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农村通向全民健康覆盖的障碍及其原因分析--基于供需双方经济激励机制角度

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中国卫生政策研究 2014年第8期7卷 4-8页

作者：胡敏 winnie c-M Yip 陈文萧庆伦复旦大学公共卫生学院上海200032 牛津大学布拉瓦尼克政府学院哈佛大学公共卫生学院美国波士顿02115

以宁夏回族自治区为案例,本研究对五个样本县进行大规模家庭入户调查、乡镇卫生院和村卫生室机构调查,分析了西部农村通向全民健康覆盖之路的障碍,并从供需双方经济激励机制角度剖析其原因。分析认为西部农村面临基层门诊服务可及性不足... 详细信息

以宁夏回族自治区为案例,本研究对五个样本县进行大规模家庭入户调查、乡镇卫生院和村卫生室机构调查,分析了西部农村通向全民健康覆盖之路的障碍,并从供需双方经济激励机制角度剖析其原因。分析认为西部农村面临基层门诊服务可及性不足,居民经济负担沉重;服务流向不合理,资源配置效率低下;基层供方服务技术效率和质量不佳等问题。造成这些障碍的原因包括:从需方角度来看,新农合保障"轻门诊重住院、轻基层重高层"的特点;从供方角度剖析,对村医经济激励效力低下,按项目付费提供不恰当的经济刺激,难以引导供方提高自身服务效率和质量,以及欠缺促进体系整合的激励。

关键词：农村全民健康覆盖障碍原因经济激励机制

如何提高农村基层医疗服务的效率和质量——宁夏新农合门诊按人头预付制改革设计与效果

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中国卫生政策研究 2014年第8期7卷 14-18页

作者：胡敏 winnie c-M Yip 陈文祝菁菁复旦大学公共卫生学院上海200032 牛津大学布拉瓦尼克政府学院

本研究以宁夏回族自治区为案例,针对村医经济激励水平低下,按项目付费引发不恰当诊治行为,系统内缺乏引导供方提高自身服务效率和质量并促进服务与体系整合协调的经济激励等问题,从供方合理激励的角度出发,对新型农村合作医疗支付制度... 详细信息

本研究以宁夏回族自治区为案例,针对村医经济激励水平低下,按项目付费引发不恰当诊治行为,系统内缺乏引导供方提高自身服务效率和质量并促进服务与体系整合协调的经济激励等问题,从供方合理激励的角度出发,对新型农村合作医疗支付制度进行改革设计——以乡村为整体对乡镇卫生院和村卫生室提供的门诊服务实施基于绩效的按人头预付制。随后利用配对整群随机试验设计对改革效果进行评估和检验。研究发现,这一支付制度的实施有效降低了农村基本医疗服务中抗生素的使用率,优化了供方的处方行为,对降低村卫生室的单次门诊费用有一定作用,并且促进服务向村卫生室下沉。本文的政策分析和设计思路及严格的政策评估结果可以为我国支付制度的选择和发展提供政策参考和证据支持。

关键词：按人头预付按绩效支付效率质量整合服务

Vitamin-K2 dependent GGcX and MGP are required for homeostatic calcium regulation in epididymis

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Vitamin-K2 dependent GGCX and MGP are required for homeostat...

Mediating role of resilience in the relationship between cOVID-19 related stigma and mental health among cOVID-19 survivors:a cross-sectional study

中国解剖学会2021年年会

作者： Ma He Zhang Baoli Gao Dayuan winnie Shum Li Zhen Department of Anatomy Histology and EmbryologyFourth Military Medical University School of Life Science and Technology Shanghai Tech University

A low-calcium microenvironment is essential for spermatozoa to mature in the *** elevation of calcium concentration in the epididymal lumen will lead to premature sperm activation,decreased sperm motility,and even male fertility defects or ***,the mechanism of the epididymal homeostastic calcium regulation has not been fully elucidated.

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Infectious Diseases of Poverty 2023年第2期12卷 125-125页

作者： weijun Xiao Xiaoyang Liu Hao wang Yiman Huang Zhenwei Dai Mingyu Si Jiaqi Fu Xu chen Mengmeng Jia Zhiwei Leng Dan cui winnie w.S.Mak Liming Dong Xiaoyou Su School of Population Medicine and Public Health Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China Department of Pulmonary and critical care Medicine National Center for Respiratory Medicine Center of Respiratory Medicine National Clinical Research Center for Respiratory Diseases China-Japan Friendship Hospital Beijing China Department of Pulmonary and critical care Medicine The 2nd Affiliated Hospital of Harbin Medical University Harbin Medical University Harbin China Diversity and well-Being Laboratory Department of Psychology The Chinese University of Hong Kong Hong Kong China

Background The global coronavirus disease 2019(cOVID-19)has caused many negative effects on physical and mental health of patients who have survived *** from some long-lasting physical sequelae,those cOVID-19 survivors are also suffering stigma and discrimination at different levels around the *** current study aims to assess the role resilience played in stigma and mental disorders among cOVID-19 *** The cross-sectional study was carried out among former cOVID-19 patients in Jianghan District(wuhan,china)from June 10 to July 25,*** demographic questions,the Impact of Events Scale-Revised,the Generalized Anxiety Disorder Questionnaire,the Patient Health Questionnaire,the Resilience Style Questionnaire and the Short Version of cOVID-19 Stigma Scale of 12 items were used to collect relevant information of the *** analyses,Pearson correlation analysis and Structural Equation Modeling were used to make data description and *** A total of 1541 out of 1601 cOVID-19 survivors(887 females and 654 males)were included in the *** stigma of those cOVID-19 survivors correlates significantly with anxiety(r=0.335,Pc stress disorder(PTSD)(r=0.384,Pct effect on cOVID-19 survivors’anxiety(β=0.326,Pce(β=−0.114,Pce partially mediated the association between perceived stigma and anxiety(β=0.020,PcOVID-19 *** Stigma has a significant negative impact on mental health,while resilience plays a mediator role in the relationship between stigma and mental health among cOVID-19 *** on our study,we suggested that when designing psychological interventions for cOVID-19 survivors,consideration should be taken into account to reduce stigma and improve resilience.

关键词： cOVID-19 Survivor Mental health Resilience Mediating affect Stigma

Spatial distribution of leprosy in India:an ecological study

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Infectious Diseases of Poverty 2018年第1期7卷 206-214页

作者： Kyra H.Grantz winnie chabaari Ramolotja Kagiso Samuel Buri Gershom Laura Blum Lee worden Sarah Ackley Fengchen Liu Thomas M.Lietman Alison P.Galvani Lalitha Prajna Travis c.Porco Department of Biology University of FloridaGainesvilleFLUSA Emerging Pathogens Institute University of FloridaGainesvilleFLUSA DST/NRF center for Excellence in Epidemiological Modeling and Analysis(SAcEMA) StellenboschSouth Africa Stellenbosch University StellenboschSouth Africa African Institute of Mathematical Sciences MuizenbergSouth Africa University of california BerkeleyCAUSA Francis I.Proctor Foundation for Research in Ophthalmology University of CaliforniaSan FranciscoCAUSA Department of Ophthalmology University of CaliforniaSan FranciscoCAUSA Department of Epidemiology and Biostatistics University of CaliforniaSan FranciscoCAUSA Yale University New HavenCTUSA Aravind Eye Hospital MaduraiTamil NaduIndia

Background:As leprosy elimination becomes an increasingly realistic goal,it is essential to determine the factors that contribute to its *** evaluate social and economic factors as predictors of leprosy annual new case detection rates within India,where the majority of leprosy cases ***:we used correlation and linear mixed effect regressions to assess whether poverty,illiteracy,nighttime satellite radiance(an index of development),and other covariates can explain district-wise annual new case detection rate and Grade 2 disability ***:we find only weak evidence of an association between poverty and annual new case detection rates at the district level,though illiteracy and satellite radiance are statistically significant predictors of leprosy at the district *** find no evidence of rapid decline over the period 2008-2015 in either new case detection or new Grade 2 ***:Our findings suggest a somewhat higher rate of leprosy detection,on average,in poorer districts;the overall effect is *** divide between leprosy case detection and true incidence of clinical leprosy complicates these results,particularly given that the detection rate is likely disproportionately lower in impoverished *** information is needed to distinguish the determinants of leprosy case detection and transmission during the elimination epoch.

关键词： Leprosy Hansen’s disease India Poverty Spatial

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Temporal trends and rural-urban disparities in cerebrovascular risk factors,in-hospital management and outcomes in ischaemic strokes in china from 2005 to 2015:a nationwide serial cross-sectional survey

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Stroke & Vascular Neurology 2023年第1期8卷 34-50页

作者： chun-Juan wang Hong-Qiu Gu Xin-Miao Zhang Yong Jiang Hao Li Janet Prvu Bettger Xia Meng Ke-Hui Dong Run-Qi wangqin Xin Yang Meng wang chelsea Liu Li-Ping Liu Bei-Sha Tang Guo-Zhong Li Yu-Ming Xu Zhi-Yi He Yi Yang winnie Yip Gregg c Fonarow Lee H Schwamm Ying Xian Xing-Quan Zhao Yi-Long wang Yongjun wang Zixiao Li china National clinical Research center for Neurological Diseases Beijing Tiantan HospitalCapital Medical UniversityBeijingChina National center for Healthcare Quality Management in Neurological Diseases Beijing Tiantan HospitalCapital Medical UniversityBeijingChina Vascular Neurology Department of NeurologyBeijing Tiantan HospitalCapital Medical UniversityBeiingChina center of Stroke Beijing Institute for Brain DisordersBeijngChina Beijing Key Laboratory of Translational Medicine for cerebrovascular Disease BeijingChina Duke clinical Research Institute Duke UniversityDurhamNorth CarolinaUSA Department of Neurology Duke Univeristy Medical CenterDurhamNorth CarolinaUSA Department of Epidemiology Harvard T H Chan School of Public HealthBostonMassachusettsUSA Neuro-intensive care Unit Department of NeurologyBeijing Tiantan HospitalCapital Medical UniversityBeijingChina Department of Neurology Xiangya HospitalCentral South UniversityChangshaHunanChina Department of Neurology The First Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiangChina Department of Neurology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenanChina Key Laboratory of cerebrovascular Disease Prevention and Treatment National Health Commission(Province and Ministry Co-constructed)ZhengzhouHenanChina Department of Neurology The First Affiliated Hospital of China Medical UniversityShenyangLiaoningChina Department of Neurology The First Hospital of Jilin UniversityChangchunJilinChina Department of Global Health and Population Harvard T.H.Chan School of Public HealthBostonMAUSA Ahmanson-UcLA cardiomyopathy center Ronald Reagan-UCLA Medical CenterLos AngelesCAUSA Department of Neurology Massachusetts General HospitalHarvard Medical SchoolBostonMAUSA Department of Neurology The University of Texas Southwestern Medical CenterDallasTexasUSA Research Unit of Artificial Intelligence in cerebrovascular Disease Chinese Academy of Medical SciencesBeijingChina chinese Inst

Background Stroke is the leading cause of mortality in china,with limited evidence of in-hospital burden obtained from nationwide *** aimed to monitor and track the temporal trends and rural-urban disparities in cerebrovascular risk factors,management and outcomes from 2005 to *** we used a two-stage random sampling survey to create a nationally representative sample of patients admitted for ischaemic stroke in 2005,2010 and *** sampled participating hospitals with an economic-geographical region-stratified random-sampling approach first and then obtained patients with a systematic sampling *** weighed our survey data to estimate the national-level results and assess changes from 2005 to *** we analysed 28277 ischaemic stroke admissions from 189 participating *** 2005 to 2015,the estimated national hospital admission rate for ischaemic stroke per 100000 people increased(from 75.9 to 402.7,Ptrendce of risk factors,including hypertension,diabetes,dyslipidaemia and current smoking,*** composite score of diagnostic tests for stroke aetiology assessment(from 0.22 to 0.36,Ptrendcondary prevention treatments(from 0.46 to 0.70,Ptrendwere improved.A temporal decrease was found in discharge against medical advice(DAMA)(from 15.2%(95%cI 13.7%to 16.7%)to 8.6%(8.1%to 9.0%);adjusted Ptrend=0.046),and decreases in in-hospital mortality(0.7%in 2015 vs 1.8%in 2005;adjusted OR(aOR)0.52;95%cI 0.32 to 0.85)and the composite outcome of in-hospital mortality or DAMA(8.4%in 2015 vs 13.9%in 2005;aOR 0.65;95%cI 0.47 to 0.89)were *** between rural and urban hospitals narrowed;however,disparities persisted in in-hospital management(brain MRI:rural-urban difference from−14.4%to−11.2%;cerebrovascular assessment:from−20.3%to−16.7%;clopidogrel:from−2.1%to−10.3%;anticoagulant for atrial fibrillation:from−10.9%to−8.2%)and in-hospital outcomes(DAMA:from 2.7%to 5.0%;composite outcome

关键词： admitted nationwide survey

Mindfulness-based online intervention on mental health and quality of life among cOVID-19 patients in china: an intervention design

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Infectious Diseases of Poverty 2021年第3期10卷 62-71页

作者： Ming-Yu Si wei-Jun Xiao chen Pan Hao wang Yi-Man Huang Jun Lian winnie w.S.Mak Zhi-wei Leng Xiao-You Su Qiu-PingTang Yu Jiang Lu-Zhao Feng wei-Zhong Yang chen wang School of Population Medicine and Public Health Chinese Academy of Medical Sciences and Peking Union Medical College9 DongDanSanTiaoDongchengBeijingChina Department of clinical Psychology The Third Xiangya Hospital of Central South UniversityNo.138 Tongzipo RoadYueluChangshaHunanChina Diversity and well-Being Laboratory Department of PsychologyThe Chinese University of Hong KongShatinNTHong KongChina chinese Academy of Medical Sciences and Peking Union Medical college BeijingChina National clinical Research center for Respiratory Diseases BeijingChina.

Background:cOVID-19 can lead to increased psychological symptoms such as post-traumatic stress disorder(PTSD),depression,and anxiety among patients with *** on the previous mindfulness-based interventions proved to be effective,this protocol reports a design of a randomized controlled trial aiming to explore the efficacy and possible mechanism of a mindful living with challenge(MLwc)intervention developed for cOVID-19 survivors in alleviating their psychological problems caused by both the disease and the ***:In April 2021,more than 1600 eligible participants from Hubei Province of china will be assigned 1:1 to an online MLwc intervention group or a waitlist control *** participants will be asked to complete online questionnaires at baseline,post-program,and 3-month *** differences of mental health status(***)and physical symptoms including fatigue and sleeplessness between the cOVID-19 survivors who receiving the online MLwc intervention and the control group will be *** addition,the possible mediators and moderators of the link between the MLwc intervention and target outcomes will be evaluated by related verified scales,such as the Five Facets Mindfulness *** will be analyzed based on an intention-to-t「eat approach,and SPSS software will be used to perform statistical ***:The efficacy and potential mechanism of MLwc intervention in improving the quality of life and psychological status of cOVID-19 survivors in china are expected to be *** from this study will shed light on a novel and feasible model in improving the psychological well-being of people during such public health *** registration chinese clinicalTrial Registry(chicTR),chicTR2000037524;Registered on August 29,2020,http://***/***?proj=60034.

关键词： cOVID-19 Internet Mindfulness-based intervention Mental health Randomized controlled trial china

Bringing sensation to prosthetic hands-chronic assessment of implanted thin-film electrodes in humans

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npj Flexible Electronics 2023年第1期7卷 32-45页

作者： PaulČvančara Giacomo Valle Matthias Müller Inga Bartels Thomas Guiho Arthur Hiairrassary Francesco Petrini Stanisa Raspopovic Ivo Strauss Giuseppe Granata Eduardo Fernandez Paolo M.Rossini Massimo Barbaro Ken Yoshida winnie Jensen Jean-Louis Divoux David Guiraud Silvestro Micera Thomas Stieglitz Laboratory for Biomedical Microtechnology Department of Microsystems Engineering-IMTEKAlbert-Ludwig-University FreiburgFreiburgGermany center for Neuroprosthetics and Institute of Bioengineering School of EngineeringÉcole Polytechnique Fédérale de Lausanne(EPFL)LausanneSwitzerland The Biorobotics Institute Scuola Superiore Sant’AnnaPisaItaly camin Team INRIAUniversity of MontpellierMontpellierFrance Institute of Neurology Catholic University of the Sacred HeartRomaItaly Institute of Neurosurgery Catholic University of the Sacred HeartRomaItaly Department of Neuroscience&Neurorehabilitation IRCCS San Raffaele Roma00166 RomeItaly Department of Electrical and Electronic Engineering University of CagliariCagliariItaly Biomedical Engineering Department Indiana University-Purdue UniversityIndianapolisINUSA SMI Dept.Health Science and TechnologyAalborg UniversityAalborgDenmark AXONIc/Groupe MXM VallaurisFrance BrainLinks-BrainTools Albert-Ludwig-University FreiburgFreiburgGermany Bernstein center Freiburg Albert-Ludwig-University FreiburgFreiburgGermany Present address:Laboratory for Neuroengineering Department of Health Sciences and TechnologyInstitute for Robotics and Intelligent SystemsETH ZürichZürichSwitzerland

Direct stimulation of peripheral nerves with implantable electrodes successfully provided sensory feedback to amputees while using hand *** of the electrodes is key to success,which we have improved for the polyimide-based transverse intrafascicular multichannel electrode(TIME).The TIMEs were implanted in the median and ulnar nerves of three trans-radial amputees for up to six *** present a comprehensive assessment of the electrical properties of the thin-film metallization as well as material status post *** TIMEs stayed within the electrochemical safe limits while enabling consistent and precise amplitude *** lead to a reliable performance in terms of eliciting *** signs of corrosion or morphological change to the thin-film metallization of the probes was observed by means of electrochemical and optical *** presented longevity demonstrates that thin-film electrodes are applicable in permanent implant systems.

关键词： film electrodes sensation

脑卒中伴融合型脑白质病变患者的他汀类药物治疗

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脑卒中伴融合型脑白质病变患者的他汀类药物治疗