Integrating neuroscience and humanities in healthcare evolution: a multidisciplinary perspective / Integração das neurociências e das ciências humanas na evolução dos cuidados de saúde: uma perspetiva multidisciplinar

The trajectory of healthcare has evolved from ancient holistic practices to the present biomedical model, reflecting the dynamic interplay between scientific progress, technological advancements, and the integration of humanistic values. While biomedical advancements have revolutionized medical treatments, there is an emerging recognition of the importance of integrating neuroscience and humanities to foster holistic patient care and understanding. This paper aims to explore the historical development of medicine, emphasizing the convergence of neuroscience, psychiatry, and neurology within the biomedical framework. Additionally, it investigates the resurgence of humanities in healthcare and its role in promoting patientcentered care. Through a comprehensive review of literature, this study traces the historical roots of medicine and examines the interdisciplinary intersections of neuroscience, psychiatry, neurology, and medical humanities. The exploration reveals the significant contributions of interdisciplinary approaches in enhancing patient-centered care, fostering a comprehensive understanding of health and well-being, and shaping modern healthcare practices. The integration of neuroscience and humanities offers valuable insights into the complexities of human health, bridging legacy practices with innovative approaches. Embracing this interdisciplinary perspective is crucial for promoting holistic healthcare, emphasizing patient-centered care, and enriching the understanding of health and well-being in contemporary healthcare settings.

A trajetória dos cuidados de saúde evoluiu das antigas práticas holísticas para o atual modelo biomédico, reflectindo a interação dinâmica entre o progresso científico, os avanços tecnológicos e a integração de valores humanísticos. Embora os avanços biomédicos tenham revolucionado os tratamentos médicos, há um reconhecimento emergente da importância de integrar as neurociências e as humanidades para promover a compreensão e os cuidados holísticos dos doentes. Este artigo tem como objetivo explorar o desenvolvimento histórico da medicina, salientando a convergência da neurociência, da psiquiatria e da neurologia no quadro biomédico. Além disso, investiga o ressurgimento das humanidades nos cuidados de saúde e o seu papel na promoção de cuidados centrados no doente. Através de uma revisão exaustiva da literatura, este estudo traça as raízes históricas da medicina e examina as intersecções interdisciplinares da neurociência, psiquiatria, neurologia e humanidades médicas. A exploração revela os contributos significativos das abordagens interdisciplinares para melhorar os cuidados centrados no doente, promover uma compreensão abrangente da saúde e do bem-estar e moldar as práticas modernas de cuidados de saúde. A integração das neurociências e das humanidades oferece conhecimentos valiosos sobre as complexidades da saúde humana, fazendo a ponte entre práticas antigas e abordagens inovadoras. A adoção desta perspetiva interdisciplinar é crucial para promover cuidados de saúde holísticos, enfatizando os cuidados centrados no doente e enriquecendo a compreensão da saúde e do bem-estar nos contextos de cuidados de saúde contemporâneos.

Promoção e prevenção da saúde audiovisual na infância: uma visão holística / Promotion and prevention of audiovisual health in childhood: a holistic view

Características que permeiam promoção e prevenção da saúde audiovisual podem exercer influencias comunicativas na infância por meio de maturação de habilidades ao qual está inserido. Assim, visão e audição exercem um papel crucial quanto ao desenvolvimento cognitivo infantil, sendo o tão logo o diagnóstico precoce realizado no que tange alterações oculares e auditivas identificadas contribuindo para minimizar comprometimentos no desenvolvimento infantil. Objetivo: Identificar por meio da literatura a relação entre promoção e prevenção da saúde audiovisual e o impacto na qualidade de vida das crianças na faixa etária de 0 a 11 anos, especificando a função dos profissionais de saúde, pais, responsáveis e professores. Método: Trata-se de uma Revisão da literatura, realizada entre fevereiro a junho de 2023 incluindo artigos científicos, selecionados e publicados de 2013 a 2023, em português, inglês e espanhol nas bases de dados: Pubmed, Biblioteca Virtual de Saúde (BVS), Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Web of Science, Conselho Federal de Enfermagem (COFEN), Ministério da Saúde, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), biblioteca digital da instituição Universidade nove de Julho por meio dos descritores em inglês e português, saúde ocular, saúde auditiva, criança, pré-escolar e desenvolvimento infantil. Resultados: Após aplicação dos critérios de inclusão/exclusão perfizeram o montante de 77 artigos e após análise criteriosa por pares foram elegíveis 33 artigos que fizeram parte do contingente de artigos para a pesquisa. Conclusão: Constatou-se que a partir do momento onde são realizadas as orientações necessárias e exames periódicos ocorre uma diminuição no surgimento de alterações oculares ou auditivas; tratando-se de disfunções audiovisuais já diagnosticadas, medidas de tratamento melhoram não apenas a qualidade de vida bem como o desenvolvimento cognitivo, a título de exemplo temos o aparelho auditivo, prótese auricular, óculos ou lente de contato, ensino e aprendizagem com libras e braile.(AU)

Characteristics that permeate audiovisual health promotion and prevention can exert communicative influences in childhood through the maturation of skills to which it is inserted. Thus, vision and hearing play a crucial role in children's cognitive development, and as soon as the early diagnosis is made with regard to ocular and auditory alterations identified, contributing to minimize impairments in child development. Objective: To identify, through the literature, the relationship between audiovisual health promotion and prevention and the impact on the quality of life of children aged 0 to 11 years, specifying the role of health professionals, parents, guardians and teachers. Method: This is a literature review, carried out between February and June 2023, including scientific articles, selected and published from 2013 to 2023, in Portuguese, English and Spanish in the following databases: Pubmed, Virtual Health Library (VHL), Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), Web of Science, Federal Council of Nursing (COFEN), Ministry of Health, Coordination for the Improvement of Higher Education Personnel (CAPES), digital library of the institution Universidade nove de Julho through the descriptors in English and Portuguese, eye health, hearing health, child, preschool and child development. Results: After applying the inclusion/exclusion criteria, a total of 77 articles were totaled and, after careful peer review, 33 articles were eligible to be included in the contingent of articles for the research. Conclusion: It was found that from the moment the necessary orientations and periodic examinations are carried out, there is a decrease in the appearance of ocular or auditory alterations; In the case of audiovisual dysfunctions already diagnosed, treatment measures improve not only the quality of life but also cognitive development, for example we have hearing aids, ear prostheses, glasses or contact lenses, teaching and learning with Libras and Braille. (AU)

Las características que permean la promoción y prevención de la salud audiovisual pueden ejercer influencias comunicativas en la infancia a través de la maduración de las habilidades a las que se inserta. Así, la visión y la audición juegan un papel crucial en el desarrollo cognitivo de los niños, y desde el momento en que se realiza el diagnóstico precoz con respecto a las alteraciones oculares y auditivas identificadas, contribuyen a minimizar las deficiencias en el desarrollo infantil. Objetivo: Identificar, a través de la literatura, la relación entre la promoción y prevención de la salud audiovisual y el impacto en la calidad de vida de los niños de 0 a 11 años, especificando el papel de los profesionales de la salud, padres, tutores y docentes. Método: Se trata de una revisión bibliográfica, realizada entre febrero y junio de 2023, que incluye artículos científicos, seleccionados y publicados entre 2013 y 2023, en portugués, inglés y español en las siguientes bases de datos: Pubmed, Biblioteca Virtual en Salud (BVS), Biblioteca Científica Electrónica Online (SciELO), Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Web of Science, Consejo Federal de Enfermería (COFEN), Ministerio de Salud, Coordinación para el Perfeccionamiento del Personal de Nivel Superior (CAPES), biblioteca digital de la institución Universidade nove de Julho a través de los descriptores en inglés y portugués, salud ocular, salud auditiva, infantil, preescolar y desarrollo infantil. Resultados: Después de aplicar los criterios de inclusión/exclusión, se totalizaron un total de 77 artículos y, después de una cuidadosa revisión por pares, 33 artículos fueron elegibles para ser incluidos en el contingente de artículos para la investigación. Conclusión: Se encontró que desde el momento en que se realizan las orientaciones necesarias y los exámenes periódicos, se produce una disminución en la aparición de alteraciones oculares o auditivas; En el caso de las disfunciones audiovisuales ya diagnosticadas, las medidas de tratamiento mejoran no solo la calidad de vida sino también el desarrollo cognitivo, por ejemplo tenemos audífonos, prótesis auditivas, gafas o lentes de contacto, enseñando y aprendiendo con Libras y Braille. (AU)

Importância da interação entre comunidade e graduando, para uma formação humanizada: relato de experiência / Importance of interaction between community and undergraduate, for humanized training: experience report

Durante a vivência acadêmica, as universidades conectam seus futuros profissionais para assistência à comunidade, tendo em vista uma formação centrada na humanização dos pacientes. O programa de monitoria para a clínica interdisciplinar no tratamento de feridas, do Centro Universitário do Espírito Santo (UNESC), não se limita apenas ao campo teórico, abrangendo muito a prática com o corpo social e possibilita essa experiência com a comunidade de forma humanizada. Objetivo: Relatar a inter-relação com a sociedade durante o tempo de monitoria, como isso é importante para a capacitação de excelência, e também como essa humanização contribui para tratamento e evolução do paciente. Metodologia: O estudo consiste em um relato de experiência de um dos monitores da clínica de feridas durante um semestre de monitoria, apresentando caráter descritivo. Resultados e Discussão: Durante a vivência notou-se o quão importante é enxergar esse lado humano do paciente, não se preocupando apenas com suas queixas. Agindo desse modo, teve como resultado pacientes mais felizes, engajados com o tratamento e gostando de estar naquele ambiente, por mais doloroso que fosse o real motivo. Considerações finais: É vital para o graduando aprender a lapidar sua abordagem com o paciente, atuando de maneira holística. Essa interação entre universidade e corpo social é de fundamental importância para desenvolver profissionais que saiam ainda mais capacitados para o mercado de trabalho, principalmente quando se trata de profissionais da área da saúde, possibilitando mesclar assistência e atendimento, com o processo de ensino-aprendizado das práticas de saúde.(AU)

During their academic experience, universities connect their future professionals to assist the community, with a view to training centred on the humanization of patients. The monitoring program for the interdisciplinary wound care clinic at the Centro Universitário do Espírito Santo (UNESC) is not just limited to the theoretical field, but also encompasses a lot of practice with the social body and enables this experience with the community in a humanized way. Objective: To report on the interrelationship with society during the monitoring period, how important this is for the training of excellence, and also how this humanization contributes to the treatment and evolution of the patient. METHODOLOGY: The study consists of a report on the experience of one of the wound clinic monitors during a semester of monitoring, and is descriptive in nature. Results and Discussion: During the experience, we noticed how important it is to see the human side of the patient, not just worrying about their complaints. Acting in this way resulted in happier patients, engaged with the treatment and enjoying being in that environment, no matter how painful the real reason.Final considerations: It is vital for undergraduates to learn how to refine their approach to patients, acting in a holistic way. This interaction between the university and society is of fundamental importance for developing professionals who are even more qualified for the job market, especially when it comes to health professionals, making it possible to merge assistance and care with the teaching-learning process of health practices.(AU)

Durante su experiencia académica, las universidades vinculan a sus futuros profesionales con la asistencia a la comunidad, con vistas a una formación centrada en la humanización de los pacientes. El programa de acompañamiento de la clínica interdisciplinaria de cuidado de heridas del Centro Universitario do Espírito Santo (UNESC) no se limita apenas al campo teórico, sino que abarca mucha práctica con el cuerpo social y posibilita esta experiencia con la comunidad de forma humanizada. Objetivo: Informar sobre la interrelación con la sociedad durante el período de seguimiento, cuán importante es esto para la formación de excelencia, y también cómo esta humanización contribuye al tratamiento y evolución del paciente. Metodología: El estudio consiste en un informe sobre la experiencia de uno de los monitores de la clínica de heridas durante un semestre de monitorización, y es de naturaleza descriptiva. RESULTADOS Y DISCUSIÓN: Durante la experiencia, nos dimos cuenta de lo importante que es ver el lado humano del paciente, no sólo preocuparse por sus quejas. Actuar de esta manera resultó en pacientes más felices, comprometidos con el tratamiento y disfrutando de estar en ese ambiente, por más doloroso que sea el motivo real.Consideraciones finales: Es fundamental que los estudiantes universitarios aprendan a perfeccionar su abordaje con los pacientes, actuando de forma holística. Esta interacción entre la universidad y la sociedad es de fundamental importancia para el desarrollo de profesionales aún más cualificados para el mercado de trabajo, especialmente cuando se trata de profesionales de la salud, haciendo posible la fusión de la asistencia y el cuidado con el proceso de enseñanza-aprendizaje de las prácticas de salud.(AU)

The conceptual definition,development dilemma,and path selection of a multi-level healthcare security system under the perspective of holistic governance / 中国卫生政策研究

The unclear connotation and fragmented governance of the multi-tiered medical security system pose challenges to its high-quality development.This article redefines the concept and connotation of the multi-tiered medical security system using holistic governance theory.It distinguishes the bottom layer,basic layer,and supplementary layer from the perspective of the essential attributes and direct functions of each system.Furthermore,from the perspective of holistic governance,the article analyzes the current reform practice and finds that fragmented management thinking,unclear positioning of sub-system functions,insufficient policy coordination,single participation subject,and lack of equal negotiation mechanisms are constraints on the overall effectiveness of the multi-tiered medical security system.Therefore,it is necessary to adopt systematic and targeted reform measures from the perspective of holistic governance to improve the system.

Integrating Islamic Principles to Clinical Mental Health Care: Insights from al-Balkhi's Approach to Psychiatric Disorder (Mengintegrasikan Prinsip-Prinsip Islam ke dalam Penjagaan Klinikal Kesihatan Mental: Memahami Pendekatan al-Balkhi terhadap Gangguan Mental) / Jurnal Sains Kesihatan Malaysia

@#Islam places significant emphasis on mental health, urging Muslims to approach it holistically. Until now, this characterization serves as a starting point for discussing the definition and scope of Islamic spiritual care. This research aimed to provide a comprehensive overview of al-Balkhi's contributions to Islamic psychology and their relevance to modern mental health practice. The methodology utilized in this research is a literature review that synthesized information from scientific texts, research reports, and historical accounts related to alBalkhi's work. This review synthesizes Abu Zayd al-Balkhi's pioneering contributions to Islamic mental health principles, focusing on his seminal work Masalih al-Abdan Wa al-Anfus (Sustenance of the Body and Soul). This review highlights the enduring relevance of al-Balkhi's insights in mental health care, advocating for a holistic approach rooted in Islamic principles. His classifications of depressive states and therapeutic methods, like exposure-based treatments, still influence modern psychotherapy. Al-Balkhi's holistic view emphasizes the link between spiritual and physical well-being. Analyzing his theories alongside current knowledge aids in diagnosing consistently and guiding therapy effectively. Integrating historical perspectives can enhance culturally sensitive mental health interventions within Muslim communities, respecting diverse cultural contexts.

Path to improving medical service of outpatient department of oncology hospital from the perspective of holistic health / 现代医院

In 2023,the National Health Commission and the National Administration of Traditional Chinese Medicine jointly issued the"Plan for Improving Medical Experience and Enhancing Patient Satisfaction(2023-2025)".The document puts forward a series of key tasks to guide medical institutions to embrace a"patient-centered"approach,aiming at enhancing the comfort,intelligence,and digitization of medical services.To comprehensively enhance patients'medical experience and satis-faction,an outpatient department of oncology hospital in Tianjin has explored and implemented various strategies from a holistic health perspective,including the establishment of an outpatient service system,innovation in chronic disease diagnosis and treat-ment models,improvement of humanistic aspects,environmental enhancements,and development of a smart outpatient system.These efforts have further advanced the implementation of a scientific,continuous,efficient,high-quality,and comfortable medi-cal service model in outpatient settings,promoting the standardization,regulation,and quality of outpatient services.

Inclusão da espiritualidade do paciente durante o tratamento quimioterápico / Inclusion of the patient's spirituality during chemotherapy

Resumo A relação da espiritualidade com a saúde tem sido estudada e apontada como uma dimensão que traz benefícios na promoção, proteção e recuperação, além de colaborar com o enfrentamento de doenças. Assim, o objetivo deste estudo é relatar uma experiência vivenciada durante um ensaio clínico randomizado, que incluiu a dimensão espiritual do paciente no tratamento contra o câncer, a partir da realização de uma pesquisa que incluiu a espiritualidade do paciente oncológico durante o processo quimioterápico. O ensaio clínico foi composto por 30 pacientes portadores de câncer atendidos em uma Unidade de Assistência de Alta Complexidade em Oncologia. Percebeu-se que eles demonstraram surpresa por terem sua dimensão espiritual incluída, relatando que era uma questão importante para vivenciarem o que estavam passando. Também se notou a importância de incluir estudantes de medicina na coleta dos dados, oportunizando aos futuros profissionais contato com essa temática no contexto do cuidado em saúde. A vivência de experiências que trazem questões tão subjetivas, delicadas, profundas e essenciais sobre o ser humano, como são a espiritualidade e a fé, permitiu ao pesquisador desenvolver uma reflexão sobre a necessidade de mudança de paradigma na forma de prestar cuidado à saúde.

Abstract The relationship between spirituality and health has been studied and pointed out as a dimension that brings benefits in the promotion, protection, and recovery of health, in addition to collaborating with the combat against diseases. Thus, the objective of this study is to report an experience of a randomized clinical trial that included the spiritual dimension of patients in clinical treatment against cancer, resulting from a research that included the spirituality of cancer patients during chemotherapy. This randomized clinical trial consisted of 30 cancer patients treated at a High Complexity Care Unit in Oncology. We noticed that the patients showed surprise for having their spiritual dimension included, reporting that it was an important dimension for experiencing the moment they were going through. We also perceived the importance of including medical students in the data collection, providing opportunities for the future professional to have contact with this issue in the context of healthcare. The experience that brings such subjective, delicate, profound, and essential questions about the human being, such as spirituality and faith, allowed the researcher to develop a reflection on the need for a paradigm shift in the way of providing healthcare.

Os Seis Pilares da Medicina do Estilo de Vida no Manejo de Doenças Não Transmissíveis - As Lacunas nas Diretrizes Atuais / The Six Pillars of Lifestyle Medicine in Managing Noncommunicable Diseases - The Gaps in Current Guidelines

Resumo Fundamento: As doenças crônicas não transmissíveis (DCNT), também conhecidas como doenças crônicas de longa duração, são consideradas a principal causa de morte e incapacidade em todo o mundo, e os seis pilares da medicina do estilo de vida (nutrição, exercício, controle de tóxicos, manejo do estresse, saúde do sono e conexão social) desempenham um papel importante na gestão holística da sua prevenção e tratamento. Além disso, as diretrizes médicas são os documentos mais aceitos com recomendações para o manejo das DCNT. Objetivo: O presente estudo tem como objetivo analisar a ausência de pilares de estilo de vida nas principais diretrizes médicas brasileiras sobre as DCNT e identificar evidências na literatura que possam justificar sua inclusão nos documentos. Método: As diretrizes brasileiras foram selecionadas de acordo com as causas de morte mais relevantes no Brasil, informadas pelo Sistema de Informações sobre Mortalidade publicado pelo Ministério da Saúde em 2019. Os periódicos foram selecionados na biblioteca PUBMED de acordo com a doença e os pilares do estilo de vida não mencionados. Resultados: Causas relevantes de mortes no Brasil são o infarto agudo do miocárdio (IAM), o diabetes mellitus (DM) e as doenças pulmonares obstrutivas crônicas (DPOC). Foram identificadas seis diretrizes relacionadas a essas DCNT e todas abordam aspectos do estilo de vida, mas apenas uma, referente à prevenção cardiovascular, destaca todos os seis pilares. Apesar disso, uma pesquisa bibliográfica envolvendo mais de 50 artigos mostrou que há evidências de que todos os pilares podem ajudar no controle de cada uma dessas DCNT. Conclusão: Raramente os seis pilares do estilo de vida são contemplados nas diretrizes brasileiras para IAM, DM e DPOC. A revisão da literatura identificou evidências de todos os pilares do estilo de vida para oferecer uma abordagem holística para a gestão e prevenção das DCNT.

Abstract Background: Noncommunicable diseases (NCDs), also known as chronic diseases that are long-lasting, are considered the major cause of death and disability worldwide, and the six pillars of lifestyle medicine (nutrition, exercise, toxic control, stress management, restorative sleep, and social connection) play an important role in a holistic management of their prevention and treatment. In addition, medical guidelines are the most accepted documents with recommendations to manage NCDs. Objective: The present study aims to analyze the lack of lifestyle pillars concerning the major Brazilian medical guidelines for NCDs and identify evidence in the literature that could justify their inclusion in the documents. Method: Brazilian guidelines were selected according to the most relevant causes of death in Brazil, given by the Mortality Information System, published by the Brazilian Ministry of Health in 2019. Journals were screened in the PUBMED library according to the disease and non-mentioned pillars of lifestyle. Results: Relevant causes of deaths in Brazil are acute myocardial infarction (AMI), diabetes mellitus (DM), and chronic obstructive pulmonary diseases (COPD). Six guidelines related to these NCDs were identified, and all address aspects of lifestyle, but only one, regarding cardiovascular prevention, highlights all six pillars. Despite this, a literature search involving over 50 articles showed that there is evidence that all the pillars can help control each of these NCDs. Conclusion: Rarely are the six pillars of lifestyle contemplated in Brazilian guidelines for AMI, DM, and COPD. The literature review identified evidence of all lifestyle pillars to offer a holistic approach for the management and prevention of NCDs.

Evaluating a wellness intervention including micro-practices for healthcare professionals before and during COVID-19 / Evaluando una intervención de bienestar con micro prácticas para profesionalesde la salud antes y durante el COVID-19

Abstract Objective: To describe, with a mixed design study, healthcare professionals' pre-post descriptive measures of quality of life (subjective wellness) and prolonged fatigue, as well as an improvement in overall wellness and satisfaction regarding micro-practices as a result of participation in a wellness intervention before and during COVID-19. Material and Methods: This study had a mixed design involving two independent groups of healthcare professionals participating in a wellness intervention with micro-practices before and during COVID-19. The intervention contained multimodal presentations with animated cartoon stories, comics, storytelling, readings, breathing, mindfulness and visualization exercises, adapted from second-order factors in the Indivisible Self model. Pre-post descriptive measures of quality of life (subjective wellness), prolonged fatigue, as well as improvement in overall wellness and satisfaction regarding micro-practices were collected. Results: Attending to either wellness interventions before or during COVID-19 had a positive and, in some cases significant, effect on important indicators of quality-of-life and prolonged fatigue among healthcare professionals. A qualitative analysis indicated a subjective improvement in overall wellness and satisfaction regarding the use of micropractices included in the wellness interventions, regardless of whether these were presented in person or virtually. Most participants subjectively indicated that they improved in the targeted indicators, especially achievement of better wellness. Conclusions: During ordinary and extraordinary circumstances, healthcare professionals require specific interventions that act primarily to provide them with strategies that can improve physical, emotional, and spiritual health. Use of micro-practices in multimodal workshops to improve healthcare practitioner wellness is a successful tool for learning or remembering the importance of pausing during daily clinical activities and refocusing their energy.

Resumen Objetivo: Describir, con un estudio de diseño mixto, la medición descriptiva pre-post sobre la calidad de vida (bienestar subjetivo) y la fatiga prolongada entre profesionales de salud, así como su mejora en el bienestar general y satisfacción respecto al uso de micro-prácticas como resultado de participar en una intervención de bienestar antes y durante COVID-19. Material y métodos: Este estudio tuvo un diseño mixto en el que participaron dos grupos independientes de profesionales del sector salud en una intervención de bienestar con micro-prácticas antes y durante el COVID-19. La intervención consistió en presentaciones multimodales con historias con dibujos animados, cómics, narración de cuentos, lecturas, ejercicios de respiración, mindfulness y visualización, adaptados a partir de los factores de segundo orden del modelo del Yo Indivisible. Se recolectaron medidas descriptivas pre-post de calidad de vida (bienestar subjetivo), fatiga prolongada, así como su mejora en el bienestar general y la satisfacción con respecto a las micro-prácticas. Resultados: La asistencia a cualquiera de las intervenciones para el bienestar antes o durante la COVID-19 tuvo un efecto positivo y, en algunos casos, significativo, sobre importantes indicadores de calidad de vida y fatiga prolongada entre los profesionales del ámbito de la salud. El análisis cualitativo indicó una mejoría subjetiva en cuanto a su bienestar general y satisfacción con respecto al uso de las micro-prácticas incluidas en las intervenciones de bienestar, independientemente de si éstas se presentaron en persona o virtualmente. La mayoría de los participantes indicaron subjetivamente que habían mejorado en los indicadores enfocados, especialmente el logro de un mayor bienestar. Conclusiones: Durante circunstancias ordinarias y extraordinarias, los profesionales de la salud requieren intervenciones específicas que actúen principalmente para proporcionarles estrategias que puedan mejorar la salud física, emocional y espiritual. El uso de microprácticas en talleres multimodales para mejorar el bienestar de los profesionales es una herramienta exitosa para aprender o recordar la importancia que tiene hacer una pausa durante las actividades clínicas diarias y reenfocar su energía.

Efeitos do treinamento resistido sobre indicadores de saúde de sobreviventes de câncer de mama / Effects of resistance training on health indicators in breast cancer survivors

O objetivo deste estudo foi investigar os efeitos do treinamento resistido sobre indicadores de saúde em sobreviventes de câncer de mama. Vinte e duas mulheres com histórico de mastectomia e linfadenectomia completaram 12 semanas de treinamento. Avaliações de força, índice de massa corporal, composição corporal, aspectos hematológicos, bioquímicos e de estabilidade de membrana eritrocitária foram realizadas antes e depois do período de treinamento. Em todos os exercícios, ocorreram ganhos significantes de força máxima e resistência de força. Além disso, houve diminuição do percentual de gordura corporal, aumento do percentual de massa magra, redução de eritrócitos, plaquetas e hemoglobina, bem como mudanças desejáveis para todas as variáveis de perfil lipídico. Em conjunto, esses achados destacam o impacto multidimensional do treinamento resistido sobre a saúde de sobreviventes de câncer de mama e revelam a necessidade de monitoramento constante desse público.

The present study aimed to investigate the effects of resistance training on health indicators in breast cancer survivors. Twenty-two women with a history of mastectomy and lymphadenectomy completed 12 weeks of training. Strength, body mass index, body composition, hematological, and biochemical aspects, and erythrocyte membrane stability were performed before and after the training. In all exercises, there were significant gains in maximal force and force endurance. Moreover, there was a decrease in body fat percentage, an increase in lean mass percentage, a reduction in erythrocytes, platelets, and hemoglobin, as well as desirable changes for all lipid profile variables. Altogether, these findings highlight the multidimensional impact of resistance training on the health of breast cancer survivors and reveal the need for constant monitoring of this public.

2. A Newly Established Quality/Competency "Taking a Multi-Systemic View towards a Patient as a Living Person" / 医学教育

Based on the social context of an aging society and surveys conducted since 2020, the need for comprehensive perspectives and approaches that consider patients'psychosocial background and a cross-organ perspective has been identified. As a result, a new quality and ability, namely comprehensive attitudes toward patients, has been established as part of the core curriculum for medical education in FY2022. Specific learning objectives include "holistic perspectives and approaches," "community perspectives and approaches," "life perspectives and approaches," and "social perspectives and approaches". An educational design that draws on multiple learning theories to enable reflection on one's own way of being has been proposed to integrate abstract and concrete, conceptual and experiential, and self and others perspectives. It is expected that this medical education will lead to improvement in the well-being of individuals, families, and communities.

Construction of jingjin differentiation system based on holistic concept / 中国针灸

As a diagnostic method to guide the treatment of sinew/fascia diseases, jingjin (muscle regions of meridians) differentiation is an important component of syndrome differentiation system of acupuncture and moxibustion. In clinical practice, because of the limitations of the ideological guidance of the holistic view, the systemic and dialectical thinking and the syndrome element collection, the system of diagnosis and treatment of sinew/fascia diseases is not comprehensive. Through combing the origin of the holistic view of jingjin, the paper expounds the differentiation framework of sinew/fascia diseases from 4 aspects of differentiation, i.e. the location of disease, etiology, nature of disease and condition of disease. It suggests to construct jingjin differentiation system by taking the holistic ideas as the core, the syndrome element research as the common method and the evidence-based medicine as the theoretical basis so that the thinking of syndrome differentiation and the diagnostic approaches based on jingjin theory can be enriched.

Intrinsic "self-consistent" phenomenon based on holistic view of traditional Chinese medicine / 中国中药杂志

The fundamental principle of traditional Chinese medicine(TCM) is holism, and it is crucial for TCM to address the key issue of the "holistic view" of Chinese herbal medicine. While the overall regulatory effects of Chinese herbal medicine have been widely recognized, the holistic internal logic of individual ingredients of Chinese herbal medicines require further clarification. In order to comprehensively understand the mechanism of action of Chinese herbal medicine, this paper combined the holistic view of Chinese herbal medicine with differentiation thinking to explore the intrinsic logical relationships within Chinese herbal medicine. Starting from the perspective of the coexistence of multiple components in Chinese herbal medicine, this paper systematically examined the "self-consistent" phenomenon within single Chinese herbal medicine. This phenomenon refers to the consistent or opposing actions of various components in terms of their physical and chemical properties, pharmacokinetic effects, biological effects, flavors and properties, and TCM efficacy. The paper summarized various logical relationships of syndrome differentiation exhibited by the same Chinese herbal medicine, analyzed the underlying reasons, and focused on analyzing external factors affecting the "self-consistent" phenomenon in the efficacy of Chinese herbal medicine, aiming to better elucidate the theoretical basis of the pharmacological effects of Chinese herbal medicine, further enrich the scientific connotation of the holistic view of Chinese herbal medicine, and provide theoretical guidance for the preparation process, compatibility patterns, and formulation design of Chinese herbal medicine.

Quality control strategy of traditional Chinese medicine based on pharmaceutical product lifecycle management / 中国中药杂志

Quality control is pivotal in the research and development of traditional Chinese medicine, whose connotation is not limi-ted to the qualitative or quantitative detection of an indicator component, but extends to the establishment of a whole process quality control system from the perspective of pharmaceutical product lifecycle management. This study discussed the quality control strategy of Chinese medicine based on the concept of pharmaceutical product lifecycle management, and proposed the following suggestions:(1) to focus on the "holistic view" and "phased" characteristics of quality control and strengthen the establishment of quality control strategy based on top-level design;(2) to strengthen the research on quality control of Chinese medicine based on quality risk management, focus on the correlations of quality control indicators with the safety and effectiveness of traditional Chinese medicine, and establish a quality evaluation system consistent with the characteristics of traditional Chinese medicine;(3) to consider the characteristics of different registration classifications in the establishment of quality control strategy;(4) to highlight the quality correlation research, strengthen the quality transfer research, ensure the quality traceability, and establish a sound quality management system;(5) to strengthen the quality research on marketed drugs to achieve dynamic quality improvement.

Analysis of governance model and development path of government support for the development of"Huimin Insurance"from the perspective of holistic governance / 中国卫生政策研究

Objective:Based on the goal of multi-level medical insurance system,put forward the holistic governance way for government supporting the"Huimin Insurance".Methods:The development process and characteristics of"Huimin Insurance"in China were analyzed.Based on the concept of holistic governance and multiple governance tools,a holistic governance model for government supporting the"Huimin Insurance"was constructed,and the existing problems were analyzed based on the current situation of typical regional governance.Results:At present,the holistic governance is not enough,there are problems such as fuzzy product positioning,immature information and marketing tools,and different levels of cooperation among the insurers and healthcare services,which affect the sustainability of the"Huimin Insurance".Conclusion:As a new attempt in the construction of a multi-level medical insurance system,government departments should provide holistic governance from the perspective of top-level design to support the development of the"Huimin Insurance",including clarifying the boundaries of government market responsibilities,promoting systematic support from government departments,strengthening information governance tools,and realizing multiple co-governance by improving the level of social participation.

Research on the social and commercial integration mode of Huimin Insurance from the perspective of holistic governance / 中华医院管理杂志

As an important part of China′s multi-level medical insurance system, commercial health insurance has developed rapidly in recent years, but its guarantee level is still limited, and its role in the multi-level medical insurance system is not fully played. Huimin Insurance, as a new public private partnership health insurance, takes into account the dual characteristics of commercial operation and inclusive protection, and provides an important supplement to meet the needs of the masses for multi-level protection, alleviate the economic burden of serious diseases, and promote the innovation and development of the pharmaceutical industry. The author systematically analyzed the characteristics of social and commercial integration in the development of Huimin Insurance in China from the aspects of value-oriented mechanism, policy complementary mechanism and operation support mechanism, and analyzed the problems of in the current development process of Huimin Insurance based on the holistic governance framework of multi-level medical security system in three dimensions of " hierarchy-institutional-tool". It is suggested that the functional positioning of multiple subjects should be clarified, the ability of information integration should be enhanced, and the product design and serviceshould be optimized, so as to fully enlarge the supplementary security efficiency of Huimin Insurance, and explore a new path for the formation of a multi-level medical insurance system with Chinese characteristics.

Efficacy of Guanqiao Zhengqi holistic therapy for chronic rhinosinusitis / 中国基层医药

Objective:To investigate the efficacy of Guanqiao Zhengqi holistic therapy in the treatment of chronic rhinosinusitis. Methods:A total of 200 patients with chronic rhinosinusitis who received treatment in the Department of Otolaryngology, Shanxi Provincial Integrated Traditional Chinese Medicine and Western Medicine Hospital ( n = 72) and Shanxi Yishengtang Traditional Chinese Medicine Center ( n = 128) from January 2021 to January 2022 were included in this study. These patients were randomly assigned to undergo treatment either with mometasone furoate nasal spray and levocetirizine hydrochloride tablets (control group, n = 100) or Guanqiao Zhengqi holistic therapy combined with mometasone furoate nasal spray and levocetirizine hydrochloride tablets (observation group). All patients were treated for 4 weeks and followed up for 3 months. Clinical efficacy, modified Visual Analogue Scale score, Lund-Kennedy endoscopy scoring system score, and duration of glucocorticoid and anti-leukotriene use were compared between the two groups. Results:The total response rate in the observation group was significantly higher than that in the control group [92.00% (92/100) vs. 73.00% (73/100), χ2 = 18.45, P < 0.001). There was no significant difference in the modified Visual Analogue Scale score between the two groups before treatment ( Z = 1.37, P = 0.170). There was a significant difference in the modified Visual Analogue Scale score between the two groups after treatment ( Z = -5.27, P < 0.001). Before treatment, there was no significant difference in the Lund-Kennedy endoscopy scoring system score between the two groups ( Z = -1.65, P = 0.098) and the Lund-Kennedy endoscopy scoring system score differed significantly between the two groups after treatment ( Z = -6.03, P < 0.001). The duration of glucocorticoid and anti-leukotriene use in the observation group was significantly shorter than that in the control group [10.00 (10.00, 14.00) days vs. 42.00 (28.00, 70.00) days, 7.00 (7.00, 7.00) days vs. 21.00 (14.00, 26.25) days, Z = -11.27, P < 0.001, Z = -12.31, P < 0.001). Conclusion:Based on the conventional treatment with western medicine, Guanqiao Zhengqi holistic therapy for the treatment of chronic rhinosinusitis can effectively reduce clinical symptoms, reduce the dose of hormones and anti-leukotriene used, shorten the use cycle, and improve the therapeutic efficacy.

Multi-disciplinary coordination model in palliative care based on integrated medicine / 中华全科医师杂志

Palliative care is the final link in the whole lifecycle health management and is an important part of promoting a healthy China. In order to further improve service efficiency and the quality of end-of-life care, Shanghai Jiading Yingyuan Hospital has constructed a new interdisciplinary team collaboration model for palliative care from the perspective of integrated medical theory, and applied this model to clinical practice. By elaborating on the theory of team integration, member composition and division of labor, implementation process and preliminary effects, this study aims to provide a theoretical basis and reference for other regions to carry out the integration path and collaborative model of interdisciplinary services in palliative care.

Breast Cancer Patients’ Experience of Current Health Services as A Holistic Care: A Qualitative Study

@#Introduction: Breast cancer is now one of the leading causes of death and morbidity worldwide, including in Indonesia. Every health care professional and community member should pay close attention to these issues. Women diagnosed with breast cancer will experience physical, psychological, and social issues. Methods: This study looked into breast cancer patients’ experiences with holistic nursing care. The complexity of the difficulties confronting breast cancer patients will influence their experiences and perceptions, necessitating a holistic approach to nursing services. A qualitative exploratory, descriptive method was adopted in the investigation. During data collection, fifteen participants were recruited and interviewed. Focus Group Discussion (FGD) was utilized to collect data. Result: The study’s findings provide five significant themes: (1) knowledge and understanding of breast cancer; (2) experiences felt at the beginning of breast cancer complaints; (3) non-health breast cancer treatment; (4) perception of nursing services received by breast cancer patients; (5) facts and holistic needs during and beyond treatment; and (6) patients’ expectations of nursing services to help their needs. Conclusion: The findings provide information on how breast cancer patients understand the examination procedure, accept a diagnosis, and proceed to treatments.

Discussion on the construction of holistic nursing based on SWOT in apheresis platelets collection / 中国输血杂志

【Objective】 To explore the application and effectiveness of holistic nursing based on SWOT in platelet collection at blood stations. 【Methods】 SWOT analysis was used to analyze the causes of adverse reactions to blood donation in platelet donors, put forward countermeasures and take holistic nursing measures. Routine nursing was adopted from January to June 2021, and holistic nursing based on SWOT analysis was adopted from July to December 2021. The adverse reactions and the nursing quality before and after the implementation of holistic nursing in the two groups were compared, and the satisfaction of blood donors to the nurses was analyzed. 【Results】 After the implementation of holistic nursing based on SWOT analysis, the incidence of adverse reactions in blood donation was 2%(2/100) in the observation group, significantly lower than 11%(11/100) in the control group(P<0.05). Nursing satisfaction score of the observation group was (93.10±4.97 points), significantly higher than that of the control group (78.12±5.36 points)(P<0.05). 【Conclusion】 The implementation of holistic nursing based on SWOT analysis can significantly reduce the incidence of adverse reactions in platelet donors and improve the satisfaction of blood donors with the nursing work, thus significantly improving the quality of nursing in the department.