1,092 research outputs found
Attitudes about complementary and alternative medicine did not predict outcome in a homeopathic proving trial
No full textObjectives: A homeopathic proving states that when a homeopathic remedy is given to a healthy person, they will experience symptomatic effects specific to that remedy. The aim of this study was to assess if attitudes about complementary and alternative medicine (CAM) predicted proving outcome.Design: An exploratory study nested in a double blinded randomized controlled proving trial of the remedy Belladonna C30.Subjects: Two hundred and six (206) healthy subjects took part in the reproving trial of whom 29 (14%) proved.Interventions: Subjects completed the Attitudes to Alternative Medicine Scale prior to participating in the proving trial (n = 206) and after the proving trial was completed (n = 77).Outcome measures: The primary outcome was whether attitude to CAM predicted proving outcome.Results: Attitudes about CAM at baseline did not predict proving outcome (?2 = 35.34, df = 36, p = 0.50) and attitudes to CAM did not alter after taking part in the proving trial for either provers or non provers.Conclusion: Subjects classified as being provers in a proving trial did not have significantly different attitudes about CAM than nonprovers. The experience of proving the study remedy did not alter the prover's attitudes about CAM.<br/
The use of intuition in homeopathic clinical decision making: an interpretative phenomenological study
No full textWhile intuition plays a role in clinical decision making within conventional medicine, little is understood about its use in complementary and alternative medicine (CAM). The aim of this qualitative study was to investigate intuition from the perspective of homeopathic practitioners; its’ manifestation, how it was recognized, its origins and when it was used within daily clinical practice. Semi-structured interviews were carried out with clinically experienced non-National Health Service (NHS) UK homeopathic practitioners. Interpretative phenomenological analysis was used to analyze the data. Homeopaths reported many similarities with conventional medical practitioner regarding the nature, perceived origin and manifestation of their intuitions in clinical practice. Intuition was used in two key aspects of the consultation: (i) to enhance the practitioner–patient relationship, these were generally trusted; and (ii) intuitions relating to the prescribing decision. Homeopaths were cautious about these latter intuitions, testing any intuitive thoughts through deductive reasoning before accepting them. Their reluctance is not surprising given the consequences for patient care, but we propose this also reflects homeopaths’ sensitivity to the academic and medical mistrust of both homeopathy and intuition. This study is the first to explore the use of intuition in decision making in any form of complementary medicine. The similarities with conventional practitioners may provide confidence in validating intuition as a legitimate part of the decision making process for these specific practitioners. Further work is needed to elucidate if these findings reflect intuitive use in clinical practice of other CAM practitioners in both private and NHS (i.e. time limited) setting
The urinary excretion of tryptophan and tryptophan metabolites in the chronic ethanol-fed rat
No full textAn investigation was made into the hypothesis that chronic ethanol ingestion disturbs the metabolism of tryptophan which is reflected by alterations in the urinary excretion of the metabolites 5-hydroxyindoleacetic acid (5-HIAA), anthranillic acid (AA) and indoleacetic acid (IAA). In particular, we investigated whether experimental chronic alcoholism is associated with a decrease in the tryptophan metabolite ratios as suggested in the literature. Male Wistar rats were chronically fed a nutritionally-complete liquid diet in which ethanol comprised 35% of total calories: controls were pair-fed identical amounts of the same diet in which ethanol was replaced by isocaloric glucose. At 6 weeks, 24 h urine samples were collected for the analysis of tryptophan, 5-HIAA, AA and IAA by HPLC. During ethanol-feeding there were reductions in the daily urinary excretion (i.e. μmol/24 h) of tryptophan (–57%, P = 0·026) and concomitant increases in 5-HIAA excretion (62%, P = 0·057). Expression of data in terms of lean tissue mass (i.e. urinary creatinine) revealed identical conclusions. An analysis was performed on the molar ratios of these urinary analytes. The tryptophan: total metabolite ratio was significantly decreased (by −53%), but the AA: total metabolite ratio was not significantly altered (P = 0·102). The ratios 5-HIAA/AA and 5-HIAA/IAA were slightly increased, but they did not attain statistical significance (P > 0·351). It was concluded that chronic ethanol feeding is associated with significant changes in the urinary excretion of tryptophan and its related metabolites. Many of the above changes were contrary to previous clinical data and this may be due to dietary and nutritional deficiencies or to alterations in the diurnal pattern of 5-hydroxytryptamine and tryptophan metabolism
Meta-analysis of the related nutritional supplements dimethyl sulfoxide and methylsulfonylmethane in the treatment of osteoarthritis of the knee
No full textDimethyl sulphoxide and methylsulfonylmethane are two related nutritional supplements used for symptomatic relief of osteoarthritis (OA). We conducted a meta-analysis to evaluate their efficacy in reducing pain associated with OA. Randomized or quasi-randomized controlled trials (RCTs), identified by systematic electronic searches, citation tracking and searches of clinical trial registries, assessing these supplements in osteoarthritis of any joint were considered for inclusion. Meta-analysis, based on difference in mean pain related outcomes between treatment and comparator groups, was carried out based on a random effect model. Seven potential trials were identified of which three RCTs, two DMSO and one MSM (total N = 326 patients) were eligible for inclusion. All three trials were considered high methodological quality. A significant degree of heterogeneity ({chi}2 = 6.28, P = 0.043) was revealed. Two studies demonstrated statistically significant (but not clinically relevant) reduction in pain compared with controls; with one showing no group difference. The meta-analysis confirmed a non significant reduction of pain on visual analogue scale of 6.34 mm (SE = 3.49, 95% CI, –0.49, 13.17). The overall effect size of 1.82 was neither statistically nor clinically significant. Current evidence suggests DMSO and MSM are not clinically effective in the reduction of pain in the treatment of OA. No definitive conclusions can currently be drawn from the data due to the mixed findings and the use of inadequate dosing periods
Ultramolecular homeopathy has no observable clinical effects. A randomized, double-blind, placebo-controlled proving trial of Belladonna 30C
No full textAims: to investigate if ultramolecular homeopathy has any clinical effects. This was assessed using the proving of the homeopathic remedy Belladonna given at an ultramolecular dose (30C), as a model. A proving states that when a homeopathic remedy is given to a healthy person, they will experience symptomatic effects specific to that remedy. If ultramolecular doses are clinically active, the Belladonna 30C group should experience more true Belladonna proving symptoms than the placebo group.Methods: healthy subjects (n = 253), aged 18–30 years, took part in this double-blind, randomized placebo-controlled study. Total study duration was 4 weeks. Subjects were randomized before 1 week placebo run-in. They received 2 weeks of treatment intervention (Belladonna 30C or placebo) and were followed up for 1 week. Subjects recorded any symptoms experienced during the total study period on a daily basis using a structured questionnaire. Symptom diaries were analysed blind to determine if each subject had proved or not (based on predefined criteria). The main outcome was the proportion of subjects who had proved in each treatment group.Results: no significant group differences in proving rates were observed [Belladonna provers N = 14 (13.9%); placebo provers N = 15 (14.3%); mean difference − 0.4%, 95% confidence interval − 9.3, 10.1] based on intention to treat analysis. Primary outcome was not affected by seasonality or the individual's attitude to complementary medicine.Conclusion: ultramolecular homeopathy had no observable clinical effects
Patient coping strategies in COPD across disease severity and quality of life: a qualitative study
No full textQuality of life (QoL) has a weak relationship with lung function (LF) impairment in COPD; some cope well despite poor LF, while others suffer disproportionate QoL impairment despite well-preserved LF. Adjuvant non-pharmacological interventions such as rehabilitation and psychological/behavioural support may help if acceptable and targeted appropriately, but are under-used and sometimes declined by patients. This study aimed to explore and understand variations in experiences and coping strategies in patients with different severities of disease and disease-specific QoL. Thirty four participants were purposively sampled across a spectrum of LF and QoL impairment, to cover a grid of sub-groups (‘very severe LF, good QoL’, moderate LF, poor QoL’ etc.). Semi-structured interviews, digitally recorded, were analysed by thematic analysis. Data saturation was achieved. Four themes emerged: symptom impact, coping strategies, coping challenges, support needs. Most described employing multiple coping strategies yet over half reported significant challenges coping with COPD including: psychological impact, non-acceptance of diagnosis and/or disease progression, effects of comorbidities and inadequate self-management skills. Approximately half wanted further help, ideally nonpharmacological, across all LF impairment groups but mainly with lower QoL. Those with lower QoL additionally reported greater psychological distress and greater use of non-pharmacological support strategies where accessible. Patients who develop effective coping strategies, have better quality of life independent of objective LF, whereas others cope poorly, are aware of this, and report more use of non-pharmacological approaches. This study suggests that severely impaired QoL, irrelevant of lung function, is a powerful patient centred indication to explore the positive benefits of psychological and behavioural support for distressed
Presentiment or entanglement? An alternative explanation for apparent entanglement in provings
No full textA number of authors have recently discussed the possible role entanglement in homeopathy. Walach et al have published a homeopathic proving which they interpreted as demonstrating entanglement between placebo and verum groups in a proving. The lack of a ‘run-in’ period was a weakness of this trial.We present further results of our proving of Belladonna which show that subjects who reported symptoms during the placebo run-in period (‘presentiment provers’) were more likely to report symptoms during the treatment period. This data suggests and the observations of Walach et al may be explicable by conventional mechanisms including differential reporting and constitutional typ
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