Biomedical subjects

Clare Stevinson

Publications and source records attributed to Clare Stevinson.

7 recordsLinked to original sources

PubMed2005

Preliminary study of the lived experience of exercise for cancer survivors.

There is a growing body of evidence indicating the physical and psychosocial health benefits of exercising during cancer rehabilitation. However, physical activity levels of cancer survivors are generally low. This study adopted a qualitative approach to increase understanding of the lived experience of exercise for cancer survivors. Semi-structured interviews were carried out with six female cancer survivors who had taken part in the 2003 Race for Life fundraising event for Cancer Research UK. Following verbatim transcription of interviews, data reduction was carried out using Van Manen's method of thematic content analysis. Assimilation of central themes forms the basis of the final report. The essence of cancer survivors' experience of exercise was determined as 'going forward'-to move on, physically and mentally following treatment, to rebuild social networks, and to restore a positive, confident outlook towards the future. The central theme of 'going forward' was identified in aspects of participants' physical and mental recovery, and their future intentions for exercise. Race for Life represented a positive focus for participants after cancer treatment, and proved to be an appropriate starting point for initiating, or returning to exercise following cancer. The results of the study support the suggestion that advice regarding exercise should be included in rehabilitation care for some cancer patients.

Adult↗

PubMed2004

Exercise interventions for cancer patients: systematic review of controlled trials.

OBJECTIVE: To systematically review controlled trials investigating the effects of exercise interventions in cancer patients. METHODS: Studies were located through searching seven electronic databases (Medline, Embase, Cochrane Library, CancerLit, PsycInfo, Cinahl, SportDiscus), scanning reference lists of relevant articles, contacting experts (n = 20), and checking the contents lists of journals available through ZETOC (Electronic Table of Contents). To be included, trials had to be prospective, controlled, involve participants diagnosed with cancer and test an exercise intervention. Types of outcome were not restricted. Two reviewers independently applied the selection criteria. RESULTS: Thirty-three controlled trials (including 25 randomized trials) were included in the review. There was some evidence that physical function was increased among those who exercised. Furthermore, symptoms of fatigue did not appear to be increased and there were few adverse effects reported. There was insufficient evidence to determine effects on other outcomes, such as quality of life, with results hampered by the heterogeneity between studies as well as poor methodological quality. Data were also lacking on the long term effects of exercise relating to cancer recurrence or survival. CONCLUSIONS: There is preliminary evidence that exercise interventions for cancer patients can lead to moderate increases in physical function and are not associated with increased symptoms of fatigue. However, it is impossible from current evidence to determine whether exercise has long term beneficial effects on survival or quality of life.

Controlled Clinical Trials as Topic↗

PubMed2003

Effectiveness of artichoke extract in preventing alcohol-induced hangovers: a randomized controlled trial.

BACKGROUND: Extract of globe artichoke (Cynara scolymus) is promoted as a possible preventive or cure for alcohol-induced hangover symptoms. However, few rigorous clinical trials have assessed the effects of artichoke extract, and none has examined the effects in relation to hangovers. We undertook this study to test whether artichoke extract is effective in preventing the signs and symptoms of alcohol-induced hangover. METHODS: We recruited healthy adult volunteers between 18 and 65 years of age to participate in a randomized double-blind crossover trial. Participants received either 3 capsules of commercially available standardized artichoke extract or indistinguishable, inert placebo capsules immediately before and after alcohol exposure. After a 1-week washout period the volunteers received the opposite treatment. Participants predefined the type and amount of alcoholic beverage that would give them a hangover and ate the same meal before commencing alcohol consumption on the 2 study days. The primary outcome measure was the difference in hangover severity scores between the artichoke extract and placebo interventions. Secondary outcome measures were differences between the interventions in scores using a mood profile questionnaire and cognitive performance tests administered 1 hour before and 10 hours after alcohol exposure. RESULTS: Fifteen volunteers participated in the study. The mean number (and standard deviation) of alcohol units (each unit being 7.9 g, or 10 mL, of ethanol) consumed during treatment with artichoke extract and placebo was 10.7 (3.1) and 10.5 (2.4) respectively, equivalent to 1.2 (0.3) and 1.2 (0.2) g of alcohol per kilogram body weight. The volume of nonalcoholic drink consumed and the duration of sleep were similar during the artichoke extract and placebo interventions. None of the outcome measures differed significantly between interventions. Adverse events were rare and were mild and transient. INTERPRETATION: Our results suggest that artichoke extract is not effective in preventing the signs and symptoms of alcohol-induced hangover. Larger studies are required to confirm these findings.

Adolescent↗

PubMed2002

Risks associated with spinal manipulation.

The aim of this systematic review was to summarize the evidence about the risks of spinal manipulation. Articles were located through searching three electronic databases (MEDLINE, EMBASE, Cochrane Library), contacting experts (n =9), scanning reference lists of relevant articles, and searching departmental files. Reports in any language containing data relating to risks associated with spinal manipulation were included, irrespective of the profession of the therapist. Where available, systematic reviews were used as the basis of this article. All papers were evaluated independently by the authors. Data from prospective studies suggest that minor, transient adverse events occur in approximately half of all patients receiving spinal manipulation. The most common serious adverse events are vertebrobasilar accidents, disk herniation, and cauda equina syndrome. Estimates of the incidence of serious complications range from 1 per 2 million manipulations to 1 per 400,000. Given the popularity of spinal manipulation, its safety requires rigorous investigation.

Cerebrovascular Disorders↗

PubMed2002

Validating a new non-penetrating sham acupuncture device: two randomised controlled trials.

For clinical trials of acupuncture, it would be desirable to have a sham procedure that is indistinguishable from the real treatment, yet inactive. A sham needle has been designed which telescopes instead of penetrating the skin. The Park Sham Device involves an improved method of supporting the sham needle and requires validation. The objective of these studies was to test whether the sham procedure using the new device was 1) indistinguishable from the same procedure using real needles in acupuncture naïve subjects, and 2) inactive, where the specific needle sensation (de qi) is taken as a surrogate measure of activity. The studies were designed as subject and assessor blind, randomised controlled trials. Study 1) included 58 patients enrolled in a clinical trial of acupuncture for acute stroke. Study 2) included 63 healthy, acupuncture naïve, adult volunteers. The interventions used were real or sham acupuncture using the Park Sham Device. Study 1) was set in a district general hospital, and study 2) in a university laboratory. The outcome measure in study 1) was the form of treatment that patients believed they had received. In study 2) the outcome measure was experience of de qi, as judged by three acupuncture experts. No patient in either group(study 1) believed he or she had been treated with the sham needle. In 40 volunteers (study 2) for whom experts achieved consensus, the relative risk of experiencing de qi with real acupuncture to that with sham acupuncture was 15.38 (95% CI 2.26 to 104.86). The inter-rater reliability of all 13 experts (study 2), calculated from their judgements on 10 subjects selected by randomisation, was 0.52 (95% CI 0.19 to 0.61). In conclusion, the results suggest that the procedure using the new device is indistinguishable from the same procedure using real needles in acupuncture naïve subjects, and is inactive, where the specific needle sensation (de qi) is taken as a surrogate measure of activity. It is therefore a valid control for acupuncture trials. The findings also lend support to the existence of de qi, a major concept underlying traditional Chinese acupuncture.

Acupuncture Points↗

PubMed2002

A systematic review of the safety of kava extract in the treatment of anxiety.

This paper systematically reviews the clinical evidence relating to the safety of extracts of the herbal anxiolytic kava (Piper methysticum). Literature searches were conducted in four electronic databases and the reference lists of all papers located were checked for further relevant publications. Information was also sought from the spontaneous reporting schemes of the WHO and national drug safety bodies and ten manufacturers of kava preparations were contacted. Data from short-term post-marketing surveillance studies and clinical trials suggest that adverse events are, in general, rare, mild and reversible. However, published case reports indicate that serious adverse events are possible including dermatological reactions, neurological complications and, of greatest concern, liver damage. Spontaneous reporting schemes also suggest that the most common adverse events are mild, but that serious ones occur. Controlled trials suggest that kava extracts do not impair cognitive performance and vigilance or potentiate the effects of central nervous system depressants. However, a possible interaction with benzodiazepines has been reported. It is concluded that when taken as a short-term monotherapy at recommended doses, kava extracts appear to be well tolerated by most users. Serious adverse events have been reported and further research is required to determine the nature and frequency of such events.

Anti-Anxiety Agents↗

PubMed2002

Complementary/alternative medicine in dermatology: evidence-assessed efficacy of two diseases and two treatments.

The objective of this article is to provide a brief, but critical, overview of the evidence related to complementary/alternative medicine (CAM) use, and to offer valid and useful information for dermatologists in clinical practice. Systematic literature searches were conducted on these databases: Medline, EMBASE, The Cochrane Library, CISCOM and AMED (until October 2000). Where appropriate, the evaluation of the published literature was based on systematic reviews and randomized controlled trials. After scanning the literature it was decided to focus on a selection of two conditions (atopic dermatitis and chronic venous insufficiency) and two treatment modalities (aloe vera gel and tea tree oil). Data for the life-time prevalence of CAM use by patients with dermatological disease ranges between 35 to 69%. The most popular modalities include herablism and (other) dietary supplements, while atopic dermatitis is one of the conditions most frequently treated with CAM. For patients with atopic dermatitis the evidence relates to autogenic training, hypnotherapy, diet, herbal medicine, and dietary supplements. Compelling evidence of effectiveness exists for none of these therapies. However, some promising data have been reported for those with a psychological component: autogenic training, biofeedback and hypnotherapy. For chronic venous insufficiency there is relatively convincing evidence for the effectiveness of oral horse chestnut seed extract. The data for aloe vera gel and tea tree oil indicate that for neither is there compelling evidence of effectiveness. The use of CAM treatments is not free of risk; direct and indirect risks associated with CAM must be considered.

Chronic Disease↗