To "tell or not to tell"-Exploring disclosure about medicine use by people living with sleep disorders.

OBJECTIVE: To explore the difference in rates and reasons for disclosure of either conventional or complementary medicine (CM) to healthcare practitioners between people living with sleep disorders (SDs) and those without SDs. METHODS: A cross-sectional survey (N = 2019 adults) that measured sociodemographic characteristics, health status, health service utilisation, health literacy and health communication (medicine disclosure) of a representative sample of Australians was conducted. Data from participants reporting an SD (n = 265) were compared to those not reporting an SD to assess measures of health communication and disclosure about medicine use. RESULTS: Overall, rates of medicine disclosure to both conventional and CM practitioners were high, in respondents with (70%) and without an SD (57%). Those reporting an SD had higher expectations of their conventional health practitioner's knowledge of CM, associated clinical decision-making skills, and approval of CM use, and held a higher degree of concern about drug interactions (P < 0.05). The main reasons cited for disclosing CM use to conventional health practitioners and conventional medicine use to CM practitioners were "I want them to fully understand my health status" and "I was concerned about drug interactions with the CMs used." CONCLUSION: The high rate of medicine use disclosure by people with SDs is driven by an intention to inform their healthcare practitioner about their health status and concerns about potential medicine interactions. Therefore, research about the expectations that people with an SD have of their conventional healthcare practitioners' knowledge of CM and CM-drug interactions requires further examination. Likewise, further examination of CM practitioner's conventional medicine knowledge is encouraged.

The Perspectives of Australian Naturopaths about Providing Health Services for People with Sleep Disorders.

Objective: The purpose of the study was to determine and describe the clinical approach Australian naturopaths take in providing care for people with sleep disorders, as it well known that Australians commonly seek care from naturopathic practitioners and no data on naturopathic practices for people with sleep disorders is currently documented.Participants: Naturopaths registered with the Australian PRACI (Practitioner Research and Collaboration Initiative) involved in the clinical management of people with sleep disorders.Methods: Consenting participants were invited to participate in semi-structured phone interviews conducted with the aid of a project-specific interview guide until data saturation was evident. Interview recordings were transcribed verbatim and analyzed thematically.Results: A total of 20 naturopaths across 5 different Australian states were interviewed, 4 themes were identifiable. Thematic interpretation suggests that (1) sleep health consults were common and involved detailed history taking by providers, (2) herbal remedies supported by lifestyle and sleep hygiene behaviors were the most common treatments recommended, and (3) interprofessional communication to medical doctors was seldom reciprocated. Government-funded research and establishing statutory registration of naturopaths were identified as key steps in profiling the professions role and to develop/evaluate integrated patient-centered sleep health care models.Conclusion: Naturopaths engage in the treatment of sleep disorders yet face barriers in executing an integration of such approaches within the current health care system. Research is required to explore how to overcome these barriers and develop integrated patient-centered models of care within tertiary sleep clinics and/or primary care physicians.

Antimutagenic and antioxidant/prooxidant activity of quercetin.

The present study has been performed to evaluate the antimutagenic activity of quercetin, ascorbic acid and their combination against an oxidative mutagen. An effort was also made to correlate this activity to the in vitro antioxidant activity of these agents. Antimutagenicity testing was done in Ames Salmonella Assay system using Salmonella typhimurium TA102 against t-butylhydroperoxide as an oxidative mutagen. In vitro antioxidant scavenging activity was tested for DPPH free radical, superoxide anion, hydrogen peroxide and hydroxyl radical in their specific test systems. Quercetin (0.5-8 nmole/plate) and ascorbic acid (0.1-100 micromole/plate) showed significant effect. Quercetin (4 and 8 nmole/plate) when combined with ascorbic acid (500 nmole/plate) showed an increase in the antimutagenic activity. In vitro antioxidant activity of quercetin was better than ascorbic acid in all the test systems used. The study indicated that the antimutagenic activity of quercetin was not solely accountable by its antioxidant nature. However, in vitro free radical scavenging activity of quercetin correlated well with the antimutagenic activity.