ABSTRACT
ABSTRACT BACKGROUND AND OBJECTIVES: Cannabis sativa is a plant that has been used by humankind for many years and is in the media spotlight due to its pharmacological features, being considered the great therapeutic option of the century. With the advent of the Drug Law (Lei de Drogas - Law No. 11,343/2006) there was a starting point for the situation of cannabis in Brazil. Thus, the objective of this narrative review was to discuss information about legal issues regarding cannabis in the Brazilian territory. CONTENTS: The Collegiate Directorate Resolution (Resolução da Diretoria Colegiada - RDC) No. 327 of December 2019, published by Brazilian Health Surveillance Agency (Agência Nacional de Vigilância Sanitária - ANVISA), provides on the procedures for granting health authorization for manufacturing and importation, as well as establishes requirements for marketing, prescription, storage, monitoring and surveillance of cannabis products for medicinal purposes to human use. The Bill of Law (Projeto de Lei - PL) No. 399/2015, proposed to amend article 2 of Law No. 11,343, of August 23, 2006, to enable planting and marketing of drugs containing extracts, substrates or parts of the cannabis plant. CONCLUSION: Cannabis cultivation in Brazil would make a great contribution not only to the pharmaceutical industry, but also to the agricultural industry, generating jobs and reducing raw material costs for drugs. However, the slow pace of Brazilian politics would be an obstacle. There is a need for more consolidated and specific legislation to regulate cannabis.
RESUMO JUSTIFICATIVA E OBJETIVOS: A Cannabis sativa é uma planta utilizada pela humanidade há muitos anos e está em evidência nas mídias devido ao seu caráter farmacológico, sendo considerada a grande opção terapêutica do século. Com o advento da Lei de Drogas (Lei nº 11.343/2006) houve um ponto de partida para a situação da cannabis no Brasil. Dessa forma, o objetivo desta revisão narrativa foi discorrer sobre informações acerca de questões legais quanto à cannabis no território brasileiro. CONTEÚDO: A Resolução da Diretoria Colegiada (RDC) nº 327, de dezembro de 2019, publicada pela Agência Nacional de Vigilância Sanitária (ANVISA), dispõe sobre os procedimentos para a concessão da autorização sanitária para a fabricação e a importação, bem como estabelece requisitos para a comercialização, prescrição, dispensação, monitoramento e a fiscalização de produtos de cannabis para fins medicinais de uso humano. O Projeto de Lei (PL) nº 399/2015, propôs alterar o artigo 2º da Lei nº 11.343, de 23 de agosto de 2006, para viabilizar o plantio e a comercialização de fármacos que contenham extratos, substratos ou partes da planta cannabis. CONCLUSÃO: O cultivo da cannabis no Brasil traria uma grande contribuição não só para a indústria farmacêutica, como também para a indústria agrícola, na geração de empregos e na redução dos custos da matéria-prima de fármacos. No entanto, a morosidade da política brasileira seria um empecilho. Há necessidade de uma legislação mais consolidada e específica para regulamentação da cannabis.
ABSTRACT
Objective. This work sought to characterize the primary care nursing consultation services reported in the official systems of health services records in Colombia between 2002 and 2020. Methods. This was a cross-sectiona, retrospective study. Node geographic analysis and descriptive statistics were performed for quantitative data from the Special Registry of Health Providers and the Ministry of Health and Social Protection. Results.The study identified 6079 nursing services of which 72% are outpatient, 95.05% are assigned to institutions providing health services, 99.75% are of low complexity, and 48.22% of the offer was created in the last five years. The nodes with the highest increase in the offer of services are Caribbean (n = 909) and Pacific (n = 499), while Amazon (n = 48) showed the lowest offer in the last five years. Conclusions.Disparity is evident in the availability of services by region and node, in addition to a low liberal exercise to provide nursing care.
Objetivo.Caracterizar los servicios de consulta de enfermería de primer nivel de atención reportados en los sistemas oficiales de registros de servicios de salud en Colombia durante el periodo 2002-2020. Métodos.Estudio transversal de corte retrospectivo. Se realizó análisis geográfico por nodos y estadística descriptiva para los datos procedentes del Registro Especial de Prestadores en Salud (REPS) del Ministerio de Salud y Protección Social. Resultados.Se identificaron 6079 servicios de enfermería de los cuales el 72% son ambulatorios, el 95.05% están adscritos a instituciones prestadoras de servicios de salud, un 99.75% son de complejidad baja y, el 48.22% de la oferta se creó en los últimos 5 años. Los nodos que han mostrado mayor aumento en la oferta de servicios son Caribe (n=909) y Pacífico (n=499), mientras que Amazonia (n=48) ha mostrado la menor oferta en los últimos cinco años. Conclusión.Existe disparidad en la disponibilidad de servicios por región y nodo, además de un bajo ejercicio independiente para la provisión de atención en enfermería.
Objetivo.Caracterizar os serviços de consulta de enfermagem de primeiro nível de atenção informados nos sistemas oficiais de registro dos serviços de saúde na Colômbia durante o período 2002-2020. Métodos.Estudo transversal, retrospectivo. Foi realizada análise geográfica por nós e estatística descritiva para os dados do Cadastro Especial de Provedores de Saúde (REPS) do Ministério da Saúde e Proteção Social. Resultados.Foram identificados 6079 serviços de enfermagem, sendo 72% ambulatorial, 95.05% vinculados a instituições que prestam serviços de saúde, 99.75% são de baixa complexidade e 48.22% da oferta foi criada nos últimos 5 anos. Os nós que apresentaram maior aumento na oferta de serviços são Caribe (n = 909) e Pacífico (n = 499), enquanto a Amazônia (n = 48) apresentou a menor oferta nos últimos cinco anos. Conclusão.Há disparidade na disponibilidade de serviços por região e nó, além de um baixo exercício independente para a prestação de cuidados de enfermagem.
Subject(s)
Primary Health Care , Nursing Administration Research , Primary Care Nursing , Law of Supply and Demand , Health Services Accessibility , Nursing ServicesABSTRACT
Objective:To analyze the department distribution and workload of China′s physician team, and promote the establishment of a well-structured physician team.Methods:Based on the relevant data of Health Statistics Yearbook, the distribution of departments and workload of diagnosis and treatment of physicians during the 13th Five-Year Plan period were analyzed. Results:During the " 13th Five-Year Plan" period, the number of physicians increased by an average of 6.11% per year, of which the average annual growth rate in medical cosmetology and rehabilitation medicine exceeded 10%, and the number of infectious disease physicians declined. The daily visits per physician decreased by an average of 4.67% per year, and the daily inpatients per physician decreased by 4.14%. Among them, the daily visits per physician in infectious diseases, preventive health care, oncology had increased overall, and the daily inpatients per physician in medical cosmetology, dental had decreased the most.Conclusions:It is suggested to optimize the professional structure and department distribution in accordance with the principle of " matching medical service needs with a certain workload" , and promote the establishment of a physician team with reasonable distribution to better meet medical service needs.
ABSTRACT
The development characteristics of tertiary public hospitals in China presented differently under the macro environment in different periods. Based on the theory of supply and demand chain of medical services, the authors discussed the key factors affecting the high-quality development of tertiary public hospitals under the new situation from the four elements of production, distribution, circulation and consumption, and put forward countermeasures and suggestions as follows: optimizing the supply of medical talents and system construction in the production process; speeding up the layout of high-quality resources and the construction of an integrated medical service system in the distribution process; strengthening imformation construction and the scientific and technological innovation in the circulation process; expanding healthcare/prevention integration and refining supporting policies in the consumption process, so as to provide reference for accelerating the high-quality development of public hospitals in China.
ABSTRACT
Abstract In Colombia, there is a significant gap between the educational supply of medical specialties and their demand in health care institutions of varying complexity. This is a serious problem in the case of internal medicine, given its importance in the clinical management of complex patients and diseases, its interdependence with a large number of specialties and its impact on morbidity, mortality, quality of life and patient and family satisfaction with care. Thus, this study, using some elements of health economics, develops four topics:i)the introduction, which highlights the importance of internal medicine within the framework of Colombia's healthcare laws and provides a definition which gives specificity and identity to this specialty;ii)an analysis of this specialty's supply and demand;iii)health impacts or outcomes which may be attributed to the presence of internists; andiv)in conclusion, a discussion of elements which vindicate the need to improve the educational supply in this field.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1309).
Resumen En Colombia existe una brecha importante entre la oferta educativa de especializaciones médicas y su demanda en los servicios de salud de diferente complejidad. Esto constituye un grave problema en el caso de la medicina interna, dada su importancia en el manejo clínico de pacientes y enfermedades complejas, su interdependencia con un gran número de especializaciones y sus impactos sobre la morbilidad, mortalidad, discapacidad, calidad de vida y satisfacción con la atención de los pacientes y sus familiares. En tal sentido, este estudio, retomando algunos elementos de la economía de la salud, desarrolla cuatro tópicos:i)la introducción que destaca la importancia de la medicina interna en el marco de las leyes en salud de Colombia y precisa una definición que le brinda especificidad e identidad a esta especialización,ii)análisis de la oferta y la demanda de esta especialización,iii)impactos o desenlaces en salud atribuibles a la presencia de médicos internistas yiv)a manera de conclusión, se discuten elementos que vindican la necesidad de mejorar la oferta educativa en este campo.(Acta Med Colomb 2020; 45. DOI:https://doi.org/10.36104/amc.2020.1309).
Subject(s)
Specialization , Internal Medicine , Law of Supply and DemandABSTRACT
OBJECTIVE：To pro vide reference f or resolving structural imbalance of “supply and demand dislocation ”in each stage of new drug R&D funds in China. METHODS ：Through analyzing the fund demand in each stage of new drug R&D and the problem of “supply and demand dislocation ”in detail ，a financing scheme matching the fund demand of each stage was designed ， and analyzed with the financing process of “Wanke”. RESULTS & CONCLUSIONS ：In the basic stage of new drug R&D ，there was a large demand for funds ，but there were great technical risks ，transformation risks and investment risks ，little attention and support from investors ，resulting in the lack of R&D funds in this stage. It is suggested to increase the investment of R&D enterprises themselves. In the stage of new drug discovery ，the risks of R&D and investment were still high ，more funds were needed and funds were in short supply. It is suggested to attract more venture capital into this stage. From preclinical stage to clinical stage Ⅱ，there was a greater demand for funds. It is suggested that this stage should mainly rely on venture capital and pledge financing with patents. From the clinical stage Ⅲ to pre-marketing ，R&D had entered the mature stage with less investment risk. Therefore ，more venture capital could be obtained in this stage ，and there was a situation of excess capital. At this time ，in addition to venture capital ，R&D enterprises can also choose listing financing. In the post-marketing stage ，the sales right of a certain region in the product sales link could be transferred to provide new reserve funds for the next round of new drug R&D ，so as to achieve a virtuous circle of R&D activities. One of the reasons for the success of “Wanke”R&D financing lied in the combination of various financing methods in the financing process. It is suggested that China should improve the financial financing system and patent value evaluation system at the national level ，so as to promote the drug patent pledge financing in China as soon as possible. Finally ，new drug R&D institute must establish the concept of independent innovation ，speed up the output of technological innovation results ，so as to achieve the improvement of China ’s independent R&D capability.
ABSTRACT
Traditional Chinese medicine (TCM) plays an important role in the fight against coronavirus diseasef-2019 (COVID-19) epidemic. A total of 241 Chinese patent medicines and 242 prescriptions were recommended by the state and 26 provinces (autonomous regions and municipalities directly under the central government) for the prevention and treatment of COVID-19. A total of 53 varieties of commonly used medicinal materials were selected by analysis, of which 20 were common key varieties in medicinal materials of Chinese patent medicines and prescriptions, including Glycyrrhizae Radix et Rhizoma, Forsythiae Fructus, Pogostemonis Herba, etc. At the same time, some cold-quilt medicines and ethnic medicines also played an important role in the epidemic. By evaluating the supply and regeneration ability of the key varieties of TCM resources under the current COVID-19 epidemic situation, means of the source, regeneration cycle, medicinal parts, new production and market information of 53 kinds of TCM at present, it is suggested that the artificial cultivation of Glycyrrhizae Radix et Rhizoma and Paeoniae Radix Rubra can be strengthened, the development of Lonicerae Japonicae Flos, Isatidis Radix and other domestic medicinal materials can be controlled. In response to the change in market demand, the production variety structure and planting area of Chinese medicinal materials were timely adjusted to improve the quality standard and safety index of Chinese medicinal materials, and in order to provide ideas for the rational allocation of TCM resources and the development of Chinese medicinal materials industry under the epidemic situation.
ABSTRACT
PURPOSE: This study was done to estimate supply and demand for nursing workforce to provide community-based primary healthcare in the North Korean region to cost-efficiently narrow the health gap between the two Koreas in case of a Korean reunification. METHODS: To understand the nursing education system and current state of nursing workforce in North Korea, the authors interviewed six North Korean defectors who had worked as nurses in North Korea. Based on the interview results and literature review, the supply and demand for the primary healthcare nursing workforce that would be needed after Korean reunification were estimated RESULTS: Currently, a total of 2,100 to 2,700 North Korean nurses were estimated to have graduated from nursing schools with a 2 year curriculum or completed 6-month military nurse training courses every year. The projected number of nurses in demand to provide primary health care ranged from 84,160 to 105,200 and the shortage would be between 31,586 and 52,626. CONCLUSION: An active utilization of the North Korean nursing workforce to improve the health of North Koreans after reunification will be the best way to reduce the reunification cost which will be inflicted mainly on South Korea.
Subject(s)
Humans , Curriculum , Democratic People's Republic of Korea , Education, Nursing , Korea , Military Personnel , Nursing , Primary Health Care , Schools, NursingABSTRACT
Cardiopulmonary bypass (CPB) is often accompanied by postoperative nerve injury in children. Studies have shown that monitoring of cerebral blood flow and cerebral oxygenation during enhanced operation can help to detect the adverse events of cerebral ischemia and hypoxia in time, guide physicians to adjust perfusion parameters in time, and can significantly reduce the incidence of postoperative nerve injury and improve the prognosis of children. Transcranial doppler (TCD) can directly reflect cerebral perfusion and indirectly reflect cerebral oxygen supply and demand by monitoring cerebral blood flow velocity, and jugular blood oxygen saturation (SjbO2) and cerebral local oxygen saturation (CrSO2) directly reflect cerebral oxygen supply and demand by monitoring cerebral oxygenation in the cerebral hemisphere. Therefore, the combined monitoring of these indexes during the perioperative period of cardiac surgery in children can reflect the cerebral oxygen supply and demand in an all-round way, and prevent the ischemic and hypoxic nerve injury. The research status has been reviewed in present paper of TCD, SjbO2 and CrSO2 in monitoring cerebral oxygen supply and demand during perioperative cardiac surgery in children with CPB in order to provide evidence for the prevention of postoperative nerve injury.
ABSTRACT
Objective To evaluate the effect of desflurane-remifentanil anesthesia on balance between cerebral oxygen supply and demand during cerebral revascularization in the patients with moyamoya disease.Methods Forty patients of both sexes with moyamoya disease,aged 18-64 yr,with body mass index of 18-25 kg/m2,undergoing superficial temporal artery-middle cerebral artery anastomosis,were allocated into 2 groups using a random number table method:desflurane-remifentanil group (D group) and propofol-remifentanil group (P group),with 20 cases in each group.Anesthesia was induced by intravenously injecting etomidate 0.3 mg/kg,sufentanil 0.4-0.5 μg/kg,and cis-atracurium 0.15-0.2 mg/kg.The patients were mechanically ventilated after tracheal intubation,and the end-tidal pressure of carbon dioxide was maintained at 35-45 mmHg.Anesthesia was maintained with propofol 4-6 mg · kg-1 · h-1 (group P),4％-6％ desflurane (group D),remifentanil 0.1-0.3 μg· kg-1 · min-1,remifentanil 0.1-0.3 μg · kg-1 · min-1 and intermittent intravenous boluses of cis-atracurium,and BIS value was maintained at 40-60.At 15 min after intubation (T1),30 min after skin incision (T2),immediately after opening the dura mater (T3),immediately after vascular bypass and patency (T4),and at the end of surgery (T5),blood samples were obtained from the radial artery and internal jugular bulb for blood gas analysis,jugular venous oxygen saturation (SjvO2) was recorded,and arteriovenous blood O2 content difference (Da-jvO2) and cerebral O2 extraction rate (CERO2) were calculated.Results Compared with group P,Da-jvO2 at T3-6 and CERO2 at T4-6 were significantly decreased,and SjvO2 was increased at T4-6 in group D (P＜0.05).Compared with the value at T1,Da-jvO2 was significantly decreased,and SjvO2 was increased at T5 in group D (P＜0.05).CERO2 was significantly lower,and SjvO2 was higher at T5 than at T3 in group P (P＜0.05).Compared with the values at T4,CERO2 was significantly decreased,and SjvO2 was increased at T5 in P and D groups (P＜ 0.05).Conclusion Compared with propofol-remifentanil anesthesia,desflurane-remifentanil anesthesia can maintain the balance between cerebral oxygen supply and demand better during cerebral revascularization in the patients with moyamoya disease.
ABSTRACT
Objective To analyze the allocation and utilization of health resources for the elderly in Xicheng district of Beijing.Methods A questionnaire survey on the allocation and utilization for elderly was conducted during March 2016 to December 2016 in Xicheng district of Beijing.The participants were selected from 4 community health service centers (CHS) in the district by stratified cluster random sampling method.The main contents of the questionnaire included chronic diseases prevalence among the elderly residents,health resources utilization,satisfaction and suggestion of the health service system.Two hundred questionnaires were distributed and equal number of questionnaire was received with a retrieval rate of 100.0％.Results At the end of 2014,there were 632 medical and health institutions in Xicheng district.The residents aged 60 and over were increased from 292 416 in 2010 to 354 696 in 2014;those aged 65 and over increased from 218 891 to 246 560;those aged over 80 increased from 61 620 to 81 011;and those aged over 100 increased from 74 to 384.Among 200 participants 78.0％ (156/200) suffered with chronic diseases,and 29.5％ (59/200) had more than 2 kind of chronic diseases;65.0％ (130/200) preferred the first visit in the secondary or tertiary hospitals,while 33.5 ％ (67/200) chose community health service center for their first visit;and 54.0％ (108/200) visited tertiary hospitals more than 4 times per year.For the health service,11.5 ％ (12/200) were "very satisfied",26.5 ％ (53/200) were "satisfied",59.5 ％ (119/200) were "not satisfied",and 2.5％ (5/200) were "very dissatisfied".Among all participants 81％ (162/200) felt too long waiting time;63.0％ (126/200) were dissatisfied with service attitude of medical staff in the secondary or tertiary hospitals,while 6.5％ (13/200) were dissatisfied with service attitude of medical staff in community health service centers.Conclusion The population of Xicheng district is progressively aging in recent years,the health service demand of elderly is large,the residents prefer to large hospitals for their first visit,and the elderly residents in Xicheng district are less satisfied with the current status of health and medical resources.
ABSTRACT
Objective To discuss the influence of two recombinant hemoglobin (rHb1.1 and rHb2.0) and human serum albumin (HSA) on oxygen supply and demand balance in rat with coronary heart disease (CHD). Methods Male Wistar rats were randomly divided into normal control group, CHD model group, HSA treatment group, rHb1.1 treatment group and rHb2.0 treatment group, 20 rats in each group. Rat model of CHD was established by high fat diet combined with pituitrin injection. The mean arterial pressure (MAP) decreased to 40 mmHg (1 mmHg = 0.133 kPa) after femoral arterial blood was drawn from the femoral arteries, and the rats were resuscitated with 13.4% HSA, rHb1.1 and rHb2.0, respectively, at the rate of 60 mL·kg-1·h-1 (20 mL/kg). The changes of electrocardiogram (ECG) ST-segment were calculated before model reproduction and at 12 hours after the last time injection of pituitrin. MAP, heart rate (HR), superior mesenteric artery blood flow (QSMA) and arterial blood gas analysis were recorded at 0, 30, 60, 90 and 120 minutes after the administration. The blood was collected after 12-hour fasting, and serum total cholesterol (TC) and triglyceride (TG) were determined by enzymatic method. The pathological changes in cardiac tissue were observed with light microscope. Results Compared with the normal control group, the changes of ECG ST-segment and TC, TG of model group were significantly increased. Compared with the model group, rHb can significantly reduce the value of ST segment changes, and HSA has no such effect; rHb short-term infusion has no significant effect on blood lipids, but can reduce myocardial pathological changes. Compared with the normal control group, the MAP of the model group decreased significantly, the HR was increased, the QSMA was slowed down, the pH value, the residual alkali (BE), the arterial carbon dioxide partial pressure (PaCO2) and HCO3- were decreased significantly. MAP in rHb1.1 group and rHb2.0 group were significantly higher than those in HSA group. Values of MAP were significantly higher in rHb2.0 group than those in rHb1.1 group at 90 minutes and 120 minutes (mmHg: 80.9±3.3 vs. 69.4±4.9, 79.2±4.0 vs. 69.1±3.7, both P < 0.05). The HR of HSA, rHb1.1 and rHb2.0 decreased to normal in 30 minutes after administration, significantly lower than those in the model group (bpm: 534±46, 518±28, 526±37 vs. 609±52, all P < 0.05). In the rHb2.0 group, the QSMA increased significantly at 60, 90 and 120 minutes compared with the model group (qv·mL-1·min-1: 5.6±0.4 vs. 3.9±0.6, 6.2±0.6 vs. 4.1±0.4, 6.9±0.7 vs. 4.0±0.3, all P < 0.05), but there was no significant difference between the HSA group and the rHb1.1 group. The pH, BE, PaCO2 did not return to the normal level after administration of HSA; pH, PaCO2 and HCO3- in the rHb1.1 group returned to normal level at 60 minutes after administration, and BE returned to normal level at 90 minutes after administration. Each index in rHb2.0 group can restore to normal levels 30 minutes ahead of. Conclusion Recombinant hemoglobin can significantly improve the oxygen supply and demand balance of rats with CHD model, can quickly and effectively correct the hypoxic state of blood metabolic acidosis, and rHb2.0 has better effect than rHb1.1.
ABSTRACT
OBJECTIVES: This study investigated the busyness of dentists and analyzed factors related to busyness in these professionals. METHODS: The subjects were 243 practicing dentists. Surveys were carried out via mail. Busyness was measured by using the Mumma scale. The data were analyzed using the Kruskal-Wallis test. RESULTS: The dentists' busyness index was 1.91. Of the participants, 40% of practicing dentists wanted more patients, 30.8% did not overwork but did not want more patients, and 27.1% overworked and did not want more patients. The busyness index was significantly related to the number of dental hygienists and dentists. However, it did not differ with respect to the number of assistant nurses. CONCLUSIONS: The busyness index should be considered when developing relevant human resource plans.
Subject(s)
Humans , Dental Hygienists , Dentists , Postal ServiceABSTRACT
Based on health economics principle and the present situation,the academic paper mostly analyzed various relevant market and government factors to changes in supply and demand of acup-mox services,and thereby could be used for reference to reforms about health economics policy in acup-mox field.
ABSTRACT
In order to identify existing agro-industrial by-products and remainders in the region of the Mexican Bajio, which by their availability and level of production could be incorporated in the feeding of gestating sows, the statistical information of agricultural products that by an agro-industrial process generate by-products for livestock was integrated. In this sense, a list of by-product processing plants was created. Likewise, a survey was designed and applied to a significant sample (equation of sampling proportions for maximum variance) of these companies, to know the amounts of raw materials used, transformation coefficients, and the amount and destiny of generated by-products. According to the aforementioned, the future availability of these by-products was determined and regression models were designed. The by-products and remainders that were identified as feasible to be used were more than twenty. However, on the basis of the annual supply and demand of each by-product, the ones that showed the greatest potential to be used in feeding gestating sows were the following: rice husk (4 375 ton), saved of rice (2 905 ton), sesame meal (between 14 400 and 28 800 ton), cabbage remainders (1 092 ton), broccoli and cauliflower remainders (annual 13 400 and 1 800 ton, respectively), avocado remainders (4 800 ton) and palm oil for frying process of nuts (12 000 L). Those with better potential while measuring their future availability are broccoli and cauliflower remainders. With the aim to use agro-industrial by-products and remainders available in the Bajio for sow feeding, bromatologic and nutritional characteristics should be determined, as well as its possible impact on the energy and protein digestibility and sow performance.
Con el propósito de identificar subproductos y desechos agroindustriales existentes en la región del Bajío mexicano, que por su disponibilidad y nivel de producción pudieran ser incorporados en la alimentación de las cerdas gestantes, se integró la información estadística de productos agrícolas que mediante un proceso agroindustrial generan subproductos para consumo pecuario. En este contexto, se creó un padrón de empresas procesadoras de dichos productos; asimismo, se diseñó y aplicó una encuesta a una muestra significativa (muestreo de proporciones de varianza máxima) con el fin de conocer las cantidades de materias primas utilizadas, los coeficientes de transformación, la cantidad de subproductos generados y, finalmente, su destino. De acuerdo con lo anterior, se dispuso estimar la disponibilidad futura de estos subproductos y se diseñaron modelos de regresión. Más de 20 subproductos y desechos se identificaron como factibles para utilizarse. Sin embargo, con base en la oferta y en la demanda anual de cada uno de éstos, los que mostraron mayor potencial de uso fueron: cascarilla de arroz y salvado de arroz (4 375 ton y 2 905 ton, respectivamente), pasta de ajonjolí (entre 14 400 y 28 800 ton), desperdicio de col (1 092 ton), desechos de brócoli (13 400 ton), desechos de coliflor (1 800 ton), desechos de aguacate (4 800 ton) y aceite de palma para fritura (12 000 L). Los de mejor potencial al medir su disponibilidad futura son los desechos de brócoli y coliflor. Con el propósito de aprovechar los subproductos y desechos agroindustriales disponibles en el bajío para la alimentación de la cerda adulta, deben determinarse las características bromatológicas y nutritivas de aquéllos, así como su posible impacto sobre la digestibilidad de la energía y proteína en la dieta y en el desempeño productivo de la cerda.
ABSTRACT
This paper will focus on recent changes in the relationships between the public and the private sector within the health assistance network, by analyzing selected information on health services and on legal rules related to supporting the private assistance subsystem. This approach recasts analyses which articulate the simultaneous examination of both the material and political instances that permanently redefine the range of activity of SUS. Consideringthe limitations of the empirical bases here analyzed, one questions the implied assumptions in the meanings of autonomy sustained both in the public and in the private components, departing from hypotheses on the delineation of independent tendenciestoward the expansion of universal coverage and he restratification of supply and demand.
As recentes mudanças nas relações entre o público e o privado na rede assistencial são enfocadas com base na análise de informações selecionadassobre serviços de saúde e normas legais relacionadas com o suporte ao subsistema assistencial privado. Essa abordagem retoma as análises que articulam o exame simultâneo das bases materiais e políticas que redefinem permanentemente o âmbito de atuaçãodo SUS. Considerando os limites de abrangência das bases empíricas analisadas, questiona-se os pressupostos subjacentes as acepções de autonomia dos componentes público e privado, a partir das hipóteses sobre o delineamento de tendências interdependentes de expansão de coberturas universais e reestratificação da oferta e demanda.
Subject(s)
Health Services Coverage , Healthcare Financing , Unified Health System , Health Systems , Universal Access to Health Care Services , BrazilABSTRACT
Academic analysis was made on the relationship between the supply and demand of higher education on the condition of rapid economic development.The development target of the healthcare manpower up to 2020 in Zhejiang Province was discussed through a comparative study method.A simulated prediction of the demand for the healthcare manpower was made by the specific ratio method of healthcare manpower/population.This study shows that by 2020 the number of doctors per thousand will reach 2.4,which is the average figure of the developed countries in the 1990's,then can adapt to the effective demand in Zhejiang Province.
ABSTRACT
Starting from the definition of public health, the paper analyzes the general properties of public health products as public products and the special properties of public health products as health products and discusses the structures and features of public health products in both supply and demand models. It also puts forward some suggestions for realizing balance between the supply and demand of public health products: ①establishing a parallel operational mechanism; ②creating “complete information” linking supply and demand; and ③ bringing about “entire rationale” to public behavior.