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mhealth as a health system strengthening tool in China

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International Journal of Nursing Sciences 2020年第S01期7卷 19-22页

作者： Maoyi Tian Xinyi Zhang Jing Zhang The George Institute for Global Health at Peking University health Science Centre BeijingChina The George Institute for Global Health University of New South WalesSydneyAustralia School of Public health University of New South WalesAustralia

Over the past 70 years,there was a rapid epidemiological transition in disease burden in China,from infectious disease to non-communicable diseases(NCDs),which requires long-term prevention and management.Rapid growth in mobile phone use,internet connectivity and digital health technology,presents new opportunities for improvement in NCD healthcare delivery and population-based outcomes.Although there were a growing number of research to evaluate the feasibility and effectiveness of the mobile health(mhealth)interventions for NCD management,the extent to which mhealth contributes towards the health system strengthening in China remains unknown.In this paper,we provided a high-level overview of mhealth in China and its role for Chinese health system strengthening.We conclude with several recommendations for the future of mhealth research in China based on existing evidence identified.

关键词： Cell phone use China Delivery of health care Digital health Internet Non-communicable diseases Telemedicine

移动健康在中国医疗卫生体系中的作用（英文）

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International Journal of Nursing Sciences 2020年第S1期 19-22+90页

作者：田懋一张馨艺张京 The George Institute for Global Health at Peking University health Science Centre The George Institute for Global Health University of New South Wales School of Public health University of New South Wales

在过去的70年时间里,我国的疾病负担正在经历从传染性疾病到慢性非传染病的快速流行病学转变。有别于传染性疾病,慢性非传染性疾病需要的长期的预防和管理。移动电话的广泛应用、互联网的大面积覆盖以及新型的数字健康技术的发展,为慢... 详细信息

在过去的70年时间里,我国的疾病负担正在经历从传染性疾病到慢性非传染病的快速流行病学转变。有别于传染性疾病,慢性非传染性疾病需要的长期的预防和管理。移动电话的广泛应用、互联网的大面积覆盖以及新型的数字健康技术的发展,为慢性非传染性疾病的医疗服务提供模式以及改善人群的健康结局提供了无限的机遇。尽管已有一些研究证明了移动健康干预模式在慢性非传染性疾病管理方面的有效性和可行性,但是在一定程度上移动健康干预模式是否可以加强和促进我国卫生医疗体系还不得而知。本文回顾了我国移动健康干预模式及其在促进我国卫生医疗体系中的角色,并基于目前已有的证据对我国未来移动健康干预模式的发展提出了建议。

关键词：移动电话中国卫生保健提供数字健康因特网非传染性疾病远程医疗

Nutritional quality of pre-packaged foods in China under two warning labelling models

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Nutritional quality of pre-packaged foods in China under two...

Reformulation and strengthening of return-of service(ROS)schemes could change the narrative on global health workforce distribution and shortages in sub-Saharan Africa

中国营养学会第十五届全国营养科学大会

作者： Yuan Li Jingmin Ding Le Dong Huijun Wang Jiguo Zhang Wenwen Du Puhong Zhang The George Institute for Global Health at Peking University health Science Centre National institute for Nutrition and health Chinese Centre for Disease Control and Prevention

Objective: Growing evidence has shown that ultra-processed foods were significantly associated with increased risks of obesity and other noncommunicable diseases. Front-of-package(FOP) labels were recommended by many countries to promote healthy choice of pre-packaged foods, among which warning labelling, increasingly adopted in Latin Countries, was proved most effective in reducing the choice of unhealthy foods. The aim of this study is to evaluate the healthiness of pre-packaged foods in China using two warning labelling models, so as to provide policy reference for the development of FOP in China. Methods This study used nutrients and ingredients data of pre-packaged foods in China collected from supermarkets and retail stores during 2017 to 2020 using FoodSwitch China applications through designated collecting in particular areas and crowdsourcing across the country. The data were classified into 18 groups according to the food categorization system developed by the Food Monitoring Group at The george institute global health as part of The International Network for Food and Obesity/non-communicable diseases Research, Monitoring and Action Support(INFORMAS). A total of 14 eligible groups of foods data were included for analysis. The 4 excluded food groups were 1) Vitamins and supplements;2) Alcohol;3) Special foods;4) Foods unable to be categorized. Foods were classified into 4 processed levels according to NOVA classification system(1, unprocessed or minimally processed;2, processed culinary ingredients;3, processed and 4, ultra-processed). Two warning labelling models including the Pan American health Organization Nutrient Profile Model(PAHO NP model) and Chilean nutrient profile models(Chilean NP model) were employed to assess the nutritional quality of collected foods under the eligibility of processed and ultra-processed foods. Total sugars instead of free sugars were measured in PAHO NP model given the shortage of free sugar values. Daily reference intakes in China were also used for all foods as a measu

关键词： Nutrient profiling Labelling Front-of-package labels Warning Labels Processed foods Pre-packaged foods Food policy

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Family Medicine and Community health 2020年第4期8卷 63-66页

作者： Sikhumbuzo A Mabunda Blake Angell Kenneth Yakubu Andrea Durbach Rohina Joshi health Systems George Institute for Global HealthSydneyNew South WalesAustralia Medical Education University of New South Wales-Kensington CampusSydneyNew South WalesAustralia The institute for global health University College LondonLondonUnited Kingdom Law University of New South Wales-Kensington CampusSydneyNew South WalesAustralia

Despite policies for addressing shortages and maldistribution of health professionals,sub-Saharan Africa continues to experience shortages and maldistribution of skilled health professionals.Policies such as return-of service schemes or state-funded educational initiatives do not seem to be achieving their intended objectives,potentially due to poor design,implementation;and lack of monitoring and evaluation of the strategies.A focus by global health experts on strengthening and reformulating educational initiatives offers potential for producing,retaining and recruiting health professionals.

关键词： return service strengthening

Temporal trends in diagnosis,treatment,and outcome for non-ST-segment elevation acute coronary syndrome in three regions of China,2008–2015

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Chinese Medical Journal 2021年第16期134卷 1997-1999页

作者： Rong Liu Yu-Qing Sun Xiao-Xia Hou Yang Zheng Mark DHuffman Craig SAnderson Liu He Shi-Jun Xia Chao Jiang Xin Du Jian-Zeng Dong Chang-Sheng Ma Department of Research and Development Heart Health Research Center(HHRC)Beijing100029China Cardiovascular Program The George Institute for Global HealthFaculty of MedicineUniversity of New South WalesSydney 2050Australia Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China Department of Cardiology Beijing Tongren HospitalCapital Medical UniversityBeijing100176China Department of Cardiology The First Bethune Hospital of Jilin UniversityChangchunJilin 130021China institute for global health Northwestern University Feinberg School of MedicineChicago 60611USA Neurological Program The George Institute for Global HealthFaculty of MedicineUniversity of New South WalesSydney 2050Australia Neurological Program The George Institute China at Peking University Health Science CenterBeijing 100600China Department of Cardiology The First Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450052China.

To the Editor:As acute coronary syndromes(ACS)is common causes of morbidity and mortality in China,they serve as an important case example to assess the impact of these health reforms on the quality,safety,and efficiency of healthcare.[1]ACS comprises a wide spectrum of disease subgroups,including ST-segment elevation myocardial infarction(STEMI),unstable angina(UA),and non-ST-segment elevation myocardial infarction(NSTEMI).Previous studies have shown increases in the intensity of testing and treatment while stable in-hospital mortality for STEMI in China between 2001 and 2011.[2]As non-ST-segment elevation acute coronary syndrome(NSTE-ACS)patients,who account for about two-thirds of ACS patients,have a wide spectrum of disease severity,risk-stratified management is recommended to ensure appropriate allocation of resources,especially in limited-resource settings of China.As limited data exist on the use of medical services and clinical outcomes in relation to health reforms,we aimed to determine temporal trends in diagnosis,treatment,and outcome for hospitalized NSTE-ACS patients in three regions of China between 2008 and 2015.

关键词： diagnosis unstable treatment

E-health:Can It Contribute to Reductions in Road Traffic Injuries?

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伤害医学（电子版） 2012年第2期1卷 1-2页

作者： Robyn Norton The George Institute for Global Health University of Oxford Public health University of Sydney

The use of electronic technologies (e-health),including mobile devices (m-health),as a means to prevent and manage disease and improve health outcomes is a relatively new area of endeavour,but one which is gaining significant momentum,especially in settings where lowcost solutions to improve health outcomes are required[1].In many low and middle-income countries,access to mobile phones and the internet is already high and increasing,especially among adolescents (the highest risk group for road traffic injuries),and with costs for these technologies continuing to decline,they offer significant opportunities to contribute to improvements in health outcomes.

关键词：创伤和损伤钙调蛋白结合蛋白质类计算机通信网络磷蛋白磷酸酶类溶液设备和供应胰岛素因特网青少年人类

Understanding the Effects of Iatrogenic Management on Population health:A Medical Innovation Perspective

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China CDC weekly 2023年第27期5卷 614-618页

作者： Jian Yang Shuduo Zhou Xiangning Feng Ying Chen Yunxuan Hu Ming Xu Department of global health School of Public HealthPeking UniversityBeijingChina institute for global health and Development Peking UniversityBeijingChina

In this paper,we introduce an iatrogenesis intervention framework guided by medical innovation,which encompasses the objectives,influences of medical innovation on iatrogenesis,factors affecting various types of iatrogenesis,and strategies for controlling iatrogenesis.Advancements in medical innovation across various domains can bridge the patient safety implementation gap by uncovering,characterizing,refining,accelerating,scaling,extending,and mobilizing the external and internal conditions and factors that influence the control and elimination of iatrogenesis.

关键词： elimination scaling controlling

Prevalence of Atrial Fibrillation in China and Its Risk Factors

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Biomedical and Environmental Sciences 2013年第9期26卷 709-716页

作者： LI Ying WU Yang Feng CHEN Ke Ping LI Xian ZHANG Xing XIE Gao Qiang WANG Fang Zheng ZHANG Shu State Key Laboratory of Cardiovascular Disease Fuwai Hospital National Center for Cardiovascular Disease Chinese Academy of Medical Sciences and Peking Union Medical College Peking University Clinical Research institute The George Institute for Global Health at Peking University health Science Center

Objective To study the prevalence of atrial fibrillation （AF） and the relation with its risk factors in China. Methods A total of 19 363 participants （8635 males and 10 728 females） aged 〉35 years in geographically dispersed urban and rural regions of China were included in this cross-sectional survey. All participants received questionnaire, physical and blood examination. Echocardiography were performed for AF patients found in the survey. Results Of the 19 363 participants, 199 were diagnosed with AF. The estimated age-standardized prevalence of AF was 0.78% in men and 0.76% in women. The prevalence of AF in participants aged 〈60 years was 0.41% in men and 0.43% in women, and was 1.83% in both men and women aged 〉_60 years. About 19.0% of males and 30.9% of females with AF were diagnosed with valve disease. Age- and sex-adjusted multivariable logistic regression analysis revealed that myocardial infarction, left ventricular hypertrophy （LVH）, obesity, and alcohol consumption were associated with a increased risk of AF（P〈0.05）. Conclusion The age standardized prevalence of AF is 0.77% in the participants enrolled in the present study. The number of AF cases aged 〉35 years is 5.26 million according to 2010 Chinese Census. Most risk factors for AF, identified mainly in Western countries, are also detected in China.

关键词： Atrial fibrillation Epidemiology Risk factors Chinese population

Catheter ablation for atrial fibrillation is associated with reduced risk of mortality in the elderly:a prospective cohort study and propensity score analysis

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Journal of Geriatric Cardiology 2020年第12期17卷 740-749页

作者： Xin SU Xin DU Shang-Xin LU Chao JIANG Jing DU Shi-Jun XIA Zhao-Jie DONG Zhao-Xu JIA De-Yong LONG Cai-Hua SANG Ri-Bo TANG Nian LIU Song-Nan LI Rong BAI Jian-Zeng DONG Chang-Sheng MA Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityNational Clinical Research Centre for Cardiovascular DiseasesBeijingChina Heart health Research Center BeijingChina The George Institute for Global Health Faculty of MedicineUniversity of New South WalesSydneyAustralia Beijing Centre for Disease Prevention and Control BeijingChina

Background It is unclear whether catheter ablation(CA)for atrial fibrillation(AF)affects the long-term prognosis in the elderly.This study aims to evaluate the relationship between CA and long-term outcomes in elderly patients with AF.Methods Patients more than 75 years old with non-valvular AF were prospectively enrolled between August 2011 and December 2017 in the Chinese Atrial Fibrillation Registry Study.Participants who underwent CA at baseline were propensity score matched(1:1)with those who did not receive CA.The outcome events included all-cause mortality,cardiovascular mortality,stroke/transient ischemic attack(TIA),and cardiovascular hospitalization.Results Overall,this cohort included 571 ablated patients and 571 non-ablated patients with similar characteristics on 18 dimensions.During a mean follow-up of 39.75±19.98 months(minimum six months),24 patients died in the ablation group,compared with 60 deaths in the non-ablation group[hazard ratio(HR)=0.49,95%confidence interval(CI):0.30-0.79,P=0.0024].Besides,6 ablated and 29 non-ablated subjects died of cardiovascular disease(HR=0.25,95%CI:0.11-0.61,P=0.0022).A total of 27 ablated and 40 non-ablated patients suffered stroke/TIA(HR=0.79,95%CI:0.48-1.28,P=0.3431).In addition,140 ablated and 194 non-ablated participants suffered cardiovascular hospitalization(HR=0.84,95%CI:0.67-1.04,P=0.1084).Subgroup analyses according to gender,type of AF,time since onset of AF,and anticoagulants exposure in initiation did not show significant heterogeneity.Conclusions In elderly patients with AF,CA may be associated with a lower incidence of all-cause and cardiovascular mortality.

关键词： Atrial fibrillation Catheter ablation Mortality Stroke The elderly