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Medical Marijuana: A Primer on Ethics, Evidence, and Politics

January 22, 2015 Comments off

Medical Marijuana: A Primer on Ethics, Evidence, and Politics (PDF)
Source: The Journal for Nurse Practitioners – JN

Controversy in the United States about the decriminalization of cannabis to allow health care providers to recommend it for therapeutic use (medical marijuana) has been based on varying policies and beliefs about cannabis rather than on scientific evidence. Issues include the duty to provide care, conflicting reports of the therapeutic advantages and risks of cannabis, inconsistent laws, and even the struggle to remove barriers to the scope of practice for advanced practice registered nurses. This article reviews the ethics, evidence, and politics of this complex debate.

Medical Marijuana Laws and Teen Marijuana Use

January 7, 2015 Comments off

Medical Marijuana Laws and Teen Marijuana Use
Source: Cato Institute

Medical marijuana is popular with the general public. A recent Gallup poll found that 70 percent of Americans say they favor making marijuana legally available for doctors to prescribe in order to reduce pain and suffering (Mendes 2010).

Given this level of support, it could be viewed as surprising that approximately half of the states still have not legalized medical marijuana. Opponents of medical marijuana, however, have employed a number of arguments, several of which focus on marijuana use by teenagers. For instance, Montana state senator Jeff Essmann was quoted in 2011 as saying, “The number one goal is to reduce access and availability to the young people of this state that are being sent an incorrect message that this is an acceptable product for them to be using” (Florio 2011).

Building the Evidence Base for Complementary and Integrative Medicine Use among Veterans and Military Personnel

January 7, 2015 Comments off

Building the Evidence Base for Complementary and Integrative Medicine Use among Veterans and Military Personnel
Source: Medical Care (Supplement Five)

Articles include:

  • Physical Health, Mental Health, and Utilization of Complementary and Alternative Medicine Services Among Gulf War Veterans
  • Perceptions of Providers and Administrators in the Veterans Health Administration Regarding Complementary and Alternative Medicine
  • CAM Utilization Among OEF/OIF Veterans: Findings From the National Health Study for a New Generation of US Veterans
  • US Veterans Use Vitamins and Supplements as Substitutes for Prescription Medication
  • Complementary and Alternative Medicine Among Veterans and Military Personnel: A Synthesis of Population Surveys
  • Variations in the Implementation and Characteristics of Chiropractic Services in VA

NCCAM Clinical Digest: Stress and Relaxation Techniques

January 6, 2015 Comments off

NCCAM Clinical Digest: Stress and Relaxation Techniques
Source: National Center for Complementary and Alternative Medicine

Relaxation techniques may be helpful in managing a variety of health conditions, including anxiety associated with illnesses or medical procedures, insomnia, labor pain, chemotherapy-induced nausea, and temporomandibular joint dysfunction. For some of these conditions, relaxation techniques are used as an adjunct to other forms of treatment. Relaxation techniques have also been studied for other conditions, but either they haven’t been shown to be useful, research results have been inconsistent, or the evidence is limited.

Caffeine improves reaction time, vigilance and logical reasoning during extended periods with restricted opportunities for sleep

December 31, 2014 Comments off

Caffeine improves reaction time, vigilance and logical reasoning during extended periods with restricted opportunities for sleep
Source: Psychopharmacology

Rationale
Various occupational groups are required to maintain optimal physical and cognitive function during overnight periods of wakefulness, often with less than optimal sleep. Strategies are required to help mitigate the impairments in cognitive function to help sustain workplace safety and productivity.

Objectives
To test the effectiveness of repeated 200 mg doses of caffeine on cognitive function and live-fire marksmanship with soldiers during three successive nights of sustained wakefulness followed by 4-h afternoon sleep periods.

Methods
Twenty Special Forces personnel (28.6 ± 4.7 years, 177.6 ± 7.5 cm and 81.2 ± 8.0 kg) were randomly assigned to receive four 200-mg doses of caffeine (n = 10) or placebo (n = 10) during the late evening and early morning hours during three successive days. An afternoon 4-h sleep period followed. The psychomotor (PVT) and field (FVT) vigilance, logical reasoning (LRT) tests and a vigilance monitor assessed cognitive function throughout the study. Live-fire marksmanship requiring friend–foe discrimination was assessed.

Results
Caffeine maintained speed on the PVT (p < 0.02), improved detection of events during FVT (p < 0.001), increased number of correct responses to stimuli as assessed by the vigilance monitor (p < 0.001) and increased response speed during the LRT (p < 0.001) throughout the three overnight testing periods. Live-fire marksmanship was not altered by caffeine.

Conclusions
A total daily dose of 800 mg caffeine during successive overnight periods of wakefulness is an effective strategy to maintain cognitive function when optimal sleep periods during the day are not available.

NCCAM Clinical Digest: Yoga for Health

November 5, 2014 Comments off

NCCAM Clinical Digest: Yoga for Health
Source: National Center for Complementary and Alternative Medicine (NCCAM)

This issue of the digest summarizes current scientific evidence about yoga for health conditions, including chronic low-back pain, asthma, and arthritis.

The scientific evidence to date suggests that a carefully adapted set of yoga poses may help reduce pain and improve function in people with chronic low-back pain. Studies also suggest that practicing yoga (as well as other forms of regular exercise) might confer other health benefits such as reducing heart rate and blood pressure, and may also help alleviate anxiety and depression. Other research suggests yoga’s deep breathing is not helpful for asthma, and studies looking at yoga and arthritis have had mixed results.

New Article Demonstrates Daily Use of Certain Supplements Can Decrease Health Care Expenditures

October 6, 2014 Comments off

New Article Demonstrates Daily Use of Certain Supplements Can Decrease Health Care Expenditures
Source: Council for Responsible Nutrition

Use of specific dietary supplements can have a positive effect on health care costs through avoided hospitalizations related to Coronary Heart Disease (CHD), according to a new article published in the Journal of Dietary Supplements. The article, “From Science to Finance—A Tool for Deriving Economic Implications from the Results of Dietary Supplement Clinical Studies,” published by Christopher Shanahan and Robert de Lorimier, Ph.D., explores a potential cost-benefit analysis tool that, when applied to a high-risk population (U.S. adults over 55 with CHD) who take dietary supplements, specifically omega-3 fatty acid or B vitamin dietary supplements, can result in the reduction of the individuals’ odds of experiencing a costly medical event.

Hospitalizations for all U.S. adults over the age of 55 with CHD cost the United States over $64 billion in 20122, and the amount spent on the treatment of CHD, rather than the prevention, is burdensome on both the societal and individual levels—and only expected to increase, according to the article. “One way to control the burden of CHD costs is to minimize the number of costly inpatient procedures,” the authors said. “Many dietary supplement products are available in the market today that have been shown to have positive effects on heart health through associated clinical studies…Thus, the potential decrease of total health care expenditures in the United States is a strong argument for the daily use of dietary supplements.”

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