The Development, Validity, and Responsiveness of a Patient-Centred Outcome Measurement Tool for Evaluating Integrative Medicine Interventions.

Background: The paper sets out the development, validity, and responsiveness of the Integrative Medicine Treatment Evaluation Form (IMTEF), which has been designed to measure the effects of complementary and integrative therapy (CIT) interventions in cancer and palliative care (PC) patients in a National Health Service (NHS) hospital setting. Treatment evaluation is essential for ensuring safety and quality of services, for meeting NHS governance requirements. It also helps to add to the evidence base for complementary and integrative therapies through collecting data about treatments. Methods: A number of different Patient Reported Outcome Measures (PROMs) tools were reviewed in order to design the IMTEF, which details questions that captures both quantitative and qualitative data. The IMTEF was reviewed by patients and a range of health care practitioners. Results: IMTEF's validity is supported by feedback from health care practitioners and patients, by its ability to detect different degrees of change in relation to change scores, and by its correlations with Visual Analog Scale (VAS) scores. Conclusion: The IMTEF can be used to assess the effects of therapeutic bodywork and CITs when many of the patients do not have the capacity or the time to answer many questions, and when therapists do not know in advance the number of treatments that patients will be able to receive. Because of the way it is structured, it can also assess the effects after a number of sessions.

Scarring alopecia in chronic cutaneous lupus erythematosus with neutrophils: A new scenario with therapeutic connotations.

The relationship between autoinflammatory and autoimmune conditions has been demonstrated in recent decades. Several autoimmune conditions exhibit an autoinflammatory component, which can manifest in various ways. Neutrophilic dermatosis in the context of lupus erythematosus (LE) is one example. Otherwise, neutrophils are rare in LE, except for the bullous variant and nonbullous neutrophilic LE. In this paper, we describe a case of scarring alopecia due to LE that stopped responding to a treatment that had been effective for years. The biopsy specimen demonstrated the presence of neutrophils in the inflammatory infiltrate. A treatment with dapsone was prescribed and yielded rapid improvement. This first case of scarring alopecia in the context of nonbullous neutrophilic LE emphasizes the importance of the infiltrate in determining the optimal therapeutic choice.

Shiatsu and Acupressure: Two Different and Distinct Techniques.

BACKGROUND: Although shiatsu has been taught in specialized schools in Japan since 1940, there is a limited amount of research for its practice. As a result, authors substitute shiatsu with acupressure to use available research on acupressure. It is the position of the authors that, while the two share common aspects, they are substantively different. This project was undertaken to describe technical differences and advocate for a clear distinction, especially in research studies and academic discussions. METHODS: To understand whether it is appropriate to include acupressure studies in the evidence for shiatsu an analysis of the references included in a frequently cited systematic review was conducted to collect information about the protocols. In addition, a preliminary exploration of shiatsu practitioners' perceptions about the differences between shiatsu and acupressure is described. This exploration used videos of shiatsu and acupressure techniques and asked practitioners to comment on their perception of similarity. DISCUSSION: The results identified several key technical differences between the two, including type of pressure applied, the positioning of the thumb, and the way in which body weight is used. Researchers should separate shiatsu and acupressure in their designs and purposively choose one or the other. To facilitate such clarification, we have proposed a definition for shiatsu that may facilitate the differentiation between these two techniques. CONCLUSION: The authors hope to stimulate discussion about the differences between shiatsu and acupressure, and to question the appropriateness of using acupressure studies as evidence of the efficacy of shiatsu. A true understanding of the efficacy of shiatsu cannot be determined until studies use a common definition of shiatsu and discontinue substituting acupressure research for evidence of shiatsu efficacy. When this happens, it is proposed that a clearer picture of the safety, efficacy, and mechanism of action of both shiatsu and acupressure will emerge.

Extinction of the initial within-compound association established in a blocked preexposure to two compound flavours / Extinción de la asociación intracompuesto inicial establecida en una preexposición por bloques a dos compuestos de sabores

Extinction of the A↔X association after blocked preexposure to AX-BX was studied in two experiments. In Experiment 1, two groups of rats received long (14 trials) or short (4 trials) blocked preexposure to AX-BX and subsequent conditioning of X. The results showed that the AX association was equally preserved after long and short preexposure. Experiment 2 studied the effect of blocked preexposure to 0, 1 or 2 ruptures of the AX association on extinction. In this experiment a "rupture" is produced when, in subsequent blocks, one element of the original compound is presented in compound with a different element. A significant extinction was observed only when the AX association was broken twice

Se estudió la extinción de la asociación A↔X después de una preexposición por bloques a AX-BX en dos experimentos. En el Experimento 1, dos grupos de ratas recibieron una preexposición en bloques larga (14 ensayos) o corta (4 ensayos) a AX-BX y posteriormente se condicionó X. Los resultados mostraron que la asociación AX se preservó igualmente tanto después de la preexposición larga como de la corta. En el Experimento 2 se estudió el efecto de la preexposición por bloques a 0, 1 o 2 rupturas en la extinción de la asociación AX. En este experimento una "ruptura" se produce cuando, en los posteriores bloques, uno de los sabores que forman el compuesto inicial es presentado formando un compuesto con otro sabor diferente. Solo se observó una extinción significativa cuando la asociación AX se rompió dos veces

Preservation of within-compound associations after blocked preexposure to two compound flavors.

Three experiments investigated the extinction of the within-compound A↔X association established when two compound flavors, AX and BX, are preexposed in blocks (i.e., AX, AX, AX, ... BX, BX, BX). In Experiment 1, a group of rats received preexposure to a block of AX trials followed by a second block of BX trials (AX-BX), while a second group received blocked preexposure to the same stimuli in the opposite order (BX-AX). Subsequently, flavor A was paired with lithium chloride. This conditioning resulted in a similar reduction of consumption of flavor X in both groups. In Experiment 2 four groups of rats received blocked preexposure to AX-BX, AX-B, A-BX, or A-X. After aversive conditioning of X, consumption of A and B was significantly lower for the groups which received these flavors paired with X than for the groups for which these flavors were presented isolated. In Experiment 3 a group of rats was preexposed to a block of SaltX presentations followed by a block of BX presentations (SaltX-BX), and a second group received blocked preexposure to (BX-SaltX). After subsequent sodium depletion, consumption of X was high and similar for the SaltX-BX and for the BX-SaltX groups. These results indicate that the within-compound association established in the first block of a blocked preexposure is not extinguished when the preexposure phase is concluded.