Domestic violence and refuge services in AustraliaIn Australia and internationally, domestic violence is a major cause of homelessness for women and children and yet provision for accommodation for this user-group is not well documented or understood. When designing emergency accommodation, the concerns, preferences, and perspectives of individuals who access refuge services must be sought in order to create spaces that are conducive to the needs of this diverse and vulnerable group. An empathic ‘lens’ can provide meaningful insights that can inform the design of refuge services specifically targeted at addressing these needs. This paper describes an authentic interdisciplinary learning experience for nursing, architecture and landscape students at a university in Sydney, Australia, and presents the results of a study designed to measure the impact of this initiative on participants’ empathy towards women and children who access refuge services as a result of homelessness and/or domestic violence. Empathy levels were measured using the Comprehensive State Empathy Scale, a validated measurement tool.An authentic interdisciplinary learning experienceThe learning experience consisted of collaborative meetings with stakeholders from the refuge sector, fieldwork, individual research, exchanging ideas and problem-solving in teams. Students then developed design guides for refuges that demonstrated their emerging understanding of the specific needs and perspectives of the issues faced by women and children who had experienced violence and found themselves homeless. Pre-post Comprehensive State Empathy Scale results indicated that the empathy levels of nursing and landscape students increased and those of architecture students decreased, however, these results were not statistically significant.Building empathy in teaching and learningThe significance of the results from this study include an ability to compare the changes in empathy in students working collaboratively on a project and to ascertain possible reasons for this using a validated measurement tool. As empathy is one of the strongest negative correlates of prejudice, authentic teaching and learning activities, such as the one described in this paper, have the potential to positively impact the lived experience of women and children leaving situations of domestic violence.
BackgroundThe 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.MethodsThe 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 = 47) or mock laser (n = 49) at the acupoints LI 10 and LI 11.ResultsParticipants 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.ConclusionsSubjective ‘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 further research into interoception phenomenon which may contribute to a better understanding of the placebo effect and De Qi psychophysical responses.Trial registrationAustralian and New Zealand Clinical Trial Registry reference: ACTRN12613001138774 on 11th of October 2013.
Australian and New Zealand Clinical Trial Registry reference: ACTRN12613001138774 on 11th of October 2013.
BackgroundLateral elbow pain (LEP) due to tendinosis is one of the most common musculoskeletal pains of the upper limbs, yet there is no satisfactory treatment. This study was an international, prospective, multi‐centre, randomized, controlled, clinical trial to evaluate the efficacy of acupuncture compared to sham laser in the treatment of LEP.MethodsThe study used a parallel and stratified design (1:1 allocation using a computer‐generated sequence) and was participant‐, outcome assessor‐ and statistician‐blinded. Subjects from 18 to 80 years with unilateral chronic LEP (minimum three months) were recruited at four centres in Australia, China, Hong Kong and Italy. The treatment group received manual acupuncture at acupoints LI 10 and LI 11 on the affected side whereas the control group received sham laser acupuncture at the same acupoints. The primary endpoint was disabilities of the arm, shoulder, and hand (DASH) questionnaire score at the three‐week post‐treatment follow‐up visit. Three VAS scales (pain at rest, pain on motion and pain during exertion) were secondary outcomes measures. Ninety‐six subjects were allocated to either the treatment group (n = 47) or control group (n = 49) and were all included in the analysis.ResultsAt the follow‐up visit, we found significant differences in DASH score between the two groups (p = .015). The median change to baseline for the treatment group was −11.7 (interval: −50.83 to 23.33), and for the control group −7.50 (interval: −36.67 to 29.10). The estimated effect size was 0.47, indicating a medium effect. Significant differences were also found for secondary outcome measures for VAS of pain. There were no severe adverse events. Our findings suggest that acupuncture has a moderate efficacy in the treatment of LEP.ConclusionsAcupuncture was shown to be efficacious in improving the function of the arm associated with lateral elbow tendinosis. Both the DASH score and the pain VAS on two occasions (at rest and during motion) showed a significant change over time indicating acupuncture as a potential treatment for LEP due to tendinosis.
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