论《消费者权益保护法》在解决医患纠纷中的法律适用

在实践中，医患关系已具备了消费关系的形式特征，把医疗、预防、保健、康复等行为纳入公民消费范围是未来趋势，这将更有利于保护公民的合法权益。     

Personal relationships with an intelligent interactive telephone health behavior advisor system: a multimethod study using surveys and ethnographic interviews

The burgeoning of consumer health informatics and virtual health care can help people improve their health. However, little is known about individuals' reactions to such systems. We conducted an evaluation of the telephone-linked care (TLC) system, a computer-based telecommunications system, that functions as an at home monitor, educator, and counselor for patients with chronic health conditions. Our multimethod assessment of individuals' reactions to using TLC included both quantitative and qualitative methods. Ethnographic in-depth open-ended interviews indicated more subtle and surprising reactions to TLC than the overall positive responses from surveys: individuals formed personal relationships with this technology. This relationship formation suggests that TLC designers may have been successful in their attempts to emulate a conversation with a human being. Our study adds to evidence that technology can serve as a projective device for peoples' values and psychological issues. Both designers and users project values and goals onto computer-based technologies and take on different identities through it. Different groups of users, therefore, may see the same technology differently. People also form relationships with technologies, as they did with TLC. These findings, as well as implications for system design and health outcomes, need to be explored in additional studies.     

Plain Language for Patient Education

Low health literacy continues to be a barrier in patient education. One solution to low health literacy is creating or providing patient education materials written in plain language. Plain language follows guidelines created for federal agencies to ensure that documents are written in clear and accessible language for all audiences. Health care professionals and librarians can locate or recommend plain language health information from many reputable consumer health websites.     

Review of Health Source – Consumer Edition

The pace of publication in consumer health continues unabated. EBSCO’s Health Source – Consumer Edition provides one of the few indexing and abstracting services to assist users looking to these types of publications for help with their health questions. This column provides a guide to some of the database features and resources. While the reading level for some of its indexed sources is relatively high, and the collection of books is dated at present. Health Source – Consumer Edition remains a valuable tool in the consumer health librarian’s toolkit.     

Personas in online health communities

Many researchers and practitioners use online health communities (OHCs) to influence health behavior and provide patients with social support. One of the biggest challenges in this approach, however, is the rate of attrition. OHCs face similar problems as other social media platforms where user migration happens unless tailored content and appropriate socialization is supported. To provide tailored support for each OHC user, we developed personas in OHCs illustrating users’ needs and requirements in OHC use. To develop OHC personas, we first interviewed 16 OHC users and administrators to qualitatively understand varying user needs in OHC. Based on their responses, we developed an online survey to systematically investigate OHC personas. We received 184 survey responses from OHC users, which informed their values and their OHC use patterns. We performed open coding analysis with the interview data and cluster analysis with the survey data and consolidated the analyses of the two datasets. Four personas emerged—Caretakers, Opportunists, Scientists, and Adventurers. The results inform users’ interaction behavior and attitude patterns with OHCs. We discuss implications for how these personas inform OHCs in delivering personalized informational and emotional support.     

FROM THE EDITORS

Abstract

Consumer empowerment through authoritative health information is a positive force in today's health care environment. As the nation's lead agency for protecting the health and safety of people, the Centers for Disease Control and Prevention (CDC) has as part of its mission the responsibility of providing credible information to enhance health decisions. CDC health communications are provided through many venues, and particularly its Web site. This article identifies CDC consumer health sites, giving particular attention to two new initiatives, the CDC Kids Page and CDC en Espãol, which have been developed for specialized consumer health audiences.     

Chemical-induced asthma and the role of clinical,toxicological, exposure and epidemiological research in regulatory and hazard characterization approaches

Uncertainties in understanding all potential modes-of-action for asthma induction and elicitation hinders design of hazard characterization and risk assessment methods that adequately screen and protect against hazardous chemical exposures. To address this challenge and identify current research needs, the University of Cincinnati and the American Cleaning Institute hosted a webinar series to discuss the current state-of-science regarding chemical-induced asthma. The general consensus is that the available database, comprised of data collected from routine clinical and validated toxicological tests, is inadequate for predicting or determining causal relationships between exposures and asthma induction for most allergens. More research is needed to understand the mechanism of asthma induction and elicitation in the context of specific chemical exposures and exposure patterns, and the impact of population variability and patient phenotypes. Validated tools to predict respiratory sensitization and to translate irritancy assays to asthma potency are needed, in addition to diagnostic biomarkers that assess and differentiate allergy versus irritant-based asthmatic responses. Diagnostic methods that encompass the diverse etiologies of asthmatic responses and incorporate robust exposure measurements capable of capturing different temporal patterns of complex chemical mixtures are needed. In the absence of ideal tools, risk assessors apply hazard-based safety assessment methods, in conjunction with active risk management, to limit potential asthma concerns, proactively identify new concerns, and ensure deployment of approaches to mitigate asthma-related risks.     

Opioid consumption in patients undergoing Roux-en-Y bariatric surgery compared with population controls with and without obesity

BackgroundPatients with obesity are prescribed more opioids than the general population.ObjectivesTo compare opioid consumption in patients with obesity who underwent Roux-en-Y bariatric surgery (RYGB) with population controls with and without obesity, not undergoing bariatric surgery, and to identify characteristics associated with opioid use.SettingThis study included all patients with a principal diagnosis of obesity, aged 18–72 years, with a RYGB surgical code in the Swedish Patient Register between 2007 and 2013.MethodsRYGB patients (n = 23,898) were age- and sex-matched with 1 control patient with obesity (n = 23,898) and 2 population controls without obesity (n = 46,064). Participants were classified as nonconsumers and consumers based on their opioid dispensations during the 12 months before baseline. Opioid consumption was assessed for 24 months.ResultsNonconsumers. Within 24 months, a significantly higher proportion of RYGB patients (16.6%) started using opioids compared with the controls with obesity (14.3%, P < .0001) and population controls (5.4%, P < .0001). RYGB patients and controls with obesity had higher median daily intake of opioid morphine equivalent (MEQ) (2.8 mg/d) than population controls (2.5 mg/d, P < .0001). Consumers. Within 24 months, the proportion of RYGB patients and controls with obesity that was using opioids were similar (53.1% and 53.4%), but higher compared to population controls (38.0%, P < .0001). The median daily opioid MEQ was higher among RYGB patients than in population controls (10.5 versus 7.8 mg/d, P < .0001). RYGB patients, overall, had higher incidence of bowel surgery and cholecystectomy compared with controls with obesity and population controls, leading to prolonged opioid use in this group. Opioid consumption in general was associated with chronic pain and psychiatric disorder, which were more common in patients with obesity than in the population controls.ConclusionRYGB surgery increased the risk of prolonged opioid use in patients with obesity who were nonconsumers before surgery but had no effect on overall opioid use among prior consumers. RYGB-associated complications requiring surgery influenced opioid use for both nonconsumers and consumers. Regular reassessments of pain mechanisms and specific treatment owing to type of pain could prevent unnecessary opioid use in this patient group.