Onehealth, an evidence-based decision-making software, is based on the United Nations' epidemiological reference modules to predict the effect of health services. Onehealth is a large database. The software is using activitybased costing, simulating investment costs of health system and changes of mortality in different coverage levels. By the cost of inputs/avoid deaths, it could quantify the cost of health services effectiveness and provide an intuitive basis for the rational allocation of health resources. This study introduces the relevant concepts, model structures and applications of Onehealth. We took the study of child nutrition interventions in Sudan for example and to present Onehealth tool's operating. As a new auxiliary and evidence-based decision-making software with scientific and rigorous theoretical approach, Onehealth has practical significance on the national or regional macro decision-making.
Objective To provide evidence for the establishment of an essential medicines list, we investigated the institutional medicine supply in rural hospitals and community health service centers in Chengdu. Methods The trained investigators collected medicine sales records and information about the management of institutional pharmacies. Through in-depth interviews with the pharmaceutical personnel, we inquired into the drug supervision and supply networks in rural areas. Then we performed secondary research based on a comparative analysis of drug classification, administration and pharmacies in developed countries. Results Seven township hospitals/community health service centers had pharmacies, facilities, storage, and a clean environment. Three of them used electrical databases to manage medicine sales records. Five township hospitals and 5 village medical rooms purchased medicines from the drug supervision and supply networks every week. In this way, they ensured the quality and accessibility of drugs in rural areas. In the urban community health service centers, medicines were supplied based on the traditional commercial distribution system. Conclusion Rational allocation of health resources to set up institutional pharmacies and village medicine rooms is important. The supervision of village medical rooms must be stricter. We should expand the use of electrical databases and integrate the supervision and supply networks with the supply system of the essential medicines.
Objective To investigate the use of the mental health service by college students and the main factors which influence this. Methods A stratified sampling study was conducted among 2 800 students from 5 of the top 100 colleges (as ranked by Internet). All five were located in Southwest China. The students were surveyed by the Questionnaires of Mental Health Service for College Students. Results We retrieved 2 760 (98.58%) questionnaires. Of these, 11.2% of the students (310/2 760) used the mental health service before entering college. 13.6% (376/ 2 760) used mental health service after entering college, of these, 78.5%(295/376) broke off. The mental health service was needed by 32.7% (902/ 2 760), but they did not seek it. When college students considered the mental health service, 65.8%(1 815/2 760), were concerned about the ability of the service organizations to provide professional help, 48.4% (1 336/2 760) were concerned about the service cost, 47.9% ( 1 312/2760) were concerned about the convenience of the service and 38.0% (1 049/2 760) were concerned about social cultural factors. Conclusion Currently, few college students use the mental health service. The main factors influencing the use of the mental health service by college students are the professional ability of the service organizations, the nature and severity of the student’s psychological problems, and the convenience and cost of the mental health service.
It is essential to improve the practice of community healthcare service for the resolution of the problem of inadequate and overly expensive medical services, to promote the harmonization of doctor-patient relationship. From the aspects of the introduction of community healthcare service and the necessity of its standard management, the civil legal relation of community healthcare and its major problems, as well as the rights and duties of community doctors, the authors discussed the importance and necessity of scientific management, right protection by law as well as sound and orderly development of community healthcare service.
ObjectiveTo systematically summarize and analysis the patterns of the screening, organization and promotion of appropriate health technology, to provide references for establishing the localization and long-term mechanism of appropriate health technology promotion for different regions.
MethodsDatabases including CBM, CNKI, WanFang Data and VIP databases were searched from their inception to February 2016, to collect studies about the promotion and application of appropriate health technology in China. Two reviewers independently screened literature, and extracted data. Then, a descriptive analysis was conducted.
ResultsA total of 26 studies were included, of which, 21 studies were related to specific patterns of the appropriate health technologies promotion and 5 studies were related to indicators screening system. The screening principle of appropriate health technology was a reference to national screening recommendation technology with local optional technology, taking into account locals needs and four aspects of technology:safety, effectiveness, economy and suitability. At the provincial and county levels, a leading group and a technical experts' group were established to take responsibility for project coordination and management, and provide technical guidance. Two patterns were being formed, one is a three or four level vertical promotion network, such as from the county to the townships and villages, the other is a radiation promotion from the point to the surface revolving around county and township.
ConclusionThe screening of appropriate health technology is lack of objectivity, unified and strong operability index system. The "top-down" model led by the government could not meet the reality requirement of grassroots. It is necessary to establish a "bottom-up" mechanisms for the screening, organization and promotion of appropriate health technology, which can meet the reality requirement of grassroots.
Objective To evaluate and select essential medicine for urolithiasis using evidence-based methods based on the burden of disease. Methods By means of the approaches, criteria, and workflow set up in the second article of this series, we referred to the recommendations of evidence-based or authority guidelines from inside and outside China, collected relevant evidence from domestic clinical studies, and recommended essential medicine based on evidence-based evaluation. Data were analyzed by Review Manager (RevMan) 5.1 and GRADE profiler 3.6 to evaluate quality of evidence. Results (1) Three evidence-based guidelines were included. Based on WHOEML (2011), NEML (2009), CNF (2010) and the quantity and quality of evidence, we made a recommendation for diclofenac sodium, nifedipine, allopurinol and ibuprofen used in symptomatic treatment of urolithiasis. (3) Results of domestic studies (including four RCTs, n=566; two observational studies, n=96) indicated that calculus-removed rates of diclofenac sodium, nifedipine and allopurinol were 91.5%, 86.4%~93.3% and 86.4% respectively with significant differences. Diclofenac sodium daily cost 7.00 to 8.57 yuan, nifedipine 1.48 to 4.44 yuan, and allopurinol 0.24 to 0.82 yuan. Ibuprofen had a total efficiency of 94.5% with a significant difference for alleviating renal colic, which cost 0.11 yuan daily. Four recommended medicines with safety, clinical efficacy, high economical efficiency and applicability had been marketed with specifications and dosage forms corresponding to guidelines in China. Conclusion For urolithiasis: (1) We offer a b recommendation for diclofenac sodium (capsule/tablet, 50 mg×24, or 25 mg×24) which is contradicted in patients with gastrointestinal bleeding and in pregnant women or women with planned pregnancy. (2) We offer a weak recommendation for nifedipine (tablet/capsule, 10 mg×100 or 10 mg×60) which is contraindicated in dialysis-receiving patients with malignant hypertension and should be cautiously used in patients with irreversible renal failure. (3) We offer a weak recommend allopurinol (tablet, 100 mg×100) which is contraindicated in patients with allergic reaction, severe insufficiency of the liver or kidney, or significant lack of blood cells. (4) We offer a b recommendation for ibuprofen (tablet, 20 mg×20) which is contraindicated in patients with allergic reaction to aspirin.
ObjectiveTo understand the possible influential factors and the effectiveness of interventions for quality of life in breast cancer survivors. MethodThe latest literatures about studies on quality of life in breast cancer survivors were reviewed. ResultsAlthough the cure rate and survival rate of patients with breast cancer had improved, breast cancer as a major stress event, the disease itself and treatment related adverse reactions might cause the fatigue, activity decline, anxiety, depression, and other negative emotions of patients, which seriously affected the quality of life of patients and survival prognosis. The patients’ age, socio-economic background, tumor characteristics, and treatment methods were the factors affecting their quality of life. To a certain extent, meditation, music therapy, and proper physical exercise could improve the quality of life of patients with breast cancer. ConclusionBreast cancer itself and related treatment methods may affect not only the affected organs, but also multiple dimensions of patients’ quality of life, so attention should be paid to improve quality of life in breast cancer survivors, providing with individualized interventions.
ObjectiveTo explore the clinical effect of healthy education on functional constipation caused by unhealthy lifestyle, and to analyze the disadvantages affecting the curative effect.
MethodsA total of 167 cases of functional constipation from February 2009 to February 2012 were included. All of the patients were followed up for one year. We collected clinical data of curative effect and influencing factors, determined the clinical value of healthy education, and analyzed the influence of different factors on the curative effect of healthy education.
ResultsThe total curative effect after one-year follow-up was 84.4%. The curative effect in elderly patients was significantly higher than that in middle-aged ones (P<0.05). The curative effect in urban patients was remarkably higher than that in rural ones (P<0.05). And the curative effect of patients with college degree wass much higher than that in patients with education background of primary school or below (P<0.05).
ConclusionHealthy education has important value on releasing and eliminating functional constipation caused by unhealthy lifestyle. And it needs individual education aimed at patients with different age, education degree, and domicile.
Objective To analyze the causal relationship between educational attainment and the risk of systemic lupus erythematosus (SLE). Methods Based on the data from publicly available genome-wide association studies, we employed single nucleotide polymorphisms (SNPs) strongly associated with educational attainment as instrumental variables. Two-sample Mendelian randomization analysis was used to investigate the causal relationship between educational attainment and SLE. The primary analysis method used was the inverse variance weighted with multiplicative random effects. Validation methods included inverse variance weighted with fixed effects and MR-Egger methods. Additionally, sensitivity analysis was conducted using the leave-one-out approach. Results Finally, 433 SNPs were included. The inverse variance weighted with multiplicative random effects analysis indicated no causal effect of educational attainment on the risk of SLE [odds ratio =1.111, 95% confidence interval (0.813, 1.518), P=0.509]. Similarly, the other two methods did not find any evidence of a causal relationship (P>0.05); however, significant heterogeneity was observed. The MR-Egger regression analysis provided no evidence of horizontal pleiotropy among the included instrumental variables (P>0.05). The leave-one-out approach did not identify any individual SNP that had a significant impact on the overall effect estimate. ConclusionIn conclusion, this study does not support a causal effect of educational attainment on the risk of SLE.
With the development of health technology assessments, the public are increasingly aware of the importance of assessing timeliness for health decision-making, which emerges the requirement for early and timely assessment for emerging health technologies. Providing early and timely assessments prior to a technology accesses the market or prior to implementation can provide decision-makers with sufficient time to develop an application program for a new technology. This paper mainly summarizes the profiles of three emerging health technology horizon scanning systems in Canada, Australia, New Zealand and Sweden, and compares and analyzes their related contents, thus providing reference experience for the construction of emerging health technology horizon scanning system in China.
