...Health care providers may use placebos intentionally or unintentionally. When used intentionally, as in giving a sugar pill for pain or prescribing oral vitamins for fatigue, an element of deception is involved. The doctor does not believe the treatment is effective for the condition but believes it will be helpful for the patient because of the patient’s belief in the doctor’s prescription. This is an ethically compromised position regardless of the possible benefit to be derived and usually is not considered acceptable practice. Unintentionally, providers often create placebo responses just by their enthusiastic endorsement of and belief in a treatment. In this case, there is no deception, as the provider genuinely believes in the treatment...
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...S0895-4356(97)00203-5 The Powerful Placebo Effect: Fact or Fiction? Gunver S. Kienle* and Helmut Kiene ¨ Institut fur Angewandte Erkenntnistheorie und Medizinische Methodologie, D-79112 Freiburg, Germany ABSTRACT. In 1955, Henry K. Beecher published the classic work entitled ‘‘The Powerful Placebo.’’ Since that time, 40 years ago, the placebo effect has been considered a scientific fact. Beecher was the first scientist to quantify the placebo effect. He claimed that in 15 trials with different diseases, 35% of 1082 patients were satisfactorily relieved by a placebo alone. This publication is still the most frequently cited placebo reference. Recently Beecher’s article was reanalyzed with surprising results: In contrast to his claim, no evidence was found of any placebo effect in any of the studies cited by him. There were many other factors that could account for the reported improvements in patients in these trials, but most likely there was no placebo effect whatsoever. False impressions of placebo effects can be produced in various ways. Spontaneous improvement, fluctuation of symptoms, regression to the mean, additional treatment, conditional switching of placebo treatment, scaling bias, irrelevant response variables, answers of politeness, experimental subordination, conditioned answers, neurotic or psychotic misjudgment, psychosomatic phenomena, misquotation, etc. These factors are still prevalent in modern placebo literature. The placebo topic seems to invite sloppy...
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...Is it ethically sound to use a placebo in clinical trials? Should medical researchers be allowed to conduct research in developing communities? These are some of the questions that bioethicists debate when discussing the use of human subjects in medical experimentation. I argue that it is not ethically permissible to use human subjects in developing communities for medical research that has a placebo control group because it is exploitative and values certain human life over others. In some research initiative, such as the AZT trials, HIV positive poor pregnant women in Africa were used as test subjects. The study used a placebo control group as well as a treatment group to test the effectiveness of a lower drug dosage. Placebos as a control...
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...blood clotting. These symptoms are late manifestations of a disease process that is initiated in early pregnancy and is the major cause of maternal mortality and morbidity (MORLEY 2004) The purpose of this literature review is to critically analyse the research available for the use of aspirin in the prevention of pre-eclampsia. However it was difficult to find the relevant articles that related to only the use of aspirin and not a combination of aspirin and other hypertension reducing medication. Also a lot of evidence pointed to the administration of magnesium sulphate based medication working in combination with aspirin or aspirin use in IVF conception methods. The search for relevant articles began with a search in Pub Med .Using the words, “Pre- eclampsia AND aspirin”, gave 494 results. Limitations were then applied to narrow the search. Firstly the search was narrowed to relevant article published in the last 5 years which reduced the finding to 88. Then only relevant articles in relation to the human’s species were applied and this reduced the number of articles to 77. When the search was limited to randomised controlled trials only this left only 4 relevant articles. However 3 of these studies did not apply to the research question as they were to do with the use of aspirin in IVF conceptions. These articles were disregarded from the other article. Therefore one relevant study was found in this search....
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...DULOXETINE VS PLACEBO FOR URINARY INCONTINENCE DULOXETINE VS PLACEBO FOR URINARY INCONTINENCE TAMMY RILEY OKLAHOMA PANHANDLE STATE UNIVERSITY STRESS INCONTINENCE Stress urinary incontinence is the involuntary leakage of urine on effort or exertion or on sneezing, coughing, or laughing. These symptoms affect many women between the ages of 33-75 years of age. The current treatment options for stress incontinence is limited to pelvic floor muscle training, devices, behavioral interventions and surgery . EVIDENCE BASED PRACTICE GUIDELINES The title of the guideline is Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guidelines. The guideline was developed as a framework for diagnosis and treatment of non-neurogenic overactive bladder (OAB) and to provide direction to clinicians and patients regarding how to recognize non neurogenic overactive bladder. The direction of the study was to “conduct a valid diagnostic process and approach treatment with the goals of maximizing symptom control and patient quality of life while minimizing adverse events and patient burden” (National Guideline Clearinghouse, 2014). Another guideline objective was to serve as a guide for all types of providers who evaluate and treat OAB patients, including those in general practice as well as those who specialize in various branches of medicine. The guideline of the evidence based practice states that the first line of treatment...
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...Psychology Journal Critique Paper Example Hopker, Foad, Beedie, Coleman, & Leech (2010) performed a study to determine how conditioned stimuli affect subsequent response to unconditioned stimuli. They used a placebo to act as conditioned analgesia to show how it affected subsequent analgesic response, which they coupled with an individual’s expectations of outcome of the interventions; positive outcome is expected if a person holds positive beliefs and vice versa (Hopker, Foad, Beedie, Coleman, & Leach, 2010). The researchers applied their theory in sports medicine to show how a placebo analgesic affected the pain endurance after an injury. Previous studies have demonstrated that a person’s expectation of relief from pain has the ability to...
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...Stimulation) unit for pain management?” Bi, X., Effects of transcutaneous electrical nerve stimulation on pain in patients with spinal cord injury: a randomized controlled trial. Journal of Physical Therapy Science 27: 23-25 (2014). Xia Bi, Department of Rehabilitation Medicine, Shanghai Gongli Hospital, China, focused his research on investigating the effectiveness with using transcutaneous electrical nerve stimulation on patients in pain due to a spinal cord injury. Bi states that there have been many clinical papers that have reported positive effects of TENS in pain management but controversy exists over which conditions can be treated using this method. He states that if TENS were shown to be effective method of alleviating pain in Spinal Cord Injury (SPI) patients, it would decrease medical costs and improve quality of life. Bi discusses how their results are consistent with those of previous studies (Celik EC, The effect of low frequency TENS in the treatment of neuropathic pain in patients with spinal cord injury) which reported the effectiveness of TENS in the pain relief of SCI patients. The study had several limitation which were mention in the paper stating that the sample size of subjects was insufficient for generalization of the results, a follow up was not performed, and lastly they did not compare the efficacy of low frequency TENS with high frequency TENS because of the limited number of subjects. The study was fairly easy to read regarding vocabulary as well as...
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...Simon Fraser University Burnaby, BC, Canada V5A 1S6 (604) 291-4104 FAX: (604) 291-4920 email: bushe@sfu.ca An edited version of this paper was published in the Journal of Applied Behavioral Science, 1995, 31:1, 13-30 Gervase R. Bushe (Ph.D. Case Western Reserve) is Associate Professor, Organization Development in the Faculty of Business Administration, Simon Fraser University, Burnaby, BC, Canada, V5A 1S6. Graeme Coetzer (MBA Simon Fraser University) is a doctoral student in organization development in the Faculty of Business Administration, Simon Fraser University. Appreciative Inquiry as a Team Development Intervention: A Controlled Experiment ABSTRACT In a controlled laboratory experiment the effects of a team development intervention based on the theory of appreciative inquiry was compared with task oriented team development and lectures on group processes, outcomes and performance. 96 undergraduate students in two semesters of an introductory organization behaviour course participated in 4 person teams and had 13 weeks to complete a task worth 25% of each member's final grade. One third of teams received an appreciative inquiry intervention, another third received a task oriented team development intervention and the final third received a lecture on group dynamics (placebo). Pre and post surveys assessed group process and outcomes; project grades were used to assess task performance. ANOVAs and ANCOVAs on each of the process...
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...The veterans I serve has spent years in a military only to come home to a world who looks down on them because they are no longer normal and find it very hard to adjust to the civilian world due to the imagines stained on their brain from the world. In the wars in Iraq and Afghanistan, about one in ten returning soldiers seen in VA have a problem with alcohol or other drugs (Veteran Affairs 2012). As human service provider I witness this co diagnosis of PTSD ( Post Traumatic Stress Disorder) and SUD (Substance Abuse Disorder) daily and it has encouraged me to form a opinion. After some deep thought I would like to look into the efficiency of the treatment prescribed to solders suffering from PTSD and which is more effective. In this paper I will be looking Cognitive behavioral therapy offered when trying to treat PTSD and SUD . On the other hand I will like to look into a variety of medication therapy which includes anxiety medication and drugs known as a selective serotonin reuptake inhibitor. On an weekly basis I deal with over 100 veterans who have been diagnosed with PTSD and in most cases are dual diagnosed with SUD (Substance Use Disorder). While looking over these veterans charts I notice that many have attended Cognitive behavioral therapy,...
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...Running Head: CHRONIC CONSTIPATION TREATMENT Prucalopride for the treatment of chronic constipation in women in whom laxatives fail to provide adequate relief [Name of the Writer] [Name of the Institution] Prucalopride for the treatment of chronic constipation in women in whom laxatives fail to provide adequate relief Structured Abstract The literature analysis was carried out to determine the degree to explore former researches that have been carried out in the area of the usage of Prucalopride. In this regard, the usage and utility of Prucalopride was explored with reference to women who do not respond to the usage of laxatives in chronic constipation cases. An exploration of a vast volume of research established that the usage of Prucalopride has been explored extensively but there is a lack of literature that pertains to the usage of Prucalopride with regard to women in particular. Through a sequential elaboration of chronic constipation, chronic constipation in women, and an exploration of the trends that have come forth in the experimentation that has been carried out to ascertain the utility of Prucalopride for women where laxatives have not yielded results; it was revealed that there is a lack of extended experimentation in the area. Background Constipation Constipation is generally observed in western societies and it is not an uncommon recording in clinical practices. Due to the high frequency of the occurrence of constipation, it is generally...
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...acute ST-Elevation Myocardial Infarction (STEMI). His risk factors include obesity, Type II diabetes mellitus, and family history. Upon exam the patient asks why he has not been started on a beta blocker yet. He explains further that when his brother had a “heart attack” in 2005, he was immediately placed on a beta blocker because the cardiologist reported how beta blockers reduce mortality after myocardial infarction (MI). The patient wants to know if a beta blocker would reduce his chance of mortality? Using the Patient-Intervention-Comparator-Outcome (PICO) format we formulated the following question. In a 67-year-old male with multiple co-morbidities with MI (P), does treatment with a beta blocker (I), compared with no beta blocker or placebo (O), reduce mortality rate (O)? Risk Factors, Incidence and Prevalence of Disease * US incidence rates of cardiovascular disease, including MI, are seen in men more than women (Alexander et al., 2007). This trend is also true in Utah ("Impact of heart," 2007). * The incidence rates of cardiovascular disease increase with age (Alexander et al., 2007). * Risk factors for cardiovascular disease include not eating enough fruits and vegetables, lack of physical exercise, smoking cigarettes and the co-morbidities of diabetes, hypertension, hyperlipidemia, and obesity ("CDC national heart," 2010). * The clinical scenario patient was at high MI risk being male, over 65, diabetic and obese. Article Critiques * The following...
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...Descriptive and Inferential Statistics Paper Casie Thibeault PSY/315 July 27, 2013 Michelle A. Williams, PhD Descriptive and Inferential Statistics Paper The very word “statistics” seems to produce anxiety in most students - anxiety produced from its connection to mathematics. The first step in controlling anxiety is to understand the connection and just how useful statistics can be for comprehending information that has been gathered. A statistic is a representation of information, and its function is to help researchers either to organize, summarize, or understand data. The ability to describe data is essential when gathering statistics. Statistics can be broken down into two basic types: descriptive statistics and inferential statistics. Descriptive statistics are a summary of information that makes the data presented more easily understood. The descriptive method is limited to only the population in which the researcher is dealing with, and only describes that particular group (Purdue OWL, 1995-2013). Inferential statistics offers a more detailed conclusion regarding the hypothesis. A benefit of the inferential method is that it can be used to take a broader view of populations, making it possible to draw conclusions about sizeable groups of people (Purdue OWL, 1995-2013). In a nutshell, the simple way to distinguish between the two would be that descriptive statistics summarize and inferential statistics draw conclusions. Both descriptive and inferential...
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...as acupuncture, ayurveda, homeopathy, and naturopathic medicine; mind-body interventions like art therapy, dance therapy, hypnotherapy and meditation; biologically-based therapies like diet supplements, herbal products and megavitamins; manipulative and body-based methods such as chiropractic massage therapy, osteotherapy, reflexology and acupressure and finally energy therapies like biofield therapies (e.g. therapeutic touch and Qi gong) and bioelectromagnetic-based therapies like pulsed fields and magnetic fields (Wong, 2009). With a lot of controversy arising as to whether alternative medicine is quackery, this paper focuses on homeopathy with specific attention on the way it is believed to work and the various controversial issues about homeopathy such as dilution problem, quantum entanglement, and clinical evidence and whether it is simply an elaborate placebo. Homeopathy is a system of medicine whereby individuals are treated with natural substances which are highly diluted. These remedies trigger the body’s natural healing power thereby providing relief from physical and emotional states. The principle of homeopathy is Similia Similibus Curenturc meaning that “let likes cure likes”. The implication of this is that if a substance can bring about signs and symptoms in a health individual, the same...
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...Depression Treatment: The Natural Way There is a lot of controversy about appropriate treatments for depression. Today antidepressants are among the most prescribed medications in the world. Despite their popularity, research has suggested that antidepressant medications may not be as successful as people had imagined in counteracting depression (Johnson & Kirsch, 2008, p. 1). Extensive research and studies show that natural remedies are better than antidepressants for treating depression because there are fewer side effects, more health benefits and according to most studies, antidepressants are no more effective than placebos. Although there are many natural remedies for treating the symptoms of depression, this paper will focus on St. John’s Wort, omega-3 fatty acids, SAM-e and exercise. These four natural remedies are the most widely used and studied alternatives to treating depression. Side Effects According to Dr. Hyla Cass (2007) and a study done in 1998, prescription medication puts more than one million people in the hospital every year. The study also states that prescription medication kills more than one hundred thousand people per year. Doctor Cass (2007) states that there are almost no deaths from herbal use and that the side effects from herbs are usually mild. One report says that for every one million people prescribed antidepressants in a year, 30.1 of them will die from an overdose. Doctor Cass (2007) quotes Norman Farnsworth, Ph.D., (as cited in Cass...
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...medicine can also be used to treat diseases or conditions including, but not limited to: arthritis, anxiety/depression, stomach pain, headache/migraine, insomnia, and recurring pain. Among the most commonly used alternative medicines are fish oil/omega 3, glucosamine, Echinacea, Ginkgo Biloba, and Flaxseed Oil. This research paper will focus primarily on the herbal/dietary supplement St. John’s wort, which is commonly used to treat depression. Depression is a commonly treated disorder within the United States that has an estimated prevalence of 17% and is often complex in its diagnosis and treatment approaches (Linde, Ramirez, Mulrow et al., 1996). St. John’s wort has also been used for other ailments such as sleep disorders, healing cuts, and hemorrhoids. It commonly used to treat depression in Germany and Europe and is increasing in popularity within the United States. According to Gaster and Holroyd, between 1995 and 1997 the sales of St. John’s wort went from $20 million to $200 million (2000). Regardless of its historical and widespread use to treat depression, meta-analysis have revealed that St. John’s wort’s benefits are minimal when compared to placebos. St. John wort contains many active ingredients including, but not limited to: cyclopseudohypericin, hypericin, hyperforcin, isohypericin, protohypericin, and pseudohypericin (Pharmacology Weekly, 2008). Many of the ingredients have been directly associated to antidepressant effects. The supplement works through many...
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