Objective:To study the efficacy of acupuncture combined with Tuina(Chinese therapeutic massage)compared to acupuncture alone and sham acupuncture in aspects of symptom control and mobility functions in farmers sufferi...Objective:To study the efficacy of acupuncture combined with Tuina(Chinese therapeutic massage)compared to acupuncture alone and sham acupuncture in aspects of symptom control and mobility functions in farmers suffering from knee osteoarthrosis(KOA).Methods:Individuals enrolled at a community hospital in Thailand were extended invitations to take part in the research project.Those who volunteered provided informed consent and were then randomly assigned to one of three groups,namely the combined group,the acupuncture group,and the control group.Thirty-four cases in the combined group received acupuncture and Tuina treatments;32 cases in the acupuncture group received acupuncture alone;and 30 cases in the control group received sham acupuncture intervention.Each group underwent therapeutic sessions once daily for 10 d.As the main outcome measured,the Western Ontario and McMaster Universities osteoarthritis index(WOMAC)was used to assess pain,stiffness,and function.The secondary outcomes included movement angles measured with a goniometer and balance function evaluated by the timed up and go test.Results:A total of 96 patients were analyzed.After the intervention,WOMAC total score and pain,stiffness,and function scores were significantly reduced and the joint range of motion was improved in both the combined group and the acupuncture group when compared to the control group(P<0.05);there were no significant differences between the combined group and the acupuncture group.Compared to the acupuncture group,a lowered balance score was observed in the combined group(P<0.05).Conclusion:After once-daily interventions for 10 consecutive days in KOA patients,both the combination of acupuncture and Tuina and acupuncture alone proved effective in alleviating pain and improving the range of motion compared to the control group.展开更多
Background:Chagas disease is one of the neglected tropical diseases(NTDs).International goals for its control involve elimination of vector-borne transmission.Central American countries face challenges in establishing...Background:Chagas disease is one of the neglected tropical diseases(NTDs).International goals for its control involve elimination of vector-borne transmission.Central American countries face challenges in establishing sustainable vector control programmes,since the main vector,Triatoma dimidiata,cannot be eliminated.In 2012,the Ministry of Health in Nicaragua started a field test of a vector surveillance-response system to control domestic vector infestation.This paper reports the main findings from this pilot study.Methods:This study was carried out from 2012 to 2015 in the Municipality of Totogalpa.The Japan International Cooperation Agency provided technical cooperation in designing and monitoring the surveillance-response system until 2014.This system involved 1)vector reports by householders to health facilities,2)data analysis and planning of responses at the municipal health centre and 3)house visits or insecticide spraying by health personnel as a response.We registered all vector reports and responses in a digital database.The collected data were used to describe and analyse the system performance in terms of amount of vector reports as well as rates and timeliness of responses.Results:During the study period,T.dimidiata was reported 396 times.Spatiotemporal analysis identified some high-risk clusters.All houses reported to be infested were visited by health personnel in 2013 and this response rate dropped to 39%in 2015.Rates of insecticide spraying rose above 80%in 2013 but no spraying was carried out in the following 2 years.The timeliness of house visits improved significantly after the responsibility was transferred from a vector control technician to primary health care staff.Conclusions:We argue that the proposed vector surveillance-response system is workable within the resourceconstrained health system in Nicaragua.Integration to the primary health care services was a key to improve the system performance.Continual efforts are necessary to keep adapting the surveillance-response system to the dynamic health systems.We also discuss that the goal of eliminating vector-borne transmission remains unachievable.This paper provides lessons not only for Chagas disease control in Central America,but also for control efforts for other NTDs that need a sustainable surveillance-response system to support elimination.展开更多
基金registered in the Thai Clinical Trials Registry(No.TCTR20221129004)approved by the Institutional Review Board of the University of Phayao(No.1.2/024/65)。
文摘Objective:To study the efficacy of acupuncture combined with Tuina(Chinese therapeutic massage)compared to acupuncture alone and sham acupuncture in aspects of symptom control and mobility functions in farmers suffering from knee osteoarthrosis(KOA).Methods:Individuals enrolled at a community hospital in Thailand were extended invitations to take part in the research project.Those who volunteered provided informed consent and were then randomly assigned to one of three groups,namely the combined group,the acupuncture group,and the control group.Thirty-four cases in the combined group received acupuncture and Tuina treatments;32 cases in the acupuncture group received acupuncture alone;and 30 cases in the control group received sham acupuncture intervention.Each group underwent therapeutic sessions once daily for 10 d.As the main outcome measured,the Western Ontario and McMaster Universities osteoarthritis index(WOMAC)was used to assess pain,stiffness,and function.The secondary outcomes included movement angles measured with a goniometer and balance function evaluated by the timed up and go test.Results:A total of 96 patients were analyzed.After the intervention,WOMAC total score and pain,stiffness,and function scores were significantly reduced and the joint range of motion was improved in both the combined group and the acupuncture group when compared to the control group(P<0.05);there were no significant differences between the combined group and the acupuncture group.Compared to the acupuncture group,a lowered balance score was observed in the combined group(P<0.05).Conclusion:After once-daily interventions for 10 consecutive days in KOA patients,both the combination of acupuncture and Tuina and acupuncture alone proved effective in alleviating pain and improving the range of motion compared to the control group.
基金This study used funding from the Ministry of Health in Nicaragua(MoH)and Japan International Cooperation Agency(JICA)The MoH played an important role in the design of the study and data collection as described in the paper.Neither organization were not involved in analysing and interpreting data or in writing the manuscript.
文摘Background:Chagas disease is one of the neglected tropical diseases(NTDs).International goals for its control involve elimination of vector-borne transmission.Central American countries face challenges in establishing sustainable vector control programmes,since the main vector,Triatoma dimidiata,cannot be eliminated.In 2012,the Ministry of Health in Nicaragua started a field test of a vector surveillance-response system to control domestic vector infestation.This paper reports the main findings from this pilot study.Methods:This study was carried out from 2012 to 2015 in the Municipality of Totogalpa.The Japan International Cooperation Agency provided technical cooperation in designing and monitoring the surveillance-response system until 2014.This system involved 1)vector reports by householders to health facilities,2)data analysis and planning of responses at the municipal health centre and 3)house visits or insecticide spraying by health personnel as a response.We registered all vector reports and responses in a digital database.The collected data were used to describe and analyse the system performance in terms of amount of vector reports as well as rates and timeliness of responses.Results:During the study period,T.dimidiata was reported 396 times.Spatiotemporal analysis identified some high-risk clusters.All houses reported to be infested were visited by health personnel in 2013 and this response rate dropped to 39%in 2015.Rates of insecticide spraying rose above 80%in 2013 but no spraying was carried out in the following 2 years.The timeliness of house visits improved significantly after the responsibility was transferred from a vector control technician to primary health care staff.Conclusions:We argue that the proposed vector surveillance-response system is workable within the resourceconstrained health system in Nicaragua.Integration to the primary health care services was a key to improve the system performance.Continual efforts are necessary to keep adapting the surveillance-response system to the dynamic health systems.We also discuss that the goal of eliminating vector-borne transmission remains unachievable.This paper provides lessons not only for Chagas disease control in Central America,but also for control efforts for other NTDs that need a sustainable surveillance-response system to support elimination.
