumers were motivated to purchase branded products over-the-counter from health foods stores or pharmacies, after seeking naturopathic advice2 or becoming self-informed. Avoiding consultation fees made herbal and nutritional supplements more affordable for these consumers.

Nutrition and poverty alleviation Consistent with the focus on ‘intensive’ CAM use, the majority of consumer participants were well informed about nutrition and the role of dietary habits in maintaining health. Several adhered to diets that addressed health needs in practical, meaningful ways.

Issues of cost and financial barriers to consuming healthy foods and nutritional supplements were a central concern.

Minerva

To help restore balance in mature women • Clinically researched formula with published studies • Unique proprietary blend of standardised, high-quality herbal extracts with proven stability

Clinically Researched

• Convenient one-a-day formula for optimal patient compliance • Vegan, low excipient formula in a vegetable capsule

VEGAN

• Strictly Practitioner Only Minerva

Minerva is the Roman goddess of wisdom and the patron goddess of medicine.

EstroG-100® is a patented blend of three botanical root extracts, and has been clinically researched and shown to be safe and effective.

BioMedica Nutraceuticals | P 1300 884 702 or +61 2 8339 0539 | F +61 2 9669 3027 E info@biomedica.com.au | www.biomedica.com.au

JATMS | Autumn 2016 | 23

ARTICLE

Several interviewees had coeliac disease, necessitating gluten-free diets to minimise painful symptoms and emotional lability. Others were longterm vegetarians, with philosophical appreciation of animal lives, and awareness of ‘the interconnectedness of eating and general wellbeing’, who preferred organic or biodynamic produce. For those interested in nutrition for health, philosophical integrity and avoiding ‘sensitivity reactions’ and illness, the expense of high quality foods and supplements was a significant challenge.

A depressed, middle-aged caravan-park resident, Vida, believes psychosomatic effects create disease, ‘everything affects everything else’, and emotions affect eating and digestion. Causes such as fear, or after-effects of childhood abuse, remain poorly acknowledged within a medical paradigm. To avoid medication, Vida’s favoured solution to anxietytriggered indigestion, on a meagre pension income, is ‘food remedies’ sourced from friends. She also takes commercial vitamins and minerals to support immunity and counter ageing, despite sensitivity to their perceived over-energising effect. Mainly she avoids junk food, preferring health-giving meals of rice, salads, vegetables, bread, fruits, occasionally fish or meat, and plenty of water, and regularly includes herbs in meals, and yoghurt, which helps her feel well. Vida minimises food costs by eating simply. If unwell she consumes raw vegetables for a couple of months.

She bemoaned the closure of a local health foods business, observing that people now purchase supplements from supermarkets. Her dietary preferences ensure a familiar calm environment for eating, reducing impacts of long-standing anxiety on her ‘nerves’ and stomach, providing whole-foods that aren’t excessively ‘stimulating’ to digestion, and supporting general wellbeing.

Aside from individualised naturopathic advice or guidance from dietitians working in community health, and

24 | vol22 no1 | JATMS

For those interested in nutrition for health, philosophical integrity and avoiding ‘sensitivity reactions’ and illness, the expense of high quality foods and supplements was a significant challenge. supplements purchased over the counter from a pharmacy, nutrition projects in Sephirah – where food insecurity has been identified as problematic – were geared toward poverty alleviation in addition to health. They include a weekly vegetarian community café, community vegetable gardens (since 2010), a permaculture and artists’ collective that stages social events, and charity-run outlets for distribution of free food from the Second Bite organisation, which ‘recycles’ food2 that would otherwise be trashed as part of Australia’s $5 to $8 billion annual food wastage.44,45 These activities operate through a local volunteer labour force, who gain formal training, work experience and social connections.

Psychic healing I designated a widely popular group of alternative practices sought by consumers as ‘psychic healing’. Psychic healing was commonly resorted to for uncategorised mental/emotional discomfort or non-psychiatric states such as ‘stuck energy’ (one’s own), or ‘stale energy lingering around’ (someone else’s). An example was the ‘shamanic treatment’, or ‘energy clearing’ sought by Danielle, a student of Chinese massage who believed strongly in ‘psychic connection’, to remedy a subjective malaise caused by contacting a traumatised friend, who ‘drained vital energy’. She explained the efficacy of the treatment in terms of the practitioner’s understanding, as derived from psychokinetic ‘esoteric acupuncture’. Rather than ‘fixing’ symptoms, this method aims to elevate body energy, permitting a restitution of wellbeing.

Nicole, a 35 year-old mother of a young child with autistic behaviours, was curious about tarot cards, and ‘psychic stuff’ generally. She visited ‘psychics’ for readings, to aid decision-making, for instance before medicating her son following his diagnosis of autism, and to prepare for family members’ expected negative reactions. She claimed psychic advice allayed anxiety and improved her outlook on life, by determining she was ‘on the right track’. A two-year span of future predictions offered a novel and inadvertent means of mental health promotion, providing answers that stopped Nicole from feeling ‘desperate’. She said: It’s kind of like cheating, because they give you answers … I s’pose you’re supposed to let things happen naturally … But I guess it depends on what you thrive on in life, if you thrive on that ‘knowing’ …

Another visitor to psychic healers, 59 year-old pacifist Shaun, experienced a ‘breakdown’ after an unexpected divorce and financial losses in the 2008-09 economic crisis. He sought comfort in the optimistic words and dreams of a clairvoyant friend, subjective assistance from a ‘spirit guide’, and holistic approaches to wellbeing consistent with his belief that mind and body are inseparable. On disability support payment and medications, Shaun used a bushfire assistance voucher (explained below) to consult a man for ‘spiritual healing’, using diagrammatic symbols of the aura, crystal dowsing, flower essences, and blessings from Archangel Michael.

He experienced a welcome catharsis and renewed vigour from the psychic treatment, which released his pent-up

grief and obstructed energy that had seemed like ‘walking through molasses’.

Limited consumer access to physical therapies For consumer interviewees generally, massage or other touch-based therapies were unaffordable, and few sought this type of treatment due to cost. Exceptions were an older-aged sole parent of a child with Down Syndrome, who enjoyed funded massage therapy as supplemental healthcare for carers when she resided in NSW; George (above), who received free Reiki for a short time from a practitioner girlfriend; and another sole parent who was offered heavily discounted rates for massage during a homeless period following bushfires in 2009. Several others with acute disabling back pain received free physiotherapy through the community health service, and up to five free chiropractic or osteopathic sessions per year via medical referral.

Only two consumer participants took advantage of the belated extension (commencing 2011-2012) to CAM providers registered with health insurers of a short-term (to March 2013) state government funding initiative permitting residents affected by bushfires to receive CAM treatments using $50 vouchers.46 Low-income consumers were not adequately notified about the scheme, most remaining unaware of this funding until it was too late to claim their vouchers. Some with limited computer literacy found online claim forms inconvenient to retrieve.

Conclusion Research findings described in this paper emphasise low-income rural consumers’ poverty, their limited access to non-medical healthcare, and use of diverse CAM, particularly informal or less widely-recognised self-

treatments and folk-cultural practices, extra to professional CAM services.

NOTES 1. Limited wildcrafting of introduced weeds by Australian herbalists is noted by Evans (2009). Wehi (2009) describes Maori elders’ wildcrafting of urban-grown New Zealand plants.

Taylor (1998), and Korndoerfer (2011), express concern for the environmental impacts of wildcrafting commercially successful herbs.

2. See Second Bite organisation (Australia) website, online at: secondbite.org.

REFERENCES References for this article are available on request. Please email the editor at atms.journal@westnet.com.au or the author at tass.holmes@unimelb. edu.au.

Tianmen Acupuncture Needles ™

Silky smooth insertion Extra-long spring handle Greater control & manoeuvrability Elegant sleek shaft Super sharp tip

Shipping Australia Wide • Free Needle Samples • Always In Stock • Sourced By Practitioners

www.sanacupuncturesupplies.com.au Save 10% off your first order when you subscribe to our mailing list.

ARTICLE

Brief Interventions for clients with drug and alcohol issues Katrina Alexander | B SocSci (Psychology), BClinSc (Osteopathy) A Brief Intervention (BI) is a short face-to-face conversation about alcohol and drug consumption, motivation to change, and options for change which is provided during a window of opportunity or an information-sharing moment with a health professional.

It is a technique or tool used to initiate change in behaviours that are detrimental to health such as smoking, drug and alcohol consumption. It is an opportunistic intervention that can occur in the assessment phase when treating patients for other health concerns. An opportunistic intervention occurs at a critical moment in a person’s life, for example, when they are faced with other health concerns. A BI can be undertaken in as little as a few minutes and can be supported by written information and self-help strategies. It is evidence-based and can be very effective in assisting patients to self-monitor.

A BI can engage with people who may not yet be ready for change, increase the person’s perception of real and

26 | vol22 no1 | JATMS

potential risks and problems associated with alcohol and other drug use and associated practices, and motivate behavioural change, thereby improving health outcomes, by helping the person to consider the reasons for change and the risks of not changing.1

NDSHS collected data from nearly 24,000 people across Australia. The survey was conducted from 31 July to 1 December 2013. Roy Morgan Research was commissioned to conduct the survey fieldwork.3 The following statistics are taken from the NDSHS.

There is strong evidence for the effectiveness of BIs in primary care settings for reducing alcohol and tobacco consumption, and growing evidence for such effectiveness in regard to other substances. (For the purpose of this article substance is defined as alcohol, over the counter drugs (OTC), prescription drugs and illicit drugs.) BIs are low in cost and are effective across all levels of hazardous and harmful substance use and so are an ideal method of health promotion and disease prevention in primary care patients.2

Alcohol use

The National Drug Strategy Household Survey (NDSHS) has been conducted every two to three years since 1985. The 2013

• Compared to 2010, fewer people in Australia drank alcohol in quantities that exceeded the lifetime risk and single occasion risk guidelines in 2013.

• Fewer 12–17 year olds are drinking alcohol and the proportion abstaining from alcohol increased significantly between 2010 and 2013 (from 64% to 72%).

• Almost five million people in Australia aged 14 or older (26%) reported being victims of an alcoholrelated incident in 2013, although this proportion had declined from 29% in 2010.

Illicit use of drugs There were declines in the use of some illegal drugs, including ecstasy (from 3.0% to 2.5%), heroin (from 0.2% to 0.1%) and GHB (from 0.1% to less than 0.1%) in 2013, but the misuse of pharmaceuticals increased from 4.2% in 2010 to 4.7% in 2013.

While there was no significant increase in methamphetamine use in 2013, there was a change in the main form of methamphetamine used. Use of powder decreased significantly from 51% to 29% while the use of ice (or crystal methamphetamine) more than doubled, from 22% in 2010 to 50% in 2013.3 It is important to acknowledge that all substance use is not the same.

Schaeffer’s model proposes five types of use: experimental (single or short-term use), recreational/social (controlled use in social setting), situational (use for a specific reason), intensive (high dose, or binge), and compulsive (frequent or daily doses, withdrawal).

Assessment and Schaeffer’s model4 Experimental substance use is motivated by curiosity or desire to experience new feelings or moods. This may occur alone or in the company of one or more friends who are also experimenting. It normally involves single or short-term use.

Social use is when substances are used on specific social occasions by experienced users who know what drug suits them and in what circumstances (e.g. ecstasy use by experienced users at dance parties, or alcohol with a meal).

Situational use is when substances are used when specific tasks have to be performed and special degrees of alertness, calm, endurance or freedom from pain are sought (e.g. truck driving, shift work or studying for exams).

Intensive use is similar in nature to situational but is more excessive in the degree of use. It is often related to an

individual’s need to achieve relief or a high level of performance. It can also involve binge alcohol and other drug use, where there is excessive use of a substance at one time. The pattern of binge use may be occasional, or may relate to specific situations.

Compulsive use leads to psychological and physiological dependence where the user cannot at will discontinue use without experiencing significant mental or physical distress. Drug use is central to the user’s day-to-day life.

Evidence A randomized study by Bernstein and colleagues found that when cocaine and heroin users seen in primary care received a brief intervention, the patients had a 50% higher incidence of abstinence at follow up than patients who did not receive a brief intervention.5

Clinical signs and symptoms Alcohol Physical: under-nutrition, boils, scabs, parotid swelling, Cushingoid face, spider naevi, palmar erythema, the smell of alcohol on the breath, red eyes, jaundice sclera, presence of alcoholrelated illness, reported alcohol intake of 60/80gms or more per day on a regular basis (smaller amounts if taken with other CNS depressants or if elderly, previous history of withdrawal.)

Drugs Physical: puncture marks, phlebitis, cellulitis, skin abscesses, erosion or irritation around nostrils/septum, irritation or rash around nose and mouth, excessive weight loss, signs of numerous old injuries, frequent accidents, general physical state indicating poor lifestyle: nutrition or hygiene, intoxication, presence of drugrelated illness.

Psychological: depression, anxiety, personality change.

Social: unemployment or loss of job,

marriage or other family problems, no fixed abode, legal problems, school and/ or behavioural problems.

One or two of these signs in isolation may indicate nothing. However, fitting an overall profile of the above may indicate a substance problem.

Harm minimisation is the current drugrelated policy in Australia governing all drug-related laws and responses. Harm minimisation considers the health, social and economic consequences of alcohol and other drugs use in relation to the individual and the community.

It has been a key policy of Australian state and federal governments since the National Campaign against Drug Abuse was launched in 1985. The harm minimisation approach is based on the following premises. Drug use, both licit and illicit, is an inevitable part of society.

It occurs across a continuum, ranging from occasional use to dependent use. A range of harms is associated with different types and patterns of alcohol and other drug use. A range of approaches can be used to respond to these harms.

The concept of harm minimisation is not well understood or accepted in the wider community, as many people believe that attempting to reduce the harm associated with drugs implies condoning their use.

BI strategies do not condone drug use.

They aim to educate people to make informed decisions and choices. The intention is to keep people as safe as possible.

Assessment When you gain further information from the patient you will be able to assess the level of risk. If the patient is low risk or using at a hazardous level, such as binging, give the patient health information. If the risk is assessed as harmful give the patient health information, the Alcohol Use Disorders Identification Tool (AUDIT) and refer to services. The AUDIT is a tenquestion test developed by the World

JATMS | Autumn 2016 | 27

ARTICLE PRECONTEMPLATION Client does not recognize the need for change or is not actively considering change.

RELAPSE Client has relapsed to drug use.

health Organisation. This tool can help determine if a person is at risk of alcohol abuse problems.6

Stages of Change

Interpretating scores The AUDIT alcohol consumption questions (AUDIT-C) is a shortened version of the 10 question AUDIT. It is a three question screening test (see Figure 1). To score the AUDIT, point values of each answer are summed. A score of 8 or more in men (7 in women) indicates a strong likelihood of hazardous or harmful alcohol consumption. A score of 20 or more suggests alcohol dependence (although some authors claim scores of more than 13 in women and 15 in men indicate likely dependence).6

CLIENT LEAVES TREATMENT

CONTEMPLATION Client recognizes problem and is considering change.

MAINTENANCE Client is adjusting to change and is practising new skills and behaviours to sustain change.

ACTION Client has initiated change.

Figure 2: Stages of Change

10

*Adapted from Prochaska, J.O., and DiClemente, C.C. (1982).

Transtheoretical therapy: Toward a more integrative model of change.

Psychotherapy: Theory, Research and Practice, 19 (3), 276-288.

Figure 1: The AUDIT-c screening test 7

AUDIT-C Questionnaire

Brief Intervention steps

Patient Name ____________________________ Date of Visit ______________

Step 1. Get to know the person, find out what worries them. Listen to their story.

1. How often do you have a drink containing alcohol? a. Never

b. Monthly or less

c. 2-4 times a month

d. 2-3 times a week

e. 4 or more times a week

2. How many standard drinks containing alcohol do you have on a typical day? a. 1 or 2

b. 3 or 4

c. 5 or 6

d. 7 to 9

e. 10 or more

3. How often do you have six or more drinks on one occasion? a. Never

b. Less than monthly

c. Monthly

d. Weekly

e. Daily or almost daily

Effective parameters and precautions The use of a BI will be beneficial in most circumstances. It is important to ascertain the health status of the patient during assessment. A BI is not usually as effective for patients with chronic relapsing behaviours or those with a co-morbid mental health issue

28 | vol22 no1 | JATMS

or other serious health issues. Do not do a BI when the person does not wish to participate or is intoxicated or is too sick or injured or is in a highly emotional state. What you do depends on where the patient is in the process of changing. The first step is to be able to identify where the patient is coming from.

Step 2. ASK: Do you smoke/drink alcohol/take any other drug? If yes, ASK: How much, how often, and how do you feel about your use? Is there anything that you want to change?

Step 3. Decide what stage of change the person is at by what they say.

Step 4. Write down their stage of change and what advice you gave them. Next time you see the person ask how they are and what changes they have made.

Reinforce any positive changes and do another BI if necessary.8

Stages of change This transtheoretical model offers an integrative framework for understanding and intervening in intentional behaviour change.9 There are six stages in this model (see Figure 2): 1. Pre-contemplation is when the patient is not yet considering change or is unwilling. The practitioner’s task at this stage of change is to raise awareness.

2. Contemplation is when the patient sees the possibility of change but is uncertain or ambivalent. The primary task for the practitioner is to assist the patient to resolve ambivalence towards choosing change.

3. Determination. This stage of change is not included in Figure 2. but is often considered part of the preaction stage. In this stage the person is considering what to do. The primary task of the practitioner is to help identify change strategies.

4. The Action stage is when the patient is taking steps towards change but needs further assistance to stabilise the process. The primary task of the practitioner is to help the patient implement change strategies and learn to minimise any relapses.

5. Maintenance is when the patient has achieved set goals in relation to their substance misuse and is working to maintain implemented changes.

The primary task at this stage is to assist the patient to develop skills to maintain recovery through positive feedback mechanisms.

6. The final stage of change is the recurrence stage. It is important here to help the patient deal with consequences and to determine what to do next.9

Self-care for the patient BIs are successful when clinicians relate patients’ risky substance use to improvement in their overall health and wellbeing.

‘People are better persuaded by the reasons they themselves discovered than those that come into the minds of others’ (Blaise Pascal ).11

Benefits to practice Utilizing a BI increases clinicians’ awareness of substance use issues among their patients and offers clinicians a systematic approach to addressing substance use. This ensures less judgement is placed upon the patient and enhances patient-clinician relations.

REFERENCES 1. Australian Government, Department of Health, Module 9: working with young people on aod issues: facilitators guide, 6.1 brief interventions – a definition, (cited 2015 Dec 20). Available from: http://www. health.gov.au/internet/publications/ publishing.nsf/Content/drugtreat-pubsfront9-fa-toc~drugtreat-pubs-front9fa-secb~drugtreat-pubs-front9-fa-secb6~drugtreat-pubs-front9-fa-secb-6-1 2. World Health Organization, Department of Mental Health and Substance Dependence, Brief intervention for problematic substance use: guidelines for use in primary care draft version v1.1 September 2003(cited 2015 Oct

10) Available from: http://www.who.int/ substance_abuse/activities/en/Draft_Brief_ Intervention_for_Substance_Use.pdf 3. Australian Institute of health and Welfare.

National drug strategy household survey detailed report; 2013 (cited 2015 Oct 8) Available from: http://www.aihw.gov.au/ publication-detail/?id=60129549469 4. Australian Government, Department of Health, Module 9: working with young people on aod issues: facilitators guide, 2.2 schaeffer’s model, (cited 2015 Oct 20) Available from: http://www.health.gov.au/ internet/publications/publishing.nsf/Content/ drugtreat-pubs-front9-fa-toc~drugtreatpubs-front9-fa-secb~drugtreat-pubs-front9fa-secb-2~drugtreat-pubs-front9-fa-secb-2-2 5. Berntein J, Bernstein E, Tassiopoulos K, Heeren T, Levenson S, Hingson R. drug and alcohol dependence: brief motivational intervention at a clinic visit reduces cocaine and heroin use; 2005.Vol 77. Pp49-59 6. Bohn MJ, Babor TF, Kranzler HR. The alcohol use disorders identification test (AUDIT): validation of a screening instrument for use in medical settings. Journal of studies on alcohol; 1995 Jul 56 (4): 423–32. PMID 7674678.

7. Stable Resource Toolkit. AUDIT-C Overview (cited 2016 Feb 8). Available from: http:// www.integration.samhsa.gov/images/res/ tool_auditc.pdf 8. Hagger B, Entwistle D, Brief intervention and motivational interviewing tool; 2012 (cited 2015 Sept 12) Available from: http:// www.health.nt.gov.au/library/scripts/ objectifyMedia.aspx?file=pdf/64/32.pdf 9. DiClemente CC, Prochaska JO, Miller WR. (Ed); Heather N (Ed), 1998. Treating addictive behaviors: Stages of change diagram (2nd ed.). Applied clinical psychology, (pp. 3-24).

New York, NY, US: Plenum Press, xii, 357 pp.

10. Prochaska JO, DiClemente CC. The transtheoretical approach. In: Norcross, JC; Goldfried, MR. (eds.) Handbook of psychotherapy integration (2nd ed). New York: Oxford University Press. 2005: 147–171.

11. Carsten J. When a client is silent during therapy: part 2. (Internet).(cited 2016 Jan 21) Available from: http://www. elliottcounselinggroup.com/items-interest/ when-client-silent-during-therapy-part-two/

JATMS | Autumn 2016 | 29

ARTICLE

A Role for Homoeopathy in Urinary Tract Infection Robert Medhurst | BNat ND DHom

U

rinary tract infections or UTIs are one of the more common conditions we see in clinical practice. The lifetime incidence rate for this illness for women is 50%, and 5% for men. Babies and the elderly form two of the high risk groups for UTIs. The more specific groups at higher risk of developing this disorder are sexually active women, diabetics, men with pre-existing prostate disease, those with urinary catheters, and babies born with anatomical disorders of the urinary tract that result in vesico-ureteric reflux.

UTI is a general term encompassing urethritis, cystitis and pyelonephritis.

The disease is usually associated with a bacterial infection, and the organism most commonly implicated here is E.coli, although infection with mycoplasma or chlamydia, particularly in cases of urethritis, may also be involved. The symptoms reported for UTIs commonly include chills, fever, dysuria, haematuria, urinary frequency, a feeling of fullness in the bladder after voiding urine, and suprapubic, back or loin pain.

Failure to successfully manage UTIs may result in the progression to a more severe infection, and the development of hypertension as well as kidney failure.

Medically, UTIs are frequently treated with antibiotics, but the rates of resistance to these drugs, particularly the older antibiotics, are rising significantly, leading to increased levels of UTI recurrence that become harder and harder to manage.

From a naturopathic perspective, berberine-containing herbs, Cranberry, Buchul and Olive leaf are often helpful, but patient compliance with regimes employing these herbs can often be problematic. Prevention, using things

30 | vol22 no1 | JATMS

such as super-hydration (while avoiding electrolyte deficiency), Cranberry and probiotics can be successful, but often fail to halt an active UTI. In my experience and that of several noted authorities in this area,1-9 there are a number of homoeopathic medicines that have been found to be very effective in the management of UTIs. Brief discussions of these medicines follow, and it should be noted that these appear here for educational purposes only, and are not intended to replace the advice of a qualified healthcare practitioner.

Cantharis This is one of the most commonly used homoeopathic medicines in UTIs. The primary symptom is intense scalding or burning pain, either with or without urination. Urine is passed by drops and each drop of urine passed is often described as being like passing burning acid. There may also be anxiety, restlessness, urinary tenesmus, haematuria, the urine may appear jelly-like or contain substances with the appearance of scales. Severe urge to urinate and cramping around the urinary bladder may be reported. Symptoms are worse from drinking coffee, drinking or hearing running water and better from cold applications, rubbing, and having completely voided the bladder.

Arsenicum album The salient prescribing feature for Arsenicum is burning pain. The sufferer may appear thirsty, anxious and restless.

There’s often a frequent urge to urinate that produces very little urine, and the urine that is produced may be scanty, burning and albuminous. White cells, red cells, and epithelial cells may be

present in the urine. Other indicators are diarrhoea, chilliness, as well as weakness or exhaustion. Symptoms are worse after midnight and from cold or cold drinks and better for heat and warm drinks.

Equisetum The indicators here include a history of urinary and faecal incontinence with dull pain in the area of the bladder or rightsided lumbar pain, and a feeling of fullness or incomplete emptying of the bladder that is not relieved by urination. The urine is normally albuminous and is only produced drop by drop. There is often a frequent urge to urinate with strong burning urethral pain, particularly at the end of urination. The UTI may coincide with pregnancy or may occur postpartum. Symptoms are worse on the right side, from motion, from sitting or pressure and are better in the afternoon and from lying down.

Benzoic acid The common guides to this remedy for someone with a UTI are the colour and smell of their urine. It’s usually reported as being dark brown and having a strong and offensive ammoniacal odour. There may be a history of depression, asthma, enuresis, cystitis, gout, cracking joints and renal insufficiency. Sufferers may also have an odour about them like urine. Symptoms are worse from cold and motion and better from heat and profuse urination.

Sepia This is often useful where there is evidence of weakness, depression, nocturnal enuresis or enuresis from coughing or sneezing, excessive perspiration, a yellowish skin and a history of recurrent cystitis. The urine may appear thick and offensive and there

may be haematuria. Fine gravel may be present in the urine. Urination may be slow and accompanied by a suprapubic bearing down sensation and may be preceded by a cutting sensation in the bladder. Symptoms are worse in the late afternoon and evening, from coitus, before a thunderstorm and after sweating.

Symptoms are better from exercise, warmth, drawing the limbs up, and after sleep.

Terebinthina This is a common prescription in nephritis and urethritis, particularly where there is haematuria. The urine may have a characteristic odour of violets, it may be scanty or suppressed and have a muddy sediment if allowed to settle. Tenesmus and strangury may be reported here with location of the pain alternating between the bladder and umbilicus. Symptoms are worse from pressure and better from walking and generally better for motion.

Sarsaparilla This is well worth considering where the sufferer experiences renal colic and produces bloody urine in a thin weak stream. A descending burning pain in the region of the right kidney may be reported. Severe pain may be felt, particularly in the meatus, before and while urinating, but is more commonly noted when passing the last few drops.

There may be a slight dribbling enuresis while sitting. Urinary tenesmus may be present and a chill may spread from the bladder when urinating. Symptoms are worse from cold, motion, pressure and while sitting and are better from warmth and standing.

Mercurius corrosivus The guides to the prescription of Merc cor include a constant urge to urinate, and an intense burning sensation on urination followed by perspiration. Haematuria, urinary tenesmus, diarrhoea and general irritation of most mucous membranes may also guide this prescription. There may be a stabbing pain ascending up the urethra into the bladder. The urine is characteristically albuminous, cloudy and bloody, scanty, hot and burning and is

passed drop by drop. A greenish urethral discharge may also be noted. Symptoms are worse at night and better from rest.

Staphysagria UTI sufferers suited to this remedy may appear to be sensitive, nervous and irritable and have a history of recurring cystitis or prostatitis, and often it’s triggered by internalised anger, emotional upset or while convalescing. There may be urinary urgency, frequent but ineffectual urge to urinate, a feeling of pressure in the bladder as well as a feeling as if a drop of urine is rolling continuously along the urethra. The pain in this instance may be burning in character and occur during or long after urination has ceased. The UTI will commonly develop after sexual intercourse, giving rise to what’s often referred to as honeymoon cystitis. Foreign bodies such as catheters, cystoscopes and surgical procedures may also be implicated as the cause of the infection.

Symptoms are worse from anger, touching affected parts or sexual excess and better from warmth, rest at night and lying curled up on the side.

Aconite In this instance, the symptoms often come on very suddenly, often from exposure to dry cold weather or very hot weather, and may be accompanied by fever. Fear and anxiety, as well as physical and mental restlessness may be observed. The urine may be scanty and blood stained and the sufferer may complain of sensitivity in the kidney areas, urinary tenesmus and severe burning pain on urination.

Urinary retention may cause severe pain and increased restlessness. Symptoms are worse on the right side, from pressure, lying on the affected side and in the evening and night, and better from rest.

Chimaphila This can be particularly useful in cases where the UTI is associated with prostatitis. There may be urinary urgency inhibited by a restriction to urine flow, requiring straining to pass the urine, as well as burning on urination. The urine in this instance is often scanty and cloudy and contains a stringy mucoid sediment.

The sufferer may complain of swelling of the prostate, as if he’s sitting on a ball.

Symptoms are worse on the left side, from sitting on a cold surface and during cold, damp weather, and are better from walking.

Pulsatilla Pulsatilla has a role in chronic recurrent UTIs, particularly when these are associated with hormonal changes related to pregnancy, menopause or menstruation.

Weepiness, a clingy disposition, a lack of thirst and appetite for food as well as a dislike of warm, stuffy rooms may be noted, These features, along with a paroxysmal burning dysuria, urgency worse on lying down and urinary incontinence, particularly from coughing or sneezing, often guide the prescriber to the remedy. Symptoms are worse before menses, from lying on the back, from walking, cold, wet weather and getting the feet wet. Symptoms are better in open air and from consolation.

REFERENCES 1. Das RBB. Select Your Remedy. 14th ed. New Delhi B Jain; 1992.

2. Clarke JH. A Clinical Repertory to the Dictionary of the Materia Medica. England: Health Sciences Press; 1979. ISBN 0-85032-061-5.

3. Dewey WA. Practical Homoeopathic Therapeutics. 2nd ed. New Delhi: B Jain; 1991.

Book code B-2189.

4. Bouko Levy MM. Homeopathic and Drainage Repertory. France: Editions Similia; 1992. ISBN-2904928-70-7.

5. Raue CG. Special Pathology and Diagnostics with Therapeutic Hints. 4th ed. New Delhi: B Jain; 1896.

6. Knerr KB. Repertory of Hering’s Guiding Symptoms of our Materia Medica. New Delhi: B Jain; 1997. ISBN 81-7021-241-3.

7. Lilienthal S. Homoeopathic Therapeutics. 3rd ed. New Delhi: Indian Books and Periodicals; 1890.

8. Morrison R, Desktop Guide. California: Hahnemann Clinic Publishing; 1983. ISBN 0-9635-368-0-X. 9. Von Lippe A. Key Notes and Red Line Symptoms of the Materia Medica. New Delhi: India Books and Periodicals; 2001. Book Code No IB0579.

JATMS | Autumn 2016 | 31

ARTICLE

Commemoration of Simon Schot Legacy Peter Lewis | ATMS 0178

About 36 years ago I experienced an industrial accident that significantly damaged my respiratory tract, for which I had only limited assistance from orthodox medicine. During a time when organics were in their infancy, I took it upon myself to rebuild my health using organic products. A supposedly organic grower had sprayed their crop one morning with a copper-based poison.

Unfortunately I walked among that crop barefooted, which caused my constitution to deteriorate rapidly.

I had entered into shock by the time I reached Simon’s clinic in Mapleton, Queensland. He took it on himself to keep me under constant surveillance for 10 days in convalescence accommodation attached to his clinic. Naturopathic convalescence with Simon gradually facilitated health recovery. Not long after this, Simon invited me into phytotherapy and naturopathy studies, knowing full well how precarious my crisis had been at the time.

My very close brush with constitutional necrosis convinced him that I would evolve into a notable clinician; currently I am co-owner of Rockhampton Health Options with my wife, Lynette.

This brings me to a commemoration of my valued mentor Simon Schot, whose legacy is conveyed in the fabric of our previous ATMS logo. The creation of this emblem came to us through Simon, who I know was involved with ATMS from its inception.

Importantly, for Simon the emblem represented collaboration of the practitioner with Vis medicatrix naturae (The Healing Force of Nature).

Simon understood that for an emblem to be useful it requires literal meaning, and must be a vehicle of a directly discernible reality. The emblem is a convenient practical device acting to clearly represent complementary medicine essentials. Our scope of complementary medicine comprises three therapeutic divisions, physical medicine, natural medicine and the medicine of the psyche.

32 | vol22 no1 | JATMS

It is with this understanding that the original ATMS logo conveys its message. This elegant synergy underpins traditional naturopathic practice. Furthermore, represented within our original ATMS logo resides the primordial solvent, termed Vis medicatrix naturae.

The staff in the emblem emphasises Vis medicatrix naturae, the primordial mystery of life, which we can observe by way of bioplasm (living protoplasm). The emblem’s serpents emphasise diametrically opposed metabolic processes, namely anabolism and catabolism. When these processes are favourable, natures’ gift is optimal vitality.

I reflect upon Simon’s association of metabolic processes with our significant luminaries. The solar orb he associated with Vis, as it pertains to the staff in our emblem.

Vis in naturopathic practice governs the law of cure, inherent within the constitution.

Conservation of Vis occurs within bioplasm, necrotic cells are incapable of Vis conservation. The lunar orb phases are waxing, which he associated with anabolism, while waning he associated with catabolism. Waxing and waning phases in our emblem are connected with the serpents.

The creation of this emblem came to us through Simon, who I know was involved with ATMS from its inception.

Importantly, for Simon the emblem represented collaboration of the practitioner with Vis medicatrix naturae (The Healing Force of Nature).

This brings us to the three divisions in our scope of practice. According to Simon, physical medicine is emphasised through palmar dexterity. He communicated a subtle yet firm mode of physical medicine, strongly suggesting using the palmar surface of the hand only. Administration of scientific massage ought to be painless, otherwise, he postulated, iatrogenic lesions are likely to result. It is noted that the staff also emphasises our spinal cord.

Suggestions direct physical medicine toward a spinal focus and with a sound basis. Spinal innervation lesions potentially result in organ morbidity.

Natural medicine clearly emphasises biotic vegetation. Harvesting of biotic vegetation, to maximise Vis medicatrix naturae for efficacy, is always during budding or blossoming. Phytomedicine sourced from Australian and European botanicals are obvious. Gumnut blossoms are prominent

in Australian phytomedicine. Rosaceae blossoms and Liliaceae buds need no introduction. Simon valued Liliaceae phytomedicine in crisis cases, while Rosaceae phytomedicine is noteworthy during convalescence. He would often say, “The lily and the rose combine the wisdom and the love divine.�

As aforementioned the staff of our emblem he clearly associated with our

spine. Superiorly, the protuberance can be associated with the pons. Laterally, the wings of the emblem are associated with the cerebellum, in Latin termed Arbor vitae (Tree of Life) by medieval anatomists. Furthermore, cerebellum lobe fissures are distinct, and note the similarity with the wings in the emblem.

We know the cerebellum is associated with afferent and efferent pathways involving voluntary locomotion. Naturopathic practitioners instructed by Simon through psyche medicine will be familiar with administration of clinical equanimity.

The sash and the orbital border represent the indestructible life of the earth. It has no beginning and no end. Most subtly, green chlorophyll can be an analogy for blood, within which flows the vital force. The legacy of Simon Schot will forever be etched into this elegant emblem created in the mind of this complementary medicine teacher.

JATMS | Autumn 2016 | 33

PRACTITIONER PROFILE

oils that we use - and the connection with the client through touch can be a healing process for both the client and the therapist. The other aspect of natural medicine is that we treat the individual, which means that every treatment varies according to the needs of the client. Dealing with people of all ages also helps me to understand the processes of life.

What advice would you give to a new practitioner starting out?

ATMS Member Interview Robert Balbi

Which modality do you practise?

This is a difficult question. I became a practitioner to help people, and financially to cover costs, not to make a fortune. I would advise first of all to examine why you are considering a career in natural health and what you want out of your career. Once you know your focus and your goal then you can embark on the journey. There are many modalities to choose from and all provide opportunities for a great career. The good thing is you can continually change and add to your expertise through study and experience.

What are your ambitions?

I am a Remedial Massage therapist, but I incorporate other modalities which I have learned through our CEP over the past sixteen years.

To remain in the natural therapy area, but perhaps look at some type of research to promote natural therapies by giving them mainstream credibility. How to do this I am not sure at the present but I am sure I will find a way.

How long have you been in practice?

Anything else you would like to add?

After studying at Australasian College of Natural Therapies, gaining a Diploma and a Certificate Level 3 in Remedial Massage in 1998, I began my practice at my home in February 1998. In September 1998 I joined the Care for the Carers Programme at Calvary Hospital, Kogarah, on a voluntary basis, and I am still involved in this programme today. I also massage, on a pre-game basis, for the Sutherland Sharks first grade and under 20's soccer teams in the NSW Premier League. Due to family commitments I no longer have a home clinic, but provide a fully mobile service to my clients and sub-contract to Calvary Holistic Healing Centre, which is at Calvary Hospital, Kogarah, and caters for all members of the community.

Government health policies are influenced by powerful organisations such as the medical profession, the health funds and the pharmaceutical industry. It also comes down to cost. Our association is as powerful as we make it, so it is vital that we support our association and our fellow members in their chosen professions: massage therapists, Bowen therapists, traditional Chinese medicine practitioners, herbalists, nutritionists, educators, colleges etc, to ensure that natural medicine continues to benefit the whole community.

Major influences on your career

The growing acceptance of the many modalities of natural medicine is great. I believe that natural medicine tends to prevent illness by strengthening our immune system by nutrition and manual therapies, such as massage in all its forms. Herbalists use natural remedies to boost health and cure illnesses, and their work is based on many thousands of years of research and practice. We treat the individual and this is of absolute importance.

I commenced my career in massage at the age of 43, because I felt my current work in sales and marketing and my previous employment in accounts and personnel (Human Resources) were not satisfying or of benefit to the community. My brother-in-law had suffered a neck injury in a car accident and was in pain most of the time. We were at my in-laws’ home for Christmas, and I suggested to him that I massage his neck to see if it relieved the pain. At this stage I was untrained and, using some Tiger Balm, I massaged his neck gently for about 25 minutes. He felt better and rang me a few days later advising me that he had not had any pain for three days, but that it had now returned. I had had several massages, mainly due to stress, and had found them helpful. It was these incidents that pushed me to making massage my new career.

What do you most like about being a natural medicine practitioner?

I think the fact that natural medicine uses the body's own selfhealing properties to bring healing is wonderful. The use of natural products - in the case of a massage therapist, the oils and essential

34 | vol22 no1 | JATMS

Status and/or role of natural medicine in the broad context of Australian health care

Western medicine tries to cure illnesses with drugs (often derived from natural remedies) and surgery. The only concern I have is that western medicine focuses on the illness not the person. Both approaches complement each other, so let us work together to improve the health of our community.

The main concern to our community though is the cost of care. All practitioners must make a living, but I am sure many people think twice about seeing specialists in western medicine because they can't afford the cost. I am not advocating that we become charities but that we keep our rates to affordable levels to the community we serve.

Add Bowen Therapy to your Tool Box! Enrol now in Certificate IV and Diploma classes for 2016

Registered Training Organisation (TOid 41134)

With Bowen Training Australia Australia’s Premiere Training Group Bowen Training Australia offers a unique opportunity to learn Bowtech™, the original Bowen Technique. Increase your skill set to benefit both you and your client.

• • • •

Effective Efficient State of the Art New Skill Set

• • • •

Practitioner Friendly Gentle and Holistic Non Invasive Soft Tissue Therapy

www.bowentraining.com.au 01.pdf 1 29/02/2016 09:54:13

C

M

Y

CM

MY

CY

CMY

K

JATMS | Autumn 2016 | 35

LAW REPORT

Work Health and Safety:

Emergency Plans and Providing First Aid Ingrid Pagura | BA, LLB

In the next few issues I will review work, health and safety issues in workplaces. In this issue I am focussing on the requirements of a 'person conducting a business or undertaking' (PCBU) to prepare and maintain an emergency plan for the workplace and to provide first aid.

the workplace what they should do in an emergency. According to the Safe Work Australia Emergency Plans Fact Sheet, an emergency plan must include the following:

To refresh our memories, the Work Health and Safety Act 2011 (WHSA), defines a PCBU ‘as a person who conducts a business or undertaking whether alone or with others and whether or not for profit or gain’.

This means individuals, partnerships, companies and the self-employed are also defined as PCBUs.

• notifying emergency service organisations at the earliest opportunity;

Duty to provide and maintain an emergency plan A PCBU must ensure that an emergency plan is prepared for the workplace, including one for workers who may work at a number of workplaces.

An emergency plan is a written set of instructions telling workers and others at

36 | vol22 no1 | JATMS

• emergency procedures, including an effective response to an emergency; • evacuation procedures;

• medical treatment and assistance; • effective communication between the person authorised to coordinate the emergency response and all other people at the workplace; • testing of the emergency procedures, including the frequency of testing; and • information, training and instruction to relevant workers in relation to implementing the emergency procedures.

Emergency plans should be easy to understand and tailored to your workplace. You must always take into account the sort of work you are doing, the size and location of your workplace and the sorts of hazards you might find in and around your workplace. Make sure your plan covers procedures for fire, medical emergencies, bomb threats, armed confrontations and workers going offsite (e.g., to a client’s home).

So what should you include in your emergency plan?

• Emergency contact details for key personnel who have specific roles or responsibilities, for example fire wardens and first aid officers; • Contact details for local emergency services, for example police, fire brigade and poison information centre; • Procedures to alert people at the workplace to an emergency, for example, siren or bell alarm; • Evacuation procedures, including arrangements for assisting disabled workers and visitors;

Emergency plans should be easy to understand and tailored to your workplace. You must always take into account the sort of work you are doing, the size and location of your workplace and the sorts of hazards you might find in and around your workplace.

Reviewing emergency plans The PCBU must review their emergency plans so that they stay current and effective. They must be updated, particularly when there are changes to the workplace such as new workers or refurbishments. Another time to review it is after the plan has been tested, whether that is after a practice drill or after a real emergency.

• A map of the workplace clearly showing the location of fire extinguishers, emergency exits and assembly points; and • How to advise neighbouring businesses about emergencies.

Finally, make sure your workers know what to do in an emergency. Emergency plans, or a summary of their key elements, should be easily accessible by workers or on display in the workplace, for example on a notice board. They should include a map of the exits and the location of the assembly point. Every worker must be familiar with this.

Workers must also be trained in emergency procedures. Training can include practising evacuations, and identifying assembly points and location of emergency equipment.

Shared workplaces Where your workplace is in a building with other organisations, the PCBU must consult, cooperate and coordinate activities with all other PCBUs or people who have a work, health or safety duty in relation to the same matter, so far as is reasonably practicable. In those cases where there are several PCBUs, a master emergency plan could be prepared for all relevant duty holders’ use.

1. Out of immediate danger (e.g., out of the room); 2. Out of the compartment (e.g., through the fire doors or smoke doors) or to a lower level of the building; 3. Total evacuation of the building.

Check Check all rooms, especially change rooms, toilets, behind doors, storage areas etc.

For a useful tool to make sure you haven’t forgotten anything, see the Safe Work Australia Emergency Plans Fact Sheet found at www.safeworkaustralia. gov.au/sites/SWA/about/ Publications/Documents/657/ Emergency_plans_fact_sheet.pdf

Records

Evacuation

Report

A major part of all emergency plans is evacuation. This means calmly removing people from danger in a safe and orderly manner without panic.

Report to the chief warden and notify emergency services of any people unaccounted for.

Fire and Rescue NSW has prepared the following information about evacuations in emergency situations. All PCBUs must familiarise themselves with these steps, as they will apply in any emergency situation and PCBUs will be responsible for carrying them out.

Alert Alert the Chief Warden and other staff.

Ensure the emergency services have been notified (ring 000 and ask for Fire, Police or Ambulance).

Assembly Tell staff which assembly area is to be used.

Evacuate Evacuate staff and visitors in the following order:

Save as many records as possible if it is safe to do so.

Head count Do a head count of all staff, contractors and visitors.

For further information please see Fire and Rescue NSW website www.fire.nsw. gov.au.

Duty to provide first aid PCBUs must make first-aid arrangements for their workplace so workers can get immediate help if they are injured at work.

Under Regulation 42 of the Work Health and Safety Regulations they must: • provide first aid equipment and access to first aid facilities; • make sure all workers have access to the first aid equipment; and • appoint an adequate number of workers who are trained to give first aid, or make sure that workers have access to a suitable number of first aiders.

JATMS | Autumn 2016 | 37

LAW REPORT

First aid requirements will vary in different workplaces depending on a number of things, including: • type of work being carried out at the workplace; • type of hazards at the workplace; • size and location of the workplace; and

Item

Kit contents Quantity

Instructions for providing first aid – including Cardio-Pulmonary Resuscitation (CPR) flow chart

1

Note book and pen

1

Resuscitation face mask or face shield

1

Disposable nitrile examination gloves

5 pairs

Gauze pieces 7.5 x 7.5 cm, sterile (3 per pack)

5 packs

• number and makeup of workers and others at the workplace.

Saline (15 ml)

8

Wound cleaning wipe (single 1% Cetrimide BP)

10

The First Aid in the Workplace Code of Practice provides practical guidance for the provision of appropriate first aid in the workplace, including first aid training, first aid kits, procedures and facilities.

Adhesive dressing strips – plastic or fabric (packet of 50)

1

Splinter probes (single use, disposable)

10

Tweezers/forceps

1

Antiseptic liquid/spray (50 ml)

1

Non-adherent wound dressing/pad 5 x 5 cm (small)

6

Non-adherent wound dressing/pad 7.5 x 10 cm (medium)

3

Non-adherent wound dressing/pad 10 x 10 cm (large)

1

Conforming cotton bandage, 5 cm width

3

Conforming cotton bandage, 7.5 cm width

3

Crepe bandage 10 cm (for serious bleeding and pressure application)

1

Scissors

1

Non-stretch, hypoallergenic adhesive tape – 2.5 cm wide roll

1

Safety pins (packet of 6)

1

BPC wound dressings No. 14, medium

1

BPC wound dressings No. 15, large

1

Dressing – Combine Pad 9 x 20 cm

1

Plastic bags - clip seal

1

Triangular bandage (calico or cotton minimum width 90 cm)

2

Emergency rescue blanket (for shock or hypothermia)

1

Eye pad (single use)

4

Access to 20 minutes of clean running water or (if this is not available) hydro gel (3.5 gm sachets)

5

Instant ice pack (e.g. for treatment of soft tissue injuries and some stings).

1

First aid record keeping requirements are also covered by the legislation. A PCBU must keep a register of injuries recording any injury that has occurred for at least five years. These records must be readily accessible. If the first aid was in response to a serious illness or injury, the PCBU will also have to notify their regulator within 48 hours and their insurer also within that time if there is the possibility of a workers compensation claim.

First Aid Kits The Safe Work Australia First Aid in the Workplace Code of Practice App C outlines what should be in a first aid kit.

(See Figure 1.)

For more details on first aid facility requirements please see Part 3 - FIRST AID EQUIPMENT, FACILITIES and TRAINING of the First Aid in the Workplace Code of Practice at www. safeworkaustralia.gov.au/ sites/SWA/about/Publications/ Documents/693/first-aid-inworkplace.pdf.

Over the next few issues we’ll look at managing injuries in the workplace and managing risks. If you would like more information on any WHS issue generally, please see www.safeworkaustralia. gov.au.

38 | vol22 no1 | JATMS

Figure 1: Contents of a First Aid Kit

BOOK REVIEWS

Postural Correction: an Illustrated Guide to 30 Pathologies Reviewed by Stephen Clarke Jane Johnson. Human Kinetics, Lower Mitcham SA. 2016. ISBN 978-1-4925-0712-3 Price. AUD 47.27 Also available as ebook at HumanKinetics.com

This is one of a series of seven handson guide books by Jane Johnson developed to provide massage therapists and other bodyworkers with specific tools of assessment and treatment. In a previous issue of JATMS we reviewed Ms Johnson’s excellent book on postural assessment. Readers who found that book a useful assessment tool will be just as enthusiastic about the present work, as it deals in the same clear and systematic manner with correcting posture malalignment. As this point practitioners aligned to the view that “correcting” posture to a nominal norm has less practical value than restoring optimal function will be reassured to know that the author begins with a thoughtful note on the effectiveness of postural correction: although the approach and techniques set out in this book are based on the inherent rationale

of correction she is not presenting a doctrinaire advocacy for it. “Rather it provides ideas on how postural change might be achieved once the decision has been made that changing posture might be beneficial.”

This book presents five steps to postural correction: identifying factors that contribute to posture malalignment, muscle stretching, massage techniques for lengthening muscles, deactivating trigger points, strengthening muscles, and taping, bracing and casting. The book is divided into four parts. Part One, on getting started with postural correction, is introductory. Chapter One deals with causes and consequences of malalignment, suitable candidates for correction, and contraindications.

Chapter Two sets out five general steps to postural correction, accompanied

JATMS | Autumn 2016 | 39

BOOK REVIEWS

by a table of techniques that support it.

As in Postural Assessment, clear and concise tables are an important tool for summarising information. Parts Two, Three and Four deal with the specific features of malalignment and correction in the spine, pelvis and lower limb, and the shoulder and upper limb respectively. Each chapter opens with a set of learning outcomes. The structure of each chapter is to assemble under rubrics of the malalignments that occur in each of the area it deals with a description of the malalignment itself, with a photo illustration; an exposition of the effects on function of the associated muscles, accompanied by a table; the appropriate treatments; and the exercises that therapists can advise to their patients. Each treatment is also illustrated with clear photos.

There is also an appendix that has information of high importance for the great army of workers condemned to office work stations.

Professional therapists, teachers and students should all find much of great value in this well-researched and wellorganised book.

Stumbling Stones. A Path through Grief, Love and Loss Reviewed by Stephen Clarke Airdre Grant. ISBN 9781743790571. Hardie Grant Books. 2016 Price. AUD 24.99 Available at info@hardiegrant.com.au

40 | vol22 no1 | JATMS

Airdre Grant is an academic at Southern Cross University in northern New South Wales, where she completed a PhD in the relationship between spirituality and health. Within a year she lost her twin brother, her dog and her father, in that order. There is a particular bond between twins: “Dear God, I miss my twin”, says Grant. “ … For the first time in my life I was really alone.” She cites C.S.Lewis: “the death of a beloved is an amputation.” This marvellous book is an account of the inner and outward journeys Grant undertook in trying to find healing for this pain. As she says, “We view these events as painful and to be avoided yet they are inevitable and offer much to enrich the soul. They are not easy and occur in many forms. This is a much under-recognised emotion that can govern how a person operates in the world.”

There is great wisdom in this book, but it isn’t declamatory. It’s modestly presented, almost self-effacingly, but profound for all that. Answers to the hard questions put to all of us by grief emerge seemingly unbidden from the gripping anecdotes of destiny that Grant relates. That this happens is a measure both of the writer’s craft and of her deft insight into the significant milestones along the roads of loss. With a seamless blend of cool observation and empathy Grant weaves her own odyssey – an analogy she herself employs late in the book - in search of resolution into those of others similarly afflicted. This is achieved in prose of unmannered elegance that makes the book no less a joyful literary experience than it is an instructive one. Grant introduces us to a caravan of people traversing landscapes of loss and grief – death, illness, separation, betrayal - whose sorrows evoke our empathy, and whose resolutions, and failures to achieve resolution, deepen our knowledge of spiritual possibilities.

Grant’s odyssey takes her to sacred places, among them the kitchens and verandas of the bereaved and betrayed, the abode of a Tibetan oracular woman,

Iona, India and her native New Zealand, all to meet the challenge of surviving grief and in doing so to become stronger. From this journey comes a book about the soul beginning to “turn back toward the source of pain and the slow, introspective work of facing up to darkness, of working toward healing and eventual recovery.”

THERE IS GREAT WISDOM IN THIS BOOK, BUT IT ISN’T DECLAMATORY. IT’S MODESTLY PRESENTED, ALMOST SELFEFFACINGLY, BUT PROFOUND FOR ALL THAT.

Grant’s wide learning adds a scholarly dimension to the uplifting effect of her book. She cites a diverse range of writers whose work has contributed to our understanding of loss, including Emily Post, Plato, Elizabeth Barrett Browning and Joan Didion. Perhaps it is Joseph Campbell who comes closest to a summary of the fundamental wisdom of Stumbling Stones: “It is by going down into the abyss that we recover the treasures of life. Where you stumble, there lies your treasure.”

Stumbling Stones gives us a priceless guide through the thin space which in Celtic mythology describes the liminal region between Heaven and Earth and which Grant sees as an analogy for the space in which it may be possible to make the recovery from grief to acceptance. It will be of great value to any readers and particularly to counsellors and practitioners helping clients to emerge from the decay of hope and fulfilment where loss has imprisoned them.

CALL NOW 0405 386 256 CHRIS O’BRIEN

MYOFASCIAL RELEASE TRAINING

Myofascial Release, Deep Tissue Massage, Anatomy, Trail Guide to the Body, Neuromuscular Therapy, Anatomy Trains,Fascial Fitness,Orthopedic Massage Positional Release, Fibromyalgia, Craniosacral, BodyReading, Stretching, Sports Massage, Taping, Lymphatic Drainage, Muscle Energy Techniques, Chair Massage,Pregnancy Massage,Stone Massage, Reiki, Polarity Therapy, Lomi Lomi, Equine, Canine, Ayurvedic, Shirodara, Shiatsu, Acupressure, Thai Massage, TuiNa,QiGong, Tai Chi, Reflexology, Cupping, Yoga, and more

ALL PROGRAMS ATTRACT CONTINUED EDUCATION POINTS

Chris O’Briens programs are widely respected and sell out fast.

PROGRAMS FOR EVERY SKILL LEVEL Learn the most effective treatment for chronic musculoskeletal pain and dysfunction with Core Body Therapy. Developed from 1000s of hours of clinical experience and extensive training in Myofascial Release, Trigger Point Therapy and Craniosacral Therapy.

Myofascial Release treats the whole person, is easy on the body and gets amazing results.

BO ONL OK TOD INE AY

www.corebodytherapy.com.au

Visit www.terrarosa.com.au E: terrarosa@gmail.com

info@corebodytherapy.com.au

SYDNEY INSTITUTE OF   TRADITIONAL CHINESE MEDICINE CRICOS 01768k | NTIS 5143 

  Nowadays alternate medicine practitioners are all learning  Acupuncture and Chinese Herbal Medicine

Open Day: 23 July 2016 & 24 September 2016,10am to 2pm 



Enrol into Sydney Institute of     Traditional Chinese Medicine (SITCM)   

   F E E H E L P AVA I L A B L E   

Bachelor Degree of Traditional Chinese Medicine   (double modalities of acupuncture and Chinese  herbal medicine)     C O U R S E C O M M E N C E S : 16 F E B 2 015

  Aproved

by AUSTUDY  Recognized by major Health Funds  

•

32 years since establishment with graduates successfully  practicing nationally and abroad

• National TCM registration • Limited seat for international students   • 4 years visa for overseas students    Flexible Time and Practical Course

We are in the city: Level 5, 545 Kent St, Sydney NSW 2000 02 9261 2289

administration@sitcm.edu.au

www.sitcm.edu.au

JATMS | Autumn 2016 | 41

RECENT RESEARCH

Acupuncture and TCM Xiangyong Y, Zhongsheng Y, Wenchao L, Hui D, Shuzhou Q, Gang C, XiaoHui W, Lian Z. External application of traditional Chinese medicine in the treatment of bone cancer pain: a meta-analysis. Supportive Care in Cancer 2016, 24(1):11-17.

Conclusion: This systematic review showed positive but weak evidence of EA-TCM for bone cancer pain because of the poor methodological quality and the small quantity of the included trials. Future rigorously designed RCTs are required.

Conclusions: Taken together, A1E can inhibit CSCs and reduce the expression of stemness markers. Treating CSCs with A1E may be a potential therapy for cervical cancer.

Herbal Medicine Kwon T, Bak Y, Ham S-Y, Yu D-Y, Yoon D-Y. Leach MJ, Page AT.

Background: Bone cancer pain presents a clinical challenge with limitations of current treatments. Many patients seek additional therapies that may relieve pain.

Many external applications of traditional Chinese medicines (EAs-TCMs) have been evaluated in clinical trials, but fewer are known about them outside of China. The objective of this study is to assess the efficacy for bone cancer pain.

Methods: A systematic literature search was conducted in seven databases until December 2014 to identify randomized controlled trials (RCTs) about EAs-TCMs in the treatment of bone cancer pain.

The primary outcome was total pain relief rate. The secondary outcomes were adverse events at the end of treatment course. The methodological quality of RCTs was assessed independently using six-item criteria according to the Cochrane Collaboration. All data were analyzed using Review Manager 5.2.0. We included any RCTs evaluating an EA-TCM for the treatment of bone cancer pain. We conducted a meta-analysis.

Results: We included six RCTs with 534 patients. In general, the reporting of methodological issues was poor. Compared with morphine sulfate sustained release tablets (MSSRTs) or radiotherapy or bisphosphonates, we analyzed data from five trials reporting on complete response effect score (relative risk (RR) = 5.38, 95 % confidence interval (CI) = 2.80–10.31, P < 0.00001) and partial response (RR = 1.18, 95 % CI = 1.02–1.37, P = 0.02) and six trials reporting on total pain relief rate (RR = 1.49, 95 % CI = 1.43–1.67, P < 0.00001). Six RCTs showed significant effects of EA-TCM for improving pain relief in patients with bone cancer pain. In addition, no severe adverse events were found.

42 | vol22 no1 | JATMS

A1E reduces stemness and self-renewal in HPV 16-positive cervical cancer stem cells. BMC Complementary and Alternative Medicine 2016, 16:42 DOI: 10.1186/s12906-016-1013-4

Background: Cervical cancer is the second most common cancer in females.

Recent reports have revealed the critical role of cervical cancer stem cells (CSCs) in tumorigenicity and metastasis. Previously we demonstrated that A1E exerts an antiproliferative action, which inhibits the growth of cervical cancer cells.

Methods: A1E is composed of 11 oriental medicinal herbs. Cervical cancer cell culture, wund healing and invasion assay, flow cytometry, sheroid formation assay, and wstern blot assays were performed in HPV 16-positive SiHa cell and HPV 16-negative C33A cells.

Results: A1E targets the E6 and E7 oncogenes; thus, A1E significantly inhibited proliferation of human papilloma virus (HPV) 16-positive SiHa cells, it did not inhibit the proliferation of HPVnegative C33A cells. Accordingly, we investigated whether A1E can regulate epithelial-to-mesenchymal transition (EMT), CSC self-renewal, and stemnessrelated gene expression in cervical cancer cells. Down regulation of cell migration, cell invasion, and EMT was observed in A1E-treated SiHa cells. Specifically, A1E-treated SiHa cells showed significant decreases in OCT-3/4 and Sox2 expression levels and in sphere formation. Moreover, CSCs makers ALDH+ and ALDH, CD133 double positive cell were significantly decreased in A1E-treated SiHa cells.

However, A1E treatment did not down regulate ALDH+ expression and the number of ALDH/CD133 double positive cells in C33A cells.

Herbal medicine for insomnia: A systematic review and meta-analysis. Sleep Medicine Reviews 2015, 24:1–12 doi:10.1016/j. smrv.2014.12.003

Insomnia is a prevalent sleep disorder that can profoundly impact a person's health and wellbeing. Herbal medicine represents one of the most frequently used complementary and alternative treatments of insomnia. However, the safety and efficacy of herbal medicine for the treatment of this disorder is currently uncertain.

In order to ascertain the evidence base for herbal medicine for insomnia, we systematically searched seventeen electronic databases and the reference lists of included studies for relevant randomised controlled trials (RCTs).

Fourteen RCTs, involving a total of 1602 participants with insomnia, met the inclusion criteria. Four distinct orally administered herbal monopreparations were identified (i.e., valerian, chamomile, kava and wuling). There was no statistically significant difference between any herbal medicine and placebo, or any herbal medicine and active control, for any of the thirteen measures of clinical efficacy.

As for safety, a similar or smaller number of adverse events per person were reported with kava, chamomile and wuling when compared with placebo. By contrast, a greater number of events per person were reported with valerian. While there is insufficient evidence to support the use of herbal medicine for insomnia, there is a clear need for further research in this area.

Mirghafourvand M, Mohammad-AlizadehCharandabi S, Ahmadpour P, Javadzadeh Y. Effects of Vitex agnus and Flaxseed on cyclic mastalgia: A randomized controlled trial.

Complementary Therapies in Medicine 2016, 24: 90-95.

of the effects after stopping the treatment in order to decide whether these alternative treatments are suitable to treat mastalgia or not.

Homoeopathy

Objectives: Evidence on the effect of Vitex agnus and Flaxseed on cyclical mastalgia is not enough. This study aimed to assess the efficacy of Vitus agnus and Flaxseed on cyclical mastalgia.

Quirk T, Sherr J.

Design and setting: This randomized controlled trial was conducted on 159 women referred to health centers of Tabriz, Iran. Subjects were allocated into three groups (n=53 per group) using block randomization.

HIV/AIDS is a multifaceted condition affecting the whole person and family, which requires an individualized and holistic approach, as defined by Person Centered Health Care. In East Africa, Homoeopathy for Health in Africa offers patients an integrative, holistic method to supplement standard medical treatment and mitigate the side effects of anti-retroviral (ARV) drugs that often interfere with patient adherence to treatment and lead to drug resistance.

Patients who have homoeopathy treatment as a supplement to ARVs report amelioration of side effect symptoms, increased energy and enhanced well-being, allowing them to work and care for their families.

Results of an audit give demographic information. AIDS medical practitioners support homoeopathy, an approved form of medicine in Tanzania. Cases are presented that demonstrate the challenges and successes of treating HIV/AIDS patients in East Africa.

Interventions and Main outcome measures: Group I received 25g daily Flaxseed powder and placebo ofV. agnus; group II received daily 3.2-4.8mgV. agnus tablet and placebo of Flaxseed and control group received both placebo.

Nominal day breast pain was applied at baseline, first, and second month after the intervention. Data was analyzed using general linear model.

Results: There was no statistical significant difference between the three groups in terms of socio-demographic characteristics and baseline values. The breast pain improved significantly in both intervention groups during the first and second month after intervention.

Mean NDBP score was significantly lower than that in the control group at the first month after the intervention in the Flaxseed [adjusted mean difference: -3.1 (95% CI: -4.2 to -2.0)] and Vitus agnus groups [-3.3 (-4.3 to -2.2)] and the second month after the intervention in Flaxseed [-7.0 (-8.1 to -5.9)] andVitus agnus groups [-6.4 (-7.5 to -5.3)].

Conclusion: Flaxseed and Vitex agnus are effective in short-term period in decreasing cyclical mastalgia. However, further studies are needed to examine the long-term effectiveness and sustainability

Experiences with an integrative approach to treating HIV/AIDS in East Africa. Journal of Medicine and the Person 2015, 13(1): 55-64

Massage Wilson M, Gettel V, Esquenazi S, Walsh J. Implementing nurse-delivered massage to promote comfort among hospitalized inpatients. The Journal of Pain 2015, 16(4): S111 doi:10.1016/j.jpain.2015.01.463

Non-pharmacologic comfort measures are known to provide benefit, however, they remain inaccessible for many hospitalized patients due to cost,

feasibility, and reliance on a biomedical model. We therefore implemented a massage program to engage direct care nurses (n = 29) in promoting a biopsychosocial model of pain care. We describe here the secondary analysis of pilot study data on the types and frequencies of brief bedside massages nurses provided in critical and noncritical inpatient units after attending a 2-hour training course.

We examined relationships between nurse characteristics and number of massages completed during the 8-week study period. Nurses reported on 347 massage encounters that lasted on average 9.7 minutes (SD 7.6). Massages were offered most commonly for stress/relaxation (n = 126) and pain (n = 100). Body parts massaged most frequently were: arms (n = 70), back (n = 55), hands (n = 35), legs (n = 35) and feet (n = 13). Total number of massages was positively associated with nurses' compassion satisfaction measurements on post-test surveys (r = .32, p = .02), and negatively associated with nurse education level (n = -.39, p = .04). Length of massage in minutes was negatively associated with number of patients in care assignment (r = -.23, p < .001). No relationship was observed between massage frequency and nurses' age, unit type, or years of nursing experience. Findings suggest that nurses working in critical and non-critical patient care settings may have the capability to implement massage after receiving education and encouragement. Increasing non-pharmacologic options is an important goal for patient comfort and satisfaction. Nurse-delivered massage should be further investigated for its ability to reduce dependency on medicines and limit associated side effects while promoting therapeutic nurse-patient relationships. Supported by grants from Texas Health Resources Foundation and Texas Health Nursing Education Fund.

JATMS | Autumn 2016 | 43

RECENT RESEARCH

Field T.

Therkleson T, Stronach S.

Knee osteoarthritis pain in the elderly can be reduced by massage therapy, yoga and tai chi: A review. Complementary Therapies in Clinical Practice 2016, 22:87-92 doi: 10.1016/j. ctcp.2016.01.001

Broken Heart Syndrome. A Typical Case. Journal of Holistic Nursing 2015, 33(4): 345-350 doi: 10.1177/0898010115569883

Background and methods: This is a review of recently published research, both empirical studies and meta-analyses, on the effects of complementary therapies including massage therapy, yoga and tai chi on pain associated with knee osteoarthritis in the elderly.

Results: The massage therapy protocols have been effective in not only reducing pain but also in increasing range of motion, specifically when moderate pressure massage was used and when both the quadriceps and hamstrings were massaged. The yoga studies typically measured pain by the WOMAC. Most of those studies showed a clinically significant reduction in pain, especially the research that focused on poses (e.g. the Iyengar studies) as opposed to those that had integrated protocols (poses, breathing and meditation exercises).

The tai chi studies also assessed pain by self-report on the WOMAC and showed significant reductions in pain. The tai chi studies were difficult to compare because of their highly variable protocols in terms of the frequency and duration of treatment.

Discussion: Larger, randomized control trials are needed on each of these therapies using more standardized protocols and more objective variables in addition to the self-reported WOMAC pain scale, for example, range-of-motion and observed range-of-motion pain. In addition, treatment comparison studies should be conducted so, for example, if the lower-cost yoga and tai chi were as effective as massage therapy, they might be used in combination with or as supplemental to massage therapy.

Nonetheless, these therapies are at least reducing pain in knee osteoarthritis and they do not seem to have side effects.

44 | vol22 no1 | JATMS

This case describes a combination external treatment for “Broken Heart Syndrome” that includes a lavender footbath, massage using moor extract, and oxalis ointment to the abdomen applied by an Anthroposophic nurse for a specific personality type. Lavender footbaths have been used since ancient times for relaxation and calming, while moor extract has been used medicinally in Europe since the middle ages for warmth and environmental protection. Rhythmical massage using moor extract and oxalis ointment poultice to the abdomen are part of the tradition of Anthroposophic nursing when managing stress induced by emotional and physical trauma. An elderly lady with specific characteristics diagnosed as Broken Heart Syndrome received one treatment a week for 4 weeks given by an Anthroposophic nurse at an integrative medical center. Between treatments, education was given to enable self-treatment in the home. The nursing treatments, each using lavender footbaths, moor extract massage, and oxalis ointment poultice to the abdomen, proved very effect, and no negative effects were reported. External applications need to be considered by nurses caring for specific personality types with Broken Heart Syndrome

address it. The aim of this article is to analyze the self-care strategies among adolescents and young people diagnosed with depression or with self-perceived depressive distress in Catalonia using a qualitative design.

Methods: We analyzed the self-care strategies of 105 young people (17–21 years of age) in Catalonia who had participated in a national survey on adolescents. The sample was divided into thirds, with 37 who had a previous diagnosis of depression, 33 who had self-perceived emotional distress, and 35 controls. The participants’ narratives on self-care strategies for emotional distress were elicited through in-depth semistructured interviews. The data were managed using ATLAS-Ti 6.5 software18.

We applied hermeneutic theory and the ethnographic method to analyze the interviews.

Results: The ten self-care strategies identified in the analysis were grouped into four areas covering the various pathways the young people followed according to whether they had a diagnosis of depression or their depressive distress was self-perceived. The young people feel responsible for their emotional distress and consider that they are capable of resolving it through their own resources.

Their strategies ranged from their individuality to sociability expressed through their relationships with others, membership of groups or other selfcare strategies (relaxation, meditation, naturopathy, etc.).

Naturopathy Martorell-Poveda M-A, Martinez-Hernáez A, Carceller-Maicas N, Correa-Urquiza M. Self-care strategies for emotional distress among young adults in Catalonia: a qualitative study. International Journal of Mental Health Systems 2015, 9: 9 doi: 10.1186/s13033-0150001-2

Background: Emotional distress is common in adolescence, and self-care strategies are frequently preferred to

Conclusions: The study results highlight the importance of sensitivity in considering young people’s self-care strategies as another option in the care of emotional distress.

Vemu B, Selvasubramanian S, Pandiyan V. Emu oil offers protection in Crohn’s disease model in rats. BMC Complementary and Alternative Medicine 2016, 16:55 DOI: 10.1186/ s12906-016-1035-y

Background: Emu oil is a product of animal origin used for the treatment of inflammation, burns etc. as a part of aboriginal medicine in Australia. Crohn’s disease is a common inflammatory manifestation in humans and other animal species relating to the ulceration and digestive disturbances in upper gastro-intestinal tract. Aloe vera is commonly used substance from plant sources for inflammation, wound healing and various other properties. Given the difference in the source of the substances all the while playing a similar therapeutic role in different parts of the world, the present investigation was undertaken to evaluate the protective effect of aloe vera and emu oil alone and in combination; in comparison to sulfasalazine (Allopathic drug) as an alternative for the treatment of Crohn’s disease.

Methods: Wistar albino rats were divided into six groups with two sub-groups of six animals each. After pre-treating the animals with sulfasalazine, aloe vera, emu oil and their combination for five consecutive days, the animals were sub-cutaneously administered indomethacin on 4th and 5th day and each sub-group was sacrificed on day 6 and 9. After sacrifice, serum and intestine of these animals was collected. Intestine length from duodenum till caecum was measured for estimating relative organ weight and disease activity index. Part of intestine was preserved in formalin for histopathology while the rest was used for analysis of oxidative parameters and myeloperoxidase. Serum collected was used for measuring alkaline phosphatase and cholesterol.

Results: Assessment of the parameters in treatment groups indicated that the combination of aloe vera and emu oil resulted in better protection by suppressing the oxidative (P < 0.05) and histomorphological changes indicating a enhanced effect of these two agents which was found to be better than sulfasalazine.

Conclusion: The combination of emu oil

and aloe vera exhibited enhanced effect resulting in significant protection from indomethacin induced ulceration. This might be due to the different mechanism of anti-inflammatory effects (Salicylic acid in aloe vera and n3, n6 fatty acids acting as pseudosubstrates to cyclooxygenase enzyme) of components of the animal and plant products tested.

Nutrition Zheng M, Wu JHY, Louie JCY, Flood VM, Gill T, Thomas B, Cleanthous X, Neal B, Rangan A. Typical food portion sizes consumed by Australian adults: results from the 2011–12 Australian National Nutrition and Physical Activity Survey. Scientific Reports 2016, 6,

Considerable evidence has associated increasing portion sizes with elevated obesity prevalence. This study examines typical portion sizes of commonly consumed core and discretionary foods in Australian adults, and compares these data with the Australian Dietary Guidelines standard serves. Typical portion sizes are defined as the median amount of foods consumed per eating occasion. Sex- and age-specific median portion sizes of adults aged 19 years and over (n = 9341) were analysed using one day 24 hour recall data from the 2011–12 National Nutrition and Physical Activity Survey. A total of 152 food categories were examined.

There were significant sex and age differences in typical portion sizes among a large proportion of food categories studied. Typical portion sizes of breads and cereals, meat and chicken cuts, and starchy vegetables were 30–160% larger than the standard serves, whereas, the portion sizes of dairy products, some fruits, and non-starchy vegetables were 30–90% smaller. Typical portion sizes for discretionary foods such as cakes, icecream, sausages, hamburgers, pizza, and alcoholic drinks exceeded the standard serves by 40–400%.

The findings of the present study are particularly relevant for establishing Australian-specific reference portions for dietary assessment tools, refinement of nutrition labelling and public health policies.

Scott-Boyer MP, Lacroix S, Scotti M, Morine MJ, Kaput J, Priami C. A network analysis of cofactor-protein interactions for analyzing associations between human nutrition and diseases.

Scientific Reports 2016, 6, Article number: 19633 doi:10.1038/srep19633

The involvement of vitamins and other micronutrients in intermediary metabolism was elucidated in the mid 1900’s at the level of individual biochemical reactions. Biochemical pathways remain the foundational knowledgebase for understanding how micronutrient adequacy modulates health in all life stages. Current daily recommended intakes were usually established on the basis of the association of a single nutrient to a single, most sensitive adverse effect and thus neglect interdependent and pleiotropic effects of micronutrients on biological systems.

Hence, the understanding of the impact of overt or sub-clinical nutrient deficiencies on biological processes remains incomplete. Developing a more complete view of the role of micronutrients and their metabolic products in protein-mediated reactions is of importance. We thus integrated and represented cofactor-protein interaction data from multiple and diverse sources into a multi-layer network representation that links cofactors, cofactor-interacting proteins, biological processes, and diseases. Network representation of this information is a key feature of the present analysis and enables the integration of data from individual biochemical reactions and protein-protein interactions into a systems view, which may guide strategies for targeted nutritional interventions aimed at improving health and preventing diseases. Continued on page 57

JATMS | Autumn 2016 | 45

46 | vol22 no1 | JATMS

Acupuncture 3 3

3 3 3 3 3 3 3

3

3 3 3 3 3 3 3

3 3 3

3

3 3 3 3

3 3 3 3 3

3 3 3 3 3 3

3 3 3

3 3 3 3 3 3 3 3 3 3 3 3

3

3

3

3

3



3



3 3 3 3 3

3 3 3

3



3

3 3 3 3 3 3

3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

3 3 3 3

3

3

3

3



3 3 3 3 3

3 3 3

3

3



3

3

3

3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

3 3

3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

3 3 3 3 3

3 3 3 3 3 3 3 3 3 3







3

3

3

3 3 3 3

3

3 3

3

3

l

u

3 3 3

l

l

u

u

l

l

u u

l

l

u

u

l

u

l

u

l

l

u u

l

u

3

l

u

l

l

l

u

u

3 3

3

3 3

l

l

l

l

l

l

l

l

l

l

l

l

l

l

l

l

l

l

l l

l

u

l

l

l

l

l

u

l

l

l

u

u

u

u

3

(Certificate IV)

Remedial Massage

* Need to Apply directly to Fund

3 Therapy covered by Fund

Please note that this table is only a guide to show what funds cover ATMS accredited modalities. If the modality that you are accredited for is not listed, this means that no health fund covers the modality. The only exceptions are Chiropractic and Osteopathy. ATMS accreditation in a modality does not guarantee provider status as all funds have their individual set of strict eligibility requirements. Please see our website www.atms.com.au or contact our office for current requirements.

Rebates do not usually cover medicines, only face to face consultations. For further rebate terms and conditions, patients should contact their health fund. Policies may change without prior notice. u ARHG are only recognising Remedial Therapists who are accredited for this modality and were approved for ARHG Provider status under their old criteria. l ARHG are recognising Chinese Massage, however the eligibility requirements and provider number is exactly the same as Remedial Massage. See ARHG Health Fund Information for further information.

3 3 3

3 3 3

3 3 3 3 3

(No longer ATMS Accredited)

3

3 3 3

3

3

3 3 3 3



3 3

3

Lymphatic Drainage

3 3 3

3 3 3 3 3 3 3

3 3

Counselling 

Deep Tissue Massage

3 3 3 3 3

3 3 3

3

Hypnotherapy

3

3

3

3

Iridology

3

3

3 3 3 3 3 3 3 3 3 3

(Certificate IV)

3 3

Remedial Massage

3 3

Remedial Therapies

3 3 3

Rolfing

3 3 3 3 3 3

Alexander Technique 3

(No longer ATMS Accredited)

Health Partners HBF HCF Medibank Private NIB

(No longer ATMS Accredited)

3

(No longer ATMS Accredited)

3 3

Aromatherapy 3

Sports Massage

Australian Unity BUPA CBHS Health Fund Doctors Health Fund GU Health (Grand United)*

Bowen Therapy 3

Traditional Chinese Remedial Massage

3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3

Chinese Herbal Medicine 3

(HLT Diploma or higher level qualification)

ACA Health Benefits Fund Cessnock District Health CUA Health (Credicare) Defence Health Partners GMHBA (Geelong Medical) Frank Health Fund Health Care Insurance Limited Health.com.au HIF (Health Insurance Fund of WA) Latrobe Health Services MDHF (Mildura District Hospital Fund) Navy Health Fund Onemedifund Peoplecare Health Insurance Phoenix Health Fund Police Health Fund Queensland Country Health Railway and Transport Reserve Bank Health Society St Lukes Teachers Health Teachers Union Health Transport Health Westfund

Herbal Medicine 3

Homoeopathy

3

Kinesiology

3

Naturopathy

3

Nutrition

3

Reflexology

3

(HLT Diploma or higher level qualification)

3

Shiatsu

Australian Health Management Australian Regional Health Group

Health Fund

HEALTH FUND UPDATE

Traditional Chinese Remedial Massage

HEALTH FUND NEWS

Health Funds ATMS is a ‘professional organisation’ within the meaning of section 10 of the Private Health Insurance Accreditation Rules 2011. This potentially allows ATMS accredited members to be recognised as approved providers by the various private health funds. Approved health fund provider status is, however, subject to each individual health fund’s requirements.

Consequently, membership of ATMS does not automatically guarantee provider status with all health funds. Please also note that several health funds do not recognise courses done substantially by distance education, or qualifications obtained overseas.

Additional requirements for recognition as a provider by health funds include: • Clinic Address (Full Street Address must be provided – Please note that some health funds may list your clinic address on their public websites) • Current Senior First Aid • Current Professional Indemnity Insurance (some health funds require specific minimum cover amounts.

Please refer to the individual health fund terms and conditions for further information) • Compliance with the ATMS Continuing Education Policy along with any additional continuing education requirements stipulated by the health fund • Current National Registration (where applicable) • Compliance with the Terms and Conditions of Provider Status with the individual health funds ATMS must have current evidence of your first aid and insurance on file at all times.

When you join or rejoin ATMS, or when you upgrade your qualifications, you will need to fill out the ATMS Health Fund Application and Declaration Form available on the ATMS website. Once this is received, along with any other required information for health fund eligibility assessment, details of eligible members

are sent to the applicable health funds on their next available listing. The ATMS office will also forward your change of details, including clinic address details to your approved health funds on their next available list. Please note that the health funds can take up to one month to process new providers and change of details as we are only one of many health professions that they deal with..

Lapsed membership, insurance or first aid will result in a member being removed from the health funds list.

As health funds change their provider eligibility requirements from time to time, upgrading qualifications may be necessary to be re-instated with some health funds.

TERMS AND CONDITIONS OF PROVIDER STATUS Many of the Terms and Conditions of Provider Status for the individual health funds are located on the ATMS website.

For the Terms and Conditions for the other health funds, it will be necessary to contact the health fund directly.

BEING A PROVIDER IMPLIES ACCEPTANCE OF THE TERMS AND CONDITIONS FOR THE HEALTH FUNDS. Please note that whilst there is no law or regulation requiring patient clinical notes to be taken in English, many of the major health funds do require patient clinical notes to be taken in English.

Failure to do this will be a breach of the Health Funds Terms and Conditions and may result in the practitioner being removed as a provider for that health fund.

For health funds to rebate on the services of Accredited members, it is important that a proper invoice be issued to patients. The information which must be included on an invoice is also listed on the ATMS website. It is ATMS policy that only Accredited members issue their own invoice. An Accredited member must never allow another practitioner, student or staff

member to use their provider details, as this constitutes health fund fraud.

Misrepresenting the service(s) provided on the invoice also constitutes health fund fraud. Health fund fraud is a criminal offence which may involve a police investigation and expulsion from the ATMS Register of Members.

It is of note that the health funds require practitioners to be in private practice.

Some health funds will not recognise claims where accommodation, facilities or services are provided or subsidised by another party such as a public hospital or publicly funded facility. Rebates are only claimable for the face to face consultation (not the medicines or remedies); however this does not extend to mobile work including markets, corporate or hotels. Home visits are eligible for rebates..

ONLINE OR PHONE CONSULTATIONS ARE NOT RECOGNISED FOR HEALTH FUND REBATES. Please be aware that whilst a health fund may indicate that they provide a rebate for specific modalities, this rebate may only be claimable if the client has the appropriate level of health cover with that fund and has not exceeded any limits on how much they are eligible to claim back over a certain period of time.

BEING A PROVIDER IMPLIES ACCEPTANCE OF THE TERMS AND CONDITIONS FOR THE HEALTH FUNDS.

Australian Health Management (AHM) Names of eligible ATMS members will be sent to AHM each month. AHM’s eligibility requirements are listed on the ATMS website www.atms.com.au.

ATMS members can check their eligibility by checking the ATMS website or by contacting the ATMS Office on 1800 456 855. Your ATMS Number will be your provider number, unless you wish to have online claiming. You will then need to contact AHM directly for the new provider number.

JATMS | Autumn 2016 | 47

HEALTH FUND NEWS

Australian Regional Health Group (ARHG) This group consists of the following health funds: • ACA Health Benefits Fund Ltd • Cessnock District Health Benefits Fund • CUA Health Limited^ • Defence Health • GMHBA (Including Frank Health Fund) • Health.com.au • Health Care Insurance Limited# • HIF WA • Latrobe Health Services (Federation Health) • Mildura District Hospital Fund • Navy Health Fund • Onemedifund • Peoplecare Health Insurance • Phoenix Health Fund • Police Health Fund • Queensland Country Health Fund Ltd# • Railway and Transport Fund Ltd# • St Luke’s Health# • Teachers Health# • Teachers Union Health# • Transport Health# • Westfund Details of eligible members, including member updates are sent to ARHG by ATMS monthly. The details sent to ARHG are your name, address, telephone and accredited discipline(s). These details will appear on the ARHG websites. If you do not wish your details to be sent to ARHG, please advise the ATMS office on 1800 456 855.

The ARHG provider number is based on your ATMS number with additional lettering. To work out your ARHG provider number please follow these steps: 1 Add the letters AT to the front of your ATMS member number 2 If your ATMS number has five digits go to step 3. If it has two, three or four digits, you need to add enough zeros to the front to make it a five digit number (e.g. 123 becomes 00123).

48 | vol22 no1 | JATMS

3 Add the letter that corresponds to your accredited modality at the end of the provider number; A ACUPUNCTURE C CHINESE HERBAL MEDICINE H HOMOEOPATHY N NATUROPATHY O AROMATHERAPY W WESTERN HERBAL MEDICINE If ATMS member 123 is accredited in Western herbal medicine, the ARHG provider number will be AT00123W. 4 If you are accredited in several modalities, you will need a different provider number for each modality (e.g. if ATMS member 123 is accredited for Western Herbal Medicine and Aromatherapy, the ARHG provider numbers are AT00123W and AT00123O.

ARHG - REMEDIAL MASSAGE AND CHINESE MASSAGE Remedial Massage and Chinese Massage therapists who graduated after March 2002 must hold a Certificate IV or higher from a registered training organisation.

Members who are accredited for Remedial Massage or Chinese Massage, will need to use the following letters.

M MASSAGE THERAPY R REMEDIAL THERAPY The letter at the end of your provider number will depend on your qualification, not the modality in which you hold accreditation*. All members who meet the ARHG eligibility requirements, who hold a Diploma of Remedial HLT50302 or HLT50307 or a Diploma of Chinese Remedial Massage HLT50102, HLT50107 or HLT50112 will be able to use both the ‘M’ and ‘R’ letters. It is recommended to use the ‘R’ as often as possible, but as not all health funds under ARHG cover ‘Remedial Therapy’, it will be necessary to use the ‘M’ at the end of the provider number for those funds only. All other eligible Remedial Massage Therapists who do not hold the Diploma of Remedial HLT50302

or HLT50307 or a Diploma of Chinese Remedial Massage HLT50102, HLT50107 or HLT50112 are required to use the ‘M’ at the end of their provider number. *Members accredited for Remedial Therapies and approved for ARHG for this modality under their previous criteria will continue to be recognised under Remedial Therapy and will be fine to use the ‘R’ in their provider number. Should members in this situation lapse membership, first aid or insurance etc they will then be required to meet the current ARHG criteria.

CUA HEALTH– BOWEN THERAPY, KINESIOLOGY AND REFLEXOLOGY For the additional modalities that CUA Health covers that are not listed above including Bowen Therapy, Kinesiology and Reflexology, eligible providers will need to use the following to work out your provider number: 1 Add the letters AT which will be the start of your provider number 2 Add the letter that corresponds to your accredited modality at the end of the provider number; B BOWEN THERAPY K KINESIOLOGY R REFLEXOLOGY 3 Then add your ATMS Number. If your ATMS number has five digits your provider number will now be complete. If it has two, three or four digits, you need to add enough zeros to the front to make it a five digit number (e.g. 123 becomes 00123).

If ATMS member 123 is accredited in Kinesiology, the CUA provider number will be ATK00123.

4 If you are accredited in several modalities, you will need a different provider number for each modality (e.g. if ATMS member 123 is accredited for Kinesiology and Reflexology, the CUA provider numbers are ATK00123 and ATR00123.

HEALTH FUND NEWS

RESERVE BANK HEALTH SOCIETY –REFLEXOLOGY For the additional modalities that Reserve Bank Health Society covers that are not listed above including Reflexology, eligible providers will need to use the following to work out your provider number: 1 Add the letters AT which will be the start of your provider number 2 Add the letter that corresponds to your accredited modality at the end of the provider number; R REFLEXOLOGY 3 Then add your ATMS Number. If your ATMS number has five digits your provider number will now be complete. If it has two, three or four digits, you need to add enough zeros to the front to make it a five digit number (e.g. 123 becomes 00123).

If ATMS member 123 is accredited in Reflexology, the Reserve Bank Health Society provider number will be ATR00123.

TEACHERS HEALTH – BOWEN THERAPY, KINESIOLOGY, REFLEXOLOGY AND SHIATSU For the additional modalities that Teachers Health covers that are not listed above including Bowen Therapy, Kinesiology, Reflexology and Shiatsu, eligible providers will need to use the following to work out your provider number: 1 Add the letters AT which will be the start of your provider number 2 Add the letter that corresponds to your accredited modality at the end of the provider number; B BOWEN THERAPY K KINESIOLOGY R REFLEXOLOGY S SHIATSU

3 Then add your ATMS Number. If your ATMS number has five digits your provider number will now be complete. If it has two, three or four digits, you need to add enough zeros to the front to make it a five digit number (e.g. 123 becomes 00123).

If ATMS member 123 is accredited in Kinesiology, the Teachers Health provider number will be ATK00123.

4 If you are accredited in several modalities, you will need a different provider number for each modality (e.g. if ATMS member 123 is accredited for Kinesiology and Reflexology, the Teachers Health provider numbers are ATK00123 and ATR00123.

ADDITIONAL NOTE For all modalities that these funds (Health Care Insurance Limited, Queensland Country Health Fund Ltd, Railway and Transport Fund Ltd, St Luke’s Health, Teachers Union Health, Transport Health) cover that are not listed above including Bowen Therapy, Kinesiology, Nutrition and Reflexology, eligible providers will need to use their ATMS number. Please refer to the Health Fund Table.

Australian Unity Names and details of eligible ATMS members will be sent to Australian Unity each month. ATMS members will need to contact Australian Unity on 1800 035 360 to register as a provider, after filling out the Australian Unity Application Form located on the ATMS website to activate their provider status.

This only needs to happen the first time.

The provider eligibility requirements for Australian Unity are located on the ATMS website www.atms.com.au.

Your ATMS number can be used as your Provider Number, or you can contact Australian Unity for your Australian Unity generated Provider Number. Please note that Australian Unity requires Professional Indemnity Insurance (to at least $2 million) and Public Liability Insurance (to at least $10 million).

BUPA Names and details of eligible ATMS members will be sent to BUPA on a weekly basis. The provider eligibility requirements for BUPA are located on the ATMS website www.atms.com.au.

The Provider eligibility requirements include an IELTS test result of an overall Band 6 or higher for TCM qualifications completed in a language other than English. BUPA will generate a Provider Number after receiving the list of eligible practitioners. BUPA advises ATMS of your Provider Number and ATMS will then advise those members directly.

CBHS Health Fund Limited Names and details of eligible ATMS members will be sent to CBHS each month. The details sent to CBHS are your name, address, telephone and accredited discipline(s). These details will appear on the CBHS website. If you do not want your details to be sent to CBHS, please advise the ATMS office on 1800 456 855.

The provider eligibility requirements for CBHS are located on the ATMS website www.atms.com.au. Your ATMS number will be your Provider Number.

Doctors Health Fund Names and details of eligible ATMS members will be sent to Doctors Health Fund each month. Please note that Doctors Health Fund only covers Remedial Massage. The provider eligibility requirements for Doctors Health Fund are located on the ATMS website www.atms.com.au. Your ATMS number will be your Provider Number.

Grand United Corporate To register with Grand United Corporate, please apply directly to Grand United on 1800 249 966.

HBF Names and details of eligible ATMS members will be sent to HBF each month. The provider eligibility requirements for HBF are located on the ATMS website www.atms.com. au. HBF is a Western Australian based

JATMS | Autumn 2016 | 49

HEALTH FUND NEWS

health fund. HBF will only generate a provider number after they receive the first claim from your first HBF client.

At this time you will be required to download and complete their Provider Registration form located under their â&#x20AC;&#x2DC;Just for Providersâ&#x20AC;&#x2122; section of the HBF website www.hbf.com.au.

HCF Names and details of eligible ATMS members will be sent to HCF on a weekly basis. The provider eligibility requirements for HCF are located on the ATMS website www.atms. com.au. HCF do not issue provider numbers nor use your ATMS number as your provider number. They do however require your ATMS membership details, including your ATMS number, to be clearly indicated on all invoices and receipts issued.

Health Partners Names and details of eligible ATMS members will be sent to Health Partners each month. The provider eligibility requirements for Health Partners are located on the ATMS website www.atms.com.au. Health Partners uses the same Provider number system as ARHG for certain modalities and the ATMS number or other modalities.

The provider number is based on your ATMS number with additional lettering. To work out your Health Partners provider number please follow these steps: 1 Add the letters AT to the front of your ATMS member number 2 If your ATMS number has five digits go to step 3. If it has two, three or four digits, you need to add enough zeros to the front to make it a five digit number (e.g. 123 becomes 00123).

3 Add the letter that corresponds to your accredited modality at the end of the provider number;

50 | vol22 no1 | JATMS

A ACUPUNCTURE C CHINESE HERBAL MEDICINE H HOMOEOPATHY M REMEDIAL MASSAGE N NATUROPATHY W WESTERN HERBAL MEDICINE If ATMS member 123 is accredited in Western Herbal Medicine, the provider number will be AT00123W. 4 If you are accredited in several modalities, you will need a different provider number for each modality (e.g. if ATMS member 123 is accredited for Western Herbal Medicine and Aromatherapy, the provider numbers are AT00123W and AT00123O. For all other modalities that Health Partners cover that are not listed above including Alexander Technique, Bowen Therapy, Kinesiology and Reflexology, eligible providers will need to use their ATMS number.

Medibank Private Names and details of eligible ATMS members will be sent to Medibank Private on a monthly basis. The provider eligibility requirements for Medibank Private are located on the ATMS website www.atms.com.au.

Medibank Private requires Clinical Records to be taken in English.

Medibank Private generates Provider Numbers after receiving the list of eligible practitioners from ATMS. Medibank Private sends these provider numbers directly to ATMS. ATMS will then forward this information to the provider. Please note that Medibank has placed a restriction of up to a maximum 3 clinic addresses that will be recognised for Remedial Massage.

There are no restrictions on the number of recognised clinics for other modalities.

NIB Names and details of eligible ATMS members will be sent to NIB on a weekly basis. The provider eligibility requirements for NIB are located

on the ATMS website www.atms. com.au. NIB does accept overseas Acupuncture and Chinese Herbal Medicine qualifications which have been assessed as equivalent to the required Australian qualification by Vetassess. Your ATMS Number will be your provider number, unless your client wishes to claim online.

Your client will need to contact NIB directly or search by your surname and postcode on the NIB website www. nib.com.au for your provider number for online claiming purposes.

HICAPS ATMS members who wish to activate these facilities need to register directly with HICAPS. HICAPS do not cover all health funds and modalities. Please go to www.hicaps.com.au or call 1800 805 780 for further information.

ADVERTORIAL

BioTensegrity: Anatomy of the 21st Century

By John Sharkey | MSc Massage therapy is recognised as the manual manipulation of the soft tissues, namely muscles, connective tissue (fascia), tendons, ligaments and joints.

Clinical massage helps alleviate the discomfort associated with daily living strains and overuse issues leading to pain conditions.

Massage schools usually teach human anatomy and Newtonian based biomechanics. All this was in an effort to understand the mechanical structure-function relationship. This lever-based biomechanics and one muscle one-movement philosophy has long been at odds with what massage therapists intuitively feel and clinically observe. In such a model the foot has little relation to the wrist, the sub occipital structures work autonomously with no concern for the sacrum and pain experienced in the shoulder would require massaging the shoulder and local soft tissues only.

Massage therapists work directly with the cellular network. At the most basic level all structures are the result of interactions between atomic forces, and the orderly arrangements that they settle into are governed by some basic rules of physics.

Essentially, it is the fundamental and inter-related principles of geodesic geometry, close-packing and minimalenergy that lead to the formation of crystals and molecules, which thus become the physical representations of the invisible forces within them.

Molecules, cells, tissues, organs, and organisms are all constructed on these tensegrity principles of enclosed geometric structures within enclosed geometries.

Understanding this model will provide you with the vocabulary and underlying logic of â&#x20AC;&#x153;body architectureâ&#x20AC;? that forms the context of therapeutic benefits.

The biological tensegrity systems (Biotensegrity) is a structural design principle in biology that describes a relationship between every part of an organism and the mechanical system that integrates them into a complete functional unit.

John Sharkey, MSc is a Clinical Anatomist and Founder of the European Neuromuscular Therapy. He is working at the Department of Clinical Sciences, University of Chester/NTC, Dublin, Ireland. He will be in Australia from 2nd of June 2016, teaching Biotensegrity. More details at www. terrarosa.com.au

Individual cells, which are self stressed, are poised and ready to receive mechanical signals that are then converted into biochemical expression.

In massage therapy we make contact with that inner cellular network by touching the outermost reaches of the same cellular network, the skin.

Biotensegrity will add to your confidence and ability to achieve those therapeutic goals. A new era is dawning in our understanding of anatomy and living movement. That new anatomy and understanding of whole body structure is Biotensegrity.

Biotensegrity is an essential model for massage therapists and movement practitioners of every stripe.

Disclaimer: The views and opinions expressed in these advertorials are those of the authors and do not necessarily reflect the opinions of ATMS or its Directors.

JATMS | Autumn 2016 | 51

ADVERTORIAL

Relief for menopausal women: A clinically trialled synergistic combination of traditional herbal extracts

By Carey Hanna | BHSc (Comp Med), Adv Dip (Nat), Dip (Nut)

Due to the concerns with Menopausal Hormone Therapy (MHT) use, it is understandable that the transition into menopause is a time where many women may seek out complementary and alternative medicines (CAM) to help manage symptoms and improve their quality of life. The holistic approach of course incorporates diet and lifestyle modifications to reduce weight, guidance on weight bearing exercise to support healthy bones and lean muscle mass, and mind-body techniques, such as meditation to help manage stress, mood changes and insomnia.

MHT is known to increase the risk of breast cancer, and is one of the most important modifiable risk factors.1 As an alternative, herbal medicine is a powerful modality that can be used to ease many of the common symptoms associated with menopause.

The documented use of some herbal medicines date back hundreds of years, providing long-term safety and efficacy assurance.

Cynanchum wilfordii, Phlomis umbrosa, and Angelica gigas are three examples which have been used as herbal remedies for more than 400 hundred years in Korea. Research on the unique, standardised, proprietary blend of these three herbs; known as EstroG-100® and Estromon®, has

shown positive results for alleviating some of the most common menopausal symptoms, including hot flushes, night sweats, vaginal dryness, insomnia, fatigue, mood changes, problems with memory and concentration, urinary incontinence, joint and rheumatic pain and formication (crawling sensation on the skin).2-3

Centuries of wisdom, now clinically trialled A randomised, double-blind, placebocontrolled trial, evaluated the clinical efficacy of EstroG-100®, in 61 periand postmenopausal women aged 42-70; from White Hispanic, White non-Hispanic and African American backgrounds.2 Participants were divided into two groups to receive either EstroG-100® (n-29) or placebo (n-32), and were required to complete an updated version of the Kupperman Menopause Index (KMI); a questionnaire which rates the severity of menopausal symptoms. The primary endpoint assessed was the mean change in KMI score.

After 12 weeks, results revealed that 257mg of EstroG-100®, taken twice daily (total daily dose of 514mg), showed statistically significant improvements in the following 10 menopause-related symptoms; vasomotor (hot flush or cold sweat), paresthesia (numbness

and tingling), insomnia, nervousness, vertigo, fatigue, rheumatic pain, melancholia, formication (sensation of crawling on the skin) and vaginal dryness, compared to placebo.

EstroG-100® had no significant effect on body weight, BMI, serum oestradiol (E2) or follicle stimulating hormone (FSH) levels, liver enzymes, or blood lipids (LDL and HDL); all of which have been previously observed with MHT. Furthermore, no adverse events were observed or reported by participants who received EstroG-100® in this study.

Similar results were seen in a 12 month prospective, randomised, doubleblind, placebo-controlled clinical trial, which included peri menopausal Korean women (average age of 54); treatment group (n=19) and placebo group (n=23).3 This study looked at supplementation with Estromon® (257mg of Cynanchum wilfordii, Phlomis umbrosa, and Angelica gigas) plus vitamins, minerals and amino acids including; vitamin B1, B2, B3, B6 and B12, vitamin A, vitamin E, vitamin C, vitamin D3, biotin, iron, lysine and arginine. Taken twice daily, this treatment resulted in statistically significant improvements in various menopause-related symptoms when compared to placebo. After 3 months, the Estromon® group showed statistically

Disclaimer: The views and opinions expressed in these advertorials are those of the authors and do not necessarily reflect the opinions of ATMS or its Directors.

52 | vol22 no1 | JATMS

Youthfulness: Understanding human biomechanics and alkalisation

By AOIT significant improvement in various menopausal symptoms compared to the placebo group. These symptoms included; hot flushes, dyspareunia (difficult or painful intercourse), sleep disorder, mental awareness (memory and concentration) issues, joint pain, musculoskeletal disease, dyspepsia, urinary incontinence and fatigue.

Following the 12 month point, the Estromon® group showed a significant improvement in bone metabolism markers and increase in femoral bone density, a significant increase in human growth hormone (hGH) and a significant reduction in serum triglyceride levels from baseline to 12 months.3 For more information, please refer to the technical sheet titled “The Science behind a unique combination of herbal extracts for the alleviation of menopausal symptoms” and “The role of complementary medicine in menopause’ available on the BioMedica website.

Full reference list available upon request from BioMedica.

Despite our age we all want to live a quality life where we can move around with little discomfort to our joints, with no disease and retain the energy and vigour of youth. This can be delivered by firstly understanding our original design in regard to movement and resting positions. Secondly by understanding the vital role played by the Ph. of our body chemistry.

Let us consider the first one. In the developed world most of us sit in chairs for much of the day. Cars, toilets, lounges they are all chairs. At the office, schools, eating our meals, we all sit in chairs.

Our biomechanics were designed to sit cross legged and in other positions on the floor. When we sit in chairs we are holding our muscles in neutral positions nothing is ever being stretched. It is said “if you don’t use it you lose it.” You become stiffer and stiffer as the years roll by until you are all hunched over unable to straighten up. We were not designed specifically to perform repetitive movements day after day for years on end. Our work creates lesions in the muscles, shortens the tendons leading to mechanical problems galore.

The second one, body chemistry is directed at the tissues and blood that

move away from their ideal ph. range and become more acid. This state not only invite disease, but it ages the cells more quickly as oxygen becomes depleted. Otto Warburg a German researcher received two Nobel Prizes in Medicine in 1932 for his discovery of the cause of cancer leading to the subsequent "cure". He found that cancer thrived in an acidic environment.

Acidosis is primarily caused by the modern diet where most foods form acid residues in the tissues. Alkalisation on the other hand is our normal state where the diet is over 80% fruits and vegetables leading to healthy cells. These foods are also the only ones that give us our Vitamin C, a necessary nutrient to ensure that collagen; our supportive tissue is providing us with that “youthful look”.

If our joints are always in acidosis they initially become painful and later on inflexible.

Conclusion: Start today sitting on the floor eating from a low table, using cushions for support. Avoid repetitive work, and eat over 80% fruits and vegetables to ensure a youthful life ahead.

AOIT – Provider of CPE workshops www.aoit.com.au

Disclaimer: The views and opinions expressed in these advertorials are those of the authors and do not necessarily reflect the opinions of ATMS or its Directors.

JATMS | Autumn 2016 | 53

ADVERTORIAL

Aluminium Toxicity?

By Jon Gamble | BA ND ADHom ATMS #1190 Have you ever suspected that aluminium toxicity could be the main cause of your patient’s illness?

Aluminium is the third most abundant mineral in the earth’s crust. It is added to water supplies, deodorants, cosmetics, antacids and vaccines.

We are surrounded by its light, shiny products, yet aluminium toxicity may not be suspected as the reason for your patient’s chronic illness.

When you suspect toxicities in autistic children or older patients (who may be destined for dementia) aluminium toxicity must be considered. (See The Age of Aluminium documentary https://www.youtube.com/ watch?v=A2aNSt5jkaM on the health impacts of aluminium.)

A patient presents to your clinic with these symptoms: • Confusion, poor memory • Muscle weakness • Dry skin and mucous membranes • Speech problems • Anaemia • Allergies • Hypersensitivity to electro magnetic radiation (EMR) This could be an autistic child, an adult with chronic fatigue, autoimmune disease, or fibromyalgia. You consider the possible causes, like nutritional deficiency, poor gut function, heavy metal toxicity or a combination of these. You decide to do some chelation therapy, treat the gut, or put your patient on intense nutritional therapy. Your regime will sometimes help your patient and sometimes it will not. Where to from here?

Most chronically ill patients have a multiple heavy metal load, so you might ask what the value of identifying a specific heavy metal is? All heavy metals are neurotoxic, damage immunity, iron metabolism, and cause a wide array of debilitating symptoms. Identifying which element is responsible for your patient’s symptoms, can help to target the problem. Aluminium’s unique symptoms are dryness, weakness, hypersensitivity and mental confusion.

The Oligoscan report below is of a woman in her forties. She presented with poor memory, fatigue and repeated infections.

When you can discover in only a few minutes which metals are the most likely cause of the presenting symptoms, it allows you to refine your treatment.

In the above case, aluminium was the likely cause of this woman’s mental and physical symptoms. Rewarding for patient and practitioner - especially when the movement of the elements can be easily monitored in subsequent scans, at three or six monthly intervals.

See www.oligoscan.net.au for more information. Contact: jon@ karunahealthcare.com.au

She was supplemented with large doses of silica and zinc, which antagonise the absorption of and remove aluminium, plus one dose of BioResearch Al Met (Aluminium Metallicum chelate): five drops every second day. At follow up six weeks later, this woman’s symptoms were all improving, so the same treatment was continued.

Disclaimer: The views and opinions expressed in these advertorials are those of the authors and do not necessarily reflect the opinions of ATMS or its Directors.

54 | vol22 no1 | JATMS

RECENT RESEARCH

ADVERTORIAL

A story of TCM Research

By Yifan Yang

Chinese medicine made a huge contribution to medicine in 2015 when Professor Tu Youyou, an eightyfive year old TCM researcher of The Academy of Traditional Chinese Medicine in Beijing, China, shared the Nobel Prize in Medicine in 2015.

During the Vietnam War in the 1960s the Chinese government decided to set up a research program to find a new drug for treating malaria, which was highly prevalent in Vietnam.

Many scientists conducted studies but their trials failed again and again.

One day, Ms. Tu Youyou found a record of malaria treatment with a Chinese herb QING HAO Artemisia in an ancient medical book dating back to 1600 years in the Jin dynasty.

Rather than use the traditional boiling extraction methods, the Jin dynasty TCM doctor used the raw herbal juice instead. With this low temperature extraction method the malarial parasite had a 100% killing rate.

Soon after Ms. Tu Youyou’s discovery, many TCM universities undertook clinical trials, and the chemical structure of Artemisia was discovered. Through several decades of application and pharmaceutical refinement, QING HAO SU (Artemisia extract drug) has been proven to be the most effective medicine

for malaria, surpassing Quinine, the traditional chemical drug for this disease. Soon it became the first choice of US marines for their overseas troops to combat malaria, and QING HAO SU was approved by FDA, United States, as a formal drug in 2009.

After wiping out malaria in China, the herbal drug was introduced to African countries which were still affected by malaria. Since then millions of lives have been saved. It is for this reason Professor Tu Youyou was awarded a Nobel Prize.

It is estimated that there are more than 100,000 TCM books that were published before 1900 which may hold great medical value waiting to be discovered. Studying Traditional Chinese Medicine is the first step of this discovery. The philosophy of TCM will benefit learners.

Enrolment into the Sydney Institute of Traditional Chinese Medicine for 2017 has now opened. Open day is 23rd July and 24th September 2016, 10:00am – 2:00pm. The course commences on 13th February 2017.

Ph: (02) 9261 2289, website: www. sitcm.edu.au

Nutrition (cont.)

Zhao L-G, Sun J-W, Yang Y, Ma X, Wang YY, Xiang Y-B. Fish consumption and all-cause mortality: a meta-analysis of cohort studies. European Journal of Clinical Nutrition 2016, 70(2): 155 doi: http:// dx.doi.org.ezproxy.scu.edu.au/10.1038/ejcn.2015.72

Background: Although fish consumption may have an influence on specific mortality of major chronic diseases, the relationship between fish consumption and all-cause mortality remains inconsistent.

Methods: We performed a systematic search of publications using PubMed and Web of science up to 31 December 2014.

Summary relative risk (RR) for the highest versus lowest category of fish consumption on risk of all-cause mortality was calculated by using a random effects model. Potential nonlinear relation was tested by modeling fish intake using restricted cubic splines with three knots at fixed percentiles of the distribution.

Results: Twelve prospective cohort studies with 672 389 participants and 57 641 deaths were included in this meta-analysis.

Compared with the lowest category, the highest category of fish intake was associated with about a 6% significantly lower risk of all-cause mortality (RR=0.94, 95% confidence interval (CI): 0.90, 0.98; I(2)=39.1%, P=0.06). The dose-response analysis indicated a nonlinear relationship between fish consumption and all-cause mortality. Compared with never consumers, consumption of 60 g of fish per day was associated with a 12% reduction (RR=0.88, 95% CI: 0.83, 0.93) in risk of total death.

Conclusions: These results imply that fish consumption was associated with a reduced risk of all-cause mortality.

Disclaimer: The views and opinions expressed in these advertorials are those of the authors and do not necessarily reflect the opinions of ATMS or its Directors.

JATMS | Autumn 2016 | 55

PRODUCTS & SERVICES GUIDE

10 knots Uniforms

Bio-Practica

sales@10knots.com.au | www.10knots.com.au | 0487 101 001

www.bio-practica.com.au | 08 8130 8700

Imagine if your uniforms were designed by a fellow Practitioner, someone who knows what the uniform should perform like in an active job... Introducing 10 knots uniforms, designed by Practitioners for Practitioners.

• Style and Comfort – freedom to move, adjustable fit and superb cut.

• Durable and breathable quality fabrics. Natural Linen or Functional (Poly/Viscose).

• Ethically designed and manufactured in Australia, stock held on site, no minimum order.

Feel the difference, from AM to PM appointments you will look and feel fresh. … I designed your uniforms with a genuine desire to make a difference, aesthetically and practically.

Bio-Practica believes in empowering Healthcare Professionals. Bio-Practica believes that natural healthcare practitioners should play a fundamental role in preventative healthcare. We believe in a holistic methodology for medicine, drawing knowledge from traditional uses, clinical experience, scientific-based research and clinical trials. Our formulations are based on leading-edge research and traditional evidence to obtain optimal clinical results. Please join your peers for upcoming seminars: Innovative Workshop Exposome Meets Genome with Vanessa Hitch in April 2016 and Australia Wide National Summit Advanced Understanding in Acid-Based Balance in June 2016. Please see our website for more information.

Academy of Integrated Therapies (AOIT)

Cathay Herbal

orders@cathayherbal.com | www.cathayherbal.com | 1800 622 042

info@aoit.com.au | www.aoit.com.au | 07 3359 8523 About 15 years ago Neil Skilbeck, a Chiropractor and Osteopath made a valuable discovery integrating soft tissue and bones together. This has led to our course of Musculoskeletal Therapy (MST).

We believe in integrating knowledge as it leads to very powerful solutions such as we have demonstrated through our courses. We also provide CE workshops to fill in gaps in basic training of most body therapy courses.

These consist of foot corrections, nerve dynamics, limb neurology, axial and appendicular assessment and treatment and our specialty of pelvic mechanics.

BioMedica Nutraceuticals

Established in 1986, Cathay Herbal is a company that is run by practitioners who constantly work to ensure they understand and meet the needs of you, the practitioner. All products sold by Cathay Herbal undergo rigorous development and investigation before being offered as part of their range. With one of the largest ranges of Chinese Classical formulas outside of China, they don’t just stock the popular ones. Cathay’s range is large and comprehensive.

As well as the classical Black Pill range they also have many formulas available in tablet and capsules and a range of herbal granules, liquids and plasters.

Chi-Chinese Healing College

admin@chihealing.com.au | www.chihealing.com.au | 0416 286 899

info@biomedica.com.au | www.biomedica.com.au | 1300 884 702 BioMedica is an Australian owned company dedicated to the research, development and production of high quality, low excipient and efficacious practitioner formulations. Our products are developed by practitioners for practitioners. As a ‘Strictly Practitioner Only’ company, BioMedica is strongly dedicated to preserving and enhancing the role of the holistic practitioner.

Our products are only sold to practitioners in a clinical setting, this has been our long standing policy since our inception in 1998, and remains firmly in place to this day. We also aim to provide highly relevant technical education materials and seminars, with practical research and insights that can be immediately integrated into clinical practice.

The ATMS Products & Services Guide will appear in every issue of JATMS The cost is $150 for one issue or $500 for 4 consecutive issues. Listing comprises of – Logo, 100 word profile and contact information.

If you wish to list your company, practice, products, services or training course to appear in the next issue’s ATMS Products & Services Guide, please contact Yuri Mamistvalov on 0419 339 865.

56 | vol22 no1 | JATMS

Established since 1990 in Australia founded and directed by Master Zhang Hao, offering quality courses in nationally accredited qualifications of Diploma of Traditional Chinese Medicine Remedial Massage (An Mo Tui Na) and Diploma of Remedial Massage. The College is also conducting the short CE skill update courses and workshops throughout the year specially for professional massage therapists and health care workers. The College now also trading under the name - Australian School of Remedial Therapies to specialize in delivering Vocational Training Programs. If you still like the caring, practical and personalised traditional study model and environment - Try us!

Health World Limited

www.healthworld.com.au | 07 3117 3300 Health World Limited is recognised as a Leading Natural Health Science Company and the innovators in Natural Health products and Healthcare professional education. Health World Limited and Metagenics have invested in cutting edge manufacturing technology and equipment in order to expand production of the highest quality Natural Medicines. This level of commitment ensures that Health World Limited produces products that you and your patient can trust for quality and effectiveness.

Helio Supply Co

tcm@heliosupply.com.au | www.heliosupply.com.au | 02 9698 5555 Helio Supply Co is a wholesaler of Acupuncture and TCM supplies. We distribute nationally as well as internationally and pride ourselves on our service to customers. Established in 2000, we are committed to providing educational opportunities, a practitioner support line and sourcing the best domestic and international equipment and materials.

Herbs of Gold Pty Ltd

info@herbsofgold.com.au | www.herbsofgold.com.au | 02 9545 2633 Herbs of Gold has been dedicated to health since 1989, providing premium and practitioner strength herbal and nutritional supplements. Formulated by qualified, clinical and industry experienced naturopaths, herbalists and nutritionists, our formulations are based on current scientific research and traditional evidence. We take great care in all aspects of our business; right from the selection of raw materials through to the finished product, reviewing our environmental impact and sustainability of ingredients. All Herbs of Gold products meet stringent regulations for safety, quality and efficacy.

HESTA

hesta@hesta.com.au | hesta.com.au | 1800 813 327 For more than 25 years, HESTA has focused on helping those in the health and community services sector reach their retirement goals. We now have more than 785,000 members, 155,000 employers and more than $28 billion in assets.

HESTA’s size means we can offer many benefits to members and employers. These include: low fees, a fully portable account, easy administration, access to low-cost income protection and death insurance, limited financial advice (at no extra cost), super education sessions and transition to retirement options. We also provide access to great value health insurance, banking and financial planning.

For more information visit hesta.com.au or call 1800 813 327.

Issued by H.E.S.T. Australia Limited ABN 66 006 818 695 AFSL No. 235249,Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. For more information about HESTA, call 1800 813 327 or visit hesta.com.au for a copy of a Product Disclosure Statement which should be considered when making a decision about HESTA products.

Oligoscan Australasia

jon@karunahealthcare.com.au | www.oligoscan.net.au | 02 4228 0977 For practitioners of CAM to adequately treat patients with chronic diseases, it is essential to have at your fingertips to investigative tools to give the answers you need to create a viable treatment plan. Using the Oligoscan we can detect in only a few minutes the patient’s heavy metal load in addition to the bio-availability of their nutritive minerals. We can show patients why they have their symptoms, and help them to see a way out and back to health. Oligoscan is non-invasive, requires no tissue biopsy, and uses state of the art technology called Spectrophotometry. For the next practitioner training day go to http://oligoscan.net.au/events.html.

Oncology Massage Training

info@oncologymassagetraining.com.au www.oncologymassagetraining.com.au | 0410 486 767 Are you turning away clients with cancer? Oncology Massage Limited provide internationally recognised training for therapists who want to work safely with clients with cancer, in treatment for cancer or a history of cancer.

Courses are held nationally around Australia, and we will schedule courses in regional areas where there is enough interest. We also maintain a national listing of therapists, trained by OM Ltd, which is accessed by cancer support organisations and hospitals nationally.

Don’t turn clients with cancer away, or refer them on. Improve your skills and get the confidence you need to improve client wellbeing.

Contact us at info@oncologymassagetraining.com.au for more information or check out the website.

Sun Herbal

info@sunherbal.com.au | www.sunherbal.com | 1300 797 668 The No. 1 supplier of prepared Chinese herbal medicine in Australia and New Zealand. Your clinical success is our bottom line.

BLACK PEARL® pills • ChinaMed® capsules • Red Peony® granules for KIDS 192 herbal formulas effective for both common and difficult to treat conditions.

Sun Herbal supports you with: • A comprehensive website • Telephone support • Detailed reference manuals • Seminars & webinars • Regular Sun Herbal ‘Extracts’ (research and case studies) • Patient brochures & posters • Samples & bonus offers • Practitioner dispensing only

Terra Rosa

Terra Rosa www.terrarosa.com.au

Your Source for Massage Information

terrarosa@gmail.com | www.terrarosa.com.au | 0402 059 570 Terra Rosa specialised in educational massage DVDs and books. It has the largest collection of massage DVDs in Australia and the world, covering all modalities from Anatomy, Swedish Massage, Reflexology, Sports Massage to Myofascial Release and Structural Integration. We also provide the best in continuing education with workshops by international presenters including Orthopaedic Massage, Taping, Fascial Fitness and Myofascial Therapy.

JATMS | Autumn 2016 | 57

EDUCATION & TRAINING

Continuing Education Continuing education (CE) is a structured program of further education for practitioners in their professional occupations.

The ATMS CE policy is designed to ensure its practitioners regularly update their clinical skills and professional knowledge. One of the main aims of CE is to keep members abreast of current research and new developments which inform contemporary clinical practice.

The ATMS CE policy is based on the following principles: • Easily accessible to all members, regardless of geographic location • Members should not be given broad latitude in the selection and design of their individual learning programs • Applicable to not only the disciplines in which a member has ATMS accreditation, but also to other practices that are relevant to clinical practice which ATMS does not accredit (e.g. Ayurveda, yoga) • Applicable to not only clinical practice, but also to all activities associated with managing a small business (e.g. bookkeeping, advertising) • Seminars, workshops and conferences that qualify for CE points must be of a high standard and encompass both broad based topics as well as discipline-specific topics • Financially viable, so that costs will not inhibit participation by members, especially those in remote areas • Relevant to the learning needs of practitioners, taking into account different learning styles and needs

58 | vol22 no1 | JATMS

• Collaborative processes between professional complementary medicine associations, teaching institutions, suppliers of therapeutic goods and devices and government agencies to offer members the widest possible choice in CE activities

• Alexander K. Brief interventions for clients with drug and alcohol issues

• Emphasis on consultation and cooperation with ATMS members in the development and implementation of the CE program

• Pagura I. Work Health and Safety: Emergency Plans and Providing First Aid

ATMS members can gain CE points through a wide range of professional activities in accordance with the ATMS CE policy. CE activities are described in the CE policy document as well as the CE Record.

These documents can be obtained from the ATMS office (telephone 1800 456 855, fax (02) 9809 7570, or email info@ atms.com.au) or downloaded from the ATMS website at www.atms.com.au.

It is a mandatory requirement of ATMS membership that members accumulate 20 CE points per financial year. CE points can be gained by selecting any of the following articles, reading them carefully and critically reflecting on how the information in the article may influence your own practice and/or understanding of complementary medicine practice.

You can gain one (1) CE point per article to a maximum of three (3) CE points per journal from this activity: • Mars M, Oliver M. Mindfulness is more that a buzz word • Arthur R. Acid base balance in health from past to present.

• Reilly W. Dark field microscopy of human blood: history and practice • Holmes T. CAM use by poor Victorian consumers

• Medhurst R. A role for homoeopathy in urinary tract infection

As part of your critical reflection and analysis, answer in approximately 100 words the following questions for each of the three articles: 1 What new information did I learn from this article?

2 In what ways will this information affect my clinical prescribing/ techniques and/or my understanding of complementary medicine practice?

3 In what ways has my attitude to this topic changed?

Record your answers clearly on paper for each article. Date and sign the sheets and attach to your ATMS CE Record.

As a condition of membership, the CE Record must be kept in a safe place, and be produced on request from ATMS.

EDUCATION & TRAINING

Continuing Education - Calendar 2016 DATE

EVENT

PRESENTER

LOCATION

21/02/16

Seminar: Mastering Trigger Point Therapy

Chris Beazley

Charmhaven, NSW

28/02/16

Seminar: Trigger Points for Low Back, Pelvis and Extremities

Raymond Smith

Parramatta, NSW

6/03/16

Seminar: Integrating Muscle Energy Techniques (METs) and Positional Release into your Treatments

Chris Beazley

Moss Vale, NSW

(Sunday)

Seminar: Understanding a Natural Medicine Practitioners Requirement for Clinical Practice (Massage & Bodywork practitioners)

Maggie Sands

Canberra, ACT

(Wednesday)

Webinar: Spagyric Plant Preparations: A better way?

Peter Berryman

N/A

13/03/16

Seminar: Integrating Muscle Energy Techniques (METs) and Positional Release into your Treatments

Chris Beazley

Wallsend, NSW

13/03/16

Seminar: Trigger Points for Lower Back, Pelvis and Extremities

Raymond Smith

Penrith, NSW

(Wednesday)

Webinar: Marketing With Soul - How to get busy without selling out

Jeff Shearer

N/A

Sunday

Seminar: Nutritional Deficiencies, Body Signs and Clinical Signs in Clinical Practice

Brad McEwen

Parramatta, NSW

(Tuesday)

Webinar: Eat right for your Ayurvedic body type

Shaun Matthews

N/A

(Sunday)

Seminar: Understanding a Natural Medicine Practitioners Requirement for Clinical Practice (Massage & Bodywork practitioners)

Maggie Sands

Newcastle, NSW

Tuesday

Webinar: Clinical Applications of Microminerals

Brad McEwen

N/A

Saturday

Seminar: Chronic Fatigue Syndrome

Stephen Eddey

Charmhaven, NSW

Sunday

Seminar: The Paleo Diet

Stephen Eddey

Charmhaven, NSW

17/04/16

Seminar: Treat the Pelvic Girdle

Chris Beazley

Charmhaven, NSW

Sunday

Seminar: Nutritional Deficiencies, Body Signs and Clinical Signs in Clinical Practice

Brad McEwen

Brisbane, Qld

(Sunday)

Seminar: Understanding a Natural Medicine Practitioners Requirement for Clinical Practice (Massage & Bodywork practitioners)

Maggie Sands

Bankstown, NSW

1/05/16

Seminar: Integrating Muscle Energy Techniques (METs) and Positional Release into your Treatments

Chris Beazley

Charmhaven, NSW

3/05/2016 (Tues)

Seminar: Integrating Muscle Energy Techniques (METs) and Positional Release into your Treatments

Chris Beazley

Crows Nest, NSW

(Sunday)

Seminar: Understanding a Natural Medicine Practitioners Requirement for Clinical Practice (Massage & Bodywork practitioners)

Maggie Sands

Penrith, NSW

Saturday

Seminar: Understanding a Natural Medicine Practitioners Requirement for Clinical Practice (Massage & Bodywork practitioners)

Maggie Sands

Crows Nest, NSW

Sunday

Seminar: Nutritional Deficiencies, Body Signs and Clinical Signs in Clinical Practice

Brad McEwen

Melbourne, VIC

(Tuesday)

Webinar: Record Keeping/TCM/Acupuncture requirements

Daniel Zhang

N/A

22/05/16

Seminar: Lymphatic/Detox Massage

Lynne Davidson

Wallsend, NSW

25/05/2016 (Wed)

Seminar: Pregnancy Massage

Lynne Davidson

Crows Nest, NSW

29/05/16

Seminar: Treat Cervical and Thoracic Pain

Laurie Fawkner

Charmhaven, NSW

5/06/16

Seminar: Musculoskeletal assessment and palpation techniques

Raymond Smith

Kogarah, NSW

(Sunday)

Seminar: Understanding a Natural Medicine Practitioners Requirement for Clinical Practice (Massage & Bodywork practitioners)

Maggie Sands

Gold Coast, Qld

Tuesday

Webinar: Clinical Applications of B Vitamins

Brad McEwen

N/A

19/06/16

Seminar: Corrective Exercise for Bodyworkers

Chris Beazley

Charmhaven, NSW

Sunday

Seminar: Nutritional Deficiencies, Body Signs and Clinical Signs in Clinical Practice

Brad McEwen

Adelaide, SA

(Monday)

Webinar: Dietary Treatments for Acne

Stephen Eddey

N/A

26/06/16

Seminar: Acupressure for the Emotions

John Kirkwood

Adelaide, SA

(Sunday)

Seminar: Understanding a Natural Medicine Practitioners Requirement for Clinical Practice (Massage & Bodywork practitioners)

Maggie Sands

Charmhaven, NSW

(Wednesday)

Webinar: Prescribing Ayurvedic Herbs (Part 1)

Shaun Matthews

N/A

(Wednesday)

Webinar: Nutritional Treatments for Type II Diabetes

Stephen Eddey

N/A

Sunday

Seminar: Nutritional Deficiencies, Body Signs and Clinical Signs in Clinical Practice

Brad McEwen

Perth, WA

Tuesday

Webinar: Clinical Applications of Vitamins A, C, D, E and K

Brad McEwen

N/A

(Wednesday)

Webinar: Prescribing Ayurvedic Herbs (Part 2)

Shaun Matthews

N/A

11/09/16

Seminar: Acupressure for the Immune System

John Kirkwood

Adelaide, SA

(Sunday)

Seminar: Ayurvedic Holistic Detoxing

Shaun Matthews

Sydney area

(Tuesday)

Webinar: Nutritional Treatments for the Ageing

Stephen Eddey

N/A

(Sunday)

Seminar: Understanding a Natural Medicine Practitioners Requirement for Clinical Practice (Massage & Bodywork practitioners)

Maggie Sands

Melbourne, VIC

The proposed seminar and webinar topics, dates and locations (for seminars) are subject to change.

Please keep an eye on the ATMS website www.atms.com.au for the latest information and to book online.