黑龙江地区既有居住建筑节能改造实践的学习研究

在我国北方严寒地区城市,大量的既有建筑进行了节能改造。普遍采用外墙外保温措施以及具有地方特色的建筑元素,但是如果各改造分项配合措施不得当就会降低节能改造的效果。文章从影响建筑节能改造中的各个分项着手,对于既有建筑改造过程中各分项配合以及外墙保温做法问题提出一些技术改进建议。     

试论“治未病”理论思想的内涵及其价值导向

"治未病"思想是中医学的精华,通过对"治未病"内涵和概念的梳理,提出应根据临床实践需要将其分为三个阶段:未病先防、已病防变、瘥后防复;基于"治未病"理论的基础,阐述了"治未病"思想的价值导向是促进卫生资源趋向公平性和可及性,卫生部门应充分发挥"治未病"思想在中医预防保健服务体系构建中的指导作用,提升其在公共卫生服务体系和初级卫生保健的贡献率。     

冷链物流市场分析——合肥市农产品冷链市场为例

随着社会经济的发展,居民对物质生活的要求越来越高,对冷鲜产品的要求也越来越高,带动冷链物流的发展。文中在总结合肥农产品冷链物流模式的基础上,分析影响合肥农产品冷链物流市场发展状况及原因,进而提出若干对策建议。     

我国农产品冷链物流存在的问题及对策

目前我国农产品冷链物流的发展相对滞后,严重影响了农民的增收和农产品的出口质量。针对我国农产品冷链物流发展中存在的鲜活农产品通过冷链流通的比例偏低、农产品冷链物流技术落后、第三方冷链物流企业发展滞后等问题,提出了加大科技投入力度、加快培育第三方冷链物流企业、加快专业冷链物流人才的培养等对策,以促进我国农产品冷链物流的发展。     

Cost-effectiveness of dipeptidyl peptidase-4 inhibitor monotherapy versus sulfonylurea monotherapy for people with type 2 diabetes and chronic kidney disease in Thailand

Objective: With a high prevalence of chronic kidney disease (CKD) in type 2 diabetes (T2DM) in Thailand, the appropriate treatment for the patients has become a major concern. This study aimed to evaluate long-term cost-effective of dipeptidyl peptidase-4 (DPP-4) inhibitor monothearpy vs sulfonylurea (SFU) monotherapy in people with T2DM and CKD.

Methods: A validated IMS CORE Diabetes Model was used to estimate the long-term costs and outcomes. The efficacy parameters were identified and synthesized using a systematic review and meta-analysis. Baseline characteristics and cost parameters were obtained from published studies and hospital databases in Thailand. Costs were expressed in 2014?US Dollars. Outcomes were presented as an incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were performed to estimate parameter uncertainty.

Results: From a societal perspective, treatment with DPP-4 inhibitors yielded more quality-adjusted life years (QALYs) (0.024) at a higher cost (>66,000 Thai baht (THB) or >1,829.27 USD) per person than SFU, resulting in the ICER of >2.7 million THB/QALY (>74,833.70 USD/QALY). The cost-effectiveness results were mainly driven by differences in HbA1c reduction, hypoglycemic events, and drug acquisition cost of DPP-4 inhibitors. At the ceiling ratio of 160,000 THB/QALY (4,434.59 USD/QALY), the probability that DPP-4 inhibitors are cost-effective compared to SFU was less than 10%.

Conclusions: Compared to SFU, DPP-4 inhibitor monotherapy is not a cost-effective treatment for people with T2DM and CKD in Thailand.     

Healthcare costs for Crohn’s disease patients treated with infliximab: a propensity weighted comparison of the effects of treatment adherence

Objective:

The objective for the research was to evaluate the direct healthcare costs for Crohn’s disease (CD) patients categorized by adherence status.

Methods:

Adult patients with ≥1 claim for infliximab and ≥2 claims for CD who were continuously insured for 12 months before and after their first infliximab infusion (index date) were identified in a 2006–2009 US managed care database. Patients were excluded if they had rheumatoid arthritis claims, received infliximab billed as a pharmacy benefit, or received another biologic drug. Patients were categorized as being either adherent or intermittently adherent to infliximab using a pre-defined algorithm. Total and component direct costs, CD-related costs, rates of surgery, and days of hospitalization were estimated for the 360-day post-index period. Propensity weighted generalized linear models were used to adjust the cost estimates for potential confounding variables.

Results:

The total propensity weighted cost for infliximab adherent patients was $40,425 (95% CI?=?[$38,686, $42,242]), compared to $41,082 (95% CI?=?[$38,163, $44,223]) for the intermittently adherent (p?=?0.71). However, adherent patients had lower total direct medical costs, exclusive of infliximab, that were $13,097 (95% CI?=?[$12,141, $14,127]) compared with $20,068 (95% CI?=?[$17,676, $22,784]) for intermittently adherent patients as a result of substantially lower hospital and outpatient costs (p?Conclusions:

Greater drug-related costs for infliximab adherent patients were offset by lower costs from hospitalization and outpatient visits. These findings indicate that adherent patients have improved clinical outcomes, at a similar aggregate cost, than patients who are only intermittently adherent to therapy.     

Sources of Productivity Growth Dynamics: Is Japan Suffering From Baumol's Growth Disease?

This study examines the sources of labor productivity growth dynamics in Japan (1970–2010) and investigates the extent to which Japanese economic performance has been affected by Baumol's growth disease (BGD). We find that BGD silently undermines Japanese economic growth. However, the magnitude is miniscule, and consequently the aggregate labor productivity growth rate has not been decreasing monotonically. We also explore how BGD is arising and why it is small in the Japanese economy. BGD is weak because (1) the positive Baumol growth effect is also working in certain services sectors and (2) BGD is not a durable phenomenon: even if a sector begins to suffer from BGD, it is likely to recover quickly.     

基于食品安全的农产品冷链物流发展现状与优化对策

分析了农产品冷链物流对食品安全的重要性,指出我国农产品冷链安全发展方面存在农产品冷链基础设施薄弱、农产品冷链安全标准化建设滞后、政府监管体制混乱、农产品冷链安全的应用研究欠缺等问题,提出了加大农产品冷链配套设施建设力度、健全农产品冷链安全的技术标准体系、推进政府工作建设、建立农产品冷链安全研究机制的对策来发展我国安全农产品冷链物流。     

对福州市商超速冻食品配送现状的思考

当今,速冻食品发展越来越迅速,在福州市各个商超占有率很高。但是速冻食品的配送在福州市还存在着诸如冷藏运输车没有做到全程制冷、政府监管力度不够、企业配合不够等很多问题,由此商超速冻食品的质量还无法得到保证,食品的运输效率无法提高。针对此问题,从运输企业、商超、政府等三方面进行思考,从源头出发,寻找解决问题的办法,以期更有效率地进行商超速冻食品的配送,确保食品安全。     

Fruits and vegetables availability for human consumption in Latin American and Caribbean countries: Patterns and determinants

Inadequate intake of fruits and vegetables (F&V) is one of the leading causes of chronic diseases in the world. This study examined the patterns and determinants of F&V availability for human consumption in Latin American and Caribbean countries between 1991 and 2002. The results showed that there were considerable disparities between and within countries and only one-third of the sampled countries (if only 20% wastage is assumed) could achieve the World Health Organization’s recommendation of 146 kg of F&V intake/capita/year. The elasticities estimated from a fixed effect regression also showed that income, urbanization, price, and poverty were some of the important factors that affect the long-term availability of F&V.