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

Arachnoid cysts do not contain cerebrospinal fluid: A comparative chemical analysis of arachnoid cyst fluid and cerebrospinal fluid in adults

<p>Abstract</p> <p>Background</p> <p>Arachnoid cyst (AC) fluid has not previously been compared with cerebrospinal fluid (CSF) from the same patient. ACs are commonly referred to as containing "CSF-like fluid". The objective of this study was to characterize AC fluid by clinical chemistry and to compare AC fluid to CSF drawn from the same patient. Such comparative analysis can shed further light on the mechanisms for filling and sustaining of ACs.</p> <p>Methods</p> <p>Cyst fluid from 15 adult patients with unilateral temporal AC (9 female, 6 male, age 22-77y) was compared with CSF from the same patients by clinical chemical analysis.</p> <p>Results</p> <p>AC fluid and CSF had the same osmolarity. There were no significant differences in the concentrations of sodium, potassium, chloride, calcium, magnesium or glucose. We found significant elevated concentration of phosphate in AC fluid (0.39 versus 0.35 mmol/L in CSF; <it>p </it>= 0.02), and significantly reduced concentrations of total protein (0.30 versus 0.41 g/L; <it>p </it>= 0.004), of ferritin (7.8 versus 25.5 ug/L; <it>p </it>= 0.001) and of lactate dehydrogenase (17.9 versus 35.6 U/L; <it>p </it>= 0.002) in AC fluid relative to CSF.</p> <p>Conclusions</p> <p>AC fluid is not identical to CSF. The differential composition of AC fluid relative to CSF supports secretion or active transport as the mechanism underlying cyst filling. Oncotic pressure gradients or slit-valves as mechanisms for generating fluid in temporal ACs are not supported by these results.</p

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

Internet Gaming Disorder Behaviors in emergent adulthood: a pilot study examining the interplay between anxiety and family cohesion

Understanding risk and protective factors associated with Internet Gaming Disorder (IGD) has been highlighted as a research priority by the American Psychiatric Association, (2013). The present study focused on the potential IGD risk effect of anxiety and the buffering role of family cohesion on this association. A sample of emerging adults all of whom were massively multiplayer online (MMO) gamers (18–29 years) residing in Australia were assessed longitudinally (face-to-face: N = 61, Mage = 23.02 years, SD = 3.43) and cross-sectionally (online: N = 64, Mage = 23.34 years, SD = 3.39). IGD symptoms were assessed using the nine-item Internet Gaming Disorder Scale-Short Form (IGDS-SF9; Pontes & Griffiths Computers in Human Behavior, 45, 137–143. https://doi.org/10.1016/j.chb.2014.12.006, 2015). The Beck Anxiety Inventory (BAI; Beck and Steer, 1990) and the balanced family cohesion scale (BFC; Olson Journal of Marital & Family Therapy, 3(1) 64–80. https://doi.org/10.1111/j.1752-0606.2009.00175.x, 2011) were applied to assess anxiety and BFC levels, respectively. Linear regressions and moderation analyses confirmed that anxiety increased IGD risk and that BFC weakened the anxiety-related IGD risk