NHMRC information paper: evidence on the effectiveness of homeopathy for treating health conditions

This paper provides a summary of evidence from research on the effectiveness of homeopathy in treating health conditions in humans. Findings There was no reliable evidence from research in humans that homeopathy was effective for treating the range of health conditions considered: no good-quality, well-designed studies with enough participants for a meaningful result reported either that homeopathy caused greater health improvements than placebo, or caused health improvements equal to those of another treatment. For some health conditions, studies reported that homeopathy was not more effective than placebo. For other health conditions, there were poor-quality studies that reported homeopathy was more effective than placebo, or as effective as another treatment. However, based on their limitations, those studies were not reliable for making conclusions about whether homeopathy was effective. For the remaining health conditions it was not possible to make any conclusion about whether homeopathy was effective or not, because there was not enough evidence. Conclusions Based on the assessment of the evidence of effectiveness of homeopathy, NHMRC concludes that there are no health conditions for which there is reliable evidence that homeopathy is effective. Homeopathy should not be used to treat health conditions that are chronic, serious, or could become serious. People who choose homeopathy may put their health at risk if they reject or delay treatments for which there is good evidence for safety and effectiveness. People who are considering whether to use homeopathy should first get advice from a registered health practitioner. Those who use homeopathy should tell their health practitioner and should keep taking any prescribed treatments

Influence of therapist competence and quantity of cognitive behavioural therapy on suicidal behaviour and inpatient hospitalisation in a randomised controlled trial in borderline personality disorder: Further analyses of treatment effects in the BOSCOT study

<br>Objectives. We investigated the treatment effects reported from a high-quality randomized controlled trial of cognitive behavioural therapy (CBT) for 106 people with borderline personality disorder attending community-based clinics in the UK National Health Service – the BOSCOT trial. Specifically, we examined whether the amount of therapy and therapist competence had an impact on our primary outcome, the number of suicidal acts, using instrumental variables regression modelling. Design. Randomized controlled trial. Participants from across three sites (London, Glasgow, and Ayrshire/Arran) were randomized equally to CBT for personality disorders (CBTpd) plus Treatment as Usual or to Treatment as Usual. Treatment as Usual varied between sites and individuals, but was consistent with routine treatment in the UK National Health Service at the time. CBTpd comprised an average 16 sessions (range 0–35) over 12 months.</br> <br>Method. We used instrumental variable regression modelling to estimate the impact of quantity and quality of therapy received (recording activities and behaviours that took place after randomization) on number of suicidal acts and inpatient psychiatric hospitalization.</br> <br>Results. A total of 101 participants provided full outcome data at 2 years post randomization. The previously reported intention-to-treat (ITT) results showed on average a reduction of 0.91 (95% confidence interval 0.15–1.67) suicidal acts over 2 years for those randomized to CBT. By incorporating the influence of quantity of therapy and therapist competence, we show that this estimate of the effect of CBTpd could be approximately two to three times greater for those receiving the right amount of therapy from a competent therapist.</br> <br>Conclusions. Trials should routinely control for and collect data on both quantity of therapy and therapist competence, which can be used, via instrumental variable regression modelling, to estimate treatment effects for optimal delivery of therapy. Such estimates complement rather than replace the ITT results, which are properly the principal analysis results from such trials.</br&gt

Health communication implications of the perceived meanings of terms used to denote unhealthy foods

Background: Using appropriate terminology in nutrition education programs and behaviour change campaigns is important to optimise the effectiveness of these efforts. To inform future communications on the topic of healthy eating, this study explored adults’ perceptions of the meaning of four terms used to describe unhealthy foods: junk food, snack food, party food, and discretionary food. Methods: Australian adults were recruited to participate in an online survey that included demographic items and open-ended questions relating to perceptions of the four terms. In total, 409 respondents aged 25–64 years completed the survey. Results: ‘Junk food’ was the term most clearly aligned with unhealthiness, and is therefore likely to represent wording that will have salience and relevance to many target audience members. Snack foods were considered to include both healthy and unhealthy food products, and both snack foods and party foods were often described as being consumed in small portions. Despite being used in dietary guidelines, the term ‘discretionary food’ was unfamiliar to many respondents. Conclusions: These results demonstrate that different terms for unhealthy foods can have substantially different meanings for audience members. A detailed understanding of these meanings is needed to ensure that nutrition guidance and health promotion campaigns use appropriate terminology

Prevalence of drug resistance in patients with pulmonary tuberculosis presenting for the first time with symptoms at chest clinics in India. Part 2. Findings in urban clinics among all patients with or without history of previous chemotherapy

A previous report (Indian Council of Medical Research First Drug Resistance Investigation, 1968) presented the results of a co-operative investigation on the prevalence of drug resistance in patients with pulmonary tuberculosis, presenting for the first time with symptoms at chest clinics in India and giving no history of previous antituberculosis chemotherapy. However, the information obtained from that investigation is of rather limited value because, in most clinics, fairly large proportions of patients reporting for the first time do so with a history of previous treatment. This is because antituberculosis chemotherapy is offered not only by chest clinics, but also by general hospitals and private practitioners. In these circumstances, information on the prevalence of drug resistance among all patients, irrespective of the history of previous antituberculosis chemotherapy, will be of great value, not only to the cliniciansin- charge of the chest clinics but also to those responsible for formulating general policies of treatment in the country. The second drug resistance investigation was undertake

Prevalence of drug resistance in patients with pulmonary tuberculosis presenting for the first time with symptoms at chest clinics in India. 1. Findings in urban clinics among patients giving no history of previous chemotherapy

IT is generally accepted that information on the prevalence of drug resistance is essential for countries which contemplate mass chemotherapy programme for tuberculosis (International Union against Tuberculosis, 1961). In India in 1964, information on this subject was confined to certain limited areas only (Tuberculosis Chemotherapy Centre, Madras, 1959, 1960, 1964 ; Frimodt-Moller, 1962 ; Menon, 1963 ; Balbir Singh, 1964). Therefore, the Indian Council of Medical Research (I.C.M.R.) launched a series of investigations to determine the prevalence of drug resistance in tuberculous patients reporting for the first time with symptoms at chest clinics ; chest clinics were chosen since they are an obvious starting point for any mass chemotherapy programme. A special sub-committee of the Indian Council of Medical Research (see footnote) was constituted to organise the execution of these investigations, and a Central Laboratory set up on the premises of the Tuberculosis Chemotherapy Centre, Madras, to undertake all the necessary bacteriological investigations

Information paper: evidence on wind farms and human health

This Information Paper provides Australians with a summary of the evidence on possible health effects of wind farms in humans and explains how NHMRC developed its summary based on the findings of independent reviews of the evidence. It is intended for use by any person or group interested in wind farms. Wind farms in Australia Wind turbines use rotating blades attached to towers to convert wind energy into electricity. A group of wind turbines is known as a wind farm and may be located on land or offshore. Wind turbine design has evolved over the last 20 years to enable better harnessing of wind energy. Wind farms have been promoted as a viable and sustainable alternative to traditional, non-renewable forms of energy production. Since the introduction of the Renewable Energy Act 2000, the number of wind farms in Australia has grown substantially. At the end of 2013, there were 68 wind farms across the country and more were being constructed or planned. Why NHMRC is conducting this work NHMRC is responsible for ensuring that Australians receive the best available, evidence-based advice on matters relating to improving health and to preventing, diagnosing and treating disease. Concern about the effects on health from living near a wind farm has been expressed by some members of the community. Therefore, NHMRC examined the evidence on health effects associated with exposure to specific emissions from wind farms — noise, shadow flicker and electromagnetic radiation. The current investigation of the potential health effects of wind farms builds upon NHMRC’s previous work in this area. In 2010, NHMRC’s Public statement: Wind turbines and health was published, with supporting evidence from Wind turbines and health: A rapid review of the evidence. The 2010 NHMRC Public Statement concluded that there “is currently no published scientific evidence to positively link wind turbines with adverse health effects”. Due to the limited amount of published scientific literature, NHMRC committed to carrying out a more extensive search for evidence. This Information Paper provides an update to NHMRC’s previous work in this area. It is based on a comprehensive review of the available scientific evidence following well-established systematic review principles, which provide the most rigorous process for identifying and critically appraising evidence. In Australia, responsibility for regulating the planning, development and operation of wind farms lies with state, territory and local governments. The outcomes of NHMRC’s review may assist these organisations to make decisions about the regulation of wind farms. NHMRC’s review of the evidence will enable well-designed and targeted research to be undertaken in areas that have been identified as gaps in the evidence base

In their own words: A qualitative study exploring influences on the food choices of university students

Issue addressed: University students generally make independent decisions regarding food choices. Current research about knowledge of Australian Dietary Guidelines (ADG), sources of nutrition information and influences on food choices for this group is scarce. Methods: Qualitative data were collected from gender‐separated focus groups comprising four female (n = 31) and four male (n = 18) to identify: knowledge of ADG; sources of nutrition information; factors that influence food choices; perceived relevant nutrition messages and how best to deliver them. Results: Gaps in knowledge were identified particularly regarding number of serves and serving size for food groups. Social media was the most commonly reported source of knowledge. Social media was also a major influence on food choice due to its impact on body ideals. Conclusion: Current health promotion nutrition messages were perceived irrelevant given the focus on long‐term health risks. Health and adhering to the ADG were not identified as important. The desire to look a particular way was the major influence on food choices. So what? While there is an awareness of ADG, our participants made a deliberate decision not to follow them. This provides a challenge for developing relevant preventive health messages for this target audience

New hurdles for translational research

New guidelines for the collection and use of human tissues for research will impose new requirements on researchers to seek ethical approval and patient consent. This extends to the use of surplus tissue, such as breast cancer excision biopsies, which, until recently, have been regarded as having been 'abandoned' by the patient. This article argues that some of these new constraints provide hurdles to translational research that are unnecessary for patient protection. This is particularly significant when emerging technologies are expected to elicit major advances in clinical cancer research

Beyond Chapter 4.7

Chapter 4.7 of the National Statement on Ethical Conduct in Human Research refers specifically to Aboriginal and Torres Strait Islander Peoples. It lays out the points at which researchers working with Aboriginal and Torres Strait Islanders must consider their approach, and the engagement with individuals, communities or groups who are involved in or affected by their research. History, of Australia and of research involving Aboriginal and Torres Strait Islander Australians, has informed this approach. The response to that history has been a rational, institutionalised, systematic demand for a different perception of what should direct research and research processes to ensure engagement with and service to the community with whom the researchers wish to do the work. This paper considers whether these principles could inform the approach to other research work.not applicabl