Review of economic analysis of available interventions on idiopathic short stature: A protocol for systematic review and meta-analysis.

BACKGROUND: Idiopathic short stature (ISS) causes a high economic burden worldwide. As part of a research project that synthesizes economic evidence for Korean medicine treatment of ISS, we describe the methods that will be used for the comprehensive review of articles that analyze health-related economic evaluation for available interventions for ISS using a systematic review methodology. METHODS: Eight electronic English, Korean, and Chinese databases will be searched from their inception until December 2020 to identify studies on the economic evaluation of available interventions on ISS, without language, study design, or publication status restrictions. From the included studies, the effectiveness, utility, and cost data will be collected as the outcome measures by two researchers independently. Descriptive analysis of individual studies will be conducted. If it is judged that the interventions and outcomes of the included studies are sufficiently homogeneous, we will attempt a quantitative synthesis through meta-analysis using Review Manager version 5.4 software (Cochrane, London, UK). RESULTS: This study will summarize the evidence regarding the economic evaluation of available interventions for ISS. CONCLUSIONS: The findings of this review will help clinicians and patients in evidence-based decision-making in clinical settings and help policy makers develop effective policies and distribute resources based on the available evidence.

SoftPuntura, software educativo sobre Acupuntura y Digitopuntura / Soft-Puncture, educational software on acupuncture and digital acupuncture

Introducción: la Medicina Natural y Tradicional actualmente se aplica como estrategia curricular en las carreras de las ciencias médicas, responde al lineamiento 138 de la política del partido. Objetivo: diseñar un software educativo sobre los principales puntos de acupuntura y digitopuntura para desarrollar habilidades teóricas y prácticas en los estudiantes de la carrera de medicina. Método: se realizó un estudio de desarrollo tecnológico en la Universidad de Ciencias Médicas de Pinar del Río, de octubre de 2014 a febrero de 2015. Como universo se tuvo en cuenta a todos los estudiantes de la carrera de medicina y profesores que imparten contenidos relacionados con el tema; la muestra de 60 estudiantes y 30 profesores se seleccionó de forma aleatoria simple, se utilizaron métodos teóricos y empíricos, se realizó un análisis estadístico porcentual, se diseñó y aplicó el software teniendo en cuenta las necesidades de aprendizaje. Resultados: se determinó un alto porciento de estudiantes que dominaron los principales contenidos sobre las técnicas de acupuntura y digitopuntura, los cuales eran deficientes antes de su aplicación, además se obtuvo aceptación por el estudiantado y los profesores, por lo que fue considerado como una útil herramienta para el estudio de la Medicina Natural y Tradicional en la carrera de Medicina. Conclusiones: se diseñó un recurso del aprendizaje que permite interactuar con la acupuntura y la digitopuntura, de fácil acceso y transportación, útil a estudiantes y profesores, lo que permitió el perfeccionamiento del proceso docente educativo en las asignaturas de la carrera de medicina(AU)

Introduction: Natural and Traditional Medicine is currently applied as a curricular strategy in medical science studies, it responds to the 138th guideline of the policies of the Cuban Communist Party. Objective: to design educational software on the main points of acupuncture and digital acupuncture to develop theoretical and practical skills in medical students. Method: a study of technological development was carried out at Pinar del Rio University of Medical Sciences, from October 2014 to February 2015. As a target group, all the students of the medical professions and professors who taught contents related to the subject were taken included; the sample of 60 students and 30 professors was chosen in a simple randomized approach, theoretical and empirical methods were used, a percentage statistical analysis was done, the software was designed and applied considering the needs of learning. Results: a high percentage of students who mastered the main contents on the acupuncture and digital acupuncture techniques were determined, which were deficient before their application, besides of having acceptance by the student body and the professors, because it was considered as a useful tool for the study of Natural and Traditional Medicine in medical studies. Conclusions: a learning resource was designed to interact with acupuncture and digital acupuncture, with easy access and transportation, useful to students and professors, which allowed the improvement of the educational process in the subjects of the medical studies(AU)

An economic evaluation of Alexander Technique lessons or acupuncture sessions for patients with chronic neck pain: A randomized trial (ATLAS).

OBJECTIVES: To assess the cost-effectiveness of acupuncture and usual care, and Alexander Technique lessons and usual care, compared with usual GP care alone for chronic neck pain patients. METHODS: An economic evaluation was undertaken alongside the ATLAS trial, taking both NHS and wider societal viewpoints. Participants were offered up to twelve acupuncture sessions or twenty Alexander lessons (equivalent overall contact time). Costs were in pounds sterling. Effectiveness was measured using the generic EQ-5D to calculate quality adjusted life years (QALYs), as well as using a specific neck pain measure-the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: In the base case analysis, incremental QALY gains were 0.032 and 0.025 in the acupuncture and Alexander groups, respectively, in comparison to usual GP care, indicating moderate health benefits for both interventions. Incremental costs were £451 for acupuncture and £667 for Alexander, mainly driven by intervention costs. Acupuncture was likely to be cost-effective (ICER = £18,767/QALY bootstrapped 95% CI £4,426 to £74,562) and was robust to most sensitivity analyses. Alexander lessons were not cost-effective at the lower NICE threshold of £20,000/QALY (£25,101/QALY bootstrapped 95% CI -£150,208 to £248,697) but may be at £30,000/QALY, however, there was considerable statistical uncertainty in all tested scenarios. CONCLUSIONS: In comparison with usual care, acupuncture is likely to be cost-effective for chronic neck pain, whereas, largely due to higher intervention costs, Alexander lessons are unlikely to be cost-effective. However, there were high levels of missing data and further research is needed to assess the long-term cost-effectiveness of these interventions.

Comparative Assessment of the Heart's Functioning by Using the Akabane Test and Classical Methods of Instrumental Examination.

Acupuncture physicians have studied the application of reflexotherapy to cardiology. However, no one has investigated the connection of ancient Chinese diagnostic methods with modern tools. A total of 102 patients (54 men and 48 women) with heart pathology, namely, sick-sinus syndrome, Wolff-Parkinson-White syndrome, and atrioventricular blockade, were studied using the usual instrumental methods (transesophageal electrophysiological study of the heart, echocardiography), after which they underwent Akabane thermopuncture testing as in traditional Chinese medicine. The results of cardio examination from one side of the Akabane test with that from the other side were compared by means of a multiple stepwise regression analysis. We revealed the effects on the characteristic pattern of acupuncture channel lesions inherent in a definite heart pathology, i.e., the most vulnerable acupuncture channel (AC), of such factors as disturbances of the contractile, conductive, or automatic heart functions, and changes in the chambers' size or circulation volume. Сhanges in the indices of the left and the right branches of these channels usually reflect the opposing natures of the changes in these indicators, which should be considered in reflexotherapy. The main value of the Akabane test along with the use of mathematical analysis lies in early, quick, and inexpensive detection of the above-mentioned heart disturbances.

Actitudes de los gerentes o directores del área de salud de las entidades promotoras de salud del régimen contributivo (EPS C), frente a la inclusión de la acupuntura en el modelo de atención actual en la ciudad de Bogotá / Attitudes of the managers or directors of the health area of the health promoting entities of the contributory regime (EPS C), compared to the inclusion of acupuncture in the current care model in the city of Bogotá

Introducción: El objetivo de la investigación consistió en describir los conocimientos, actitudes y prácticas que tienen los Gerentes o Directores del área de salud de las entidades promotoras de salud del régimen contributivo (EPS C) frente a la prestación de la Medicina Tradicional China Acupuntura en el modelo de atención actual en la ciudad de Bogotá, durante el año 2012. La investigación buscó aportar elementos de análisis sobre algunos aspectos de tipo administrativo que regulan la construcción de modelos de atención al interior de las entidades promotoras de salud (EPS C), sobre la prestación de servicios de Acupuntura. Metodología: Se realizó un estudio descriptivo, transversal, aplicando una encuesta de Conocimientos, Actitudes y Prácticas a los 11 Gerentes o Directores de todas las entidades promotoras de salud (EPS C) de la ciudad de Bogotá, mediante la aplicación de 17 preguntas basadas en una escala de Likert. Resultados: El 100% de las entidades promotoras de salud (POS C) pudieron ser evaluadas. Obteniendo que los conocimientos en el 52% de los encuestados eran altos, en 29% medios, y en 19% bajos. En las prácticas, 71% tenían actitudes favorables, 22% neutras, y 7% desfavorables. Por último en prácticas, 27% eran altas, 31% medias, y 42% bajas. Conclusiones: Se evidencia una actitud favorable hacia la acupuntura por parte de los encuestados en un contexto de salud que no motiva su utilización, ocasionado por el desconocimiento sobre su mecanismo de acción, seguridad, eficacia, presencia de eventos adversos, y ausencia de estudios científicos que respalden su uso.

Acupuncture: a useful tool for health care in an operational medicine environment.

Acupuncture is a form of medical care that originated in China; it has evolved and progressed over thousands of years to become one of the most commonly used forms of health care throughout the world. Allopathic (Western) medicine has begun to seriously investigate and to use this system only in the past three decades. Although acupuncture's mechanisms for healing are not fully understood, it helps many conditions. Using acupuncture reduces or eliminates the need for expensive medications and the potential risk of adverse events resulting from medications, with cost savings and health benefits to patients. During a deployment of naval combat engineers to Iraq in support of Operation Iraqi Freedom, acupuncture was used in the health care of sailors, Marines, and soldiers. It objectively and subjectively improved the health of troops in the field. Troops were able to function while being treated, reducing or avoiding sick in quarters or light limited duty status and saving operational man-days. Acupuncture in the right hands can serve as a health force multiplier (amplifying a provider's clinical impact) and can be integrated into routine health care, whether in garrison or in the field.

Effect of magnitopuncture on sympathetic and parasympathetic nerve activities in healthy drivers--assessment by power spectrum analysis of heart rate variability.

The object of this study was to assess the effects of magnitopuncture applied to Dazhui (DU14) point and Neiguan (PC6) points on sympathetic and parasympathetic nerve activities by power spectrum analysis of heart rate variability in healthy drivers during simulated driving. Using power spectrum analysis, the low frequency (LF) and high frequency (HF) components of heart rate variability can be calculated reflecting the sympathetic and parasympathetic activity. The 40 healthy male subjects were randomly divided into two groups: A (study group) and B (control group). All subjects were required to be well rested before the experiment. The subjects of both groups were required to perform a simulated driving task for 3 h. During the driving, magnitopunctures were applied to the DU14 and PC6 points for A while the subject performed the task for 2.5 h, and for B magnitopunctures were applied to non-acupuncture points which were 1.5 cm away from the two acupuncture points respectively over the same time. Subjective response to a questionnaire was obtained after the simulated task in the two groups. At the end of the driving task the LF component in normalized units (NU) had decreased significantly ( P<0.05) indicating a reduced sympathetic nerve activity and the HF component (NU) increased significantly ( P<0.05) indicating a increased parasympathetic nerve activity for A compared with pre-stimulation while for B no significant differences were observed. There were significant group differences in LF (NU), HF (NU) and LF:HF at the end of the driving task ( P<0.05). It was concluded that a modulating effect of magnitopuncture on sympathetic and parasympathetic nerve activities in healthy subjects was associated with the acupuncture points. The findings represent physiological evidence that magnitopuncture may reduce mental fatigue in healthy drivers.

Establishment of a nurse-run acupuncture treatment for hayfever. By Mary Anne Cochrane [corrected].

This interview describes how the need to set up an acupuncture clinic for the treatment of hayfever, was identified in a large teaching practice in south-east London. It then details the preliminary consultations for establishing the service, while taking into consideration the UKCC (1992a,b, 2000) guidelines, especially in relation to nurses' accountability and recognition of boundaries. It examines the issues of training and consultation time, as well as costs to the practice, and evaluates the benefits and costs of treatment to the patient. It also identifies some of the potential problems that may be encountered in providing acupuncture. The summary includes some guidance to others considering implementation of a similar service.