The use of traditional Chinese medicine principles in chiropractic technique

Objectives: The authors of this manuscript seek to define the role, and scientific backing for the inclusion of Traditional Chinese Medicine (TCM) principles in the chiropractic techniques know as Applied Kinesiology (AK) and Neuro-Emotional Technique (NET). A discussion of the suitability of TCM principles within the chiropractic profession is also presented. Data Sources: A search through the electronic databases Medline, Meditext, Pubmed, OVID, CINAHL, and the Cochrane Library was performed for the period of 1900 – 2007 using the key words Traditional Chinese Medicine, Meridian, five-element, five-phase, acupuncture, chiropractic, Applied Kinesiology, and Neuro-Emotional Technique. The results were limited to works published in English appearing in peer-reviewed journals. A hand search was then performed within the reference lists of the articles retrieved. Study Selection: Based on their relevance to the subject, 196 references were obtained. Data Extraction and Synthesis: Only those historical principles and current research findings that pertain specifically to the TCM concepts used in AK and NET have been included. Conclusions: Principles and philosophies from TCM are incorporated into the diagnostic and treatment of protocols of the chiropractic techniques AK and NET. The scientific backing for this inclusion is still evolving and it is clear that further research is required to support the placement of TCM principles and practices within these chiropractic techniques. The welcoming of TCM principles into chiropractic practice may broaden the scope of the chiropractic profession and allow chiropractors to more faithfully adhere to the biopsychosocial model of healthcare

The influence of a biopsychosocial-based treatment approach to primary overt hypothyroidism: A protocol for a pilot study

Background Hypothyroidism is a prevalent endocrine condition. Individuals with this disease are commonly managed through supplementation with synthetic thyroid hormone, with the aim of alleviating symptoms and restoring normal thyroid stimulating hormone levels. Generally this management strategy is effective and well tolerated. However, there is research to suggest that a significant proportion of hypothyroid sufferers are being inadequately managed. Furthermore, hypothyroid patients are more likely to have a decreased sense of well-being and more commonly experience constitutional and neuropsychiatric complaints, even with pharmacological intervention. The current management of hypothyroidism follows a biomedical model. Little consideration has been given to a biopsychosocial approach to this condition. Within the chiropractic profession there is growing support for the use of a biopsychosocial-based intervention called Neuro-Emotional Technique (NET) for this population. Methods/Design A placebo-controlled, single-blinded, randomised clinical pilot-trial has been designed to assess the influence of Neuro-Emotional Technique on a population with primary overt hypothyroidism. A sample of 102 adults (≥18 years) who meet the inclusion criteria will be randomised to either a treatment group or a placebo group. Each group will receive ten treatments (NET or placebo) over a six week period, and will be monitored for six months. The primary outcome will involve the measurement of depression using the Depression, Anxiety and Stress Scale (DASS). The secondary outcome measures to be used are; serum thyroid stimulating hormone, serum free-thyroxine, serum free-triiodothyronine, serum thyroid peroxidase auto-antibodies, serum thyroglobulin auto-antibodies as well as the measurement of functional health and well-being using the Short-Form-36 Version 2. The emotional states of anxiety and stress will be measured using the DASS. Self-measurement of basal heart rate and basal temperature will also be included among the secondary outcome measures. The primary and secondary measures will be obtained at commencement, six weeks and six months. Measures of basal heart rate and basal temperature will be obtained daily for the six month trial period, with recording to commence one week prior to the intervention. Discussion The study will provide information on the influence of NET when added to existing management regimens in individuals with primary overt hypothyroidism

Microstructural characterisation of TiAlTiAu and TiAlPdAu ohmic contacts to AlGaN/GaN

Ti/Al/Ti/Au and Ti/Al/Pd/Au contacts to AlGaN/GaN have been investigated to ascertain the effect of annealing temperature on the structural evolution of the contacts. Ti/Al/Ti/Au contacts become ohmic after rapid thermal annealing at 750°C or higher, corresponding to the formation of an interfacial TiN phase, with inclusions penetrating through the AlGaN layer observed after annealing at 950°C. The Pd layer is shown to be more efficient at inhibiting diffusion of Au to the interface than Ti. Ohmic behaviour was not seen with the Ti/Al/Pd/Au scheme. Either the presence of Au at the interface may improve ohmic behaviour, or the Ti:Al ratio is insufficient in this scheme

Demographic characteristics and perceptions of supply and demand of chiropractic services in Australia: Results from stage 1 of the work force study survey

Objectives: The aim of this report is to describe the demographic characteristics including the age profile, gender differences, income and perceptions of supply and demand of the chiropractic profession in Australia. This workforce study (WFS) was divided into three components, Australian Chiropractors (Stage 1), their patients (Stage 2), and members of the general public (Stage 3). Methods: A web-based, 64-item, cross-sectional survey questionnaire was issued to registered chiropractors (CAA and non-CAA members) throughout Australia in 2010. At the time of the survey there were 3,892 registered chiropractors. Survey invitations were sent to those who were registered chiropractors, and had provided email addresses (n=1,917). Results: Demographic Characteristics: There is evidence to suggest that the profession may be becoming increasingly female over time. Income exclusively from chiropractic care included 27.9% who reported an annual pre-tax net income of $115,000 or less and 32.3$115,000. Of the latter group, 12% indicated that they were earning more than $215,000. Income was not related to the hours worked per week particularly for males. Supply and Demand: When considering their home state and their local region, more chiropractors thought that there was undersupply in their state, but an adequate supply in their local region. A large proportion (40%) of the sample felt that universities in Australia were graduating the correct number of chiropractors per year, and 32% reported that too many were being produced in Australia. Very few reported that the Universities were not graduating enough chiropractors. Conclusion: This paper reflects some of the findings from Stage 1 of the three stage Workforce study, showing a profession heading towards a more even gender balance and characterised by a higher than average annual income. Future research should include the impact on supply and demand of the possibility of an increasingly female profession. In addition to this, although there is a perception that there is under-utilisation of chiropractic services in inland, rural and remote areas, the extent of which should be further explored. Information from this study will assist with strategic decision making and planning. A strategic framework for the profession should not only consider the findings from this study but also explore other factors that may have an impact on supply and demand, for example general trends in health and aging from local and national government reports

Chiropractic in Australia: A survey of the general public

Background: An increase in the use of complementary and alternative medicine was identified in several countries including Australia. There is a need to assess the current position of chiropractic within the Australian health system. Objectives: To estimate the lifetime prevalence of the use of chiropractic in Australia; to investigate the perceptions and attitudes of Australian general public about: their health status, the chiropractic profession, chiropractic and health services in general. Methods: A survey was carried out in which a novel 21-item questionnaire was utilised. To obtain a sample whose opinions would be representative of the Australian general population with a 95% level of significance and 4% margin of error, 600 respondents were required. Descriptive statistics, the chi-squared test and logistic regression were used to present and analyse the data. Results: 757 respondents completed the survey. A high prevalence of pain and discomfort relating to the musculoskeletal system were found, particularly in the lower back (71.1 % of the respondents) and neck (55.6%). The first contact with respect to therapy for the greatest proportion of respondents was general medicine (35.5%), followed by chiropractic (16%), physiotherapy (13.8%) and massage (10.2%). Physiotherapy was rated highest in its ability to relieve the symptoms (18%) followed by chiropractic (15.9%), massage (15.5%) and medicine (14%). In our sample 302 (39.9%) participants used chiropractic before and 75.9% of these consumers were satisfied or highly satisfied with the services provided. No significant differences in income, age and gender were found with regards to those individuals who reported a previous use of chiropractic services. The main reasons for not using chiropractic were: that there was no perceived need for a chiropractic intervention, associated cost, lack of information about chiropractic, lack of referral, being attended by another health professional, and concern about the safety and efficacy of the treatment. Most of the respondents considered that attending to general health and well-being was more important than simply alleviating symptoms and their personal philosophy was a major determinant when it came to the choice of health services. Conclusions: This study suggests that chiropractic is a thriving profession in Australia. It would appear that there is a need for chiropractic services in Australia, particularly in attending to the highly prevalent realm of musculoskeletal disorders. A considerable number of Australians already utilise chiropractic services. Encouragingly, the vast majority of these consumers are satisfied with the service provided. Chiropractic could play an even greater role within the Australian health if better integrated with the mainstream and allied medicine. A more active approach should be taken by chiropractic practitioners and institutions to improve the general public's knowledge about chiropractic

Microstructural characterisation of TiAlTiAu and TiAlPdAu ohmic contacts to AlGaN/GaN

Ti/Al/Ti/Au and Ti/Al/Pd/Au contacts to AlGaN/GaN have been investigated to ascertain the effect of annealing temperature on the structural evolution of the contacts. Ti/Al/Ti/Au contacts become ohmic after rapid thermal annealing at 750°C or higher, corresponding to the formation of an interfacial TiN phase, with inclusions penetrating through the AlGaN layer observed after annealing at 950°C. The Pd layer is shown to be more efficient at inhibiting diffusion of Au to the interface than Ti. Ohmic behaviour was not seen with the Ti/Al/Pd/Au scheme. Either the presence of Au at the interface may improve ohmic behaviour, or the Ti:Al ratio is insufficient in this scheme

Comparing antibody responses to Onchocerca volvulus and non-parasite antigens in placebo-controlled and ivermectin-treated onchocerciasis patients

Serum antibodies to parasite-specific and non-parasite antigens were evaluated  using enzyme-linked immunosorbent assay (ELISA). Out of the 470 sera collected, 409 were from residents of an onchocerciasis hyper-endemic area, 55 non-endemic and 6 European normal sera served as control. The patients’ age, sex, skin  microfilaria densities, dermal and ocular clinical manifestations (colour of optic disc) have been well characterised. The study population had participated in a  placebocontrolled (n=191) trial of ivermectin (Mectizan®) treatment (n=218). The parasite antigens are phosphate buffered saline crude extract of adult worms of Onchocerca volvulus, a recombinant antigen (Ov1.9) and a monoclonal antibody purified antigen (Cam 1). The non-parasite antigens are deoxycholate citrate extract of optic nerve (nerve-DOC) and commercially available IgA, IgM and IgG were used to assay for rheumatoid factor (Rh-F) auto-antibodies. Generally, antibodies to parasite antigens in onchocerciasis patients were remarkably higher than control group (p<0.05) using exact F-test. There was no significant difference (p>0.05) in antibodies to nerve-DOC and Rh-F in patients compared to control. Antibodies increased with increasing skin snip microfilaria load from 0.69±0.28 with 0mf/mg (n=54) as against 0.80±0.26 for those with 4-20mf/mg. Observed slight negative correlation in IgG antibody levels and severity of disc colour with mean OD values of 0.26±0.22 in those graded as having no optic nerve disease (OND) (disc 1, n=86) and 0.17±0.19 for those with severe changes (disc 3, n=49) was not statistically significant (P>0.05). An age dependent significant decrease (P<0.05) in antibodies were observed with 0.64±0.34 for 15-30yr old (n=48) compared to 0.48±0.35 for those 50yr (n=50) for PBS with a similar trend for IgG to Ov1.9 and Cam1. In conclusion, serum parasite-specific and non-parasite antibodies may not be responsible for the pathology of optic nerve disease. Onchocerciasis patients were apparently not at higher risk of developing rheumatoid arthritis than the control.Keywords: Onchocerciasis; Antibodies; Antigens; Immune responses; Ivermectin

The Association of Dietary Fiber Intake with Cardiometabolic Risk in Four Countries across the Epidemiologic Transition.

The greatest burden of cardiovascular disease is now carried by developing countries with cardiometabolic conditions such as metabolic syndrome, obesity and inflammation believed to be the driving force behind this epidemic. Dietary fiber is known to have protective effects against obesity, type 2 diabetes, cardiovascular disease and the metabolic syndrome. Considering the emerging prevalence of these cardiometabolic disease states across the epidemiologic transition, the objective of this study is to explore these associations of dietary fiber with cardiometabolic risk factors in four countries across the epidemiologic transition. We examined population-based samples of men and women, aged 25⁻45 of African origin from Ghana, Jamaica, the Seychelles and the USA. Ghanaians had the lowest prevalence of obesity (10%), while Jamaicans had the lowest prevalence of metabolic syndrome (5%) across all the sites. Participants from the US presented with the highest prevalence of obesity (52%), and metabolic syndrome (22%). Overall, the Ghanaians consumed the highest dietary fiber (24.9 ± 9.7 g), followed by Jamaica (16.0 ± 8.3 g), the Seychelles (13.6 ± 7.2 g) and the lowest in the USA (14.2 ± 7.1 g). Consequently, 43% of Ghanaians met the fiber dietary guidelines (14 g/1000 kcal/day), 9% of Jamaicans, 6% of Seychellois, and only 3% of US adults. Across all sites, cardiometabolic risk (metabolic syndrome, inflammation and obesity) was inversely associated with dietary fiber intake, such that the prevalence of metabolic syndrome was 13% for those in the lowest quartile of fiber intake, compared to 9% those in the highest quartile of fiber intake. Notably, twice as many of participants (38%) in the lowest quartile were obese compared to those in the highest quartile of fiber intake (18%). These findings further support the need to incorporate strategies and policies to promote increased dietary fiber intake as one component for the prevention of cardiometabolic risk in all countries spanning the epidemiologic transition

Structure Formation, Melting, and the Optical Properties of Gold/DNA Nanocomposites: Effects of Relaxation Time

We present a model for structure formation, melting, and optical properties of gold/DNA nanocomposites. These composites consist of a collection of gold nanoparticles (of radius 50 nm or less) which are bound together by links made up of DNA strands. In our structural model, the nanocomposite forms from a series of Monte Carlo steps, each involving reaction-limited cluster-cluster aggregation (RLCA) followed by dehybridization of the DNA links. These links form with a probability $p_{eff}$ which depends on temperature and particle radius $a$. The final structure depends on the number of monomers (i. e. gold nanoparticles) $N_m$, $T$, and the relaxation time. At low temperature, the model results in an RLCA cluster. But after a long enough relaxation time, the nanocomposite reduces to a compact, non-fractal cluster. We calculate the optical properties of the resulting aggregates using the Discrete Dipole Approximation. Despite the restructuring, the melting transition (as seen in the extinction coefficient at wavelength 520 nm) remains sharp, and the melting temperature $T_M$ increases with increasing $a$ as found in our previous percolation model. However, restructuring increases the corresponding link fraction at melting to a value well above the percolation threshold. Our calculated extinction cross section agrees qualitatively with experiments on gold/DNA composites. It also shows a characteristic ``rebound effect,'' resulting from incomplete relaxation, which has also been seen in some experiments. We discuss briefly how our results relate to a possible sol-gel transition in these aggregates.Comment: 12 pages, 10 figure

Theory of Melting and the Optical Properties of Gold/DNA Nanocomposites

We describe a simple model for the melting and optical properties of a DNA/gold nanoparticle aggregate. The optical properties at fixed wavelength change dramatically at the melting transition, which is found to be higher and narrower in temperature for larger particles, and much sharper than that of an isolated DNA link. All these features are in agreement with available experiments. The aggregate is modeled as a cluster of gold nanoparticles on a periodic lattice connected by DNA bonds, and the extinction coefficient is computed using the discrete dipole approximation. Melting takes place as an increasing number of these bonds break with increasing temperature. The melting temperature corresponds approximately to the bond percolation threshold.Comment: 5 pages, 4 figure. To be published in Phys. Rev.