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Associate Professor Christopher Zaslawski

Biography

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 President of the Chinese Medicine Council of New South Wales and 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.

Professional

President - Chinese Medicine Council of NSW

Member- He 031 Standards Australia

Member of the accreditation Committee of the Chinese Medicine Board of Australia

Member of the Australian Acupuncture and Chinese Medicine Association (AACMA)

Member of Pattern Identification Network Group (IPING)

Image of Christopher Zaslawski
Associate Professor, School of Life Sciences
CertAdvAc (Guangzhou TCM), PracDipAc (ACA), BAppSc (Syd), MHlthScEd (Syd), PhD (UTS)
 
Phone
+61 2 9514 7856

Research Interests

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

Chapters

Zaslawski, C.J. & Lee, M.S. 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.
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Zaslawski, C.J., Kim, M.S. & 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.
Zaslawski, C.J. 2012, 'An evidence-based review of acupuncture as an adjunctive therapy in comprehensive cancer care' in Soh, K.S., Kang, K.A. & Harrison, D.K. (eds), The Primo Vascular System Its Role in Cancer and Regeneration, Springer, United States, pp. 319-325.
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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, C.J. & 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.
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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 [1]. 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 [2]. 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 [3], 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 [4]. 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) [5] will be used to highlight some of the ethical requirements of human research and offer direction for some ethical challenges.

Conferences

Dean, S., Zaslawski, C. & Pappas, E. 2015, 'Mindful empathy', 9th International Conference on Teaching, Education and Learning (ICTEL), Bangkok, Thailand.
Berle, C., Zaslawski, C., Cobbin, D., Meier, P., Walsh, S. & Cheah, S.L. 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&#8211;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, L.M., Koh, B., Edwards, J. & Zaslawski, C.J. 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, L.M., Koh, B., Jonson, P.T. & Zaslawski, C.J. 2009, 'Athletes healthcarebehaviour: an ethnographers conumdrum', Proceedings of 4th Annual International Ethnography Symposium, University of Liverpool, Liverpool England.
Freeman, L.M., White, D. & Zaslawski, C.J. 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.J. 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.
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.
Berry, K., Ferguson, J., Cobbin, D.M., Zaslawski, C.J., Walsh, S.P. & Meier, P.C. 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, D.M., Zaslawski, C.J., Walsh, S.P. & Meier, P.C. 2006, 'Acupuncture and the treatment of alcohol and other drug addiction', WFAS World Conference on Acupuncture.
Berry, K., Ferguson, J., Cobbin, D.M., Zaslawski, C.J., Walsh, S.P. & Meier, P.C. 2005, 'Understanding and treating addicition from a TCM perspective', AACMA Annual Conference, Melbourne.
Berry, K., Ferguson, J., Cobbin, D.M., Zaslawski, C.J., Walsh, S.P. & Meier, P.C. 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, D.M., Zaslawski, C.J., Walsh, S.P. & Meier, P.C. 2004, 'An Examination of the Effectiveness of Acupuncture as an adjunct to existing alcohol and other drug treatment programs', WFAS World Conference on Acupuncture.
Berry, K., Ferguson, J., Cobbin, D.M., Zaslawski, C.J., Walsh, S.P. & Meier, P.C. 2004, 'An Examination of the effectiveness of acupuncture as an adjunct to existing alcohol and other drug treatment programs', UTS Royal Norht Shore Hospital 21st Annual Scientific Research Conference.

Journal articles

Elsdon, D.S., Spanswick, S., Zaslawski, C. & Meier, P.C. 2017, 'Protocol: Testing the Relevance of Acupuncture Theory in the Treatment of Myofascial Pain in the Upper Trapezius Muscle.', J Acupunct Meridian Stud, vol. 10, no. 1, pp. 67-74.
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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&nbsp;weeks with outcomes measured throughout the trial and at 2&nbsp;weeks and 4&nbsp;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.
Dean, S.J., 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.
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Choi, T.-.Y., Lee, M.S., Kim, J.I. & Zaslawski, C. 2017, 'Moxibustion for the treatment of osteoarthritis: An updated systematic review and meta-analysis.', Maturitas, vol. 100, pp. 33-48.
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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, I(2)=65%), including at follow-up (n=305; SMD, -0.36; 95% CI: -0.70 to -0.01, P=0.04, I(2)=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, I(2)=91%) and response rate (n=758 knees; RR, 1.10; 95% CI: 1.05-1.16, P <0.0001, I(2)=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.
Zaslawski, C.J. 2017, 'Ginseng for erectile dysfunction (Protocol)', Cochrane Database of Systematic Reviews, no. 5.
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Zheng, S., Kim, C., Lal, S., Meier, P., Sibbritt, D. & Zaslawski, C. 2017, '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.', J Clin Psychol.
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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.
Smith, C.A., Zaslawski, C.J., Cochrane, S., Zhu, X., Zheng, Z., Loyeung, B., Meier, P.C., Walsh, S., Xue, C.C., Zhang, A.L., Fahey, P.P. & Bensoussan, A. 2017, 'Reliability of the NICMAN Scale: An Instrument to Assess the Quality of Acupuncture Administered in Clinical Trials.', Evid Based Complement Alternat Med, vol. 2017, p. 5694083.
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BACKGROUND: The aim of this study was to examine the reliability of a scale to assess the methodological quality of acupuncture administered in clinical research. METHODS: We invited 36 acupuncture researchers and postgraduate students to participate in the study. Firstly, participants rated two articles using the scale. Following this initial stage, modifications were made to scale items and the exercise was repeated. Interrater reliability was assessed for individual items using the Fleiss kappa statistic, whilst the overall scale used the intraclass correlation coefficient statistic. A threshold agreement of 0.61 was acceptable. RESULTS: We received 26 responses and a 72% response rate. The first phase of testing found moderate reliability with intraclass correlation coefficients of 0.46 and 0.55 for the articles. The interrater reliability of the scales varied between and within the researchers (0.35, 0.60) and was more consistent with the postgraduate students (0.54, 0.54). Five items on the scale scored below the threshold and were revised for further testing. In this phase the intraclass correlation coefficient demonstrated variability between articles but improved to achieve reliability above the agreed threshold. CONCLUSION: This study provides evidence of the reliability of the NICMAN scale although improvements to a small number of items remain.
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, pp. 1-8.
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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', Journal of Acupuncture and Meridian Studies.
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Razavy, S., Gadau, M., Zhang, S.P., Wang, F.C., Bangrazi, S., Berle, C., Harahap, M., Li, T., Li, W.H. & Zaslawski, C. 2017, 'Psychophysical responses in patients receiving a mock laser within context of an acupuncture clinical trial: an interoceptive perspective.', BMC Complement Altern Med, vol. 17, no. 1, p. 348.
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BACKGROUND: The psychophysical responses induced by verum acupuncture are characterized by a constellation of unique subjective sensory responses commonly termed De Qi. Furthermore, a variety of sham interventions have been used as a control for acupuncture clinical trials. Indeed, one such control has been mock laser which has been used as control intervention in several acupuncture clinical controlled trials. The current study aim was to examine the De Qi sensory responses and its related characteristics elicited from acupuncture and compare them to those reported following sham laser in participants enrolled in a clinical trial. METHODS: The study was embedded in a multi-center, two-arm randomised clinical trial, which evaluated the effect of acupuncture on lateral elbow pain. De Qi was assessed using the Massachusetts General Hospital Acupuncture Sensation Scale (MASS). Ninety-six participants were randomly allocated to receive either acupuncture (n&nbsp;=&nbsp;47) or mock laser (n&nbsp;=&nbsp;49) at the acupoints LI 10 and LI 11. RESULTS: Participants in both intervention groups reported similar De Qi psychophysical characteristics; however, both intensity and frequency of the individually perceived De Qi characteristics were significantly higher in the acupuncture group. 'Soreness', 'deep pressure', and 'fullness-distension' in the acupuncture group and 'tingling', and 'sharp pain' in mock laser group, were identified as the leading characteristics. Similar level of MASS De Qi Index (MDI) scores were reported for 'Hong Kong-China' and 'Australia-Italy' with a significantly higher level of De Qi reported by 'Hong Kong-China'. Furthermore, two distinct De Qi categories were identified, namely De Qi (in line with classical sensory responses of Suan, Ma, Zhang, and Zhong) and pain. CONCLUSIONS: Subjective 'somatic or interoceptive awareness' should be taken into account when De Qi psychophysical responses are examined. The study accentuates the necessity and the significance of fu...
Razavy, S., Gadau, M., Zhang, S.P., Wang, F.C., Bangrazi, S., Berle, C., Harahap, M., Li, T., Li, W.H. & Zaslawski, C. 2017, 'Investigation of the phenomenon of Propagated Sensation along the Channels (PSCs) in the upper limb following administration of acupuncture and mock laser', Journal of Acupuncture and Meridian Studies.
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Soo Lee, M., Lee, J.A., Alraek, T., Bian, Z.X., Birch, S., Goto, H., Jung, J., Kao, S.-.T., Moon, S.-.K., Park, B., Park, K.-.M., You, S., Yun, K.-.J. & Zaslawski, C.J. 2016, 'Current research and future directions in pattern identification: Results of an international symposium', Chinese Journal of Integrative Medicine, vol. 20.
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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.
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.
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Dean, S.J., 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.
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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.
Kim, T.-.H., Zaslawski, C., Kwon, S. & Kang, J.W. 2016, 'Korean Medicine in General Practice: Current Status, Challenges, and Vision in Clinical Evidence', EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE.
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Jung, J., Park, B., Lee, J.A., You, S., Alraek, T., Zhao-Xiang, B., Birch, S., Kim, T.-.H., Hao, X., Zaslawski, C., Kang, B.-.K. & Lee, M.S. 2016, 'Standardization and future directions in pattern identification research: International brainstorming session', CHINESE JOURNAL OF INTEGRATIVE MEDICINE, vol. 22, no. 9, pp. 714-720.
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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.
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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.
Chen, J., Loyeung, B., Zaslawski, C., Liang, F.R. & Li, W.H. 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.
To analyze and compare the curriculum and delivery of a Chinese and Australian university-level Chinese medicine program.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.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.A better understanding of the different curricula and approaches to Chinese medicine education will facilitate student learning and educational outcomes.
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.
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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.
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Zaslawski, C., Berle, C., Gadau, M., Li, W.H., Li, T., Wang, F.C., Bangrazi, S., Li, L., Ligouri, S., Liu, Y.S., Tan, Y.S. & Zhang, S.P. 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.
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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&#8211;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.
Yu, X., Lim, C.E.D. & 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.
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Fogarty, S., Stojanovska, L., Harris, D., Zaslawski, C., Mathai, M.L. & McAinch, A.J. 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.
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Zaslawski, C.J., Walsh, S.P., 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.
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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...
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.
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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 nave 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. & Study, T.E.A.I. 2014, 'Acupuncture and moxibustion for lateral elbow pain: a systematic review of randomized controlled trials', BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE, vol. 14.
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Wc Ng, R., Lim, C., Cheng, L.L., Strutt, R., Wiltshire, J., Cigolini, M. & Zaslawski, C.J. 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.
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Bilton, K.M., Hammer, L. & Zaslawski, C.J. 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.
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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.
Fogarty, S., Harris, D., Zaslawski, C.J., McAinch, A.J. & 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.
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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.
Choi, T., Lee, M.S., Kim, T., Zaslawski, C.J. & 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.
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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.
Koh, B., Freeman, L.M. & Zaslawski, C.J. 2012, 'Alternative medicine and doping in sports', Australasian Medical Journal, vol. 5, no. 1, pp. 18-25.
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Biopsychology; Complementary and alternative medicine; Doping; Sports law
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.
Koh, B., Freeman, L. & Zaslawski, C. 2012, 'Alternative medicine and doping in sports', Australasian Medical Journal, vol. 5, no. 1, pp. 18-25.
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Koh, B., Freeman, L. & Zaslawski, C. 2012, 'Alternative medicine and doping in sports.', The Australasian medical journal, vol. 5, no. 1, pp. 18-25.
Athletes are high achievers who may seek creative or unconventional methods to improve performance. The literature indicates that athletes are among the heaviest users of complementary and alternative medicine (CAM) and thus may pioneer population trends in CAM use. Unlike non-athletes, athletes may use CAM not just for prevention, treatment or rehabilitation from illness or injuries, but also for performance enhancement. Assuming that athletes' creative use of anything unconventional is aimed at "legally" improving performance, CAM may be used because it is perceived as more "natural" and erroneously assumed as not potentially doping. This failure to recognise CAMs as pharmacological agents puts athletes at risk of inadvertent doping.The general position of the World Anti-Doping Authority (WADA) is one of strict liability, an application of the legal proposition that ignorance is no excuse and the ultimate responsibility is on the athlete to ensure at all times whatever is swallowed, injected or applied to the athlete is both safe and legal for use. This means that a violation occurs whether or not the athlete intentionally or unintentionally, knowingly or unknowingly, used a prohibited substance/method or was negligent or otherwise at fault. Athletes are therefore expected to understand not only what is prohibited, but also what might potentially cause an inadvertent doping violation. Yet, as will be discussed, athlete knowledge on doping is deficient and WADA itself sometimes changes its position on prohibited methods or substances. The situation is further confounded by the conflicting stance of anti-doping experts in the media. These highly publicised disagreements may further portray inconsistencies in anti-doping guidelines and suggest to athletes that what is considered doping is dependent on the dominant political zeitgeist. Taken together, athletes may believe that unless a specific and explicit ruling is made, guidelines are open to interpretation. The...
Kim, N., Lee, D., Seo, H., Sun, S., Oh, Y., Kim, J., Yoon, I., Seo, E., Shim, G. & Zaslawski, C.J. 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.
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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
Berle, C.A., Cobbin, D.M., Smith, N.F. & Zaslawski, C.J. 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.
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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.
Smith, C.A., Zaslawski, C.J., Zheng, Z., Cobbin, D.M., Cochrane, S., Lenon, G.B., Loyeung, Y., Meier, P.C., 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.
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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.
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.
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Berle, C.A., Cobbin, D.M., Smith, N.F. & Zaslawski, C.J. 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.
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Berle, C.A., Cobbin, D.M., Smith, N.F. & Zaslawski, C.J. 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.
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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.
Fogerty, S., Harris, D., Zaslawski, C.J., 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.
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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.J. 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.
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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.
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.
Lee, J.H. & Zaslawski, C.J. 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.
Zaslawski, C.J. 2008, 'Book Review- Correcting the Errors in the Forest of Nedicine', Australian Journal of Acupuncture and Chinese medicine, vol. 3.
Zaslawski, C.J. 2008, 'Acupuncture for Persistent Allergic Rhinitis', Australian Journal of Acupuncture and Chinese Medicine, vol. 3, no. 1, pp. 56-56.
Zaslawski, C.J. 2008, 'Blood Stasis: China's Classical Concept in Modern Medicine', Australian Journal of Acupuncture and Chinese Medicine, vol. 3.
Zaslawski, C.J., 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.
Kim, M., Cobbin, D.M. & Zaslawski, C.J. 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.
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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
Li, W., Cobbin, D.M. & Zaslawski, C.J. 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.
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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 &copy; 2008.
White, P., Golianu, B., Choi, S. & Zaslawski, C.J. 2006, 'Standardization of Nomenclature in Acupuncture Research (SoNAR)', Evidenced based Complementary and Alternative Medicine, vol. 4, no. 2, pp. 267-270.
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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, C.J. & Gorman, S.M. 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, C.J. 2004, 'The impact of ethics on the design and conduct of acupuncture clinical trials', Clinical Acupuncture and Oriental Medicine, vol. 4, pp. 121-126.
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Zaslawski, C.J., Cobbin, D.M., 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.
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Zaslawski, C.J. 2003, 'Clinical Reasoning in traditional Chinese medicine: implications for clinical research', Clinical Acupuncture and Oriental Medicine, vol. 4, pp. 94-101.
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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.
Birch, S., Hammerschlag, R., Zaslawski, C.J. & Trinh, K.V. 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.
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MacPherson, H., Sherman, K., Hammerschlag, R., Birch, S., Lao, L. & Zaslawski, C.J. 2002, 'The clinical evaluation of traditional East Asian systems of medicine', Clinical Acupuncture and Oriental Medicine, vol. 3, no. 1, pp. 15-19.
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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.
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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. &copy; 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.
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Walsh, S.P., Cobbin, D.M., Bateman, K. & Zaslawski, C.J. 2001, 'Feeling the Pulse', European Journal of Oriental Medicine, vol. 3, no. 5, p. 30.
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Aird, M., Coyle, M.E., Cobbin, D.M. & Zaslawski, C.J. 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, M.E., Aird, M., Cobbin, D.M. & Zaslawski, C.J. 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.
Zaslawski, C.J. 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.
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, C.X. & Zhang, S.P. 1997, 'Strategies to maintain the credibility of sham acupuncture used as a control treatment in clinical trials.', Journal of alternative and complementary medicine (New York, N.Y.), vol. 3, no. 3, pp. 257-266.
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.