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BACKGROUND:There is a need for more Comparative Effectiveness Research (CER) to strengthen the evidence base for clinical and policy decision-making. Effectiveness Guidance Documents (EGD) are targeted to clinical researchers. The aim of this EGD is to provide specific recommendations for the design of prospective acupuncture studies to support optimal use of resources for generating evidence that will inform stakeholder decision-making.METHODS:Document development based on multiple systematic consensus procedures (written Delphi rounds, interactive consensus workshop, international expert review). To balance aspects of internal and external validity, multiple stakeholders including patients, clinicians and payers were involved.RESULTS:Recommendations focused mainly on randomized studies and were developed for the following areas: overall research strategy, treatment protocol, expertise and setting, outcomes, study design and statistical analyses, economic evaluation, and publication.CONCLUSION:The present EGD, based on an international consensus developed with multiple stakeholder involvement, provides the first systematic methodological guidance for future CER on acupuncture.

published_or_final_version / abstract / Obstetrics and Gynaecology / Master / Master of Philosophy

published_or_final_version / Paediatrics and Adolescent Medicine / Master / Master of Philosophy

published_or_final_version / Speech and Hearing Sciences / Doctoral / Doctor of Philosophy

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology, Homoeopathy, Technikon Natal, 1996. / The aim acupuncture of this study was to compare the treatment and homoeopathic treatment smoking cessation. The study was a clinical trial, in which an acupuncture treatment group group. Thirty was compared with a homoeopathic treatment volunteers who were anxious to stop smoking participated in the trial and were randomly divided into two groups. One group received acupuncture treatment (n=l5), while the other group received homoeopathic treatment (n=l5) in the form of isotherapy. The study took place over a period of 9 months and each participant completed a 3-month trial period. Prior to the trial period each sUbject completed a set of questionnaires. These ~ncluded the Fagerstrom Tolerance Test which determined their dependence on nicotine; a questionnaire to determine if the subject smoked predominantly for reduction of negative affect, for positive affect or as an habitualaddiction; and a questionnaire to determine the subject's estimation of the health risks of smoking. / M

A dissertation proposal presented in partial fulfilment of the requirements for the Master's Degree in Technology: Chiropractic, Technikon Natal, 2002. / Lateral epicondylitis is a relatively common disorder affecting approximately one third of the nearly thirty-two million tennis players worldwide. It usually presents as a chronic disorder that follows a remitting relapsing course, and as such represents a challenge to manage. At present the scientific literature does not favour any particular treatment modality and as such well designed placebo studies are required to assess the efficacy of the various modalities of treatment, with a long term view of establishing an effective treatment protocol to manage lateral epicondylitis. The purpose of this study was to determine the efficacy of dry needling the posterior distal muscles of the upper extremity as a treatment for lateral epicondylitis. Sixty patients were included in the study. They all under went a case history, physical examination and an elbow regional examination. They were then randomly allocated into the experimental or control groups. The thirty patients in the experimental group received dry needling while the thirty included in the control group received placebo or 'sham' needling. All participants in the study received three treatments over a nine-day period with subjective and objective measurements being taken before the 1st. 2nd, and 3rd treatments, with a 4th being taken after the third treatment. Examination of the statistical data revealed that a significant improvement in the experimental group versus the control group in terms of both subjective / M

分娩痛是一種生理性的疼痛，分娩過程中劇烈疼痛痛苦難以忍受，同時使產婦焦慮、緊張和恐懼，致使產婦血中兒茶酚胺、腎上腺皮質激素增高，導致血壓升高，心臟負荷加重﹔產婦由於疼痛呼喊、過度換氣、耗氧量增加，可導致呼吸性堿中毒，從而影響胎盤血供，導致母兒出現低氧血症。隨著產程進展、疼痛加劇，產婦血壓升高、呼吸頻率增快，過度耗氧，引起胎兒宮內窘迫，種種危險和痛苦導致剖宮產率逐年上升，加之藥物麻醉對產婦和胎兒都可以產生一定的不良反應。因此，合理地運用適當的疼痛緩解措施，可以使疼痛應激反應減輕甚至消失，提 高圍產期品質，分娩鎮痛日益受到重視。 研究目的 研究希望通過對現有關於通過穴位進行分娩鎮痛的臨床研究類文獻搜集、整理、分析，從而對通過穴位分娩鎮痛的常用方法、常用穴位、有效率等等方面做一個較為全面的展示，並對當前通過穴位分娩鎮痛的臨床研究的現狀和可能存在的問題進行探討。 方法 以中國期刊全文資料庫進行標準檢索，檢索選項為“主題”，檢索詞為“針刺”or“穴位”並包含“分娩鎮痛”or“分娩痛”，時間年限設定為2004年－2014 年。按納入排除標準進一步篩選文獻。 小結 就通過穴位分婉鎮痛的常用方法、常用穴位、有效率、產程變化、產後出血量等等方面進行文獻研究總結後，發現近年來通過穴位分娩鎮痛的臨床實驗文獻逐漸增多，初步證明穴位分娩鎮痛安全有效，但目前可搜到的臨床文獻存在臨床研究方式較為單一、選穴單一、結論標準不統一、隨機對照試驗設計不嚴謹等等問題，提示我們進行進一步研究。 關鍵字：分娩鎮痛﹔針刺鎮痛﹔ 穴位鎮痛﹔ 分娩痛﹔

O stress pode ser definido como uma reação complexa, necessária e benéfica ao organismo, porém quando permanece por um período prolongado cria-se um desequilíbrio no funcionamento global orgânico, enfraquecendo o sistema imunológico e deixando o indivíduo exposto a infecções e doenças oportunistas. Diversos tratamentos são propostos para o controle do stress dentre eles está à acupuntura, uma técnica milenar que consiste na inserção de agulhas em pontos específicos da pele. O eletroencefalograma (EEG) é um instrumento de registro gráfico das variações do potencial de membrana dos neurônios corticais, seu registro e sua interpretação é um processo rotineiro de diagnóstico neurológico e neste caso foi utilizado para verificar se existe alguma alteração no espectro de frequência do EEG imediatamente após a aplicação da acupuntura. Foram selecionados 38 sujeitos randomizados em grupo controle (n= 13), grupo acupuntura (n=13) e grupo eletroacupuntura (n=12). Antes das intervenções os sujeitos foram submetidos ao Inventário de Sintomas de Stress para adultos de Lipp (ISSL), a escala visual analógica (EVA) de stress, mensurados frequência cardíaca (FC) e pressão arterial (PA). As intervenções ocorreram durante vinte minutos e vinte minutos antes e depois das intervenções foram realizados os registros de EEG. Após o término do EEG os sujeitos novamente responderam ao EVA e foram mensurados FC e PA. Para análise dos dados foram utilizados ANOVA, correlação, BOOTSTRAP e teste t-student. Não foram encontradas diferenças significativas em relação ao espectro de frequência do EEG e a EVA antes e depois das intervenções, houve uma diminuição significante da FC após as intervenções. Não houve alteração da PA durante todo o processo. A acupuntura e a eletroacupuntura não apresentaram efeitos imediatos significativos após sua realização no espectro de frequência do EEG, embora tenha apresentado uma tendência a alterações. Não houve relação do espectro do EEG e os quesitos questionário de Lipp e EVA / Stress can be defined as a complex, necessary and beneficial response by the body, but when it remains for a prolonged period creates an imbalance in the overall organ function, by weakening the immune system, leaving exposed the individual opportunistic infections and diseases. Several treatments are proposed for the control of stress among them is acupuncture, an ancient technique that involves inserting fine needles into specific points on the skin. The electroencephalogram (EEG) is a tool of graphic record of the variations of the membrane potential of cortical neurons registration and its interpretation is a routine process of neurological diagnosis and this case was used to verify if there is any change in the frequency spectrum of the EEG immediately after application of acupuncture. 38 subjects randomized into control group (n = 13), acupuncture group (n = 13) and electroacupuncture group (n = 12) were selected. Before the intervention the subjects were submitted to the Inventory of Stress Symptoms for adults Lipp (ISSL), a visual analog scale (VAS) of stress, measured heart rate (HR) and blood pressure (BP). The interventions occurred for twenty minutes and twenty minutes before and after interventions EEG records were performed. After the end of the EEG subjects again responded to the EVA and HR and BP were measured. For data analysis, ANOVA, correlation, BOOTSTRAP and student t test were used. No significant differences were found in relation to the frequency of the EEG spectrum and VAS before and after the interventions, there was a significant decrease in HR after the interventions. There was no change in BP during the entire process. Acupuncture and electroacupuncture showed no significant immediate effect after its completion in the EEG frequency spectrum, although it had a tendency to change. There was no relation of the EEG spectrum and the questions questionnaire Lipp and EVA