Trends of increase in western medical services in traditional medicine hospitals in china

Background: Compare changes in types of hospital service revenues between traditional Chinese medicine (TCM) hospitals and Western-medicine based general hospitals. Methods: 97 TCM hospitals and 103 general hospitals were surveyed in years of 2000 and 2004. Six types of medical service revenue between the two types of hospitals were compared overtime. The national statistics from 1999 to 2008 were also used as complementary evidence. Results: For TCM hospitals, the percentage of service revenue from Western medicine increased from 44.3% to 47.4% while the percentage of service revenue from TCM declined from 26.4% to 18.8% from 1999 to 2004. Percentages of revenue from laboratory tests and surgical procedures for both types of hospitals increased and the discrepancy between the two types of hospitals was narrowed from 1999 to 2004. For TCM hospitals, revenues from laboratory tests increased from 3.64% to 5.06% and revenues from surgical procedures increased from 3.44% to 7.02%. General hospitals\u27 TCM drug revenue in outpatient care declined insignificantly from 5.26% to 3.87%, while the decline for the TCM hospitals was significant from 19.73% to 13.77%. The national statistics from 1999 to 2008 showed similar trends that the percentage of revenue from Western medicine for TCM hospitals increased from 59.6% in 1999 to 62.2% in 2003 and 66.1% in 2008 while the percentage of revenue from TCM for TCM hospitals decreased from 18.0% in 1999, 15.4% in 2003, and 13.7% in 2008. Conclusion: Western medicine has become a vital revenue source for TCM hospitals in the current Chinese health care environment where government subsidies to health care facilities have significantly declined. Policies need to encourage TCM hospitals to identify their own special and effective services, improve public perception, increase demand, strengthen financial sources, and ultimately make contributions to preserving one of the national treasures

Man of Letters, Literary Lady, Journalist or Reporter?

The enormous changes wrought in the British newspaper industry during the late nineteenth and early twentieth centuries brought about a revolution in newspaper reading habits, financing and influence, all aspects of which have been well-documented by historians of the press. But what of the contributor, particularly the freelance whose millions of words formed, mostly anonymously, the content of the new mass market press? How did writers negotiate changes in the literary marketplace during this time as editors demanded more ‘news’ and less in the way of whimsical paragraphing, and sketches, the traditional newspaper output of the professional man, or woman, of letters? Through the study of memoirs, correspondence and the fictional output of contributors to the press during this time, it is possible to discern the often fraught relations between writers and their most lucrative market

Acupuncture or low frequency infrared treatment for low back pain in Chinese patients: a discrete choice experiment

Acupuncture is a popular but controversial treatment option for low back pain. In China, it is practised as traditional Chinese medicine; other treatment strategies for low back pain are commonly practised as Western medicine. Research on patient preference for low back-pain treatment options has been mainly conducted in Western countries and is limited to a willingness-to-pay approach. A stated-preference, discrete choice experiment was conducted to determine Chinese patient preferences and trade-offs for acupuncture and low frequency infrared treatment in low back pain from September 2011 to August 2012 after approval from the Department of Scientific Research in the study settings. Eight-six adult outpatients who visited the ‘traditional medicine department’ at a traditional Chinese medicine hospital and the ‘rehabilitation department’ at a Western medicine hospital in Guangdong Province of China for chronic low back pain during study period participated in an interview survey. A questionnaire containing 10 scenarios (5 attributes in each scenario) was used to ask participants' preference for acupuncture, low frequency infrared treatment or neither option. Validated responses were analysed using a nested-logit model. The decision on whether to receive a therapy was not associated with the expected utility of receiving therapy, female gender and higher out-of-pocket payment significantly decreased chance to receive treatments. Of the utility of receiving either acupuncture or low frequency infrared treatment, the treatment sensation was the most important attribute as an indicator of treatment efficacy, followed by the maximum efficacy, maintenance duration and onset of efficacy, and the out-of-pocket payment. The willingness-to-pay for acupuncture and low frequency infrared treatment were about $618.6 and$592.4 USD per course respectively, demonstrated patients' demand of pain management. The treatment sensation was regarded as an indicator of treatment efficacy and the most important attribute for choosing acupuncture or low frequency infrared treatment. The high willingness-to-pay demonstrated patients' demand of pain management. However, there may be other factors influencing patients' preference to receive treatments

The dynamics of expanding mangroves in New Zealand

In contrast to the global trend of mangrove decline, New Zealand mangroves are rapidly expanding, facilitated by elevated sediment inputs in coastal waters as a consequence of large-scale land use changes following European settlement. New Zealand mangroves are at the southern limit of the global mangrove extent, which limits the tree height of Avicennia marina var. australasica, the only mangrove species present. Mangroves in New Zealand thrive in the sheltered environments of infilling drowned river valleys with abundant supply of fine terrigenous sediments, showing various stages of mangrove succession and expansion dynamics. Bio-physical interactions and carbon dynamics in these expanding temperate mangrove systems show similarities to, but also differ from those in tropical mangrove forests, for instance due to the limited height and complexity of the mangrove communities. Likewise, ecosystem services provided by New Zealand mangroves deviate from those offered by tropical mangroves. In particular, the association of mangrove expansion with the accumulation of (the increased supply of) fine sediments and the consequent change of estuarine ecosystems, has provoked a negative perception of mangrove expansion and subsequently led to mangrove clearance. Over recent decades, a body of knowledge has been developed regarding the planning and decision making relating to mangrove removal, yet there are still effects that are unknown, for example with respect to the post-clearance recovery of the original sandflat ecosystems. In this chapter we discuss the dynamics of New Zealand’s expanding mangroves from a range of viewpoints, with the aim of elucidating the possible contributions of expanding mangroves to coastal ecosystem services, now and in the future. This chapter also reviews current policies and practice regarding mangrove removal in New Zealand and addresses the (un)known effects of mangrove clearance. These combined insights may contribute to the development of integrated coastal management strategies that recognise the full potential of expanding mangrove ecosystems

Attitudes to traditional Chinese medicine amongst Western trained doctors in the People’s Republic of China

This study analyses the attitudes of Western trained doctors to traditional Chinese medicine (TCM) in Shenyang, Northern China. Research methodology involved a series of structured interviews as well as developing a questionnaire. Two hundred and fifty questionnaires were distributed in four centres, 177 were returned. Ninety-eight percent of respondents had some theoretical and practical TCM training; the older doctors having significantly more than their recently qualified colleagues. There was clear consensus that TCM (mainly herbal medicine) was useful and safe in treating patients with chronic or intractable illness. Doctors were influenced in their choice of treatment by their training, clinical experience and the available published research. TCM was not practiced in isolation, but in conjunction with Western medicine; 76% treating their patients with TCM, 90% treating their friends or family and 82% referring patients to TCM specialists

Attitudes to traditional Chinese medicine amongst Western trained doctors in the People's Republic of China

This study analyses the attitudes of Western trained doctors to traditional Chinese medicine (TCM) in Shenyang, Northern China. Research methodology involved a series of structured interviews as well as developing a questionnaire. Two hundred and fifty questionnaires were distributed in four centres, 177 were returned. Ninety-eight percent of respondents had some theoretical and practical TCM training; the older doctors having significantly more than their recently qualified colleagues. There was clear consensus that TCM (mainly herbal medicine) was useful and safe in treating patients with chronic or intractable illness. Doctors were influenced in their choice of treatment by their training, clinical experience and the available published research. TCM was not practiced in isolation, but in conjunction with Western medicine; 76% treating their patients with TCM, 90% treating their friends or family and 82% referring patients to TCM specialists.Traditional Chinese medicine China Western medicine

The influence of natural surface microtopographies on fouling

Multiple antifouling strategies of marine organisms may consist of combinations of physical, chemical and mechanical mechanisms. In this study, the role of surface microtopography (<500 mum) of different marine organisms, such as Cancer pagurus , Mytilus edulis , Ophiura texturata and the eggcase of Scyliorhinus canicula , has been investigated as a possible component of their defence systems. High resolution resin replicates of these natural surface structures were exposed to natural fouling in field experiments. Abundances of recruits were determined and compared to those on untextured, but otherwise identical, control surfaces to quantify the influence of the different microtopographies on fouling rates. Antifouling effects of microtopographies varied with type of microtopography and coloniser species. The surface microtopography of C. pagurus significantly rejected macrofoulers. The surface structures of the eggcase and O. texturata had repellent effects on microfoulers. Barnacle settlement was temporarily reduced on surface microtopographies of M. edulis and the eggcase. These results emphasise the promising non-toxic antifouling properties of microtextured surface

On the use of multicriteria decision analysis to formally integrate community values into ecosystem‐based freshwater management

Freshwater ecosystems are essential to peoples' economic, cultural, and social well‐being, yet are still among the most threatened ecosystems on the planet. Consequently, a plethora of recent regulations and policies seek to halt the loss of restore or safeguard freshwaters, their biodiversity, and the ecosystem services they provide. Ecosystem‐based management (EBM), an approach that considers human society as an integral part of ecosystems, is increasingly being promoted to help meet this challenge. EBM involves an overarching regulatory framework and local solutions with trade‐offs and compromises—factors that not only make decision processes complex but also provide the means for combining top–down regulation with bottom‐up priorities into collaborative management strategies. Although stakeholder participation is encouraged in most modern freshwater management, community values are often largely neglected. Here, we introduce a well‐known participatory decision support framework based on multicriteria decision analysis (MCDA) to operationalize EBM and promote community‐inclusive decision making in freshwater management. We explain the different steps that this approach comprises, which lead to the prioritization of a management strategy in a collaborative way. We also show how cultural values that inherently embed strong links between the environment and people can be used together with typical ecological and socio‐economic values. We illustrate the MCDA‐based EBM‐approach for New Zealand, one of the few countries in which regional freshwater management is mandated to uphold environmental quality standards, while safeguarding local community values and ecosystem services. Finally, we discuss some of the challenges, which are increasingly emerging as a result of mandated community collaboration in environmental management