A mixed methods sequential explanatory study of the utilisation and practice of traditional Chinese medicine by Chinese people in Hong Kong and Guangzhou

Little is known about why traditional Chinese (TCM) continues to be used and practised by Chinese people despite the existence of evidence-based Western medicine (WM). This study aims to explore Chinese patients and TCM practitioners’ attitudes and beliefs towards the utilisation and practice of TCM and to determine if there are any differences in the way in which Chinese people use and practice TCM in different regions of China, in this study, Hong Kong and Guangzhou. A mixed-method, sequential explanatory study was undertaken that involved two phases. In the first phase, a structured questionnaire translated into Chinese was used to collect data from a convenience sample of Chinese patients attending outpatient clinics in Hong Kong and Guangzhou. A Chinese research assistant who could speak Cantonese and Mandarin distributed the questionnaires to patients attending the TCM outpatient clinics in Hong Kong and Guangzhou. Also, a random sample of Chinese medicine practitioners in Hong Kong was sent a questionnaire by post, as a list of Chinese medicine practitioners names, and clinic addresses in Hong Kong are available on the Chinese Medical Council’s Internet website. For TCM practitioners in Guangzhou, a Chinese research assistant distributed the questionnaire in-person to a random sample of TCM doctors working at the Guangzhou University of Traditional Chinese medicine in Guangzhou. In the second phase of the study, semi-structured interviews were conducted with patients and Chinese medicine practitioners in Hong Kong and patients and TCM practitioners in Guangzhou. Patients and TCM practitioners who took part in an interview were randomly selected from a list of patients and TCM practitioners who had previously filled out a questionnaire in the first phase of the study. A total of 1,200 patients and 400 TCM practitioners took part in the study, which comprised of 600 patients attending an out-patient TCM clinic in Hong Kong and 600 attending an out-patient TCM clinic in Guangzhou. The response rate for patients who took part was 81.4% (n= 505) and for Guangzhou 91.6% (n=550). For TCM practitioners, the response rate was 55% (n=110) for practitioners in Hong Kong and 61.5% (n= 123) for practitioners in Guangzhou. Patients’ mean age was 44.6 years, and the sample consisted of 41.2% males and 58.8% females. For TCM practitioners, the mean age was 45.4 years and the sample consisting of 66.1% males and 33.9% females. In the second phase of the study, semi-structured interviews were conducted with 16 patients and 16 TCM practitioners in Hong Kong and Guangzhou, respectively. The results showed that for patients in Hong Kong and Guangzhou the most common use of TCM was for the treatment of acute medical conditions, such as colds and flu and also for chronic medical conditions, such as rheumatism and diabetes. Also, patients in Guangzhou were found to use TCM to “recuperate” the body after taking Western medicines prescribed by WM doctors, or after suffering a chronic illness. Concurrent use of TCM and WM was found to be more common in patients in Guangzhou, than in patients in Hong Kong. The integration of TCM services in hospitals in Hong Kong is notably different from that of China. Unlike China, where TCM practitioners are permitted to treat in-patients inside state-run hospitals, in Hong Kong, TCM practitioners are only permitted to treat patients on an outpatient basis and not as in-patients. The results of this study contribute to the existing body of literature about the utilisation and practice of TCM by Chinese people in Hong Kong and Guangzhou. The study also provides unique information about the practice of TCM in Hong Kong since the implementation of the Chinese medicine Ordinance and the establishment of the Chinese Medicine Council of Hong Kong. Although the study contributes to the existing body of literature concerning the utilisation and practice of TCM by Chinese people and TCM practitioners ‘respectively, it does have several inherent limitations. Among the significant limitations is the fact that, as a cross-sectional survey design was used, therefore no “cause and effect” relationships can be drawn from the results. Furthermore, because statistical tests, in general, require a large sample size to ensure a representative distribution of the population being studied, the total number of patients and TCM practitioners who participated in the study is relatively small

Winter residency and site association in the critically endangered North East Atlantic spurdog (Squalus acanthias)

Identification and incorporation of residential behaviour into elasmobranch management plans has the potential to substantially increase their effectiveness by identifying sites where Marine Protected Areas (MPAs) might be used to help conserve species with high migratory potential. There is evidence that spurdog (Squalus acanthias) displays site association in some parts of its global distribution, but this has currently not been shown within the North East Atlantic where it is critically endangered. Here we investigate the movements of electronically tagged spurdog within Loch Etive, a sea loch on the west coast of Scotland. Archival data storage tags (DSTs), that recorded depth and temperature, revealed that mature female spurdog over wintered within the loch, restricting their movements to the upper basin, and remaining either in the loch or the local vicinity for the rest of the year. This finding was supported by evidence for limited movements from conventional mark/recapture data and acoustically tagged individual spurdog. Some of the movements between the loch basins appear to be associated with breeding and parturition events. This high level of site association suggests that spatial protection of the loch would aid the conservation of different age and sex classes of spurdog

Receipt from J. M. Thorburn & Co. to Ogden Goelet

https://digitalcommons.salve.edu/ochre-court/1292/thumbnail.jp

Using individual tracking data to validate the predictions of species distribution models

The authors would like to thank the College of Life Sciences of Aberdeen University and Marine Scotland Science which funded CP's PhD project. Skate tagging experiments were undertaken as part of Scottish Government project SP004. We thank Ian Burrett for help in catching the fish and the other fishermen and anglers who returned tags. We thank José Manuel Gonzalez-Irusta for extracting and making available the environmental layers used as environmental covariates in the environmental suitability modelling procedure. We also thank Jason Matthiopoulos for insightful suggestions on habitat utilization metrics as well as Stephen C.F. Palmer, and three anonymous reviewers for useful suggestions to improve the clarity and quality of the manuscript.Peer reviewedPostprintPostprintPostprintPostprintPostprin

Study site standard operating procedures

published_or_final_versionICH GCP E6 guidelines 193Clinical proceduresAppendicesPreparation of clinical trial protocol and protocol amendments 1Quality assurancePre-study visit 9Study closureTrial operationReview and validation of clinical trial protocol 14Introduction vReview of protocol amendments 22Review of investigators brochure 26Review of case report form 31Contracts and budgets 35Study organisation and planning 40Study team : definition of responsibilities 58Pre studyRecruitment of subjects 62Pre-study planning of investigational products and devices 68Pre-study planning for laboratory investigations 73Independent ethics committee or institutional review board 78Investigator meeting and GCP training 86Pre-study checklist 89Site initiation visit 93Blinding : codes and code breaking 101Investigational products accounting and dispensing 104Case report form completion 110Obtaining written informed consent 114Adverse event and serious adverse event reporting 129Monitoring visits 134Data clarification 139Study closure visit 145Archiving of study data 149Independent data monitoring 155Audits 158Inspections 164Measurement of blood pressure 171Spirometry testing 175Measurement of body weight and height 178Venepuncture (adults) 182Preparation and approval of SOPs 187Format for investigators CV 188Declaration of Helsinki 19

Estimation of Scottish pluvial flooding Expected Annual Damages using interpolation techniques

Flood modelling and mapping, underpinned by hydraulic modelling, are typically used to define flood hazard and allow a quantification of risk and associated Expected Annual Damages (EAD). At a regional or national scale, such modelling is often a lengthy process, which does not allow changes in risk resulting from new science such as revised rainfall frequency estimates or climate projections to be readily quantified by policy makers. A framework of interpolation and extrapolation methods has been developed in the R language via practical application to the city of Perth in central Scotland. These methods allow existing flood mapping, design rainfall estimates and property receptor datasets combined with revised design rainfall estimates to be used to rapidly assess the consequences of change in risk and EAD. The results are evaluated against detailed hydraulic modelling and are shown to provide a good approximation of changes in flood depth and EAD for properties previously modelled as at risk of flooding, particularly residential properties, with lower confidence for non-residential properties. In the Scottish context, the methods are considered to be robust for regional and national scale application and would allow policy makers with a means to rapidly determine the consequence of changes in design rainfall estimates without the immediate requirement to undertake complex hydraulic modelling

Growth and yield responses to amending the sugarcane monoculture: interactions between break history and nitrogen fertiliser

Experiments were established in the Burdekin Irrigation Area in North Queensland, Australia, to measure whether yield improvements from breaking the sugarcane monoculture or fumigating the soil could be modified by the application of different rates of nitrogen (N) fertiliser. Experiments were conducted in consecutive crop cycles (phase 1, planted 1998; phase 2, planted 2001) using the variety Q117, with the interaction between N applications and rotation histories discussed for the two plant crops. Histories consisted of alternate crop, bare fallow or mixed grass-legume pastures for periods of 42-66 months, compared with continuous cane as plough-out replant without (PORP) or with (PORP-F) soil fumigation. The N strategies involved combinations of N rates (0-180kgN/ha) and application times (at planting, 90 days after planting (DAP) or split between these times) in phase 1 and N rates (0-300kgN/ha) in phase 2. Histories had differing effects on N available to the cane crop and hence on response to N fertiliser. Some combinations of history and N rate were N-limited and strong linear relationships between biomass production or cane yield and crop N content could be developed. Critical N contents for biomass production (R2≤0.93) and fresh-weight cane yield (R2≤0.88) were 1.42 and 0.57kgN/t, respectively. Application of N fertiliser was shown to have significant impacts on both tiller addition and the retention of tillers to produce harvestable stalks. However, the application of fertiliser N had limited (phase 1) or no (phase 2) capacity to provide the quantum of yield response in soil health benefits associated with breaking the sugarcane monoculture. Increasing N application rates above that required to optimise crop yield resulted in significant decreases in sugar content of cane and thus lower sugar yields. Yield increases solely from improved soil health (i.e. exclusive of N response) constituted advantages averaging 15% (phase 1) to 20% (phase 2) compared with PORP. These effects were manifest early in the establishment of primary shoots in the plant crops, although the longevity of these benefits was limited. Replanting cane after a 3-year crop cycle (plant, 1st and 2nd ratoon) on land that had been under pasture, crop, bare fallow or PORP-F histories (phase 2, cycle 2) showed carryover effects of histories on N availability and fertiliser N responsiveness, but limited yield impacts attributable to residual soil health benefits. These results reinforce the importance of crop rotation during breaks between sugarcane cycles to maintain soil health and improve crop productivity

Influence of supply-channel velocity on farm delivery meter gate flow measurement

The work presented here is an extension of previous papers that updated the calibration of round (Armco-type) meter gates (three sizes: 0.30, 0.46, and 0.61 m), developed ratings for rectangular gates (two sizes: 0.46 and 0.61 m) on round pipes, and examined errors and uncertainty related to using these devices for water discharge measurement. Previous works examined gate discharge ratings under low supply-channel flow velocity perpendicular to the gate discharge pipeline. Here, additional testing was conducted to test the hypothesis that higher velocities in the supply channel would show decreased meter gate flow compared to the low-velocity ratings, but that the published gate calibration method would still yield accurate flow-rate calculations. All testing was conducted in a test facility with the gate discharge pipe set perpendicular to the supply channel, as is common in field installations. Velocities up to 0.94 m=s (3.1 ft=s) were tested with the smaller gate and 0.66 m=s (2.2 ft=s) for all other gates. These velocities are on the upper end of velocities found in common earthen irrigation canals (and in many lined channels at the farm delivery level) in California. Interestingly, results indicate that the Froude number of the supply-channel flow did not have a statistically significant (at an α-level of 0.01) influence on gate discharge coefficients. Discharge percent error and uncertainty were examined to compare the discharge coefficients presented in the literature to the discharge measured during the testing at different supply-channel velocities. Under recommended operating conditions, the uncertainty was within ±5% without adjustments for supply-channel velocity. This extended work supports earlier recommendations that meter gates can be an accurate flow measurement device for farm water delivery flow measurement if installed and operated correctl