Ethical review of clinical study on intervention with traditional Chinese medicine in new public health emergencies / 中国中药杂志

High-quality clinical study on traditional Chinese medicine is of great significance to effectively control new public health emergencies represented by outbreaks of infectious diseases and ensure people's health and safety, but it still faces a series of ethical issues. Based on the seven core values of equity, good deeds, effectiveness, respect for individuals, freedom, reciprocity, and solida-rity proposed in the Guidelines for Management of Ethical Issues in Outbreaks of Infectious Diseases, this article emphasizes the characteristics and laws of clinical studies on traditional Chinese medicine. Main points of ethical review of traditional Chinese medicine were summarized in the aspects of overall concept, syndrome differentiation and treatment, prevention before disease onset, cultural value, and clinical basis. Based on the outbreak of coronavirus disease 2019(COVID-19), we collected relevant registered Chinese medicine clinical studies, summarized the core issues of the ethics review for COVID-19, and further improved the traditional Chinese medicine ethics review system and resources, so as to better serve ethical review and scientific studies in public health emergencies.

Suggestions on design of evidence-based traditional Chinese medicine clinical study for new public health emergencies / 中国中药杂志

2019 novel coronavirus(2019-nCoV) has occurred for 2 months, and seriously affected the people's health in the world. Therefore, scientific prevention and control strategies and effective intervention measures are the only ways to solve the world problem. In the determination of intervention measures, not only the effectiveness evaluation, but also accessibility, treatment cost, inventory and production capacity and other relevant sociological issues shall be considered, especially in low and middle-income countries and regions. With the introduction of clinical epidemiological experiment design and evidence-based medicine evidence evaluation into the evaluation of curative effect of traditional Chinese medicine(TCM), TCM has officially entered the studies of syndrome regularity of new public health emergencies(such as SARS and influenza) clearly diagnosed by modern medicine for many years, as well as the development of relevant guidelines, consensus and paths. The results of curative effect show that TCM could significantly alleviate symptoms, control disease and tendency, reduce the occurrence of critical illness, and improve the clinical efficacy and the prognosis and quality of life of patients, which fully reflects the consciousness and self-confidence of traditional Chinese medicine workers. For the evidence-based evaluation of TCM intervention in new public health emergencies, the basic principles and general methods of clinical epidemiology and evidence-based medicine shall be followed to obtain high-quality evidence; besides, we shall also fully realize that clinical scientific study is carried out with the epidemic treatment as the primary task. The scientific hypothesis comes from the clinical problems unsolved. The scientific study conclusions aim to give feedbacks to clinical diagnosis and treatment regimens. The core elements of clinical trials are population(P), intervention(I), control(C), outcome(O), which are abbreviated as "PICO". The evaluation of intervention measures for new public health emergencies with traditional Chinese medicine shall have clear study objectives and a high quality, with a correct analysis method as the guarantee of real and reliable results. Then, the selection of patients, the de-finition of intervention measures and control measures, the development of end-point indicators, the clinical quality control under special epidemics, the data verification, and the data analysis methods to be adopted are all characteristics and key points that need special consideration. It is suggested that scientific experimental design, rigorous collection and scientific data analysis shall be conducted to reflect the therapeutic value of traditional Chinese medicine, so that the study results could be adopted and shared, and become the scientific evidence for China and even the global to republish the diagnosis and treatment regimens.

New Public Health and National Public Health System / 農村醫學 地域保健

The New Public Health(NPH) is a comprehensive approach to protecting and promoting the health status of each individual member and society as a whole. NHP is not so much a philosophy to broaden the understanding of public health as it is an action plan to address current public health system. This paper's objectives include increasing public and professional awareness of the significant changes in the national public health systems of developed countries and contributing to more effective delivery of public health services in Korea. This paper reviews articles and documents concerning NPH and the public health system, and outlines of the achievements in developed countries since NPH movement began. These include the change in the definition and function of public health, expansion of public health networks, strengthening of public health policy, reorientation of public health delivery systems, promotion of workforce capacity, and the implementation of evidence-based management. To overcome the challenges facing the public health system of Korea, we must prioritize the value of population-based approach, expand the notion of a public health system to encompass all sectors that can influence health, promote a "Health in All Policies" approach, focus on an evidence-based health policy and program, develop core competencies for public health workers, and establish performance standards for public health organizations based on the core functions of public health.

The Evaluation of Community-Based Public Health Education with Reference to Core Concepts in New Public Health / 医学教育

Although great changes have already been made to medical education in Japan, the public health system urgently requires a paradigm change in the educational model. Recently, changes in the concept of public health have been proposed as “New Public Health” based on the World Health Organization's Health Promotion Movement in developed countries. We defined the core concepts and basic theories of New Public Health and have evaluated the validity to New Public Health of the community-based public health education model used since 1978 at Shimane Medical University. We have also established an educational environment that supports the development and dissemination of the model.

Healthy Cities and Communities Projects as the Undergraduate Medical Education / 医学教育

We presented here an overview of the international innovation of public health and introduced our community-based educational practice of public health. We also reported it was effective for public health education to let students participate together with teachers in the cooperative movement developing healthy community and let them learn community dynamics, skills of participatory action research and the process of policy making. Today, the under-and post-graduate education of new public health will be effctively performed by participating in the practical healthy community project, which is performed cooperatively by communities, social resources and the university.