What are placebos?

Originally, placebos were thought of as inert pills or medications that were presented by physicians in the medical context or by researchers in clinical or experimental studies. Today, the term has a broader definition and it is used in a variety of settings. Placebos are present in our everyday lives, and sometimes have profound impacts on behaviors, and experiences (different types of placebo effects). The word Placebo is derived from a Latin phrase meaning “to please”.

“A placebo is a substance or procedure that has no inherent power to produce an effect that is sought or expected.” (Williams & Podd, 2004)

In general terms, when considering placebo, the entire ritual surrounding the administration of the substance or procedure is considered. Placebos are context specific. What might be a placebo in one condition may actually serve as a nocebo (opposite placebo, negative outcome) in another context. Also, a placebo in one context may serve as an active treatment (substance, procedure) in another context. Learning and cultural influences play a large role in determining whether a substance or procedure serve as a placebo. The study of placebos has advanced substantially over the past few years, and has provided important information in regards to neurobiology, and various other biological mechanisms. Coming Soon The Amazing World of Placebo Effects: The Neurobiology of Placebo Effects

Investigating Placebo Effects 2- Sham Knee Surgery

Mosley et al. (2002) conducted a randomized, placebo-controlled trial to evaluate the efficacy of arthroscopy for osteoarthritis of the knee. Patients were assigned to receive an arthroscopic debridement, arthroscopic lavage or placebo surgery. Patients and assessors of outcome were blinded to which condition the patients were in. Outcomes were assessed at multiple points over a 24-month period. Five self-reported scores and one objective test of walking and stair climbing was used as measures. Neither of the intervention groups reported less pain or better function than the group receiving the sham surgery. In fact, at two weeks participants that received the sham surgery performed better on an objective walking and stair climbing measure than those in the debridement group. This was also found at one year and the debridement group showed a trend towards worse functioning at two years. However, it is not clear if this outcome occurred due to a placebo (via expectation) effect or natural history.

Placebo Effects- Sham Knee Surgery (video)

Coming Soon! The Amazing World of Placebo Effects

Investigating Placebo Effects

This is the first in a series of articles that will investigate
placebo and nocebo effects. Currently, there is some exciting
research being done in these areas. This series will explore
placebo and placebo - related effects in many different areas.

The individual's mind, emotions, and beliefs play a central role
in any treatment or therapy (procedure, protocol). Placebo effects
are mediated by many molecules in the brain which may affect the
course of a disease or response to treatment. Many misconceptions
exist regarding placebo effects- in the lay public and scientific
community. Probably, the most common misconception is in how
the words 'placebo effect' and 'placebo response' are defined.
Commonly the words refer to outcomes in placebo groups, without
consideration that a variety of factors are responsible for the
reduction of a symptom when taking a placebo or receiving a placebo
-related treatment. The reduction of the symptom could be due to:

Spontaneous remission
Regression to the mean
Effects of co-intervention
Biases
Real placebo response (Neurobiological& various physiological responses)

Another common misconception is that there is only one placebo effect. There is not one, but many (various mechanisms underlie placebo effects). It is more appropriate to think in terms of effects not effect.

Placebo effects have been shown in many different areas in science. Sometimes placebo effects have been shown to mimic or even exceed effects produced by active treatments (such as therapies or medications).

The content featured in this series of articles will be the same type of content featured in my new book - The Amazing World of Placebo Effects.

Sports Performance & Over-thinking

Sports Performance & Over-thinking

Sometimes athletes over-think the situation while performing. Why does over-thinking in high level athletes often lead to decreased athletic performance? Dr. Adam Lawson, Cognitive Neuroscientist, offers the following explanation.

Much of the brain can be divided into conscious controlled and automatic systems, with conscious controlled systems being focused on handling new or unusual challenges while automatic systems are best able to quickly and efficiently act on well learned acts. Practice, whether a sport or an intellectual ability, allows for the transfer of tasks from conscious controlled to automatic systems. The advantage of utilizing these automatic systems is that they are very good at repeating an action over and over again. Sometimes, our conscious and automatic systems become a hindrance, however, because two systems trying to control one body does not work very well. In the case of intellectual tasks, our conscious awareness of two competing thoughts (one automatic and one conscious controlled) can lead to the indecisiveness we call over-thinking.

Choosing a Medical Malpractice Lawyer

Recently someone suggested I look at a site called Medical Malpractice Lawyers. When I first heard about the site I wasn't really interested. However, once I looked at the site I was very impressed with the information and also with the reasons given for starting the site. I highly recommend this site, especially if you are thinking about hiring a Medical Malpractice lawyer. The site is also a great source for anyone interested in learning more about different types of medical malpractice cases.

Baby Brain Damage – Brain damage in infants is mostly caused by factors like a lack of oxygen to the brain, an unhealthy placenta, being prematurely separated from the placenta, a squashed umbilical cord, and too high or too low blood pressure in the infant. Brain damage can also be worse in infants that are born premature. Because of this damage, babies that have it are prone to several disabilities, including defective eye sight and neurological disorders such as cerebral palsy. Once they reach childhood, they may experience difficulty with speech and learning and could develop other problems such as attention deficit disorder.

Nursing Home Abuse – This term refers to any physical, sexual, psychological, verbal, or financial abuse inflicted upon residents of a nursing home facility. Such abuse continues to be a growing issue in our country; however, many cases go unreported because the victims involved are too scared or ashamed to come forward. Typically, nursing home abuse is experienced by the female residents of the facility, though some males have reportedly been victims, as well. To learn more about nursing home abuse and what you can do to help prevent it, visit Nursing Home Abuse.net.

The site lists 25 different types of cases. The site also features articles:
10 Questions to Ask an Attorney Before Retaining Their Services
The owners of the site do not accept advertising or recommend specific medical malpractice attorneys. They have purposely chosen to remain anonymous in order to eliminate the potential appearance of a conflict of interest wherein they would receive additional clients through this website.

Stats Made Ez: Stats and Public Understanding

Recently I asked Dr. Jonathan Gore the following question- Why is a basic understanding of stats important for the public?

My answer to why stats is important is that pretty much everything operates based on probability. Even some of the "hard" sciences are starting to realize that phenomena that used to only require a basic equation are now having to factor in probability to account for all that they observe. To understand events that occur in our daily lives, including understanding other people’s behaviors, the economy, and health, we have to address probabilities rather than basic equations. When I talk with religious people about the importance of statistics, and they question its relevance, I say, "Statistics is the best tool for humans to understand how God’s creation works." We may never know the complete picture, but statistics give us the best possible estimate.

Pretty much everything, including science operates based on probability. One of the biggest roadblocks to the dissemination of science and stats is that people have a strong need for absolute certainty. Science is not about absolutes.

Stats Made Ez: Why We Need Statistics!

This is the first in a series of short articles that will discuss basic stats. Learning about stats will help you think in terms of probabilities, and allow you to gain a better understanding of research data.

Statistic: 1 number that summarizes a property of a set of numbers (Osbaldiston, 2011)

One of the key reasons of why we need statistics is to be able to effectively conduct research. Without the use of statistics it would be very difficult to analyze the collected data and make decisions based on the data. Statistics give us an overview of the data and allow us to make sense of what is going on. Without statistics, in many cases, it would be extremely difficult to find meaning in the data. Statistics provides us with a tool to make an educated inference.

Most scientific and technical journals contain some form of statistics. Without an understanding of statistics, the statistical information contained in the journal will be meaningless. An understanding of basic statistics will provide you with the fundamental skills necessary to read and evaluate most results sections. The ability to extract meaning from journal articles, and the ability to evaluate research from a statistical perspective are basic skills that will increase your knowledge and understanding of the article of interest.

Gaining knowledge in the area of statistics will help you become a better-informed consumer. Of course, statistics can be used or misused. Some individuals do mislead with statistics. If you understand basic statistical concepts, you will be in a better position to evaluate the information you have been given.

In future articles will be discussing: mean, median, mode, range, standard deviation, t-tests, correlation coefficient, and many other statistical concepts.