Traditional Chinese medicine research in the post-genomic era: good practice, priorities, challenges and opportunities

Background and aims: GP-TCM is the 1st EU-funded Coordination Action consortium dedicated to traditional Chinese medicine (TCM) research. This paper aims to summarise the objectives, structure and activities of the consortium and introduces the position of the consortium regarding good practice, priorities, challenges and opportunities in TCM research. Serving as the introductory paper for the GPTCM Journal of Ethnopharmacology special issue, this paper describes the roadmap of this special issue and reports how the main outputs of the ten GP-TCM work packages are integrated, and have led to consortium-wide conclusions. Materials and methods: Literature studies, opinion polls and discussions among consortium members and stakeholders. Results: By January 2012, through 3 years of team building, the GP-TCM consortium had grown into a large collaborative network involving ∼200 scientists from 24 countries and 107 institutions. Consortium members had worked closely to address good practice issues related to various aspects of Chinese herbal medicine (CHM) and acupuncture research, the focus of this Journal of Ethnopharmacology special issue, leading to state-of-the-art reports, guidelines and consensus on the application of omics technologies in TCM research. In addition, through an online survey open to GP-TCM members and non-members, we polled opinions on grand priorities, challenges and opportunities in TCM research. Based on the poll, although consortium members and non-members had diverse opinions on the major challenges in the field, both groups agreed that high-quality efficacy/effectiveness and mechanistic studies are grand priorities and that the TCM legacy in general and its management of chronic diseases in particular represent grand opportunities. Consortium members cast their votes of confidence in omics and systems biology approaches to TCM research and believed that quality and pharmacovigilance of TCM products are not only grand priorities, but also grand challenges. Non-members, however, gave priority to integrative medicine, concerned on the impact of regulation of TCM practitioners and emphasised intersectoral collaborations in funding TCM research, especially clinical trials. Conclusions: The GP-TCM consortium made great efforts to address some fundamental issues in TCM research, including developing guidelines, as well as identifying priorities, challenges and opportunities. These consortium guidelines and consensus will need dissemination, validation and further development through continued interregional, interdisciplinary and intersectoral collaborations. To promote this, a new consortium, known as the GP-TCM Research Association, is being established to succeed the 3-year fixed term FP7 GP-TCM consortium and will be officially launched at the Final GP-TCM Congress in Leiden, the Netherlands, in April 2012.

Care homes’ use of medicines study: prevalence, causes and potential harm of medication errors in care homes for older people

Introduction: Care home residents are at particular risk from medication errors, and our objective was to determine the prevalence and potential harm of prescribing, monitoring, dispensing and administration errors in UK care homes, and to identify their causes. Methods: A prospective study of a random sample of residents within a purposive sample of homes in three areas. Errors were identified by patient interview, note review, observation of practice and examination of dispensed items. Causes were understood by observation and from theoretically framed interviews with home staff, doctors and pharmacists. Potential harm from errors was assessed by expert judgement. Results: The 256 residents recruited in 55 homes were taking a mean of 8.0 medicines. One hundred and seventy-eight (69.5%) of residents had one or more errors. The mean number per resident was 1.9 errors. The mean potential harm from prescribing, monitoring, administration and dispensing errors was 2.6, 3.7, 2.1 and 2.0 (0 = no harm, 10 = death), respectively. Contributing factors from the 89 interviews included doctors who were not accessible, did not know the residents and lacked information in homes when prescribing; home staff’s high workload, lack of medicines training and drug round interruptions; lack of team work among home, practice and pharmacy; inefficient ordering systems; inaccurate medicine records and prevalence of verbal communication; and difficult to fill (and check) medication administration systems. Conclusions: That two thirds of residents were exposed to one or more medication errors is of concern. The will to improve exists, but there is a lack of overall responsibility. Action is required from all concerned.

Modeling camera orientation and 3D structure from a sequence of images taken by a perambulating commercial video camera

In this paper we report the degree of reliability of image sequences taken by off-the-shelf TV cameras for modeling camera rotation and reconstructing 3D structure using computer vision techniques. This is done in spite of the fact that computer vision systems usually use imaging devices that are specifically designed for the human vision. Our scenario consists of a static scene and a mobile camera moving through the scene. The scene is any long axial building dominated by features along the three principal orientations and with at least one wall containing prominent repetitive planar features such as doors, windows bricks etc. The camera is an ordinary commercial camcorder moving along the axial axis of the scene and is allowed to rotate freely within the range +/- 10 degrees in all directions. This makes it possible that the camera be held by a walking unprofessional cameraman with normal gait, or to be mounted on a mobile robot. The system has been tested successfully on sequence of images of a variety of structured, but fairly cluttered scenes taken by different walking cameramen. The potential application areas of the system include medicine, robotics and photogrammetry.

Enterprise pedagogy in music: an exploration of multiple pedagogies

This article investigates the nature of enterprise pedagogy in music. It presents the results of a research project that applied the practices of enterprise learning developed in the post-compulsory music curriculum in England to the teaching of the National Curriculum for music for 11-to-14-year-olds. In doing so, the article explores the nature of enterprise learning and the nature of pedagogy, in order to consider whether enterprise pedagogy offers an effective way to teach the National Curriculum. Enterprise pedagogy was found to have a positive effect on the motivation of students and on the potential to match learning to the needs of students of different abilities. Crucially, it was found that, to be effective, not only did the teacher’s practice need to be congruent with the beliefs and theories on which it rests, but that the students also needed to share in these underlying assumptions through their learning. The study has implications for the way in which teachers work multiple pedagogies in the process of developing their pedagogical identity.

Beyond a constructivist curriculum : a critique of competing paradigms in music education

The distinction between learning to perform on an instrument or voice and learning music in a wider sense is one that is made in many countries, and is especially pertinent in England in the context of recent policy developments. This article argues that, whilst this distinction has come to represent curricula based on the opposing paradigms of behaviourist and constructivist approaches to learning, this opposition does not necessarily extend to the pedagogy through which the curricula are taught. A case study of the National Curriculum in England highlights the characteristics of a curriculum based on constructivist principles, along with the impact this has when taught in a behaviourist way. It is argued that conceiving the curriculum in terms of musical competencies and pedagogy in terms of musical understanding would provide a basis for greater continuity and higher quality in the music education experienced by young people.

Children’s physic: medical perceptions and treatment of sick children in early modern England, c. 1580-1720

Historians of medicine, childhood, and paediatrics, have often assumed that early modern doctors neither treated children, nor adapted their medicines to suit the peculiar temperaments of the young. Through an examination of medical textbooks and doctors’ casebooks, this article refutes these assumptions. It argues that medical authors and practising doctors regularly treated children, and were careful to tailor their remedies to complement the distinctive constitutions of children. Thus, this article proposes that a concept of ‘children’s physic’ existed in early modern England: this term refers to the notion that children were physiologically distinct, requiring special medical care. Children’s physic was rooted in the ancient traditions of Hippocratic and Galenic medicine: it was the child’s humoral makeup that underpinned all medical ideas about children’s bodies, minds, diseases, and treatments. Children abounded in the humour blood, which made them humid and weak, and in need of medicines of a particularly gentle nature.