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Introduction: The tool for assessing the Mental Health System of the World Health Organization has been used in different countries in different countries,by which examining the mental health system and identifying their problems along with finding out the instrumental problems are done simoltaneously. Objetive: this study was conducted in order to develop the means of evaluating the mental health system organization of the world health organization in iran. Method: This research is based on the implementation, analytical, and in terms of variables, combination (qualitative and quantitative), and purposeful, exploratory, and from the perspective of the result, an application that was carried out in six phases. Phase I: Review of texts that have been used to recognize the status of countries Different and Iran. Phase II: The status of mental health system in Khuzestan province was investigated and the problems of mental health system and instrumental problems were determined. Phase III: weaknesses and strengths of the mental health system evaluation tool were surveyed in Khuzestan province, Phase IV: To identify the key components of the WHO Mental Health Routing Program and the 2013-2015 operational plan for development of tools, in the fifth phase: The proposed components were embedded in each main field of the tool, and the content of the content validity and content validity index were evaluated by the experts. Result: Finally, 11 main components were identified and 95 questions were designed for them, which in the sixth phase these questions Mental Health Managers were given an exploratory and confirmatory factor analysis and identified their main factors and their impact on the development of the Mental Health Assessment System of the World Health Organization. Using PLS software from 11 components and 95 suggested questions, 6 factors influencing The development of tools has been identified whose impact coefficients include: Leadership and Governance (0.972), mental health and e-service use (0.929), Policy and Legislative Framework (0.697), status analysis (0.613), mental health services pattern for common disorders (0.413), mental health promotion services (0.259). Conclusion: The development of the Mental Health Assessment Tool of the World Health Organization in Iran will help identify the mental health gap and, with regard to the problems, will be the best pattern for providing mental health services
Introducción: La herramienta para evaluar el Sistema de Salud Mental de la Organización Mundial de la Salud se ha utilizado en diferentes países en diferentes países, mediante el cual el examen del sistema de salud mental y la identificación de sus problemas junto con el descubrimiento de los problemas instrumentales se realizan de forma simultánea. Objetive: este estudio se realizó con el fin de desarrollar los medios para evaluar la organización del sistema de salud mental de la organización mundial de la salud en Irán. Método: Esta investigación se basa en la implementación, analítica y en términos de variables, combinación (cualitativa y cuantitativa), y con una finalidad, exploratoria y, desde la perspectiva del resultado, una aplicación que se realizó en seis fases. Fase I: Revisión de textos que se han utilizado parareconocer el estado de países diferentes e Irán. Fase II: Se investigó el estado del sistema de salud mental en la provincia de Khuzestan y se determinaron los problemas del sistema de salud mental y los problemas instrumentales. Fase III: se examinaron las debilidades y fortalezas de la herramienta de evaluación del sistema de salud mental en la provincia de Khuzestan, Fase IV: para identificar los componentes clave del Programa de Enrutamiento de Salud Mental de la OMS y el plan operativo 2013-2015 para el desarrollo de herramientas, en la quinta fase : Los componentes propuestos se integraron en cada campo principal de la herramienta, y los expertos evaluaron el contenido de la validez de contenido y el índice de validez de contenido. Resultado: Finalmente, se identificaron 11 componentes principales y se diseñaron 95 preguntas para ellos, que en la sexta fase a estas Gerentes de Salud Mental se les realizó un análisis factorial exploratorio y confirmatorio e identificaron sus factores principales y su impacto en el desarrollo de la Salud Mental Sistema de evaluación de la Organización Mundial de la Salud. Utilizando el software PLS de 11 componentes y 95 preguntas sugeridas, se han identificado 6 factores que influyen El desarrollo de herramientas cuyos coeficientes de impacto incluyen: Liderazgo y Gobernanza (0,972), salud mental y uso de servicios electrónicos (0,929), Marco Político y Legislativo (0.697), análisis de estado (0.613), patrón de servicios de salud mental para trastornos comunes (0,413), servicios de promoción de salud mental (0,259). Conclusión: El desarrollo de la Herramienta de evaluación de salud mental de la Organización Mundial de la Salud en Irán ayudará a identificar la brecha de salud mental y, con respecto a los problemas, será el mejor patrón para proporcionar servicios de salud mental.
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Resumo: Trata-se de uma revisão teórica de caráter exploratório que objetivou compreender o papel do Índice de Desempenho da Saúde Suplementar (IDSS) do Programa de Qualificação de Operadoras de Planos de Saúde, elaborado pela Agência Nacional da Saúde Suplementar (PQSS-ANS). A proposta de trabalho consistiu em ampliar os conhecimentos sobre a trajetória desse índice, bem como o impacto do seu uso para regulação e concentração do setor através da análise dos documentos oficiais e dos trabalhos acadêmicos produzidos sobre o tema. Percebeu-se nesta revisão que a literatura acadêmica é extremamente escassa sobre essa temática, o que por si só justifica a necessidade de realizar mais estudos sobre a PQSS. A pesquisa concluiu que o instrumento utilizado pela ANS é eficaz, democrático e participativo no que diz respeito ao alcance dos objetivos do Programa de Qualificação das Operadoras de Planos de Saúde, pois promoveu maior transparência ao subsistema privado. No entanto, constatou-se também que o IDSS teve um papel saneante e concentrador do mercado em favor dos oligopólios privados, indo de encontro aos preceitos normativos da ANS em defesa do consumidor, da concorrência regulada e do interesse público.
Abstract: This is an exploratory literature review that aimed to understand the role of the Supplemental Health Performance Index (IDSS) Program of Health Plans Operators Qualification, prepared by the National Health Agency (ANS-PQSS). The working proposal was to increase knowledge about the history of this index as well as the impact of its use for regulation and industry concentration by analysis of official documents and academic papers written on the subject. We noticed that the academic literature is extremely scarce on this subject, which alone justifies the need for further study of the PQSS. The research concluded that the instrument used by the NSA is effective, democratic and participative regarding the achievement of objectives of the Education Program of the Health Plan Operators, and promoted greater transparency to the private subsystem. However, it was also found that the IDSS had a discriminating and concentrating role of the market in favor of private oligopolies, going against the normative principles of the ANS on consumer protection, regulated competition and public interest.
Subject(s)
Humans , Quality of Health Care , Health Evaluation , Health Systems/organization & administration , Supplemental Health/organization & administration , Health Services AccessibilityABSTRACT
Objective Meta-analysis the efficacy and safety of Exenatide and insulin therapy oral hypoglycemic drugs effect of obesity with type 2 diabetes .Methods According to the research purpose to set up the screening of related literature and exclusion criteria; formulatethe searching strategy, through PubMed、the Chinese Biological Medicine Datebase(CBM)、 CNKI、Wanfang Data Knowledge Service Platform, VIP to retrieve all theliterature selection of efficacy and safety by Exenatide oral hypoglycemic drugs and insulin therapy of obese type 2 diabetes mellitus.Choose met inclusion exclusion criteria, the complete data information randomized controlled trial (RCT) as the research object; Apply to the international commonly used Jadad score method to evaluate quality included in the test; To process the relevant data in the test ; Apply the ReviewManager 5.1 software to analysis the extracted research data.Analysis the results and put forward conclusions.Results Participants included 11 RCT , meta analysis results showed that compared with the Exenatide, in terms of reducing fasting glucose ,insulin effect more apparent [MD = 0.35, 95％CI: (0.11, 0.59), P = 0.004)]. In control effect of glycosylated hemoglobin, there was no statistically significant difference[MD=-0.04 ,95％CI:(-0.20,0.11), P=0.58],between Exenatide and insulin. Compared with the insulin, Exenatide reduce BMI more apparent[MD=-2.77,(95％CI: -3.34,-2.20),P<0.00001]; Compared with the insulin, Exenatide reduce insulin resistance index, the effect is more obvious[MD=-1.67,95％CI:(-1.93,-1.41), P<0.00001]; Adverse reaction in the process of treatment, the insulin is more likely to lead to hypoglycemia, [OR = 0.32, 95％ CI: 0.19, 0.54), P<0.0001]; While Exenatide are more likely to lead to gastrointestinal adverse reaction [OR = 4.04, 95％ CI: 2.35, 6.93), P<0.00001).Conclusion According to the Meta-analysis: Exenatide can be used in the treatment of oral hypoglycemic drugs of adult obesity with type 2 diabetes, and obvious effects of treatment of insulin resistance, long-term results still needs a large number of samples of high quality RCT to verify.
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Objective Establishing the scientific research competitiveness evaluation index system of Shanghai hospitals.Methods Delphi method and Analytic Hierarchy Process were applied.Results Thirty-four experts were invited to provide evaluation index and weighted scores.The positive coefficient from two rounds of expert's consultation were 88.24％ and 94％.The expert's opinion of authority coefficient of each indicator's was greater than 0.7.The degrees of coordinative consistency was high.Kendall concordance coefficient was increasing with the increasing of consulting times.After two rounds of Delphi expert consultation,2 level-one indictors,10 level-two indictors and 47 level-three indictors were confirmed.Conclusions After two rounds of Delphi expert consultation,using all objective indicators,an Index System for research competitiveness evaluation in the hospitals in Shanghai has been created and could be used with scientific,objectivity and feasibility.
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Objective To estimate the effect of low molecular weight heparin (LMWH) combined with conventional treatment on patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Literature on randomized control trials( RCTs) with AECOPD treated by LMWH combined with conventional methods was collected in PubMed.The studies were selected according to inclusive and exclusive criteria.The data were extracted,the quality was assessed, and meta-analysis was conducted with RevMan 5.2 software.Results There were twelve RCTs including 879 patients with AECOPD in the current study.The results of meta-analysis showed that:①LMWH could obviously improve PaO2 and PaCO2 of patients with AECOPD as compared with the control group.②There was no statistically significant difference between the LMWH-treated group and control group in the improvement of FEV1 or hematocrit.Conclusion LMWH can significantly improve arterial blood gas analysis in AECOPD, but does not improve FEV1 or hematocrit.