Therapeutic touch for healing acute wounds.

BACKGROUND: Therapeutic Touch (TT) as a treatment modality has increased in popularity over the past two decades. Its efficacy in relation to the healing of wounds has been expounded in anecdotal publications. To date however there has been no systematic review. OBJECTIVES: To identify and review all relevant data to determine the effectiveness of TT in the promotion of wound healing. SEARCH STRATEGY: The Cochrane Wounds Group Specialised Trials Register and the Cochrane Central Register of Controlled Trials were searched in May 2003. The Cochrane Complementary Medicine field database was searched in September 2002. In addition the Sigma Theta Tau International Registry of Nursing Research (1983 to 2002) was also searched in September 2002. Furthermore searches of MEDLINE (1966 to 2003) were conducted in 1997 and May 2003, CINAHL (1982 to 2002) in September 2002 and dissertation abstracts in September 2002. SELECTION CRITERIA: All randomised or quasi-randomised controlled trials, which compared the effect of TT with a placebo, another treatment, or no treatment control were considered. Studies which used TT as a stand-alone treatment, or as an adjunct to other therapies, were eligible. DATA COLLECTION AND ANALYSIS: One reviewer (DO) determined the eligibility for inclusion of all trials. Both reviewers conducted data extraction and evaluation of each trial's quality independently. Each trial was analysed based on predetermined criteria and a narrative of each trial's main conclusions was produced. MAIN RESULTS: Four trials in people with experimental wounds were eligible for inclusion. The effect of TT on wound healing in these studies was variable. Two of the studies (n = 44 & 24) demonstrated a significant effect of TT. However the results of the two other trials favoured the control group (n = 15 & 38), one of these trials demonstrated a significant effect in favour of the control group. REVIEWER'S CONCLUSIONS: There is insufficient evidence that TT promotes healing of acute wounds.

Evidence-based practice and reviews of therapeutic touch.

PURPOSE: To present principles for accurately representing research for evidence-based practice and health care policies, and to evaluate how original research results indicated adherence to those principles in literature reviews of therapeutic touch. ORGANIZING CONSTRUCTS: Critical thinking and scientific integrity. SOURCES: Reviews of therapeutic touch literature published in nursing journals between 1994 and 1998 and the research studies cited in those reviews. METHODS: Statements made in reviews about the efficacy of therapeutic touch were compared with the results and conclusions of the research cited. General conclusions reported in reviews were evaluated against a broad range of therapeutic touch (TT) research studies, including many not cited in reviews. How accurately reviewers represented the research studies was evaluated by comparing reviewers' conclusions with those of the researchers. Findings were organized into principles to guide evidence-based reviews. FINDINGS: Literature reviews about therapeutic touch often cited only research with favorable findings. When citing studies with contradictory findings, only the favorable findings were usually mentioned. In many reviews, research cited as indicating the efficacy of therapeutic touch indicated it was ineffective. Every review examined had at least one significant mistake concerning how research studies were represented. CONCLUSIONS: Accurate presentation of original research results is needed to make evidence-based decisions and to ensure that limited healthcare resources are used effectively and safely. Evidence-based principles should be followed in reviewing therapies and practices, including alternative therapies.

Amoenolide K and amoenolide K 19-acetate, two grindelane peroxides from Amphiachyris amoena. Isolation, structure determination, and preparation of amoenolide K from amoenolide A by photochemical oxygenation.

Two new 9,13-diepoxy labdane diterpenes, amoenolide K [1] and its 19-acetate [2], were isolated from the aerial parts of the composite Amphiachyris amoena and their structures were established by spectral methods, especially high-field nmr spectroscopy. Amoenolide K [1] was prepared from amoenolide A [3] by singlet oxygen addition via the ene reaction. A study was made of the ene reaction products with amoenolide K triacetate [5] which showed them to arise from stereospecific oxygen addition to the 8,9-double bond, with the exception of the sterically hindered beta-side at C-9, for which no products were isolated.

Modified labdane diterpenes from Amphiachyris amoena.

Two new modified labdane diterpenes, amoenolide L [1] and amoenolide M [2] with a 3-(p-hydroxyphenyl)propionate ester unit, were isolated from the above-ground parts of Amphiachyris amoena. Their stereochemical structures were assigned by spectral methods including uv, ir, fabms, and one- and two-dimensional high field 1H- and 13C-nmr. Properties of their acetate derivatives are also recorded.

New labdane diterpene glycosides from Amphiachyris amoena.

Five new labdane diterpene glycosides, amoenolide A 19-beta-D-glucopyranoside [1], and amoenolides E [3], F [4], G [6], and H [8] were isolated from the above-ground parts of Amphiachyris amoena. Amoenolide F is a 19-beta-D-glucopyranoside, while the others are 6-alpha-L-arabinopyranosides. Their structures were established by chemical and spectral methods, especially high-field nmr techniques, and complete 1H- and 13C-nmr assignments are given.

Five new labdane diterpenes from Amphiachyris amoena.

Five new labdane diterpenes, amoenolide A 19-aldehyde [2], and amoenolides B [3], C [4], D [5], and J [6] were isolated from the above-ground parts of Amphiachyris amoena, and their structures determined by spectral methods, in particular high-field nmr, and selective chemical studies. Amoenolide J [6] had its carbon skeleton established by the INADEQUATE 13C-13C connectivity nmr experiment.

Amoenolide A and related acetylated labdane diterpenes from Amphiachyris amoena.

Four new labdane diterpenes, amoenolide A [1] and its 19-acetate [2], 6-acetate [3], and 6,19-diacetate [4], were isolated from the above-ground parts of Amphiachyris amoena and their structures established by spectral and chemical methods. High-field 1H- and 13C-nmr assignments were made for each compound using 1D and 2D nmr techniques including 1H single-frequency spin-coupling and nOe difference experiments, one-bond and long-range carbon-hydrogen correlations, and the INADEQUATE carbon-carbon connectivity experiment. The absolute stereochemistry was established by the Horeau partial-resolution chemical method with amoenolide A and racemic 2-phenylbutyric anhydride, and by the cd exciton splitting physical method on the synthetic amoenolide A 2-acetate 6,19-dibenzoate [9].