Dilemma and outlet of the development of secondary hospitals in China / 中华医院管理杂志

Secondary hospitals play a pivotal role and serve as a link in the medical service system in China. However, at present, large general hospitals are still siphoning down resources, primary medical institutions are developing rapidly, and private medical institutions join the medical market competition. In this case, to survive and develop, the secondary hospitals should choose corresponding policies and measures according to the characteristics of each region, such as, the secondary hospitals in remote and backward county should reduce medical expenses, increase reimbursement ratio and strengthen financial compensation, urban secondary hospitals with mature conditions should strengthen the function of medical and nursing care or transform and upgrade to tertiary hospitals or integrate into the medical consortiums.

The German emergency and disaster medicine and management system-history and present / 中华创伤杂志(英文版)

As well for optimized emergency management in individual cases as for optimized mass medicine in disaster management, the principle of the medical doctors approaching the patient directly and timely, even close to the site of the incident, is a long-standing marker for quality of care and patient survival in Germany. Professional rescue and emergency forces, including medical services, are the "Golden Standard" of emergency management systems. Regulative laws, proper organization of resources, equipment, training and adequate delivery of medical measures are key factors in systematic approaches to manage emergencies and disasters alike and thus save lives. During disasters command, communication, coordination and cooperation are essential to cope with extreme situations, even more so in a globalized world. In this article, we describe the major historical milestones, the current state of the German system in emergency and disaster management and its integration into the broader European approach.

La homeopatía a través de la mirada de la alopatía / Homeopathy through the eyes of allopathy

Desde su origen, la Homeopatía ha sido objeto de críticas por parte del modelo médico convencional, debido a que la metodología y los principios en que se fundamenta el arte curativo que configuró Samuel Hahnemann no son compartidos por el paradigma dominante, el cual se basa en el pensamiento positivista que se impuso en la segunda mitad del siglo XIX. Así, aunque ha pasado más de un siglo y a pesar de que la Homeopatía ha mostrado su efectividad cuando se aplica correctamente, la percepción de la mayoría de los médicos que ejercen la alopatía sigue en el presente las mismaspautas ideológicas de hace décadas. Esto pudo comprobarse a través de una seriede entrevistas con un grupo de médicos mexicanos elegidos al azar, quienes mostraron que los prejuicios y las descalificaciones hacia la medicina homeopática siguen presentes, aunque también se encontró cierta apertura en algunos de estosespecialistas.

Since its inception, homeopathy has been criticized by the conventional medical model, because the methodology and principles underlying the healing art that Samuel Hahnemann configured are not shared by the dominant paradigm, which is based on positivist thinking that prevailed in the second half of the nineteenth century. This way, although it has been more than a century and although homeopathy has shown its effectiveness when applied correctly, the perception of most doctors practicing allopathy follows in this the same guidelines ideological decades. This was proved through a series of interviews with a group of randomly selected Mexican physicians, who showed that the prejudices and insults towards homeopathic medicine are still present, but also found some open minds in some of these specialists.

What does integrative medicine mean to the physician and the ministry of health and welfare?

Our aging society, rapid growth of diseases resulting from unhealty habits, frequent occurrences of sickness, and variations in the awareness of health by patients, the worldwide need for integrative medicine, which means the incorporation and integration of complementary and alternative medicine (CAM) into conventional medical systems, is growing rapidly. The most widely available forms of CAM in the treatment of diseases in the U.S. and Europe are acupuncture, chiropractic, phytomedicine (western herbal medicine), mind-body therapies, and nutrition therapy. The well-known hospitals in the U.S. and in Europe (e.g., Harvard, Memorial Sloan-Kettering Cancer Center, Duke, Maryland, Essen, and Humboldt) are offering integrative medicine. The clinical practices as well as the education on CAM of medical schools is becoming more widespread in Korea. It is critical for us as physicians to be aware that the role of CAM is to support and complement conventional medicine, not to substitute for it. To manage chronic diseases effectively, it is imperative for physicians to incorporate and integrate Korean oriental medicine as well as CAM into the conventional medical systems. It is the duty of the medical universities and hospitals to integrate care delivery proven by CAM therapies into the conventional medicine and to develop the standard curriculum for integrative medicine at the undergraduate and graduate levels. To globalize Korean oriental medicine and to scientifically prove the efficiency of CAM, the role of integrative medicine is critical. One of the most important roles of the Ministry of Health and Welfare is to support the hospitals in which integrative medicine is systematically practiced and financially supported. In order to successfully accomplish integrative medicine in Korea, it is important to not only establish an integrative medicine center, but to also develop the contents and clinical pathway along with legal systems regarding integrative medicine with the support of the specialists in the field of integrative medicine.

Monshinhyo That Are Also Comprehensible to Foreigners: Monshinhyo Comprehension Research / 国際保健医療

<b>Introduction</b><br> Recently, foreign residents' difficulties using the Japanese medical system are being acknowledged. This study investigates the case of the medical intake forms, <i>monshinhyo</i>, that new patients at Japanese medical facilities must complete.Many patients, especially non-native ones, find them difficult.<br><b>Method</b><br> First, 6 foreign and 6 Japanese students (hereafter, FS and JS) at 4-year universities were interviewed regarding their understanding of <i>monshinhyo</i> taken from three different departments -obstetrical, surgical, and internal medicine - at a hospital in Kansai; then, a questionnaire was developed and given to 25 FS and 85 JS.<br><b>Results</b><br> Both FS and JS noted language problems. JS could pronounce medical terms better than FS but comprehended them only about as well as FS. Moreover, both FS and JS found the styles, layouts, and purposes of some questions unclear, and they sometimes had to guess the details of what <i>monshinhyo</i> requested. These included questions involving symptoms, divisions of medical departments, and semantic range of terms for blood relations. Also, medical practices/norms not found in the native country sometimes puzzled FS.<br><b>Conclusions</b><br> Problems with <i>monshinhyo</i> arise from <i>both</i> the patients' side-Japanese as well as foreign-due to limited medical-related vocabulary/kanji and/or a lack of experience using Japanese medical services, <i>and</i> the <i>monshinhyo</i> themselves, due to their inclusion of unclear questions and ambiguous expressions. Probably, <i>monshinhyo's</i> authors' familiarity with medical terms and the Japanese medical system caused them to take for granted more knowledge than many patients actually have. To improve medical services, therefore, we suggest reexamining and reorganizing questions that already exist, introducing multiple choice and yes/no questions when possible, and providing <i>furigana</i> for <i>kanji</i>. Fundamentally, throughout the medical system, patients should be able to understand all the language they encounter. Clarifying the language, cultural assumptions, and purpose(s) of <i>monshinhyo</i> is a good starting point.

Medical Anthropology and Traditional Medicines / 日本東洋医学雑誌

From the medical anthropology's point of view, biomedicine is only one of the vaious medicines which human beings have developed through their long history though it is extremely systematic and universal. Medical anthropology has been studying various types of traditional medicines in order to evaluate relatively biomedicine.