中国医疗器械在拉丁美洲三国的进出口分析

拉丁美洲的市场,是中国医疗器械进出口很重要的市场。对中国诊断医疗产品在巴西,墨西哥和阿根廷市场的进出口分析会对中国产品进入这一市场提供理论和实践的参考依据。北美自由贸易协议和政府采购对墨西哥的市场影响很大。巴西和阿根廷的当地医疗器械制造商较弱,进入壁垒适中,中国产品有较大的竞争优势。     

中国医疗器械在拉丁美洲兰国的进出口分析

拉丁美洲的市场,是中国医疗器械进出口很重要的市场.对中国诊断医疗产品在巴西,墨西哥和阿根廷市场的进出口分析会对中国产品进入这一市场提供理论和实践的参考依据.北美自由贸易协议和政府采购对墨两哥的市场影响很大.巴西和阿根廷的当地医疗器械制造商较弱,进入壁垒适中,中国产品有较大的竞争优势.     

医院服务营销模式分析

为适应激烈的医疗市场竞争,我国的医院正在探索品牌营销的道路。借鉴营销学理论和国外的实践经验,我国的医疗服务营销要在分析营销环境和竞争优势的基础上,进行市场细分和目标市场选择,最后制定营销组合策略——产品服务项目、价格、销售渠道和营销方法。     

我国医疗机构的竞争优势和基本竞争战略

将竞争理论引入公共产品运营领域，分析我国医疗机构的2种竞争优势和3种基本竞争战略，旨在探讨竞争在我国医疗业的具体应用，帮助有志于提高经营效率的医疗机构具体应用竞争策略来更好地为患者服务，并取得行业的竞争优势.     

我国医疗器械产业国际竞争力分析

在对我国医疗器械产业的贸易竞争优势指数、Michaely指数及国际市场占有率等反映产业竞争力指标进行了计算与分析,进而对医疗器械产业技术水平、贸易方式进行分析,其结论是我国医疗器械产业在国际市场上竞争能力较差。本文提出新的竞争环境对产业的竞争能力提出新的要求,以自主创新的优势技术来提升我国医疗器械国际竞争能力是解决我国医病疗器械产业竞争力低的根本出路。     

巴西市场，机遇与风险并存（二）巴西INMETRO认证

有源医疗设备被巴西纳入在强制认证产品范围内，意味着该类产品都需要通过第三方机构OCP的认证，在获得INMETRO证书后才能进入巴西市场。本文介绍了INMETRO证书申请的流程以及所需资料。     

HACCP在单冻虾仁加工过程中的应用

随着我国加入WTO,美国、欧盟等提高了非贸易壁垒,并一度禁止中国水产品进入市场.为了拓展市场,增加贸易收入,提高产品质量,我市一些水产品出口企业,依据我国<水产品加工质量管理规范>,相继建立了各自企业各产品HACCP计划,来应对挑战,并取得了可喜的成绩.单冻虾仁作为主要出口水产品,其产品的质量将直接影响外贸和渔民的收入.为此,我们根据企业单冻虾仁HACCP计划,对生产各环节进行分析,进一步帮助完善该管理计划.     

中国医疗器械制造业国际竞争力实证研究

本文使用了贸易竞争指数、显示性比较优势指数、市场占有率指数、出口优势变差指数等指标,对中国的医疗器械制造业国际竞争力进行了实证分析。虽然我国医疗器械制造业产品贸易竞争力不强,而且具有较强出口竞争力的产品大部分都是劳动密集型的低附加值高能耗的中低端医疗器械产品,和西方发达国家还是存在相当明显的差距,但是我国医疗器械制造业在近些年还是取得了一定的发展和成绩的。也正是由于这些差距的存在,才激励着我国医疗器械制造业不断地进步和发展。     

医疗行业竞争特点、投资障碍和应对策略

本文从投资的角度分析了医疗行业的竞争特点，阐述了医疗行业已经形成的政策壁垒、资金壁垒及预期反击和尚未形成的成本壁垒或歧异壁垒。由此，提出了医疗机构可以采取的三种竞争战略：成本领先战略，标歧立异战略和目标集聚战略。     

加强医院财务管理的有效途径

医院的经济活动是以财务管理活动贯穿始终的，其经济效益主要通过药品、医疗技术的消费和其他经济活动反映出来，这些经济活动都需要通过财务管理来体现。医院财务管理得好，医院就能健康发展，否则就将处于竞争的劣势。目前，国有医院面临着机制更加灵活的民营医院引发的竞争，而且在我国已经加入WTO、行业壁垒逐渐消除的背景下，国际资本进入我国医疗行业的可能性日益变为现实。     

Aedes aegypti in Brazil: genetically differentiated populations with high susceptibility to dengue and yellow fever viruses

Aedes aegypti was eliminated from Brazil in 1955, but re-infested the country in the 1970s. Dengue outbreaks have occurred since 1981 and became endemic in several cities in Brazil after 1986. Urban yellow fever has not occurred since 1942, and only jungle yellow fever cases have been reported. A population genetic analysis using isoenzyme variation combined with an evaluation of susceptibility to both yellow fever and dengue 2 viruses was conducted among 23 A. aegypti samples from 13 Brazilian states. We demonstrated that experimental infection rates of A. aegypti for both dengue and yellow fever viruses (YFV) are high and heterogeneous, and samples collected in the endemic and transition areas of sylvatic yellow fever were highly susceptible to yellow fever virus. Boa Vista, a border city between Brazil and Venezuela, and Rio de Janeiro in the Southeast region are considered as the most important entry points for dengue dissemination. Considering the high densities of A. aegypti, and its high susceptibility to dengue and yellow fever viruses, the risk of dengue epidemics and yellow fever urbanization in Brazil is more real than ever.     

HIV Case Manager Preparedness for Practice in Ryan White CARE Act Funded Settings

While current research on the factors affecting the HIV epidemic within the general population has considered the role of HIV case managers, much remains to be known about case management effectiveness and how it might be enhanced. This article presents the data from a statewide survey of case management professionals in Florida. The study focused on case managers' preparation for practice and barriers to successful practice. The study results reflect a very broad educational preparation in multiple disciplines with highly varied means of case manager training and orientation at entry to practice. Further, the results highlighted the existence of multiple barriers that challenge the ability of case managers to cope with the demands of case management practice in sites serving people living with HIV/AIDS who are socially and economically challenged. The article concludes with recommendations for changes in the system that would enhance the preparation of case management professionals for entry to practice.     

Balanced centralized and distributed database design in a clinical research environment

Clinical research databases can meet both research and clinical needs, but this ideal is seldom achieved. Priorities often differ for those who collect and ultimately use the data and those who develop data systems. Traditional database designs also create logistical barriers that hamper communication. The Michigan Alzheimer's Disease Research Center has developed a secure, distributed data system with centralized data entry that provides an intuitive, individually customized interface for investigators in their clinics, laboratories and offices. Data are kept in a form that can be readily understood without reference to a code-book. Investigators can modify and query their own copies of the database without knowledge of programming languages. Balancing centralized and distributed designs for research databases enhance the accuracy and completeness of data collection and increases the use of data for research and clinical care.     

Health systems barriers to effective use of infectious disease surveillance data in the context of decentralization in Georgia: a qualitative study

OBJECTIVES: In Georgia, a country where there has been extensive decentralization of public health responsibilities, an intervention was recently piloted to strengthen district-level vaccine-preventable disease (VPD) surveillance and response activities. The purpose of this qualitative research study is to provide an in-depth assessment of the perceived value and need for the analysis and use of VPD surveillance data at various levels of the infectious disease surveillance and response (IDSR) system in Georgia. METHODS: Focus groups were conducted with individuals working at different levels of the IDSR system in intervention districts in order to obtain qualitative data to better understand the process of surveillance and barriers to data availability, analysis, and response. RESULTS: The results of the study suggest that in Georgia, health care system has many barriers to effective analysis and use of VPD surveillance data for decision-making at local level. Extensive decentralization that took place in Georgia may have adversely affected the IDSR system. CONCLUSION: In resource poor countries, decentralization can leave districts with insufficient resources, which may seriously affect the ability to carry out IDSR. In Georgia, this seems to be related to inadequate financing of IDSR with major gaps observed at the local level.     

Reducing barriers to physician data entry for computer-based patient records

Physician data entry and use of clinical workstations is one barrier to computer-based patient records (CPRs). Often, clinicians do not understand the potential benefits of CPRs. For the benefits to be realized, however, clinical personnel must use the workstations for both data entry and retrieval. The article reviews recent experience with physicians' direct data entry. It summarizes benefits that clinicians have realized from such systems and also disincentives to their use. It concludes by discussing implementation strategies for enhancing the benefits and reducing the barriers.     

The epidemic wave of influenza A (H1N1) in Brazil, 2009

This study describes the main features of pandemic influenza A (H1N1) in Brazil during 2009. Brazil is a large country that extends roughly from latitudes 5oN to 34oS. Brazil has tropical and sub-tropical climates, a heterogeneous population distribution, and intense urbanization in the southern portions of the country and along its Atlantic coast. Our analysis points to a wide variation in infection rates throughout the country, and includes both latitudinal effects and strong variations in detection rates. Two states (out of a total of 23) were responsible for 73% of all cases reported. Real time reproduction numbers demonstrate that influenza transmission was sustained in the country, beginning in May of 2009. Finally, this study discusses the challenges in understanding the infection dynamics of influenza and the adequacy of Brazil's influenza monitoring system.     

Student views of research training programmes in medical schools

Medical Education 2011: 45 : 748–755 Context Research activity is not a mandatory component of medical education in many developing countries, including Brazil, although such experiences can have a positive impact on the quality of medical education. The interest and involvement of medical students in research and the barriers they face in accessing research training in developing countries have not been adequately addressed. Objectives We sought to assess the availability of scientific training programmes in Brazilian medical schools, the degree of involvement of medical students in these programmes, the main barriers to student involvement in research and possible reasons for the lack of scientific training programmes. Methods This study examined 13 medical programmes conducted in six Brazilian states. A total of 1004 medical students were interviewed. We evaluated the availability of scientific training in the institutions attended by these students, the participation of the students in such activities and students’ reasons for not joining such programmes based on student answers to our questionnaire. Results Although only 7% of the medical students expressed no interest in research, only 60% of them were involved in research training. Students regarded a lack of institutional incentive as the most significant barrier to their participation in research activities. Other significant barriers included defective infrastructure and insufficient time available for professors to mentor undergraduate students. According to the feedback from the students, eight of the 13 schools investigated featured structured programmes for scientific training. However, a mean of only 47% of students participated in scientific training programmes on their campuses and 13% of students were compelled to pursue such activities off‐campus. Conclusions Although scientific training during medical education in Brazil is still less frequent than expected, most of the students were interested in research activities. The barriers to undergraduate scientific training described in this paper may help the Brazilian government improve research training in medical schools. These issues might also be explored in other developing countries.     

Campylobacter coli isolated in Brazil typed by core genome Multilocus Sequence Typing shows high genomic diversity in a global context

Campylobacter has been one of the most common causative agent of bacterial food-borne gastroenteritis in humans worldwide. However, in Brazil the campylobacteriosis has been a neglected disease and there is insufficient data to estimate the incidence of this pathogen in the country.AimsThe current study aimed to determine the phylogenetic relationships among Campylobacter coli strains isolated in Brazil and to compare them with international Campylobacter isolates available in some public databases.Methods and resultsA total of 63C. coli strains isolated in Brazil were studied. The MLST analysis showed 18 different STs including three STs not yet described in the PubMLST database. The cgMLST allocated the Brazilian strains studied into five main clusters and each cluster comprised groups of strains with nearly identical cgMLST profiles and with significant genetic distance observed among the distinct clusters. The comparison of the Brazilian strains with 3401 isolates from different countries showed a wide distribution of these strains isolated in this country.ConclusionsThe results showed a high similarity among some strains studied and a wide distribution of the Brazilian strains when compared to isolates from different countries, which is an interesting data set since it showed a high genetic diversity of these strains from Brazil in a global context. This study contributed for a better genomic characterization of C. coli strains isolated in Brazil and provided important information about the diversity of this clinically-relevant pathogen.