自我管理在慢性阻塞性肺疾病患者中的应用研究进展

正慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)是危害人类健康的重要疾病。据世界卫生组织预计,到2020年COPD将成为全球世界疾病经济负担第5位~([1])。COPD作为全球公共卫生的重大问题,在我国也正成为国家和个人主要的疾病负担。目前,COPD的治疗手段仅仅是延缓疾病的进展,致使患者在长期患病过程中,心理、生理和社会等方面均受     

高等护理专业开展循证护理教育的实践与思考

由于人口增长、年龄老化、新技术和新药物的应用，及人类健康需求层次的提高，医疗费用以高于国民生产总值的速度增长，国家卫生总费用已超过了社会经济的承受能力；而高技术、高档设备、高价药品的层出不穷，更加剧了有限卫生资源与无限增长的卫生需求之间这一全球性的矛盾。如何在保证和提高医疗质量的前提下，     

精神疾病经济负担研究进展

疾病的经济负担是指由于疾病、失能和死亡给患者、家庭与社会带来的经济损失以及为了防治疾病而消耗的卫生资源,包括医疗保健的成本,社会、工作单位、雇主、家庭和个人支出的疾病成本,反映疾病给社会带来的负担.疾病经济负担主要为直接经济负担、间接经济负担和无形经济负担.即:(1)诊断治疗的直接费用;(2)间接费用或由于疾病造成的经济后果,如收入损失等;(3)与患者生命质量的降低或致残程度有关的无形费用.三者通常用货币来衡量.     

药品不良反应监测评估体系的临床研究现状

药品不良反应(adverse drug reaction,ADR)是指药品在正常用法用量下出现的有害的和意料之外的反应[1]。药品在治疗疾病的同时产生的不良反应,不仅损害健康,增加发病率与死亡率,而且也增加了很大的经济负担[2]。ADR监测的评估是指在     

高等护理专业开展循证护理教育的实践与思考

由于人口增长、年龄老化、新技术和新药物的应用 ,及人类健康需求层次的提高 ,医疗费用以高于国民生产总值的速度增长 ,国家卫生总费用已超过了社会经济的承受能力 ;而高技术、高档设备、高价药品的层出不穷 ,更加剧了有限卫生资源与无限增长的卫生需求之间这一全球性的矛盾。如何在保证和提高医疗质量的前提下 ,促进医务人员临床医疗决策的科学化 ,合理应用现有医学护理技术如药物、诊断和治疗及护理措施等 ,充分发挥有限卫生资源的效率 ,控制医疗费用上涨已迫在眉睫。而要形成医务人员良好的医疗实践行为 ,最有效的方法是从医学教育抓起。…     

空腹和餐后甘油三酯预测心血管疾病风险研究进展

心血管疾病(cardiovascular disease,CVD)是一个严重危害我国公民健康的重大公共健康问题[1]。CVD造成的社会经济负担逐步增加,于是采取有效措施降低CVD的发病风险变得至关重要,然而CVD风险不断增加的机制尚不明确。研究[2-3]认为CVD的主要危险因素包括高血压、高血糖、血脂异常、肥胖及吸烟饮酒等。当前CVD的标准治疗包括生活方式的干预和药物治疗,旨在降低低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、胆固醇和血压等,均不能使高危人群的CVD风险"正常化"[1]。近年来,甘     

朝阳市药品经营企业从业药师合理用药认知度现状调查

药品是一把双刃剑,药物用得合理,可以防治疾病;反之,不但不能治病,还会影响身体健康.轻则可增加病人痛苦、提高医疗费用,重则可能使病人致残甚至死亡.只有正确合理地使用药物,才能避免和减少这些情况的发生.不合理用药是当前比较突出的卫生问题之一,严重威胁人民群众生命安全和身体健康. 据有关调查显示,我国城乡居民用药知识普遍匮乏,用药行为不规范现象普遍存在.随着慢性病患病逐年增加,药品的可及性不断提高,居民自我用药比例逐步上升,导致用药安全问题日益凸显.通过对我市药品经营企业从业药师合理用药认知度现状问卷调查,进一步分析了解我市药品经营企业从业药师合理用药知识现状,明确今后宣传培训的方向.     

糖尿病的综合防治：中国2型糖尿病患者的血糖管理——聚焦国际糖尿病联盟2005年全球糖尿病治疗指南和2007年中国2型糖尿病防治指南

1 解读两大指南的必要性 2型糖尿病是严重威胁人类健康且在全球广泛流行的慢性代谢性疾病,其大、小血管并发症常引起患者失明、肾衰竭、截肢和心脑血管疾病等,可导致残废和早亡。目前糖尿病所致死亡率仅次于肿瘤、心脑血管疾病而居世界第3位。糖尿病同时还给社会、家庭以及患者个人带来沉重的经济负担。     

国内外健康管理的现状

随着经济飞速发展、人民生活水平的提高,必须正视老龄化社会的到来和国民健康水平严重下滑的现实.健康管理正是针对个人和人群的各种健康危险和健康保护因素提出的有效的保护措施.主要通过调动个人、集体、社会的积极性,有效地利用有限的物力资源,控制疾病促进健康,以达到最大的健康效果的目的.     

空气压缩雾化吸入法治疗慢性阻塞性肺疾病的护理

慢性阻塞性肺疾病(COPD)是一种以不完全可逆性气流受限为特征的疾病,主要表现为慢性咳嗽、多痰、气短、呼吸困难,并伴食欲下降、体重减轻等临床症状.COPD是一种反复发作的慢性疾病,严重影响病人的劳动能力和生活质量,已经成为影响公共健康的重大问题.研究表明,未来10年慢性阻塞性肺疾病将成为世界疾病经济负担的第五位.     

Social, economic, and political forces affecting the future of occupational health nursing

1. By monitoring the major social, economic, and political forces affecting health care, one can predict how these forces may impact the role of occupational health nurses. 2. Nursing can and must chart its own course in the midst of these social, economic, and political changes. 3. Changes which have major implications for occupational health nurses are: health care needs, cost containment, multi-hospital chains, alternative approaches to health care, the workplace, ethical concerns, biomedical technology, nursing shortage, and oversupply of physicians. 4. Nursing implications can also be drawn in the areas of autonomy, political skills, and education. Active involvement and a desire to shape professional change and the future of nursing are keys.     

Regulating medicines in Europe: the European Medicines Agency, marketing authorisation, transparency and pharmacovigilance

Following a review process lasting almost four years, and culminating in several pieces of new European legislation, adjustments have been made to the European Union's (EU) regulatory framework for pharmaceuticals. The European Commission laid out its priorities for the review as: simplifying the authorisation system, ensuring a high quality of public health, completing the internal market in medicines, and preparing for the enlargement of the Union. Amongst the most important changes brought about by the new rules are those relating to the European drug approval procedures, the functions and operational transparency of the European Medicines Agency (EMEA), and the EU's pharmacovigilance system. This article provides a brief examination of key elements of these changes, and considers the extent to which they serve the goal of improved public health protection within the EU.     

Economic realities associated with diabetes care: opportunities to expand delivery of physical therapist services to a vulnerable population

Each year, more Americans are newly diagnosed with type 2 diabetes mellitus. The costs for managing this disease are high, and the cascade of problems associated with poorly controlled diabetes is significant. At the same time, the number of uninsured or underinsured Americans is growing. This article describes current trends in health insurance availability and coverage for the growing number of people with diabetes and addresses the direct costs associated with treating this disease. The economic burden of health care for people with diabetes continues to escalate. Payers and employers are interested in decreasing their direct and indirect costs, improving profit margins, decreasing employee absenteeism, and increasing employee productivity. For physical therapists to recognize existing or new opportunities to participate in the management of this costly disease, it is critical that they understand how employees, payers, and employers are responding to the changing market forces affecting health insurance.     

2007～2008年我院妇科口服中成药应用分析

目的：分析妇科口服中成药的用药情况,为临床合理用药提供依据。方法：对我院2007～2008年妇科口服中成药用的种类、用量、销售金额、用药频度、日均费用等进行分析。结果：妇康丸、益母草胶囊、五加生化胶囊临床应用广泛,而宫血宁胶囊受同类西药品种的影响,其用药量呈大幅下降趋势,一些新进药品如大黄蛰虫片使用量呈快速上升趋势。结论：我院妇科口服中成药使用情况基本合理。     

Economical impact of plasma fractionation project in Iran on affordability of plasma-derived medicines

In Iran all transfusion services are concentrated under authority of one public and centralized transfusion organization which has created the opportunity of using plasma produced in its blood centers for fractionation. In 2008 voluntary and non remunerated Iranian donors donated 1.8 million units of blood. This indicates a 25/1000 donation index. After responding to the needs for fresh plasma and cryoprecipitate each year about 150000 L of recovered plasma are reserved for fractionation. In an attempt to improve both blood safety profile and availability and affordability of plasma derived medicines, Iran's national transfusion service has entered into a contract fractionation agreement for surplus of plasma produced from donated blood by voluntary non remunerated donors. In order to ensure safety of product produced, Iran has chosen to collaborate with international fractionators based in highly regulated countries. The main objective of this study was to evaluate the impact of contract plasma fractionation on the affordability of the plasma derived medicines in Iran. During 2006–2008, Iran's contract fractionation project was able to produce 46%, 18% and 6% of IVIG, Albumin and FVIII consumed in Iran's market, respectively. In contrary to IVIG and Albumin, due to fairly high consumption of FVIII in Iran, the role of fractionation project in meeting the needs to FVIII was not substantial. However, Iran's experience has shown that contract plasma fractionation, through direct and indirect effects on price of plasma derived medicines, could substantially improve availability and affordability of such products in national health care system.     

上市后药物经济学评价方法(Ⅰ)--建立经济学评价框架,评价经济学证据

药品是中国重要的卫生资源.尽管上市前药品研究已受到相当重视,但对上市后药品的实际问题关注较少.合理使用和分配上市后药品资源是中国的决策者面临的主要问题之一.经济学评价作为优化分配和使用药品的有效工具现已得到公认.本文介绍了上市后药物的经济学评价方法与原则.上市后药物的经济学评价根据证据的有效性和数量分为三种情况,并相应地采取不同的研究方法.但上市后药物经济学评价方法应采取标准路径.此外,本文还介绍了建立经济学评价框架和评价经济学证据的方法,特别是针对同类药物的评价方法.     

Witnessing social injustice downstream and advocating for health equity upstream: "the trombone slide" of nursing

Two aspects of a study examining the congruence of critical caring theory with public health nursing practice are reported. They confirm a congruence between expert public health nursing practice and the theory in terms of (a) a caring/social justice ethics that underpins practice and (b) the relevance to their practice of the carative health promoting process of contributing to the creation of supportive and sustainable physical, social, political, and economic environments. Public health nurse participants encountered many barriers to a practice underpinned by a caring/social justice ethic, some of which limited their moral agency.     

Orphan Medicines for Pediatric Use: A Focus on the European Union

PurposeEuropean policy makers have provided a number of incentives for the development of medicines for orphan diseases as early as 1999 through the Orphan Regulation and created obligations for medicines developers to investigate their products in children through the Paediatric Regulation adopted in 2006. This article describes the challenges that developers of orphan medicines are facing with pediatric indications, discusses the interplay between the Orphan Regulation and the Paediatric Regulation, and provides some recommendations on how to optimize drug development under the current European Union regulatory framework.MethodsThis article discusses the European Union's Orphan Regulation, Paediatric Regulation, and the implications of the intersection of the regulations on the development of orphan medicines for pediatric use.FindingsAlthough these regulations have been successful in meeting their objectives separately, different regulatory frameworks entail separate governance, multiple assessments, varying approaches and priorities to unmet medical needs, and joined-up regulatory process coordination. Better integration of regulatory pathways would therefore be helpful in stimulating more global drug development of pediatric orphan medicines, including optimizing the interaction between both regulations, using innovative drug development approaches while considering alternatives to randomized clinical trials, better identification and prioritization of unmet medical needs in pediatrics, and ensuring the alignment of regulatory processes.ImplicationsRare diseases are categorized as “orphan diseases” because their occurrence in a small number of patients means that, regardless of the apparent high unmet medical need, there is limited public and market interest to justify the high development risk and significant investment to develop new treatments. However, unexplored potential within the area, as well as a conducive regulatory environment, can further support the development of medicines to treat rare diseases, including for children.