The effect of acupuncture on people with hepatitis C virus : a randomised controlled pilot study

University of Technology, Sydney. Faculty of Science.Background: The use of Complementary and Alternative Medicine (CAM) in Australia has been steadily increasing. This has resulted in many people infected with Hepatitis C Virus (HCV) consulting CAM practitioners in the hope of alleviating some of the debilitating symptoms associated with this viral infection. Chronic symptoms often lead to a reduction in everyday functional health producing a lower quality of life compared with healthy population norms or patients with other forms of liver disease. Current recommended pharmaceutical treatment has a sustained virological response in approximately 50-60% of patients. Also large numbers of people are either not suitable candidates or intolerant to treatment or do not choose this option. In the mid 1990s, HCV residents in a Sydney alcohol and drug rehabilitation centre who were also receiving auricular (ear) acupuncture as part of their rehabilitation program, verbally reported decrease in their alanine aminotransferase (ALT) blood levels after approximately 16 acupuncture treatments administered over a three month period (Berle 1997). Objective: To investigate whether 24 acupuncture treatments over a twelve week period has an effect on the health outcomes of people with HCV. Design: A randomised single blind controlled pilot study with two parallel arms. Participants: Sixteen applicants who met the eligibility criteria and agreed to participate in the study were randomised into either treatment or control group. Outcome measures: The primary outcome measure was ALT blood levels at the completion of treatment (week 12), weeks 16 and 20. The secondary outcomes were HCV PCR quantitative (viral load test) and hepatitis quality of life (QoL) questionnaire. In addition a HCV Traditional Chinese Medicine (TCM) pattern questionnaire, acupuncture treatment credibility questionnaire and acupuncture needling sensation questionnaire were administered. Setting: Participants were offered treatment at two clinic locations; a private clinic at Guildford and at the University of Technology, Sydney (UTS) city campus. Blinded serum pathology/testing was conducted through independent Douglass Hanly Moir Pathology clinics. Treatment: Sixteen HCV participants were randomly allocated to two groups; one group receiving verum acupuncture treatment and the other receiving invasive sham acupuncture treatment. The treatment methodology involved the development of a TCM pattern differentiation diagnostic/outcome measure which identified 17 TCM/HCV patterns. One participant (treatment group) left the study after eight treatments due to work commitments. Results: No significant change was found between the two groups for ALTs, viral load or any domains of the QoL measure. The TCM pattern questionnaire identified the primary, secondary and tertiary TCM pattern expressions for HCV within the study group. On completion of the treatment phase there was a significant reduction in the secondary and tertiary TCM pattern expression for the treatment group (p=0.045 and 0.037 respectively). No significant change was found for the control group. The acupuncture credibility questionnaire identified that neither the treatment nor control group identified the type of treatment they had received; however the treatment group did perceive their treatment as more credible than the control group at week 12. There was no significant difference found between or within the two groups for the acupuncture needling sensation questionnaire. Conclusions: Despite the small number of participants and no significant changes for ALTs, viral load or any domains of the QoL there was a significant difference in the secondary and tertiary TCM patterns

Intrusion-based reasoning and depression: Cross-sectional and prospective relationships

Intrusion-based reasoning refers to the tendency to form interpretations about oneself or a situation based on the occurrence of a negative intrusive autobiographical memory. Intrusion-based reasoning characterises post-traumatic stress disorder, but has not yet been investigated in depression. We report two studies that aimed to investigate this. In Study 1 both high (n = 42) and low (n = 28) dysphoric participants demonstrated intrusion-based reasoning. High-dysphoric individuals engaged in self-referent intrusion-based reasoning to a greater extent than did low-dysphoric participants. In Study 2 there were no significant differences in intrusion-based reasoning between currently depressed (n = 27) and non-depressed (n = 51) participants, and intrusion-based reasoning did not predict depressive symptoms at 6-month follow-up. Interestingly, previously (n = 26) but not currently (n = 27) depressed participants engaged in intrusion-based reasoning to a greater extent than never-depressed participants (n = 25), indicating the possibility that intrusion-based reasoning may serve as a "scar" from previous episodes. The implications of these findings are discussed. © 2013 © 2013 Taylor & Francis

Backbone of complex networks of corporations: The flow of control

We present a methodology to extract the backbone of complex networks based on the weight and direction of links, as well as on nontopological properties of nodes. We show how the methodology can be applied in general to networks in which mass or energy is flowing along the links. In particular, the procedure enables us to address important questions in economics, namely, how control and wealth are structured and concentrated across national markets. We report on the first cross-country investigation of ownership networks, focusing on the stock markets of 48 countries around the world. On the one hand, our analysis confirms results expected on the basis of the literature on corporate control, namely, that in Anglo-Saxon countries control tends to be dispersed among numerous shareholders. On the other hand, it also reveals that in the same countries, control is found to be highly concentrated at the global level, namely, lying in the hands of very few important shareholders. Interestingly, the exact opposite is observed for European countries. These results have previously not been reported as they are not observable without the kind of network analysis developed here.Comment: 24 pages, 12 figures, 2nd version (text made more concise and readable, results unchanged

How far that little candle throws his beams! An interview with Mats Isaksson

This article adopts a policy-maker perspective on corporate governance, while exploring the role of academia in influencing corporate governance principles, the reasons for the boilerplate approach to governance rules typically adopted by most companies, and the reasons for a possible disconnect between research and corporate governance policies. The article ends with some key lessons about corporate governance and the future research agenda

Multisite prospective investigation of psychological outcomes following cataract surgery in Vietnam

Copyright © 2017 BMJ Global Health. All rights reserved. Background: Cataract surgery is a low-cost and effective intervention. There is increasing evidence to suggest that cataract surgery is associated with improvements in mobility, overall functioning and reductions in psychological distress. Within lowincome and middle-income countries, cataract surgery has also been documented to lead to reductions in psychological distress; however, differences in economic activity and engagement in paid and domestic work in these countries may moderate such reductions. We aimed to examine the psychological outcomes following cataract surgery among a diverse Vietnamese sample. Methods: We report findings from the VISIONARY study, a 12-month multisite prospective study of cataract surgery outcomes conducted in Vietnam (N=462). Generalised estimating equations (GEEs) were used to identify the variables which were associated with reduced psychological distress. Results: A high proportion of participants (56.6%) reported psychological distress before surgery and severity of psychological distress had decreased by 12 months following surgery (95% CI (4.13 to 4.95)). There were regional differences in the extent of improvement in psychological distress and change in paid and unpaid work. The extent of improvement in visual acuity, male gender, and increase in paid and unpaid work hours were significant predictors of reductions in psychological distress. Conclusions: Cataract surgery appears to result in the greatest reductions in psychological distress in communities where work engagement is highest. Funding: The VISIONARY study was funded by a grant provided by the Fred Hollows Foundation, Australia. During the course of this work, BME was in receipt of an Ian Potter Foundation Fellowship and a National Health and Medical Research Council (NHMRC) fellowship (1072148), SJ received an NHMRC Senior Research Fellowship, MLH was in receipt of a National Heart Foundation Future Leader Fellowship 100034

Media outlets and their moguls: why concentrated individual or family ownership is bad for editorial independence

This article investigates the levels of owner influence in 211 different print and broadcast outlets in 32 different European media markets. Drawing on the literature from industrial organisation, it sets out reasons why we should expect greater levels of influence where ownership of individual outlets is concentrated; where it is concentrated in the hands of individuals or families; and where ownership groups own multiple outlets in the same media market. Conversely, we should expect lower levels of influence where ownership is dispersed between transnational companies. The articles uses original data on the ownership structures of these outlets, and combines it with reliable expert judgments as to the level of owner influence in each of the outlets. These hypotheses are tested and confirmed in a multilevel regression model of owner influence. The findings are relevant for policy on ownership limits in the media, and for the debate over transnational versus local control of media

The Cannabis Pathway to Non-Affective Psychosis may Reflect Less Neurobiological Vulnerability

There is a high prevalence of cannabis use reported in non-affective psychosis. Early prospective longitudinal studies conclude that cannabis use is a risk factor for psychosis, and neurochemical studies on cannabis have suggested potential mechanisms for this effect. Recent advances in the field of neuroscience and genetics may have important implications for our understanding of this relationship. Importantly, we need to better understand the vulnerability × cannabis interaction to shed light on the mediators of cannabis as a risk factor for psychosis. Thus, the present study reviews recent literature on several variables relevant for understanding the relationship between cannabis and psychosis, including age of onset, cognition, brain functioning, family history, genetics, and neurological soft signs (NSS) in non-affective psychosis. Compared with non-using non-affective psychosis, the present review shows that there seem to be fewer stable cognitive deficits in patients with cannabis use and psychosis, in addition to fewer NSS and possibly more normalized brain functioning, indicating less neurobiological vulnerability for psychosis. There are, however, some familiar and genetic vulnerabilities present in the cannabis psychosis group, which may influence the cannabis pathway to psychosis by increasing sensitivity to cannabis. Furthermore, an earlier age of onset suggests a different pathway to psychosis in the cannabis-using patients. Two alternative vulnerability models are presented to integrate these seemingly paradoxical finding

Improving corporate governance in state-owned corporations in China: which way forward?

This article discusses corporate governance in China. It outlines the basic agency problem in Chinese listed companies and questions the effectiveness of the current mechanisms employed to improve their standards of governance. Importantly, it considers alternative means through which corporate practice in China can be brought into line with international expectations and stresses the urgency with which this task must be tackled. It concludes that regulators in China must construct a corporate governance model which is compatible with its domestic setting and not rush to adopt governance initiatives modelled on those in cultures which are fundamentally different in the hope of also reproducing their success

Acupuncture Treatment of Lateral Elbow Pain: A Nonrandomized Pilot Study

© 2016 Yan-Song Liu et al. In planning for a large-scale multicenter trial to evaluate the effect of acupuncture for the treatment of lateral elbow pain, a pilot study was conducted. This was a prospective, investigator- and patient-blinded, nonrandomized, placebo controlled trial. Subjects were evaluated at baseline, before fourth, seventh, and ninth treatment, and at a two-week posttreatment follow-up. The treatment group received unilateral acupuncture at LI 10 and LI 11 at the affected side with manual needle manipulation; the control group received sham-laser acupuncture at the same acupoints. Measures included (i) disabilities of the arm, shoulder, and hand (DASH) questionnaire, (ii) pain-free grip strength (PFGS), and (iii) a visual analogue scale (VAS) for pain. Significant differences in DASH score, PFGS, and VAS between treatment and control group were found at the ninth treatment (n = 20 for each group, P < 0.05). Only DASH showed significant differences compared to the control for all the measurement time points after treatment commenced and appears to be a sensitive and appropriate primary outcome measure for the future multisite trial. Results from this pilot study provided relevant information about treatment efficacy, credibility of control treatment, and sensitivity of different outcome measures for the planning of the future trial