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Objective:To analyse China′s Traditional Chinese Medicine(TCM) health service policy from the perspective of policy life cycle, so as to provide reference for improving the policy system of TCM health service.Methods:The official websites of national government agencies were searched for policy documents on TCM health service from 2012 to 2022, using the keywords of " Chinese medicine" " Traditional Chinese Medicine" and " health service", and policy text entries were extracted and coded. A two-dimensional analytical framework of policy tools(supply, demand, and environment) and policy life cycle(agenda setting, policy formulation, policy implementation, and policy evaluation) was constructed to quantitatively analyze the policy texts.Results:A total of 58 policy documents were included, containing 2 898 text entries. The distribution of policy instruments was uneven, with a high percentage of entries using supply-based instruments(40.57%, 1 176 entries), followed by environmental instruments(38.86%, 1 126 entries) and demand-based instruments(20.57%, 596 entries). From the perspective of policy cycle, the policy tools were mainly concentrated in the stages of policy formulation(53.77%, 1 558 entries) and policy implementation(36.86%, 1 068 entries), while the policy tools in the stages of agenda setting(4.97%, 144 entries) and policy evaluation(4.40%, 128 entries) needed to be strengthened.Conclusions:In recent years, the distribution of policy tools in China′s TCM health service policy was uneven, and the articulation of the stages in the policy life cycle needed to be strengthened.
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Literature search can be defined as systematic review of all scientific resources, both published and unpublished. Literature search is continuous process. It provides new ideas of research. It helps us to frame new research questions and to identify the knowledge gap. There are no straightforward rules for literature search. Each researcher has its own m ethod of literature search. In this review article we shall discuss about various types and sources of literature, steps and techniques of literature search which will serve as a quick guide for budding research scholars.
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@#Literature search is a systematic and well-organized search from published data to identify good quality references on a specific topic. The search can be a simple involving just a couple of sources and done within an hour or so. It can also be comprehensive and thorough where it involves multiple sources. However, in EBFP main purpose of a literature search is to obtain only a few available but relevant and high-quality evidence that can help the family practitioner make a clinical decision. The first step in making evidence-based decision is to convert the clinical problem for decision-making into a clinical question. It should be phrased in a simple sentence that is relevant and specific to the clinical problem, interesting enough to warrant searching for the answer and will likely obtain the article to answer the question. Based on the formulated clinical question discussed previously, identifying the key terms to be used for the search is the next step. The key terms are usually based on the PICO or its variants, POEM, SPICE or ECLIPSE elements in the clinical question. Since it will only be a simple search in EBFP, it is recommended to look in PubMed. PubMed is the online version of Index Medicus produced by the US National Library of Medicine (NLM). If the article is not available in PubMed, Google Scholar is another free web search engine that indexes the full text of scholarly literature across an array of publication formats and disciplines. Other advice for an efficient literature search is also discussed.
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PubMedABSTRACT
Introduction: During their clinical clerkship (CC), Japanese medical students’ literature searching skills were ambiguous. We conducted a questionnaire survey on students’ search processes to determine whether this skill improved after a lecture on conducting searches. Method: This study was conducted from May to December 2019. The questionnaire survey was followed by a 90-minute lecture combining information and relevant activities. The questionnaire included students’ self-evaluation of their literature searching abilities, and references from their medical summaries and reports were compared to those of students from a 2018 group who did not attend the lecture. Results: Sixty-seven students participated in the questionnaire survey and lecture. Questionnaire results demonstrated that the most frequently used search tool was PubMed. Regularly used types of literature were Japanese textbooks medical guidelines issued by the Japanese Medical Society, and English-language medical journal articles. The two major difficulties in conducting searches were the inability to critically appraise the literature and inadequate English reading skills. The students’ satisfaction level regarding the lecture was found to be acceptable. After attending the lecture, students’ self-evaluation of their literature searching abilities improved significantly. Furthermore, compared to the 2018 group, references in students’ summaries and reports increased. Additionally, the number of English-language medical journal articles cited in reports was higher among students in the 2019 group than the 2018 group. Conclusions: Although CC students can conduct literature searches, they struggle with critical appraisal and English-language comprehension. Interventions such as lectures may effectively improve their searching skills during CC.
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Prostate cancer is the second most common cancer in men worldwide. There are many occupational factors that have been suggested to cause prostate cancer. Our aim was to evaluate the evidence for causality by a literature review of occupational factors. We searched literature in Medline and SCOPUS from 1966 to June 30, 2015 to identify occupational risk factors for prostate cancer. The following risk factors were selected: farmers/agricultural workers, pesticides – whole group, and separately organophosphate and organochlorine pesticides, carbamates and triazines, cadmium, chromium, cutting fluids, acrylonitrile, rubber manufacturing, whole body vibration, shift work, flight personnel, ionizing radiation, and occupational physical activity. For each factor a literature search was performed and presented as meta-analysis of relative risk and heterogeneity (Q and I² index). A total of 168 original studies met the inclusion criteria with 90,688 prostate cancer cases. Significantly increased risks were observed for the following occupational exposures: pesticides (metaRR = 1.15, 95% confidence interval [CI] = 1.01–1.32; I² = 84%), and specifically group of organochlorine pesticides (meta relative risk [metaRR] = 1.08, 95% CI = 1.03–1.14; I² = 0%), chromium (metaRR = 1.19, 95% CI = 1.07–1.34; I² = 31%), shift work (metaRR = 1.25, 95% CI = 1.05–1.49; I² = 78%) and pilots (metaRR = 1.41, 95% CI = 1.02–1.94; I² = 63%) and occupational physical activity in cohort studies (metaRR = 0.87, 95% CI = 0.81–0.94; I² = 0%). The literature review supports a causal association for a few of the previously suggested factors.
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Humans , Male , Acrylonitrile , Cadmium , Carbamates , Chromium , Cohort Studies , Epidemiologic Studies , Motor Activity , Occupational Exposure , Pesticides , Population Characteristics , Prostate , Prostatic Neoplasms , Radiation, Ionizing , Risk Factors , Rubber , Triazines , VibrationABSTRACT
Systematic search of literature is an important skill for researchers to help achieve a comprehensive understanding of the topic of interest. Likewise, clinicians need this skill for them to be updated on the recent evidence in providing relevant health care interventions to their patients. However, many health professionals and health science students rely on the use of limited search engines and few databases without systematically performing search and retrieval of relevant studies. This practice commonly yields inadequate references for a research project or clinical decision-making resulting to an incomplete understanding of the topic at hand. This paper aims to provide an introductory guide for researchers as well as clinicians on the step-by-step process of systematic literature search. It also provides information on the available open-access directories and databases as additional or alternative sources of evidence especially in low-resource institutions. However, careful guidelines must be considered in using open-access sources to maintain the quality of research projects and clinical decisions.
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DatabaseABSTRACT
@#Systematic search of literature is an important skill for researchers to help achieve a comprehensive understanding of the topic of interest. Likewise, clinicians need this skill for them to be updated on the recent evidence in providing relevant health care interventions to their patients. However, many health professionals and health science students rely on the use of limited search engines and few databases without systematically performing search and retrieval of relevant studies. This practice commonly yields inadequate references for a research project or clinical decision-making resulting to an incomplete understanding of the topic at hand. This paper aims to provide an introductory guide for researchers as well as clinicians on the stepby-step process of systematic literature search. It also provides information on the available open-access directories and databases as additional or alternative sources of evidence especially in lowresource institutions. However, careful guidelines must be considered in using open-access sources to maintain the quality of research projects and clinical decisions.
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In The 63rd Annual Congress of JSAM (Ehime 2014), the Committee for Safe Acupuncture of Research Department in the Japan Society of Acupuncture and Moxibustion (JSAM) conducted a workshop entitled "The Regional Anatomy Q&A for safety needling"which provided information on organ damage and neurological injuries that may occur after acupuncture treatments. This workshop stated the need for improvements in safe practices of acupuncture.<BR>This workshop was divided into three parts:(1) results of questionnaire surveys conducted in Japan for acupuncturists on their clinical experience of adverse events and for orthopaedic doctors on their clinical experience of patients who suffered adverse events after acupuncture treatment;(2) a literature search of severe adverse events e.g., pneumothorax and neurological injuries, associated with acupuncture treatment in Japan;(3) the regional anatomy of the upper part of the body, which is based on several anatomical studies on acupoints. <BR>The incidence of severe adverse events is considered to be very low during all acupuncture treatments;however, the real incidence is estimated to be higher than the number of case reports in the literature. In order to prevent severe adverse events, regional anatomical knowledge of needling points is very important, and furthermore, safe needling techniques are required. <BR>We hope that this workshop can aid in enhancing the knowledge and techniques and contribute to safe practices of acupuncture.
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Systematic review had become one of the important research area in medicine. Systematic review can be demonstrating benefit or harm of an intervention when results of individual studies are inconclusive. While narrative reviews can often include an element of selection bias, systematic reviews typically involve a comprehensive plan and search strategy with the goal of reducing bias by identifying, appraising, and synthesizing all relevant studies on a particular topic and investigation of heterogeneity among included studies. Systematic reviews typically include a meta-analysis component which involves using statistical techniques to synthesize the data from several studies into a single quantitative estimate or summary effect size. Systematic review overcomes the limitation of small sample sizes by pooling results from a number of individual studies to generate a single best estimate. Although systematic reviews are published in academic forums, the Cochrane Collaboration is a widely recognized international and not-for-profit organization that promotes, supports, and disseminates systematic reviews and meta-analyses on the efficacy of interventions in the health care field. Systematic review has become a popular and powerful tool. If rigorously conducted, it is essential for evidence-based decision making in clinical practice as well as on the health policy level.
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Bias , Cooperative Behavior , Decision Making , Delivery of Health Care , Evidence-Based Medicine , Health Policy , Meta-Analysis as Topic , Population Characteristics , Publication Bias , Sample Size , Selection BiasABSTRACT
Utilization and satisfactiontheory in diffusion science and the advantages of using micro-blog in study were described .Autilization and satisfactionmodel of micro-blog used in study by medical undergraduates born after 1990s was established with measures proposed for improving their study ability using micro-blog.
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[Objective]To analyze and understand cases of adverse effects of acupuncture and moxibustion published in medical journals between 2007 and 2011.<BR>[Methodology]We searched relevant articles with the Web of Japan Medical Abstracts Society and PubMed. We used keywords for acupuncture, moxibustion and related adverse events.<BR>[Results]We located 39 papers reporting 39 cases that occurred in Japan:infection (7 cases), organ injury (11), foreign body or needle breakage (8), neurological damage (6), cutaneous disease (1), adverse effects of moxibustion (4), and others (2). As for cases published in foreign countries, we located 60 relevant papers:infection (19 cases including 2 outbreaks), organ injury (13), foreign body or needle breakage (5), neurological damage (9), cutaneous disease (5), adverse effects of moxibustion (2), and others (7).<BR>[Conclusion]Although causal relationship has not been established in some cases, occurrences of infection, organ injury, and needle breakage/foreign body are still as high as they were before. This suggests that continual feedback to acupuncturists of information on safety is necessary.
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Meta-analysis is an objective, systematic review that employs statistical methods to combine and summarize the results of several studies. It is a quantitative synthesis of all the unbiased evidence, meant for summarizing large volume of data, establishing and determining the magnitude of an effect, and to increase power and precision of studies. The steps to performing a meta-analysis include making a hypothesis and defining the domain of research, defining inclusion/exclusion criteria, literature search, selecting the final set of studies, extracting data on variables of interest, coding procedures, calculating effect sizes and interpretations, selecting potential moderators and examine their relationships, report writing, and critical evaluation. Meta-analysis has several strengths as well as weaknesses.
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The Research Committee for the Meridian Point held its third workshop at the 57th Annual Meeting of the Japan Society Acupuncture and Moxibustion in Kyoto. Evaluations and reports were presented on two topics.<BR><BR>The first topic:Study of PSC in Japan and China.<BR> 1) Literature search on PSC in China (Wang):A literature search on major studies on PSC in China since 1979 was conducted. The report introduces the definition, characteristics and the mechanism of PSC development together with meridian phenomena.<BR><BR> 2) PSC in reference to the ryodoraku (Morikawa):Development of the reactive ryodo point in patients under hemodialysis or those who have had a total gastrectomy and the cases in which reactive ryodo points or needle sensation developed when specific regions were stimulated were reported. The relationship between reactive ryodo points and PSC was examined. <BR><BR> 3) The mechanism by which PSC develops (Yamada):Neurotransmitter substances are released from sensory nerve endings during acupuncture stimulation. Absorbed by lymphatic vessels, these substances stimulate the smooth muscle of these vessels, thus causing the PSC. Based on factors such as transmission velocity and inhibitory factors, the mechanism by which PSC develops was investigated.<BR><BR>The second topic:Specific locations of meridian points and clinical effects of the meridian point.<BR> 1) Anatomical regions for GB 30 huantiao (Ozaki and Matsuoka):In establishing the international standard for the meridian points under the guidance of WHO, both Chinese and Japanese proposals were listed for GB 30. The clinical effects-presumably emanating from the subcutaneous structure when acupuncture stimuli are applied to these points in a direction perpendicular to the body surface-were comparatively evaluated. <BR><BR> 2) Transition in the regions and main effects of GB 30 (Sakaguchi):As stated above, both Japanese and Chinese definitions were cited in establishing the international standard for GB 30 under the guidance of WHO. By quoting the classic literature from China and Japan, changes in the regions and main effects of GB 30 were comparatively evaluated.
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In this review article, the author illustrates the advanced searches for “Malaysian” health and life sciences publications. Examples of searching are made on PubMed, Google Scholar and Scopus. The strengths and weaknesses of these services are compared.
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The very first session of the symposium on ‘cancer and acupuncture’ was held at the 53<sup>rd</sup> Annual Conference of the Japan Society of Acupuncture and Moxibustion (JSAM). It suggested the efficacy and potential of acupuncture and moxibustion not only for cancer but also for cancer patients. This is the second session for further discussion. In recent years, acupuncture and moxibustion treatment for cancer patients has come to the world's attention, and many reports about its expediency and beneficial effect have been conducted in Japan and in the world. However, the adaptation range of acupuncture and moxibustion treatment for cancer is still limited because there is not enough evidence, so compilations of more sufficient case reports or research for presentation and effects in preventing relapse of cancer are required to prove its reliability. Acupuncture and moxibustion are used as one of the medical treatments directed at relieving symptoms and life-sustaining treatment in hospitals today. Earlier, frequent acupuncture treatment led to significant efficacy for cancer patients, and it is also reported that the number of lymphocytes increases in sequential acupuncture treatment but the number tends to return in a short time after cessation of treatment. Sequential autonomic immune therapy over a long term revealed several significant effects as follows; lymphocyte activation while the lymphocyte count remained, increase of cytokine (IL 12, IFNγ, TNFα, etc.) production and Th 1, Th 1/Th 2, immunostimulatory activity effect, reduction of tumor markers down to or close to normal, reduction or resolve of malignant neoplasm and recurrence prevention for unoperated cancer patients, QOL improvement with symptoms relief and life prolongation. In this seminar, it suggested that acupuncture and moxibustion are potential and appropriate treatments for cancer and further research in this field is required.
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We reviewed case reports of bilateral pneumothorax after acupuncture treatment from the point of view of clinical acupuncture. A paper showing pathological findings based on autopsy suggests that, in more cases than we had expected, acupuncture needles penetrate the lung or the pleura. We speculate a portion of these cases develop into pneumothorax and a few of these become serious. By means of literature search, we have found that 23 cases of bilateral pneumothorax after acupuncture have been published in Japan and other countries. We must learn from these case reports. Further, we should reassess the contents of clinical acupuncture education and introduce the concept of failsafe treatment.
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In Japan, a government-funded project to develop evidence-based guidelines for the treatment of rheumatoid arthritis started in 1999. Methodologists, including epidemiologists and medical librarians, were asked to participate in this project. Working as a team, the rheumatologists, clinical epidemiologists, and medical librarians reviewed the published evidence systematically. The process and the results, particularly systematic search and review of literature, were assessed from the viewpoint of epidemiology and evidence-based medicine (EBM) . The librarians, supervised by the clinical epidemiologists, searched the literature according to 30 key questions defined by the rheumatologists and classified the articles according to the“level of evidence”. Finally, 379 articles were selected (drug therapy, 207; surgical treatment, 108; rehabilitation/devices, 64) . Meta-analyses and randomized controlled trials accounted for more than 80% of the drug treatment and rehabilitation/device reports, while nearly 70% of the articles retrieved regarding surgical treatment were case series without relevant control groups. The rheumatologists wrote structured abstracts for each article so that they could be used as reference for developing practice guidelines. The literature search, individual original articles, and the PubMed system were examined from the viewpoint of research methodology; the lessons learned were described.<BR>In conclusions, clinical epidemiologists and medical librarians have contributed to developing evidence-based practice guidelines. Clinical epidemiologists were able to work as a coordinator between clinicians and medical librarians. The popularity of EBM requires that expertise in this field be strengthened and made available to a broader audience.