This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U. S. health care system through their missions of ...This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U. S. health care system through their missions of conducting cutting-edge biomedical researeh, pursuing clinical and technological innovations, Providing state-of-the-art medical care and producing highly qUalified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical sciTo survive the threats of managed care in the health care environment, acadendc medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 1h8 CEOs in all the academic medical centers in the U. S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.展开更多
Compared with high infection areas of the world, the total HIV infection rate in China is relatively low. Nonetheless, because of China’s vast territory and large population, the potential infection risk must be take...Compared with high infection areas of the world, the total HIV infection rate in China is relatively low. Nonetheless, because of China’s vast territory and large population, the potential infection risk must be taken seriously. In the next few years, needle sharing among injection drug users will remain the most common route of transmission for the HIV/ AIDS epidemic in China. Unprotected sex is gradually becoming a major route of transmission. China began to imple- ment HAART in 1999 according to international standards. Prior to 2003, there were only about 150 HIV/AIDS patients were treated with HAART in some clinical trials and about 100 HIV/AIDS patients were treated by private sources. Results of those treatments are the scientific basis for development of the therapeutic strategies in China. In March of 2003, the Chinese government initiated China CARES program. In November of 2003, the Chinese Ministry of Health announced a national policy of free ARV treatment to all HIV+ Chinese citizens who were in poverty and required ARV therapy. There are total of 19,456 HIV/AIDS patients received free ARV drugs to date in 159 regions and 441 towns. Current challenges are how to follow-up and evaluate those patients in the clinical settings. The longer the therapy is postponed, the more side effects and the higher probability of drug resistance are going to occur. It remains unclear, therefore, when HAART regimen should be started in the HIV/AIDS population in China.展开更多
Objective: to explore the application effect of improved incontinence skin care program in the prevention of incontinence dermatitis in intensive care patients. Methods: from January 2020 to January 2021, 30 patients ...Objective: to explore the application effect of improved incontinence skin care program in the prevention of incontinence dermatitis in intensive care patients. Methods: from January 2020 to January 2021, 30 patients with incontinence in our hospital were randomly divided into 15 cases in each group. Conventional nursing method was used in the control group, and incontinence skin care scheme was used in the observation group. The incidence of incontinence dermatitis, quality of life and risk of incontinence dermatitis were compared between the two groups after nursing. Results: after nursing, the incidence of incontinence dermatitis in the observation group was lower than that in the control group, and the difference was significant (P < 0.05). In addition, the quality of life of the patients in the observation group was significantly better than that in the control group (P < 0.05). Finally, in the risk assessment of incontinence dermatitis, the risk score of the observation group was significantly lower than that of the control group (P < 0.05). Conclusion: the clinical application effect of the improved incontinence skin care scheme in the prevention of incontinence dermatitis in intensive care patients is remarkable, which can further reduce the incidence of incontinence dermatitis in ICU patients and improve the quality of life of patients. It is suggested that it should be popularized and applied clinically.展开更多
Objectives:This study aimed to evaluate the clinical effectiveness,durability,and acceptability of a Korean medicine-based online mental health self-care program for mothers.Methods:This non-randomized comparative stu...Objectives:This study aimed to evaluate the clinical effectiveness,durability,and acceptability of a Korean medicine-based online mental health self-care program for mothers.Methods:This non-randomized comparative study evaluated the clinical effectiveness,durability,and acceptability of a Korean medicine-based online mental health self-care program for mothers.Group 1(regular version)included 120 participants who attended one live session per week for 5 weeks,while Group 2(shortened version)included 30 participants who completed five recorded sessions within 1 week.A total of 112 participants(93.3%)in Group 1 and all 30 participants(100%)in Group 2 completed the program and surveys.Results:Within-group analyses demonstrated significant improvements for depression(ΔCESD-10[Center for Epidemiological Studies Depression Scale-10]=−2.38±2.10,p<0.001;Cohen’s d=1.10),anxiety(ΔGAD-7[Generalized Anxiety Disorder Scale-7]=−3.82±3.20,p<0.001;d=0.93),and stress(ΔPSS[Perceived Stress Scale]=−6.44±4.50,p<0.001;d=1.12)in Group 1.Between-group analysis of covariance(ANCOVA)of postintervention scores showed significant differences favoring Group 1 in CESD-10(p<0.001)and GAD-7(p=0.025).These improvements were largely maintained through the 12-week follow-up(all p<0.001),indicating both statistical and clinical significance.The average willingness-to-pay per session was 8562.5±3609 KRW,and overall satisfaction was high.Conclusion:These findings demonstrate that the regular 5-week Korean medicine-based online program is effective,cost-effective,and capable of sustaining improvements in maternal mental health,supporting its potential use in community-based care strategies.展开更多
Objective： Prognosis of colorectal cancer strongly depends on stage at diagnosis, which can be cured in most cases at an early stage. The results were supported by different screening programmes. Few data concerning ...Objective： Prognosis of colorectal cancer strongly depends on stage at diagnosis, which can be cured in most cases at an early stage. The results were supported by different screening programmes. Few data concerning analysis of different phases of Colorectal Cancer Program were reported in literature. The aim of this study is to analyze ＂step by step＂, from a longitudinal type, the Colorectal Cancer Program, active at our Institution, verifying compliance with standards of care.Methods： We compared two different populations during the same period： patients referring to our Clinical Oncology Unit coming from Regional Colorectal Cancer Screening Program and the other population that was not in any Colorectal Cancer Program.Results： Considering patients from the Regional Colorectal Cancer Screening Program（19 patients, corresponding to 24.0% of the general case study）, 3（15.8%） were deceased and 16（84.2%） were alive without evidence of the disease（NED）. Concerning patients that are not coming from Regional Colorectal Cancer Screening Program（61 patients, corresponding to 76.0% of the general case study）, 9（14.8%） were deceased, 43（70.5%） were NED, 8（13.1%） were alive with metastases and 1（1.6%） was lost during follow-up（PFU）. Conclusions： On the basis of this experience, we concluded for high-quality care for both populations. Any critical point should be carefully analyzed in order to implement quality of care.展开更多
文摘This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U. S. health care system through their missions of conducting cutting-edge biomedical researeh, pursuing clinical and technological innovations, Providing state-of-the-art medical care and producing highly qUalified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical sciTo survive the threats of managed care in the health care environment, acadendc medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 1h8 CEOs in all the academic medical centers in the U. S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.
文摘Compared with high infection areas of the world, the total HIV infection rate in China is relatively low. Nonetheless, because of China’s vast territory and large population, the potential infection risk must be taken seriously. In the next few years, needle sharing among injection drug users will remain the most common route of transmission for the HIV/ AIDS epidemic in China. Unprotected sex is gradually becoming a major route of transmission. China began to imple- ment HAART in 1999 according to international standards. Prior to 2003, there were only about 150 HIV/AIDS patients were treated with HAART in some clinical trials and about 100 HIV/AIDS patients were treated by private sources. Results of those treatments are the scientific basis for development of the therapeutic strategies in China. In March of 2003, the Chinese government initiated China CARES program. In November of 2003, the Chinese Ministry of Health announced a national policy of free ARV treatment to all HIV+ Chinese citizens who were in poverty and required ARV therapy. There are total of 19,456 HIV/AIDS patients received free ARV drugs to date in 159 regions and 441 towns. Current challenges are how to follow-up and evaluate those patients in the clinical settings. The longer the therapy is postponed, the more side effects and the higher probability of drug resistance are going to occur. It remains unclear, therefore, when HAART regimen should be started in the HIV/AIDS population in China.
文摘Objective: to explore the application effect of improved incontinence skin care program in the prevention of incontinence dermatitis in intensive care patients. Methods: from January 2020 to January 2021, 30 patients with incontinence in our hospital were randomly divided into 15 cases in each group. Conventional nursing method was used in the control group, and incontinence skin care scheme was used in the observation group. The incidence of incontinence dermatitis, quality of life and risk of incontinence dermatitis were compared between the two groups after nursing. Results: after nursing, the incidence of incontinence dermatitis in the observation group was lower than that in the control group, and the difference was significant (P < 0.05). In addition, the quality of life of the patients in the observation group was significantly better than that in the control group (P < 0.05). Finally, in the risk assessment of incontinence dermatitis, the risk score of the observation group was significantly lower than that of the control group (P < 0.05). Conclusion: the clinical application effect of the improved incontinence skin care scheme in the prevention of incontinence dermatitis in intensive care patients is remarkable, which can further reduce the incidence of incontinence dermatitis in ICU patients and improve the quality of life of patients. It is suggested that it should be popularized and applied clinically.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT)(No.2020R1A5A2019413).
文摘Objectives:This study aimed to evaluate the clinical effectiveness,durability,and acceptability of a Korean medicine-based online mental health self-care program for mothers.Methods:This non-randomized comparative study evaluated the clinical effectiveness,durability,and acceptability of a Korean medicine-based online mental health self-care program for mothers.Group 1(regular version)included 120 participants who attended one live session per week for 5 weeks,while Group 2(shortened version)included 30 participants who completed five recorded sessions within 1 week.A total of 112 participants(93.3%)in Group 1 and all 30 participants(100%)in Group 2 completed the program and surveys.Results:Within-group analyses demonstrated significant improvements for depression(ΔCESD-10[Center for Epidemiological Studies Depression Scale-10]=−2.38±2.10,p<0.001;Cohen’s d=1.10),anxiety(ΔGAD-7[Generalized Anxiety Disorder Scale-7]=−3.82±3.20,p<0.001;d=0.93),and stress(ΔPSS[Perceived Stress Scale]=−6.44±4.50,p<0.001;d=1.12)in Group 1.Between-group analysis of covariance(ANCOVA)of postintervention scores showed significant differences favoring Group 1 in CESD-10(p<0.001)and GAD-7(p=0.025).These improvements were largely maintained through the 12-week follow-up(all p<0.001),indicating both statistical and clinical significance.The average willingness-to-pay per session was 8562.5±3609 KRW,and overall satisfaction was high.Conclusion:These findings demonstrate that the regular 5-week Korean medicine-based online program is effective,cost-effective,and capable of sustaining improvements in maternal mental health,supporting its potential use in community-based care strategies.
文摘Objective： Prognosis of colorectal cancer strongly depends on stage at diagnosis, which can be cured in most cases at an early stage. The results were supported by different screening programmes. Few data concerning analysis of different phases of Colorectal Cancer Program were reported in literature. The aim of this study is to analyze ＂step by step＂, from a longitudinal type, the Colorectal Cancer Program, active at our Institution, verifying compliance with standards of care.Methods： We compared two different populations during the same period： patients referring to our Clinical Oncology Unit coming from Regional Colorectal Cancer Screening Program and the other population that was not in any Colorectal Cancer Program.Results： Considering patients from the Regional Colorectal Cancer Screening Program（19 patients, corresponding to 24.0% of the general case study）, 3（15.8%） were deceased and 16（84.2%） were alive without evidence of the disease（NED）. Concerning patients that are not coming from Regional Colorectal Cancer Screening Program（61 patients, corresponding to 76.0% of the general case study）, 9（14.8%） were deceased, 43（70.5%） were NED, 8（13.1%） were alive with metastases and 1（1.6%） was lost during follow-up（PFU）. Conclusions： On the basis of this experience, we concluded for high-quality care for both populations. Any critical point should be carefully analyzed in order to implement quality of care.
