Chinese Medicine Practitioners Research Articles

Is Chinese Medicine Facing a Potential Workforce Crisis in Australia? Demographic Changes in the Profession over the Last Decade.

Background: As a prominent part of complementary and alternative medicine, Chinese Medicine (CM) has proved its strengths in treating a diverse range of acute and chronic medical conditions and is at present recognized in 196 countries and territories worldwide. In 2012, Australia regulated the CM profession under the National Regulation and Accreditation Scheme (NRAS) by legislation and reports quarterly demographic information about individual CM practitioners so to ensure public interest, although research examining the change of CM workforce in Australia has been scarce. Objective: This study aims to investigate the construction of the CM workforce in Australia and more importantly, evaluated its development in the last decade to capture the trajectory and trend in the present period and future potential changes. Methods: Data were sourced from the Australian Health Practitioner Regulation Agency (AHPRA) annual reports and the Chinese Medicine Board of Australia (CMBA) registration statistics from 2012 to 2023. A descriptive analysis was conducted with demographic variables, including profession, age, and gender, and chi-square tests and linear regression modeling were carried out to assess the variations between regions and across years. Results: The population of CM practitioners in 2022/2023 stagnated with slight decrease to 4,823, in contrast to the increase rate of 2.9% in the whole health care community. The number of young CM registrants (<35 y) shrank by 37.5% from 691 in 2012 to 432 in 2023. In comparison with other health care professions, CM comprises the smallest proportion of the population aged younger than 25 (0.2%) and the largest proportion aged older than 65 years (16.2%), advancing into an aging era. Conclusions: This study indicates a worrying potential decline in CM workforce in Australia, which is likely to be further exacerbated by the lack of new graduates and rise of median age among practitioners. Meanwhile, continued advancement in Western medicine technology and standards requires substantial efforts to increase both a better understanding of CM and demonstration of its efficacy. Furthermore, greater effort is needed to recruit and educate new young CM practitioners in Australia and to broaden the international training pipeline for a sustainable development of CM practice.

The Provision and Perceptions of Telemedicine Services Among Traditional Chinese Medicine Practitioners During COVID-19: A Cross-Sectional Study in Hong Kong, China.

Objectives: Telemedicine has been widely used during the COVID-19 pandemic. Among other health care professionals, Chinese medicine practitioners (CMPs) face practical challenges in providing telemedicine consultations. This study aims to explore CMPs' experience and perceptions of telemedicine service provision before and during the pandemic. Methods: A territory-wide cross-sectional online survey was conducted in Hong Kong between April and May 2022. A structured questionnaire with open-ended questions was used to investigate the provision of and perception on telemedicine service, as well as usability of telemedicine among CMPs. Results: A total of 195 CMPs participated the survey. Before COVID-19, 42% (81/195) had been providing telemedicine services, and the proportion doubled during COVID-19. CMPs in the private sector are the main providers. Mobile apps including WhatsApp, WeChat, and Zoom were commonly used for consultations (75%, 120/161). Barriers in providing telemedicine included inability of conducting physical examination on patients (69%, 134/195), legal and ethical concerns over medical negligence (61%, 118/195), and patients' incompetence on e-literacy (50%, 98/195). Respondents urged professional and regulatory bodies to provide an explicit clinical guideline that demonstrate best practice in traditional Chinese medicine telemedicine, and to clarify legal and ethical implications of such practice. Conclusions: CMPs demonstrated their competency in telemedicine, and most of them provided telemedicine during COVID-19. Development of appropriate guidelines on the provision of telemedicine would support CMPs to continue provision after the pandemic, whereas a user-friendly and comprehensive telemedicine e-platform would enhance quality of such service. Facilitating patients with lower e-literacy to access telemedicine is key to reduce disparities.

Acceptability of Chinese Medicine Information Sharing in electronic Health Record Sharing System (eHRSS) in Chinese medicine practitioners: A mixed-method study

Background and objectives The Stage Two Development of eHRSS aimed to broaden the scope of sharable data and advance technical capability for sharing of Chinese Medicine (CM) information. This study aims to evaluate the adoption level and perceived difficulties of Chinese medicine practitioners (CMPs) towards EC Connect, and its impact on CM services.Methods All registered or listed CMPs were recruited in study 1. Descriptive analysis included age, gender, socioeconomic status, and past medical history was performed with multiple logistic regression models. In-depth interviews were conducted among EC Connect Users and Healthcare Providers (HCP) who upload information of Chinese Medicine to eHRSS.Results A total of 420 participants were included in this study. The majority of the respondents were in the 31–40 years age group (N = 133, 31.7 %) and practicing in private clinic (N = 311, 74.0 %). Respondents whom agreed that the expansion of sharing scope would be helpful to various stakeholders were 5 times more likely to be interested in joining eHRSS (aOR = 5.01, 95 % CI = 2.73–9.20, p < 0.001). Study 2 found that eHRSS allowed CMPs to share and record medical data, and to access patients’ western medical records while inconsistency of medical systems between Western and Chinese medicine should be considered.Conclusions We found that accessing and sharing medical records was important to CMPs. eHRSS helped to facilitate more accurate association between Western and Chinese medical doctors, while more efforts were needed to increase the acknowledgement among the general public.

Views of Hong Kong Chinese medicine practitioners on the application of the “Chinese Medicine Anti-epidemic Plans” prepared by the Chinese medicine expert group of central authorities: a focus group study

BackgroundDrawing on the extensive utilization of traditional Chinese medicine (TCM) to combat COVID-19 in Mainland China, experts designed a series of TCM anti-epidemic strategies. This study aims to understand Hong Kong CM practitioners’ application of and opinions on the “Chinese Medicine Anti-epidemic Plans.”MethodsOnline focus group interviews were conducted, and purposive sampling was employed to invite 22 CM practitioners to voluntarily participate in three interview sessions. The interviews were audio recorded, then transcribed verbatim. The transcripts were analyzed using template analysis.ResultsThree themes were derived: (1) facilitators of the “Chinese Medicine Anti-epidemic Plans,” (2) barriers of the “Chinese Medicine Anti-epidemic Plans,” and (3) expectations on improving the “Chinese Medicine Anti-epidemic Plans.” The participants could obtain relevant information from various sources, which highlights the value of the plans for TCM medicinal cuisine and non-pharmacologic therapies and guiding junior CM practitioners, supplementing Western medicine interventions, and managing Chinese herb reserves in clinics. However, the barriers included the lack of a specialized platform for timely information release, defective plan content, limited reference value to experienced CM practitioners, and lack of applicability to Hong Kong. The expectations of the CM practitioners for improving the plans were identified based on the barriers.ConclusionsTo enhance the implementation of the anti-epidemic plans, CM practitioners in Hong Kong expect to utilize a specific CM platform and refine the plans to ensure that they are realistic, focused, comprehensive, and tailored to the local context.

Abstract PS18-08: Bridging Disparities in Survivorship Care: Leveraging Telehealth for Diverse Patients in Safety Net Hospital

Abstract Background There are 3.8 million breast cancer survivors (BCS) in the United States and 67-88% of them report unmet needs in survivorship care. With advancements in breast cancer treatment and improved survival rates, there is a growing need to expand survivorship care to address the long-term physical, psychosocial, and medical needs of cancer survivors. There is a significant disparity in access to high-quality survivorship care, particularly for diverse patient populations in safety net hospitals. BCS in marginalized communities experience worse health-related quality of life (HRQOL) outcomes following cancer treatment in the management of symptoms, complications of treatment, and overall health-related distress. Thus, new models that leverage complex care management principles and novel care delivery systems, such as telehealth, are needed to provide multidisciplinary care and support for self-management. Methods We conducted a single-arm, pilot intervention trial of telehealth group medical visits (tGMV) in a safety net hospital serving low-income and racially and ethnically diverse BCS. The study team included physicians, advanced practitioners, PCPs, clinical psychologists, nurses, dieticians, exercise instructors, Traditional Chinese Medicine practitioners, sexual health counselors, research coordinators, and patient navigators. We enrolled a total of 6 cohorts of 7-10 BCS for the tGMV intervention (2 cohorts each in English, Spanish, and Cantonese). Each cohort had four weekly sessions on the following topics: 1) Reclaiming your health after cancer, 2) Managing emotional health, 3) Sexual health and relationship, and 4) Food is medicine. All participants were trained on the telehealth video conference platform. The curriculum was culturally adapted in the Spanish and Cantonese cohorts. Study staff followed up with participants by phone after each session. We evaluated feasibility and acceptability as primary outcomes with prespecified thresholds for &amp;gt;90 % completion of planned sessions and &amp;gt;70% attendance. Participants’ evaluation of the intervention and self-efficacy were secondary outcomes, which are not reported in this abstract. Results Fifty-three women with stage I-III breast cancer were enrolled in the study. The age was 37 to 75 (median: 58). There were 14 (26%) English-speaking participants, 19 (36%) Spanish-speaking participants, and 20 (38%) Cantonese-speaking participants. Eight (15%) participants identified as White, three (5.7%) Black A/A, 23 (43%) Asians, and 19 (36%) Hispanic; 43 (81%) participants were foreign-born. Twenty-seven (51%) participants reported food insecurity on the screening survey. The overall attendance rate was 98% (English: 97%, Spanish: 97%, and Cantonese: 100%). Of the 53 participants, 41 (77%) found the telehealth format acceptable, 47 (88%) agreed/strongly agreed that it was easy to log in and stay connected, 53 (100%) agreed/strongly agreed that tGMV were a good use of their time, 52 (98%) understood the purpose of the telehealth format, and 50 (94%) felt the information was easy to understand. Conclusions Telehealth-delivered group medical visits are feasible and acceptable in a safety net setting and are a promising intervention that may help in addressing the unmet needs of cancer survivors. We also found that despite the reported low uptake of telehealth in safety net settings, emphasis on training and technical support during sessions can increase the utilization of telehealth. Citation Format: Ivan Leung, Evelin Trejo, Ana Velázquez Mañana, Elizabeth Castillo, Barbara Cicerelli, Robin McBride, Piera Wong, Huiyu Xie, Lily Zhang, Nancy Burke, Niharika Dixit. Bridging Disparities in Survivorship Care: Leveraging Telehealth for Diverse Patients in Safety Net Hospital [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS18-08.

Famous Traditional Chinese Medicine Practitioner Liu Zhibin's Experience in Treating Chronic Pain with the "Sting Bones and Boosting Yang Method"

Famous Traditional Chinese Medicine Practitioner Liu Zhibin's Experience in Treating Chronic Pain with the "Sting Bones and Boosting Yang Method"

The Making of a Health Profession: How Chinese Medicine Became a Nationally Registered Allied Health Profession in Australia

Abstract In 2012, traditional Chinese medicine (TCM) practitioners in Australia became nationally-registered allied health professionals in three categories: acupuncturist, Chinese herbal medicine practitioner, and Chinese herbal medicine dispenser. Australia was the first Western country to introduce national registration for Chinese medicine, followed by Portugal and, recently, New Zealand. The practice of TCM in Australia can be traced back to the beginning of Chinese immigration to Australia during the Victorian Gold Rush which began in the 1850s. The process which led to national registration commenced in the early 1970s with the establishment of the first acupuncture courses. Decades of gradual development of courses from unaccredited part-time diplomas to accredited bachelor degrees, and the development, by the profession, of national consensus on educational standards were essential elements in the process which led to registration. Professional associations, such as the Australian Acupuncture and Chinese Medicine Association Ltd. (AACMA), also developed a framework of professional self-regulation, including Codes of Ethics, Codes of Conduct, ongoing professional development requirements and Infection Control Guidelines, and provided leadership in the development of the profession. After decades of tribalism and division within the TCM profession, the National Academic Standards Committee brought almost all stakeholders together to reach a consensus on the Australian Guidelines for Traditional Chinese Medicine Education which were published by AACMA in 2001. Professional associations also collaborated on joint submissions to the government in support of registration, which was introduced first in the state of Victoria in 2000, and subsequently became national in 2012. Despite national registration, some barriers still remain, and professional associations continue to lobby the federal government for inclusion in Medicare, chronic disease management scheme, and Veterans Affairs.

YOLOv8-ACU: improved YOLOv8-pose for facial acupoint detection.

Acupoint localization is integral to Traditional Chinese Medicine (TCM) acupuncture diagnosis and treatment. Employing intelligent detection models for recognizing facial acupoints can substantially enhance localization accuracy. This study introduces an advancement in the YOLOv8-pose keypoint detection algorithm, tailored for facial acupoints, and named YOLOv8-ACU. This model enhances acupoint feature extraction by integrating ECA attention, replaces the original neck module with a lighter Slim-neck module, and improves the loss function for GIoU. The YOLOv8-ACU model achieves impressive accuracy, with an mAP@0.5 of 97.5% and an mAP@0.5-0.95 of 76.9% on our self-constructed datasets. It also marks a reduction in model parameters by 0.44M, model size by 0.82 MB, and GFLOPs by 9.3%. With its enhanced recognition accuracy and efficiency, along with good generalization ability, YOLOv8-ACU provides significant reference value for facial acupoint localization and detection. This is particularly beneficial for Chinese medicine practitioners engaged in facial acupoint research and intelligent detection.

Chinese medicine practitioners’ consensus on traditional Chinese medicine diagnostic patterns, symptoms, and herbal formulas for COVID-19 survivors: A Delphi study

IntroductionIn April 2022, the “Guidance and recommendations on Chinese Medicine Rehabilitation during COVID-19 recovery stage (pilot version)” (the CM Rehabilitation Guidance) was formulated for Hong Kong COVID-19 survivors. However, no consensus regarding traditional Chinese medicine (TCM) diagnostic patterns, symptoms, and herbal formulas in the Guidance has been reached among Hong Kong Chinese medicine practitioners (CMPs). Thus, this study aimed to establish a consensus among them as a guidance for practice. MethodsA modified Delphi method was conducted from July 28 to September 14, 2022. Each survey gathered feedback by using a five-point Likert scale and open-ended questions. Descriptive statistics for quantitative data and thematic analysis for qualitative data were used. The consensus was defined as ≥80 % level of agreement with interquartile range (IQR) ≤1. ResultsA total of 13 CMPs with clinical experience in managing COVID-19 survivors participated in the three-round Delphi survey. A final consensus was reached regarding the following: (1) the diagnostic pattern qi deficiency of the lung and spleen (median = 4; IQR = 0; level of agreement = 92.31 %) with six new suggested symptom items; (2) the diagnostic pattern dual deficiency of qi and yin (median = 4; IQR = 0.5; level of agreement = 100 %) with three new suggested symptom items; and (3) the suggested herbal formulas for these two diagnostic patterns after modification. ConclusionsThrough the three-round Delphi survey, we established a modified CM Rehabilitation Guidance for Hong Kong COVID-19 survivors. The modified Guidance based on the views of Hong Kong CMPs with frontline clinical experience in COVID-19 should be more applicable to current COVID-19 survivors.

Preliminary Translation of the Tianhui Laoguanshan Manuscript on Piercing as Therapy

Abstract This translation forms a triptych with the following two articles in this double special issue: Gu Man, Zhou Qi, and Liu Changhua, “Techniques for Piercing the Mai Recorded in the Laoguanshan Han Tomb Bamboo Slips” and Zhou Qi, “Research on the Lacquered Channel Figurine Excavated from a Han Tomb in Tianhui.” Here you can read an entire Tianhui Laoguanshan text in translation on the subject of therapeutic piercing. The contribution by Gu, Zhou, and Liu positions the therapy in relation to ideas and techniques in other manuscript texts contemporary to the one translated here and the printed classics of Chinese medicine. These articles are accompanied by opinion pieces written by current practitioners of Chinese medicine as expert witnesses to the evolution of the techniques and their relevance, or not, to modern practice. Together, we present an interdisciplinary analysis that we hope will engage the reader actively in the process of multifocal interpretation. The text here is introduced by a translator’s introduction that reflects broadly on the unique challenges of rendering this fascinating work into English.

Practitioner Responses to the Tianhui Laoguanshan Medical Manuscripts and Artifacts

Abstract In the process of editing this special double issue of Asian Medicine we were keen to print the responses of practitioners of Chinese medicine currently still in practice. We therefore sent colleagues the article by Gu Man, Zhou Qi, and Liu Changhua, “Techniques for Piercing the Mai Recorded in the Laoguanshan Han Tomb Bamboo Slips” and the article by Zhou Qi, “Research on the Lacquered Channel Figurine Excavated from a Han Tomb in Tianhui” while they were in preparation. We are very grateful to Edward Neal and George He for their generous responses. —Eds.

Integrated cell metabolomics and network pharmacology approach deciphers the anti-testosterone deficiency mechanisms of Bushen Zhuanggu Tang

Testicular dysfunction is distinguished by a deficiency in testosterone levels, which can be attributed to the occurrence of oxidative stress injury in Leydig cells. The empirical prescription known as Bushen Zhuanggu Tang, developed by a highly experienced traditional Chinese medicine practitioner with six decades of clinical expertize, aligns with the traditional Chinese medicine principle of "kidney governing bone". Researchers have demonstrated that the administration of BSZGT can effectively enhance testosterone production. The objective of this study is to investigate the potential anti-testicular dysfunction effects of BSZGT and elucidate its underlying mechanism in an in vitro setting. Specifically, the impact of oxidative stress induced by H2O2 on the activity and testosterone levels of Leydig cells (TM3) was examined. Furthermore, the utilization of UPLC-QE-Qrbitrap-MS enabled the identification of the involvement of BSZGT in various metabolic pathways, including arginine biosynthesis, amino acyl-tRNA biosynthesis, Alanine, aspartate and glutamine metabolism, and Citrate Cycle, through the modulation of 25 distinct metabolites. Additionally, a network pharmacological analysis was conducted to investigate the pivotal protein targets associated with the therapeutic effects of BSZGT. The findings demonstrate the identification of six key proteins (CYP19A1, CYP1B1, ALOX5, ARG1, XDH, and MPO) that play a significant role in augmenting testicular function through their involvement in the ovarian steroid production pathway. In summary, our study presents a comprehensive research methodology that combines cell metabonomics and network pharmacology to enhance the discovery of new therapeutic agents for TD.

Revealing the “Yin-Jing” mystery veil of Platycodon grandiflorum by potentiating therapeutic effects and lung-oriented guidance property

Ethnic pharmacological relevance“Yin-Jing” medicine (YJM) has been widely used by both ancient and modern Chinese medicine practitioners during long-term clinical practice. However, it remains unclear how to best guide other medicines to the targeted organs in a traditional Chinese medicine (TCM) prescription. Here, in an attempt to explain the scientific connotation of the YJM property (YJMP) attributed to a basic TCM theory, Platycodon grandiflorum (PG) was chosen as a case study to reveal the mystery of YJMP theory. Aim of the studyThe main purpose of this study is to employ modern chemical and molecular biology methods to confirm the “Yin-Jing” effect of PG, and further clarify its material basis and related possible mechanism. Materials and methodsThe ammonia-induced lung injury rat model was utilized to determine the optimal dosage of traditional prescription Hui Yan Zhu Yu decoction (HYZYD) using Wright Giemsa staining, HE staining, Masson staining, and TUNEL analysis. With the same way, PG was confirmed to have potentiating therapeutic effect (PTE) by comparison with HYZYD and [HYZYD-PG]. TMT proteomics was used to reveal the “Yin-Jing” mechanism of action. Western blot assay (WB) was employed for verification of differentially expressed proteins. Additionally, four non-crossing fragmentations (Fr. A-D) were characterized by RPLC/SEC-ELSD and HILIC-ESI–-Q-OT-IT-MS techniques. The PTE and guidance property assays were utilized to evaluate “Yin-Jing” functions by a compatible combination of hydroxysafflor yellow A (HYA) using qPCR, FCM, WB, HPLC, high content cell imaging (HCI) and high-resolution live-cell imaging (HRLCI) techniques. ResultsThe HYZYD-M (medium dose group) significantly improved the lung injury level in a pneumonia model of rats. PG enhanced the therapeutic effect of HYZYD ascribed to Yin-Jing PTE functions. TMT proteomics revealed a category of differentially expressed proteins ascribed to Golgi-ER between HYZYD and [HYZYD-PG]. Fr. C (i.e., saponins) and Fr. D (i.e., lipids) were determined as therapeutic fragmentations via the LPS-induced A549 cell injury model; however, Fr. B (fructooligosaccharides and small Mw fructans) had no therapeutic effect. Further compatibility PTE assays confirmed Fr. B significantly improved efficiency by a combination of HYA. The guidance assays showed Fr. B could significantly increase the uptake and distribution of HYA into lung cells and tissues. HCI assays showed that Fr. B increased uptake of HYA accompanied by significant activation of Golgi-ER. Unlike Fr. B, HRLCI showed that Fr. A, C and D were not only unobvious activations of Golgi-ER but also insignificant facilitation of colocalizations between HYA and Golgi-ER. ConclusionsFr. B is believed to be a key YJMP material basis of PG attributed to Yin-Jing PTE with characteristic of lung-oriented guidance property, whereas another abound Fr. C was determined to have synergistic effects rather than Yin-Jing material basis.

Atractylodes macrocephala-Paeonia lactiflora Class Formula for the Treatment of Irritable Bowel Syndrome: A Systematic Review With Meta-Analysis and Trial Sequential Analysis.

Previous meta-analyses suggested that Chinese herbal medicine (CHM) is effective for irritable bowel syndrome (IBS). Formulas with Atractylodes macrocephala and Paeonia lactiflora as the core pairs have been widely used by traditional Chinese medicine (TCM) practitioners for the treatment of IBS. We aimed to examine the efficacy and safety of the Atractylodes macrocephala-Paeonia lactiflora class formula (A-P CHM) for IBS through a meta-analysis and trial-sequential analysis (TSA). The protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42023439087. We searched seven databases for data up to May 23, 2023. The primary outcome was global IBS symptom relief. The secondary outcomes included theIBS severity scoring system (IBS-SSS) score and treatment-related adverse events. The relative ratio (RR) (dichotomous variables), the standardized mean difference (SMD) (continuous variables), the number needed to treat (NNT), the number needed to harm (NNH), and the required information size (RIS) were calculated. Twenty-four eligible articles with 3,768 participants were included. Thirteen trials were at low risk of bias (RoB). Compared with placebo or Western medication, A-P CHM was associated with a significantly higher proportion of relief of global IBS symptoms. The TSA analysis verified the primary outcome. For the secondary outcome, the A-P CHM IBS-SSS score was lower than Western medication or placebo at the end of the treatment, which was further confirmed by the TSA analysis. We asserted that A-P CHM might be a potential candidate for patients with IBS, especially for IBS-D. It may provide a theoretical basis for future optimization of irritable bowel syndrome with diarrhea (IBS-D) herbal formulas. The overall certainty of the evidence was not high; more tightly designed randomized controlled trials (RCTs) are required in the future.

Perimenopause and menopause-Symptoms and treatments

Menopause, which typically begins around 45-50 and lasts 5-10 years, is a physiological phase relevant to every woman and signifies the end of reproductive ability. Extensive research has shown that the occurrence, development, and end of menopause are related to changes in hormone levels in the body. Many women experience a transitional phase called perimenopause before officially entering menopause, in which they mainly experience menstrual irregularity, including disrupted menstrual cycles and changes in menstrual flow. In addition to the emotional and psychological changes similar to those in perimenopause, the main shift in menopause is the cessation of menstruation. Currently, the treatments for menopausal symptoms primarily involve hormone replacement therapy, although long-term use of hormones elevates the chance of getting breast and endometrial cancer. Non-pharmacological approaches such as exercising and maintaining a balanced diet can alleviate mild symptoms. Traditional Chinese medicine, a popular choice for many patients in East Asia, explains all symptoms, such as liver and kidney weakness and Yin-Yang imbalance. Traditional Chinese medicine practitioners customize herbal formulas based on individual symptoms and use acupuncture to alleviate menopausal symptoms. This review summarizes the symptoms and corresponding treatment approaches for perimenopause and menopause, as well as the limitations of current research.

Transplanted: Chinese Herbal Medicine in the United States, 1800-1911

Chinese medicine has a long history in the United States, dating back to its colonial period and extending up to the present. This essay focuses on the earliest generation of practitioners of traditional Chinese medicine in the United States. Although acupuncture is the modality most commonly associated with Chinese medicine in today’s medical marketplace, up until the 1970s, Chinese healers in the United States typically specialized in herbalism. Well before mass emigration from China to the United States began, Chinese material medica crossed the oceans, in both directions: Chinese medicinal teas and herbs came west while Appalachian ginseng went east. Beginning in the 1850s, Chinese immigrants came to the United States and transplanted their health practices, sometimes quite literally by propagating medicinal plants in their adopted home. Over time, Chinese doctors learned how to sell their services to non-Chinese patients by presenting herbalism as “nature’s remedies.”

A health-social service partnership programme for improving the health self-management of community-dwelling older adults: a hybrid effectiveness-implementation pilot study protocol

BackgroundThe ageing population requires seamless, integrated health and social care services in the community to promote the health of older adults. However, inadequate financial resources, a lack of clear operational guidelines, and various organisational work cultures may affect the implementation quality and sustainability of these services. As a unique approach, this study seeks to examine the preliminary effects of a health-social partnership programme on the health self-management of community-dwelling older adults in Hong Kong. Additionally, the study seeks to ascertain key insights into the mechanisms and processes required to implement and sustain a self-care management programme in broader practice in community settings.MethodsThis study will use a hybrid effectiveness-implementation design. During the 3-month programme, subjects in the intervention group will receive four Zoom video conference sessions and four telephone calls conducted by a health-social service team that will include a nurse case manager, community workers, general practitioners, a Chinese medicine practitioner, and social workers. Subjects in the control group will receive a monthly social telephone call from a trained research assistant to rule out the possible social effect of the intervention. The reach, effectiveness, adoption, implementation, and maintenance framework (i.e. RE-AIM framework) will be used to evaluate the implementation and effectiveness outcomes. Of the five dimensions included in the RE-AIM framework, only effectiveness and maintenance outcomes will be collected from both the intervention and control groups. The outcomes of the other three dimensions—reach, adoption, and implementation—will only be collected from subjects in the intervention group. Data will be collected pre-intervention, immediately post-intervention, and 3 months after the intervention is completed to evaluate the maintenance effect of the programme.DiscussionThis programme will aim to enhance health-promoting self-care management behaviours in older adults dwelling in the community. This will be the first study in Hong Kong to use the hybrid effectiveness-implementation design and involve key stakeholders in the evaluation and implementation of a health self-management programme using a health-social service partnership approach. The programme, which will be rooted in the community, may be used as a model, if proven successful, for similar types of services.Trial registrationClinicaltrials.gov, NCT04442867. Submitted 19 June 2020

Does Chinese herbal medicine (CHM) reduce colorectal adenoma (CRA) recurrence: protocol of a registry-based, cohort study and a qualitative interview

IntroductionColorectal adenoma (CRA) is a precancerous lesion for colorectal cancer. Endoscopic resection is the first-line treatment for CRA. However, CRA recurrence rate is high. This proposed study aims to determine...

Growth of Chinese Medicine in Iran: Past, Present, and Prospects

In recent years, the international recognition of traditional Chinese medicine has continuously increased, and that medical practice has gradually become incorporated into the medical systems of many nations. As an important country in the Belt and Road Initiative, Iran has enormous potential for cooperation with China in medical and health care. High-level officials of the two countries attach great importance to cooperation in both areas. Despite the recent rapid development of traditional Chinese medicine in Iran, that medical practice still faces many problems; examples here are the lack of practitioners of traditional Chinese medicine as well as the paucity of comprehensive cooperation among herbal medicine factories, publishing houses, traditional medicine colleges, and universities in the two countries. The present study collected and analyzed materials related to the practice of traditional Chinese medicine in Iran; in that way, it made a deep examination of the current situation, problems, and development prospects regarding traditional Chinese medicine in Iran with the aim of providing ideas and references to promote the international development of that form of medicine. Following an analysis of the development trends of traditional Chinese medicine in Iran in recent years, it became evident that the prospects for such medicine in that country are extensive, and the practice has excellent potential.

Validation of the Cantonese version of the Traditional Chinese Medicine (TCM) Body constitution Questionnaire in elderly people

BackgroundThe Traditional Chinese Medicine (TCM) Body Constitution Questionnaire (For Elderly People) (TCMECQ) is a patient-reported outcome questionnaire developed in Mandarin in 2013 to differentiate the body constitutions of the elderly aged 65 and above. Considering the cultural and linguistic differences between Mainland China and Hong Kong (HK) Special Administrative Region, the TCMECQ was translated into Cantonese following “back translation” policy and validated in proper process.MethodsTen Chinese Medicine Practitioners (CMPs) and 30 senior citizens aged 65 or above were recruited to evaluate the first version of the Traditional Chinese Medicine Body Constitution Questionnaire (For Elderly People) (Cantonese version) (TCMECQ-C). Based on their comments, the second version was developed and discussed in the panel meeting to form the third version, validated the third version on 270 recruited seniors. Based on the validation results, a panel of 5 experts finalized the Questionnaire as the final version. The TCMECQ-C developers finalized the Questionnaire as the validated endorsed third version (i.e. final version).ResultsThe item-level content validity index of most items of the TCMECQ-C (First Version) were ranging from 0.80 to 1.00 in terms of clarity, relevance and appropriateness. Factor loadings of Qi-deficiency Constitution ranging from 0.37 to 0.71, Yang-deficiency Constitution ranging from 0.36 to 0.65, Yin-deficiency Constitution ranging from 0.36 to 0.65, and Stagnant Qi Constitution ranging from 0.68 to 0.82. The chi-squared degree-of-freedom ratio was 2.13 (928.63/436), Goodness-of-Fit Index (0.83), Adjusted Goodness-of-Fit Index (0.79), Normed Fit Index (0.66), Comparative Fit Index (0.78), Incremental Fit Index (0.78), Relative Fit Index (0.61) and Tucker–Lewis Index (0.75), and Root Mean Square Error of Approximation (0.07) and Standardized Root Mean Square Residual (0.07), implied acceptable Confirmatory Factor Analysis model fit of the overall scale. A Pearson correlation coefficient (r) showed the sufficient convergent validity for excessive subscales (Phlegm-dampness Constitution and Dampness-heat Constitution with r = 0.35, p < 0.01). Cronbach’s alpha coefficient ranged from 0.56 to 0.89, including Qi-deficiency Constitution (0.67), Yang-deficiency Constitution (0.84), Yin-deficiency Constitution (0.59), Stagnant Blood Constitution (0.56), Stagnant Qi Constitution (0.89), Inherited Special Constitution (0.76) and Balanced Constitution (0.73), indicating acceptable internal consistency for subscales. The intra-class correlation coefficients of the TCMECQ-C ranged from 0.70 to 0.87 (p < 0.001), indicating moderate to good test–retest reliability.ConclusionTCMECQ-C is a valid and reliable questionnaire for assessing the body constitution in Cantonese elderly.