Acupuncture as a tool to reduce nausea in terminally ill patients.

AIM: To investigate if acupuncture reduces nausea and vomiting in terminally ill patients. DESIGN: A comparative effectiveness research design was used to generate evidence-based knowledge close to practice for the use of clinicians. The sample size was calculated to 136 patients randomised into an intervention and a control group, respectively. Nausea and vomiting were measured using the EORTC QLQ-c15-PAL (European Organisation for Research and Treatment of Cancer, Quality of Life Questionnaire, core 15, Palliation). LOCATION: The trial was conducted among terminally ill patients admitted to three in-bed hospices in Demark. PARTICIPANTS: Terminally ill patients suffering from nausea and/or vomiting; 95% of patients had cancer. INTERVENTION: The intervention group received acupuncture in addition to usual care for three days. We used the acupuncture spots: Pericardium-6, Stomach-36, Liver-3 and Yin Tang. The control group received usual care only. RESULTS: In total, 136 patients were randomised, 24 patients withdrew resulting in a total sample of 112 patients: 52 patients in the intervention group and 60 patients in the control group. In the intervention group, 75% of the patients experienced a reduction of their nausea score after the intervention compared to 55% in the control group. The statistical difference was p = 0.028. In the intervention group, 52% of the patients did not experience nausea at all after the intervention compared to 30% in the control group. In the intervention group, 31% of the patients were still vomiting after the intervention compared to 34% in the control group; no statistically significant difference was found. CONCLUSION: Acupuncture reduced the experience of nausea among terminally ill patients but did not reduce vomiting. Thus, acupuncture is recommended to reduce nausea among terminally ill patients.

Using baseline and formative evaluation data to inform the Uganda Helmet Vaccine Initiative.

Motorcycles are an important form of transportation in Uganda, and are involved in more road traffic injuries than any other vehicle. The majority of motorcycles in Uganda are used as motorcycle taxis, better known locally as boda bodas. Research shows that a motorcycle helmet is effective at reducing a rider's risk of death and head injury. As part of the Uganda Helmet Vaccine Initiative (UHVI), researchers collected baseline and formative evaluation data on boda boda operators' helmet attitudes, beliefs, and behaviors to inform UHVI activities. Researchers collected data on motorcycle helmet-related attitudes and beliefs through focus group discussions and structured roadside interviews, and researchers conducted roadside observations to collect data on helmet-wearing behaviors. Of the 12,189 motorcycle operators and passengers observed during roadside observations, 30.8% of drivers and <1% of passengers were wearing helmets. The most commonly reported helmet-wearing barriers from the focus group discussions and structured roadside interviews were: (1) 'Helmet is uncomfortable', (2) 'Helmet is too hot', (3) 'Helmet is too expensive', and (4) 'Helmet is of low quality'. Researchers incorporated findings from the formative research into the UHVI campaign to increase motorcycle helmet use. Radio messages addressing helmet comfort and cost were widely aired throughout Kampala, Uganda. In addition, campaign staff held nine boda boda operator workshops, covering approximately 900 operators, in which the facilitator addressed barriers and facilitators to helmet use. Each workshop participant received a high-quality tropical motorcycle helmet. UHVI will continue to use a data-driven approach to future campaign activities.