Study on emergency management mechanism of drug volume-based procurement / 中国药房

OBJECTIVE To provide reference for the normalization of drug volume-based procurement （hereinafter referred to as “VBP”） and the establishment of local emergency management mechanism. METHODS Based on the equilibrium theory of the whole process of emergency management with Chinese conditions， referring to the “6+1” stage model， the emergency management mechanism of VBP was constructed； 21 provincial-level procurement projects in China from 2019 to 2022 were evaluated accordingly. RESULTS The emergency management mechanism of VBP including 14 measures in 7 stages of preparation， prevention， mitigation， response， recovery， learning and monitoring was successfully constructed. The total score of the 21 provincial-level procurement projects was 3 to 11 points， and the average score of each project in the past 4 years fluctuated slightly within 6 to 7 points. Among the 5 evaluated stages， the scores of the prevention and response stage were relatively high， followed by the mitigation and preparation stage， and the lowest in the recovery stage. Among the 11 rated emergency management measures， more than half had an average score greater than 0.5， but the average score of “determining alternative enterprise selection methods” was only 0.19. CONCLUSIONS Some emergency management measures of drug VBP are lacking， and the emergency management mechanism still needs to be perfected， which is not conducive to the development of emergency management work. The procurement organizer should focus on building a complete emergency management mechanism covering all stages， and clarify the specific measures at each stage， so as to ensure procurement effective and good in operation.

Lag effect and influencing factors of temperature on other infectious diarrhea in Zhejiang province / 中华流行病学杂志

Objective@#To study the lag effect of temperature and the source of heterogeneity on other infectious diarrhea (OID) in Zhejiang province, so as to identify related vulnerable populations at risk.@*Methods@#Data on OID and meteorology in Zhejiang province from 2014 to 2016 were collected. A two-stage model was conducted, including: 1) using the distributed lag non-linear model to estimate the city-specific lag effect of temperature on OID, 2) applying the multivariate Meta- analysis to pool the estimated city-specific effect, 3) using the multivariate Meta-regression to explore the sources of heterogeneity.@*Results@#There were 301 593 cases of OID in Zhejiang province during the study period. At the provincial level, temperature that corresponding to the lowest risk of OID was 16.7 ℃, and the temperature corresponding to the highest risk was 6.2℃ (RR=2.298, 95%CI: 1.527- 3.459). 16.7 ℃ was recognized as the reference temperature. P5 and P95 of the average daily temperature represented low and high temperature respectively. When the temperature was cold, the risk was delayed by 2 days, with the highest risk found on the 5th day (RR=1.057, 95%CI: 1.030-1.084) before decreasing to the 23rd day. When the temperature got hot, the risk of OID occurred on the first day (RR=1.081, 95%CI: 1.045-1.118) and gradually decreasing to the 8th day. Differences on heterogeneous sources related to the risks of OID in different regions, presented on urban latitude and the rate of ageing in the population.@*Conclusions@#Both high or low temperature could increase the risk of OID, with a lag effect noticed. Prevention program on OID should be focusing on populations living in the high latitude and the elderly population at the low temperature areas.

Private hospitals operated in DEA-Tobit model in Shenzhen: operating efficiency and influencing factors / 中华医院管理杂志

Objective To study the efficiency changes of private hospitals in Shenzhen and explore influencing factors for the utilization efficiency of health resources. Methods DEA-Tobit two-stage model was used to analyze the operating efficiency and influencing factors of Shenzhen′s private hospitals. Results The range of technical efficiency varied between 0.690 to 0.742 in six years, and the index of total factor production was consistent with the technical change index. The input and output indicators showed non-linear growth. The internal and external factors of sample hospitals jointly influence the efficiency of operation. Conclusions The two-stage method effectively reveals the dynamic efficiency change and the influencing factors of these hospitals in Shenzhen. The technical efficiency of sample hospitals fluctuates in waves in six years,with investment redundancy and insufficient output found. Sample hospitals need to strengthen their innovative application of diagnostic and therapeutic technology,and to strengthen their internal management and improve operating efficiency.

Task model of crisis intervention / 中国心理卫生杂志

The majority of current crisis intervention models are stage models.However,it is not certain that crisis intervention follows a linear process,and fixed procedure of stage models therefore may not provide efficient or effective crisis intervention.Task models,on the other hand,emphasize flexibility in crisis intervention by presenting main components,including three continuous tasks (i.e.,assessmem,safety,and support) and 4 focused tasks (i.e.,contact,re-establishing control,problem solving,and follow up).This theoretical framework may be helpful in creating standard practices of crisis intervention,examining the effectiveness of intervention plans,and providing guidance and training to counselors and researchers.

Mudança psíquica à luz do pensamento clínico contemporâneo / Mudança psíquica à luz do pensamento clínico contemporâneo / Cambio psíquico a la luz del pensamiento clínico contemporáneo

Por meio deste trabalho, propõe-se o modelo do palco para entender o processo de mudança psíquica na clínica psicanalítica atual, repleta de problemáticas narcísicas, depressões e fenômenos limítrofes, que se mesclam ou se associam às patologias neuróticas clássicas sob a forma de correntes psíquicas. O modelo do palco se insere na concepção contemporânea da psicanálise, a qual, de acordo com Urribarri (2012), baseia-se em uma leitura renovada de Freud, que revaloriza a metapsicologia e o método freudianos como fundamentos da psicanálise, a apropriação crítica e criativa das principais contribuições pós-freudianas, juntamente com um diálogo com autores contemporâneos de diversas correntes, e a ampliação da clínica aos desafios da prática relativa aos quadros não neuróticos.

In this article, the stage model is proposed for the understanding of the process of psychic change in the current psychoanalytic clinic, full of narcissistic problems, depressions and borderline phenomena which mix or associate with classic neurotic pathologies in the form of psychic currents. The stage model is inserted in the contemporary conception of psychoanalysis, which, according to Urribarri (2012), bases itself in a new interpretation of Freud which revalues Freud's metapsychology and method as foundations of psychoanalysis, the critical and creative appropriation of the main post-Freudian contributions, together with a dialog with contemporary authors of different currents, and the expansion of the clinic to the challenges of the practice related to non-neurotic cases.

A través de este trabajo se propone el modelo de escenario para entender el proceso de cambio psíquico en la clínica psicoanalítica actual, colmada de problemáticas narcisistas, depresiones y fenómenos limítrofes que se mezclan o se asocian a las patologías neuróticas clásicas bajo la forma de corrientes psíquicas. El modelo del escenario se inserta en la concepción contemporánea del psicoanálisis, la cual, de acuerdo con Urribarri (2012), se basa en una lectura renovada de Freud que revaloriza la metapsicología y el método freudianos como fundamentos del psicoanálisis, la apropiación crítica y creativa de las principales contribucionesposfreudianas, juntamente con un diálogo con autores contemporáneos de diversas corrientes, y la ampliación de la clínica a los desafíos de la práctica relativa a los cuadros no neuróticos.

The Effect of Attention on Executive Function in Traumatic Brain Injury Patients: Testing for Stage Model

OBJECTIVES: The purpose of this study was to test stage model in Traumatic Brain Injury(TBI) patients. According to the stage model, attention deficits which is basic stage in information processing lead to memory disturbance and subsequently affect higher-order cognitive function such as memory, decision-making, abstract thinking, and judgement related to executive function. Therefore, it was hypothesized that attention affect recall(retrieval efficacy) related to executive function mostly relative to other cognitive function, in TBI patients with low executive function. METHODS: Participants were referred to a TBI clinic and then was rated on K-WAIS and Executive Intelligence Test(EXIT). Participants were divided into two groups according to Executive IQ(EIQ) score, which of high function group(N=67) was more than 80(above low average) and of low function group(N=52) was under 80 (under borderline). To test the stage model, using hierarchical regression analysis, recall(retrieval efficacy) was regressed on 3 subscales(attention, verbal, visuospatial scale) after controlling for IQ according to each group. Furthermore, the mediation effect of attention between retrieval efficacy and verbal, visuospatial score was analyzed. RESULTS: In the low function group, only attention area predicted significantly recall(retrieval efficacy), indicating that lower attention were related to lower EIQ after controlling for IQ. In the high function group, no area predicted significantly retrieval efficacy. In the low function group, verbal and visuospatial scale did not predicted significantly retrieval efficacy, indicating that there was no evidences supporting the mediation model. CONCLUSION: Only attention affect retrieval efficacy in TBI patients with low executive function. But, the mediation effect of attention between retrieval efficacy and verbal and visuospatial scale was not tested in the low function group. These results implied that stage model was tested partially. In treating cognitive deficit in TBI patients, it is necessary to develop cognitive rehabilitation program based on stage model. Furthermore, it is necessary to necessary to test mediation model in the future study.

The Effect of Cognitive Rehabilitation Program for Traumatic Brain Injury Patients

OBJECTIVES: The purpose of this study was to develop a cognitive rehabilitation program and to investigate the effect of the program that restores the deficiency of memory, which is necessary to operate on high cognitive function such as problem-solving or judgement, for TBI(traumatic brain injury) patients. METHODS: Sixteen TBI patients participated in this study. The inclusion criteria were : 1) aged 18 to 60 ; 2) higher than IQ 80 ; 3) lower than MMSE-K 25 and K-MAS(Korean version of Memory Assessment Scale) 85. We administered our program to an experimental group(N=8) in order to improve attention and memory for 4 weeks(total 12 section). Our program was not administrated to a control group(N=8) for 4 weeks. After administrating this program, we measured MMSE-K and K-MAS for the experimental and control groups. RESULTS: The findings of the study were as follows. 1) the experimental group showed significant improvement on MMSE-K score in comparison with baseline, but the control group did not. 2) the experimental group showed significant improvement on K-MAS score in comparison with baseline, but the control group did not. In particular, among the three subscales of K-MAS, only verbal memory scale revealed significant improvement, while visual and short-term memory scales revealed no differences. CONCLUSION: Our cognitive rehabilitation program improves cognitive state and memory, particulary verbal memory, for TBI patients. These results imply that our program aids in rehabilitation of basic cognition such as memory which is necessary to operate on high cognitive function such as problem-solving or judgement, for TBI(traumatic brain injury) patients.