Objective:The number of liver cancer patients in China accounts for more than half of the world.However,China currently lacks national,multicenter economic burden data,and meanwhile,measuring the differences among dif...Objective:The number of liver cancer patients in China accounts for more than half of the world.However,China currently lacks national,multicenter economic burden data,and meanwhile,measuring the differences among different subgroups will be informative to formulate corresponding policies in liver cancer control.Thus,the aim of the study was to measure the economic burden of liver cancer by various subgroups.Methods:A hospital-based,multicenter and cross-sectional survey was conducted during 2012・2014,covering 39 hospitals and 21 project sites in 13 provinces across China.The questionnaire covers clinical information,sociology,expenditure,and related variables.All expenditure data were reported in Chinese Yuan(CNY)using 2014 values.Results:A total of 2,223 liver cancer patients were enrolled,of whom 59.61%were late-stage cases(III-IV),and 53.8%were hepatocellular carcinoma.The average total expenditure per liver cancer patient was estimated as 53,220 CNY,including 48,612 CNY of medical expenditures(91.3%)and 4,608 CNY of non-medical expenditures(8.7%).The average total expenditures in stage I,H,m and stage IV were 52,817 CNY,50,877 CNY,50,678 CNY and 54,089 CNY(P>0.05),respectively.Non-medical expenditures including additional meals,additional nutrition care,transportation,accommodation and hired informal nursing were 1,453 CNY,839 CNY,946 CNY,679 CNY and 200 CNY,respectively.The one-year out-of-pocket expenditure of a newly diagnosed patient was 24,953 CNY,and 77.2%of the patients suffered an unmanageable financial burden.Multivariate analysis showed that overall expenditure differed in almost all subgroups(P<0.05),except for sex,clinical stage,and pathologic type.Conclusions:There was no difference in treatment expenditure for liver cancer patients at different clinical stages,which suggests that maintaining efforts on treatment efficacy improvement is important but not enough.To fiirtherly reduce the overall economic burden from liver cancer,more effort should be given to primary and secondary prevention str展开更多
This study examined the non-medical factors that influence expectant mothers to opt for caesarean deliveries in Ghana. Data on 395 expectant mothers across the ten regions of Ghana who were located in urban, semi-rura...This study examined the non-medical factors that influence expectant mothers to opt for caesarean deliveries in Ghana. Data on 395 expectant mothers across the ten regions of Ghana who were located in urban, semi-rural and rural areas, and spanned a period of five years (from 2012 to 2016) were obtained from the Ghana Health Service. In fitting the logistic regression model, data on 355 expectant mothers (i.e. 89.9% of the data) was assigned to the analysis sample while 40 (i.e. 10.1%) was assigned to the hold-out sample. The hold-out sample together with other statistical measures of overall model fit, pseudo R2 measures and classification accuracy were used to validate the results obtained from the analysis sample. Significance was tested at p = 0.05. Determinants including, educational level of expectant mother, parity of expectant mother, baby’s birth weight, previous caesarean delivery, location of expectant mother, age of expectant mother and, period within the year of childbirth had a significant effect on caesarean delivery. The study recommended that health practitioners should be able to foretell expectant mothers who are likely to undergo caesarean delivery in order for them to prepare financially and psychologically to avoid further complications. Due to the significant positive attitude of women towards caesarean delivery rather than normal delivery, it is necessary to inform them about the advantages of normal delivery and the health hazards associated with caesarean delivery to the mother and child.展开更多
Ketamine is a dissociative anaesthetic.It is listed by the World Health Organisation[1]in its Model List of Essential Medicines,which are basic drugs required for any health-care system.Indeed,clinically ketamine poss...Ketamine is a dissociative anaesthetic.It is listed by the World Health Organisation[1]in its Model List of Essential Medicines,which are basic drugs required for any health-care system.Indeed,clinically ketamine possesses hypnotic,analgesic and amnesic effects.It is commonly used as induction展开更多
Madhuca longifolia(M. longifolia) is also known as Mahua belonging to the family sapoteace family. M. longifolia is used in traditional and folklore system of medicine widely across India, Nepal, and Sri Lanka for its...Madhuca longifolia(M. longifolia) is also known as Mahua belonging to the family sapoteace family. M. longifolia is used in traditional and folklore system of medicine widely across India, Nepal, and Sri Lanka for its various pharmacological properties as in snake bites and in diabetes. Phytochemicals studies documented the different bioactive constituents, namely,glycosides, flavonoids, terpenes and saponins. The pharmacological studies proved that it possess wide range of biological activities such as antiulcer, antiinflammatory, antioxidant and antidiabetic activities. The toxicity studies reveal its non-toxic effect even at larger doses.Thus M. longifolia can be considered as a therapeutic agent for specific diseases. Scientific investigation on various isolated bioactive components and its efficacy on diseases proved the future usefulness of different species of Madhuca. This review summarizes the phytochemical,pharmacological, medicinal and non-medicinal uses of M. longifolia. Further exploration on M.longifolia for its therapeutic potential is however required for depth traditional knowledge.展开更多
Background:Treatment of tuberculosis(TB)in China is partially covered by national programs and health insurance schemes,though TB patients often face considerable medical expenditures.For some,especially those from po...Background:Treatment of tuberculosis(TB)in China is partially covered by national programs and health insurance schemes,though TB patients often face considerable medical expenditures.For some,especially those from poorer households,non-medical costs,such as transport,accommodation,and nutritional supplementation may be a substantial additional burden.In this article we aim to evaluate these non-medical costs induced by seeking TB care using data from a large scale cross-sectional survey.Methods:A total of 797 TB cases from three cities were randomly selected using a stratified cluster sampling design.Inpatient medical costs,outpatient medical costs,and direct non-medical costs related to TB treatment were collected using in-person interviews by trained interviewers.Mean and median non-medical costs for different sub-groups were calculated and compared using Kruskal-Wallis and Mann–Whitney U tests.Regression analysis was conducted to assess the influence of different patient characteristics on total non-medical cost.Results:The median non-medical cost was RMB 1429,with interquartile range RMB 424–2793.The median non-medical costs relating to inpatient treatment,outpatient treatment,and additional nutrition supplementation were RMB 540,91,and 900,respectively.Of the 797 cases,20%reported catastrophic expenditure on non-medical costs.Statistically significant differences were detected between different cities,age groups,geographical locations,inpatient/outpatient care,education levels and family income groups.Conclusions:Non-medical costs relating to TB treatment are a serious financial burden for many TB patients.Financial assistance that can limit this burden is urgently needed during the treatment period,especially for the poor.展开更多
基金This study was supported by the State Key Projects Specialized on Infectious Diseases(No.2O17ZX1O2O12O1-008-002,No.2O17ZX1O2O12O1-OO6-OO3)Sanming Project of Medicine in Shenzhen(No.SZSM201911015)+2 种基金the National Natural Science Foundation of China(No.81974492,No.81773521)Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(No.2019-I2M-2-004)the Natural Science Foundation of Guangdong Province(No.2020A151501478).
文摘Objective:The number of liver cancer patients in China accounts for more than half of the world.However,China currently lacks national,multicenter economic burden data,and meanwhile,measuring the differences among different subgroups will be informative to formulate corresponding policies in liver cancer control.Thus,the aim of the study was to measure the economic burden of liver cancer by various subgroups.Methods:A hospital-based,multicenter and cross-sectional survey was conducted during 2012・2014,covering 39 hospitals and 21 project sites in 13 provinces across China.The questionnaire covers clinical information,sociology,expenditure,and related variables.All expenditure data were reported in Chinese Yuan(CNY)using 2014 values.Results:A total of 2,223 liver cancer patients were enrolled,of whom 59.61%were late-stage cases(III-IV),and 53.8%were hepatocellular carcinoma.The average total expenditure per liver cancer patient was estimated as 53,220 CNY,including 48,612 CNY of medical expenditures(91.3%)and 4,608 CNY of non-medical expenditures(8.7%).The average total expenditures in stage I,H,m and stage IV were 52,817 CNY,50,877 CNY,50,678 CNY and 54,089 CNY(P>0.05),respectively.Non-medical expenditures including additional meals,additional nutrition care,transportation,accommodation and hired informal nursing were 1,453 CNY,839 CNY,946 CNY,679 CNY and 200 CNY,respectively.The one-year out-of-pocket expenditure of a newly diagnosed patient was 24,953 CNY,and 77.2%of the patients suffered an unmanageable financial burden.Multivariate analysis showed that overall expenditure differed in almost all subgroups(P<0.05),except for sex,clinical stage,and pathologic type.Conclusions:There was no difference in treatment expenditure for liver cancer patients at different clinical stages,which suggests that maintaining efforts on treatment efficacy improvement is important but not enough.To fiirtherly reduce the overall economic burden from liver cancer,more effort should be given to primary and secondary prevention str
文摘This study examined the non-medical factors that influence expectant mothers to opt for caesarean deliveries in Ghana. Data on 395 expectant mothers across the ten regions of Ghana who were located in urban, semi-rural and rural areas, and spanned a period of five years (from 2012 to 2016) were obtained from the Ghana Health Service. In fitting the logistic regression model, data on 355 expectant mothers (i.e. 89.9% of the data) was assigned to the analysis sample while 40 (i.e. 10.1%) was assigned to the hold-out sample. The hold-out sample together with other statistical measures of overall model fit, pseudo R2 measures and classification accuracy were used to validate the results obtained from the analysis sample. Significance was tested at p = 0.05. Determinants including, educational level of expectant mother, parity of expectant mother, baby’s birth weight, previous caesarean delivery, location of expectant mother, age of expectant mother and, period within the year of childbirth had a significant effect on caesarean delivery. The study recommended that health practitioners should be able to foretell expectant mothers who are likely to undergo caesarean delivery in order for them to prepare financially and psychologically to avoid further complications. Due to the significant positive attitude of women towards caesarean delivery rather than normal delivery, it is necessary to inform them about the advantages of normal delivery and the health hazards associated with caesarean delivery to the mother and child.
文摘Ketamine is a dissociative anaesthetic.It is listed by the World Health Organisation[1]in its Model List of Essential Medicines,which are basic drugs required for any health-care system.Indeed,clinically ketamine possesses hypnotic,analgesic and amnesic effects.It is commonly used as induction
文摘Madhuca longifolia(M. longifolia) is also known as Mahua belonging to the family sapoteace family. M. longifolia is used in traditional and folklore system of medicine widely across India, Nepal, and Sri Lanka for its various pharmacological properties as in snake bites and in diabetes. Phytochemicals studies documented the different bioactive constituents, namely,glycosides, flavonoids, terpenes and saponins. The pharmacological studies proved that it possess wide range of biological activities such as antiulcer, antiinflammatory, antioxidant and antidiabetic activities. The toxicity studies reveal its non-toxic effect even at larger doses.Thus M. longifolia can be considered as a therapeutic agent for specific diseases. Scientific investigation on various isolated bioactive components and its efficacy on diseases proved the future usefulness of different species of Madhuca. This review summarizes the phytochemical,pharmacological, medicinal and non-medicinal uses of M. longifolia. Further exploration on M.longifolia for its therapeutic potential is however required for depth traditional knowledge.
基金The study upon which this paper was written is part of the large program entitled“China National Health and Family Planning Commission and the Gates Foundation TB Project”-a collaboration between the Government of China and the Bill and Melinda Gates Foundation(Grant No.51914)implemented by the China Center of Disease Control and Prevention(CDC).
文摘Background:Treatment of tuberculosis(TB)in China is partially covered by national programs and health insurance schemes,though TB patients often face considerable medical expenditures.For some,especially those from poorer households,non-medical costs,such as transport,accommodation,and nutritional supplementation may be a substantial additional burden.In this article we aim to evaluate these non-medical costs induced by seeking TB care using data from a large scale cross-sectional survey.Methods:A total of 797 TB cases from three cities were randomly selected using a stratified cluster sampling design.Inpatient medical costs,outpatient medical costs,and direct non-medical costs related to TB treatment were collected using in-person interviews by trained interviewers.Mean and median non-medical costs for different sub-groups were calculated and compared using Kruskal-Wallis and Mann–Whitney U tests.Regression analysis was conducted to assess the influence of different patient characteristics on total non-medical cost.Results:The median non-medical cost was RMB 1429,with interquartile range RMB 424–2793.The median non-medical costs relating to inpatient treatment,outpatient treatment,and additional nutrition supplementation were RMB 540,91,and 900,respectively.Of the 797 cases,20%reported catastrophic expenditure on non-medical costs.Statistically significant differences were detected between different cities,age groups,geographical locations,inpatient/outpatient care,education levels and family income groups.Conclusions:Non-medical costs relating to TB treatment are a serious financial burden for many TB patients.Financial assistance that can limit this burden is urgently needed during the treatment period,especially for the poor.
