Modulatory effects of acupuncture on resting-state networks: A functional MRI study combining independent component analysis and multivariate granger causality analysis†

Further exploration of brain - acupuncture connection with magnetic resonance imaging

http://onlinelibrary.wiley.com/doi/10.1002/jmri.22887/abstract 

Researchers reported: "Following acupuncture at GB40, the strength of causal connectivity between the superior temporal gyrus (STG) and anterior insula was enhanced, while the connection strength between the STG and postcentral gyrus increased following acupuncture at KI3. Additionally, the causal influences within the auditory network increased following acupuncture at GB40, in comparison with the executive network following acupuncture at KI3."

1. Chongguang Zhong PhD¹,
2. Lijun Bai PhD^1,†,
3. Ruwei Dai PhD¹,
4. Ting Xue PhD²,
5. Hu Wang PhD¹,
6. Yuanyuan Feng PhD¹,
7. Zhenyu Liu PhD¹,
8. Youbo You PhD¹,
9. Shangjie Chen PhD³,
10. Jie Tian PhD^1,2,*

Comment NOW on Acupuncture for the Affordable Care Act

News Release
FOR IMMEDIATE RELEASE
December 16, 2011

Contact: HHS Press Office
(202) 690-6343

HHS to give states more flexibility to implement health reform
Approach will help ensure consumers have quality, affordable coverage
starting in 2014

The Department of Health and Human Services today released a bulletin
outlining proposed policies that will give states more flexibility and
freedom to implement the Affordable Care Act.

The Affordable Care Act ensures all Americans have access to quality,
affordable health insurance. To achieve this goal, the law ensures
that health insurance plans offered in the individual and small group
markets, both inside and outside of the Affordable Insurance Exchanges
(Exchanges), offer a comprehensive package of items and services,
known as “essential health benefits.”

The bulletin released today describes an inclusive, affordable and
flexible proposal and informs stakeholders about the approach that HHS
intends to pursue in rulemaking to define essential health benefits.
HHS is releasing this intended approach to give consumers, states,
employers and issuers timely information as they work toward
establishing Exchanges and making decisions for 2014. This approach
was developed with significant input from the public, as well as
reports from the Department of Labor, the Institute of Medicine, and
research conducted by HHS.

“Under the Affordable Care Act, consumers and small businesses can be
confident that the insurance plans they choose and purchase will cover
a comprehensive and affordable set of health services,” said HHS
Secretary Kathleen Sebelius. “Our approach will protect consumers and
give states the flexibility to design coverage options that meet their
unique needs.”

Under the Department’s intended approach announced today, states would
have the flexibility to select an existing health plan to set the
“benchmark” for the items and services included in the essential
health benefits package. States would choose one of the following
health insurance plans as a benchmark:

One of the three largest small group plans in the state;
One of the three largest state employee health plans;
One of the three largest federal employee health plan options;
The largest HMO plan offered in the state’s commercial market.

The benefits and services included in the health insurance plan
selected by the state would be the essential health benefits package.
Plans could modify coverage within a benefit category so long as they
do not reduce the value of coverage. Consistent with the law, states
must ensure the essential health benefits package covers items and
services in at least ten categories of care, including preventive
care, emergency services, maternity care, hospital and physician
services, and prescription drugs. If a state selects a plan that does
not cover all ten categories of care, the state will have the option
to examine other benchmark insurance plans, including the Federal
Employee Health Benefits Plan, to determine the type of benefits that
will be included in the essential health benefits package.

The policy proposed today by HHS would give states the flexibility to
select a plan that would be equal in scope to the services covered by
a typical employer plan in their state. States and insurers would
retain the flexibility to evolve the benefits package with the market
as innovative plan designs are developed and advancements in care
become available, and meet the needs of their citizens.

“More than 30 million Americans who newly have insurance coverage in
2014 will have a comprehensive benefit package,” said Sherry Glied,
PhD, assistant secretary for planning and evaluation. “In addition to
assuring comprehensive coverage for the newly insured, many millions
of Americans buying their own insurance today will gain valuable new
coverage, including more than 8 million Americans who currently do not
have maternity coverage, and more than 1 million who will gain
prescription drug coverage.”

The bulletin issued today addresses only the services and items
covered by a health plan, not the cost sharing, such as deductibles,
copayments, and coinsurance. The cost-sharing features will be
addressed in future bulletins and cost-sharing rules will determine
the actuarial value of the plan.

Public input on this proposal is encouraged. Comments are due by Jan
31, 2012 and can be sent to: EssentialHealthBenefits@cms.hhs.gov.

For the essential health benefits bulletin, visit:
http://cciio.cms.gov/resources/regulations/index.html#hie

For a fact sheet on the essential health benefits bulletin, visit:
http://www.healthcare.gov/news/factsheets/2011/12/essential-health-benefits12162011a.html

For a summary of individual market coverage as it relates to essential
health benefits, visit: http://aspe.hhs.gov/health/reports/2011/IndividualMarket/ib.shtml

For information comparing benefits in small group products and state
and Federal employee plans, visit: http://aspe.hhs.gov/health/reports/2011/MarketComparison/rb.shtml


###


Note: All HHS press releases, fact sheets and other press materials
are available at http://www.hhs.gov/news.

Last revised: December 16, 2011

Is acupuncture safe for children?

November 22, 2011, *11:00 am*

*Acupuncture Is Safe in Children, Study Finds*

*By **ANAHAD O'CONNOR* 

Joe Raedle/Getty ImagesCan acupuncture help children?

Is acupuncture safe for children?

According to a large new study in the journal
Pediatrics<http://pediatrics.aappublications.org/>,
the short answer is yes — in the hands of a trained practitioner. The
study, the first large-scale systematic review on the safety of pediatric
acupuncture, found that about one in 10 children had experienced mild side
effects, like bruising and pain and numbness at the puncture site. More
serious side effects, like infections and nerve impairment, were rare.

AOMA President's Blog: Speaking at American Herbal Guild

AOMA President's Blog: Speaking at American Herbal Guild: http://www.americanherbalistsguild.com/

Speaking at American Herbal Guild

It is important for acupuncturists to be conversant in western herbal traditions as patients will self-prescribe the materials, or may have received them from other providers. Here is a ink to the American Herbal Guild where I will be speaking pulse and tongue diagnosis for western herbalists: http://www.americanherbalistsguild.com/

First Published in: Acupuncture Today September, 2010, Vol. 11, Issue 09

Proving East Asian Medicine

By William Morris, DAOM, PhD, LAc

East Asian medical research focuses on quantitative means of proof. This affects the information obtained, thus what become considered best practices. I maintain that the world of East Asian medicine might also be understood through qualitative means.

In this article, I address the thinking behind these forms of research and to provide some examples of, and resources for, qualitative methods.

Quantitative Research
The traditional scientific approach to research has its underpinnings in what is called positivist philosophy. As a paradigm, positivists consider that true knowledge is scientific and measurable. The methods of positivism are informed by a set of principles including:
Value-freedom. Human beliefs and interests should not influence the choice of what and how to study a problem. Rather, it should be determined by objective criteria.
Causality. Research should identify causal explanations and fundamental laws.
Operationalization. The methods should enable facts to be measured quantitatively.
Independence. The researcher is independent of the subject.
Reductionism. Problems are better understood if they are reduced to the simplest possible elements.

Qualitative Research
Qualitative researchers consider that human beliefs and interest form the bedrock of decisions about what should be researched. The focus upon fundamental laws creates general information, and causes may change when applied to the individual human being. Qualitative methods of capturing information can often provide rich depth compared to quantitative. Regarding independence, qualitative research represents the researchers’ participation in, and influence upon, research and its outcomes. For Chinese medicine, which is a model of care that embraces complex systems and conditions, reductionism might miss the point.

In the hierarchical scheme of knowledge for evidence-based medicine, the randomized controlled trial sits at the top of the pyramid. This comes from a positivist point of view and does have value. The application of pharmaceutical treatments and population studies for risk-benefit assessment make the randomized controlled trial vital.

The extension of the resulting assumptions into social systems and individual lives poses a problem, however. Speaking about the world of human experience requires an extensive commitment in terms of time and dedication to process. However, this world is often dismissed as subjective and regarded with suspicion. Small qualitative studies are not generalizable in the traditional sense, yet have redeeming qualities that set them above that requirement.

Qualitative research investigates the why, not the how. Often, data is unstructured and can involve interview transcripts, e-mails, notes, feedback forms, photos and videos. Qualitative data can be used to gain insight into people’s attitudes, behaviors, value systems, concerns, motivations, aspirations, culture or lifestyles. Here, I will present six methods of qualitative research including case study, grounded theory, phenomenology, ethnography, narrative methods and historical research. Last, I will briefly present models for mixing qualitative and quantitative methods.

Case-study research is a form of qualitative descriptive research that looks intensely at an individual or small participant pool, drawing conclusions only about that participant or group and only in that specific context. Researchers do not focus on the discovery of a universal, generalizable truth, nor do they typically look for cause-effect relationships. Instead, emphasis is placed on exploration and description. Developing a case study involves gathering all the data, organizing it into an approach to highlight the focus of the study. Then, a case study narrative is developed. The narrative might be validated by review from program participants. Further, a case study series might be cross-compared to isolate any themes or patterns. The writings of Robert Stake and Robert Yin should be seriously considered by anyone wishing to employ case studies and case series in their graduate work.^1-4

Grounded theory is a systematic generation of theory from data. Rather than beginning with a hypothesis, the first step is to collect data via qualitative or quantitative means. Key points are identified in the data and marked with codes and grouped into categories which become the basis for the development of theories and reverse-engineered hypotheses. Grounded theory is gaining strength in the area of medical research and there are medical research projects receiving funds from the NIH.^5,6

Phenomenology involves describing the structures of experience as they present themselves to consciousness, without recourse to theory, deduction, or assumptions from other disciplines. Phenomenology studies the structures of consciousness as experienced from the first-person point of view. The central structure of an experience is its intentionality, being directed toward something, as it is an experience of or about some object. An experience is directed toward an object by virtue of its content or meaning (which represents the object) together with appropriate enabling conditions.^7-9

Ethnography is a form of research focusing on creating meaning through close field observation of sociocultural phenomena. Typically, the ethnographer focuses on a community that may occur geographically or in cyberspace, They may be practitioner groups, patient groups and provider networks. From these groups, informants are selected who are known to have an overview of the activities of the community. Such informants are asked to identify other informants representative of the community, using chain sampling to obtain a saturation of informants in all empirical areas of investigation. Informants are interviewed multiple times, using information from previous informants to elicit clarification and deeper responses upon re-interview. This process is intended to reveal common cultural understandings related to the phenomena under study.^10-12

Historical research involves the systematic collection and objective evaluation of data related to past occurrences in order to test hypotheses concerning causes, effects or trends of these events that may help to explain present events and anticipate future events.¹³ Historical research involves developing an understanding of the past through the examination and interpretation of artifacts such as texts, physical remains of historic sites, recorded data, pictures, maps recordings and other forms of evidence. The historian’s job is to find evidence, analyze its content and biases, corroborate it with other evidence, and use the evidence to develop an interpretation of past events that has some importance for the present. Historians use libraries to locate primary sources (firsthand information such as diaries, letters and original documents) for evidence find secondary sources, historians’ interpretations and analyses of historical evidence verify factual material as inconsistencies arise.

Narrative research methods involve the researchers collecting and telling stories about people’s lives, and writing narratives of individual experiences. As a distinct form of qualitative research, a narrative typically focuses on studying a single person, gathering data through the collection of stories, reporting individual experiences, and discussing the meaning of those experiences for the individual.

Mixed-methods research provides for quantitative and qualitative points of view to be used simultaneously. Mixed methods research refers to methods, design and philosophical assumptions. There is a good deal of discussion about philosophical assumptions that guide the direction of the collection and analysis of data.¹⁴

There are other forms of qualitative inquiry. The ones I presented here are representative of more common methods and applications. I hope that the tools presented here can further the dialog.
References

1. Yin R. Applications of Case Study Research. Thousand Oaks, Calif.: Sage, 2003.
2. Yin R. Case Study Research: Design and Methods. Thousand Oaks, Calif: Sage, 2002.
3. Stake R. The Art of Case Study Research. Thousand Oaks, Calif.: Sage, 1995.
4. Stake R. Multiple Case Study Analysis. New York: Guilford Press, 2006.
5. Glaser BG, Strauss A. Discovery of Grounded Theory. Strategies for Qualitative Research. Edison, N.J.: Aldine Transaction, 1967.
6. Bryant A, Charmaz K, eds. The Sage Handbook of Grounded Theory. In: The SAGE Handbook of Qualitative Research. Thousand Oaks, Calif: Sage Publications, 2007.
7. Merleau-Ponty M. Phenomenology of Perception. New York: Routledge, 1962.
8. Husserl E. Ideas Pertaining to a Pure Phenomenology and to a Phenomenological Philosophy. Boston: Kluwer Academic Publishers, 1991.
9. Moustakas C. Phenomenological Research Methods. Thousand Oaks, Calif.: Sage Publications, 1994.
10. Denzin NK. Interpretive Ethnography: Ethnographic Practices for the 21st Century. Thousand Oaks, Calif.: Sage Publications, Inc, 1996.
11. Denzin NK. Interpretive ethnography for the next century. J Contemp Ethnography Oct 1, 1999;28(5):510-9.
12. Heivilin D, MacColl G, Jackson E, Edwards T. Federal Programs: Ethnographic Studies Can Inform Agencies’ Actions. www.gao.gov/cgi-bin/getrpt?GAO-03-455.
13. Gay LR. Educational Research. Competencies For Analysis and Application. Prentice-Hall, Inc., 1996.
14. Clark VLP, Creswell JW. The Mixed Methods Reader. Thousand Oaks, Calif.: Sage Publications, 2008.

Military Does Acupuncture for PTSD

http://www.statesman.com/news/local/military-tries-acupuncture-to-treat-troops-for-ptsd-757786.html