Satisfaction of Village Doctors with the Township and Village Health Services Integration Policy in the Western Minority-inhabited Areas of China

Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China＇s new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors＇ satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors＇ personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels（all P〈0.05）. Age（P〈0.05） and years of practice（P〈0.01） were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level（P〈0.05） was negatively correlated with Operations Management as well. However, social insurance status（P〈0.05） was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors＇ satisfaction with TVHSIM（P〈0.01）. In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.

A New Page for Women's Reproductive Health in Integrated Traditional Chinese and Western Medicine

The integrated traditional Chinese and western medicine (ICWM) of obstetrics and gynecology (OBS/GYN) emerged eventually with more than 40 years’ hard struggle, and one of the most promising articles is the integration of the masterpieces of menstrual disorder and infertility in TCM and the virtual explosion of new knowledge and methods in

An Integrated Approach to Syrian Refugees’ Health Care in Lebanon

The purpose of this paper is to learn from the integrated health care approach for the Syrian Armenian refugees by the HKCC （Howard Karagheusian Commemorative Corporation） in Burj Hammoud in Lebanon from the perspective of the beneficiaries themselves, i.e. the Syrian Armenian refugees. One hundred families who had been residing in Burj Hammoud and who had been regularly benefiting from the health services of the HKCC for at least one year were interviewed. The interviewees used a semi-structured questionnaire. Data were analyzed and emerging themes were mapped. The Syrian Armenian refugees who participated in this study generally expressed their satisfaction with the equitable access afforded by the HKCC’s integrated health care approach. There were several reasons why the HKCC’s integrated approach to serve refugees and the local population on equal footing was given positive reviews by the sampled refugees. Based on the responses of the refugees, these reasons are mainly （a） the convenient location of the center, which is walking distance for most refugees; （b） the ability of the treating doctors to communicate with the refugees in Armenian, which facilitates diagnosis and understanding of the health problems; （c） suitable opening hours; （d） friendly staff; and （e） thorough doctors. The results do not statistically represent the overall refugee population that is served by the HKCC; due to the study’s limited demographic scope, the results cannot be generalized. This limitation was due to lack of funding to cover the whole beneficiary Syrian Armenian refugee population. The HKCC’s approach has helped in providing access to treatment and preventive measures to a refugee population that was in need of it; as a consequence, it may have improved the health outcomes of this refugee population, especially in regard to the immunization of children. An integrated approach to healthcare which provides “equal ability by refugees and host nationals to access the same healthcare resources from the same providers” seemed to have been successful in the case of the HKCC. This paper provided first exploration of an integrated health approach for refugee healthcare provision in Lebanon.

Analysis on the Development of Lushan （Xingzi） Hot Spring Health Tourism Products from the Perspective of Product Integrated Marketing

Through the development of more than 60 years, the hot spring tourism industry in China will confront with a situation of ＂innovative competition, standard development, and secondary upgrade＂. In this paper, from the perspective of product integrated marketing theory, by taking Lushan （Xingzi） hot spring as an example, the authors carry out an analysis on some problems in the development of Xingzi hot spring tourism products, propose the framework and model of the integrated development of hot spring health tourism products, and also provide some suggestions for the design of Xingzi hot spring health tourism routes.

Validity and reliability of the complementary and integrative health assessment for practitioners scale: CIHAP_(TR)

Objective:This study aimed to evaluate the validity and reliability of the Complementary and Integrative Health Assessment for Practitioners Scale for Turkish society.Methods:This methodological study was conducted between May~June 2020.The participants were 132 health care practitioners including nurses,physicians,dietitians,physiotherap ists,and psychologists,who were working in 6 different hospitals,and 4 different provinces in Turkey.Content Validity Index,item scale correlations,confirmatory factor analysis were used to evaluate validity.Cronbach’s alpha and test-retest were use d to evaluate reliability.Results:CVI was 0.95(0.81-0.98).Factor loadings ranged from 0.381 to 0.913 and,item scale correlations ranged from 0.302 to 0.837.The Cronbach’s alpha value was found 0.93 in the current study.Intraclass Correlation Coeffic ient ranged from 0.82 to 0.96.Conclusion:CIHAP was found to be valid and reliable tool for Turkish society.

Integrated Behavioral Healthcare in Thailand:A Case Study from Chiang Mai

Purpose:This study aims to examine the level of behavioral health integration in primary care clinics among patients with hypertension and type 2 diabetes in Chiang Mai,Thailand.It also aims to explore the provider perceived prevalence of behavioral problems and need for an expert behavioral health consultant on the primary care team and the risk and protective factors of the patients’psychological and cardio-metabolic health outcomes.Methodology:Using survey data between 2017 and 2018 regarding the level of integration as measured by a Practice Integration Profile,provider ratings of prevalence and need based on a Provider Survey,and patient lifestyle and behavioral problems with a Health Risk Assessment in six primary health care settings in Chiang Mai,Thailand(n=335).We conducted ordinary least squares regressions to explore the relationship between each of the patient psychological and cardio-metabolic health outcomes and physical,mental health and substance abuse variables while controlling for the demographics.Results:The results showed overall high levels of integration,but significant variability across clinics.Providers rated prevalence of health risk and need for a Behavioral Health Consultant as moderate.Results of the patient health risk assessment were variable,with some problems high severity,others low.Conclusion:The results reflect a need for integrated behavioral health into the health care system in Thailand especially for those who are in the chronic illness condition.Recommendations for future study include an evaluation of the translation quality and validity and reliability of the study measures under the Thai context.This study fills the research gap of lacking research on the level of integrated care in clinics in Thailand.

Advancing One Health education:integrative pedagogical approaches and their impacts on interdisciplinary learning

One Health is an integrative approach that emphasizes the interconnectedness of human,animal,and environmental health,advocating for collaborative,multidisciplinary efforts to address health challenges,particularly amid globalization and emerging threats.This paper examines the integration of One Health principles into global health education,highlighting the importance of interdisciplinary collaboration and innovative pedagogical approaches.It evaluates various teaching methods,including problem-based learning(PBL),team-based learning(TBL),simulation-based education(SBE),case-based learning(CBL),interdisciplinary workshops and seminars(IWS),and service-learning(SL),analyzing their strengths and weaknesses in fostering interdisciplinary understanding and practical application of One Health concepts.While these methods enhance learning by promoting critical thinking,collaboration,and real-world application,they also face challenges such as resource constraints,variability in group dynamics,and the complexity of assessing long-term learning outcomes.The paper also discusses the role of global partnerships,such as the Global One Health Research Partnership(GOHRP),in advancing One Health education through collaborative research and educational initiatives.Addressing challenges in curriculum integration and interdisciplinary collaboration is crucial for the effective implementation of One Health education,ensuring that future health professionals are equipped to tackle complex global health challenges.

Effect of sharing health messages on antenatal care behavior among women involved in microfinance-based self-help groups in Bihar India

Background:Bihar state in India has one of the highest rates of maternal and infant mortality in South Asia.Microfinance-based self-help groups(SHGs),involving rural women,are being utilized to improve maternal and child health practice and reduce mortality.SHG members receive information on key maternal and child health practices as well as encouragement for their practice.This study measures the association of health messaging to SHG members with their antenatal care(ANC)behaviors.Methods:The study was conducted in eight districts of Bihar in 2016.A three-stage cluster sampling design(with a random selection of blocks,villages,and SHGs)selected the sample of 1204 SHG members who had an infant child;of these,597 women were members of SHGs that received dedicated sessions on health messages,while 607 women belonged to SHGs that did not.To examine the impact of the health intervention on ANC practice,radius caliper method of propensity score matching controlled for various socio-demographic characteristics between the two groups.Results:Most of the interviewed women(91.5%)belonged to a scheduled caste or tribe.Nearly 44%of SHG members exposed to the health intervention were engaged in some occupation,compared to 35%of those not exposed to the intervention.After matching unexposed SHG women with exposed SHG women,no significant differences were found in their socio-demographic characteristics.Findings suggest that exposure to a health intervention is associated with increased likelihood of at least four ANC visits by SHG women(ATE=7.2,95%CI:0.76-13.7,p<0.05),consumption of iron-folic acid for at least 100 days(ATE=8.7,95%CI:5.0-12.5,p<0.001)and complete ANC(ATE=3.6,95%CI:2.3-4.9,p<0.001),when compared to women not exposed to the health intervention.Conclusions:The study shows that sharing health messages in microfinance-based SHGs is associated with significant increase in ANC practice.While the results suggest the potential of microfinance-based SHGs for improved maternal health services,the approach’s sustainability needs to be further examined.

Development of an integrated structural health monitoring system for bridge structures in operational conditions

This paper presents an overview of development of an integrated structural health monitoring system.The integrated system includes vibration and guided-wave based structural health monitoring.It integrates the real-time heterogeneous sensor data acquiring system,data analysis and interpretation,physical-based numerical simulation of complex structural system under operational conditions and structural evaluation.The study is mainly focused on developing:integrated sensor technology,integrated structural damage identification with operational loads monitoring,and integrated structural evaluation with results from system identification.Numerical simulation and its implementation in laboratory show that the system is effective and reliable to detect local damage and global conditions of bridge structures.

Health and Risks:Integrating Health into Disaster Risk Reduction,Risk Communication,and Building Resilient Communities

In recent years,‘‘health’’has been recognized explicitly as both a determinant and an outcome of the human dimension of disaster risk reduction(DRR).Every disaster creates significant public health needs that can exceed local capacity to respond,resulting in excess mortality and morbidity.The European Union report on Science

Knowledge, attitude and use of complementary and integrative health strategies: a preliminary survey of Iranian nurses

BACKGROUND： Disagreement exists regarding the need for knowledge about complementary and integrative health（CIH） strategies, as well as for the need to consider such strategies in clinical nursing practice. OBJECTIVE： This study was conducted to assess the knowledge, attitude and use of CIH strategies among nurses in Iran. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS： A cross-sectional study of nurses working in two hospitals of Zabol University of Medical Sciences, in southeast Iran, was conducted from October 2014 to April 2015. The questionnaire, developed specifically for this research, was used to assess the knowledge, attitude and use of CIH by nurses. Descriptive and inferential statistics were used to interpret the survey responses.RESULTS： Most nurses（n=95, 60.5%） have average knowledge about CIH strategies with most holding a positive attitude about use（n=81, 51.6%）. The majority（n=90, 57.3%） of nurses, however, never applied CIH methods. Where CIH was used, massage was most often clinically applied（n=129, 82.2%） and a large percentage believed it useful for treating illness（n=136, 87.9%）. Other CIH methods commonly used included prayer and herbal medicine.CONCLUSION： Nurses have positive attitudes about CIH though knowledge was typically weak. Educational programs should carefully consider how knowledge about CIH methods could be strengthened within curricula.

China President XI Jin-ping Met with Dr.Margaret Chan,Director-General of the World Health Organization,and Addressed to Promote Integrative Medicine and Chinese Medicine to Develop in Oversea Countries

China President Xi Jin-ping met with Dr. Margaret Chan, Director-General of the World Health Organization （WHO）, at the Great Hall of the People in Beijing, capital of China, Aug. 20, 2013. XI Jin-ping said that China will continue to improve public health and enhance cooperation with the WHO. The Chinese government always prioritizes its people＇s health and will make unremitting efforts to further implement reform of its public health system, Xi said. He promised that the Chinese government would continue to effectively distribute public health and medical resources in order to achieve full coverage of basic health services to all Chinese people by 2020.

Consensus statement of Chinese experts on exercise prescription(2023)

Exercise prescriptions play a vital role in the prevention and treatment of chronic diseases.A consensus regarding exercise prescription is important for physical health.The“Consensus statement of Chinese experts on exercise prescription”(hereinafter referred to as“Expert Consensus”)divides exercise prescription into two categories:fitness exercise prescription and medical exercise prescription.Traditional Chinese fitness exercises,exercise risk,exercise prescription,and basic precautions for exercise prescription are explained.

Patient-centered medical home and integrated care in the United States: An opportunity to maximize delivery of primary care

The reciprocal relationship between mental and physical health is well established.Undiagnosed,untreated,and poorly managed mental health conditions are associated with numerous physical health complications,poor treatment adherence,and decreased quality of life.Despite growing evidence regarding the importance of effectively addressing these conditions in primary care,the rates of identification remain low and follow-up and management by primary care providers has been criticized.The objective of this review was to demonstrate the role of Patient-Centered Medical Home(PCMH)and mental health integration in addressing comprehensive health care needs in primary care patients,and to describe common barriers and facilitators to the implementation of these types of programs.

The evolution of integrative medical education: the influence of the University of Arizona Center for Integrative Medicine

The University of Arizona Center for Integrative Medicine （AzCIM） was founded in 1994 with a primary focus of educating physicians in integrative medicine （IM）. Twenty years later, IM has become an internationally recognized movement in medicine. With 40% of United States＇ medical schools having membership in the Academic Consortium for Integrative Medicine and Health it is foreseeable that all medical students and residents will soon receive training in the principles and practices of IM. The AzCIM has the broadest range and depth of IM educational programs and has had a major influence on integrative medical education in the United States. This review describes the fellowship, residency and medical student programs at AzCIM as well as other significant national drivers of IM education; it also points out the challenges faced in developing IM initiatives. The field of IM has matured with new nationa board certification in IM requiring fellowship training. Allied health professional IM educational courses, as well as integrative health coaching, assure that all members of the health care team can receive training. This review describes the evolution of IM education and will be helpful to academic centers, health care institutions, and countries seeking to introduce IM initiatives.

New models for chronic disease management in the United States and China

In the United States(US)the role of the general practitioner in primary care is changing rapidly as the team leader in the new“Patient-centered Medical Home”model of care that is designed to improve the management of chronic disease.The“Collaborative Care Model”is an integrated model of treating multiple medical and behavioral conditions.These new approaches include a nurse case manager who serves as the key point of contact to provide education,facilitate treatment adherence,and guide the patient to improvements in nutrition and physical activity that cause obesity and chronic disease.A gap analysis was conducted comparing the US and Chinese general practitioner models for providing care to patients with chronic diseases.The results of the analysis were used to make recommendations for adding components of these models that are feasible and effective for Chinese general practitioners in community health centers.

Patient Feedback for Acupuncture Practice Improvement:A Survey from Mayo Clinic

Objective： To understand patient satisfaction with acupuncture appointment duration for the first and subsequent appointments in the plan of care, time spent with the acupuncture provider, willingness to pay for longer duration appointments, and lack of insurance coverage. Methods： Patients who were referred for an acupuncture consult to the Center for Integrative Medicine at Mayo Clinic were asked to participate in the survey in August 2014. Patients were given paper survey at time of appointment check-in and entered into Research Electronic Data Capture Survey database tool to reveal patient-reported outcomes. Results： In total, 104 of 329 patients receiving acupuncture treatment responded to the survey with a 32% response rate. Insight and recommended changes to the duration of the initial and subsequent appointments were obtained. Most patients reported that time spent with the provider（76 cases, 74%） and appointment length（74 cases, 68%） were ＂just right＂. Seventy cases（70%） of respondents indicated that they wanted longer treatment. Patients reported return appointments with duration of 30 min was not enough. Fifty-three patients（62%） were willing to pay for additional costs not covered by insurance. Conclusions： We used patient feedback to assess the acupuncture practice in a complementary and integrative medicine program. Most patients referred for the acupuncture consult appeared to be satisfied with the current level of practice. These findings were used to establish a quality improvement plan that may be implemented to improve patient satisfaction with the acupuncture practice.