心血管内科患者的临床药学服务实践

加强住院患者的临床药学服务有利于提高药物治疗效果.我院心血管内科临床药师在深入临床实践的过程中,对患者进行用药指导,对提高患者用药依从性,提高药物治疗的有效性及安全性有一定意义.     

探讨药学指导对糖尿病患者用药依从性的影响

目的探讨糖尿病患者药师介入用药指导后患者用药依从性的改变情况。方法抽取在我院进行治疗的糖尿病患者60例,将其随机分为观察组与对照组各30例。两组均服用常规糖尿病药物及胰岛素注射进行治疗,观察组在其基础上,药师主动对其行药学指导。在治疗3个月后对其药物依从性进行评价。结果在治疗前,两组患者在药物依从性评价方面无显著差异。药师介入用药指导3个月后,观察组的药物依从性评价较对照组明显提高。结论在糖尿病的治疗方面,通过药师指导患者用药,能够将其用药依从性显著提高。     

临床药师合理用药的实践与研究

目的总结我院临床药师参与临床合理用药的工作经验,探讨促进医院合理用药的途径和方法,为更好地开展药学服务工作提供参考。方法回顾性分析我院临床药师在药学信息服务、药学监测、查房、药物咨询、用药指导、药学分析等方面的实践经验。结果临床药师参与合理用药的分析、方案制订、咨询教育等能明显地促进药物的合理应用,减少不合理用药医嘱,对临床医师的合理用药有重要的指导意义,对和谐医患关系有积极帮助。结论临床药师对减少药品不良反应,确保用药安全、有效、合理、经济有重要影响,应不断提高自身的业务能力,丰富临床经验,从而更好地服务临床。     

医院药师在促进临床合理用药中的作用

随着我国医药卫生事业的逐步改革,药学服务理念的不断更新,药师的工作重点已逐步从药品供应转向临床服务。现阶段建立"以患者为中心"的药学服务模式,开展深入临床合理用药为核心的临床药学是提高医疗质量的重要环节[1]。药师深入临床参与到患者治疗过程中,及时发现和解决临床用药中所存在的问题,缩短患者的治疗疗程,提高药物治疗水平及治愈率,是临床药学的主要内容。     

1例药物性肝损害患者的药学监护与体会

目的通过临床药师对1例药物性肝损害患者实施药学服务,探讨临床药师在治疗团队中的作用。方法针对具体病例从药物选择、不良反应监测等方面,为患者制订个体化治疗方案,提供合理化建议。结果临床药师在本次药学服务中及时发现药物不良反应及相互作用,提出应对措施,提高了临床药物治疗水平。结论在临床治疗过程中,临床药师针对患者的实际情况开展药学服务是必要的。     

1例类风湿性关节炎继发干燥综合征患者的药学监护

目的通过临床药师对1例类风湿性关节炎继发干燥综合征患者实施药学监护的过程,探讨药师在临床治疗中的作用。方法针对具体病情,协助医师为患者制订有效的治疗方案,为患者建立药历,关注患者用药期间出现的不良反应,提出合理的药学监护措施及健康教育计划。结果临床药师为患者实施药学监护可提高药物疗效,减少用药风险。结论临床药师参与临床药物治疗,促使用药更规范合理。     

临床药师在内分泌科中的工作体会

开展临床药学的实际意义[1-2]，就是确保患者用药安全有效、提高医疗水平，使医院药学服务与临床密切结合，达到合理用药的目的。临床药师的社会功能已日趋完善，目前关于临床药师参与药学服务的文献探讨已成为焦点，在美国药师已成为医疗团队和社会药学中不可或缺的一员[3]。笔者从2011年开始在本院内分泌科进行临床药学工作，现将在内分泌科开展药学服务的方法及实际工作中的体会总结如下。     

药学监护在糖尿病合并肝脓肿患者中的应用

目的探讨糖尿病合并肝脓肿患者治疗过程中的药学监护,总结临床药师药学监护的经验。方法协助临床医师对糖尿病合并肝脓肿患者治疗过程中用药方案进行分析,并详细记录药品不良反应,加强对患者进行药物相关知识的宣教,更好发挥药物疗效。结果该例患者在治疗过程中未出现明显的用药不良反应,药物依从性较好。结论患者对药物相关知识了解欠缺,致使临床的药物不能充分发挥其疗效,有的甚至因为误用而导致严重后果,普及临床药师参与治疗过程,利于充分发挥药物的治疗作用,并尽可能防止用药不良事件的发生。     

执业药师在临床药学中的作用

国家医药卫生医药体制的不断改革,促使临床药学在医院药学发展中的作用日益突出。作为临床药学的关键组成部分和临床科学用药的基础,执业药师因掌握着全面的药学知识,在保证患者用药安全中发挥着举足轻重的作用,同时在进一步推进医药卫生体制改革方面的突出作用同样至关重要,因此深入分析执业药师在临床药学中的积极作用是当前医药界最为关注的任务之一。     

心血管内科临床药师药学监护切入点

目的心血管内科临床药师在参与临床工作实践中寻找药学监护服务的切入点及着力点。方法临床药师应用药学专业特长,结合心血管内科临床路径、思维及临床工作实践开展临床药学服务。结果与结论心血管内科临床药师应熟悉心血管内科专科特点,可先从患者入手开展用药监护与教育,提高患者的依从性;也可从非本专科用药、药物与药物、药物与食物间相互作用;从剂型与疗效、体内药代动力学、药剂学、药物化学等方面入手、开展抗菌药物合理应用。     

我国房地产税制的现状及改革构想

房地产税制是维护房地产市场公平竞争，实现国家对房地产业宏观调控的有力杠杆。然而，我国现行的房地产税制却存在税费不分、税制不统一、税制结构不合理等诸多问题。严重影响了其对房地产业应有的宏观调控作用。因此，适时地推进房地产税制的改革应是当务之急，应统一内外税制，合理界定税费的范围，建立统一、规范、合理的房地产税收体系。     

Public participation in forestry in Turkey

Recently public participation in forestry has been seriously considered in Turkey. Participation is however quite a challenge for a country with a long tradition of top-down management and a strong bottom-up dependence on public provisioning. In such a setting, it may not be surprising that the experiences with public participation in forestry in Turkey are mixed. There are some positive initiatives like the creation of farmer's cooperatives and NGOs, but their role is quite limited and small of scale. This paper is bringing together different views based on existing studies in Turkish related to Turkey's experience with implementing public participation in forestry.     

上海生态农业发展影响因素研究

文章分析了上海生态农业发展的影响因素,并利用计量模型进行检验,认为影响上海生态农业发展的主要因素有农业基础设施、农业劳动力资源、农业产业化水平、农业科技实力状况。     

西部地区人力资本投资与知识化发展

人力资本投资在推动知识化发展的过程中存在自增强机制，通过促进人力资本保值增值，进行人力资源合理配置，改善配置环境和配置政策、完善配套措施，有助于充分发挥这一机制的功能，从而实现西部地区知识化发展。     

Inter-enterprise arrears in economies in transition

In the context of economies in transition, the paper argues that an excessive liquidity squeeze could throw the economy into a persistent state of low economic activity. In such bad equilibrium, enterprise transactions become largely demonetized, with a chain of arrears, a form of involuntary credit, spreading over the entire system. The empirical analysis of the Romanian experience seems to support the view advanced in the paper.     

Is wealth found in the soil or in the brain? Investing in farm people in Malawi

Should a typical developing country invest more in agriculture or education? At what stage of development is it optimal to invest more in each of these sectors? These are important questions that governments of developing countries grapple with when designing investment plans. In this paper, I propose a soil–human capital conceptual framework of development and use it to explain estimates of agricultural returns to schooling in Malawi. I use panel survey data for Malawi and rely on the exogenous education policy changes and spatial variation in access to schooling to identify effects of schooling on agricultural incomes. In addition, I correct for selection into income activities within a panel data and instrumental variables estimation framework. I find annual agricultural returns to schooling in Malawi of 3%–4% after correcting for selection and unobserved heterogeneity and 7% in the uncorrected specifications. I also find consistently higher returns to schooling in the nonagricultural sector for those not living in the village of birth and higher returns in the agricultural sector for those living in the village of birth. Given the size of the farm sector, wealth in Malawi is still in the soil, but that future growth in wealth depends on human capital investments.     

2010年黑龙江省宏观经济展望

受世界金融危机的影响,从2008年下半年起黑龙江省经济持续走低,2009年一季度跌入谷底。2009年前三季度,在国家扩大内需的政策刺激下,黑龙江省经济企稳回升,但经济运行中还存在出口下滑、物价水平较低等问题,经济下行的压力仍然存在,经济持续回升的基础尚待巩固。展望2010年,国家将继续实施积极的财政政策和适度宽松的货币政策,随着政策效应的逐步释放,内需对经济的拉动作用仍将十分强劲,另外,随着世界经济的复苏,黑龙江省外贸形势也将逐渐好转,在＂投资、消费、出口＂这三驾马车的共同作用下,2010年黑龙江省经济将步入全面复苏通道。     

Agricultural Roots in Intergenerational Transfers in China

Economists have been interested in the motivations of intergenerational transfers, for different motivations affect the effectiveness of anti-poverty public transfers. However, one’s motivation is largely shaped by culture and social conventions. This paper sheds light on the influence of rice cultivation in intergenerational transfers in China. This is also the first time that economists consider cultural factors in the study of intergenerational transfers. Cultivating rice requires elaborate irrigation systems and large amounts of labor input so that rice farmers have to cooperate extensively with their neighbors, which has gradually shaped people’s value to be more inter-dependent. Based on micro-level data from CHARLS and sub-national rice data from China, our empirical results show strong evidence that individuals from rice regions are more likely to provide economic support for their parents. A one-percentage point increase in the share of rice in the total grain planting area will raise transfer incidence by 0.2–0.4 percentage points, and rice region residents transfer on average 300–400 yuan more in 2011 and about 1,000 yuan more in 2013 to their parents than those from wheat regions. Meanwhile they are more inclined to rely on their adult children for elderly support. Urban citizens are less affected. Using instrumental variable estimation, we are able to prove the effect is causal. With future continued deepening of population aging in China, relying on children for old age support may become more and more unrealistic, the government needs to coordinate the relationship between public transfer and private transfer to ensure the quality of life for the elderly.     

Gender Differences in Time-Poverty in Rural Mozambique

Based on time-use data from a 2013 primary household survey, this study examines the nature and extent of time-poverty experienced by men and women in peasant households in Mozambique. The main findings indicate that while women's labor allocation to economic activities is comparable to that of men, household chores and care work are almost entirely women's responsibility. The heavy burden of responsibilities leave women significantly time-poorer compared to men. Women's time-poverty worsens when the burden of simultaneous care work is taken into account. In addition, due to multitasking, the work tends to be more taxing. The examination of determinants of time-poverty shows that common measures of individual economic power, such as assets and education, do not necessarily affect the time-poverty faced by women.     

Trade-offs in sulfur emission trading in Europe

How to implement emission trading is one question in the current negotiations on a new sulfur protocol in Europe. Whereas the current protocol stipulates a 30 percent uniform reduction, national emission ceilings included in the proposed new protocol imply differentiated reductions. In addition, emission and fuel standards are proposed. This paper examines the costs and environmental impacts of emission trading. Emission trading combined with regulations is a new element in the paper. Calculations using the RAINS (Regional Acidification INformation and Simulation) model suggest that overlaying emission trading on regulations not only reduces the cost savings but has beneficial impacts as well: ecosystem protection is not changed and significant decreases in environmental benefits for countries are largely avoided. Emission trading can also be used to decrease emissions and increase ecosystem protection. If combined with existing legislation, emission trading minimizes losses in expected environmental benefits for some countries, and most countries gain. However, the initial distribution of emission ceilings has to be used so that some countries are not confronted with higher costs. Trade-offs appear to exist between the use of emission trading to achieve cost savings on the one hand, and ecosystem protection and distributional equity on the other.