Acupuncture for dry eye: a multicentre randomised controlled trial with active comparison intervention (artificial tear drop) using a mixed method approach protocol

<p>Abstract</p> <p>Background</p> <p>Previous studies of acupuncture show favourable results for both subjective and objective outcomes of dry eye. However, firm conclusions could not be drawn from these studies because the quality of the trials was too low to establish concrete evidence. Therefore, this study was designed both to avoid the flaws of the existing trials and to assess the effectiveness, cost-effectiveness and qualitative characteristics of acupuncture treatment for dry eye.</p> <p>Methods/design</p> <p>One hundred fifty participants with dry eye will be recruited into three independent hospitals from different areas: Korea Institute of Oriental Medicine, DongGuk University Ilsan Oriental Hospital and Dongshin University Gwangju Oriental Hospital. The number of participants required was calculated from the data of a previous, relevant study. These patients will be randomly allocated into acupuncture treatment or artificial tear groups. Either 17 acupuncture points (bilateral BL2, GB14, TE 23, Ex1, ST1, GB20, LI4, LI11 and single GV23) will be used 3 times a week or disposable artificial tear drops (Refresh Plus^®, ALLERGAN) will be provided for use at least once a day for 4 weeks. The ocular surface disease index (OSDI), tear film break-up time (TFBUT), Schirmer I test, visual analogue scale (VAS) for self-assessment of ocular discomfort, general assessment (by both acupuncture practitioners and participants) and quality of life (QOL) through the Measure Yourself Medical Outcome Profile-2 (MYMOP-2) will be assessed for approximately 3-months for each study participant. In addition, qualitative study and cost-effectiveness of acupuncture treatment will be conducted.</p> <p>Trial registration</p> <p>ClinicalTrials.gov (Identifier: NCT01105221).</p

Factors affecting deer ked (<it>Lipoptena cervi</it>) prevalence and infestation intensity in moose (<it>Alces alces)</it> in Norway

<p>Abstract</p> <p>Background</p> <p>The deer ked (<it>Lipoptena cervi</it>), a hematophagous ectoparasite of Cervids, is currently spreading in Scandinavia. In Norway, keds are now invading the south-eastern part of the country and the abundant and widely distributed moose (<it>Alces alces</it>) is the definitive host. However, key factors for ked abundance are poorly elucidated. The objectives of our study were to (i) determine deer ked infestation prevalence and intensity on moose and (ii) evaluate if habitat characteristics and moose population density are determinants of deer ked abundance on moose.</p> <p>Methods</p> <p>In order to identify key factors for deer ked abundance, a total of 350 skin samples from the neck of hunted moose were examined and deer keds counted. Infestation intensity was analyzed in relation to moose age and sex, moose population density and landscape characteristics surrounding the killing site.</p> <p>Results</p> <p>Deer ked infestation prevalence was 100%, but infestation intensity varied from 0.001 to 1.405 keds/cm². Ked intensity was highest in male yearlings (~1.5 years) and positively associated with longitude and Scots pine (<it>Pinus sylvestris</it>) dominated habitat and negatively associated with bogs and latitude. Moose population density during autumn showed a tendency to be positively associated, while altitude tended to be negatively associated with ked intensity.</p> <p>Conclusions</p> <p>Deer keds exploit the whole moose population within our study area, but are most prevalent in areas dominated by Scots pine. This is probably a reflection of Scots pine being the preferred winter browse for moose in areas with highest moose densities in winter. Ked intensity decreases towards the northwest and partly with increasing altitude, probably explained by the direction of dispersal and reduced temperature, respectively. Abundant deer ked harm humans and domestic animals. Moose management authorities should therefore be aware of the close relationship between moose, deer ked and habitat, using the knowledge as a management tool for locally regulating the ked burden.</p