浅谈中专毕业护士如何带教本科生护士

新护士让教员带教是临床实习的一个重要环节,是理论联系实际、巩固和提高已学知识的有效途径。众所周知,1998年以前毕业的护士大都是中专毕业,中专毕业的护士如何带教本科生新护士成了我们急需探讨的话题。     

诊所式法律教育与高校法学教育改革模式选择

诊所式法律教育在培养学生实践性法律技能、塑造法律职业道德和职业责任心等方面实现了对传统法学教育模式的突破。高校法学教育改革借鉴国外成果,选择适合我国法学教育需要的诊所式法律教育模式,既顺应国际法学教育改革的发展趋势,又符合我国素质教育的既定目标。     

双氢链霉素未知杂质的结构确证与限值设定

为了科学制定双氢链霉素产品中未知杂质的限度标准,从分子结构、来源和质量稳定性等3个方面开展研究。首先,采用制备色谱仪从双氢链霉素产品中制得杂质纯品,借助液相色谱-高分辨质谱(LC-HRMS)和核磁共振谱(NMR)进行波谱分析、研究杂质分子结构;其次,采用高效液相色谱法(HPLC),结合双氢链霉素生产过程开展杂质来源考察;最后,设计了多条件的影响因素实验,考证杂质的稳定性。结果表明：杂质分子结构与双氢链霉素的分子结构类似,同属氨基糖苷类物质;杂质来源于双氢链霉素发酵阶段产生的链霉素类似物,类似物在氢化过程被同步还原成为产品中的杂质;杂质对酸、碱、高温、氧化、光照等因素不敏感,具有较好的稳定性。由链霉素发酵代谢产生的相关性杂质稳定性较好,设定其限度标准为≤1.0%(峰面积分数)是安全、合理的,可为临床用药提供重要参考。     

定额结算下保险医疗费用支付制度安排

医疗保险机构与医院实行定额结算后,医院可通过分科定额结算办法将价格风险下移给科室,促使科室主动控费。而这种制度下,科室将通过牺牲患者利益实现自身效用;若医院按按实结算办法与科室结算医疗费用,则可在一定程度上解决上述问题。本文将针对按实结算办法建立数学模型,确定科室进行合理医疗的费用区间,并通过此模型说明按实结算下,科室通过均衡医患博弈,可在同时保证医院与患者双方利益的基础上有效地控制医疗费用。     

An analysis of exotic wagers in a parimutuel setting

In US horse racing, there is increasing emphasis placed on the creation of exotic wagers - those bets beyond the standard win, place and show. Bets on multiple races that typically do not result in a winner for several days are of particular interest to the industry. The growing carryover pool helps attract people to the racetrack in a way similar to a growing carryover in the lottery attracts more people to participate. This article examines several multiple race bets and provides a framework for their comparative analysis. The results of the analysis will help racetrack management decide if a proposed bet is appropriate for their particular track. This analysis shows a tradeoff between the difficulty of winning the bet versus the amount of the ultimate payoff. If a bet is too easy to win, then the carryover pool will never reach an attractive level. If the bet is too difficult to win, then the bettors will lose interest before the carryover pool is able to grow sufficiently large. The amount of money wagered daily is an important consideration in determining the appropriate type of exotic wager to implement.     

A cost analysis of the management of attention-deficit/hyperactivity disorder (ADHD) in children in the UK

SUMMARY

A decision analysis was performed to model the effects and health economic differences of current UK management approaches to attention-deficit/hyperactivity disorder (ADHD) in children aged between 6 and 16 years. The approaches modelled were: medication using a standard immediate-release methylphenidate (MPH-IR) (once, twice or three times daily); medication using CONCERTA®XL (OROS®* methylphenidate; MPH), a long-acting once-daily formulation of methylphenidate; or behavioural therapy (BEH). Starting treatment with BEH alone resulted in the highest annual cost (UK£2,147), while the costs of starting treatment with MPH-IR alone (£1,332), or OROS®* MPH alone (£1,362) were comparable. Treatment switches to behavioural treatment or combined treatment (medication and behavioural) due to treatment failure occurred in 11.8% of OROS®* MPH and 24.2% of MPH-IR patients. Probabilistic sensitivity analyses showed that the results were sensitive towards treatment success and the proportion of patients with comorbidities, although conclusions were not altered. UK treatment costs over 1 year appear comparable regardless of whether patients were treated first with OROS®* MPH or MPH-IR. Treating patients first with BEH and then adding stimulant medication if needed resulted in higher overall annual treatment costs.

CONCERTA® XL and OROS® are trademarks of ALZA Corporation, USA.     

Economic impact of industry-sponsored clinical trials of pharmaceutical products in Austria

Abstract

Aims: Modern pharmaceutical product development is a long and complex process associated with significant investments by pharmaceutical companies. The innovative pharmaceutical industry accounts for the vast majority of expenditures in clinical trials of potential new pharmaceuticals and therefore generates economic activity within a country. The aim was to assess the far-reaching economic impact of industry-sponsored clinical-trials (ISCTs) of pharmaceutical products for the healthcare system and the national economy.

Materials and methods: The study approach was based on three analytical steps. First, a survey among 15 pharmaceutical companies in Austria was conducted to evaluate the annual number of ISCTs subdivided according to trial phase, therapeutic areas and associated employees. Second, the monetary value of treatments performed in ISCTs was calculated based on a sample of clinical-trial protocols. Finally, the macroeconomic impact, measured in terms of value-added and jobs created by the conducted ISCTs, was calculated using Input–Output analysis by applying an extended Leontief-model.

Results: The study demonstrated that €116.22 million spent in ISCTs generated a total value added of €144 million, €74 million direct, in 2018. Each year a medical treatment value of €100 million was financed through 463 ISCTs, with an average value of medical treatment of €37,068 per recruited patient. This represents a significant 0.3% of annual current health-expenditures. In summary, each Euro invested by the pharmaceutical industry in ISCTs generates €1.95 for the Austrian economy. ISCTs also created and secured employment in the extent of 2,021 full-time-equivalents, thus resulting in an employment multiplier of 1.66.

Conclusions: In conclusion, conducting clinical-trials by pharmaceutical industry—beside its importance in its own domain—results in tangible benefits and a positive macroeconomic impact that contribute to the sustainability of the Austrian healthcare system by complementing its limited resources. Furthermore, it is a non-negligible factor in locational and industrial policy.     

The relative efficiency of schizophrenia health care systems: an international comparison using data envelopment analysis

Abstract

Aim

To compare the health economic efficiency of health care systems across nations, within the area of schizophrenia, using a data envelopment analysis (DEA) approach.     

Clinical and economic burden of postsurgical complications of high-risk surgeries: a cohort study in Thailand

Abstract

Background

This study aimed to understand the clinical and economic burden associated with postsurgical complications in high-risk surgeries in Thailand.     

临床路径系统的建立与计算机应用

临床路径是指针对某一类患者或疾病定制的常规的、可行的治疗方案,使每个患有相同疾病的患者按照统一的流程进行治疗。