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Investigation of Antibiotic Use at a Dental Teaching Hospital in Yogyakarta, Indonesia: A Review from Guidelines

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Pharmacology & Pharmacy 2014年第5期5卷 524-531页

作者： Mayu winnie Rachmawati Naoko Yoshida Hirohito Tsuboi Kazuko Kimura Department of Drug Management and Policy Graduate School of Natural Science and Technology Kanazawa University Kanazawa Japan

Objective: To investigate prescription of antibiotics by dental practitioners at a dental teaching hospital in Yogyakarta, Indonesia, and to establish whether it conforms to major guidelines. Methods: A cross-sectional study of adult outpatients’ medical records was conducted in order to scrutinize antibiotic prescriptions. The results were compared with recommendations in four published guidelines. Results: Dental practitioners prescribed a wide range of antibiotics to treat 121 diagnoses. Amoxicillin (78.8%) was most commonly prescribed, followed by clindamycin (9.9%), metronidazole (5.0%), and lincomycin (2.1%). Among all prescriptions, 79.5% were for generic antibiotics. The most common diagnoses were dental pulp gangrene followed by dental pulp necrosis (26.7% and 8.8%, respectively). According to guidelines-1 through-4, the percentages of antibiotic prescriptions that were evaluated as appropriate for the reported diagnosis were 15.1%, 7.2%, 7.5%, and 16.3%, respectively. However, 9.9%, 84.0%, 83.7% and 67.8% of prescriptions could not be classified as appropriate or inappropriate because the respective guidelines neither listed the antibiotic nor gave statement regarding appropriate indications. Conclusion: Our results suggest that significant inappropriate antibiotic prescribing occurred at a dental teaching hospital in Yogyakarta, Indonesia, according to major antibiotics guidelines. However, the four guidelines failed to list some antibiotics, failed to list indications for prescription in some cases, and were inconsistent in their recommendations. There is a need to introduce specific institutional guidelines. Our findings should be helpful for developing public health policy guidelines to minimize inappropriate antibiotic prescribing at dental hospitals.

关键词： Appropriateness Antibiotics Prescriptions Dental Teaching Hospital Guidelines

向基层机构倾斜的门诊报销制度对高血压患者门诊服务利用的影响

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北京大学学报（医学版） 2014年第3期46卷 445-449页

作者：汤淑女简伟研 winnie C-M Yip 郭岩北京大学公共卫生学院卫生政策与管理学系北京100191 Blavatnik School of Government University of Oxford

目的:研究向基层机构倾斜的门诊报销制度(即覆盖门诊服务且县、乡、村门诊报销比例由低到高的制度设计)对高血压患者门诊服务利用的影响。方法:从宁夏回族自治区"创新支付制度项目"获取2009年和2011年入户调查的面板数据,采用自然试验... 详细信息

目的:研究向基层机构倾斜的门诊报销制度(即覆盖门诊服务且县、乡、村门诊报销比例由低到高的制度设计)对高血压患者门诊服务利用的影响。方法:从宁夏回族自治区"创新支付制度项目"获取2009年和2011年入户调查的面板数据,采用自然试验的设计,针对干预组和对照组,利用双重差分法(difference-in-differences)进行分析,其结果指标为自报高血压患者样本被调查前3个月内是否就诊及其主要就诊地点的选择。结果:相较于对照组,倾向于基层的新农合门诊覆盖使得干预组高血压患者被调查前3个月内从未就诊的概率下降10.2%,并使患者将村卫生室作为主要就诊地点的概率提高了15.7%。结论:门诊报销比例向基层机构倾斜,可以引导高血压患者在疾病风险较小时就近利用门诊服务。

关键词：保险健康高血压卫生服务利用双重差分法

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清凉菜迎夏酸辣泰味端上桌

上海调味品 2013年第6期 42-49页

作者： winnie

泰味酸辣异国美食开胃泰式料理一向让人感觉又酸又辣，不少人不太敢尝试，觉得酸辣得另但其实泰式料理并不完全都是那么难以让人接受，相反吃起来让人感觉很是身心清爽，胃口大开。

关键词：凉菜不完全料理胃口美食

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麦片瘦身餐给力味

上海调味品 2011年第9期 66-70,72页

作者： winnie 不详

美国密歇根州立大学的—项研究显示，考虑到锻炼和总热量摄入等因素之后，早餐吃麦片的女性体重超重几率比不吃早饭的人低30％，而用其它食物作早餐的女性的超重几率与不吃早饭的女性类似。

关键词：麦片美国密歇根州立大学瘦身女性几率超重早餐食物

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从酒店美食节偷师世界美食

上海调味品 2012年第4期 50-55页

作者： winnie

各个美食节，媚惑人心!酸酸辣辣的泰国风味、橄榄油“浸”出来的意大利美食，飘着奶酪和巧克力味的瑞士菜品……吃到了、赚到了，然后一一学到了等到再想吃的时候，就不用眼巴巴地等着下一个美食节了.

关键词：美食酒店世界意大利橄榄油巧克力风味菜品

Antimicrobial Resistance Encountered in Garbage Collection Areas and Dumpsites in Nairobi, Kenya Using <i>Escherichia coli</i>and <i>Klebsiella</i>as Indicator Species

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Advances in Microbiology 2017年第9期7卷 653-665页

作者： Grace Waturu winnie Mutai John Kiiru Moses Musyoki Leonard Ochieng Department of Medical Microbiology School of Medicine University of Nairobi Nairobi Kenya Centre of Microbiology Research Kenya Medical Research Institute Nairobi Kenya Obstetrics and Gynecology Department School of Medicine University of Nairobi Nairobi Kenya

Dumpsites and garbage collection areas can act as reservoirs of highly resistant bacterial strains and facilitate the dissemination of Multidrug resistant strains to those living and work on or near the dumpsites and garbage collection areas. The objective of this study was to determine the potential of garbage collection areas and dumpsites in different parts of Nairobi as possible sources of resistant strains using E. coli and Klebsiella as indicator species. The study design was a cross-sectional survey. Sample collection was carried out at different days in seventeen different areas. A total of 126 samples were collected during the sampling period. The samples were then transported to the laboratory for analysis. The samples were cultured on MacConkey agar. Gram staining was done on discrete isolates based on colony characteristics. Biochemical tests were performed on colonies from primary cultures for final identification of the isolates. Antimicrobial disc susceptibility tests and pathogenicity tests were also carried out on the indicator isolates. A total of 121 E. coli and 165 Klebsiella were isolated from all the sampled sites. The highest bacterial burden was recorded from Muthurwa estate dumpsite, with a mean viable count of 8.2 × 1010 cfu/gm while the least was from Dandora dumpsite with a mean count of 1.1 × 1011 cfu/gm. Overall, gentamicin was the most effective antibacterial agent on Klebsiella and meropenem was the most effective on both E. coli and Klebsiella strains. The isolates showed high resistance to ampicillin, streptomycin, and trimethoprim-sulfamethoxazole. It is concluded that municipal waste dumpsites and garbage collection areas bear heavy burdens of potentially resistant bacteria which may constitute major public health hazards, not only to the immediate communities but also to the families of such site workers.

关键词： Dumpsite Garbage Collection Area Indicator Organisms Antimicrobial Resistance

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健康低卡孕妈也节食

上海调味品 2012年第9期 66-68,70-73页

作者： winnie

怀孕了当开心地大吃时，孕妈咪可得小心不知不觉中增加的负担，长出多余的肉肉。要吃得好、还不胖，孕妈咪在怀孕期间也要有“节食”意识。有误会孕期一人吃两人份中国的孕妇大概是最能吃的：各种蛋类、各种肉类、各种鱼类、各种虾类、... 详细信息

怀孕了当开心地大吃时，孕妈咪可得小心不知不觉中增加的负担，长出多余的肉肉。要吃得好、还不胖，孕妈咪在怀孕期间也要有“节食”意识。有误会孕期一人吃两人份中国的孕妇大概是最能吃的：各种蛋类、各种肉类、各种鱼类、各种虾类、各种汤水、各种水果、各种蔬菜、各种谷类、各种偏方、各种大补……人家要求孕妇整个产程体重增加12．5～15千克即可，我们身边孕妇动辄增重3、40斤甚至50斤，有时胖个7、80斤的也有，而且吃得怡然自得，胖得理直气壮一一因为，要给宝宝足够的营养嘛。

关键词：节食健康怀孕期间体重增加孕妇肉类水果谷类

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凉拌＋创意夏日餐桌健康公式

上海调味品 2013年第6期 34-34,36-41页

作者： winnie

凉拌菜，既是最容易上手的菜式之一，也是少油少炸、适合夏日的健康款。但是好胃口，总少不了要菜肴的形与色一起来帮忙。没听见吗，常常有人会抱怨——健康的菜都不好吃。所以一定要创意，才可以让原本可能清淡到寡的健康菜变出点新花... 详细信息

凉拌菜，既是最容易上手的菜式之一，也是少油少炸、适合夏日的健康款。但是好胃口，总少不了要菜肴的形与色一起来帮忙。没听见吗，常常有人会抱怨——健康的菜都不好吃。所以一定要创意，才可以让原本可能清淡到寡的健康菜变出点新花样来。

关键词：凉拌菜健康创意夏日公式餐桌菜式菜肴

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呱呱叫瓜果来瘦身

上海调味品 2012年第8期 56-66页

作者： winnie

一到夏天，最受欢迎的自然是那些圆墩墩的瓜瓜果果，低脂肪和高纤维是它们最大的卖点，保管你吃得越“猛”，瘦得越多，减肥效果顶呱呱。

关键词：瓜果瘦身减肥效果高纤维低脂肪夏天