Labor, HHS (Page 3)

Proposed Recipient:              University of Miami

 

Amount of Request:               $952,000.00

Total Project Cost:                 $1,441,260.00

 

 

Despite advances in conventional medicine, not all health problems are solved by traditional medical interventions. Other factors such as diet, lifestyle and built environment have emerged as significant determinants of health. With persistent inflation of health care costs and increased need for physician visits or hospitalizations, the role of solely conventional medicine in health is frequently questioned. In 2004, some 4.4 million hospitalizations are attributed to preventable conditions, accounting for 10% of the total health care expenditure. Hospitalization costs in children increased by 50% over the past nine years and were largely due to preventable short-term diabetic and gastrointestinal complications. These statistics show that although effective, our current conventional medicine practices have room for improvement.

 

Recently, complementary and alternative medicine (CAM) has gained more attention and popularity. CAM represents a body of different medical and health practices not included in conventional medical approaches (NCCAM, NIH 2007). The major differences in conventional medicine include approach, standardization and criteria for accepted practice. For many, CAM represents herbal remedies and practices derived from cultures that do not rely on biological data to support their theories. However, it is important to recognize that even in conventional medicine, several therapies used today originate from natural plant and animal sources (e.g. digitalis, atrophine and morphine). CAM may warrant a closer look than we believe.

 

Unlike adults, children do not have any autonomy in selecting their medical care. As parents and caretakers of children become interested in CAM, there is a risk they will translate the methodology to their children. Children often have unique medical issues that cannot be extrapolated from adult disorders. Without an effective pediatric CAM model, the risk of harm is high as children metabolize many substances differently than adults. Children also weigh less and require stepwise increases in their doses for medication until their weight range becomes closer to that of adults.

 

These and other factors make the best approach for delivering CAM to children an integrative medicine model backed by rigorous scientific methodology. This model combines conventional medicine with only tested CAM strategies or those for which a large amount of high-quality evidence exists. For adults, this is feasible but still difficult due to an absence of empirical data. For children, this evidence is even more sparse, making this model virtually impossible to implement.

 

In this project, we aim to develop a pediatric integrative medicine model where research and delivery of care are both emphasized. A truly integrative medicine model where research and delivery of care are both emphasized. A truly integrative model will utilize CAM in concert with conventional medicine to improve the standard of care. The Pediatric Integrative Medicine Model will allow for cross-communication between pediatricians, specialists involved in specific disease management and CAM practitioners. Plans of care reflecting the input of all involved clinicians would be presented to the patient through a single point of contact to provide an efficient, comprehensive health care delivery system. A strict evaluative process will be in place in order to determine the most effective integrative interventions tailored specifically for children.

 

 

Through the development of a pioneer center of excellence for a pediatric integrative medicine model, the following benefits will be realized:

•The University of Miami will become a resource for other institutions in the community as well as nationally who are interested in this model of care.

•By becoming a center of excellence, our patient population would have the advantage of receiving the most comprehensive care that is available nationwide.

•The collaboration between CAM practitioners and clinicians can increase the respect between the two health care delivery systems; may also establish trust by eliminating the competition usually occurring between the two fields.

•The holistic approach of most CAM interventions and therapies can increase awareness of health and wellness in children at an early age. With the impact that lifestyle and behavior have on health, children can reap the benefits of this early awareness well into adulthood.

 

Through our Pediatric Integrative Medicine Model, the University of Miami would be poised to revolutionize pediatric care and advance the use of CAM as part of standard care.

 

Specific targeted substudies may include:

•Water

One of the most important elements in our bodies yet one whose intake in children is universally limited. Exploring increased hydration therapy in children would be an inexpensive home-based intervention for improving health.

•Enzyme Deficiency

Implicated as a cause of illness and as an effecter of health, enzyme deficiencies can be improved through supplementation with natural products such as wheatgrass, raw juices and living foods.

•Ambient Lighting and Light Therapy

Extended hospitalizations reduce exposure to sunlight, potentially causing Vitamin D deficiency. Would supplementation through Vitamin D-rich foods be effective in preventing this deficiency? Additionally, are there other adverse health effects of certain lighting techniques (e.g. fluorescent or flos-fluorescent light)?

•Probiotics

Could probiotics be useful in maintaining optimal colon health in children? If so, are there dosage considerations to be explored based on the significantly smaller size of the colon? Furthermore, can the use of probiotics reduce recovery time in hospitalized children?

•Massage Therapy

The negative impacts of stress are present throughout all age groups in the U.S., but the data exploring CAM methods for stress reduction in children is sparse. Recognizing the benefits of massage in adults and even in neonates, could massage be beneficial to children with elevated stress levels (whether that stress is psychological or biological such as that from chronic diseases)? Is massage a significant effecter of biological markers of stress (inflammation, cytokines, C-reactive proteins etc.)?

•Others

Exercise, polyunsaturated fatty acids, specific vitamin and other nutritional therapies, pediatric health behavior – adherence to CAM therapies and changes in mood outcome expectations – the possibilities are extensive.