An expert consultation system for frontline health workers in primary eye care

In developing countries, blindness is a major health problem whose control depends on the application of simple measures by frontline workers because, in many of these countries, specialist medical care is not readily available. To assist primary health workers in the management of common and potentially blinding eye disorders, we have developed a prototype computer program for a hand-held computer that incorporates a set of guidelines for diagnosis and treatment. This eye treatment program will help evaluate the potential of such devices for improving health care delivery in developing countries. This approach is now feasible because of recent advances in expert system and portable computer technology.     

A Data-Mining Framework for Transnational Healthcare System

Medical resources are important and necessary in health care. Recently, the development of methods for improving the efficiency of medical resource utilization is an emerging problem. Despite evidence supporting the use of order sets in hospitals, only a small number of health information systems have successfully equipped physicians with analysis of complex order sequences from clinical pathway and clinical guideline. This paper presents a data-mining framework for transnational healthcare system to find alternative practices, including transfusion, pre-admission tests, and evaluation of liver diseases. However, individual countries vary with respect to geographical location, living habits, and culture, so disease risks and treatment methods also vary across countries. To realize the difference, a service-oriented architecture and cloud-computing technology are applied to analyze these medical data. The validity of the proposed system is demonstrated in including Taiwan and Mongolia, to ensure the feasibility of our approach.     

Health economics and cost-effectiveness research with special reference to hemato-oncology

The cost of health care is increasing globally, especially in cancer. Health economics is an increasingly important field and medical professionals should have a working knowledge of the basis for health technology assessment such as cost-effectiveness analysis, cost utility analysis and cost benefit analysis. There are limited studies on health technology assessment regarding expensive therapies, primarily from high-income countries, but these cannot be applied to countries with different gross domestic product (GDP) and cost of health care delivery. There is a need to carry out health economics related research utilizing data from India. Whereas clinical trials establish the efficacy of new drugs in controlled environments, with strict inclusion and exclusion criteria, their transferability to the “real-world” situation is not always true. With the shifting of the global cancer burden to middle-income and lower middle-income countries, this field is going to assume greater importance in the future. Health economics research conducted in India may be of benefit to other countries with similar economies. The Armed Forces Medical Services of India, with a well-established system of assessing health outcomes, and robust system of accounting for expenses, can provide the lead for these studies.     

Health economics and cost-effectiveness research with special reference to hemato-oncology

The cost of health care is increasing globally, especially in cancer. Health economics is an increasingly important field and medical professionals should have a working knowledge of the basis for health technology assessment such as cost-effectiveness analysis, cost utility analysis and cost benefit analysis. There are limited studies on health technology assessment regarding expensive therapies, primarily from high-income countries, but these cannot be applied to countries with different gross domestic product (GDP) and cost of health care delivery. There is a need to carry out health economics related research utilizing data from India. Whereas clinical trials establish the efficacy of new drugs in controlled environments, with strict inclusion and exclusion criteria, their transferability to the “real-world” situation is not always true. With the shifting of the global cancer burden to middle-income and lower middle-income countries, this field is going to assume greater importance in the future. Health economics research conducted in India may be of benefit to other countries with similar economies. The Armed Forces Medical Services of India, with a well-established system of assessing health outcomes, and robust system of accounting for expenses, can provide the lead for these studies.     

纤维素三苯甲酯手性固定相的制备及对映体的拆分

医疗保险在许多国家被证明能够有效提升医疗服务质量。然而,如何控制医疗保险系统费用的增长仍是有待解决的问题。一些发达国家如英国、加拿大、瑞典将卫生技术评估结果与政府决策和医疗保险管理结合起来,使医疗费用得到控制同时卫生服务的质量得以提高。中国正在进行医疗改革开展新的医疗保险计划,借鉴别国的经验对医疗保险体系的发展和管理意义重大。     

Unknown poisoning amongst serving personnel

Background: Poisoning is recognized as an important health problem in many countries of the world. There is incomplete information on poisoning accidents, which is a major problem in developing countries.     

Some international comparisons of mortality amenable to medical intervention

A series of outcome indicators was proposed for assessing the curative aspects of health care using several diseases for which evidence suggested that death was largely avoidable provided that appropriate medical treatment could be given in time. International data were examined for those causes for which data were readily available. Time trends in mortality were compared for each of these conditions for six countries that had experienced appreciable growth in health services during 1950-80. Mortality from the heterogeneous "avoidable" causes had declined faster than mortality from all other causes in each of the six countries. Despite problems of diagnosis, reporting, and classification of diseases that may have existed among countries, making international comparisons of absolute mortality difficult, the trends of declining mortality were similar, lending credibility to the use of these causes of mortality as indices of health care within countries. Changes within countries may also have been attributable to changes in social, environmental, genetic, and diagnostic factors, which were not examined. Nevertheless, the consistency in mortality trends for this group of "amenable" diseases suggested that improvements in medical care were a factor in their rapid decline.     

Shifting visions: "delegation" policies and the building of a "rights-based" approach to maternal mortality

"Rights-based" approaches fold human rights principles into the ongoing work of health policy making and programming. The example of delegation of anesthesia provision for emergency obstetric care is used to demonstrate how a rights-based approach, applied to this problem in the context of high-mortality countries, requires decision makers to shift from an individual, ethics-based, clinical perspective to a structural, rights-based, public health perspective. This fluid and context-sensitive approach to human rights also applies at the international level, where the direction of overall maternal mortality reduction strategy is set. By contrasting family planning programs and maternal mortality programs, this commentary argues for choosing the human rights approach that speaks most effectively to the power dynamics underlying the particular health problem being addressed. In the case of maternal death in high-mortality countries, this means a strategic focus on the health care system itself.     

International migration of doctors from developing countries: need to follow the Commonwealth Code

There is an ongoing debate on the migration of doctors, especially psychiatrists, from developing countries. It is argued that these countries, which are already running short of psychiatrists, will further be jeopardized and their health systems will collapse if this migration and subsequent recruitment continue. In this paper the author presents a personal view of the ethics and human rights of this matter. He emphasises the importance of migration of doctors in view of the current situation in developing countries and advises that the Commonwealth Code be followed to address the problem of the shortage of psychiatrists in developing countries and psychiatrists' basic right to avail themselves of the opportunities in the developed world.     

Global directions for reforming health systems and expanding insurance. What is suitable for the Arab Gulf countries?

Most countries are exploring and implementing reforms of their health care systems. The Arab countries in the Gulf are no exception after establishing modern governmental health care systems accessible to all and free of charge. Current problems of the Arab systems include financial, managerial and quality issues. The private sector in these countries has no defined national role and is gowing abruptly and unplanned. The paper presents the major global health reform directions, analyzing the current activities in the Arab Gulf countries and proposing certain practical relevant approaches for health reform, and expansion of insurance in these activites.     

元数据在真实世界医疗环境下数据标准构建中的应用

目的：分析国内外健康大数据标准研究的热点与前沿,总结其共同点与差异。方法：以Web of Science 核心合集和中国知网2000-2018 年关于健康大数据标准 的文献题录为研究对象,采用 CiteSpace 5.1.R6 SE分析相关数据。结果：获取健康大数据标准研究外文题录15 150条,分析得出高频共现关键词40个,前沿突现术语48个;中文题录1 882条 ,分析得出高频共现关键词40个,前沿突现术语23个。结论：国内外健康大数据研究热点和趋势存在差异,在临床领域,国内以电子病历标准为主,国外以影像数据标准为主;在公共卫生领 域,国内研究主要以健康档案数据为主,国外研究范畴相对较广泛;元数据成为了近年来健康数据标准研究的热点,并可能持续成为未来健康数据标准研究的热点。     

Bridging the gap--health care for the homeless

In Australia and other countries concern exists about the extent of homelessness. Because we live in a period in which access to adequate shelter is an increasing problem for many persons, we report on the health needs of long-term homeless persons. Little attention was given to their health needs during the International Year of Shelter for the Homeless in 1987.     

The challenges in making electronic health records accessible to patients

It is becoming increasingly apparent that there is a tension between growing consumer demands for access to information and a healthcare system that may not be prepared to meet these demands. Designing an effective solution for this problem will require a thorough understanding of the barriers that now stand in the way of giving patients electronic access to their health data. This paper reviews the following challenges related to the sharing of electronic health records: cost and security concerns, problems in assigning responsibilities and rights among the various players, liability issues and tensions between flexible access to data and flexible access to physicians.     

Maternity rights, work, and health in France and Italy

This article focuses on the principles and the implementation of maternity rights (MR) in France and Italy. Results show that MR are well established in both countries, where about 80% of women employed during pregnancy were back to work 1 year after childbirth. Nevertheless, social inequalities were found. Less-educated women and those who had manual jobs or worked in small firms in the private sector or off-the-books were less likely to take an extended leave and to return to work. Despite differences in child care provisions, quality and accessibility of child care were common concerns for both French and Italian mothers. Employment was not related to any health problem in Italy 1 year after birth; in France, unemployed new mothers had high rates of psychological distress. Financial worries and marital problems were associated with several health problems in both countries. In conclusion, combining work and motherhood is possible in these 2 countries without too many costs for women, at least for the more privileged among them. However, this relative ease could vanish if social and economic conditions changed for the worse.     

Community violence in Jamaica: A public health issue for the health profession

Societal violence is a public health concern that confronts different countries. In this paper, the author examines the situation of community violence in Jamaica and discusses steps which could be taken by the health community to curb the pervasive and growing problem of community violence.     

The importance of "throwing money at" the problem of global health

More funding from wealthy countries is required to improve health care and the infectious disease situation in developing countries. Although progress has been made, funds for fighting AIDS, tuberculosis, and malaria remain inadequate. These treatable and preventable diseases together kill over 6 million people every year. Funds are needed to improve access to existing medicines as well as to increase research and development of drugs. The idea that "throwing money at the problem is not going to solve it" rightly holds that increased funding is not sufficient for solving the health care problems of developing countries. In order to work, funds must be spent wisely. This does not mean that increased funding is unnecessary.     

基因公义与罕见疾病之健康照护权利

健康照护目前受到许多国家的关注，自2000年开始，在台湾的保健制度中，增加了罕见疾病的支付。这个发展固然有其人道意义，但涉及医疗资源的公平分配问题，需要深入分析。在医疗照护资源分配的公义理论中，最全面和一贯，而又言之成理的莫过于丹尼尔斯（Norman Daniels）发挥罗尔斯（John Rawls）的公义理论而成的医疗照护公义论。有关医疗照护和基因干涉的公义问题，除了分析丹尼尔斯的论述外，将更进一步运用儒家的相关论述，作一响应，和申论这两方面的公义问题。可以有怎样的合理的构想。     

“一带一路”沿线南亚、东南亚国家寄生虫病流行状况的分析

“一带一路”沿线国家的八个南亚国家和十一个东南亚国家是寄生虫病的高发区。由于受地理位置、经济状况、文化背景、饮食习惯等诸多原因的影响,疟疾、利士曼原虫、刚地弓形虫、蓝氏贾第鞭毛虫、人芽囊原虫、溶组织内阿米巴、阴道毛滴虫、日本血吸虫、蛔虫、鞭虫、钩虫、粪类圆线虫、蛲虫、带绦虫和丝虫等多种人体寄生虫在该地区流行严重,是一个严峻的公共卫生问题。分析和认识“一带一路”沿线国家南亚和东南亚国家寄生虫病的流行状况,有的放矢地制定防控措施,对预防跨境传染病的发生、促进各国之间的密切合作及彻底消除寄生虫病有重要的意义。     

My biggest mistake：A lesson from a death

Neurocysticercosis is a major public health problem in manydeveloping countries in Asia and has a profound impact onproductivity,health,economy,and quality of life.It is endemicin Nepal and is the commonest parasitic infestation of the centralnervous system,caused by larvae of the tapewormTaeniasolium.Neurological manifestations vary from a simple chronicheadache to life threatening meningoencephalitis depending onthe location and number of the parasites in the brain.In August2000,I came fro…