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To train homogeneous and excellent anesthesiologists who understand basic theory and clinical specialty, and response quickly and precisely to the emergency clinical condition. The Department of Anesthesiology, The First Affiliated Hospital of Army Medical University applied the integrated medical education mode combined with problem-based learning (PBL) to conduct the teaching of standardized residency training. We have always integrated relevant knowledge with "the alteration of pathophysiology" as the core, and standardized training teaching ideas with cases as the main line. A patient case bank has been set up based on the concept of integrated medical education, PBL training as the center, and the pathophysiological changes during anesthesia operation as the main line, which effectively achieves the goal of integrating theoretical knowledge with clinical practice. It is not only train high-quality anesthesiologists, but also improve their ability to find, analyze, and solve problems, so that the trainees form a habit of self-learning and continuous learning through the training.
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Based on the characteristics of forensic pathology, this paper explains the concept, connotation and advantages of holistic medicine and integrated medicine in the teaching of forensic pathology. Then, through the introduction of the specific teaching process design and effect analysis of the death cause analysis practical cases, it clarifies the necessity and effectiveness of integrated medicine and holistic medicine in the teaching of forensic pathology, and provides new ideas for the reform of the overall teaching of forensic pathology.
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The sustainable development of the teaching staff is crucial to the overall advancement of medical education reform under the background of medical and educational collaboration. With the support of the Shanghai Key Teachers' Teaching Incentive Program, Shanghai Jiao Tong University School of Medicine has established the interdisciplinary and inter-school teaching teams for undergraduate students and broken though the "last mile" of fully implementing the medical teaching reform of organ-system integrated curriculum in the country. Meanwhile, we also has reformed hourly remuneration system, formulated rules and regulations corresponding to each link, and improved the supervision mechanism, which has consolidated the mechanism of medical and educational collaboration, promoted the development of community for teachers and comprehensively improved the quality of medical education.
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Objective:To establish an index system for the construction of cardiovascular nursing discipline based on the internal and external integration model of organ system, and to provide reference for the construction of cardiovascular nursing discipline with patients as the center and circulatory system as the core.Methods:Based on the health science cluster system theory, embodying the integrated nursing concept and the characteristics of cardiovascular discipline, the content of the cardiovascular nursing discipline construction index system and the weight of each index were determined through literature review, semi-structured interview and expert consultation. SPSS 23.0 was used to statistically analyze the obtained consultation data.Results:The positive coefficient of the experts was 92.308%, the authority coefficient was 0.812, and the coordination coefficients of the first-, second- and third-level indicators were 0.412, 0.421 and 0.347, respectively. The final indicator system consisted of 4 first-level indicators, 17 second-level indicators and 66 third-level indicators.Conclusion:The index system of cardiovascular nursing discipline construction is scientific and reliable, which has certain guiding significance to the construction of cardiovascular nursing discipline and the cultivation of talents under the integrated medical model.
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Although it is not yet common, certified Kampo (traditional Japanese medicine) doctors and acupuncturists are cooperating with each other to provide traditional medical treatment for patients in some general hospitals in Japan. In other hospitals, however, Kampo and acupuncture-moxibustion have not been introduced, and doctors only treat patients using modern Western medicine. Many doctors must already be aware that modern Western medicine is not the only approach for the treatment of patients, but they do not make any efforts to improve the situation by adopting traditional medicine. Here, we give some examples of hospitals in which acupuncture treatments are routinely provided, having a favorable effect on both patients as well as the hospitals themselves. We believe that these examples give us a good opportunity to consider the future of an ideal medical system in which modern Western medicine and traditional Japanese medicine are successfully integrated.
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OBJECTIVE@#To describe and analyze the status quo of cardiovascular clinical practice guidelines or expert consensuses including both Chinese medicine (CM) and integrative medicine, through systematic literatures searching and quality assessment.@*METHODS@#Data bases including Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database were searched for published CM or integrative cardiovascular clinical practice guidelines or expert consensuses. The website www. medlive.cn was also retrieved as supplementary. The clinical practice evaluation tool AGREE II was used to assess the quality of included guidelines or consensuses.@*RESULTS@#A total of 31 relevant clinical practice guidelines or expert consensuses were included, covering diagnosis, treatment, Chinese patent and patient fields. Common cardiovascular diseases like coronary heart diseases, heart failure and arrhythmia were also involved. Through analysis it was found that both the quantity and quality of included guidelines have been improved year by year. A total of 4 evidence-based clinical practice guideline has been found, one of which was a guideline project plan. Except that, the remaining 27 reports were all consensus-based guidelines. The scores of each field, from highest to lowest, were clarity of presentation (58%), scope and purpose (54%), stakeholder involvement (28%), rigor of development (21%), applicability (13%) and editorial independence (8%).@*CONCLUSIONS@#Although clinical practice guidelines in cardiovascular domain of Chinese have gained increasing concern, with both quantity and quality improved, there is still huge gap in methodology and reporting standards between CM guidelines and international ones. On the one hand, it is essential to improve and standardize the methodology of developing CM guidelines. On the other hands, the evaluation system of evidence and recommendation with CM characters should be developed urgently.
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The prevalence of allergic diseases in children have increased year by year recently.Although the clinical manifestations of childhood allergic diseases are various,their pathogenesis is nearly the same.In the meantime,childhood allergic diseases are combined with nutritional,psychological,spiritual and family social problems,which if not solved properly will affect the allergic diseases themselves.Therefore,it is necessary to apply the concept of holistic integrated medicine and integrate multiple related departments to solve the problem of allergy,which is patient-oriented.This article introduces the necessity and approaches for integration of childhood allergic diseases.
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Recently, the integrated medical curriculum with main line of organ system and with core of disease has played an important role in medical educational reform. During the teaching reform of ultrasonic imaging in the First Affiliated Hospital of Chongqing Medical University, there existed some main problems: simply considering the "integration" as "combination"; unreasonable arrangement of ultrasonic courses; different emphasis on teaching goals between the traditional and integrated teaching; deficient ultrasonic knowledge of clinical teachers, etc.. To solve those problems, teachers participated in the reform must take some measures: firstly, totally understand the spirit of integrated medical reform, and the goal of reform which is improving the clinical ability and quality of medical students but not the pure teaching of medical knowledge; secondly , adjust the curriculum establishment and content of ultrasonic imaging;thirdly, fully utilize the Picture Archiving and Communication System (PACS) system to complement the problem of deficient ultrasonic knowledge of clinical teachers.
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The prevalence of allergic diseases in children have increased year by year recently.Although the clinical manifestations of childhood allergic diseases are various, their pathogenesis is nearly the same.In the meantime, childhood allergic diseases are combined with nutritional, psychological, spiritual and family social problems, which if not solved properly will affect the allergic diseases themselves.Therefore, it is necessary to apply the concept of holistic integrated medicine and integrate multiple related departments to solve the problem of allergy, which is patient-oriented.This article introduces the necessity and approaches for integration of childhood allergic diseases.
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Abstract: Background: Although Cultural Psychiatry (CP) has emerged as a significant discipline and body of knowledge in recent decades, it finds itself in a current intense debate about its identity, its contributions, and its future. Objective: To examine conflictive areas of historical, epistemological, clinical, educational, and research interest in the present and future development of CP. Method: A narrative review of outstanding sources, articles, and textbooks on CP that reflect its current vicissitudes; for each area, adequate quotations of Cervantes' Don Quixote and Shakespeare's Hamlet are used. Results: In addition to updating definitions and content, discussions about whether CP is a psychiatric subspecialty, the scope of its diagnostic, clinical and therapeutic applications, evaluation of criticisms and strengths, interactions with other disciplines, as well as reflective speculations about its future, are outlined. Discussion and conclusion: CP is considered the receptacle of many disciplines, the last bastion of humanistic medicine in a globalized world, although its development will always be marked by scholarly debates about contexts, meanings, identities, and competencies regarding its ontological and epistemological components.
Resumen: Antecedentes: La Psiquiatría Cultural (PC) es una disciplina y cuerpo de conocimiento de creciente significación en décadas recientes que, sin embargo, es actualmente materia de un debate intenso acerca de su identidad, sus contribuciones y su futuro. Objetivo: Se examinan áreas de conflicto en aspectos históricos, epistemológicos, clínicos, educacionales y de investigación. Método: Revisión narrativa de fuentes relevantes, artículos y textos que reflejan las actuales vicisitudes de la PC; se utilizan citas referenciales apropiadas de Don Quijote, de Cervantes, y Hamlet, de Shakespeare, en tanto que perspectivas opuestas y/o complementarias. Resultados: Además de actualizaciones de definición y contenidos, se discute si la PC es una subespecialidad psiquiátrica, y se revisan sus aplicaciones diagnósticas, clínicas y terapéuticas; sus críticas y méritos; su interacción con otras disciplinas y reflexiones en torno a su futuro. Discusión y conclusión: La PC es el receptáculo de muchas disciplinas, el último bastión de una medicina humanística en un mundo globalizado, pero su futuro estará marcado siempre por debates académicos acerca del contexto, los significados, las identidades y las competencias respecto a sus componentes ontológicos y epistemológicos.
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With the development of specialization and specialist differentiation of modem medicine,the developing mode of "reducing and specializing" has promoted the explosive growth of medical knowledge.Meanwhile,the medical practice based on medical knowledge is being fragmented,and medical activities are gradually moving away from the'people-oriented'core value.Therefore,current medical modality needs to be transformed into a "holistic medicine" stage,which also requires reforms of medical personnel cultivation,including the emphasizes of holistic view as well as multidisciplinary integration.Medical schools are exploring paths to achieve holistic medicine-oriented education and training of students.Currently,the concept of holistic medicine have begun to permeate in medical curriculum design and teaching method innovationand yet needs to befurther deepened in understanding and practicing the essence of the holistic medical modality in the future.
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The rapid development of China holistic integrated medicine has received extensive at tention from the medical and education sections.By introducing the research and practice of holistic integrated medicine in Shenyang Medical College,this paper expounds onthe integration of teaching,research,clinical and resources,representing by curriculum integration and sums up the achievements of holistic medical integration in Shenyang Medical College,in an aim to play an active role in the cultivation of applied medical talents with holistic integrated medical concept.
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Problem-based leaning(PBL) teaching method has been widely carried out in pathology teaching,but it still have limitations in the implementation, and integrated medicine concepts could improve the effect of PBL teaching to a great extent.In this paper,by analyzing the necessity of integrated medicine concepts in the pathologi-cal PBL teaching,some principles are put forward to optimizing PBL teaching,including the principle of integration and the networking, unpack and topology, and optimizing the"typical case selection and the shortage of PBL mechanism". Finally,the paper indicates that deep understanding of complementary relationship between integrated medicine and PBL could help to establish medical scenario,which is easier to understand,operate and grasp,thus to promote the pathological teaching reform.
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Problem-based leaning(PBL) teaching method has been widely carried out in pathology teaching,but it still have limitations in the implementation, and integrated medicine concepts could improve the effect of PBL teaching to a great extent.In this paper,by analyzing the necessity of integrated medicine concepts in the pathologi-cal PBL teaching,some principles are put forward to optimizing PBL teaching,including the principle of integration and the networking, unpack and topology, and optimizing the"typical case selection and the shortage of PBL mechanism". Finally,the paper indicates that deep understanding of complementary relationship between integrated medicine and PBL could help to establish medical scenario,which is easier to understand,operate and grasp,thus to promote the pathological teaching reform.
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Humanistic medicine is the contemporary essential characteristics of medicine,which is different from the ancient and modern medicine.The basic modality of humanistic medicine is integration,and the implementation of bio-psycho-social medical model is the basic content of humanistic medicine integration.Holistic integrated medicine is a clear understanding of the comprehensive modality of humanistic medicine,and leads and promotes the integration of humanistic medicine.The continuous improvement of the theoretical framework of holistic integrated medicine and its implementation in practice will promote the development of health care.
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Public health education is the core and foundation of the development of public health.Therefore,it is an urgent problem to explore the effective ways to improve public health education and to enhance the service abilities of public health,which meets the needs of development of modern public health.On the basis of analyzing the present situation of public health education in our country,this paper discusses the necessity of introducing the concept of integrated medicine in public health education,and then puts forward the corresponding settlement measures to solve the specific problems by utilizing the concept,thinking and method of integrated medicine,which aim to provide a certain theoretical basis for cultivating high-quality public health talents and accelerating the development of public health disciplines in China.
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Objective To observe the effect of comprehensive nursing of traditional Chinese medicine and Western Medicine on children′s supracondylar humerus fracture of ulnar deviation on postoperative recovery. Methods From November 2015 to February 2016, 52 inpatients were divided into 2 groups by random digits table method after the external fixation removal surgery with 26 cases each. The observation group was intervened by integrated nursing and was given TCM rehabilitation guidance, while the control group was intervened by regular nursing and was given regular rehabilitation guidance. After 4 weeks, the therapeutic effect was evaluated according to Chinese Medicine Orthopedic Syndrome Diagnosis and their elbow joint function was evaluated by Flynn score. In 8 weeks of follow up, all the patients were valued by their quality of life. Results In the process of intervention, with 1 case fell off in the observation group, 3 cases fell off in the control group, so finally the observation group with 25 cases, the control group with 23 cases. Fifteen cases were cured, 7 cases were improved, 3 cases were not cured at 4 weeks after surgery in the observation group, 8, 6, 9 cases in the control group, and the difference was statistically significant (Z=-2.120, P=0.034). At 4 weeks after surgery, 10, 6, 6, 3 cases were excellent, good, medium and poor evaluated by Flynn score in the observation group, 5, 4, 5, 9 cases in the control group, and the difference was statistically significant (Z=-2.051, P=0.040). Incidence of postoperative complications was 8.0% (2/25) in the observation group, 30.4% (7/23) in the control group, and the difference was statistically significant (χ2=2.622, P=0.047). Physical, psychological, social and environmental fields of quality of life were 77.84 ± 12.15, 81.13 ± 15.72, 79.95 ± 20.68, 79.44 ± 11.57 in the observation group, 63.31 ± 15.86, 63.07 ± 12.63, 65.65 ± 18.51, 61.32 ± 17.24 in the control group, and the difference was statistically significant (t=2.516- 4.363, P<0.05). Conclusions Integrated nursing intervention with TCM rehabilitation guidance is a method which can effectively help in improving the elbow movement function and the life quality of children with supracondylar humerus fractures of ulnar deviation.
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<p><b>BACKGROUND</b>Musculoskeletal disorders (MSD) comprise a wide range of conditions, associated with an enormous pain and impaired mobility, and are affecting people's lives and work. Management of musculoskeletal disorders typically involves a multidisciplinary team approach. Positive findings have been found in previous studies evaluating the effectiveness of complementary therapies, though little attention has been paid to evaluating of the effectiveness of integrated packages of care combining conventional and complementary approaches for musculoskeletal conditions in a National Health Service (NHS) setting.</p><p><b>OBJECTIVE</b>To determine the feasibility of all aspects of a pragmatic observational study designed: (1) to evaluate the effectiveness and cost effectiveness of integrated treatments for MSDs in an integrated NHS hospital in the UK; (2) to determine the acceptability of the study design and research process to patients; (3) to explore patients' expectation and experience of receiving integrated treatments.</p><p><b>METHODS</b>This is an observational feasibility study, with 1-year recruitment and 1-year follow-up, conducted in Royal London Hospital for Integrated Medicine, University College London Hospital Trust, UK. All eligible patients with MSDs newly referred to the hospital were included in the study. Interventions are integrated packages of care (conventional and complementary) as currently provided in the hospital. SF-36™ Health Survey, short form Brief Pain Inventory, Visual Analogue Scale, and modified Client Service Receipt Inventory will be assessed at 4/5 time points. Semi-structured interview/focus group will be carried out before treatment, and 1 year after commence of treatment.</p><p><b>DISCUSSION</b>We intend to conduct a pragmatic observational study of integrated medical treatment of MSDs at a public sector hospital. It will inform the design of a future trial including recruitment, retention, suitability of the outcome measures and patients experiences.</p>
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Humanos , Coleta de Dados , Estudos de Viabilidade , Doenças Musculoesqueléticas , Terapêutica , Avaliação de Resultados em Cuidados de Saúde , Estatística como AssuntoRESUMO
<b>Purpose</b>: As integrated medicine has been receiving more attention, therapeutic effect of plants has become more evident in recent years. However, many hospitals in Japan have not taken advantage of horticultural therapy in their palliative care unit yet. In the present study, we examined the role and the experience of horticulture as an individual therapy for patients in palliative care unit. <b>Results and Discussion</b>: More smiles were observed on the patients as evident from their Face scale score changes on days horticultural therapy was conducted. Coming into contact with the vital force of plants, through germination, flowering, and seed setting seemed to act as an effective care for the patients. Comparison of the nurses' daily journal and horticultural therapists' logbook showed difference in the nature of conversations recorded, indicating a specific role of horticultural therapists in palliative care. <b>Conclusion</b>: The study suggested a potential for individual therapy of patients with horticulture in palliative care as a part of integrated medicine that requires involvement of multiple medical disciplines.
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Acupuncture and moxibustion are traditional medical treatments with a long history which have been practiced since ancient times in the East and are promising therapeutic methods for many diseases and symptoms. In recent years, a large number of basic and clinical studies in the field of acupuncture and moxibustion have been reported also from Europe and United States, and expectations for establishment of acupuncture and moxibustion as integrated medicine have grown. The establishment of the Department of Oriental Medicine at Saitama Medical University goes back to the year 1984, and since then, it has been involved in the treatment, research and education for about 25 years. <BR>As to the treatment, close coordination with other departments has been developed;now, the number of patients seeking acupuncture and moxibustion treatment exceeds half of the total patient population, and some of the patients receive inpatient treatment. Acupuncture and moxibustion are given to patients with intractable pain, paralysis, or a series of unidentified complaints, for which the treatments have been found to be highly effective. It has been suggested that acupuncture and moxibustion are likely to play an important role in the setting of a medical university hospital.<BR>As to the research, basic and clinical studies on acupuncture and moxibustion have been promoted, and effects and mechanism of action of acupuncture and moxibustion were investigated in the treatment of primary headache, stroke, facial palsy, rheumatoid arthritis, Sjogren's syndrome, nonspecific low back pain, etc. Studies using autonomic nerve function and immunity as indices of characteristics of the traditional medicine were conducted for their scientific elucidation. <BR>In future, it is essential to enhance further coordination with specialists of other treatment departments, demonstrate efficacy and usefulness of acupuncture and moxibustion treatment, and promote evidence-based research work. It is my desire to give Japanese traditional medicine of acupuncture and moxibustion a clear position within medical university, have them established as integral medicine, and to offer to the world Japanese acupuncture and moxibustion treatment.