The incidence rate of chronic hepatopathy in Taiwan is high, which afflicts the patients by progressively developing irreversible cirrhosis. Hepatic fibrosis is the intermediate and crucial stage of this process, characterized by reversibility. If treated properly in this stage, cirrhosis can be successfully prevented. In the liver, activated stellate cells are the key mediators of fibrosis. Transforming growth factor-

The following is an inquiry into the phenomenon of “Spirit” and its relation to the practice of locating an acupuncture point. In this context of Traditional Chinese Medicine, which finds its roots in Taoist tradition, the aspect of Spirit shen is understood as being inextricably inter-related, inter-dependent and inter-connected with the Body and Mind aspects of this triune. Eight practitioners agreed to participate in a taped interview describing the experience of locating an acupoint. Although each practitioner described an experience which was unique, four threads emerged which are similar: (1) the practitioner focuses a body mediated awareness inward; (2) this awareness is then extended to the patient; (3) then there is the experience of movement toward the point both with intention and a palpating finger; and (4) when the point has been located there is a pause, followed by the sensation of arrival of the patient’s qi at the acupoint.

One in six couples wishing to start a family are infertile. The many causes of infertility include genetic defects that can be single gene, multifactorial or chromosomal (including Y deletions, karyotype abnormalities and gamete aneuploidy). This thesis is concerned with the association between infertility and increased sperm aneuploidy. Specific questions are: should males be screened for sperm aneuploidy before intracytoplasmic sperm injection (ICSI)? Is there a relationship between individual semen parameters and sperm aneuploidy for specific chromosome pairs? What is the role of genome organisation in male gametes and its association with infertility? Whether use of alternative therapy (in this case, traditional Chinese Medicine (TCM)) can be used to improve sperm disomy levels. Statistical analysis of questionnaire data revealed that infertility specialists believed there to be merit in screening sperm aneuploidy levels before ICSI. Evidence is presented for possible chromosome-specific and semen parameter specific mechanisms for sperm aneuploidy as is evidence of genome organisation that may be perturbed in infertile males. Finally, in six males studied, sperm aneuploidy levels improved significantly coincident with TCM. Closer investigation of the biological activity of individual therapeutic herbs and treatment cocktails revealed strong anti-oestrogenic and anti-oxidant properties. This suggests a possible mechanism of action of the herbs and provides the basis from which future placebo controlled clinical trials might continue. Possible criticisms of the work presented here include the unavailability of blood samples from many of the patients (thus preventing karyotype analysis) and the absence of a second control group in our studies on semen parameters. Nevertheless significant steps have been made towards establishing the need for, and the implementation of, a pre-ICSI screening test. Moreover progress has been made towards further understanding the aetiology of sperm aneuploidy and towards the implementation of a new treatment that may, ultimately, augment, or even replace ICSI.

Introduction Traditional Chinese Medicine (TCM) is an ancient medical practice, performed since approximately 2000 B.C. Qigong constitutes one of five main pillars in TCM and is a method of meditation, exercise as well as self-medication. Basic tenets of TCM is the body existing in balance with Qi (life-energy) and its emphasis on holistic dynamic processes over material structure. A lot of research has been done on the positive health effects of Qigong, although it is unclear whether the evidence situation is judged to be sufficient to prove Qigong effective. Objective To investigate the arguments for and against acceptance of Qigong in Swedish Healthcare Methods This is a qualitative study that followed the hermeneutical method, as well as the normative ethical theory, of study-design and data analysis. Searches of grey literature and electronic databases (Pubmed, Cochrane) were performed, serving the purpose to collect different perspectives. The selection of sources was based on relevance to the aim. Data emerged was analysed in order to investigate the most relevant ethical arguments for and against integration of Qigong in the Swedish healthcare. Results Main arguments against acceptance of Qigong were: “Traditional Chinese Medicine’s underlying philosophy stand in opposition to scientific worldview”, “Lack of strong evidence”, “Complementary and Alternative Medicine lead people away from Evidence Based Medicine”, and “Economical incentive and bias in Complementary and Alternative Medicine and Qigong”.Main arguments for acceptance of Qigong were: “Extensive proven experience”, “Further acceptance and integration may increase patient safety and promote research”, and “Qigong is risk-free and highly available at low cost” Conclusion A strong argument against acceptance of Qigong is “lack of strong evidence”. Strong arguments for acceptance of Qigong are “further acceptance and integration may promote research” and “Qigong is risk-free and highly available at low cost”. Thus, strong arguments are found for, as well as against, integration of Qigong in Swedish established healthcare. The balance between these strong arguments, however, will have to be discussed further, as there is no obvious right answer.

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This written thesis examines the process of producing Herb and Life: a Chinese Medical Family, a thirty-minute documentary video that explores the producer's family members' relationship with Traditional Chinese Medicine. This documentary uses interviews, narration, music, and observational sequences to display documentary subjects' career choices and their experiences with Traditional Chinese Medicine. This written thesis reveals the development of this documentary, from the pre-production to production and post-production stages. It also incorporates theoretical analysis and self-evaluation of this documentary video.

Submitted by Maicon Juliano Schmidt (maicons) on 2015-03-26T16:52:15Z No. of bitstreams: 1 Marcelo Felipe Nunes.pdf: 238852 bytes, checksum: 63a39a0b4853060f8c5ef0474586cb2d (MD5) / Made available in DSpace on 2015-03-26T16:52:15Z (GMT). No. of bitstreams: 1 Marcelo Felipe Nunes.pdf: 238852 bytes, checksum: 63a39a0b4853060f8c5ef0474586cb2d (MD5) Previous issue date: 2013-01-31 / Nenhuma / O objetivo do artigo foi analisar as trajetórias de formação e a atuação de acupunturistas. Trata-se de um estudo de natureza qualitativa, baseado no referencial metodológico das narrativas de histórias de vida. Participaram oito profissionais de saúde, cinco homens e três mulheres, graduados em enfermagem, fisioterapia e medicina, que utilizavam a acupuntura a partir da perspectiva da Medicina Tradicional Chinesa (MTC) e que responderam a entrevistas semiestruturadas. A análise das narrativas resultou em três categorias centrais: Busca por novas racionalidades em saúde; Inserção no complexo mundo da acupuntura; A acupuntura vai além da agulha. Ficou evidente que a busca pela acupuntura foi motivada pela insatisfação com a formação inicial no paradigma biomédico. A trajetória de formação na acupuntura foi gradativa e envolveu uma inserção profunda na racionalidade da MTC, devido à complexidade de sua proposta terapêutica, o que levou-os a entender que a inserção da agulha representa a confluência de diversos aspectos da MTC, não podendo ser reduzido a mera aplicação de uma técnica de agulhamento. Neste sentido, aponta-se a necessidade de repensar a formação desses profissionais, assim como investigar a atuação dos que trabalham no Sistema Único de Saúde. / The objective of the article was to analyze the trajectories of formation and action of acupuncturists. This is a qualitative study, based on the methodological framework of the narratives of life stories. There were eight participants among healthcare professionals, five men and three women, graduated in nursing, physiotherapy and medicine, who used acupuncture from the perspective of Traditional Chinese Medicine (TCM) and answered structured interviews. The analysis of the narratives implied three main categories: Search for new rationalities in health; Entering the complex world of acupuncture, Acupuncture goes beyond the needle. It became evident that the search for acupuncture was motivated by dissatisfaction with the initial training into biomedical paradigm. The trajectory of the education in acupuncture was gradual and involved a deep insertion into the rationality of TCM, due to the complexity of its treatment plan, which led the participants to realize that the needle insertion represents the confluence of several aspects of TCM, which can not be reduced to mere application of a needling technique. In this regard, it appoints the need of rethinking the education of the healthcare professionals, as well as to investigate the actions of those who work for the Sistema Único de Saúde.

Made available in DSpace on 2016-01-26T12:51:41Z (GMT). No. of bitstreams: 1 fulvioschiavo_dissert.pdf: 448108 bytes, checksum: c5c0f2f7e8e352dd32b55da75281ed8b (MD5) Previous issue date: 2006-04-25 / This work was elaborated on a literature review about the Acupuncture practice in the treatment of psychogenic erectile dysfunction. The erectile dysfunction is defined and inserted in the sexology context. Its aetiology, risk factors and alternatives for treatment are briefly discussed. The Acupuncture, a new Western therapeutic aid, is approached in the field of the Traditional Chinese Medicine. Due to the differences in the way of facing the sexuality between the Western and the Eastern cultures, and the possibility of approaching at the same time the physical and psychological aspects of diseases, the Acupuncture was evaluated in some studies as an option for the treatment of the psychogenic erectile dysfunction. The articles are clinic test types, retrospective study, case report and review. Taking into account the ones with better outline, the results showed that the acupuncture was efficient in about 60 to 70% of the cases. Although these results are promising, the papers have some structural failure and they do not have part of the information related to the intervention strategy (handling of the needles). Therefore, it is suggested that further studies dealing with this subject ought to be more feasible. Up to end of this research, there was not sufficient information to provide the effectiveness of Acupuncture in the treatment of the psychogenic erectile dysfunction. / Este estudo foi elaborado a partir de uma revisão da literatura sobre a aplicação da Acupuntura no tratamento da disfunção erétil psicogênica. A disfunção erétil é definida e inserida no contexto da sexologia. São comentados sua etiologia, seus fatores de risco e opções de tratamento de forma breve. A Acupuntura, uma nova arma terapêutica para o Ocidente, é abordada no contexto da Medicina Tradicional Chinesa. Devido às diferenças na maneira de encarar a sexualidade entre as culturas ocidental e oriental e a possibilidade de abordar, ao mesmo tempo, os aspectos físicos e psicológicos das doenças, a Acupuntura foi avaliada em alguns estudos como uma opção no tratamento da disfunção erétil psicogênica. São artigos dos tipos ensaio clínico, estudo retrospectivo, relato de caso e revisão. Considerando os que têm melhor delineamento, os resultados demonstraram que a acupuntura foi eficaz em cerca de 60 a 70% dos casos. Embora estes resultados sejam promissores, os estudos trazem consigo falhas de estrutura e carecem de parte das informações em relação à estratégia de intervenção (manejo das agulhas). Portanto, são feitas sugestões para que os estudos futuros abordando o tema tenham plena confiabilidade. Até o encerramento desta pesquisa, não havia dados suficientes para afirmar que a Acupuntura é eficaz no tratamento da disfunção erétil psicogênica.

Background: Pain associated with the spine (PAWS) refers to pain in the neck, thorax, lower back or sacrum. It impacts on patients' Quality of Life (QoL), including working ability, daily functioning, sleep and psychological well-being. A number of clinical trials have demonstrated that acupuncture was beneficial for patients with PAWS. However the overall effect of acupuncture on these patients' QoL is unknown. Aims: The current study aimed to conduct a systematic review (SR) of clinical trials to determine the effect of acupuncture on QoL and pain for patients with PAWS. In addition, a narrative review (NR) was conducted to compare patients' perceived changes (PCC) with the standard QoL instruments used in acupuncture clinical trials for pain. Methods: For the SR, PubMed, Embase (via ScienceDirect), CINAHL (Via EBSCO) and Cochrane Central Register of Controlled Trials were searched. Randomised controlled trials (RCTs) of acupuncture for PAWS condition(s) that include both QoL and pain assessments with a Jadad score of three or greater were included. For the NR, PubMed was searched to identify studies reporting PPC after acupuncture and/or traditional Chinese medicine. Extracted data were grouped and compared with domains of the QoL instruments. Results: In total, 21 RCTs were included and 17 of them had sufficient data for analysis. QoL was measured using 15 different instruments. Randomisation procedures and dropouts were adequately reported in all 17 studies. Four studies compared acupuncture with wait-list or usual-care. Two demonstrated that acupuncture had a superior effect on improving physical and mental components of QoL measured by Short Form-36 health survey questionnaire and pain at the three month follow-up. Studies comparing acupuncture with sham/placebo acupuncture or placebo-TENS found either no difference between the treatments or conflicting results. When acupuncture was compared with active interventions, there was no difference except that at the intermediate-term follow-up massage was better for disability and pain and physiotherapy was better for Northwick Park Neck Pain Questionnaire. Acupuncture was also better than TENS for pain. The combined therapy of acupuncture and an active intervention showed a superior result than the latter alone in the short-term. Six studies were identified for the NR. Patients reported 11 categories of changes after acupuncture, such as reduced reliance on other therapies, enhanced spirituality, prevention of disease. However, these clinical outcomes were not included in any of the QoL instruments used in the included RCTs. Conclusion: There is moderate to strong evidence that acupuncture is more effective than wait-list or usual-care at the short-term follow-up in improving QoL of patients with PAWS. When acupuncture is combined with another therapy, the combined therapy seems to produce a better outcome. Acupuncture is not better than sham/placebo acupuncture or placebo-TENS. Surprisingly, the commonly used QoL instruments do not measure all the changes perceived by patients as a result of acupuncture and/or traditional Chinese medicine. There is a pressing need to design QoL assessments that are suitable for acupuncture research. Further studies should have larger sample sizes and additional validated outcome assessments are required to detect effects of acupuncture.

The increasing popularity of traditional Chinese medicine (TCM) therapies as health care options warrants thorough examination of the efficacy and safety evidence around these therapies. This thesis explores the intersection of TCM and fatigue using two rigorous methodologies: systematic reviews (SRs) and a randomized controlled clinical trial (RCT). In order to inform the development of an RCT of acupuncture for infectious mononucleosis (mono), a common condition with no known cure, characterized by profound fatigue, we examined the literature on TCM treatment of mono as well as another fatigue condition, idiopathic chronic fatigue (ICF). Additionally, we investigated the literature on the safety of pediatric acupuncture. SRs of TCM efficacy in mono and ICF determined that although clinical trials exist, methodological flaws compromised their validity. In particular, studies published as RCTs were found to lack proper randomization. Inclusion of these studies in the SRs would have been inappropriate and demonstrates the importance of verifying RCT methods. We also present the results of the first known SR of pediatric acupuncture safety. This review was comprehensive, including a large number of databases and publications in any language. Synthesis of the results from those studies that included a denominator produced mild adverse event estimates of 16.3/100 (95% CI 11.221.5) per patient, for RCTs, and 6.3/100 (95% CI 4.97.7) per patient, for cohort studies, with a combined estimate of 7.8/100 (95% CI 6.49.2) per patient. We developed and conducted an RCT of acupuncture for mono, although limitations to recruitment resulted in the enrolment of only three participants. The primary result of the small sample size was to restrict the determination of treatment effect, however, successful implementation of other elements is informative to further research in this area. In addition, we determined the local 5-year Monospot positive incidence rate to be 1.11/1000 (95% CI 0.953.2) for all ages and 5.46/1000 (95% CI 0.8910.0) for the 15-25 year old group. This dissertation examined the evidence around TCM and fatigue and provides recommendations that are aimed at increasing the value of research and the safety and efficacy of practice in this area.