Research on acupuncture has been muddled by attempts to bridge the ancient with the modern. Barriers to effectiveness research are reflected in recurring conflicts that include disagreement on use of the most basic te...Research on acupuncture has been muddled by attempts to bridge the ancient with the modern. Barriers to effectiveness research are reflected in recurring conflicts that include disagreement on use of the most basic terms, lack of standard intervention controls, and the absence of functional measures for assessing treatment effect. Acupuncture research has stalled at the ＂placebo barrier＇ wherein acupuncture is ＂no better than placebo.＂ The most widely recognized comparative effectiveness research in acupuncture does not compare acupuncture treatment protocols within groups, thereby, mutating large scale effectiveness studies into large scale efficacy trials. Too often research in acupuncture attempts to tie outcomes to traditional belief systems thereby limiting usefulness of the research. The acupuncture research paradigm needs to focus more closely on a scientific definition of treatments and outcomes that compare protocols in terms of prevalent clinical issues such as relative effectiveness for treating pain.展开更多
The use of orthobiologics as a novel therapy for the treatment of numerous musculoskeletal disorders has increased considerably over the past decade.Currently,there are multiple alternatives available as suitable trea...The use of orthobiologics as a novel therapy for the treatment of numerous musculoskeletal disorders has increased considerably over the past decade.Currently,there are multiple alternatives available as suitable treatments;however,the use of autologous blood-derived products such as platelet-rich plasma(PRP),bone marrow aspirate(BMA)and BMA concentrate(BMAC),specifically,is expanding.Although many investigations attempted to demonstrate the effectiveness of these therapies,even with positive results,the literature lacks standardized protocols and overall accuracy in study designs,which leads to variance and difficulty in reproducibility of protocols.The efficacy of PRP for the treatment of cartilage,bone and muscle tissues is well known.Although BMAC has generated optimistic results for the same purposes,its applicability in clinical trials is still relatively recent when compared to PRP.Both products demonstrate the potential to set forth reparative processes,each in their own distinct mechanism.The combination of these biological products has been previously proposed,yet little is known about their synergism.Evidence indicates that growth factor,cytokine,and chemokine profiles seen in both PRP and BMAC vary but are likely to work synergistically to enhance musculoskeletal healing.BMAC products seem to work well without PRP;however,the addition of PRP to BMAC has been shown to act as a rich and natural source of culture medium for stem cells located either peripherally or in the bone marrow itself.Nevertheless,additional variables associated with the use of BMAC and PRP in orthopedics must be further evaluated in order to consolidate the efficacy of this therapeutic strategy.展开更多
<strong>Background:</strong> The potential for misinformation on usercontrolled Knowledge Exchange Social Websites (KESWs) is concerning since it can actively influence Internet users’ knowledge, attitude...<strong>Background:</strong> The potential for misinformation on usercontrolled Knowledge Exchange Social Websites (KESWs) is concerning since it can actively influence Internet users’ knowledge, attitudes, and behaviors related to childhood vaccinations. <strong>Objective:</strong> The present study examines the accuracy and predictors of health information posted to a Knowledge Exchange Social Website (KESW). <strong>Methods:</strong> A sample of 480 answers to childhood vaccination questions were retrieved and rated for accuracy. Multiple logistic regression modeling was used to examine whether answer characteristics (best answer, professional background, statistical information, source disclosure, online link, word count, vaccine stance, and tone) predict accuracy. <strong>Results:</strong> Overall, only 56.2% of the posted answers were rated as “accurate.” Accuracy varied by topics with between 52.8% - 64.3% being rated as accurate. When Yahoo Answers’ “best answers” were examined, only 49.2% rated as accurate compared to 57.7% of all other answers, a finding attributed to widespread nominations of vaccine misinformation as “best answers” for questions addressing the side effects of vaccines. For all other types of questions, “best answers” were more likely to be accurate. Regression modeling revealed that discussions of personal choices regarding childhood vaccinations predicted the accuracy of posted answers, with those who mentioned vaccinating their own children proving more likely to communicate accurate vaccine information, and those expressing vaccine hesitancy proving more likely to share factually inaccurate statements about vaccines. <strong>Conclusion:</strong> The high prevalence of misinformation on KESWs suggests that these websites may serve as a vector for spreading vaccine misperceptions. Further research is needed to assess the impact of various KESWs and to develop effective, coordinated responses by public health agencies.展开更多
文摘Research on acupuncture has been muddled by attempts to bridge the ancient with the modern. Barriers to effectiveness research are reflected in recurring conflicts that include disagreement on use of the most basic terms, lack of standard intervention controls, and the absence of functional measures for assessing treatment effect. Acupuncture research has stalled at the ＂placebo barrier＇ wherein acupuncture is ＂no better than placebo.＂ The most widely recognized comparative effectiveness research in acupuncture does not compare acupuncture treatment protocols within groups, thereby, mutating large scale effectiveness studies into large scale efficacy trials. Too often research in acupuncture attempts to tie outcomes to traditional belief systems thereby limiting usefulness of the research. The acupuncture research paradigm needs to focus more closely on a scientific definition of treatments and outcomes that compare protocols in terms of prevalent clinical issues such as relative effectiveness for treating pain.
文摘The use of orthobiologics as a novel therapy for the treatment of numerous musculoskeletal disorders has increased considerably over the past decade.Currently,there are multiple alternatives available as suitable treatments;however,the use of autologous blood-derived products such as platelet-rich plasma(PRP),bone marrow aspirate(BMA)and BMA concentrate(BMAC),specifically,is expanding.Although many investigations attempted to demonstrate the effectiveness of these therapies,even with positive results,the literature lacks standardized protocols and overall accuracy in study designs,which leads to variance and difficulty in reproducibility of protocols.The efficacy of PRP for the treatment of cartilage,bone and muscle tissues is well known.Although BMAC has generated optimistic results for the same purposes,its applicability in clinical trials is still relatively recent when compared to PRP.Both products demonstrate the potential to set forth reparative processes,each in their own distinct mechanism.The combination of these biological products has been previously proposed,yet little is known about their synergism.Evidence indicates that growth factor,cytokine,and chemokine profiles seen in both PRP and BMAC vary but are likely to work synergistically to enhance musculoskeletal healing.BMAC products seem to work well without PRP;however,the addition of PRP to BMAC has been shown to act as a rich and natural source of culture medium for stem cells located either peripherally or in the bone marrow itself.Nevertheless,additional variables associated with the use of BMAC and PRP in orthopedics must be further evaluated in order to consolidate the efficacy of this therapeutic strategy.
文摘<strong>Background:</strong> The potential for misinformation on usercontrolled Knowledge Exchange Social Websites (KESWs) is concerning since it can actively influence Internet users’ knowledge, attitudes, and behaviors related to childhood vaccinations. <strong>Objective:</strong> The present study examines the accuracy and predictors of health information posted to a Knowledge Exchange Social Website (KESW). <strong>Methods:</strong> A sample of 480 answers to childhood vaccination questions were retrieved and rated for accuracy. Multiple logistic regression modeling was used to examine whether answer characteristics (best answer, professional background, statistical information, source disclosure, online link, word count, vaccine stance, and tone) predict accuracy. <strong>Results:</strong> Overall, only 56.2% of the posted answers were rated as “accurate.” Accuracy varied by topics with between 52.8% - 64.3% being rated as accurate. When Yahoo Answers’ “best answers” were examined, only 49.2% rated as accurate compared to 57.7% of all other answers, a finding attributed to widespread nominations of vaccine misinformation as “best answers” for questions addressing the side effects of vaccines. For all other types of questions, “best answers” were more likely to be accurate. Regression modeling revealed that discussions of personal choices regarding childhood vaccinations predicted the accuracy of posted answers, with those who mentioned vaccinating their own children proving more likely to communicate accurate vaccine information, and those expressing vaccine hesitancy proving more likely to share factually inaccurate statements about vaccines. <strong>Conclusion:</strong> The high prevalence of misinformation on KESWs suggests that these websites may serve as a vector for spreading vaccine misperceptions. Further research is needed to assess the impact of various KESWs and to develop effective, coordinated responses by public health agencies.
