Chris Zaslawski is currently the Team leader for the Chinese Medicine team, a teaching and research unit in the University of Technology, Sydney (Australia). He has been practising acupuncture and herbal medicine for over 35 years and is an active researcher in the area. Chris has also been English editor for three acupuncture texts, which were published in conjunction with Chinese medicine colleagues from the Guangzhou University of Traditional Medicine, China. Chris has published 25 papers of which 19 were in peer reviewed journals as well as nine report and book reviews. He is currently Deputy Editor for the Australian Journal of Acupuncture and Chinese Medicine, and is also on the International Editorial Board for two other journals, Acupuncture Research, published in Beijing and the Journal of Acupuncture and Tuina Science, published in Germany.
Chris has been a temporary consultant for the World Health Organisation on four occasions and contributed to the development of two WHO documents concerning acupuncture clinical research and traditional medicine education. He also reviewed the WHO International Standard Terminologies on Traditional Medicine in the Western Pacific Region which was published in 2007. Chris is currently a member of HE 031, a Standards Australia committee for developing standards for Chinese medicine. He is also a committee member of the accreditation committee for the Chinese Medicine Board of Australia.
Chris' research has involved experimental pain and acupuncture, reliability of Chinese medicine diagnosis including tongue diagnosis and the influence of research ethics on the design of acupuncture and herbal medicine studies. He has been involved in several acupuncture clinical studies involving the efficacy of acupuncture on male sub-fertility, hepatitis C and stress. He has just completed a clinical trial regarding the effect of acupuncture on lateral elbow pain and a Delphi study on a rating scale for assessing the adequacy of acupuncture in clinical trials.
Member- He 031 Standards Australia
Member-Accreditation Committee of the Chinese Medicine Board of Australia
Member-Australian Acupuncture and Chinese Medicine Association (AACMA)
Excutive Director-World Federation of Acupuncture-Moxibustion Societies (WFAS) (2017-2020)
Guest Professor-Chengdu University of Traditional Chinese Medicine
Member-Pattern Identification Network Group (IPING)
Can supervise: YES
Musculoskeletal pain and acupuncture
Human Research Ethics and clinical trials
Standardisation in Chinese medicine
Anatomy of acupuncture points
Diagnostic Systems used in Traditional Chinese Medicine
Birch, S, Alraek, T, Bovey, M, Lee, MS, Lee, JA, Zaslawski, C, Robinson, N, Kim, TH & Bian, ZX 2020, 'Overview on pattern identification – History, nature and strategies for treating patients: A narrative review', European Journal of Integrative Medicine, vol. 35.View/Download from: Publisher's site
© 2020 Introduction: In traditional East Asian Medicine (TEAM), various systems of practice exist that have used different theories to guide their practice. Although data gathering has been limited to what can be observed by the four examinations - si zhen, the different systems of practice have focused on different observational data to make diagnostic decisions and choose corresponding treatments. The organization of the data into patterns has led to what is called Pattern Identification based systems of practice (PIs). Methods: The range of systems, theories, treatments and PIs were explored in order to highlight important issues for researchers to consider in performing PI based research Results: Expert opinions, scholarly and clinical literature on the key issues which compose ‘pattern identification’ (PI) were identified with respect to the history, development, nature and the different strategies used by different PIs for diagnosing and treating patients. Conclusion: It is important for researchers to understand these issues so as not to weaken their results and findings, whether conducting survey-based research, clinical trial research, laboratory studies or seeking to influence teaching and practice. This is the first in a series of papers by the international Pattern Identification Network Group (iPING) helping to clarify the area of research on PIs and which seek to expand lines of research on PIs so that teaching, practice, clinical and laboratory research can be more consequential.
Gadau, M, Zhang, SP, Wang, FC, Liguori, S, Zaslawski, C, Liu, WH, Bangrazi, S, Berle, C, Razavy, S, Bian, ZX, Filomena, P, Hao, Y, Jiang, HL, Lei, L, Li, T, Li, WH, Liguori, A, Liu, YS, Lu, AP, Tan, YS, Yim, WW & Xie, CL 2020, 'A multi-center international study of Acupuncture for lateral elbow pain - Results of a randomized controlled trial.', European journal of pain (London, England).View/Download from: Publisher's site
BACKGROUND:Lateral elbow pain (LEP) due to tendinosis is one of the most common musculoskeletal pains of the upper limbs, yet there is no satisfactory treatment. This study was an international, prospective, multi-center, randomized, controlled, clinical trial to evaluate the efficacy of acupuncture compared to sham laser in the treatment of LEP. METHODS:The study used a parallel and stratified design (1:1 allocation using a computer-generated sequence) and was participant-, outcome assessor- and statistician blinded. Subjects from 18 to 80 years with unilateral chronic LEP (minimum three months) were recruited at four centers in Australia, China, Hong Kong and Italy. The treatment group received manual acupuncture at acupoints LI 10 and LI 11 on the affected side whereas the control group received sham-laser acupuncture at the same acupoints. The primary endpoint was the disabilities of the arm, shoulder, and hand (DASH) questionnaire score at the three-week post-treatment follow-up visit. Three VAS scales (pain at rest, pain on motion and pain during exertion were secondary outcomes. Ninety-six subjects were allocated to either the treatment group (n = 47) or control group (n = 49) and were all included in the analysis. RESULTS:At the follow-up visit, we found significant differences in DASH score between the two groups (P = 0.015). The median change to baseline for the treatment group was -11.7 (interval: -50.83 to 23.33), and for the control group -7.50 (interval: -36.67 to 29.10). The estimated effect size was 0.47, indicating a medium effect. Significant differences were also found for secondary outcome measures for VAS pain. There were no severe adverse events. Our findings suggest that acupuncture has a moderate efficacy in the treatment of LEP. CONCLUSIONS:Acupuncture was shown to be efficacious in improving the function of the arm associated with lateral elbow tendinosis. Both the DASH score and the VAS pain on two occasions (at rest and during motion) ...
Popplewell, M, Reizes, J & Zaslawski, C 2019, 'A Novel Approach to Describing Traditional Chinese Medical Patterns: The "Traditional Chinese Medical Diagnostic Descriptor".', Journal of Alternative and Complementary Medicine, vol. 25, no. 11, pp. 1121-1129.View/Download from: Publisher's site
OBJECTIVES:In the first of a series of three articles by the present authors, diagnostic agreement between Traditional Chinese Medicine (TCM) practitioners was found to be low. This was the first time that TCM diagnoses had been evaluated with an open population of patients and this result is a cause of concern. In the second article, incorrect statistics were shown to have often been used to calculate chance-removed inter-rater agreement, and appropriate statistics such as Gwet's Agreement Coefficient 2 (AC2) was recommended for future studies. In this, the third article, a novel approach to recording TCM diagnostic patterns, the Traditional Chinese Medical Diagnostic Descriptor (TCMDD), is presented that allows chance-removed agreement calculation. An example of mapping TCM diagnostic patterns to the TCMDD format is given and diagnostic agreement is evaluated. Design, Settings, Subjects: The same 35 subjects used to report agreement in our first article were also diagnosed by additional practitioners using the TCMDD format during the same experimental sessions at the University of Technology, Sydney Clinic. TCM diagnoses from the first article were also mapped to the TCMDD format. OUTCOME MEASURES:Linearly weighted simple agreement and the AC2 statistic were utilized and all results compared. RESULTS:Linearly weighted simple agreement using the TCMDD and TCM mapped to TCMDD format averaged 0.80 ± 0.02 compared with 0.19 for TCM. TCMDD and TCM mapped to TCMDD chance-removed agreement, as calculated with AC2, ranged between 0.67 and 0.73 ± 0.03. CONCLUSIONS:The TCMDD allows the essence of diagnoses expressed by TCM practitioners to be appropriately compared. This was confirmed by the TCM mapped to TCMDD results. In both cases, simple agreement was significantly greater than that obtained with the TCM format. Chance-removed statistics and error estimates can be reliably calculated with the AC2 and the TCMDD in open populations.
Popplewell, M, Reizes, J & Zaslawski, C 2019, 'Appropriate Statistics for Determining Chance-Removed Interpractitioner Agreement.', Journal of Alternative and Complementary Medicine, vol. 25, no. 11, pp. 1115-1120.View/Download from: Publisher's site
Fleiss' Kappa (FK) has been commonly, but incorrectly, employed as the "standard" for evaluating chance-removed inter-rater agreement with ordinal data. This practice may lead to misleading conclusions in inter-rater agreement research. An example is presented that demonstrates the conditions where FK produces inappropriate results, compared with Gwet's AC2, which is proposed as a more appropriate statistic. A novel format for recording a Chinese Medical (CM) diagnoses, called the Diagnostic System of Oriental Medicine (DSOM), was used to record and compare patient diagnostic data, which, unlike the contemporary CM diagnostic format, allows agreement by chance to be considered when evaluating patient data obtained with unrestricted diagnostic options available to diagnosticians.Five CM practitioners diagnosed 42 subjects drawn from an open population. Subjects' diagnoses were recorded using the DSOM format. All the available data were initially used to evaluate agreement. Then, the subjects were sorted into three groups to demonstrate the effects of differing data marginality on the calculated chance-removed agreement.Agreement between the practitioners for each subject was evaluated with linearly weighted simple agreement, FK and Gwet's AC2.In all cases, overall agreement was much lower with FK than Gwet's AC2. Larger differences occurred when the data were more free marginal. Inter-rater agreement determined with FK statistics is unlikely to be correct unless it can be shown that the data from which agreement is determined are, in fact, fixed marginal. It follows that results obtained on agreement between practitioners with FK are probably incorrect. It is shown that inter-rater agreement evaluated with AC2 statistic is an appropriate measure when fixed marginal data are neither expected nor guaranteed. The AC2 statistic should be used as the standard statistical approach for determining agreement between practitioners.
Popplewell, M, Reizes, J & Zaslawski, C 2019, 'Consensus in Traditional Chinese Medical Diagnosis in Open Populations.', Journal of Alternative and Complementary Medicine, vol. 25, no. 11, pp. 1109-1114.View/Download from: Publisher's site
An acceptable level of diagnostic agreement is a prerequisite for consistent administration of treatment. It is critical for investigating effectiveness of different treatment approaches using multiple practitioners. To the best of our knowledge, no previous investigation of diagnostic consensus using open populations in Chinese medicine (CM) has been reported. Investigations restricted to individual medical conditions, such as have been usually studied, do not reveal any information as to what occurs in real world clinical settings. This knowledge gap led to the current study being conducted. Design/Location/Subjects/Interventions: Investigating diagnostic agreement specifically in Traditional Chinese Medicine (TCM) in an open population, two or three practitioners diagnosed 35 subjects at the University of Technology, Sydney (UTS), TCM clinic. The practitioners were restricted to a list of the 56 most frequently used TCM diagnoses at the UTS clinic. Up to three diagnostic patterns per subject could be selected, with nominated patterns scored between 1 and 5.Agreement was determined with two criteria, both expressed as simple percentages: pattern and linearly weighted agreements.The results showed that 23% of practitioners obtained pattern agreement, while 19% demonstrated weighted agreement.There appears to be very low diagnostic agreement between practitioners. This is an important finding. If unchallenged by further investigation, the recognition of such poor diagnostic consensus may lead to rejection of TCM theory before it has been adequately assessed. Diagnostic agreement must be improved so that future investigations into treatment effectiveness or mechanisms of action are made on a valid basis. Additionally, the current TCM diagnostic format must be altered to allow the application of chance-removed statistics or the calculation of a standard error with open populations. This article is the first of a series of three that report problems in TCM diagnosti...
Robinson, N, Bovey, M, Lee, JA, Zaslawski, C, Tian, P, Kim, TH, Alraek, T, Bian, ZX, Lee, MS & Birch, S 2019, 'How do acupuncture practitioners use pattern identification – An international web-based survey?', European Journal of Integrative Medicine, vol. 32.View/Download from: Publisher's site
© 2019 Elsevier GmbH Introduction: Training and practice of Traditional East Asian Medicine (TEAM) varies globally although similar diagnostic methods are used based on patients presenting signs and symptoms. These methods assist in determining disease patterns and treatment principles. The use of diagnostic principles and pattern identification (PI) was explored in this survey of TEAM practice across different countries. Methods: A web-based survey was disseminated to acupuncture professional membership organisations in UK, Australia, Italy, Korea and China using a Survey Monkey link between December 2015 and September 2017. Results: The 618 fully completed responses were available for comparison (UK 66, Australia 106, China 87, Italy 226, Korea 133). Demographic characteristics varied; UK practitioners were more likely to be female (71%) compared to the other countries (51-59%), Koreans tended to be under 40yrs (80%), compared to elsewhere (14-27%). Korean, UK and Australian respondents had fewer practitioners with biomedical training, 95% of the Italians had a biomedical qualification. TEAM diagnostic methods were more likely practised in the UK and Australian samples ( > 90%) but were lowest for the Italian sample (78%). TCM differential diagnosis was the predominant type of PI. PI was rated essential by 85% of Chinese practitioners, versus 32% Koreans, 45% Italians, 67% UK and 68% Australian respondents. Conclusion: This first international survey about acupuncturists use of PI demonstrated wide variation. The sample was limited to certain countries and relied on dissemination by specific professional bodies and participants completing an electronic questionnaire which may have affected responses but provides a platform for future studies.
Zhang, X, Tian, R, Zhao, C, Birch, S, Lee, JA, Alraek, T, Bovey, M, Zaslawski, C, Robinson, N, Kim, TH, Lee, MS & Bian, ZX 2019, 'The use of pattern differentiation in WHO-registered traditional Chinese medicine trials – A systematic review', European Journal of Integrative Medicine, vol. 30.View/Download from: Publisher's site
© 2019 Introduction: Pattern differentiation is a critical component for traditional Chinese medicine (TCM) diagnosis and treatment. However, the issue of whether pattern differentiation is appropriately applied in TCM interventional trials, including Chinese herbal medicine (CHM) interventions and non-herbal TCM interventions, is unclear. The aim of this study was to i) systematically review the current status of pattern differentiation used in WHO-registered clinical trials for different types of TCM interventions; and ii) provide suggestions for improving the use of pattern differentiation in future clinical trial design. Methods: The World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) database was searched for all TCM interventional trials registered up to 31 December 2017. In this systematic review trials with a TCM pattern differentiation in their design were included. Descriptive statistics were collated to demonstrate the characteristics of pattern differentiation applied for different TCM interventional trials. Results: Among 2955 TCM interventional trials registered during 1999–2017, 376 (12.7%) trials included pattern differentiation. Of 376 trials, the use of pattern differentiation was identified in; –the title (30.6%), objective (50.5%), participants inclusion (100%), outcomes (43.6%) and study background (12.5%). Further, 85.4% reported the specific name of the TCM intervention, 10.6% provided the intervention's targeted pattern, 83.8% reported the specific name of the TCM pattern, 7.2% presented diagnostic criteria for the pattern studied, and 19.1% adopted a pattern-related outcome as primary outcome for evaluation. Conclusion: The reporting and application of pattern differentiation in TCM trials were inadequate and confusing, which was mainly due to lack of clarity regarding study design, objectives, diagnostic criteria and outcomes.
McCambridge, AB, Zaslawski, C & Bradnam, LV 2019, 'Investigating the mechanisms of acupuncture on neural excitability in healthy adults.', NeuroReport, vol. 30, no. 2, pp. 71-76.View/Download from: Publisher's site
Acupuncture is gaining interest as a potential treatment modality for various neurological conditions. Yet, the underlying mechanisms and efficacy on brain function are not well understood. Therefore, this study investigated the previously proposed hypothesis that acupuncture suppresses motor cortex excitability using transcranial magnetic stimulation (TMS) in healthy adults. The study was randomised, sham-controlled, and double-blinded. Single and paired-pulse TMS was delivered before, during, immediately after, and 30 min after removal of the needle. Acupuncture to the right Hegu acupoint (LI-4) of the hand was delivered by an experienced acupuncturist using standardised manipulations. A disposable (0.22×30 mm, Hwato) needle was used for verum stimulation (penetrating) and a Park retractable needle for sham (nonpenetrating). The peak-to-peak amplitude of TMS-induced motor-evoked potentials was recorded from two intrinsic hand muscles. Needling sensations were quantified using the Massachusett's acupuncture sensation scale. Participant needling sensations were not different between verum or sham acupuncture (P>0.54). Corticomotor excitability, intracortical inhibition, and intracortical facilitation were not modulated by verum or sham acupuncture during, immediately after, or 30 min after, recorded from a local or distant hand muscle to the needling site (all P>0.075). Contrary to previous studies, manual acupuncture did not affect motor cortex excitability in healthy adults. Because of the increasing popularity of acupuncture therapy, further research using patient populations should be considered.
Zheng, S, Kim, C, Lal, S, Meier, P, Sibbritt, D & Zaslawski, C 2018, 'The Effects of Twelve Weeks of Tai Chi Practice on Anxiety in Stressed But Healthy People Compared to Exercise and Wait-List Groups-A Randomized Controlled Trial.', Journal of Clinical Psychology, vol. 74, no. 1, pp. 83-92.View/Download from: Publisher's site
OBJECTIVE: This randomized controlled trial was undertaken to determine whether 12 weeks of Tai Chi (TC) practice can reduce anxiety in healthy but stressed people. METHOD: Fifty participants were randomized into TC (n=17), exercise (n=17), and wait-list (WL) groups (n=16). Outcome measures used were State Trait Anxiety Inventory, Perceived Stress Scale 14 (PSS14), blood pressure and heart rate variability, visual analogue scale (VAS), and Short Form 36. RESULTS: Significant improvements were observed from baseline for both TC and exercise groups for both state (p <0.01) and trait (p <0.01) anxiety, PSS14 (p <0.01), VAS (p <0.01), mental health domain (p <0.01), and vitality domain (p <0.01). Superior outcomes were also observed for TC when compared with WL for state and trait anxiety (p <0.01) and mental health domain (p <0.05). CONCLUSION: TC reduces stress levels in healthy individuals and provides a safer, cost effective, and less physically vigorous alternative to exercise.
Razavy, S, Gadau, M, Zhang, SP, Wang, FC, Bangrazi, S, Berle, C, Li, T, Li, WH & Zaslawski, C 2018, 'Anxiety related to De Qi psychophysical responses as measured by MASS: A sub-study embedded in a multisite randomised clinical trial.', Complementary therapies in medicine, vol. 39, pp. 24-35.View/Download from: Publisher's site
Acupuncture has been broadly applied in the management of many diseases and conditions; however, its mechanism of action has been partially elucidated. Additionally, assessment of psychophysical responses in the acupuncture therapy is not common regarding anxiety disorder studies. Taken together, the therapeutic effect of acupuncture appears when De Qi psychophysical response is experienced following stimulation of the afferent sensory nerves. The present study investigates the level of anxiety perceived at different occasions in acupuncture and mock laser group. Furthermore, it examines the relationship between perceived De Qi psychophysical response and the level of anxiety experienced during administration of each intervention. The study was embedded in a two-arm parallel design multi-center, randomized clinical trial, the Tennis Elbow Acupuncture-International Study-China, Hong Kong, Australia, Italy. Participants' level of anxiety was measured using a validated instrument, the Massachusetts General Hospital Acupuncture Sensation Mood Scale. Ninety-six participants with Lateral Elbow Pain were randomly allocated into two groups; the acupuncture treatment group (n = 47) and the inactive mock laser control group (n = 49). Data were collected immediately following the interventions at the first and the ninth session within the clinical trial. Acupuncture with De Qi did not induce higher level of anxiety compared to prior administration of acupuncture. In fact, participants were more relaxed after receiving acupuncture than those who received mock laser. There was also a weak association between participants' perception of anxiety during acupuncture and the MASS De Qi Index in session nine only (p < 0.01). Further investigation of the result revealed weak positive correlation between anxiety perceived during administration of acupuncture and the following De Qi characteristics; 'soreness' (p < 0.01), 'Deep pressure' (p < 0.05), 'Heaviness' (p < 0.05), and 'Fullne...
Loyeung, B, Lee, J, Michaeil, C & Zaslawski, C 2018, 'An experimental study in distinguishing an authentic herbal substance from sham herbal substances.', Complementary therapies in medicine, vol. 39, pp. 92-96.View/Download from: Publisher's site
An unblinded randomised trial can result in biased treatment effect estimates and lead to erroneous conclusions on the efficacy of the therapeutic intervention. Unlike pharmaceutical substances, Chinese herbal medicines have special characteristics including texture, colour, odour and taste as the origin of these constituents are different. In addition, its distinctive odour makes blinding of Chinese herbal medicine RCTs very difficult, as the placebo substance needs to match the special characteristics of the herbal substance being investigated. For these reasons, two studies were undertaken to evaluate whether a participant could distinguish a herbal intervention capsule (Ganopoly combination) when compared to three types of capsules containing culinary materials following a visual, odour and taste evaluation.Study One, was a pilot involving eleven participants (n = 11) while Study Two, involved eighty one participants (n = 81) and was conducted to make improvements on Study One. For both studies, participants were asked to identify which of four capsules were a herbal substance following a visual, smell and taste evaluation.For study One it was found that for both odour (p = .484) and visual appearance (p = .077) the number of participants selecting the herbal substance was not significantly different from what may have been selected by chance. This was not the case for taste where significantly more participants selected capsule B as the herbal substance (p = .004). For Study Two test it was found that all three evaluations for odour, visual appearance and taste significantly more participants selected the herbal substance (p < .0001 in all cases). This indicates that the participant guesses were not evenly distributed across the four choices and suggests a failure to blind.The failure to blind participants highlights the difficulties in preparing sham herbal substances that look, smell and taste like the real herbal substance.
Oh, B, Eade, T, Kneebone, A, Hruby, G, Lamoury, G, Pavlakis, N, Clarke, S, Zaslawski, C, Marr, I, Costa, D & Back, M 2018, 'Acupuncture in Oncology: The Effectiveness of Acupuncture May Not Depend on Needle Retention Duration.', Integrative cancer therapies, vol. 17, no. 2, pp. 458-466.View/Download from: Publisher's site
Guidelines surrounding optimum needle retention duration in acupuncture have not been established, despite a growing evidence base for acupuncture over recent decades. This retrospective study explored the effect of varying acupuncture needle retention durations in cancer patients.Patients received either 2 (n = 35), 10 (n = 53), or 20 minutes (n = 54) of acupuncture once a week for 6 weeks. Outcomes of anxiety and depression, stress, fatigue, and quality of life (QOL), with the Hospital Anxiety and Depression Scale, Perceived Stress Scale, Functional Assessment of Cancer Therapy-Fatigue, and European Organization for Research and Treatment of Cancer Quality of Life, were measured at baseline and at 6 weeks following the intervention.The mean age of participants was 58 years (n = 152). The majority were female, diagnosed with breast cancer. Depression, stress, fatigue, and QOL were significantly improved in all 3 groups at 6 weeks postintervention. No significant differences in all outcomes were found between the 3 groups (≤2 vs 10 minutes vs 20 minutes). There were no differences with the satisfaction of the acupuncture services and perceived efficacy of acupuncture among the 3 groups. More than 95% of participants indicated that they would recommend acupuncture to other cancer patients, friends, and their family members.The efficacy of acupuncture may not only depend on needle retention duration, but may also be associated with multiple factors. Considering the limitations of this study design, robust randomized controlled studies are warranted to confirm the findings.
Oh, B, Yeung, A, Klein, P, Larkey, L, Ee, C, Zaslawski, C, Knobf, T, Payne, P, Stener-Victorin, E, Lee, R, Choi, W, Chun, M, Bonucci, M, Lang, H-D, Pavlakis, N, Boyle, F, Clarke, S, Back, M, Yang, P, Wei, Y, Guo, X, Weng, C-HD, Irwin, MR, Elfiky, AA & Rosenthal, D 2018, 'Accreditation Standard Guideline Initiative for Tai Chi and Qigong Instructors and Training Institutions.', Medicines (Basel, Switzerland), vol. 5, no. 2.View/Download from: Publisher's site
Evidence of the health and wellbeing benefits of Tai Chi and Qigong (TQ) have emerged in the past two decades, but TQ is underutilized in modern health care in Western countries due to lack of promotion and the availability of professionally qualified TQ instructors. To date, there are no government regulations for TQ instructors or for training institutions in China and Western countries, even though TQ is considered to be a part of Traditional Chinese medicine that has the potential to manage many chronic diseases. Based on an integrative health care approach, the accreditation standard guideline initiative for TQ instructors and training institutions was developed in collaboration with health professionals, integrative medicine academics, Tai Chi and Qigong master instructors and consumers including public safety officers from several countries, such as Australia, Canada, China, Germany, Italy, Korea, Sweden and USA. In this paper, the rationale for organizing the Medical Tai Chi and Qigong Association (MTQA) is discussed and the accreditation standard guideline for TQ instructors and training institutions developed by the committee members of MTQA is presented. The MTQA acknowledges that the proposed guidelines are broad, so that the diversity of TQ instructors and training institutions can be integrated with recognition that these guidelines can be developed with further refinement. Additionally, these guidelines face challenges in understanding the complexity of TQ associated with different principles, philosophies and schools of thought. Nonetheless, these guidelines represent a necessary first step as primary resource to serve and guide health care professionals and consumers, as well as the TQ community.
Oh, JE, Walsh, S & Zaslawski, CJ 2018, 'A 10 year comparison update: A survey of socio-demogrpahics and practice characteritics of members of the Australian Acupuncture and Chinese Medicine Association', Australian Journal of Acupuncture and Chinese Medicine, vol. 12, no. 1, pp. 19-25.
Background: A previous study in 2006 reported on the demographic and practice characteristics of 386 AACMA
members’ responses. In the intervening decade since the 2006 data collection many changes have occurred, including
the introduction of the National Registration and Accreditation Scheme for the Chinese medicine (CM) profession.
It was therefore decided to undertake a new survey in order to update and compare the demographic and practice
characteristics of AACMA members, to determine whether there had been a significant change.
Method: An online version of the survey that replicated the 2006 paper instrument was utilised to collect updated
data regarding AACMA practitioner attributes and practice characteristics. The 2016 responses (n = 148) was
compared against the earlier 2006 survey responses (n = 386) and the Chinese Medicine Board of Australia’s (CMBA)
registrant data for the corresponding period.
Results: A natural ageing of practitioners was observed, but similar gender distribution (higher female ratio to male
practitioners) and practice locality clustering (majority of respondents being located in Queensland, New South
Wales or Victoria) was noted. The majority of respondents answered that their training in CM was undertaken within
Australia, most likely through a university or a private college and holding a Bachelor’s degree. A trend to practice in
a full-time capacity was noted across the 10 year time period, as well as a preference to combine treatment modalities
when practising. Acupuncture and Chinese herbal medicine were the most frequently used modalities. It was also
observed that the 2016 respondents preferred to work solo, whereas the 2006 respondents preferred group practice.
For those who were working in a group practice, they were most likely to be working with other CM practitioners,
followed by other CAM practitioners. The average patient consultations completed remained steady at 15-24 patients
per week for the majority of respondent...
Xiao, H, Zaslawski, C, Vardy, J & Oh, B 2018, 'Treatment of Sciatica Following Uterine Cancer with Acupuncture: A Case Report.', Medicines (Basel, Switzerland), vol. 5, no. 1.View/Download from: Publisher's site
For women, gynaecological or obstetrical disorders are second to disc prolapse as the most common cause of sciatica. As not many effective conventional treatments can be found for sciatica following uterine cancer, patients may seek assistance from complementary and alternative medicine. Here, we present a case of a woman with severe and chronic sciatica secondary to uterine cancer who experienced temporary relief from acupuncture.
Dean, S, Walsh, S, Williams, C, Zaslawski, C, Morgan, A & Levett-Jones, T 2018, 'The mystery shopper student learning experience in undergraduate health education: A case study', Nurse Education Today, vol. 70, no. 2018, pp. 69-70.View/Download from: Publisher's site
Elsdon, DS, Spanswick, S, Zaslawski, C & Meier, PC 2017, 'Protocol: Testing the Relevance of Acupuncture Theory in the Treatment of Myofascial Pain in the Upper Trapezius Muscle.', Journal of Acupuncture and Meridian Studies, vol. 10, no. 1, pp. 67-74.View/Download from: Publisher's site
A protocol for a prospective single-blind parallel four-arm randomized placebo-controlled trial with repeated measures was designed to test the effects of various acupuncture methods compared with sham. Eighty self-selected participants with myofascial pain in the upper trapezius muscle were randomized into four groups. Group 1 received acupuncture to a myofascial trigger point (MTrP) in the upper trapezius. Group 2 received acupuncture to the MTrP in addition to relevant distal points. Group 3 received acupuncture to the relevant distal points only. Group 4 received a sham treatment to both the MTrP and distal points using a deactivated acupuncture laser device. Treatment was applied four times within 2 weeks with outcomes measured throughout the trial and at 2 weeks and 4 weeks posttreatment. Outcome measurements were a 100-mm visual analog pain scale, SF-36, pressure pain threshold, Neck Disability Index, the Upper Extremity Functional Index, lateral flexion in the neck, McGill Pain Questionnaire, Massachusetts General Hospital Acupuncture Sensation Scale, Working Alliance Inventory (short form), and the Credibility Expectance Questionnaire. Two-way analysis of variance (ANOVA) with repeated measures were used to assess the differences between groups.
Meier, P, Elsdon, D, Garvey, M, Li, WH, Loyeung, YK, Michaeil, C, Morgan, N, Walsh, S, Zheng, S & Zaslawski, C 2017, 'Moxibustion in Australia: a clinical audit of moxibustion use in a University outpatient Chinese medicine clinic', Australian Journal of Acupuncture and Chinese Medicine, vol. 11, no. 1, pp. 17-21.
Smith, CA, Zaslawski, CJ, Cochrane, S, Zhu, X, Zheng, Z, Loyeung, B, Meier, PC, Walsh, S, Xue, CC, Zhang, AL, Fahey, PP & Bensoussan, A 2017, 'Reliability of the NICMAN Scale: An Instrument to Assess the Quality of Acupuncture Administered in Clinical Trials', EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE.View/Download from: Publisher's site
Zheng, S, Kim, C, Meier, P, Sibbritt, D & Zaslawski, C 2017, 'Development of a Novel Questionnaire for the Traditional Chinese Medicine Pattern Diagnosis of Stress', JAMS Journal of Acupuncture and Meridian Studies, vol. 10, no. 4, pp. 276-285.View/Download from: Publisher's site
© 2017. Currently, there is no definitive diagnosis or list of signs and symptoms for "stress" in either modern biomedicine or Chinese medicine (CM). While modern theories on stress relate to the neurological interaction of a stressor or stimuli on the autonomic nervous system, it is generally regarded as subjective in nature and as such each individual will likely present varying somatic or cognitive signs and symptoms. A questionnaire was therefore developed, based on textual research, that incorporated both general as well as gender specific signs and symptom responses to determine the most common CM patterns associated with individuals who report as feeling stressed. For the 45 females who completed the questionnaire, the mean percentage of symptoms per CM pattern showed that the pattern with the highest average percentage was heart qi deficiency (61.88%) followed by liver blood deficiency (60.23%) and then heart blood deficiency (60.12%). For males (n = 16), heart qi deficiency was also the highest scoring CM pattern with a scoring percentage of 54.81%. In males, however, heart blood deficiency was second with 53.29% followed by liver blood deficiency with 51.10%. Of the general non gender-specific symptoms collected (n = 65 symptoms), the symptom most commonly reported by both men and women was "anxious or racing thoughts", followed by "constant worrying" and "inability to concentrate". The CM diagnostic pattern results may prove useful for clinicians as the change in diagnostic understanding will also modify the treatment principle and subsequent treatment with acupuncture or herbal medicine. Future CM research studies should consider including the questionnaire either as a diagnostic aid or as an outcome measure for acupuncture or herbal medicine studies related to stress.
Li, W, Chen, J, Liang, F & Zaslawski, C 2017, 'Growth of Chinese Medicine in Australia: past, Present and Prospect', Zhongguo zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine / Zhongguo Zhong xi yi jie he xue hui, Zhongguo Zhong yi yan jiu yuan zhu ban, vol. 37, no. 5, pp. 607-611.View/Download from: Publisher's site
© CCH. Background: Lumbar spine disc breakdown may begin as early as the second decade of life. Peak bone mass occurs between the ages of 16 and 25 years and continuously decreases thereafter where bone loss occurs at a faster rate in females increasing throughout menopause. The objectives of this study were to examine the relationship of age and gender against lumbar or non-lumbar musculoskeletal disorder (MSD) diagnosis and post-injury recovery time. Methods: Records of 144 MSD-related incidents that were recorded between 2012 and 2016 (five years) were retrieved from the injury register of a large commercial cleaning organisation (n = 700 cleaners) for analysis. The mean age of the organisations workforce was 57 years of age and 62% of cleaners were female by payroll. Results: The overall non-lumbar related MSD was higher within the older age (>45 years) group (n = 53) as opposed to the younger age (<45 years) group (n = 34). Consequently, more lumbar spinerelated MSDs occurred in the younger age (<45 years) group (n = 33) than the older age (>45 years) group (n = 24). A strong relationship was identified between the age of a cleaner (greater than or less than 45 years) and the type of MSD (lumbar or non-lumbar) (p = 0.027). It was identified that that 110 (76.38%) of cleaners recovered from their MSD within four weeks. Of those in the younger age (<45 years) group then 16.42% (n = 11) took longer than four weeks to recover. Of those in the older age (>45 years) group then 29.87% (n = 23) took longer than four weeks to recover. A relationship between age and recovery time was identified at the 90% confidence interval (p = 0.058). Conclusions: It was identified that non-lumbar musculoskeletal injury is more likely to occur as one ages. Furthermore, it was identified that age may have an adverse effect upon injury recovery time. It was recommended that manual handling, return to work training programs and work schedules be periodically reviewed to strategically ...
Choi, T-Y, Lee, MS, Kim, JI & Zaslawski, C 2017, 'Moxibustion for the treatment of osteoarthritis: An updated systematic review and meta-analysis.', Maturitas, vol. 100, pp. 33-48.View/Download from: Publisher's site
The aim of this study was to update previous reviews and examine recent evidence from randomised clinical trials (RCTs) of the use of moxibustion for osteoarthritis (OA). Twelve databases were searched from inception through to September 2016 with no language limits applied. Data extraction and risk-of-bias assessments were performed by two independent reviewers. A total of 19 RCTs met all inclusion criteria and were evaluated. Three RCTs compared the effects of moxibustion with those of sham moxibustion in patients with knee OA (KOA) and found favourable effects of moxibustion on pain reduction (n=305; SMD, -0.46; 95% CI: -0.86 to -0.06, P=0.02, I2=65%), including at follow-up (n=305; SMD, -0.36; 95% CI: -0.70 to -0.01, P=0.04, I2=54%). Eleven RCTs compared the effects of moxibustion with those of conventional oral drug therapies. Eight RCTs reported a total symptom score and the meta-analysis showed superior effects of moxibustion compared with drug therapies for this measure (n=691; SMD, -0.24; 95% CI: -0.78 to 0.29; P=0.37, I2=91%) and response rate (n=758 knees; RR, 1.10; 95% CI: 1.05-1.16, P <0.0001, I2=0%). Three RCTs found superior or equivalent effects of moxibustion on symptom score compared with intra-articular injection or topical drug therapy. The existing trial evidence is sufficiently convincing to suggest that moxibustion, compared with sham moxibustion and oral drugs, is effective for pain reduction and symptom management in KOA. The level of evidence is moderate, given the high risk of bias and small sample size.
Oh, B, Lee, KJ, Zaslawski, C, Yeung, A, Rosenthal, D, Larkey, L & Back, M 2017, 'Health and well-being benefits of spending time in forests: systematic review.', Environmental Health and Preventive Medicine, vol. 22, no. 1, pp. 1-11.View/Download from: Publisher's site
Numerous studies have reported that spending time in nature is associated with the improvement of various health outcomes and well-being. This review evaluated the physical and psychological benefits of a specific type of exposure to nature, forest therapy.A literature search was carried out using MEDLINE, PubMed, ScienceDirect, EMBASE, and ProQuest databases and manual searches from inception up to December 2016. Key words: "Forest" or "Shinrin -Yoku" or "Forest bath" AND "Health" or "Wellbeing". The methodological quality of each randomized controlled trials (RCTs) was assessed according to the Cochrane risk of bias (ROB) tool.Six RCTs met the inclusion criteria. Participants' ages ranged from 20 to 79 years. Sample size ranged from 18 to 99. Populations studied varied from young healthy university students to elderly people with chronic disease. Studies reported the positive impact of forest therapy on hypertension (n = 2), cardiac and pulmonary function (n = 1), immune function (n = 2), inflammation (n = 3), oxidative stress (n = 1), stress (n = 1), stress hormone (n = 1), anxiety (n = 1), depression (n = 2), and emotional response (n = 3). The quality of all studies included in this review had a high ROB.Forest therapy may play an important role in health promotion and disease prevention. However, the lack of high-quality studies limits the strength of results, rendering the evidence insufficient to establish clinical practice guidelines for its use. More robust RCTs are warranted.
Dean, S, Peng, W, Zaslawski, C, Elliott, D, Newton-John, T, Campo, M & Pappas, E 2017, 'Mindfulness in Physical and Occupational Therapy Education and Practice: A scoping review', Physical Therapy Reviews, vol. 22, no. 5-6, pp. 221-228.View/Download from: Publisher's site
© 2017 Informa UK Limited, trading as Taylor & Francis Group. Background: Mindfulness practices provide numerous benefits for individuals with a variety of health issues. Recent research has highlighted the benefits of mindfulness for health professionals. The potential benefits for physical and occupational therapists or students however, are currently unclear. Objectives: To perform a scoping review on the effects of mindfulness practices among physical (PT) and occupational therapists (OT) and students of those disciplines. Methods: Eligible published articles in English were identified through a literature search of MEDLINE, PsycINFO, Cochrane Library, and AMED from the inception of databases to November 2015. Titles, abstracts, and full-text articles were screened for the selection of relevant papers. Articles identified as editorials, correspondences, commentaries, case reports, abstracts alone, and review papers were excluded. Results: Six studies (two qualitative studies, one quantitative study, one mixed-method study, and two experimental studies) met the inclusion criteria. Three studies focused on PT/OT students, two on clinicians and one on current clinicians who had previously failed a course. These studies highlighted the potential benefits of mindfulness for physical and occupational therapists. They should be interpreted with caution however, due to the small number of relevant studies, high heterogeneity in mindfulness interventions and methodological limitations. Conclusions: There is a paucity of research on the effects of mindfulness among physical and occupational therapists and students of those disciplines. The lack of relevant studies makes a systematic review challenging but the findings of the current studies suggest potentially promising effects.
Dean, SJ, Foureur, M, Zaslawski, C, Newton-John, T, Yu, N & Pappas, E 2017, 'The effects of a structured mindfulness program on the development of empathy in healthcare students', NursingPlus Open, vol. 3, pp. 1-5.View/Download from: Publisher's site
Razavy, S, Gadau, M, Zhang, SP, Wang, FC, Bangrazi, S, Berle, C, Harahap, M, Li, T, Li, WH & Zaslawski, C 2017, 'Investigation of the Phenomenon of Propagated Sensation along the Channels in the Upper Limb Following Administration of Acupuncture and Mock Laser', JAMS Journal of Acupuncture and Meridian Studies, vol. 10, no. 5, pp. 307-316.View/Download from: Publisher's site
© 2017 Background Similar to De Qi psychophysical responses, propagated sensation along the channels (PSC) is considered an important phenomenon in traditional Chinese acupuncture. In acupuncture clinical trials, different acupuncture manipulation techniques are used to enhance the propagation of sensation along the channels to facilitate an optimum therapeutic result. Aim To examine and compare the PSC reported by participants in a clinical trial following the administration of acupuncture and inactive mock laser. Methods The study was embedded in a two-arm parallel design multicenter, randomized clinical trial, the Tennis Elbow Acupuncture—International Study—China, Hong Kong, Australia, Italy (TEA IS CHAI). Needle sensations were measured using a validated instrument, the Massachusetts General Hospital Acupuncture Sensation Spreading Scale. Ninety-six participants with lateral elbow pain were randomly allocated into two groups in a 1:1 ratio; the acupuncture treatment group (n = 47) and the mock laser control group (n = 49). Participants in both groups received the intervention at two acupoints, LI10 and LI11, consisting of 2 minutes of either standardized needle manipulation or mock laser at each acupoint with a rest period between each intervention period. Data were collected immediately following the interventions at the first and the ninth session within the clinical trial. Results Although participants in both groups perceived PSC radiating to similar sites along the upper limb, the frequency of the reported radiation sites among the two intervention groups for both radiation up the limb (p < 0.05) and radiation down the limb (p < 0.001) were statistically significantly different. Among the radiating sensation sites recorded within the two study groups, the sensations were reported as radiating a greater distance down the forearm to the wrist compared to up the arm. Evaluation of PSC across the four study sites revealed a statistically significant differe...
Razavy, S, Gadau, M, Zhang, SP, Wang, FC, Bangrazi, S, Berle, C, Harahap, M, Li, T, Li, WH & Zaslawski, C 2017, 'Psychophysical responses in patients receiving a mock laser within context of an acupuncture clinical trial: an interoceptive perspective', BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE, vol. 17.View/Download from: Publisher's site
Chen, J, Loyeung, B, Zaslawski, C, Liang, FR & Li, WH 2016, 'Comparison of traditional Chinese medicine education between mainland China and Australia—a case study', Journal of Integrative Medicine, vol. 14, no. 4, pp. 291-296.View/Download from: Publisher's site
© 2016 Journal of Integrative Medicine Editorial Office. E-edition published by Elsevier (Singapore) Pte Ltd. All rights reserved. Objective To analyze and compare the curriculum and delivery of a Chinese and Australian university-level Chinese medicine program. Methods A review of PubMed and the Chinese National Knowledge Infrastructure for relevant educational papers was undertaken. Online and paper documents available at the University of Technology Sydney (UTS) and the Chengdu University of Traditional Chinese Medicine (CDUTCM) were read and analyzed. In addition, in-depth interviews with academics from the two universities were conducted during 2014 to 2015. Results The two Chinese medicine programs share the common goal of providing health services to the local community, but differ in some aspects when the curricula are compared. Areas such as student profile, curriculum structure, teaching approaches and education quality assurance were found to be different. The UTS program adopts a “flipped learning” approach with the use of educational technology aiming at improving learning outcomes. On the other hand, the CDUTCM has better clinical facilities and specialist physician resources. Conclusion A better understanding of the different curricula and approaches to Chinese medicine education will facilitate student learning and educational outcomes.
Liu, Y-S, Gadau, M, Zhang, G-X, Liu, H, Wang, F-C, Zaslawski, C, Li, T, Tan, Y-S, Berle, C, Li, W-H, Bangrazi, S, Liguori, S & Zhang, S-P 2016, 'Acupuncture Treatment of Lateral Elbow Pain: A Nonrandomized Pilot Study', EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE.View/Download from: Publisher's site
Zaslawski, C, Berle, C, Gadau, M, Li, WH, Li, T, Wang, FC, Bangrazi, S, Li, L, Ligouri, S, Liu, YS, Tan, YS & Zhang, SP 2016, 'Protocol for Acupuncture Treatment of Lateral Elbow Pain: A Multisite Randomised Controlled Trial in China, Hong Kong, Australia, and Italy', Evidence-Based Complementary and Alternative Medicine, vol. 2016, pp. 1-9.View/Download from: Publisher's site
Background. Lateral elbow pain is one of the most common musculoskeletal pains associated with the upper limb and has an estimated population incidence of 1–3%. Methods/Design. This study protocol is for a multisite randomised controlled study and is designed to evaluate the clinical efficacy of acupuncture in the treatment of chronic (over three months’ duration) lateral elbow pain. Four study sites, in the People’s Republic of China, Hong Kong, Italy, and Australia, will recruit 24 participants each. A total of 96 participants will be randomised to either an acupuncture group or a sham laser control group. The primary outcome measure will be the Disabilities of Arm, Shoulder, and Hand questionnaire with secondary outcome measures of Pain-Free Grip Strength Test, Muscle Tension Test, and a pain visual analogue scale. Discussion. Key features for conducting a multisite international acupuncture randomised clinical trial have been detailed in this protocol. Trial Registration. This trial is registered at Australian and New Zealand Clinical Trial Registry ACTRN12613001138774 on 11 October, 2013.
Bilton, K & Zaslawski, C 2016, 'Reliability of Manual Pulse Diagnosis Methods in Traditional East Asian Medicine: A Systematic Narrative Literature Review', JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE, vol. 22, no. 8, pp. 599-609.View/Download from: Publisher's site
Gadau, M, Zhang, S-P, Yip, H-Y, Yeung, W-F, Bian, Z-X, Lu, A-P & Zaslawski, C 2016, 'Pattern Differentiation of Lateral Elbow Pain in Traditional Chinese Medicine: A Systematic Review', JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE, vol. 22, no. 11, pp. 921-935.View/Download from: Publisher's site
Jung, J, Park, B, Lee, JA, You, S, Alraek, T, Zhao-Xiang, B, Birch, S, Kim, T-H, Hao, X, Zaslawski, C, Kang, B-K & Lee, MS 2016, 'Standardization and future directions in pattern identification research: International brainstorming session', CHINESE JOURNAL OF INTEGRATIVE MEDICINE, vol. 22, no. 9, pp. 714-720.View/Download from: Publisher's site
Kim, T-H, Zaslawski, C, Kwon, S & Kang, JW 2016, 'Korean Medicine in General Practice: Current Status, Challenges, and Vision in Clinical Evidence', EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE.View/Download from: Publisher's site
Soo Lee, M, Lee, JA, Alraek, T, Bian, ZX, Birch, S, Goto, H, Jung, J, Kao, S-T, Moon, S-K, Park, B, Park, K-M, You, S, Yun, K-J & Zaslawski, CJ 2016, 'Current research and future directions in pattern identification: Results of an international symposium', Chinese Journal of Integrative Medicine, vol. 20.View/Download from: Publisher's site
A symposium on pattern identification (PI) was held at the Korea Institute of Oriental Medicine (KIOM) on October 2, 2013, in Daejeon, South Korea. This symposium was convened to provide information on the current research in PI as well as suggest future research directions. The participants discussed the nature of PI, possible research questions, strategies and future international collaborations in pattern research. With eight presentations and an extensive panel discussion, the symposium allowed participants to discuss research methods in traditional medicine for PI. One speaker presented the topic, ‘Clinical pattern differentiation and contemporary research in PI.’ Two speakers presented current trends in research on blood stasis while the remaining five other delegates discussed the research methods and future directions of PI research. The participants engaged in in-depth discussions regarding the nature of PI, potential research questions, strategies and future international collaborations in pattern research.
Yu, X, Lim, CED & Zaslawski, C 2016, 'Moxibustion for diarrhoea-predominant irritable bowel syndrome: what is the current evidence?', Focus on Alternative and Complementary Therapies, vol. 21, no. 2, pp. 118-119.View/Download from: Publisher's site
Zaslawski, C 2016, 'Editorial', Australian Journal of Acupuncture and Chinese Medicine, vol. 10, no. 1, p. 3.
Dean, SJ, Zaslawski, C, Roche, M & Adams, J 2016, '"Talk to Them": Teaching communication skills to students of traditional chinese medicine.', Journal of Nursing Education and Practice, vol. 6, no. 12, pp. 49-56.View/Download from: Publisher's site
Objective: To explore students’ perceptions of the efficacy and value of teaching communication skills in a health professional course for Traditional Chinese Medicine (TCM).
Methods: Individual surveys were used to evaluate students’ self-assessment of their communication skills pre and post a communication subject in a four-year degree course in a Bachelor of Health Science in TCM at a large metropolitan university in Australia. Quantitative and qualitative data were collected.
Results: Findings indicate that students recognise the need for good communication skills training as part of their professional training and self-reported that their communication skills improved following a semester of study of a communication subject.
Conclusions: One of the primary components driving increasing demand for complementary and alternative medicine (CAM), which includes TCM, is that consumers place a high value on effective communication and quality engagement with their CAM provider. Communication skills are often seen as the cornerstone of good health care practice, patient recovery and practitioner job satisfaction. Implementing a focused communication skills component in health professional educational programs, including those for TCM, is therefore essential. Further research is needed to explore the retention of these skills throughout health professionals’ degree programs and after graduation and clinical experience, to evaluate the effectiveness and sustainability of personal communication skills education. Practice implications: Communication skills training should be incorporated into health care profession curricula, early in the program and integrated with clinical exposure.
Joyce, P, Wardle, J & Zaslawski, C 2016, 'Medical student attitudes towards complementary and alternative medicine (CAM) in medical education: a critical review.', Journal of complementary & integrative medicine, vol. 13, no. 4, pp. 333-345.View/Download from: Publisher's site
This paper aims to remedy a gap in the knowledge by presenting the first critical review of the literature on major themes relating to medical students perceptions and attitudes towards the exponentially growing field of complementary and alternative medicine (CAM).After a comprehensive database search of the literature, 21 papers were chosen as suitable for the review. The results from these papers were tabled and discussed.The results indicated that medical students lacked knowledge of CAM and are generally positive towards CAM education (especially in the preclinical years, if it provided evidence of efficacy and post-placement). Medical students thought that CAM should generally be incorporated into the medical curriculum mainly so they can confidently undertake referral to CAM practitioners. Being able to communicate with future patients about their CAM use was a major motivation for medical students to learn about CAM and a factor for medical student support of further incorporation of CAM content in the medical curricula. Educational exposure to CAM in many forms and in many papers was shown to significantly affect medical student attitudes to CAM. This may be reflective of the fact that, outside direct CAM training, there may be limited accessible opportunities for medical students and if integration is to occur, educational exposure is most important.The rise of CAM as a social and clinical phenomenon necessitates consideration of further inclusion of these topics in the medical curriculum, if future physicians are to be able to fully discharge their role as care providers in an increasingly medically pluralistic world. However, the inclusion of CAM needs to be done in an objective and critical manner, which is relevant to the learner.
Fogarty, S, Stojanovska, L, Harris, D, Zaslawski, C, Mathai, ML & McAinch, AJ 2015, 'A randomised cross-over pilot study investigating the use of acupuncture to promote weight loss and mental health in overweight and obese individuals participating in a weight loss program', EATING AND WEIGHT DISORDERS-STUDIES ON ANOREXIA BULIMIA AND OBESITY, vol. 20, no. 3, pp. 379-387.View/Download from: Publisher's site
Zheng, S, Lal, S, Meier, P, Sibbritt, D & Zaslawski, C 2014, 'Protocol: the effect of 12 weeks of Tai Chi practice on anxiety in healthy but stressed people compared to exercise and wait-list comparison groups: a randomized controlled trial.', Journal of Acupuncture and Meridian Studies, vol. 7, no. 3, pp. 159-165.View/Download from: Publisher's site
Stress is a major problem in today's fast-paced society and can lead to serious psychosomatic complications. The ancient Chinese mind-body exercise of Tai Chi may provide an alternative and self-sustaining option to pharmaceutical medication for stressed individuals to improve their coping mechanisms. The protocol of this study is designed to evaluate whether Tai Chi practice is equivalent to standard exercise and whether the Tai Chi group is superior to a wait-list control group in improving stress coping levels. This study is a 6-week, three-arm, parallel, randomized, clinical trial designed to evaluate Tai Chi practice against standard exercise and a Tai Chi group against a nonactive control group over a period of 6 weeks with a 6-week follow-up. A total of 72 healthy adult participants (aged 18-60 years) who are either Tai Chi naïve or have not practiced Tai Chi in the past 12 months will be randomized into a Tai Chi group (n = 24), an exercise group (n = 24) or a wait-list group (n = 24). The primary outcome measure will be the State Trait Anxiety Inventory with secondary outcome measures being the Perceived Stress Scale 14, heart rate variability, blood pressure, Short Form 36 and a visual analog scale. The protocol is reported using the appropriate Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) items.
Gadau, M, Yeung, W-F, Liu, H, Zaslawski, C, Tan, Y-S, Wang, F-C, Bangrazi, S, Chung, K-F, Bian, Z-X & Zhang, S-P 2014, 'Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials', BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE, vol. 14.View/Download from: Publisher's site
Zaslawski, CJ, Walsh, SP, James, J & Deare, J 2014, 'A Survey of the Socio-Demographics and Practice Characteristics of Members of the Australian Acupuncture and Chinese Medicine Association Ltd', Australian Journal of Acupuncture and Chinese Medicine, vol. 9, no. 1, pp. 13-19.
Background: The Australian Acupuncture and Chinese Medicine Association Ltd (AACMA) is the largest national professional body for Chinese medicine practitioners in Australia yet little is known about specific practice characteristics of its members. Method: In December 2006, a four-page questionnaire was mailed to all association members listed on the AACMA database for that year. The questionnaire sought to obtain information on the demographics and practice characteristics of the AACMA members. In total 1 520 questionnaires were mailed out to the AACMA members, of which 386 were returned. Results: The age distribution for respondents was bimodal, with those in the 46-50 and 31-35 brackets being the highest reported ranges. With regard to education, most respondents stated they had obtained their practice qualifications in Australia (n = 279; 73%), while 46 (12%) replied they had received their qualification from overseas. Most respondents replied that they had obtained a Bachelor degree (n = 207; 54%) while 58 (15%) reported having a Diploma and 37 an Advanced Diploma (9%). Concerning practice characteristics, nearly 70% (n = 268) reported that they practised more than 20 hours per week, with significantly more females working fewer than 20 hours compared to males (p = 0.006). When a breakdown of the pattern of modality use was undertaken, approximately 31% (n = 121) of respondents reported using a combination of both acupuncture and Chinese herbal medicine, while 20% (n = 77) stated they used acupuncture solely while only 0.5% (n = 2) used herbal medicine alone. The remainder used various combinations involving acupuncture, Chinese herbal medicine, Chinese remedial massage (Tuina) and/or Western remedial massage. Conclusion: This is the first time a survey of members of a particular Chinese medicine (CM) association has been undertaken in Australia. To further develop CM, a large scale survey needs to be undertaken to further define and establish the social de...
Bilton, KM, Hammer, L & Zaslawski, CJ 2013, 'Contemporary Chinese Pulse Diagnosis: A Modern Interpretation of an Ancient and Traditional Method', Journal of Acupuncture and Meridian Studies, vol. 6, no. 5, pp. 227-233.View/Download from: Publisher's site
Wc Ng, R, Lim, C, Cheng, LL, Strutt, R, Wiltshire, J, Cigolini, M & Zaslawski, CJ 2013, 'Number and Necessity of Tests performed in the Last Week of Life of a Cancer Patient', Journal of Geriatrics and Palliative Care, vol. 1, no. 1.View/Download from: Publisher's site
Zaslawski, C 2013, 'Editorial', Australian Journal of Acupuncture and Chinese Medicine, vol. 8, no. 1, p. 1.
Zaslawski, C 2013, 'Society for Acupuncture Research Conference 2013', Australian Journal of Acupuncture and Chinese Medicine, vol. 8, no. 2, p. 46.
Choi, T, Lee, MS, Kim, T, Zaslawski, CJ & Ernst, E 2012, 'Acupuncture for the treatment of cancer pain: a systematic review of randomised clinical trials', Supportive Care in Cancer, vol. 20, pp. 1147-1158.View/Download from: Publisher's site
Purpose: Controlling cancer-related pain is an important component in the palliative care of cancer patients. The objective of this review was to assess the effectiveness of acupuncture for treating cancer pain. Methods: Fourteen databases were searched from their inception through April 2011. Randomised clinical trials (RCTs) were included if acupuncture was used as the sole treatment or as a part of a combination therapy for cancer pain. Studies were included if they were controlled with a placebo or controlled against a drug-therapy or no-treatment group. The Cochrane criteria were used to assess the risk of bias. Results: A total of 15 RCTs met our inclusion criteria. All of the included RCTs were associated with a high risk of bias. The majority of acupuncture treatments or combination therapies with analgesics exhibited favourable effects compared with conventional treatments in individual studies. However, a meta-analysis suggested that acupuncture did not generate a better effect than drug therapy (n=886; risk ratio (RR), 1.12; 95% CI 0.98 to 1.28; P=0.09). The comparison between acupuncture plus drug therapy and drug therapy alone demonstrated a significant difference in favour of the combination therapy (n=437; RR, 1.36; 95% CI 1.13 to 1.64; P=0.003). The results of this systematic review provide no strong evidence for the effectiveness of acupuncture in the management of cancer pain. Conclusion: The total number of RCTs included in the analysis and their methodological quality were too low to draw firm conclusions. Future rigorous RCTs will be necessary to assess the clinical efficacy of acupuncture in this area.
Fogarty, S, Harris, D, Zaslawski, CJ, McAinch, AJ & Stojanovska, L 2012, 'Development of a Chinese medicine pattern severity index for understanding eating disorders', Journal of Alternative and Complementary Medicine, vol. 18, no. 6, pp. 597-606.View/Download from: Publisher's site
Eating disorders commonly affect young girls and women. Four eating disorders are analyzed in this study: anorexia nervosa (AN), bulimia nervosa (BN), eating disorders not otherwise specified (EDNOS), and binge eating disorder (BED). Eating disorders are a modern concept and as such there is no critically appraised research on how Traditional Chinese Medicine (TCM) conceptualizes of or treats eating disorders. The purpose of this study is to identify and quantify the TCM patterns relevant to eating disorders based on a systematic evaluation of the results of a self-reported questionnaire. Methods: One hundred and ninety-six (196) female participants (142 with a self-reported eating disorder and 54 with no eating disorder) completed an online survey, designed to collect data on their current general health and, where relevant, their eating disorder. The Berle methodology was used to identify TCM patterns involved in eating disorders to tabulate and score the number of signs and symptoms experienced by the participants. Results: For many of the TCM patterns, statistically significant differences were found between presentation severity across the four eating disorders. Conclusions: For the first time, there is evidence-based research to classify the TCM patterns involved in AN, BN, EDNOS, and BED. Evidence is given to support the anecdotal theories of TCM patterns involved in eating disorder presentation. These results have relevance on how eating disorders are treated and viewed by TCM practitioners.
Zaslawski, C 2012, 'Guest Editorials: Response to Friends of Science in Medicine: Medicine, Science, Arts and Friends: What do we make of the claims made by Friends of Science in Medicine (FSM)?: Where does the evidence lie? A response to the recent media blitz on Chinese medicine and acupuncture', Australian Journal of Acupuncture and Chinese Medicine, vol. 7, no. 1, pp. 4-5.
Biopsychology; Complementary and alternative medicine; Doping; Sports law
Smith, CA, Zaslawski, CJ, Zheng, Z, Cobbin, DM, Cochrane, S, Lenon, GB, Loyeung, Y, Meier, PC, Walsh, S, Xue, C, Zhang, T, Zhu, X & Benosoussan, A 2011, 'Development of an instrument to assess the quality of acupuncture: Results from a Delphi process', Journal of Alternative and Complementary Medicine, vol. 17, no. 5, pp. 441-452.View/Download from: Publisher's site
Background: Quality acupuncture influences the outcomes of clinical research, and issues associated with effective administration of acupuncture in randomized controlled trials need to be addressed when appraising studies. Objective: The study objective was to achieve consensus on domains and items for inclusion in a rating scale to assess quality acupuncture administered in clinical research. Study design and subjects: An active group of Australian acupuncture researchers initially identified a pool of items assessing quality. The Delphi consensus process was then used to select and reduce the number of items, and an additional expert panel of 42 researchers were invited to participate. Participants initially ranked items along a five-point scale for the first Delphi round, and indicated an agree or disagree response during the second round. For an item to be retained into the second round, an item had to attain greater than 80% agreement that the item described a dimension of quality acupuncture and related study design. Results: Thirty-two (32) experts agreed to participate in the study. After two rounds of the Delphi process, consensus was reached on 14 domains and 26 items relating to quality acupuncture. Domains, items, and minimum standards related to study design; rationale of the intervention; criteria relating to needling stimulation either manual or electrostimulation; duration and frequency of treatment; and practitioner training. Conclusions: Items for inclusion in an instrument to assess quality acupuncture in clinical research were identified. Further development of the instrument including relative weighting of items and reliability testing is under way.
Berle, CA, Cobbin, DM, Smith, NF & Zaslawski, CJ 2011, 'An innovative method to accommodate Chinese medicine pattern diagnosis within the framework of evidence-based medical research', Chinese Journal of Integrative Medicine, vol. 17, no. 11, pp. 824-833.View/Download from: Publisher's site
Pattern diagnosis is an integral aspect of Chinese medicine (CM). CM differentiates biomedical diseases into patterns, based upon the patients symptoms and signs. Pattern identification (PI) is used to diagnose, direct the treatment principle and determine the treatment protocol. Most CM research has used fixed formula treatments for Western-defined diseases with outcomes measured using objective biomedical markers. This article presents an innovative method used in a randomised controlled pilot study using acupuncture for participants with hepatitis C virus. Each participants CM patterns were identified and quantified at baseline which directed the treatment protocol for the treatment group. Data identified that while each participant expressed different patterns at baseline all participants displayed multiple patterns. Six patterns showed some expression by all 16 participants; Liver (Gan) yin vacuity expressing a group aggregate mean percentage of 47.2, binding depression of Liver qi 46.9, and Liver Kidney (Shen) yin vacuity 45.1. Further sub category gender grouping revealed that pattern ranking changed with gender; Liver yin vacuity (male 53.4%, female 51.93%), binding depression of Liver qi (male 50.0%, female 42.86%) and Liver Kidney yin vacuity (male 42.9%, female 47.96%). The quantification of CM patterns described in this article permitted statistical evaluation of presenting CM patterns. Although this methodology is in its infancy it may have potential use in the integration of PI with rigorous evidence based clinical research. Biomedical markers often do not relate to symptom/signs and therefore this innovative measure may offer an additional CM evaluation methodology and further CM PI understanding.
Kim, N, Lee, D, Seo, H, Sun, S, Oh, Y, Kim, J, Yoon, I, Seo, E, Shim, G & Zaslawski, CJ 2011, 'Hwangryunhaedoktang in adult patients with Atopic Dermatitis: a randomised, double-blind, placebo-controlled, two-centre trial - study protocol', BMC Complementary and Alternative Medicine, vol. 11, no. 68, pp. 1-8.View/Download from: Publisher's site
Background: Atopic Dermatitis is a chronic relapsing eczematous skin disease with increasing prevalence and rising costs. It has a clear impact on a patient's quality of life. Many patients are worried about the use of usual care techniques, such as cort
Lim, D & Zaslawski, C 2011, 'Non-specific effects of acupuncture: Genuine or placebo?', Focus on Alternative and Complementary Therapies, vol. 16, no. 3, pp. 221-222.View/Download from: Publisher's site
Berle, CA, Cobbin, DM, Smith, NF & Zaslawski, CJ 2010, 'A Novel Approach to Evaluate Traditional Chinese Medicine Treatment Outcomes Using Pattern Identification', Journal of Alternative and Complementary Medicine, vol. 16, no. 4, pp. 357-367.View/Download from: Publisher's site
Traditional Chinese Medicine (TCM), a modem interpretation of Chinese medicine, developed in the 1950s. It differentiates biomedical diseases into patterns. Each pattern comprises symptom/signs that have their own unique treatment protocol. Most TCM research has used fixed formula treatments for Western-defined diseases with outcomes often measured using objective biomedical markers. More recently, a number of trials have attempted to accommodate TCM clinical practice within the framework of rigorous evidence-based medical research. The aim of this article is to describe a novel outcome measure based on TCM patterns that was used in a pilot study for people with hepatitis C virus (HCV). Methods: Sixteen (16) participants with HCV were enrolled in a randomized, controlled pilot study and allocated to a treatment or control group. TCM pattern diagnosis was obtained at baseline and used to guide acupuncture treatment for the treatment group. Each individual's primary, secondary, and tertiary TCM patterns were identified, which involved the systematic evaluation of the participant's infonnation against the TCM patterns and conversion of the pattern to a percentage. Baseline and postintervention percentages for the three rCM patterns for the two groups were compared to assess change.
Berle, CA, Cobbin, DM, Smith, NF & Zaslawski, CJ 2010, 'Response to Cox-North's Comments on "A Novel Approach to Evaluate TCM Treatment Outcomes Using Pattern Identification"', Journal of Alternative and Complementary Medicine, vol. 16, no. 11, pp. 1135-1135.View/Download from: Publisher's site
Fogerty, S, Harris, D, Zaslawski, CJ, McAinch, A & Stojanovska, L 2010, 'Acupuncture as an adjunct therapy in the treatment of eating disorders: a randomised cross-over pilot study', Complementary Therapies In Medicine, vol. 18, no. 6, pp. 233-240.View/Download from: Publisher's site
Objective This study examines the role of acupuncture as an adjunct therapy in the treatment of eating disorders in female patients. Design A randomised cross-over study was used in this study. The two treatments phases were the private multi-disciplinary outpatient eating disorder facility in Melbourne, Australia, only (referred to as their treatment as usual) and a continuation of their treatment as usual supplemented by acupuncture. Participants Patients receiving treatment at a private multi-disciplinary outpatient eating disorder facility in Melbourne, Australia were asked to participate in the study. Nine consenting women (5 with Anorexia Nervosa, 4 with Bulimia Nervosa), aged (mean and SD) 23.7 (9.6) years, participated in the study. Main outcome measures The main outcome measure was the Eating Disorder Inventory-3. Secondary outcome measures were the Becks Depression Inventory-2, State Trait Anxiety Inventory and the Eating Disorder Quality of Life Scale. Results There was evidence that acupuncture improved the participants Quality of Life as measured by the physical/cognitive and psychological components of the Eating Disorder Quality of Life scale. There was also evidence of decreases in anxiety (both State and Trait as measured by the State Trait Anxiety Intervention) and perfectionism (as measured by the Eating Disorder Inventory-3). Conclusion This pilot study shows potential of the benefit of acupuncture as an adjunct therapy in the treatment of eating disorders particularly in the area of quality of life.
Zaslawski, C 2010, 'An interview with Professor Chris Zaslawski: standardization and its role in acupuncture research.', Journal of acupuncture and meridian studies, vol. 3, no. 1, pp. 65-66.View/Download from: Publisher's site
Zaslawski, CJ 2010, 'Ethical considerations for acupuncture and Chinese herbal medicine clinical trials: A cross-cultural perspective', Evidenced based Complementary and Alternative Medicine, vol. 7, no. 3, pp. 295-301.View/Download from: Publisher's site
Many ethical concerns revolve around the four basic principles of research: merit and integrity, respect for human beings, weighting of riskbenefit and justice. These principles form the basis for any discussion concerning human research ethics and are applicable to all areas of research including acupuncture and Chinese herbal medicine. World Health Organisation document, Guidelines for Clinical Research on Acupuncture, states that `consideration should be given to the different value systems that are involved in human rights such as social, cultural and historical issues and that `further studies should be conducted in relation to ethical issues involved in clinical research on acupuncture. In addition to outlining the four basic principles, this paper will also examine the effect of Asian culture on Western human research ethics and how this may impact upon issues such as informed consent and weighting of riskbenefit.
Lee, JH & Zaslawski, CJ 2009, 'Blinding in Clinical Trials', Australian Journal of Acupuncture and Chinese Medicine, vol. 4, no. 2, pp. 32-33.
Blinding is an important design feature to control bias in randomised controlled trials. Placebos that are improperly formulated or implemented may introduce bias into a trial, thereby making the reporting and success of blinding inadequate.
Li, W, Cobbin, DM & Zaslawski, CJ 2008, 'A comparison of effects on regional pressure pain threshold produced by deep needling of LI4 and LI11, individually and in combination', Complementary Therapies In Medicine, vol. 16, no. 5, pp. 278-287.View/Download from: Publisher's site
sites (acupoints and nonacupoints) across the body with an algometer. Interventions: The same manual acupuncture techniques were applied to four interventions of large intestine 4 (LI4) unilaterally; LI4 bilaterally; large intestine 11 (LI 11) unilaterally; and LI4 in conjunction with LI11, both unilaterally. Main outcome measures: (1) Percentage change in PPT from preintervention baseline measured at the 10 regional sites following every intervention; (2) participants' perceptions of pain; needling sensations; tension during, and anxiety prior to, each intervention; and changes in practitioner behaviour. Results: Following all four interventions, statistically significant increases in mean PPT were observed. These occurred at nine sites following the LI4 intervention either unilaterally or bilaterally; at six sites for LI11 intervention; and at five sites following the combined LI11 and LI4 intervention. These increases were significantly greater for the bilateral LI4 intervention than the unilateral LI4 intervention at only two sites (p < 0.02 and p < 0.0001). There were no statistically significant differences in the subjective perceptions among the four interventions. Conclusion: The enhanced effects on PPT by the bilateral compared with the unilateral intervention at LI4 although limited, do provide some support for the traditional Chinese medicine (TCM) assumption that bilateral needling of the same point enhances the treatment effect. There was no support for the assumption that combined needling of points from the same channel should enhance the treatment effect and failure to obtain better effects by combined needling of points from the same channel could result from the interaction occurring during the combined needling. Crown Copyright © 2008.
Kim, M, Cobbin, DM & Zaslawski, CJ 2008, 'Traditional Chinese medicine tongue inspection: an examination of the inter and intrapractitioner reliability for specific tongue charactersitics', Journal of Alternative and Complementary Medicine, vol. 14, no. 5, pp. 527-536.View/Download from: Publisher's site
Aim: To examine the reliability of Traditional Chinese Medicine (TCM) tongue inspection by evaluation of inter-and intrapractitioner agreement levels for specific tongue characteristics, achieved by a group of TCM practitioners. Method: Ten (10) realisti
Zaslawski, CJ 2008, 'Acupuncture for Persistent Allergic Rhinitis', Australian Journal of Acupuncture and Chinese Medicine, vol. 3, no. 1, pp. 56-56.
Zaslawski, CJ 2008, 'Blood Stasis: China's Classical Concept in Modern Medicine', Australian Journal of Acupuncture and Chinese Medicine, vol. 3.
Zaslawski, CJ 2008, 'Book Review- Correcting the Errors in the Forest of Nedicine', Australian Journal of Acupuncture and Chinese medicine, vol. 3.
Zaslawski, CJ, Zheng, Z & Smith, C 2008, 'The Status and Future of Acupuncture Research:10 Years Post NIH Consensus Conference', Australian Journal of Acupuncture and Chinese Medicine, vol. 3, pp. 66-67.
White, P, Golianu, B, Choi, S & Zaslawski, CJ 2006, 'Standardization of Nomenclature in Acupuncture Research (SoNAR)', Evidenced based Complementary and Alternative Medicine, vol. 4, no. 2, pp. 267-270.View/Download from: Publisher's site
As more clinical acupuncture trials for pain are published, it becomes increasingly difficult to compare and evaluate the merits and shortcomings of such studies. A major contributory factor to this centers on the description of, and the assumptions made about, the control intervention used. In considering an acupuncture control, it is important to evaluate its physiological activity and thus far, this has not been done. A variety of different and sometimes very novel controls have been tried and used in the research setting and the inevitable consequence of this is confusion, particularly when attempting to interpret the results of trials. Researchers and other interested parties such as patients, primary care practitioners, funding agencies etc., searching for evidence in the literature are likely to be misled or confused by such variability. There is therefore a need to define and standardize many of these terms, to clarify reporting and to convey the correct information in a way that it is not misleading. This paper details the background and need for this and is primarily intended to assist those who intend to publish primary and secondary acupuncture research. However, standardization of reporting will be of benefit to anybody who will need to examine the literature for evidence. This article proposes and recommends a nomenclature when reporting future acupuncture clinical research. This nomenclature arose through discussion at a meeting convened by the World Health Organisation (Western Pacific Regional Office) and will be incorporated into their policy document later this year.
Zaslawski, CJ & Gorman, SM 2005, 'The ethics of complementary and alternative medicine research: a case study of Traditional Chinese Medicine at the University of Technology, Sydney', Monash Bioethics Review, vol. 24, no. 3, pp. 52-60.
This article considers various approaches used in complementary and alternative medicine research, and discusses the challenges that reviewing such research poses for human Research Ethics Committees. Drawing on our experience with the University of Technology, Sydney HREC, we offer some suggestions about how ethical principles governing conventional medical research can be applied in the context of research in complementary and alternative medicine. We argue that effective HREC review requires members to gain familiarity with such research, which helps ensure that such research is conducted rigourously and ethically.
Zaslawski, CJ 2004, 'The impact of ethics on the design and conduct of acupuncture clinical trials', Clinical Acupuncture and Oriental Medicine, vol. 4, pp. 121-126.View/Download from: Publisher's site
Zaslawski, CJ 2003, 'Clinical Reasoning in traditional Chinese medicine: implications for clinical research', Clinical Acupuncture and Oriental Medicine, vol. 4, pp. 94-101.
The diagnostic processes of Traditional Chinese Medicine (TCM) are fundamental to the practice of acupuncture. A review was conducted of some central issues underlying pattern differentiation and the integration of the TCM diagnostic system into acupuncture research. Problems with diagnostic reliability and the implications for clinical trials are discussed. Future research should include diagnostic reliability studies and the development of strategies for improving diagnostic reliability within acupuncture clinical trials.
Zaslawski, CJ, Cobbin, DM, Lidums, E & Petocz, P 2003, 'The impact of site specificity and needle manipulation on changes to pain pressure threshold following manual acupuncture: a controlled study', Complementary Therapies In Medicine, vol. 11, no. 1, pp. 11-21.View/Download from: Publisher's site
Birch, S, Hammerschlag, R, Zaslawski, CJ & Trinh, KV 2002, 'The non-specific effects of acupuncture treatment: when and how to control for them', Clinical Acupuncture and Oriental Medicine, vol. 3, no. 1, pp. 20-25.View/Download from: Publisher's site
MacPherson, H, Birch, S, Bovey, M, Budd, S, Hammerschlag, R, Hopwood, V, Kawakita, K, Lao, L, Lewith, G, MacPherson, H, Mills, S, Romoli, M, Sherman, K, Pancucci, S, Trinh, K, White, A, Zaslawski, C, White, A, Cummings, M, Jobst, K, Rose, K & Niemtzow, R 2002, 'Standards for reporting interventions in controlled trials of acupuncture: The STRICTA recommendations', Clinical Acupuncture and Oriental Medicine, vol. 3, no. 1, pp. 6-9.View/Download from: Publisher's site
Acupuncture treatment and control group interventions in parallel-group randomized trials of acupuncture are not always precisely reported. In an attempt to improve standards, an international group of experienced acupuncturists and researchers devised a set of recommendations, designating them STRICTA: STandards for Reporting Interventions in Controlled Trials of Acupuncture. In a further consensus-building round, the editors of several journals helped redraft the recommendations. These follow the CONSORT format, acting as an extension of the CONSORT guidelines for the specific requirements of acupuncture studies. Participating journals are publishing the STRICTA recommendations and requesting prospective authors to adhere to them when preparing reports for publication. Other journals are invited to adopt these recommendations. The intended outcome is that interventions in controlled trials of acupuncture will be more adequately reported, thereby facilitating an improvement in critical appraisal, analysis and replication of trials. © 2002, Elsevier Science Ltd. All rights reserved.
MacPherson, H, Sherman, K, Hammerschlag, R, Birch, S, Lao, L & Zaslawski, C 2002, 'The clinical evaluation of traditional East Asian systems of medicine', Clinical Acupuncture and Oriental Medicine, vol. 3, no. 1, pp. 16-19.View/Download from: Publisher's site
MacPherson, H, Sherman, K, Hammerschlag, R, Birch, S, Lao, L & Zaslawski, CJ 2002, 'The clinical evaluation of traditional East Asian systems of medicine', Clinical Acupuncture and Oriental Medicine, vol. 3, no. 1, pp. 15-19.
Aird, M, Coyle, ME, Cobbin, DM & Zaslawski, CJ 2000, 'A Study of the Coparative Accuracy of Two Methods of Locating Acupuncture points', Acupuncture in Medicine, vol. 18, no. 1, pp. 15-21.
Coyle, ME, Aird, M, Cobbin, DM & Zaslawski, CJ 2000, 'The Cun Measurement System: An Investigation into its Suitability in Current Practice', Acupuncture in Medicine, vol. 18, no. 1, pp. 10-14.
White, A, Aird, M, Coyle, M, Cobbin, D & Zaslawski, C 2000, 'The reliability of the 'Cun' measurement (multiple letters)', Acupuncture in Medicine, vol. 18, no. 2, pp. 144-145.
Garvey, M, Rogers, C, Ryan, D, Congxing, Y & Zaslawski, C 1997, 'Toward development of appropriate clinical trial methodology for acupuncture: Considerations and design of a research project on stress', American Journal of Acupuncture, vol. 25, no. 2-3, pp. 161-168.
The College of Traditional Chinese Medicine at the University of Technology, Sydney (UTS), undertook a clinical research project (1) to test the hypothesis that traditional Chinese acupuncture is effective in the treatment of stress, and (2) to develop a clinical trial methodology consistent with the practice of traditional acupuncture and the rigors of scientific research. This paper focuses on acupuncture trial methodology, e.g., subject selection, establishing appropriate controls, ethical issues, etc. Of particular concern is the inappropriate design of Western clinical trials on the effects of acupuncture. These trials commonly use a standard acupoint formula on every participant, rather than specific treatment unique to the individual, which is the manner in which acupuncture is traditionally practiced. Those problems and viable solutions are addressed along with the practical issues and limitations of implementing a study in the context of the university setting.
Zaslawski, C, Rogers, C, Garvey, M, Ryan, D, Yang, CX & Zhang, SP 1997, 'Strategies to maintain the credibility of sham acupuncture used as a control treatment in clinical trials', Journal of Alternative and Complementary Medicine, vol. 3, no. 3, pp. 257-266.View/Download from: Publisher's site
Many clinical trials concerning acupuncture are flawed by methodological problems. One of the major difficulties is the appropriate selection and use of a placebo control. This article evaluates the use of sham acupuncture as a placebo control and analyzes its credibility as a control treatment. Sixty-four subjects were assessed for their perception of whether they were receiving sham or real acupuncture while participating in a clinical trial of acupuncture. It was found that if used under specific experimental conditions, sham acupuncture can function as a credible control. Specific strategies are suggested to maintain the credibility of sham acupuncture as a placebo control.
Zaslawski, CJ 1997, 'Clinical reasoning and category identification (Bian Zheng) in Traditional Chinese Medicine and the implications for development of educational strategies', American Journal of Acupuncture, vol. 25, no. 2-3, pp. 153-160.
The identification of disease categories (bian zheng) in Traditional Chinese Medicine (TCM) is an essential aspect of the diagnostic process. This article considers the literature on clinical reasoning in relationship to bian zheng. Three models of cognitive processing are identified and discussed, specifically, the classical model, the prototype model and the exemplar model, and then viewed from the context of the clinical encounter in TCM. Finally, the implications for TCM education are discussed with strategies for improving the learning process.
Zaslawski, CJ 2012, 'An evidence-based review of acupuncture as an adjunctive therapy in comprehensive cancer care' in Soh, KS, Kang, KA & Harrison, DK (eds), The Primo Vascular System Its Role in Cancer and Regeneration, Springer, United States, pp. 319-325.View/Download from: Publisher's site
The use of acupuncture as an adjunctive therapy for cancer has been increasing over several decades. While there has only been one Cochrane review completed in this area, with another at the protocol stage, several high-quality RCTs have been published in the last decade. These studies have focused on the effect of acupuncture on managing many of the disabling symptoms associated with radiation therapy, chemotherapy or surgical intervention. These include conditions such as nausea, pain control, xerostomia and fatigue. This chapter will report on the current evidence for using acupuncture for these conditions as well as some of the problems associated with designing and implementing a rigorous acupuncture clinical trial
Zaslawski, CJ & Garvey, M 2012, 'Have you got consent? An overview of human research ethics for East Asian medicine' in Yoshiharu Motoo (ed), Traditional Medicine: New Research, Nova Science Publishers, New York, USA, pp. 225-238.
During the last four decades the requirement of a committee to oversee the ethical concerns of human research has become an integral part of the research process . This review process is well established in many western countries such as the United States of America, United Kingdom, Europe and Australia and more recently in many Asian countries as well . Indeed many countries have produced guidelines and developed national networks to deal with research governance and the oversight of human clinical research. These committees are known as Institutional Review Boards (IRB) in the United States of America, or Research Ethics Committees (REC) as occurs in the United Kingdom. Their role is to ensure the protection of the welfare and rights of all participants in research , not only clinical research but also other types of research methodologies that involve humans such as surveys, interviews and focus groups. Generally there has been little interest in the ethical issues involved in conducting research into East Asian medicine (EAM) and in some respects this may have impeded the development of clinical evidence . This chapter will discuss the principles of ethical research and how these can impact on the design and conduct of clinical EAM research. Arguments to address some common ethical concerns for EAM research will also be suggested and these will be helpful to those new to EAM research as well as those more experienced. Finally extracts from the latest version of the Helsinki Declaration (2008)  will be used to highlight some of the ethical requirements of human research and offer direction for some ethical challenges.
Zaslawski, CJ & Lee, MS 2012, 'International standardization of East Asian medicine: the quest for standardization' in Scheid, V & MacPherson, H (eds), Integrating East Asian Medicine into Contemporary Healthcare, Elsevier, London, pp. 89-104.
Zaslawski, CJ, Kim, MS & Garvey, M 2012, 'Vignette for Chapter Six: International Standardisation: What Does It Mean for East Asian Medicines?' in Scheid, V & MacPherson, H (eds), East Asian Medicine: Traditions, Best Practice and the Evidence Mosaic, Elsevier, London.
Eslami, A, Zaslawski, C, Nassif, N & Lal, S 2018, 'CARDIOVASCULAR CHANGES DURING WORKING MEMORY AND ATTENTION TASKS: AN ASSESSMENT OF BLUE- AND WHITE-COLLAR WORKERS', PSYCHOPHYSIOLOGY, 58th Annual Meeting of the Society-for-Psychophysiological-Research, WILEY, Quebec City, CANADA, pp. S136-S136.
Acupuncture is a therapeutic technique that is being used as an adjuvant to treatment in a variety of health-related disorders. However despite its increasing use in western countries, the underlying mechanisms are not fully understood. The aim of this study is to investigate the underlying neurophysiological mechanisms of acupuncture by examining the effect of real (verum) and sham acupuncture to the hand on the excitability of the motor cortex (M1) in healthy adults. A better understanding of the underlying mechanisms of acupuncture may improve the potential therapeutic application of acupuncture for neurological disorders in the future.
Healthy, right-handed, adults with no neurological or musckuloskeletal conditions participated in the study. Participants were randomised to receive verum or sham acupuncture to the Hegu acupoint of the hand on separate days, with a minimum 5 day washout. The intervention type was double-blinded, and the acupuncturist was not involved in data collection or analysis. Transcranial magnetic stimulation (TMS) was delivered to the left M1 and surface electromyography was used to record TMS-induced responses from the First Dorsal Interossues (FDI) and Adductor Digiti Minimi (ADM). Stimulus-response curves, short-intracortical inbhition (SICI-2 ms) and intracortical facilitaiton (ICF-15 ms) were measured before, during, immediately after needle removal, and 30 min after needle removal. Needling sensation questionnaires were administered after each session, and self-rated anxiety was assessed before, during and after needle removal.
Relative to sham, verum acupuncture did not modulate corticomotor or intracortical excitability in either muscle across time (all P > 0.05). There were no differences in the severity of needling sensations between sessions (all P > 0.05), therefore sham park needle acupuncture was likely an adequate sham control.
There was little-to-no evidence that acupuncture to ...
Kalatzis, G, Lees, T, Nassif, N, Zaslawski, C & Lal, S 2017, 'Exploring cognitive function in diabetes and non-diabetes samples using electroencephalography (EEG) and psychometric assessment: a comparative study', 37th Annual Scientific Meeting of the Australasian Neuroscience Society.
Kalatzis, G, Lees, T, Nassif, N, Zaslawski, C & Lal, S 2016, 'Investigating cognitive function in diabetes and healthy samples using electroencephalography (EEG) and psychometric assessment: a comparative study.', Inter-University Neuroscience & Mental Health Conference.
Dean, S, Zaslawski, C & Pappas, E 2015, 'Mindful empathy', 9th International Conference on Teaching, Education and Learning (ICTEL), International Conference on Teaching, Education and Learning (ICTEL), Bangkok, Thailand.
Razavy, S, Berle, C, Zaslawski, C & Li, W 2014, 'The measurement of deqi within an acupuncture clinical trial using three different instruments', Journal of Integrative Medicine (JIM), Science Press, pp. 210-210.
De-qi is purported to be an indicator of the treatment efficacy or dose of acupuncture treatment. Several instruments have been developed to measure the level of De-qi. These include the Massachusetts General Hospital Acupuncture Sensation Scale (MASS) and Southampton Needle Sensation Questionnaire (SANSQ). In addition, some studies have used a simple Visual Analogue Scale (VAS). Despite their widespread use, scant research has been undertaken to evaluate whether there is a relationship among the three instruments. A study was therefore embedded within a clinical trial to determine whether statistically similar level of De-qi reported by participants on the three measurement occasions (session 1, session 5 and session 9) used the three different instruments. Methods: Three established instruments (MASS, SANSQ and VAS) that measure De-qi were administered in a clinical trial that was to assess the efficacy of acupuncture for lateral elbow pain (commonly known as tennis elbow). The needle manipulation was standardized and consisted of two periods of needle manipulation. Each period consisted of 2 min of deep needling using the technique of" wagging the dragons tail" at the sites of LI10 and LI11 at a frequency of 2 Hz. Following the administration of the acupuncture at the first, the fifth and the ninth sessions completed the three instruments. The evaluator administering the instruments was blind to the allocation of the participants. Results: The preliminary results concerning the consistency levels of De-qi among the three measurement periods will be presented and some of the issues of De-qi measurement …
Berle, C, Zaslawski, C, Cobbin, D, Meier, P, Walsh, S & Cheah, SL 2013, 'The effect of acupuncture treatment compared to sham laser for lateral elbow pain: a randomised controlled pilot study', Australian Journal of Acupunture and Chinese Medicine, WFAS World Federation of Acupuncture Societies, Australian Acupuncture and chinese Medicine Association, Sydney, pp. 25-32.
Background: Lateral elbow pain is a common painful musculoskeletal condition affecting approximately 1–3% of the population. Methods: A randomised participant-blinded controlled pilot study was undertaken to determine whether acupuncture could relieve pain and improve function for this condition. Twenty participants were randomly allocated to either a standardised acupuncture protocol (n= 11) or sham laser (n= 9) over ten sessions. Outcome measures were PPT test, McGill/Melzac pain, DASH and VAS pain questionnaires. Participants were evaluated at baseline, on completion of treatment (week five) and one month later. Results: There was no significant difference between the groups at baseline for any outcome parameter. There were no significant changes found at completion or one month follow-up for the PPT and VAS measures. There were significant improvements for the acupuncture group for the McGill questionnaire at week five for the affective (p= 0.01) and miscellaneous (p= 0.02) sections; week nine total score (p< 0.03), affective (p= 0.01) and miscellaneous (p= 0.01) sections; the DASH at week five for work (p= 0.02) and sport (p= 0.01) modules and week nine general (p < 0.04), work (p= 0.01) and sport (p= 0.006) modules. There were no significant changes for any outcome measure for the control group. There was no significant difference found between the two groups for blinding efficacy (expectancy/credibility scale) and experience of deqiat baseline or on completion. Conclusion: Results indicate that acupuncture may be helpful in alleviating pain and improving arm functionality, but small participant numbers preclude any definitive conclusions, a larger sufficiently powered study is required.
Freeman, LM, Koh, B, Edwards, J & Zaslawski, CJ 2012, 'Defining Alternative Medicine in the Context of Athletic Performance and the Spirit of Sports: D(etermination), O(bservance), P(ermissibility) or E(ducation', Proceedings International Conference on Sports and Society, 3rd International Conference on Sports and Society, Common Ground, Cambridge, UK.
Freeman, LM, Koh, B, Jonson, PT & Zaslawski, CJ 2009, 'Athletes healthcarebehaviour: an ethnographers conumdrum', Proceedings of 4th Annual International Ethnography Symposium, University of Liverpool, Liverpool England.
Freeman, LM, White, D & Zaslawski, CJ 2009, 'Emergent practitioners of CHinese Medicine: an ethnographic inquiry into medical thought', Proceedings of 4th Annual International Ethnography Symposium, University of Liverpool, Liverpool England.
Zaslawski, C, Walsh, S, Deare, J & James, J 2016, 'Referral practices and the Australian Chinese medicine profession: Report on AACMA survey', Book of Abstracts, AACMAC 2008: Australasian Acupuncture and cghinese Medicine Annual Conference, Star City Sydney Hotel and Casino, Darling Harbour, Sydney, Australia, pp. 15-15.
Zaslawski, CJ 2007, 'The influence of cross-cultural research ethics on Chinese medicine clinical trial design', Complementary Therapies In medicine, Authenticity, best practice, and the evidence mosaic The challenge of integrating traditional East Asian medicines into Western Health Care, Elsevier, University of Westminster, London, UK, pp. 115-115.
Berry, K, Ferguson, J, Cobbin, DM, Zaslawski, CJ, Walsh, SP & Meier, PC 2006, 'Integration fo CAM in Public Helath Care Services - A reflection on soem of the experiences from the UTS Alcohol and Other Drugs Clinical Placement Program as Rozelle Hospital', AACMA Annual Conference, Adelaide.
Berry, K, Ferguson, J, Cobbin, DM, Zaslawski, CJ, Walsh, SP & Meier, PC 2004, 'Acupuncture: Panacea or Placebo? An examination of the effectiveness of acupuncture as an adjunct to existing alcohol and other drug (AOD) programs', 15th International Conference on the Reduction of Drug Related Harm.
Berry, K, Ferguson, J, Cobbin, DM, Zaslawski, CJ, Walsh, SP & Meier, PC 2004, 'An Examination of the Effectiveness of Acupuncture as an adjunct to existing alcohol and other drug treatment programs', WFAS World Conference on Acupuncture.