Management of Non-medical Prescribing in Britain and Its Enlightenment to China / 中国药房

OBJECTIVE:To systematically investigate the management mode of non-medical prescribing in Britain and its enlightenment to the establishment and implementation of non-medical prescribing in China. METHODS:By retrieving domestic and foreign literatures,non-medical prescribing in Britain was introduced systematically in terms of development history,types, core elements,implementation status and effect;the suggestions were put forward for the development of non-medical prescribing in China. RESULTS & CONCLUSIONS:Britain implemented non-medical prescribing since 1994. After years of practice and a series of legislation and revision,independent prescribers (including nurses and pharmacists) have owned the statutory right to prescribe any medicine for patients by 2012. In Britain,non-medical prescribing is divided into independent prescribing which mainly exists in community pharmacies and is limited to specific diseases,supplementary prescribing which exists in hospitals or clinic and needs to be signed with doctors. The management institutions are mainly composed of one state administrative department (British Department of Health) and three professional associations (British Nursing and Midwifery Council,The Royal Pharmaceutical Society of Great Britain,The Pharmaceutical Society of Northern Ireland). There are detailed and strict stipulations on the qualification and corresponding responsibilities of the prescribing authority. The British government has provided legal protection for the development of the non-medical prescribing model,and the number of non-medical prescribers is increasing. The implementation of this model has increased the patients'access to medical services. Drawing lessons from the development of non-medical prescribing management in Britain,our country needs to improve legislation,provide legislative protection for the implementation of non-medical prescribing,expand the scope of practice of nurses and pharmacists,establish and improve the training program of non-medical prescribing professionals to promote the development of non-medical prescribing model in China.

Study on Narcotics and Psychotropic Substances Control( Part Ⅲ):Development and Status Quo of Con-trolled Drugs Control in Britain / 中国药房

OBJECTIVE:To study the development and status quo of controlled drugs control in Britain,and to provide evi-dence for narcotics and psychotropic substances(NPS)control in China. METHODS:The development and status quo of NPS con-trol by Britain were summarized and studied through retrieving and collecting literatures,reports and policies about NPS from do-mestic and foreign databases,news reports and international website. RESULTS & CONCLUSIONS:British control for controlled drugs dated back to Pharmacy Act in 1868,and Britain was the first country to control drugs by legislations. A unique British sys-tem of narcotics control was established and improved after issued Rolleston Report and two pieces of Brain Report in Britain. Final-ly,the British system of narcotics control was established,which combined public health prevention with judicial redress. At pres-ent,controlled drugs are classified and controlled by Advisory Committee on Drug Abuse,Serious Organised Crime Agency and National Drug Abuse Treatment Agency subordinated to Ministry of Interior,based on Misuse of Drugs Act.

Introduction and reflections of the British pediatrician training model / 中华医学教育探索杂志

This paper introduces pediatrician training model in Britain, from medical students to consults, including its step-by-step training methods, multi angle multi-level evaluation methods, and em-phasis on the professionism and clinical competence. Through the comparison of the current pediatrician training model in China, this paper provides a reference for Chinese pediatrician training model in future.

The applicability of a validated team-based learning student assessment instrument to assess United Kingdom pharmacy students' attitude toward team-based learning / 보건의료교육평가

PURPOSE: It aimed at testing the validity and reliability of a validated team-based learning student assessment instrument (TBL-SAI) to assess United Kingdom pharmacy students' attitude toward TBL. METHODS: TBL-SAI, consisting of 33 items, was administered to undergraduate pharmacy students from two schools of pharmacy each at University of Wolverhampton and University of Bradford were conducted on the data, along with comparison between the two schools. RESULTS: Students' response rate was 80.0% (138/173) in completion of the instrument. Overall, the instrument demonstrated validity and reliability when used with pharmacy students. Sub-analysis between schools of pharmacy did, however, show that four items from Wolverhampton data, had factor loadings of less than 0.40. No item in the Bradford data had factor loadings less than 0.40. Cronbach's alpha score was reliable at 0.897 for the total instrument: Wolverhampton, 0.793 and Bradford, 0.902. Students showed preference to TBL, with Bradford's scores being statistically higher (P<0.005). CONCLUSION: This validated instrument has demonstrated reliability and validity when used with pharmacy students. Furthermore students at both schools preferred TBL compared to traditional teaching.

Cooperation and Conflict: Faction Problem of Western Medicine Group in Modern China / 의사학

After the defeat of the Opium War and the Sino-Japanese War, China's intellectuals realized necessity of modernization (Westernization) to survive in the imperial order of the survival of the fittest. In particular, it was urgent to accept Western medicine and train the doctors who learned Western medicine to change the sick and weary Chinese to be robust. Thus, new occupations of the Western Medicine Group (xiyi, doctors who learned Western medicine) emerged in China. As with the first profession, the new Western Medicine Group tried to define standards of Western medicine and medical profession; however, it was difficult in the absence of the strong central government. In addition, they formed a faction by the country where they studied or the language they learned. The factions included the Britain - America faction(yingmeipai) consisting of the Britain - America studied doctors or graduates from Protestant missions based medical schools, and the Germany - Japan faction(deripai), graduates from medical schools by Japanese or German government and the Chinese government. In 1915, they founded the National Medical Association of China mainly consisting of the Britain - America faction and the National Medical and Pharmaceutical Association of China led by the Germany – Japan faction. Initially, exchanges were active so most of eminent doctors belonged the two associations at the same time. They had a consciousness of a common occupation group as a doctor who had learned Western medicine. Thus, they actively cooperated to keep their profits against Chinese medicine and enjoy their reputation. Their cooperation emitted light particularly in translation of medical terms and unified works. Thanks to cooperation, the two associations selected medical terminologies by properly using the cases of the West and Japan. Additionally, medical schools of the Britain - America faction and the Germany – Japan faction produced various levels of the Western Medicine Group doctors for China to timely respond to the rapidly increased demand. However, a conflict over the promotion of hygiene administration and the unification, organization of medical education did not end. This conflict was deepening as the Nanjing nationalist government promoted sanitary administration. It was the Britain - America faction who seized a chance of victory. It was because figures from the Britain - America faction held important positions in the hygiene department. Of course, some related to the National Medical and Pharmaceutical Association of China were also involved in the hygiene department; however, most took charge of simple technical tasks, not having a significant impact on hygiene administration. To solve the problem of factions of the Western Medicine Group, the Britain - America faction or the Germany - Japan faction had to arrange the education system with a strong power, or to organize a new association of two factions mixed, as in Chinese faction(zhonghuapai). But an effort of the Britain - America faction to unify the systems of medical schools did not reach the Germany - Japan faction's medical schools. Additionally, from 1928, executives of the two Chinese medical associations discussed their merger; however they could not agree because of practitioners'interests involved. Substantially, a conflict between factions of the Western Medicine Group continued even until the mid-1930s. This implies that the then Chinese government had a lack of capacity of uniting and organizing the medical community.

La tabla de supervivencia, posibilidad de vida y de más vida A propósito de la reforma social inglesa de 1832 / Table of survival, possibility of life and more life With regard to the english social reform of 1832

La garantía de la salud en el orden político inglés decimonónico en el cual la duración media de la vida estaba determinada por la situación del individuo en la estructura de clases, no era posible ante un estado carente de organismos sanitarios de administración y control de la salubridad pública, además del influjo arrollador del sector económico egoísta, individualista y privatizador, y por la ausencia de ciudadanía activa que propiciara la agencia de espacios de acción colectiva y de acción política. Fue necesario el advenimiento de artefactos matemáticos como la tabla de supervivencia, para convencer al cuerpo social y político liberal de la época de la posibilidad de cada vez más y mejor vida, e iniciar la larga marcha de la participación política democrática hacia el estatus de ciudadano. (Acta Med Colomb 2015; 40: 326-330).

The guarantee of health in the nineteenth-century English political order in which the average length of life was determined by the status of the individual in the class structure, was not possible in front of a state devoid of health management organizations an health public control, in addition to the overwhelming influence of a selfish, individualist and privatizing economic sector, and the absence of active citizenship which could foster the management of collective and political action spaces. The advent of mathematical artifacts such as table survival was necessary to convince the liberal social and political body of the epoch of the possibility of getting more and better life, and begin the long march of democratic political participation towards the status of citizens. (Acta Med Colomb 2015; 40: 326-330).

Comparison and enlightenment on the general practice education between Britain and Aus-tralia / 中华医学教育探索杂志

General practice education at higher medical university is the foundation of the general practice educational system. It has close relationship with the cultivation quality of the general practitioners. By taking British and Australian medical colleges as examples, the paper introduced the current situation of British and Australian general practice education for undergraduate medical stu-dents and elaborated their theory learning content, their practice learning content ,their education re-form and research progress and their education target and effect. General practice education in Britain and Australia sheds light on how to set theory course, arrange practice part and improve educational research, which general practice education in China can draw lessons from.

Lessons from orthopedic surgeon training system in Britain / 中华医学教育探索杂志

The tralning system for orthopedic surgeon in Britaln is mature and complete. After completing education in medical college, medical students receive a 2-year base tralning (FY1, FY2), which focus on learning and consolidating basic medical knowledge and clinical skill, followed by a 6-year specialist tralning, which subdivides into tralning of ankle and foot, hand, should and elbow, hip, knee, spine, and pediatric surgery, provided by several district hospital (Peripheral hospitals). Students are required to return to teaching center for review, ward inspection, case discussion at regular inter-vals. Compared with the specialist tralning system based on the hospital staffs in chi-na, the role ofsocial workersin British during the period of tralning makes better mobility of tralnee among medical institutions and medical treatments, which makes the tralning more comprehensive and professional. In addition, there is no consistent system for examination and admittance of specialist, and awareness of specialist tralning among medical institutions and doctors is weak. Therefore, it should be done to form a single tralning system and unify the tralning specification and assessment standard.

Comparison of different scoring systems in patients undergoing colorectal cancer surgery for predicting mortality and morbidity.

BACKGROUND: Preoperative risk estimation evaluating mortality and morbidity might help surgical decision. AIMS: The aim of this study was to compare the sensitivities of physiologic and operative severity score for the enumeration of mortality and morbidity (POSSUM), portsmouth‑POSSUM (P‑POSSUM), colorectal‑POSSUM (CR‑POSSUM), the Association of Coloproctology of Great Britain and Ireland colorectal cancer model (ACPGBI CRC) and revised ACPGBI CRC scoring systems that are used for evaluating mortality and morbidity in colorectal surgery performed in third‑level healthcare centers. SETTINGS AND DESIGN: A retrospective analysis has been performed on 335 consecutive patients undergoing colorectal cancer surgery between 2002 and 2012. MATERIALS AND METHODS: Mortality and morbidity risks of 335 patients who underwent colorectal cancer were evaluated using these scoring systems and the results were compared with actual mortality and morbidity within postoperative 30‑day that extend the duration of hospital stay. STATISTICAL ANALYSIS USED: The receiver operating characteristic (ROC) curves were designed to identify the score values. RESULTS: Results of POSSUM and P‑POSSUM systems showed statistical differences compared with those of CR‑POSSUM, ACPGBI CRC and revised ACPGBI CRC systems (P < 0.05). P‑POSSUM was found to be the best scoring system for predicting mortality risk, although all scoring systems seem to be appropriate for this parameter. On the other hand POSSUM, which can predict morbidity, was found to have moderate differentiation ability due to the magnitude of the area under the ROC curve. CONCLUSIONS: Despite altering patient demographics and surgical conditions, POSSUM seems to lead as the best scoring system for predicting mortality and morbidity among others including those most‑recently proposed.

Assessing the performance of the radiology information systems in use in the teaching hospitals of Isfahan city based on the Great Britain’s royal college of radiologists’ guidelines.

Background: Radiology Information System (RIS) coordinates the organizational processes and administrative based on information. The present study was an attempt towards a performance assessment of the RISs used in general Isfahan hospitals. Methods: This study was descriptive cross-sectional in nature. Its statistical population consisted of the general teaching hospitals of Isfahan city (Iran). Due to the limitedness of the population of study, the sample size was the same as the population size. The data were collected using a self-designed checklist produced based on the royal college of radiologists’ guidelines, i.e. input components (13 items), process components (10 items) and output components (8 items). The researcher collected the data through observation and interview. The validity of the checklist was assessed by the health information system field’s valid authorities. Finally, the gathered data were put into SPSS 16 software and analyzed using descriptive statistics. Results: Among the RIS in the hospitals, Kashani, Isa Ibn Maryam and Nour & Ali Asghar had the highest rank for input components (mean score = 30.79%). As for process components, Al-zahra, Kashani and Isa Ibn Maryam gained the highest position (mean score = 38.9%). Finally, Al-zahra and Kashani hospitals with a mean score of 66.66% enjoyed the highest rank for output components. Conclusion: RIS must be capable of satisfying a number of requirements including satisfying the medical needs of the patients, producing the reports, image and report processing, patients’ appointment scheduling, the procedures for receiving and administrating the orders and other radiology procedures.

The UK Foundation Programme for newly qualified doctors: a SWOT analysis / O Foundation Programme do Reino Unido para médicos recém-formados: uma análise utilizando a matriz DAFO / El Foundation Programme del Reino Unido para los médicos recién titulados: un análisis utilizando la matriz DAFO

Introduction: After completing a five year undergraduate degree, all newly qualified doctors in the United Kingdom undertake a two-year Foundation Programme which aims to provide them with the necessary experience, supervision and guidance to prepare them for a career in clinical medicine. Foundation Doctors are paid members of the team and undertake a variety of clinical rotations with supervision from senior colleagues, a process that is regulated by a UK Foundation Programme Office. Objective: This paper aims to provide a reflective analysis of this programme to greater inform the international audience. Methods: A critical reflective analysis utilising the SWOT format (Strength, Weaknesses, Opportunities and Threats), conducted by two Foundation Doctors working in the UK. Results and Discussion: We identified a well-established programme which enabled graduates to gain a broad range of clinical experience as a paid doctor but one with considerable variation at both individual and group level. Long-standing shortcomings of being a junior-doctor including long hours and excessive paperwork were still prevalent. We highlighted potential opportunities and threats within the current system, some of which were dependent upon larger political systems governing the NHS in the UK. Conclusion: The Foundation Programme is a robust approach to the training and development of early career doctors. Further research and a deeper international dialogue on the best-practice in this field is needed.

Introdução: Depois de completar os cinco anos do curso de graduação em medicina, todos os médicos recém-formados no Reino Unido cursam o Foundation Programme, com duração de dois anos, que visa proporcionar-lhes a experiência, supervisão e orientação necessárias para prepará-los para uma carreira clínica em medicina. Os médicos cursando o Foundation Programme são membros remunerados das equipes dos serviços e realizam várias rotações clínicas supervisionadas por médicos experientes, um processo que é regulado pelo UK Foundation Programme Office. Objetivo: Este trabalho visa fornecer uma análise reflexiva sobre o Foundation Programme para maior informar o público internacional. Métodos: Uma análise crítica e reflexiva utilizando a matriz DAFO (Debilidades, Ameaças, Fortalezas e Oportunidades) realizada por dois jovens médicos cursando o Foundation Programme do Reino Unido. Resultados e Discussão: Trata-se de um programa bem estabelecido, que permite aos graduados obterem uma ampla gama de experiência clínica, como médicos remunerados, porém com variações consideráveis, tanto a nível individual como coletivo. Problemas persistentes para os jovens médicos incluem jornadas longas de trabalho e ainda um predomínio de burocracia excessiva. Oportunidades e ameaças potenciais foram destacadas dentro do sistema atual, algumas delas dependentes do macro contexto político que rege o NHS no Reino Unido. Conclusão: O Foundation Programme é uma robusta iniciativa para a formação e desenvolvimento de médicos em início de carreira. São necessárias maiores investigações e um diálogo internacional mais aprofundado sobre as melhores práticas nesta área.

Introducción: Al finalizar el curso de pregrado de cinco años en medicina, los médicos recién titulados en el Reino Unido participarán del Foundation Programme, con duración de dos años, destinado a darles la experiencia, la supervisión y la orientación necesarias para prepararlos para una carrera clínica en la medicina. Los médicos que atienden el Foundation Programme son miembros pagos de los equipos del servicio y realizan diversas rotaciones clínicas supervisadas por médicos con experiencia, un proceso que está regulado por el UK Foundation Programme Office. Objetivo: Este estudio tiene como objetivo proporcionar un análisis reflexivo sobre el Foundation Programme para mejor informar al público internacional. Métodos: Análisis crítico y reflexivo usando la matriz DAFO (Debilidades, Amenazas, Fortalezas y Oportunidades) realizado por dos jóvenes médicos que atienden al Foundation Programme del Reino Unido. Resultados y Discusión: Se trata de un programa bien establecido que permite a los graduados obtener una amplia gama de experiencia clínica, como médicos remunerados, pero con variaciones considerables, tanto al nivel individual como colectivo. Problemas persistentes para los médicos jóvenes incluyen largas horas de trabajo y aún el predominio de una burocracia excesiva. Potenciales oportunidades y amenazas se han destacado en el sistema actual, algunos de ellos dependientes del macro contexto político que rige el NHS en el Reino Unido. Conclusión: El Foundation Programme es una iniciativa robusta para la formación y desarrollo de los médicos en inicio de carrera. Se requiere una mayor investigación y un diálogo internacional más profundizado sobre las mejores prácticas en esta área.

Entre Londres e Paris, 1945-1975: formação da psicanálise contemporânea / Between London and Paris, 1945-1975: the formation of contemporary psychoanalysis / Entre Londres y Paris, 1945-1975: formación del psicoanálisis contemporáneo

Traçando um panorama da Psicanálise entre 1945 e 1980, este artigo busca situar nele as obras de Jean Laplanche, Jean-Bertrand Pontalis, André Green, Joyce McDougall e Betty Joseph.

Dibujando un panorama del Psicoanálisis entre 1945 y 1980, este artículo trata de localizar en el mismo las obras de Jean Laplanche, Jean-Bertrand Pontalis, André Green, Joyce McDougall y Betty Joseph.

Sketching a broad view of the development of Psychoanalysis between 1945 and 1980, this paper offers some suggestions about the place occupied in it by the works of Jean Laplanche, Jean-Bertrand Pontalis, André Green, Joyce McDougall and Betty Joseph.

Principles of British health visiting / Princípios do modelo britânico do visitador em saúde / Los princípios del modelo británico del visitador de salud

In an international context, it is sometimes helpful to consider how concepts are understood in different countries, and to explore some different roles. Such knowledge rarely transfers directly from one country or place to another, but to hear about developments from elsewhere can spark ideas and thinking that may be helpful for local developments. This paper gives some brief background about how the health visiting profession developed in Great Britain, and then explains the values and principles that underpin its practice today. Some parallels are drawn with the health situation in modern Brazil.

Em um contexto internacional, muitas vezes, é importante considerar como os conceitos são compreendidos nos diferentes países e explorar algumas de suas distintas funções. Esse conhecimento raramente pode ser transferido de um país ou de uma localidade para outra, mas ouvir outras experiências de desenvolvimento, de quaquer parte do mundo, pode despertar idéias e pensamentos que sejam úteis ao desenvolvimento local. Este artigo apresenta um breve histórico sobre como a profissão de visitador em saúde se desenvolveu na Grã-Bretanha, explicando os valores e princípios que, atualmente, servem de base à sua prática, estabelecendo-se alguns paralelos com a atual situação da saúde no Brasil contemporâneo.

En el contexto internacional, muchas veces es importante considerar como los conceptos son comprendidos en los diferentes países y explorar algunas de sus diferentes funciones. Ese conocimiento raramente puede ser transferido de un país o de una localidad para otra, no obstante, escuchar las experiencias de desarrollo, de cualquier parte del mundo, posibilitan despertar ideas y pensamientos que pueden ser útiles para el desarrollo local. Este artículo presentó un breve histórico sobre como la profesión de visitador de salud se desenvolvió en Gran Bretaña, explicando los valores y principios que actualmente sirven de bases para su práctica y estableciendo algunos paralelos con la actual situación de salud de Brasil contemporáneo.

Standardized diagnosis and management of aplastic anemia / 中国实用内科杂志

Aplastic anemia(AA)is a life-threatening blood disease.The British guideline and Chinese experts' experiences indicate that it is related to the abnormality of cellular immunity.Diagnosis by adequate exclusion,strict indication for stem cell transplantation and more immunosuppression plus hematopoietic stimulating therapies should be paid more attention in the treatment of this disease.

Comparison of Medical Humanistic Education between China and Britain / 中国医学伦理学

Nowadays,with the ever-tenser physician-patient relationship,construction of medical professionalism has turned out to be a heated topic.This essay tries to explore the construction of medical professionalism from the perspective of cultivating a humanistic culture among medical students.Based on the comparison of medical humanistic education between China and Britain,this article arrives at the conclusion that defective humanistic education is one of important reasons that cause the inadequacy of medical professionalism among Chinese physicians,and points out some effectual measures to improve the medical professionalism in our country by the inspiration from our British counterparts.

Introduction to Medication Strategy in Paediatrics in Great Britain / 中国药房

OBJECTIVE:To provide the reference for the Chinese government to establish medication policy in paediatrics.METHODS:The paediatric medication strategy set up by British Drug and Health Product Administration Bureau was introduced,and the current situation and problems in paediatric medication were analyzed.RESULTS & CONCLUSION:China should learn from British experience,and establish our own medication strategy in paediatrics as soon as possible.