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400863 Foundations of Research and Evidence-Based Practice

Evidence selection

Purpose: To present a critical evaluation of the current evidence concerning the therapeutic value of vitamin C for the prophylaxis and treatment of the common cold. Data sources: Cochrane, PubMed, Natural Standard, and the National Center for Complementary and Alternative Medicine databases were searched to identify and acquire primary research reports, literature reviews, and secondary analyses related to the clinical objective. Published clinical trials, literature reviews, meta-analyses, and systematic reviews were evaluated for evidence based practice implications. Conclusions: Vitamin C is frequently used for the treatment and prophylaxis of the common cold; however, no published recommendations were found in a review of the nurse practitioner literature that specifically address the efficacy of vitamin C for the common cold. Our literature review revealed that vitamin C is not effective at preventing the common cold in the general adult population; however, it is effective at preventing colds when consumed regularly by athletes training in subarctic conditions. We also found that regular vitamin C consumption may reduce the duration of cold symptoms in both adults and children, but it does not decrease the severity of cold symptoms. Implications for practice: NPs should counsel their patients that regular vitamin C consumption may decrease the duration of cold symptoms, but does not affect symptom severity or act as a prophylaxis.

Answer the question, “Why did you choose these articles”.

Answer:

Chronic low back pain (cLBP) is a significant health problem now a days and recently acupuncture is gaining momentum as a treatment to relief cLBP. To investigate the effectiveness of acupuncture as a treatment to cLBP, three research articles were selected and examined. The objectives of two of them were to found out whether acupuncture work as pain relief in chronic low back pain while other one were vested in acupuncture works an


d tried to provide a objective method for measurement. Xu et al. (2013) used a meta analysis of thirteen controlled trials (randomized) to investigate the effect of acupuncture in cLBP. They identified 2678 patients for their controlled groups and I-square test, Cohen’s test and Begg’s test were performed for meta analysis. Evaluation parameters for their clinical outcome were disability, pain intensity, quality of life and spinal flexion. In their study, they have shown that acupuncture achieved better results in comparison with other treatments for cLBP. Like the previous research study, Weiß et al. (2013) have also studied the effectiveness of the acupuncture as a treatment of cLBP but with different design. There subject were patient from a rehabilitation program and total 143 patients were took part in two group. One was control and the other one was intervened with acupuncture treatment. They also pointed out that acupuncture is an effective method. In contrast with the previous two research program, Li et al. (2013) have assumed that acupuncture is an effective method and tried to provide an

objective method for measurement by studying altered default mode network. The objective of this evidence search was to find out whether acupuncture is an effective treatment tool against cLBP. For this purpose, research article of Xu et al. (2013) and Weiß et al. (2013) were selected. However, mechanism of acupuncture is still not very much clear and pain is subjective matter. To answer this predicament, study of Li et al. (2013) were selected.

Evidence summary

Chronic low back pain is one of most common reason for people to attain medical treatment and it is quite a financial burden to some families. In that context, acupuncture is increasing popularity as a treatment for chronic low back pain. Therefore, this essay will discuss the effectiveness of acupuncture as a treatment of chronic low back pain based on academic research.

Xu et al. (2013) have shown in their study that acupuncture is an effective tool against acupuncture. They have also shown that it is much more effective that other treatments for chronic low back pain. Similar like the previous author, Weiß et al. (2013) have reported similar findings in their study. Along with that, they have also reported that acupuncture and traditional Chinese medicine is highly accepted among the subjects and acupuncture is a well tolerated treatment with close to none adverse events. However, mechanism of acupuncture is still not clear and there is no clear objective protocol for this treatment method. Along with that, pain is a subjective matter which poses a significant hindrance in this situation. Keeping this situation in mind, Li et al.

(2014) have sought to investigate how acupuncture influences chronic low back pain by examining the default mode network connectivity. They reported that less connectivity is present amongst the patient with chronic low back pain in comparison with control patients. They have come to the conclusion that default mode network modulation by acupuncture is related to its therapeutic effects. They also presented an objective assessment method for acupuncture by default mode network imaging.  From the above discussion, it can be seen that all the researchers have agreed that acupuncture has therapeutic effects as a treatment for chronic low back pain. Additionally, Weiß et al. (2013) have also shown that acupuncture is a well tolerated treatment with no adverse effects. This suggests that acupuncture has the potential to be effective treatment for the chronic low back pain. Furthermore, the findings of the researches performed by Xu et al. (2013) and Weiß et al. (2013) is rather significant as sample size for both of their studies were fairly high. For example, Xu et al. (2013) performed their analysis with a sample pool of 2678 patients. To make further interesting, Li et al. (2014) have provided an objective measure technique to study effect of acupuncture, which in turn will help better understanding of the technique.

Therefore, from the above discussion, it can be concluded that acupuncture has therapeutic effects as a treatment for the chronic low back pain. Recent studies and researches related to this subject have only emphasises this point evidently.

References

Li, J., Zhang, J. H., Yi, T., Tang, W. J., Wang, S. W., & Dong, J. C. (2014). Acupuncture treatment of chronic low back pain reverses an abnormal brain default mode network in correlation with clinical pain relief. Acupuncture in Medicine, 32(2), 102-108.

Weiß, J., Quante, S., Xue, F., Muche, R., & Reuss-Borst, M. (2013). Effectiveness and acceptance of acupuncture in patients with chronic low back pain: results of a prospective, randomized, controlled trial. The Journal of Alternative and Complementary Medicine, 19(12), 935-941.

Xu, M., Yan, S., Yin, X., Li, X., Gao, S., Han, R., ... & Lei, G. (2013). Acupuncture for chronic low back pain in long-term follow-up: a meta-analysis of 13 randomized controlled trials. The American journal of Chinese medicine, 41(01), 1-19.

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