Objective : To develop a sham needle, which is applicable to clinical trials on acupuncture and test its credibility.
Methods : The Park Sham Needle' unit was developed. The apparatus consists of a blunt needle, the shaft of which telescopes into the handle when tapped, so that while the needle appears to have been inserted, it does not actually pierce the skin, and a Park Tube' that is composed of a standard guide tube and an oversize guide tube with a plastic flange at one end which adheres to the skin with double-sided sticky tape. The needle is held in place by the Park Tube. In a credibility test, 56 subjects received our new sham needle on the left LI-4 acupoint and were asked whether or not they felt the needle being inserted into the skin.
Results : Forty-six subjects (82%) were convinced that they received real needle insertion.
Conclusion : Park Sham Needle seems to be applicable to randomised, subject-blinded, and controlled trials on acupuncture.

To assess the current level of acceptance in the United States of complementary and alternative medicine, recent research into the prevalence, acceptance, accessibility, and recognition of complementary and alternative therapies were reviewed. Several signs point to an increasing acceptance of complementary and alternative medicine in the United States; the use of complementary and alternative medicine is significantly increasing, many aspects of Chinese medicine and Ayurveda are becoming mainstream, practitioners in the United States are beginning to be licensed, and insurance companies are beginning to cover some complementary and alternative therapies. Remaining challenges to true acceptance include the restrictive Western mindset, the absence of published studies, a lack of consistent manufacturing processes and quality standards, and a fear of adulteration. Although the field still faces many challenges, alternative and complementary medicine, including Chinese medicine and Ayurvedic medicine, is becoming more accepted and accessible in the United States.
Government ; Health Knowledge, Attitudes, Practice ; Health Services Accessibility ; Humans ; Industry ; Medicine, Ayurvedic ; Medicine, Chinese Traditional ; utilization ; Patient Acceptance of Health Care ; Private Sector ; Public Sector ; United States

BACKGROUND: The question of which type of prosthetic aortic valve leads to the best outcomes in patients in their 60s remains controversial. We examined the hemodynamic and clinical outcomes of aortic valve replacement in sexagenarians according to the type of prosthesis. METHODS: We retrospectively reviewed 270 patients in their 60s who underwent first-time aortic valve replacement from 1995 to 2011. Early and late mortality, major adverse valve-related events, anticoagulation-related events, and hemodynamic outcomes were assessed. The mean follow-up duration was 58.7±44.0 months. RESULTS: Of the 270 patients, 93 had a mechanical prosthesis (mechanical group), and 177 had a bioprosthesis (tissue group). The tissue group had a higher mean age and prevalence of preoperative stroke than the mechanical group. The groups had no differences in the aortic valve mean pressure gradient (AVMPG) or the left ventricular mass index (LVMI) at 5 years after surgery. In a sub-analysis limited to prostheses in the supra-annular position, the AVMPG was higher in the tissue group, but the LVMI was still not significantly different. There was no early mortality. The 10-year survival rate was 83% in the mechanical group and 90% in the tissue group. The type of aortic prosthesis did not influence overall mortality, cardiac mortality, or major adverse valve-related events. Anticoagulation-related events were more common in the mechanical group than in the tissue group (p=0.034; hazard ratio, 4.100; 95% confidence interval, 1.111–15.132). CONCLUSION: The type of aortic prosthesis was not associated with hemodynamic or clinical outcomes, except for anticoagulation-related events.
Aortic Valve ; Bioprosthesis ; Follow-Up Studies ; Hemodynamics* ; Humans ; Mortality ; Prevalence ; Prostheses and Implants* ; Retrospective Studies ; Stroke ; Survival Rate