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Journal of Clinical and Nursing Research 2024年第8期8卷 218-231页

作者： Teng Sun Rebecca A.Guariño Shandong Provincial Qianfoshan Hospital Jinan 250000Shangdong ProvinceChina

Objective:This study aimed to understand the affordability,accessibility,and quality of maternal and child health services for postpartum mothers,and their impact on ***:The study utilized the Anderson model and revised the Maternal Pregnancy and Perinatal Health Service Questionnaire.A survey was conducted among 289 mothers aged 20–49 in Feicheng ***:Regarding accessibility,most respondents(133)reported that travel time to healthcare services exceeded 60 minutes,while 99 respondents indicated a travel time of 16–30 *** issue of affordability was highlighted,with 86.85%of participants perceiving maternal healthcare services as costly,indicating a significant financial *** than 50%of respondents were satisfied with two specific dimensions(Paffordability,and quality significantly affect mothers’satisfaction with maternal health *** research should focus on developing more suitable service pathways for rural mothers.

关键词： affordability Accessibility Quality Maternal health care services Level of satisfaction Rural area

Availability and affordability of Therapeutic Monoclonal Antibodies After the New Medical Reform in Hubei Province,China

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Current Medical Science 2022年第6期42卷 1325-1333页

作者： Yu-feng DING Jin-wen ZHANG Mei-jun XIA Guang-jie WU Wei-jie LI Da FENG Shi-wei GONG Department of Pharmacy Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China Department of Pharmacy Business and Administration School of PharmacyTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430030China

Objective In 2017,China launched a new round of medical reform(NMR)to address the inaccessibility of high-priced drugs for patients with serious *** study explored the impact of the NMR on the accessibility and affordability of high-priced monoclonal antibodies(mAbs),and the effective promotion policies after the *** We used a standard method developed by the World Health Organization to conduct two surveys on the availability of mAbs and their prices before and after the NMR in the public hospitals in Hubei province,*** interviewing hospital pharmacy experts,we identified the potential value of the current NMR in improving the access to therapeutic *** The average availability of 13 mAbs increased by 8.1%in the surveyed hospitals of Hubei province after the *** median unit price of 10 mAbs dropped by 34.3%.The average affordability of a treatment cycle of 10 mAbs dropped from 680 days to 298 days of the disposable daily income for a middle-income resident(56.2%reduction).The drug price negotiation of medical insurance inclusion and the promotion of consistent evaluation of generic and original drugs could effectively promote the accessibility of ***,the zero markup of drug pricing and the limit on the proportion of drug revenues in public hospitals showed certain negative effects on the availability of *** Not all current NMR policies play a positive role in promoting the accessibility of *** further improve the accessibility of mAbs in the future in China,it is therefore critical to increase the investment in independent research and development of high-quality mAbs,establish localized guidelines for the rational use of mAbs in clinical practice,and have a cost-sharing mechanism for high-priced drugs with multiple stakeholders.

关键词： availability affordability monoclonal antibody new medical reform Hubei province China

Treatment of coronavirus disease 2019 in Shandong,China:a cost and affordability analysis

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Infectious Diseases of Poverty 2020年第3期9卷 31-38页

作者： Xue-Zheng Li Feng Jin Jian-Guo Zhang Yun-Feng Deng Wei Shu Jing-Min Qin Xin Ma Yu Pang School of Public Health Cheeloo College of MedicineShandong UniversityJinanPeople’s Republic of China Provincial Key Laboratory for Respiratory Infectious Diseases in Shandong Shandong Provincial Chest HospitalCheeloo College of MedicineShandong UniversityJinanPeople’s Republic of China Katharine Hsu International Research Center of Human Infectious Diseases Shandon Provincial Chest HospitalCheeloo College of MedicineShandong UniversityNo.44 Wenhuaxi RoadLixia District250012 JinanPeople’s Republic of China Department of Planning and Finance Shandong Provincial Chest HospitalCheeloo College of MedicineShandong UniversityJinanPeople’s Republic of China National Clinical Laboratory on Tuberculosis Beijing Key laboratory on Drug-resistant Tuberculosis ResearchBeijing Chest HospitalCapital Medical UniversityBeijing Tuberculosis and Thoracic Tumor InstituteNo 9Beiguan StreetTongzhou DistrictBeijing 101149People’s Republic of China

Background:Coronavirus disease 2019(COVID-19)is now a global public *** the pandemic of COVID-19,the economic impact of COVID-19 is essential to add value to the policy-making *** retrospectively conducted a cost and affordability analysis to determine the medical costs of COVID-19 patients in China,and also assess the factors affecting their ***:This analysis was retrospectively conducted in Shandong Provincial Chest Hospital between 24 January and 16 March *** total direct medical expenditures were analyzed by cost *** also assessed affordability by comparing the simulated out-of-pocket expenditure of COVID-19 cases relative to the per capita disposable *** between groups were tested by student t test and Mann-Whitney test when appropriate.A multiple logistic regression model was built to determine the risk factors associated with high ***:A total of 70 COVID-19 patients were included in the *** overall mean cost was USD 6827 per treated *** highest mean cost was observed in drug acquisition,accounting for 45.1%of the overall *** mean cost was significantly higher in patients with pre-existing diseases compared to those without preexisting ***-existing diseases and the advanced disease severity were strongly associated with higher *** USD 0.49 billion were expected for clinical manage of COVID-19 in *** rural households,the proportions of health insurance coverage should be increased to 70%for severe cases,and 80%for critically ill cases to avoid catastrophic health ***:Our data demonstrate that clinical management of COVID-19 patients incurs a great financial burden to national health *** cost for drug acquisition is the major contributor to the medical cost,whereas the risk factors for higher cost are pre-existing diseases and severity of *** of insurance coverage will need to address the barriers of rural

关键词： COVID-19 Cost Treatment affordability China

Availability, Prices and affordability of Glaucoma Medicines among Private Pharmacies of Nampula City in Mozambique

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Open Journal of Epidemiology 2022年第2期12卷 158-169页

作者： Joel Bambamba Neivaldo Murrube Paulo Pires Ângela Bambamba Christpina Anale Avelino Mazuze João Mazalo Momade Fumo Ramos Manuel Hermenegildo Tomo Department of Optometry Faculty of Health Sciences Lúrio University Nampula Mozambique Department of Pharmacy Faculty of Health Sciences Lúrio University Nampula Mozambique Department of Family Medicine Faculty of Health Sciences Lúrio University Nampula Mozambique

Introduction: Glaucoma is a group of chronically progressive disorders of the optic nerve and a worldwide leading cause of irreversible vision loss. Eye chronic diseases including glaucoma are major public health problems around the world, rapidly increasing with a growing and aging population. The treatment of chronic diseases lasts a lifetime. The purpose of this study is to assess the availability, prices and affordability of the medicines for glaucoma management in private pharmacies of Nampula City in Mozambique. Material and Methods: The standardized methodology designed by the World Health Organization and Health Action International was employed to conduct the study about the availability, price and affordability of glaucoma medicines in Nampula City from October to November 2021. Data were collected in 39 private pharmacies using a survey with fifteen glaucoma Medicines. Results: The Average of medicines availability was 46.6% (0.0% - 71.8%) with a mean of 8.86. The availability level demonstrated that 14 (93.3%) of all surveyed glaucoma medicines were very low and 1 (6.67%) was fairly high. Timolol was the most available medicine, found in 28 (71.8%) while apraclonidine, carteolol, levobunolol, carbachol, brinzolamide, bimatoprost, travoprost and unoprostone were not available. The medicine with the lowest price was latanoprost (2.84 USD) and the higher was acetazolamide (23.58 USD). None of the surveyed medicines were considered affordable. Conclusion: The majority of surveyed glaucoma medicines were not available and they were totally unaffordable against the defined thresholds. Policy strategy and technical options should be driven and implemented by the government to ensure the availability and affordability of glaucoma medicines at various levels of the Mozambican healthcare system.

关键词： Availability Prices affordability Medicines Glaucoma

Research on affordability Modeling of Aircraft Based on Effectiveness Indexes

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International Journal of Plant Engineering and Management 2011年第1期16卷 15-20页

作者： YAN Sheng-wen GUO Ji-han School of Management Northwestern Polytechnical University Xi'an 710072 P. R. China Engineering College Air Force Engineering University Xi'an 710038 P. R. China

With the cost estimation of military aircraft as the research object, this paper aims to study the contradiction between the choice of explanatory variables in index modeling and the maintaining of model validity. It analyzes and establishes a cost estimation modeling concept based on an Effectiveness Index and studies the way to construct Effectiveness Indexes for the sake of cost estimation modeling. Based on a case study, the paper establishes and analyzes the Effectiveness Index-based cost estimation models and DAPCA （Development And Procurement Costs of Aircraft） models developed by the RAND Corparation . The comparison of these models shows that the Effective- ness Index-based cost parameter models not only comprehensively consider the obvious driving parameter indexes of the cost, but reduces the variables of regressive analysis, hence giving the model a higher reliability.

关键词： military aircraft effectiveness index affordability cost parameter model

A Review of Rechargeable Zinc-Air Batteries:Recent Progress and Future Perspectives

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Nano-Micro Letters 2024年第7期16卷 358-401页

作者： Ghazanfar Nazir Adeela Rehman Jong-Hoon Lee Choong-Hee Kim Jagadis Gautam Kwang Heo Sajjad Hussain Muhammad Ikram Abeer AAlObaid Seul-Yi Lee Soo-Jin Park Department of Nanotechnology and Advanced Materials Engineering Hybrid Materials Research Center(HMC)Sejong UniversitySeoul 05006Republic of Korea Department of Chemical and Biomolecular Engineering Yonsei University50 Yonsei-RoSeodaemun-GuSeoul 03722Republic of Korea Department of Chemistry Inha UniversityIncheon 22212Republic of Korea Solar Cell Applications Research Lab Department of PhysicsGovernment College University LahoreLahore 54000 PunjabPakistan Department of Chemistry College of ScienceKing Saud UniversityP.O.Box 2455Riyadh 11451Saudi Arabia

Zinc-air batteries(ZABs)are gaining attention as an ideal option for various applications requiring high-capacity batteries,such as portable electronics,electric vehicles,and renewable energy *** offer advantages such as low environmental impact,enhanced safety compared to Li-ion batteries,and cost-effectiveness due to the abundance of ***,early research faced challenges due to parasitic reactions at the zinc anode and slow oxygen redox *** advancements in restructuring the anode,utilizing alternative electrolytes,and developing bifunctional oxygen catalysts have significantly improved *** have achieved battery reversibility over thousands of cycles,introduced new electrolytes,and achieved energy efficiency records surpassing 70%.Despite these achievements,there are challenges related to lower power density,shorter lifespan,and air electrode corrosion leading to performance *** review paper discusses different battery configurations,and reaction mechanisms for electrically and mechanically rechargeable ZABs,and proposes remedies to enhance overall battery *** paper also explores recent advancements,applications,and the future prospects of electrically/mechanically rechargeable ZABs.

关键词： Zinc-air batteries Energy storage affordability Reversibility

Cost of treatment support for multidrug-resistant tuberculosis using patient-centred approaches in Ethiopia: a model-based method

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Infectious Diseases of Poverty 2023年第4期12卷 54-62页

作者： Laura Rosu Lucy Morgan Ewan M.Tomeny Claire Worthington Mengdi Jin Jasper Nidoi David Worthington Liverpool School of Tropical Medicine Pembroke PlaceLiverpoolL35QAUK Management Science Lancaster UniversityLancasterUK Makerere University Lung Institute KampalaUganda

Background Patient and health system costs for treating multidrug-resistant tuberculosis (MDR-TB) remain high even after treatment duration was shortened. Many patients do not finish treatment, contributing to increased transmission and antimicrobial resistance. A restructure of health services, that is more patient-centred has the potential to reduce costs and increase trust and patient satisfaction. The aim of the study is to investigate how costs would change in the delivery of MDR-TB care in Ethiopia under patient-centred and hybrid approaches compared to the current *** We used published data, collected from 2017 to 2020 as part of the Standard Treatment Regimen of Anti-Tuberculosis Drugs for Patients with MDR-TB (STREAM) trial, to populate a discrete event simulation (DES) model. The model was developed to represent the key characteristics of patients’ clinical pathways following each of the three treatment delivery strategies. To the pathways of 1000 patients generated by the DES model we applied relevant patient cost data derived from the STREAM trial. Costs are calculated for treating patients using a 9-month MDR-TB treatment and are presented in 2021 United States dollars (USD).Results The patient-centred and hybrid strategies are less costly than the standard-of-care, from both a health system (by USD 219 for patient-centred and USD 276 for the hybrid strategy) and patient perspective when patients do not have a guardian (by USD 389 for patient-centred and USD 152 for the hybrid strategy). Changes in indirect costs, staff costs, transport costs, inpatient stay costs or changes in directly-observed-treatment frequency or hospitalisation duration for standard-of-care did not change our *** Our findings show that patient-centred and hybrid strategies for delivering MDR-TB treatment cost less than standard-of-care and provide critical evidence that there is scope for such strategies to be implemented in routine care. These

关键词： affordability Multidrug-resistant tuberculosis Directly-observed treatment Patient-centred approach Tuberculosis treatment delivery

Role of Community Health Practitioners in National Development: The Nigeria Situation

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International Journal of Clinical Medicine 2016年第7期7卷 511-518页

作者： Asiton-a Solomon Ibama Pauline Dennis Community Health Services Department Rivers State Primary Health Care Management Board Port Harcourt Nigeria

This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of social welfare services provision among others for the citizens of a country over time, with particular emphasis on medical care component of such index aimed at reduction in diseases and poverty in the population. The objective of the review work is to determine the extent to which Community Health Practice, particularly by Community Health Practitioners is capable of ensuring National Development in democratic governance or otherwise, in the context of our country, Nigeria. The methodology applied was traditional review of published literatures concerning the subject and findings of operational research of programme implemented by Community Health Practitioners at the Primary Health Care facilities and household level in the communities. This paper emphasizes on Primary Health Care services delivery contribution to National Development, since it is the level where Community Health Practitioners are mainly commissioned to render their services. Home-Based Care Strategy for Integrated Maternal, Newborn and Child Health piloted in three (3) local government areas (Ahoada West, Etche and Oyigbo) in Rivers State, Nigeria, in 2012 and implemented by Community Health Practitioners, aimed at reducing maternal, newborn and child morbidity and mortality by 20% by 2015 in line with the United Nations (UN) Millennium Development Goals 4 and 5, had been shown to achieve an average of 26% improvement in utilization of maternal and newborn health services, an average of 27% overall reduction in maternal malnutrition status, an average of 14% overall improvement in under 5 years malnutrition status among others in 2013 on comparing with baseline indicators. Nigeria also attained 80% coverage in routine immunization in most vaccine preventable diseases except Tetanus Toxio

关键词： National Development National Development Community Community Health Practitioners Roles Primary Health Care Promotive Preventive Curative Rehabilitative Accessibility Acceptability affordability Rural Nigeria Health System

The Challenges of Cochlear Implant Users in Jos, North Central Nigeria

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第4期11卷 175-192页

作者： Babson Benjamin Bako School of Advanced Education Research and Accreditation Castellón Spain

Cochlear implants (CIs) are remarkable solutions for severe to profound sensorineural hearing loss globally. Access to cochlear implants in developing countries is not without challenges. This study examined the challenges of CI users in Jos, Nigeria. The study is a cross-sectional survey that used a convenient sampling technique to sample 41 respondents. CICQ questionnaire was used to elicit data from the respondents. A simple percentage was used to analyze the data. The results revealed that 62.5% of the CI users lived below 100,000 Naira (USD244) as their yearly income. The majority (93.75%) have severe to profound hearing loss bilaterally but used CI unilaterally. Cost and access to CI accessories and management have affected the economic, social and psychological life of the CI users and that of their relations. ENT personnel said that the demand for CI in their facility is very high and managing CI users is very challenging due to inadequate manpower, finance and equipment. Easy access to CIs, their accessories and services at affordable cost, effective training for ENT personnel, and adequately equipped health facilities were recommended.

关键词： Cochlear Implant Accessibility affordability Family and Societal Challenges

Medical Diagnosis Expert System for Malaria and Related Diseases for Developing Countries

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E-Health Telecommunication Systems and Networks 2018年第2期7卷 43-56页

作者： Kenneth Ikechukwu Nkuma-Udah Gloria Azogini Chukwudebe Emmanuel Nwabueze Ekwonwune Department of Biomedical Technology Federal University of Technology Owerri Nigeria Department of Electrical/Electronic Engineering Federal University of Technology Owerri Nigeria Department of Computer Science Imo State University Owerri Nigeria

There is a strong need for cost-effective technologies to manage disease processes and thus reduce morbidity and mortality in the developing countries. Yet bringing intelligent healthcare informatics to bear on the dual problems of reducing healthcare costs and improving quality and outcomes is a challenge even in countries with a reasonably developed technology infrastructure. This paper focused at how appropriate an ap-plication of Medical Diagnosis Expert System (MDES) is to manage diseases in developing countries. MDES is usually designed to enable clinicians to identify diseases and describe methods of treatment to be carried out taking into account the user capability. The MDES described here is implemented using the C Language Integrated Production System (CLIPS). The CLIPS is an expert system, which has a shell composed of four modules: the user interface, the explanation system, the inference engine and the knowledge base editor. In the system, a number of patient cases will be selected as prototypes and stored in a separate database. The knowledge is acquired from literature review, human experts and the internet of the specific domain and is used as a base for analysis, diagnosis and recommendations.

关键词： Developing affordability Appropriateness Expert System Medical Diagnosis Developing Countries Artificial Intelligence