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Showing 91 to 100 of 101 (0.061 seconds)Spelling suggestions: "subject:"hinese medicine"" "subject:"hinese edicine""
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Auriculoterapia chinesa para redução de estresse e melhoria de qualidade de vida de equipe de enfermagem: ensaio clínico randomizado / Chinese Auricular therapy to reduce stress and improve life quality of Nursing Team: Randomized Clinical TrialLeonice Fumiko Sato Kurebayashi 04 July 2013 (has links)
Introdução: A equipe de Enfermagem em hospitais tem sido exposta a ambientes de trabalho estressantes, submetidos, muitas vezes, à condições de trabalho precárias, com baixa qualidade de vida. A auriculoterapia chinesa apresentou eficácia em estudo preliminar para redução de estresse com um protocolo escolhido com base na Medicina Tradicional Chinesa(MTC) e este Ensaio Clínico se propôs a avaliar a eficácia e o alcance da técnica quando é aplicada com e sem protocolo fechado. Objetivos: Descrever e investigar os níveis de estresse da equipe de Enfermagem do Hospital Samaritano; Comparar a eficácia da auriculoterapia chinesa realizada com e sem protocolo, descrever os principais diagnósticos de MTC para estresse e a eficácia dos pontos escolhidos. Material e Método: Na primeira fase, 484 profissionais responderam a um questionário de dados sócio-demográficos e à Lista de Sintomas de Stress de Vasconcellos(LSS). Foram incluídos aqueles com pontuação entre 37 a 119 pontos (médio e alto estresse). Randomizaram-se 213 pessoas em 3 grupos (controle, grupo protocolo e grupo sem protocolo); 175 finalizaram o tratamento de 12 sessões de auriculoterapia com agulha semipermanente, duas vezes por semana, por seis semanas. O protocolo de pontos utilizado foi: ponto Rim, Tronco Cerebral, Shenmen e Yang do Fígado 1 e 2. Os instrumentos de Coleta de dados no Ensaio Clínico foram a LSS, o Inventário de Sintomas de Stress da Lipp (ISSL), o Instrumento de Qualidade de Vida (SF36v2), uma Ficha de diagnósticos de MTC. O período de coleta foi de novembro de 2011 a julho de 2012 e sete acupunturistas participaram do estudo. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da EEUSP e do Hospital. Resultados: Na primeira fase, a pontuação média de estresse de 484 profissionais foi de 45,92 (nível médio). Os que apresentaram níveis mais elevados de estresse foram: as enfermeiras (p=0,012), profissionais do turno da manhã (p=0,022) e sujeitos com doenças auto referidas (p=0,001). Na segunda fase, os dois grupos de intervenção obtiveram diferenças estatísticas significativas quando comparadas ao grupo controle (p<0,05), com efeito superior para o grupo sem protocolo segundo a LSS no pós-tratamento e follow-up. Quanto ao ISSL, houve melhores resultados para o grupo sem protocolo para a fase de resistência/quase exaustão e domínio psicológico da fase de alerta. Quanto ao SF36v2, houve diferença estatística (p<0,05) somente para o grupo sem protocolo quanto ao domínio físico no follow-up. No domínio mental, ambos os grupos de intervenção obtiveram resultados positivos(p<0,05), com ligeira superioridade para o grupo sem protocolo quanto ao índice d de Cohen. Os principais diagnósticos de MTC foram: Estagnação de Qi e Xue nos meridianos tendino-musculares, Calor de Estômago e Subida de Yang do Fígado, Estagnação de Qi do Fígado, Distúrbio de Shen, Deficiência de Yin do Rim, Deficiência de Qi e Xue do Baço-Pâncreas. Os pontos mais utilizados foram os cinco pontos do protocolo somados a Estômago, Baço e pontos de dor. Conclusão: o grupo sem protocolo obteve melhores resultados para redução de estresse e melhoria de qualidade de vida, demonstrando que a auriculoterapia chinesa quando feita de forma individualizada / Introduction: Hospitals Nursing Team have been exposed to highly stressful work environment and submitted many times to precarious work conditions and thus low quality of life. Chinese auricular therapy has presented efficiency in a preliminary study to reduce stress by a selected protocol based on Chinese Traditional Medicine (MTC). This Clinical Trial is proposed to evaluate the effectiveness and reach of the technique whenever this is applied with or without a closed protocol. Objectives: Describe and investigate the stress levels of Samaritano Hospitals Nursing Team; Compare the effectiveness of Chinese Auricular Therapy performed with or without protocol; Describe the main diagnosis of MTC for stress and efficiency of the selected points. Material and Method: On the first phase, 484 professionals answered to a questionnaire containing demographic social data and to the Vasconcelos List of Stress Symptoms (LSS). Those ones with score between 37 and 119 points (average and high stress) were included. 213 people were randomized in 3 groups (control, protocol group and group without protocol); 175 ended a 12-session auricular therapy treatment with semi-permanent ear needles twice a week for six weeks. The scoring protocol used was: Kidney point, Brain stern point, Shenmen and Yang of the Liver 1 and 2. The instruments for the data collection in the Clinical Trial were LSS, Lipp Stress Symptoms Inventory (ISSL), Instrument of Life Quality (SF36v2), MTC diagnosis chart. The period of data collection was between November 2011 and July 2012 and seven acupuncturists participated in the trial. This study was approved by the School and Hospital Ethical Committee on Clinical Trial. Results: On the first phase, the average scoring of stress was of 45,92 (average level of stress). The professionals that presented higher stress levels were: nurses (p=0,012), morning shift professionals (p=0,022) and subjects with self-referred diseases (p=0,001). On the second phase, the two intervention groups presented differences once compared with the control group (p<0,05), with higher effect in the group without protocol according to LSS in the after treatment and follow-up. Regarding ISSL, there were better results to without protocol group for resistance/quasi-exhaustion phase and physical domain of alert phase. In relation to SF36v2, there was statistics difference (p<0,05) only for the group without protocol in connection with physical dominance during follow-up. In mental dominance, both of intervention groups presented positive results (p<0,05), with an slight superior effect for the group without protocol as per Cohens index. The main MTC diagnosis was: Qi stagnation and Xue in the tendino-muscular meridians, Stomach Heat and Rising of Yang of the Liver, Qi stagnation of the Liver, Shen Disturbs, Kidney Yin Deficiency, Qi deficiency and Xue of Spleen-Pancreas. The mostly used points were the five ones of the protocol plus Stomach, Spleen and pain points. Conclusion: the group without protocol presented the best results for stress reduction and improvement of life quality, demonstrating that Chinese auricular therapy made in a personalized way broaden the reach of the technique.
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Traditional Chinese Medicine extracts exert angiogenic and protective effects towards human endothelial progenitor cells: from cellular function to molecular pathwayTang, Yubo 26 May 2014 (has links)
Despite intense research efforts, the repair of large bone defects is still not satisfactory and remains a major challenge in Orthopaedic Surgery. In this context bone tissue engineering has emerged as a promising strategy. However, one of the fundamental principles underlying tissue engineering approaches is that newly formed tissue must maintain sufficient vascularization to support its growth. Thus an active blood vessel network is an essential pre-requisite for scaffold constructs to integrate within existing host tissue. Currently, great efforts are made to address this problem employing transplantation of vascular cells and loading of appropriate biological factors.
Endothelial progenitor cells (EPCs) are a heterogeneous subpopulation of bone marrow mononuclear progenitor cells with potential for differentiation to the endothelial lineage and thus vasculogenic capacity. However, clinical studies reported that with the increase of age, increased susceptibility to apoptosis and accelerated senescence may contribute to the numerical and functional impairments observed in EPCs, which may lead to a reduced angiogenic capacity and an increased risk of vascular disease. Hence attention has increasingly been paid to enhance mobilization and differentiation of EPCs for therapeutic purposes.
A large body of evidence indicates that in Traditional Chinese Medicine (TCM) a plethora of herbs and herbal extracts are effective in the treatment of vascular diseases such as chronic wounds, diabetic retinopathy and rheumatoid arthritis. Thus, it seems rational to explore these medicinal plants as potential sources of novel angiomodulatory factors.
In this thesis we demonstrated that treatment with TCM herbal extracts promote cell growth, cell migration, cell-matrix and capillary-like tube formation of BM-EPCs. Among these TCM extracts, Salidroside (SAL) and Icariin (ICAR) incubation increased VEGF and nitric oxide secretion, which in turn mediated the enhancement of angiogenic differentiation of BM-EPCs. A mechanic evaluation provided evidence that SAL stimulates the phosphorylation of Akt, mammalian target of rapamycin (mTOR) and ribosomal protein S6 kinase (p70S6K), as well as phosphorylated ERK1/2, which is associated with the cell migration and tube formation. Furthermore, a pilot in vivo study showed that SAL has the potential to enhance bone formation in a murine femoral critical-size bone defects model.
Another new finding of the present study is that hydrogen peroxide (H2O2)-induced cytotoxicity is counteracted by TCM extracts. We found that SAL, Salvianolic acid B (SalB) and ICAR significantly abrogated H2O2-induced cell apoptosis, reduced the intracellular level of reactive oxygen species (ROS) and nicotinamide adenine dinucleotide phosphate-oxidase (NADPH) expression, and restored the mitochondrial membrane potential of BM-EPCs. Our data suggest that this protective effect of SalB is mediated by the activation of mTOR, p70S6K, 4EBP1, and by the suppression of MKK3/6-p38 MAPK-ATF2 and ERK1/2 signaling pathways after H2O2 stress. In addition, the investigation also demonstrates that ICAR owns the ability to inhibit apoptotic and autophagic programmed cell death via restoring the loss of mTOR and attenuation of ATF2 activity upon oxidative stress.
Based on the outcomes of the present work, we propose SAL, SalB and ICAR as novel proanigiogenic and cytoprotective therapeutic agents with potential applications in the fields of systemic and site-specific tissue regeneration including ischaemic disease and extended musculoskeletal tissue defects.
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Development of a Chinese version WHO Self-Assessment Tool for Evaluating Health Promotion in HospitalZHOU, FENGQIONG 02 1900 (has links)
[Support Institutions:]
Department of Administration of Health, University of Montreal, Canada
Public Health School of Fudan University, Shanghai, China / Afin de développer un instrument de la version chinoise d`OMS outil d'auto-évaluation de la promotion
de la santé dans l'hôpital(OMSOAEPSH), un processus complexe de traduction socio-culturelle a été
nécessaire. De plus, de tester la fiabilité et la validité, un enquête a été menée à la fois en Chine et au
Canada (Montréal), cette recherche a été le premier fois d`adopter un contre-culture de l`approche
complétée qui comprend : cet origine outil en anglais d`OMSOAEPSH proposé par l’OMS a été traduit
et adapté en Chinois; la traduction de l’édition source de l’OMSAÉPSH en chinois, puis sa
retraduction en anglais par une autre personne afin de tester la pertinence de la ` traduction culturelle`,
ensuite trois professionnels de la santé qui connaissent bien l’anglais ont commenté la qualité de la
traduction. Une méthode d’échantillonnage non aléatoire a été utilisée. Huit professionnels chinois qui
travaillent au sein d’organisations de santé à Montréal ont d’abord été interviewés pour finaliser une
épreuve pilote. Ensuite, une enquête formelle a été effectuée dans 3 capitales provinciales en Chine
(Shanghai, Kunming et Hefei) au cours de l’été 2008. Au total, quarante gestionnaires issus de
vingt-deux hôpitaux de ces trois villes ont participé à la recherche. Deuxièmement, pour fournir un
première description de la situation actuelle de la chine de la promotion de la santé en utilisant cette
outil chinoise, ces trois villes ont les différents niveaux de développement économique et de culture
différente mais ils sont tous profondément influencé par la médecine traditionnelle chinoise. Le
modèle de gestion des hôpitaux chinois, l’influence et le rôle de la Médecine Traditionnelle Chinoise
(MTC) pour développer la promotion de la santé en Chine ont fait l’objet d’une discussion approfondie
dans cette thèse. Tous les répondants ont été volontaires pour participer à la première enquête et la
reprise de l`enquête après trois – sept jours. La fiabilité des analyses de cohérence interne par Alpha
de Cronbach, inter-évaluateurs fiabilité par analyses de corrélation, Test-retest fiabilité par Paire
Sample T-test, la validité des essais par le biais de l`analyse factorielle et Pearson Bivariate
Correlations analyse. NPAR test a été utilisé d`analyser la promotion de la santé entre les différentes
villes et de comparer leurs différents niveaux entre les différent hôpitaux de grade.
Résultats : Seul un item sur quarante (le mot <contenter>) a été jugé unanimement comme ayant un
sens différent par rapport à la version originale. Le coefficient alpha de Cronbach’s était 0.938 pour
l'ensemble des items et de 0.896 pour l`ensemble des domaines. Cette total de Cronbach Appha de l`
coefficient pourrait être affecté par le nombre d`indicateurs. L'alpha de Cronbach’s de la norme 1 à
norme 5 était : 0.79, 0.82, 0.81, 0.79 et 0.76. L’analyse du modèle ‘Split-half’ de 0.1 à 1, indiquant qu'il
n'y avait aucune différence significative entre les valeurs de l'essai initial et l'essai de répétition de
chaque article (pré et post test). Ceci montre que l'outil (version chinoise) est fiable. L’analyse
factorielle confirme la validité d`OMSOAEPSH chinoise en général, mais sa validité a besoin de
nouvelles recherches théoriques et empiriques. Les données qualitatives montrent que tous les
participants pensent que cet outil d'auto-évaluation est avantageux en théorie mais, en pratique,
seulement 17 des 35 répondants [chefs d’hôpitaux] entendent utiliser cet instrument dans leur milieu
de travail, 15 des 35 gestionnaires d'hôpital l'ont refusé, et 3 employés ne sont pas sûr de l'utiliser. Le
score moyen de promotion de la santé, du plus élevé au moins élevé était: norme 5 : 28.95 (72.4% du
score plein), norme 4 : 35.7 (71.4%) ; norme 3 : 21.34 (71.1%) ; norme 2 : 28.85 (68.1%) ; norme 1 :
28.17 (62.6%). Le score mayen d`évaluation pour les différents hôpitaux de Grade III à Grade I était154.19 + 7.34 (n=21), 158.67 + 10.7 (n=9), 144.82 + 14.54 (n=11). Le résultat d’analyse de variance a
montré qu'il n'y avait aucune différence significative entre les valeurs de différents Grades hôpitaux.
Cette thèse a souligné les valeurs caractéristiques du système de soins chinois, notamment que la
prévention de la maladie est primauté, le service centré sur le patient- sens. La MTC, combinée avec
la médecine occidentale, ainsi que le rôle de l'hôpital, doivent permettre la promotion de la santé dans
les communautés environnantes ; ce sont les stratégies pour développer la promotion de la santé,
même si la Chine présente un certain nombre de conditions difficiles à ce développement. Cette
recherche crée une base pour de futures recherches sur une promotion de la santé efficace dans les
hôpitaux chinois. / The first purpose of this research is to develop a Chinese version (WHO self-assessment tool for
Health Promotion in Hospital(WHOSATHPH), and test its reliability and validity through a pilot test in
Canada (Montréal) and spot field investigation in China, this research was the first time to adopt
completely cross-culture approach which includes:translated the source English edition tool into
Chinese, then back translated it into English. 8 Chinese health professionals who have worked both in
China and Montreal were investigated to complete the pilot test. Then 3 health professionals whose
work language is English (1 Native American, 1 evaluation professor, the author of WHOSATHPH)
commented the back-translation quality. The spot field investigation was performed in three Chinese
capital cities, Shanghai, Hefei and Kunming from 5 June to 30 August 2008. Non-probability sample
was used to survey 40 hospital leaders who are from 22 China hospitals, and 3 health management
researchers (include 1 government officer). The second purpose of this research is to provide a
primary description of China current HPH development by using this Chinese version WHOSATHPH,
and to discuss China current hospital service evaluating principle and management model, and
analysis the value and culture of TCM and its role and influence to China HPH development. Three
capital cities(Shanghai, Kunming, and Hefei) which stand for different economic development level
and different culture context feature but all deep influenced by TCM were investigated. 22 hospitals
and 35 hospital leaders were given interview while they answered the questionnaire. All the
respondents were vonluntary to take part in the first survey and the repeat survey after 3-7 days if they
would like to. Reliability analysis include internal consistency(Cronbach Alpha),inter-rater
relibility(Correlation analysis),Test-retest reliability( Paire-Sample T-test), Validity Test through factor
analysis and Pearson Bivariate Correlations analysis. NPAR test was used to analyize the different
cities and different grade hospitals comparison. Result: Only 1 word <satisfy>) was marked different
meaning comparing with the back translation English version with original version by all of them.
Reliability measures utilized Cronbach's Alpha, the general coefficient of the Chinese version
WHOSATHPH was 0.938, Cronbach's alpha for the domains was 0.896. The Cronbach`s alpha for
v
five standards from one to five were: 0.793, 0.819, 0.807, 0.785, 0.755. 8 groups data were used for
Inner-raters analysis, result shows that Shanghai respondents had comment consistency but Hefei
and Kunming respondents didn't show inner raters assessed consistency. Pair T-Test for 40 items
between pre and post test, the signification p was from 0.1-1 which indicates not statistic significant
difference. Factor analysis shows this tool has the general theory construct validity, but the domain
construct validity has not show the contruct validity. The results showed that Chinese version
WHOSATHPH has high internal consistency but the high Cronbach`s Alpha might concern to the
number of items. All the respondents thought WHOSATHPH was valuable in theory research, 15
respondents refused to use this instrument in their work, only 17 respondents accepted it, 3
respondents were not sure to use. The rejective reasons were: no government finance budget support,
no demand from the government, difficult to follow. The acceptive reasons were: help to improve the
work quality, help to guide HPH development. This research result shows that the Chinese version has
reliability and general construct validity, but its validity needs the further conceptual and empirical
research to prove. ① For five standards from the highest to lowest: standard5 (continuity and
cooperation) 28.95(72.4% of full score), standard4 (healthy workplace) 35.71(71.4%), standard3
(patient information and prevention) 21.34 (71.1%), standard2 (patients assessment) 23.85 (68.1%),
standard1 (management and policy) 28.17(only 62.6% of full score). These results show China
hospitals has better HPH development level, their means are all over 60% of full score,②The mean of
the total score for different grade hospital were: Grade III (n=21)154.19 + 7.34, Grade II(n=9) 158.67 +
10.7, Grade I (n=11) 144.82 + 14.54. Variance analysis result shows that there was no statistic
significant difference between different grade hospitals. However, the last conclusion need further
research with large ramdom sample size investigation. This thesis discussed the quality and
weakness of China health care system and its successive strategies to develop HPH in very poor
finance support, huge population, and difficult social condition and polluted environment. Disease
prevention first, patient-center, combined the TCM with west medicine are regarded as the successive
strategies for China HPH development. This research created a foundation for future HPH research.
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| 94 |
尾張藩「奥御医師」野間林庵家の研究西島, 太郎, NISHIJIMA, Taro 31 March 2008 (has links)
No description available.
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| 95 |
中醫脈診科學化研究：以時域分析法和血液共振理論為例 / An Investigation of the Scientific Credentials of Chinese Pulse Diagnosis：Time Domain Analysis and Blood Resonance Theory as Example陳智豪, CHEN, ZIH-HAO Unknown Date (has links)
本論文乃是藉由現代中醫科學研究，進一步指出中醫科學化的可能性及其問題。由於中醫理論十分駁雜，筆者將焦點主要集中於中醫脈診之上，藉由汪叔游和王唯工的研究，來討論中醫脈診科學化的可能性和問題。
本論文進行方式，主要可分為兩個步驟，首先針對傳統中醫理論地位的問題加以討論，其次乃是針對現代中醫實驗。
在第一步驟中，筆者提出一個理論作為科學理論所必須符合的最低標準，即是科學化三原則，分別是：可落實原則、主體際性原則以及系統化原則。藉由科學化三原則筆者嘗試論證傳統中醫並非是科學理論或是經驗有效的理論，最多僅能將中醫醫療實踐視為經驗有效的醫療診斷技術。
在第二步驟中，筆者藉由汪叔游和王唯工的實驗，來討論其經驗上和概念上的問題。藉由兩人的研究，筆者將進一步指出中醫科學化的過程中，必須經過理論的重新建構，而不是僅在於累積客觀的經驗資料就可證實中醫理論。
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| 96 |
Development of a Chinese version WHO Self-Assessment Tool for Evaluating Health Promotion in HospitalZHOU, FENGQIONG 02 1900 (has links)
Afin de développer un instrument de la version chinoise d`OMS outil d'auto-évaluation de la promotion
de la santé dans l'hôpital(OMSOAEPSH), un processus complexe de traduction socio-culturelle a été
nécessaire. De plus, de tester la fiabilité et la validité, un enquête a été menée à la fois en Chine et au
Canada (Montréal), cette recherche a été le premier fois d`adopter un contre-culture de l`approche
complétée qui comprend : cet origine outil en anglais d`OMSOAEPSH proposé par l’OMS a été traduit
et adapté en Chinois; la traduction de l’édition source de l’OMSAÉPSH en chinois, puis sa
retraduction en anglais par une autre personne afin de tester la pertinence de la ` traduction culturelle`,
ensuite trois professionnels de la santé qui connaissent bien l’anglais ont commenté la qualité de la
traduction. Une méthode d’échantillonnage non aléatoire a été utilisée. Huit professionnels chinois qui
travaillent au sein d’organisations de santé à Montréal ont d’abord été interviewés pour finaliser une
épreuve pilote. Ensuite, une enquête formelle a été effectuée dans 3 capitales provinciales en Chine
(Shanghai, Kunming et Hefei) au cours de l’été 2008. Au total, quarante gestionnaires issus de
vingt-deux hôpitaux de ces trois villes ont participé à la recherche. Deuxièmement, pour fournir un
première description de la situation actuelle de la chine de la promotion de la santé en utilisant cette
outil chinoise, ces trois villes ont les différents niveaux de développement économique et de culture
différente mais ils sont tous profondément influencé par la médecine traditionnelle chinoise. Le
modèle de gestion des hôpitaux chinois, l’influence et le rôle de la Médecine Traditionnelle Chinoise
(MTC) pour développer la promotion de la santé en Chine ont fait l’objet d’une discussion approfondie
dans cette thèse. Tous les répondants ont été volontaires pour participer à la première enquête et la
reprise de l`enquête après trois – sept jours. La fiabilité des analyses de cohérence interne par Alpha
de Cronbach, inter-évaluateurs fiabilité par analyses de corrélation, Test-retest fiabilité par Paire
Sample T-test, la validité des essais par le biais de l`analyse factorielle et Pearson Bivariate
Correlations analyse. NPAR test a été utilisé d`analyser la promotion de la santé entre les différentes
villes et de comparer leurs différents niveaux entre les différent hôpitaux de grade.
Résultats : Seul un item sur quarante (le mot <contenter>) a été jugé unanimement comme ayant un
sens différent par rapport à la version originale. Le coefficient alpha de Cronbach’s était 0.938 pour
l'ensemble des items et de 0.896 pour l`ensemble des domaines. Cette total de Cronbach Appha de l`
coefficient pourrait être affecté par le nombre d`indicateurs. L'alpha de Cronbach’s de la norme 1 à
norme 5 était : 0.79, 0.82, 0.81, 0.79 et 0.76. L’analyse du modèle ‘Split-half’ de 0.1 à 1, indiquant qu'il
n'y avait aucune différence significative entre les valeurs de l'essai initial et l'essai de répétition de
chaque article (pré et post test). Ceci montre que l'outil (version chinoise) est fiable. L’analyse
factorielle confirme la validité d`OMSOAEPSH chinoise en général, mais sa validité a besoin de
nouvelles recherches théoriques et empiriques. Les données qualitatives montrent que tous les
participants pensent que cet outil d'auto-évaluation est avantageux en théorie mais, en pratique,
seulement 17 des 35 répondants [chefs d’hôpitaux] entendent utiliser cet instrument dans leur milieu
de travail, 15 des 35 gestionnaires d'hôpital l'ont refusé, et 3 employés ne sont pas sûr de l'utiliser. Le
score moyen de promotion de la santé, du plus élevé au moins élevé était: norme 5 : 28.95 (72.4% du
score plein), norme 4 : 35.7 (71.4%) ; norme 3 : 21.34 (71.1%) ; norme 2 : 28.85 (68.1%) ; norme 1 :
28.17 (62.6%). Le score mayen d`évaluation pour les différents hôpitaux de Grade III à Grade I était154.19 + 7.34 (n=21), 158.67 + 10.7 (n=9), 144.82 + 14.54 (n=11). Le résultat d’analyse de variance a
montré qu'il n'y avait aucune différence significative entre les valeurs de différents Grades hôpitaux.
Cette thèse a souligné les valeurs caractéristiques du système de soins chinois, notamment que la
prévention de la maladie est primauté, le service centré sur le patient- sens. La MTC, combinée avec
la médecine occidentale, ainsi que le rôle de l'hôpital, doivent permettre la promotion de la santé dans
les communautés environnantes ; ce sont les stratégies pour développer la promotion de la santé,
même si la Chine présente un certain nombre de conditions difficiles à ce développement. Cette
recherche crée une base pour de futures recherches sur une promotion de la santé efficace dans les
hôpitaux chinois. / The first purpose of this research is to develop a Chinese version (WHO self-assessment tool for
Health Promotion in Hospital(WHOSATHPH), and test its reliability and validity through a pilot test in
Canada (Montréal) and spot field investigation in China, this research was the first time to adopt
completely cross-culture approach which includes:translated the source English edition tool into
Chinese, then back translated it into English. 8 Chinese health professionals who have worked both in
China and Montreal were investigated to complete the pilot test. Then 3 health professionals whose
work language is English (1 Native American, 1 evaluation professor, the author of WHOSATHPH)
commented the back-translation quality. The spot field investigation was performed in three Chinese
capital cities, Shanghai, Hefei and Kunming from 5 June to 30 August 2008. Non-probability sample
was used to survey 40 hospital leaders who are from 22 China hospitals, and 3 health management
researchers (include 1 government officer). The second purpose of this research is to provide a
primary description of China current HPH development by using this Chinese version WHOSATHPH,
and to discuss China current hospital service evaluating principle and management model, and
analysis the value and culture of TCM and its role and influence to China HPH development. Three
capital cities(Shanghai, Kunming, and Hefei) which stand for different economic development level
and different culture context feature but all deep influenced by TCM were investigated. 22 hospitals
and 35 hospital leaders were given interview while they answered the questionnaire. All the
respondents were vonluntary to take part in the first survey and the repeat survey after 3-7 days if they
would like to. Reliability analysis include internal consistency(Cronbach Alpha),inter-rater
relibility(Correlation analysis),Test-retest reliability( Paire-Sample T-test), Validity Test through factor
analysis and Pearson Bivariate Correlations analysis. NPAR test was used to analyize the different
cities and different grade hospitals comparison. Result: Only 1 word <satisfy>) was marked different
meaning comparing with the back translation English version with original version by all of them.
Reliability measures utilized Cronbach's Alpha, the general coefficient of the Chinese version
WHOSATHPH was 0.938, Cronbach's alpha for the domains was 0.896. The Cronbach`s alpha for
v
five standards from one to five were: 0.793, 0.819, 0.807, 0.785, 0.755. 8 groups data were used for
Inner-raters analysis, result shows that Shanghai respondents had comment consistency but Hefei
and Kunming respondents didn't show inner raters assessed consistency. Pair T-Test for 40 items
between pre and post test, the signification p was from 0.1-1 which indicates not statistic significant
difference. Factor analysis shows this tool has the general theory construct validity, but the domain
construct validity has not show the contruct validity. The results showed that Chinese version
WHOSATHPH has high internal consistency but the high Cronbach`s Alpha might concern to the
number of items. All the respondents thought WHOSATHPH was valuable in theory research, 15
respondents refused to use this instrument in their work, only 17 respondents accepted it, 3
respondents were not sure to use. The rejective reasons were: no government finance budget support,
no demand from the government, difficult to follow. The acceptive reasons were: help to improve the
work quality, help to guide HPH development. This research result shows that the Chinese version has
reliability and general construct validity, but its validity needs the further conceptual and empirical
research to prove. ① For five standards from the highest to lowest: standard5 (continuity and
cooperation) 28.95(72.4% of full score), standard4 (healthy workplace) 35.71(71.4%), standard3
(patient information and prevention) 21.34 (71.1%), standard2 (patients assessment) 23.85 (68.1%),
standard1 (management and policy) 28.17(only 62.6% of full score). These results show China
hospitals has better HPH development level, their means are all over 60% of full score,②The mean of
the total score for different grade hospital were: Grade III (n=21)154.19 + 7.34, Grade II(n=9) 158.67 +
10.7, Grade I (n=11) 144.82 + 14.54. Variance analysis result shows that there was no statistic
significant difference between different grade hospitals. However, the last conclusion need further
research with large ramdom sample size investigation. This thesis discussed the quality and
weakness of China health care system and its successive strategies to develop HPH in very poor
finance support, huge population, and difficult social condition and polluted environment. Disease
prevention first, patient-center, combined the TCM with west medicine are regarded as the successive
strategies for China HPH development. This research created a foundation for future HPH research. / [Support Institutions:]
Department of Administration of Health, University of Montreal, Canada
Public Health School of Fudan University, Shanghai, China
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La transmission et l’assimilation des savoirs médicaux liés à la pratique de l’acuponcture et de la moxibustion au Japon (via la Chine et la Corée) et en Europe à l’époque pré-moderne (XVIe siècle - XIXe siècle) / The transmission and assimilation of acupuncture and moxibustion knowledge in Japan (via China and Korea), and in Europe in the early modern period (sixteenth century to nineteenth century) / 近世日本における鍼灸医学の形成とその普及―東アジアおよびヨーロッパの文化交流の一例として―Vigouroux, Mathias 04 December 2014 (has links)
À partir de la fin du XVIe siècle, l’acuponcture connut un renouveau au Japon sous l’impulsion de Manase Dôsan (1507-1594) et la mise en place de nouvelles écoles d’acuponcture qui commencèrent à se détacher de la tradition chinoise. Ils représentaient deux tendances qui n’étaient pas nécessairement antinomiques — à savoir d’un côté, une fidélité aux savoirs chinois, et de l’autre côté, l’apparition de nouvelles techniques et théories indigènes — et qui se retrouvèrent tout au long de la période d’Edo (1603-1858). Le développement de l’imprimerie et les stratégies de vulgarisation et de diffusion du savoir médical sino-japonais adoptées par de nombreux médecins lettrés à cette époque favorisèrent par ailleurs la circulation des connaissances. Ainsi, aux traités de médecine importés de Chine ou de Corée, s’ajoutaient leurs rééditions japonaises commentées ou non, les traités de médecine sino-japonaise écrits en chinois classique (avec ou sans signes de lecture) ou en langue vernaculaire et les traités de vulgarisation. Ces livres véhiculaient un savoir issu de différentes traditions, chinoise, coréenne, ou indigène, faisant du Japon pré-moderne un pays à la confluence des savoirs médicaux. Le XVIe et le XVIIe siècles correspondaient aussi à l’arrivée des puissances européennes et aux premières descriptions européennes de l’acuponcture et de la moxibustion, deux pratiques thérapeutiques qui continuèrent d’intéresser les médecins européens en poste à Dejima tout au long de l’époque d’Edo et plus généralement ceux en Europe qui avaient accès à leurs descriptions. Notre travail s’inscrit dans la problématique de la circulation des savoirs en Asie orientale et entre l’Asie orientale et l’Europe. Circulation des savoirs qu’il faut non seulement entendre au sens de transmission et de diffusion des savoirs et des savoir-faire, mais aussi en considérant l’impact de ces savoirs sur le pays récepteur. Nous analysons ainsi la nature des transformations qui se sont opérées au cours des processus de transmission, la manière dont les savoirs ont été compris et décrits par ceux qui ont pu les observer directement et la manière dont ils ont été assimilés par des individus d’un milieu différent de celui dans lequel ils ont été produits. La dynamique médicale de l’époque est restituée par une analyse combinée de la théorie et de la pratique clinique. Ce travail met notamment en lumière l’indissociabilité de la production des savoirs et de leur circulation en montrant comment une pratique se construit à partir des textes transmis. Notre approche méthodologique quantitative et qualitative des sources primaires laisse aussi apparaître le rôle limité de la mobilité humaine dans la transmission des savoirs liés à la pratique de l’acuponcture entre la Chine, la Corée et le Japon. Plus généralement, elle rend compte d’une transmission systématique de tout un système médical de la Chine vers le Japon et d’une transmission parcellaire de ce système du Japon vers l’Europe. L’analyse de la réception de la moxibustion et de l’acuponcture en France à la fin du XVIIIe siècle et au début du XIXe siècle révèle enfin l’importance des institutions médicales dans la soudaine popularité de ces thérapies et la manière dont les médecins français se les approprièrent en ne retenant que le terme (moxa et acuponcture) et le principe (combustion directe sur la peau et insertion d’une aiguille dans le corps). / This dissertation investigates the circulation of acupuncture knowledge between China, Korea and Japan, and between East Asia and Europe in the early modern period (16th century–19th century). In the first part, I analyze the sixteenth and seventeenth century revival of acupuncture focusing on Manase Dôsan (1507-1594) and the emergence of new indigenous theories and techniques. Using the archives of the Nagasaki trade and the transcript of the conversations between Chinese, Korean and Japanese physicians, I also identify the Chinese and Korean acupuncture textbooks transmitted to Japan during the Edo period (1603-1868), their reception by Japanese physicians, and the role geographical mobility played in the transmission of theoretical and tacit medical knowledge. In the second part, I first review the transmission of acupuncture and moxibustion to early modern Europe, and then I analyze their reception in the late eighteenth early nineteenth century France, focusing on the reasons of their sudden vogue in French hospitals, the way French physicians investigated these two therapies, and the reasons of their failure to deeply integrate medical practices. / 本論文では日本の鍼灸医学を研究対象にして、古い伝統をもつ中国医学と近世に発達した日本の医学とを比較軸にしながら、江戸時代の社会、および同時期のフランスにおいて日本医学の知識と技術がどのように形成され、そして普及したかについて、論述している。つまり、当該時期の中国・日本、およびフランスの医学文献・非医学文献に基づき、社会的・政治的な背景に配慮しながら、日本の鍼灸が近世期に入って中国医学から独立した新しい技術と理論を形成した過程を整理・考察し、また日本国内および国外にその日本の医学知識が普及した過程をも検討した。第一部前半では、五世紀以来これまで中国の鍼灸医学が絶対的な尺度であったのに対して、十六世紀後半の安土・桃山時代に入ると、鍼灸の流派が急増し、内容的にも独創的な気運が見え始める。それらは、打針、管針、腹診などのような中国の鍼灸医学に見られない新技術や新理論をともなって登場した。そこで、日本鍼灸の中国からの独立の過程に関して、技術および理論の両面から具体例に基づいて、中国医学・医術の摂取と独自化について述べる。この独立がどの程度のものであったのか、技術のみの独立か、理論のみの独立か、あるいは両方の独立かを明らかにする。例えば、道三流や杉山流のように、理論面では中国鍼灸医学に基づきながら、臨床面では針より灸を頻繁に使う点に日本鍼灸の特徴が見られる流派があった。打鍼流のように、理論・技術ともに中国鍼灸医学を離れ、新しい針術と理論を形成した流派もあった。砭針のように、古代中国医術の名を借りてはいるが、実際の臨床では全く違った技術もあった。第一部後半では、中国や朝鮮からの医書の輸入とその日本における覆刻の問題を取り上げ、併せて長崎経由で来日した中国人や朝鮮人の医師に注目しながら、鎖国といわれる体制のなかで日本と通商を許された限られた国々との医学上の交流を考察する。広く知られているように、江戸幕府は貿易相手国を三国に限定し、日本人の国外渡航を禁じて、出入国を厳重に取り締まる鎖国政策をとっていたが、この閉鎖的な政策にもかかわらず、輸出された医書の量や日本に渡来した医師の数を見ると、医学的・文化的な交流はかなり盛んであったことがわかる。そのうち本研究では、中国からの輸入医書を通した医学知識の摂取と、朝鮮からの来日医師を通した直接的な医術の摂取を明らかにする。特に、朝鮮通信使の参府に際しては、信使一行と接触した日本人の中には医師も含まれ、朝鮮人医師との間に医事に関する質疑も交わされている。その時の筆談記録『医事問答』等を中心に、来日朝鮮人医師、およびその日本への影響に関して検討する。結論としては、江戸時代に輸入された医書は、覆刻によって全国的な規模で医学知識の普及と形成に影響を及ぼしたのに対して、来日医師たちは地域的な規模でしか影響を及ぼさなかった。第三部では、同時代のフランスにおける日本の鍼灸医学の受容過程について論じる。中国由来の東洋医学とは異なる歴史と体系を持つ西洋医学は、十六世紀にポルトガル人の渡来とともに日本に伝えられ、江戸時代には長崎に滞在したオランダ東インド会社の医師たちを通して導入された。そのオランダ人の医師の中では、テン・ライネ、エンゲルベルト・ケンペル、フォン・シーボルトが日本の医学、特に鍼灸医学について興味を持ち、日本人医師に教わった鍼灸医学の理論と技術をヨーロッパの医師たちに紹介した。五世紀における中国医学の伝来以来、日本は常に医学知識の受信国であったが、オランダの医師を媒介として日本が初めて医学知識の輸出国になった。しかしながら、西洋医学に見られない経絡・陰陽のようなヨーロッパ人には理解しがたい理論が多かったので、理論よりも日本独特の管針・打針などの技術が受け入れられた。特にヨーロッパの国々の中でもフランスの医師が日本の鍼灸医学について強い関心を示し、十九世紀初から十九世紀の半ばにかけては『鍼灸極秘伝』などの日本の針灸書がフランス語に翻訳されたり、パリの公的な病院でも鍼灸医学の研究が行なわれたり、日本の鍼灸医学は盛んであった。そこで、フランスで出版された鍼灸医学について書かれた医学書、および大学に提出された博士論文に見える日本鍼灸医学－その拒否感・肯定感・再評価について述べる。
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The illegal trade in endangered animals in KwaZulu-Natal, with an emphasis on rhino poachingGriffiths, Megan Laura 02 1900 (has links)
The illegal trade in endangered animals in KwaZulu-Natal, with an emphasis on rhino poaching, is tactically addressed in this dissertation. The aim is to expose the nature and extent of these crimes; the victims, offenders and modus operandi involved; the adjudication of wildlife offences; the causes and consequences concerned; the relevant criminological theories to explain these crimes; and recommendations for prevention. This research intends to examine the contemporary pandemic of rhino poaching in KwaZulu-Natal, South Africa, and offer potential techniques for intervention. Furthermore, one of the main goals of the study is to reveal and enhance the extremely neglected field of conservation criminology. A general disregard by society for the environment, as well as the overall ineffectiveness and corruption of criminal justice and conservation authorities, comes to the fore. The purpose of the research is therefore to suggest possible prevention strategies in order to protect the rights of endangered species. / Criminology and Security Science / M.A. (Criminology)
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The illegal trade in endangered animals in KwaZulu-Natal, with an emphasis on rhino poachingGriffiths, Megan Laura 02 1900 (has links)
The illegal trade in endangered animals in KwaZulu-Natal, with an emphasis on rhino poaching, is tactically addressed in this dissertation. The aim is to expose the nature and extent of these crimes; the victims, offenders and modus operandi involved; the adjudication of wildlife offences; the causes and consequences concerned; the relevant criminological theories to explain these crimes; and recommendations for prevention. This research intends to examine the contemporary pandemic of rhino poaching in KwaZulu-Natal, South Africa, and offer potential techniques for intervention. Furthermore, one of the main goals of the study is to reveal and enhance the extremely neglected field of conservation criminology. A general disregard by society for the environment, as well as the overall ineffectiveness and corruption of criminal justice and conservation authorities, comes to the fore. The purpose of the research is therefore to suggest possible prevention strategies in order to protect the rights of endangered species. / Criminology and Security Science / M.A. (Criminology)
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A Pedagogy of Holistic Media Literacy: Reflections on Culture Jamming as Transformative Learning and HealingStasko, Carly 14 December 2009 (has links)
This qualitative study uses narrative inquiry (Connelly & Clandinin, 1988, 1990, 2001) and self-study to investigate ways to further understand and facilitate the integration of holistic philosophies of education with media literacy pedagogies. As founder and director of the Youth Media Literacy Project and a self-titled Imagitator (one who agitates imagination), I have spent over 10 years teaching media literacy in various high schools, universities, and community centres across North America. This study will focus on my own personal practical knowledge (Connelly & Clandinin, 1982) as a culture jammer, educator and cancer survivor to illustrate my original vision of a ‘holistic media literacy pedagogy’. This research reflects on the emergence and impact of holistic media literacy in my personal and professional life and also draws from relevant interdisciplinary literature to challenge and synthesize current insights and theories of media literacy, holistic education and culture jamming.
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