基于Logistic方程的流行病随机模型教学研究

本文讨论了医学院校数学教学改革的必要性,并结合流行病随机模型理论,详细展示了现代医学科研新模式下的医学数学课堂教学过程,对实验结果进行了分析。同时,明确了新形势下医学院校数学教师的教学任务。     

论分税制下财政转移支付与地方财政努力差异——基于功能与地区多重分类考察的另类荷兰病分析

文章主要研究分税制下政府间转移支付与地区财政努力差异的关系.通过理论模型推导和对转移支付的实证检验发现:中国现行转移支付制度在总体上抑制了地方政府的财政努力.就区域效果而言,转移支付在促进东部发达省份财政努力的同时,抑制了中、西部落后地区的财政努力;就转移支付的功能类型而言,以税收返还为主的条件性转移支付会激励地方政府努力征税,而非条件性转移支付,包括财力性和专项转移支付将不同程度地抑制地方财政努力.这就产生了挤出效应与另类"荷兰病"的问题.     

Unintended Consequences of Lockdowns: Evidence from Domestic Helpers in Urban China

This paper addresses the reactions of domestic helpers to the Wuhan (Hubei Province) lockdown that began on January 23, 2020. We use a novel dataset containing the information of over 40,000 Chinese domestic helpers registered on a leading professional website from November 2019 to June 2020. The results indicate a declining pattern of short-term labor supply of domestic helpers across 11 major Chinese cities, which shows an increase in the expected monthly wage of domestic helpers in these cities. More importantly, using a difference-in-difference (DID) model, this paper provides some evidence on the existence of labor market discrimination against domestic helpers born in Hubei Province due to employers’ fear of infection.     

传染病类突发公共卫生事件风险评估与应对

突发公共卫生事件会冲击社会经济运行,特别是具备传染性时这种冲击的程度和范围会更深更广,而通过建立模型来模拟传染病类突发公共卫生事件,将为传染病评估和应对提供积极有效的依据。故以SEIR模型为基准,针对SEIR模型存在的不足,将重大传染病事件分为三个阶段发展三阶段模型,将相关参数由静态参数改进为动态参数,分类模拟"封城"以及传染病存在复发可能性的情形,并利用2020年新冠肺炎疫情数据进行动态模拟。对经典SEIR模型以及改进的三阶段模型分别进行参数估计和系统仿真发现,在无人为干预的自然传播情况下,传染病感染数量峰值会出现在1~2个月后;加强隔离、加大医疗资源投入能显著减小传播规模;改进的三阶段模型能对传染病类事件起到很好的预测作用,可为未来传染病评估和应对提供有效依据。由此,为有效应对传染病类突发公共卫生事件,建议从加强隔离、加大医疗资源投入、疫情后期持续关注等角度着手完善我国传染病应急防控体系,在传染病发生时能够对相关人员做到尽早隔离,提高治愈率,减少传染数量,从源头上降低突发公共卫生事件对经济的负面影响。     

Examining Dutch disease across Australian regions

The recent mining boom represents one of the largest external shocks to the Australian economy in its post‐war history. Although most agree that it had a positive effect on the Australian economy as well as on people’s living standards, there is disagreement over the extent to which this boom has caused deindustrialisation and the so‐called Dutch disease in Australia. Our empirical findings support the presence of Dutch disease nationally for Australia using data for the period 1984–2013. Regionally, the results show that Dutch disease was concentrated mainly in the eastern and southern states of Australia—Victoria, Queensland, South Australia and Tasmania.     

Time spent on erythropoietin stimulating agents administration in hemodialysis centers in Panama: a time and motion study

Objectives: There is a lack of data in Panama on the potential differences in total healthcare professional (HCP) time between routine administrations of short-acting erythropoietin simulating agents (ESAs) (i.e. epoetin alfa) and continuous erythropoietin receptor activator (CERA) (i.e. methoxy polyethylene glycol–epoetin beta). This study aimed to quantify the HCP time associated with a single administration of epoetin alfa and CERA for the treatment of anemic patients with chronic kidney disease (CKD) on hemodialysis.

Methods: This was a multi-center, cross-sectional study, using a time-and-motion methodology. Costs related to HCP time and consumables usage associated with administration of epoetin alfa and CERA were estimated.

Results: Based on 60 administrations of either CERA or epoetin alfa, the estimated savings in mean total active HCP time were 2.34 (95% confidence interval?=?1.87–2.81) min (–30%) per administration. When extrapolating to a full year’s treatment with intravenous ESA, it would require a total of 20.3 (95% CI?=?19.90–20.71) h of HCP time for epoetin alfa vs 1.1 (95% CI?=?1.01–1.19) h for CERA per patient per year. Estimated savings in active HCP time per patient per year were 19.20 (95% CI?=?19.20–19.21) h (–95%). This, in turn, translates into staff cost efficiency that favors Mircera with an estimated annual saving of $78.24 (95% CI?=?78.24–78.28) (–95%) per patient.

Conclusions: Data from a real-world setting showed that the adoption of CERA could potentially lead to a reduction in active HCP time.

• Highlights

• Few comparative data have explored the costs and potential savings of using long-acting erythropoietin–stimulating agents (ESA) instead of short-acting ESAs to treat anemia in CKD patients on hemodialysis.

• This time-and-motion study shows that use of CERA reduces total healthcare professional time and could represent a save for an institution in a real-world setting in Panama.

     

“四化管理”在应急收治管理中的应用实践——以手足口病患儿为例

目的:研究"四化管理"模式在手足口病患儿应急收治管理中的应用实践效果。方法:选取2012年8月-2013年9月,辽源市妇幼保健计划生育服务中心收治的130例手足口病患儿作为研究对象,按照数字法分为对照组和观察组,对比两组护理管理模式的效果和患儿家属满意度。结果:观察组的消毒隔离质量、健康教育水平、护理文书管理、危重护理质量等方面均显著优于对照组,差异具有统计学意义(P<0.05);观察组的患儿家属的护理满意度98.5%明显高于对照组84.6%,差异具有统计学意义(P<0.05)。结论:"四化管理"模式应用于应急收治手足口病,可显著提高临床护理质量和患儿家属满意度,值得临床选择和广泛推广。     

碳酸镧治疗慢性肾衰竭并发高磷血症患者的Meta分析

目的：探讨碳酸镧治疗慢性肾衰竭并发高磷血症患者的疗效。方法以碳酸镧（lanthanum carbonate）、高磷血症（hyperphosphatemia）、安慰剂（placebo）、碳酸钙（calcium carbonate）、终末期肾病（end-stage renal disease）等为关键字,检索中国期刊全文数据库、中文科技期刊数据库、万方数据知识服务平台、Web of Science、PubMed等数据库,对文献的质量评价后进行Meta分析。结果共纳入10篇,经Meta分析结果显示,对于治疗后血磷水平,WMD=－0.60,95%CI：－0.75～－0.45,碳酸镧与安慰剂在控制血磷水平上差异有统计学意义;对于治疗后血钙水平,WMD=－0.01,95%CI：－0.07～0.05,碳酸镧与安慰剂在控制血钙水平上差异无统计学意义;对于治疗后血PTH水平,WMD=－29.75,95%CI：－39.22～－20.28,说明碳酸镧与安慰剂在控制血PTH水平上差异有统计学意义。对于治疗后血磷水平,WMD=－0.41,95%CI：－0.48～－0.34,碳酸镧与碳酸钙在控制血磷水平上差异有统计学意义;对于治疗后血钙水平,WMD=－0.19,95%CI：－0.25～－0.13,碳酸镧与碳酸钙在控制血钙水平上有统计学意义;对于治疗后血PTH水平,WMD=－174.66,95%CI：－198.86～－150.46,碳酸镧与碳酸钙在控制血 PTH 水平上差异有统计学意义。结论碳酸镧可明显降低慢性肾衰竭并发高磷血症患者的血磷和PTH,对血钙无明显影响,在有效性上优于碳酸钙。     

益生菌对小儿特异反应性疾病早期预防的影响

目的：探讨益生菌对小儿特异反应性疾病早期预防的影响。方法选取在广东省惠州市中心人民医院出生的164例新生儿,将其资料按随机数字表法分为观察组与对照组,各82例。观察组新生儿口服双歧杆菌三联活菌散,对照组新生儿给予安慰剂,比较两组新生儿特异反应性疾病的发生情况。结果观察组新生儿特异反应性疾病的发病率为22.0%,明显低于对照组的47.6%,差异有统计学意义（P＜0.05）。结论及时服用益生菌能够对特异反应性疾病起到有效的预防作用。     

新技术下服务产品“虚拟化”探究

产品"虚拟化"的服务业可以有效地摆脱困扰服务业的鲍莫尔"成本病"的影响,实现生产率的快速增长。本文通过一个双头博弈模型,借助"自助服务外包给顾客"的形式说明了"虚拟服务"大大优于现在占据主体服务市场的实体"柜台"服务,"虚拟服务"将取代实体"柜台"服务,从而实现服务业"产业化"经营的目标。