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1.
BMC Health Serv Res ; 24(1): 562, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38693514

RESUMO

BACKGROUND: This study aimed to examine the reporting quality of existing economic evaluations for negotiated glucose-lowering drugs (GLDs) included in China National Reimbursement Drug List (NRDL) using the Consolidated Health Economic Evaluation Reporting Standards 2013 (CHEERS 2013). METHODS: We performed a systematic literature research through 7 databases to identify published economic evaluations for GLDs included in the China NRDL up to March 2021. Reporting quality of identified studies was assessed by two independent reviewers based on the CHEERS checklist. The Kruskal-Wallis test and Mann-Whitney U test were performed to examine the association between reporting quality and characteristics of the identified studies. RESULTS: We have identified 24 studies, which evaluated six GLDs types. The average score rate of the included studies was 77.41% (SD:13.23%, Range 47.62%-91.67%). Among all the required reporting items, characterizing heterogeneity (score rate = 4.17%) was the least satisfied item. Among six parts of CHEERS, results part scored least at 0.55 (score rate = 54.79%) because of the incompleteness of characterizing uncertainty. Results from the Kruskal-Wallis test and Mann-Whitney U test showed that model choice, journal type, type of economic evaluations, and study perspective were associated with the reporting quality of the studies. CONCLUSIONS: There remains room to improve the reporting quality of economic evaluations for GLDs in NRDL. Checklists such as CHEERS should be widely used to improve the reporting quality of economic researches in China.


Assuntos
Hipoglicemiantes , China , Humanos , Hipoglicemiantes/economia , Hipoglicemiantes/uso terapêutico , Análise Custo-Benefício , Mecanismo de Reembolso/normas , Negociação
2.
BMC Ophthalmol ; 23(1): 471, 2023 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-37985976

RESUMO

BACKGROUND: Transepithelial corneal crosslinking (CXL) is a novel surgical approach for the treatment of keratoconus, which is a bilateral asymmetrical ophthalmological disease accompanied by progressive corneal ectasia. Silicon hydrogel (SiH) contact lenses have been extensively used in clinical ophthalmologic medicine, as a postoperative ophthalmological intervention. However, the ideal lens application duration after transepithelial CXL remains uncertain. Here, we aimed to investigate the effects and comfort of immediate corneal contact lens use after transepithelial CXL for keratoconus. METHODS: In this prospective study, 60 patients with keratoconus who underwent transepithelial CXL treatment were enrolled from September 2021 to January 2023 with a male:female ratio of 39:21, and an average age of 25.42 ± 5.47 years. The patients were divided randomly into two groups: group A contained 30 patients wearing silicone hydrogel contact lenses for 7 days postoperatively, and group B contained 30 patients wearing the same contact lenses for 3 days. Ten subjective ophthalmologic symptoms were surveyed by the patients, including pain, photophobia, foreign body sensation, tearing, burning, blurred vision, dry eyes, difficulty opening the eyes, astringency, and stinging. Ophthalmologic signs, including corneal edema and conjunctival congestion, were recorded by a single clinician on postoperative days 1, 3, and 7. RESULTS: Each surgical procedure was readily performed without complications, and both groups postoperative day 7 (P = 0.04), where group B scored (0.01 ± 0.41) lesser than group A (0.12 ± 0.29), whilst corneal edema in both groups recorded significantly different on postoperative days 5 and 7 (group A demonstrated the result of 0.17 ± 0.14 and 0.08 ± 0.11 for the respective days, whereas group B indicated 0.10 ± 0.13 and 0.03 ± 0.07 at the corresponding times). CONCLUSIONS: Immediate use of silicone hydrogel corneal lenses after transepithelial CXL effectively alleviates postoperative ocular distress, particularly with a three-day use period as the ideal duration.


Assuntos
Lentes de Contato , Edema da Córnea , Ceratocone , Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Ceratocone/tratamento farmacológico , Ceratocone/diagnóstico , Silício/uso terapêutico , Estudos Prospectivos , Crosslinking Corneano , Hidrogéis/uso terapêutico , Córnea , Silicones/uso terapêutico , Reagentes de Ligações Cruzadas/uso terapêutico , Fármacos Fotossensibilizantes/uso terapêutico , Riboflavina/uso terapêutico , Raios Ultravioleta , Topografia da Córnea
3.
Sci Rep ; 13(1): 12249, 2023 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-37507531

RESUMO

Due to the impact of the surrounding environment, the safety impact factors encountered during the construction of loess tunnels are complex and numerous, which causes frequent accidents, and there is a lack of safety risk assessment methods applicable to the construction of loess tunnels under complex environment. Based on the Luochuan tunnel project of the Xi'an-Yan'an High-Speed Railway, this paper analyzes the impact factors of loess tunnel construction risks, and 15 main impact factors involving subjective and objective factors are selected to establish the safety risk assessment system of loess tunnel construction under complex environment. To determine the weight of the impact factors, this paper introduces the combination weighting method based on game theory for the first time. Then, the risk assessment model of loess tunnel construction safety is established by using the conventional cloud model theory. Finally, the model is applied to the supporting project for verification. The results show that support and lining have the largest impact on tunnel construction safety, followed by construction management, surrounding rock grade, harmful engineering ground, monitoring measurement, forepoling, and construction method. The assessment result is consistent with the actual construction risk degree, which proves that the assessment result of the model is accurate and reliable, and the model has guiding significance for the safety risk assessment of loess tunnel construction under complex environment.

4.
Integr Med Res ; 12(1): 100915, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36632129

RESUMO

Background: Traditional Medicine (TM) has a wide uptake in most countries. In China, Traditional Chinese Medicine (TCM) is a common kind of primary health because of its beneficial effects. This review aimed to appraise the publication reporting quality of economic evaluations for selective TCM in the National Reimbursement Drug List (NRDL), Version 2020, based on the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement. Methods: Electronic databases were searched for economic evaluation that supported the TCM negotiations in NRDL (2020 version) published from 2001 to 2021, including PubMed, Web of Science, Embase, CNKI, WanFang, and SinoMed. The CHEERS statement was used to appraise the reporting quality of included TCM economic evaluations. Results: A total of 360 articles were retrieved, but only 38 economic evaluations met the inclusion criteria. None of the articles reported all items in the CHEERS checklist. The mean score of included articles is low at 10.93±2.62, with an average scoring rate of 51.31±10.53%. The least reported items included: "Characterizing heterogeneity," "Conflicts of interest", "Discount rate," and "Study perspective," with a reporting rate of 0.00%, 5.26%, 7.89%, and 15.79%, respectively. Conclusion: An upward trend occurred in the quantity and quality of the economic evaluation publications of TCM in China. TCM economic evaluations are still at an early stage, with an urgent need for improving reporting quality. It may result from research experiences or different ideas between TCM and Western Medicine. Adhering to reporting guidelines like CHEERS and educating economic evaluation investigators can improve TCM economic evaluations' reporting quality.

5.
BMC Health Serv Res ; 22(1): 1475, 2022 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-36463141

RESUMO

PURPOSE: To assess the reporting quality of published economic evaluations of the negotiated oncology drugs listed for China's 2020 National Reimbursement Drug List (NRDL). METHODS: A comprehensive search was conducted to identify economic evaluation studies of negotiated oncology drugs listed in China's 2020 NRDL using the PubMed/MEDLINE, Embase, Web of Science, CNKI, SinoMed, and WanFang Database up to March 31, 2021. The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist scored the reporting quality between 0 and 100. A linear regression analysis was employed to examine the influence of various characteristics on the reporting quality scores. RESULTS: Eighty papers were included in the study, with the majority published during the past decade. Furthermore, more than half of the articles (57.5%, or 46 out of 80) were written in English. The average CHEERS score was 74.63 ± 12.75 and ranged from 43.48 to 93.75. The most inadequately reported items included choice of model, characterization of heterogeneity, and discussion, as well as currency, price date and conversion. Higher scores were associated with articles published from 2019 to 2021 and English publications. CONCLUSION: The economic evaluation studies of negotiated oncology drugs listed in 2020 NRDL had moderate reporting quality. The Chinese economic evaluation publications could improve the reporting quality if the CHEERS checklist is consistently implemented. Also, the Chinese journals maybe explore introducing a reporting standard for economic evaluations.


Assuntos
Povo Asiático , Oncologia , Humanos , Análise Custo-Benefício , Lista de Checagem , China
6.
Clin Appl Thromb Hemost ; 28: 10760296221144038, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36503260

RESUMO

We aimed to investigate the efficacy and safety of rivaroxaban for acute and long-term management of cerebral venous sinus thrombosis (CVST). This study reviewed CVST-diagnosed patients admitted to the First Affiliated Hospital of Guangxi Medical University from January 2015 to December 2020. The primary outcome was a composite of recurrent thrombosis or major bleeding events. The secondary efficacy outcomes included a disease recovery time (DRT) presenting the time from admission to the endpoint as recovery (the modified Rankin scale [mRS] score [0-1]) within 30 and 90 days, and length of hospital stay (LHS). Patients treated with rivaroxaban (38) and warfarin (45) were enrolled in the final analysis. The primary outcome had no significant difference (5.3% vs 11.1%, P = .576) between the 2 groups. The secondary efficacy outcome regarding the median 30-d DRT was 17 days (95% confidence interval [CI], 14.6-19.4) in the rivaroxaban group, compared with 26.0 days (95% CI, 16.8-35.2) in the warfarin group (hazard ratio, 1.806; 95% CI, 1.051-3.103; log-rank P = .026). Two groups have a significant difference in LHS (P = .041). Patients with cerebral edema, intracerebral hemorrhage, and mild/moderate disability (admission mRS score [2-3]) treated with rivaroxaban recovered faster than those with warfarin (log-rank P < .05). Patients with cerebral edema, intracerebral hemorrhage, and mild/moderate disability treated with rivaroxaban had a shorter recovery time than those treated with warfarin within 1 month from admission, indicating that rivaroxaban a promising convenient therapy for CVST, helping them speedily restore social functions.


Assuntos
Edema Encefálico , Trombose dos Seios Intracranianos , Humanos , Rivaroxabana/efeitos adversos , Inibidores do Fator Xa/efeitos adversos , Anticoagulantes/efeitos adversos , Edema Encefálico/induzido quimicamente , Edema Encefálico/tratamento farmacológico , População do Leste Asiático , China , Varfarina/efeitos adversos , Hemorragia Cerebral/tratamento farmacológico , Trombose dos Seios Intracranianos/tratamento farmacológico , Resultado do Tratamento
7.
Front Psychol ; 13: 1043417, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36532969

RESUMO

Introduction: Customer-centered management theory has considerable potential for increasing the quality of higher education (HE) in China and promoting its sustainable development. Methods: This study applied customer-centered enterprise management theory to develop an HE stakeholder satisfaction scale based on data from 1,654 students, teachers, and other staff members, including human resources personnel. Results: The three-part stakeholder satisfaction survey consists of the China University Student Satisfaction Scale, the China University Teacher and Staff Satisfaction Scale, and the China University Graduate Human Resources Department Satisfaction Scale. All three subscales were valid, reliable, and can be used to foster management innovation, although they require adjustments to improve their coverage of different HE environments. Discussion: Organizational self-assessment based on customer-centered corporate management theory has much to contribute to the quality and sustainability of China's HE systems.

8.
J Vis Exp ; (180)2022 02 22.
Artigo em Inglês | MEDLINE | ID: mdl-35285824

RESUMO

Cardiac reprogramming has become a potentially promising therapy to repair a damaged heart. By introducing multiple transcription factors, including Mef2c, Gata4, Tbx5 (MGT), fibroblasts can be reprogrammed into induced cardiomyocytes (iCMs). These iCMs, when generated in situ in an infarcted heart, integrate electrically and mechanically with the surrounding myocardium, leading to a reduction in scar size and an improvement in heart function. Because of the relatively low reprogramming efficiency, purity, and quality of the iCMs, characterization of iCMs remains a challenge. The currently used methods in this field, including flow cytometry, immunocytochemistry, and qPCR, mainly focus on cardiac-specific gene and protein expression but not on the functional maturation of iCMs. Triggered by action potentials, the opening of voltage-gated calcium channels in cardiomyocytes leads to a rapid influx of calcium into the cell. Therefore, quantifying the rate of calcium influx is a promising method to evaluate cardiomyocyte function. Here, the protocol introduces a method to evaluate iCM function by calcium (Ca2+) flux. An αMHC-Cre/Rosa26A-Flox-Stop-Flox-GCaMP3 mouse strain was established by crossing Tg(Myh6-cre)1Jmk/J (referred to as Myh6-Cre below) with Gt(ROSA)26Sortm38(CAG-GCaMP3)Hze/J (referred to as Rosa26A-Flox-Stop-Flox-GCaMP3 below) mice. Neonatal cardiac fibroblasts (NCFs) from P0-P2 neonatal mice were isolated and cultured in vitro, and a polycistronic construction of MGT was introduced to NCFs, which led to their reprogramming to iCMs. Because only successfully reprogrammed iCMs will express GCaMP3 reporter, the functional maturation of iCMs can be visually assessed by Ca2+ flux with fluorescence microscopy. Compared with un-reprogrammed NCFs, NCF-iCMs showed significant calcium transient flux and spontaneous contraction, similar to CMs. This protocol describes in detail the mouse strain establishment, isolation and selection of neonatal mice hearts, NCF isolation, production of retrovirus for cardiac reprogramming, iCM induction, the evaluation of iCM Ca2+ flux using our reporter line, and related statistical analysis and data presentation. It is expected that the methods described here will provide a valuable platform to assess the functional maturation of iCMs for cardiac reprogramming studies.


Assuntos
Cálcio , Reprogramação Celular , Animais , Cálcio/metabolismo , Fibroblastos/metabolismo , Camundongos , Miocárdio/metabolismo , Miócitos Cardíacos/metabolismo
9.
Front Biosci (Landmark Ed) ; 27(1): 16, 2022 01 12.
Artigo em Inglês | MEDLINE | ID: mdl-35090321

RESUMO

BACKGROUND: Currently, individual clinical prognostic variables are used sequentially with risk-stratification after TNM staging in clinical practice for the prognostic assessment of patients with NSCLC, which is not effective for estimating the collective impact of multiple individual variables on patient outcomes. Here, we developed a clinical and PET/CT volumetric prognostic (CPVP) index that integrates the prognostic power of multiple clinical variables and metabolic tumor volume from baseline FDG-PET, for use immediately after definitive therapy. PATIENTS AND METHODS: This retrospective cohort study included 998 NSCLC patients diagnosed between 2004 and 2017, randomly assigned to two cohorts for modeling the CPVP index using Cox regression models examining overall survival (OS) and subsequent validation. RESULTS: The CPVP index generated from the model cohort included pretreatment variables (whole-body metabolic tumor volume [MTVwb], clinical TNM stage, tumor histology, performance status, age, race, gender, smoking history) and treatment type. A clinical variable (CV) index without MTVwb and PET/CT volumetric prognostic (PVP) index without clinical variables were also generated for comparison. In the validation cohort, univariate Cox modeling showed a significant association of the index with overall survival (OS; Hazard Ratio [HR] 3.14; 95% confidence interval [95% CI] = 2.71 to 3.65, p < 0.001). Multivariate Cox regression analysis demonstrated a significant association of the index with OS (HR = 3.13, 95% CI = 2.66 to 3.67, p < 0.001). The index showed greater prognostic power (C-statistic = 0.72) than any of its independent variables including clinical TNM stage (C-statistic ranged from 0.50 to 0.69, all p < 0.003), CV index (C-statistic = 0.68, p < 0.001) and PVP index (C-statistic = 0.70, p = 0.006). CONCLUSIONS: The CPVP index for NSCLC patients has moderately strong prognostic power and is more prognostic than its individual prognostic variables and other indices. It provides a practical tool for quantitative prognostic assessment after initial treatment and therefore may be helpful for the development of individualized treatment and monitoring strategy for NSCLC patients.


Assuntos
Neoplasias Pulmonares , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Fluordesoxiglucose F18 , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/terapia , Estadiamento de Neoplasias , Prognóstico , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Medição de Risco
10.
Sensors (Basel) ; 21(21)2021 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-34770315

RESUMO

Gas supply system risk assessment is a serious and important problem in cities. Existing methods tend to manually build mathematical models to predict risk value from single-modal information, i.e., pipeline parameters. In this paper, we attempt to consider this problem from a deep-learning perspective and define a novel task, Urban Gas Supply System Risk Assessment (GSS-RA). To drive deep-learning techniques into this task, we collect and build a domain-specific dataset GSS-20K containing multi-modal data. Accompanying the dataset, we design a new deep-learning framework named GSS-RiskAsser to learn risk prediction. In our method, we design a parallel-transformers Vision Embedding Transformer (VET) and Score Matrix Transformer (SMT) to process multi-modal information, and then propose a Multi-Modal Fusion (MMF) module to fuse the features with a cross-attention mechanism. Experiments show that GSS-RiskAsser could work well on GSS-RA task and facilitate practical applications. Our data and code will be made publicly available.


Assuntos
Aprendizado Profundo , Aprendizagem , Medição de Risco
12.
J Clin Pharmacol ; 60(9): 1220-1230, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32488878

RESUMO

Knowledge of pharmacokinetic (PK) behavior of norvancomycin (NVCM) in pediatric patients is lacking, which leads to empirical therapy in clinical practice. This study developed a population PK model of children aged 0-15 years; 112 opportunistic samples in total from 90 children were analyzed. The stability and prediction of the final model were evaluated by goodness-of-fit plots, nonparametric bootstrap, visual predictive check, and normalized prediction distribution errors. The PKs of NVCM in children was described by a 2-compartment model with first-order elimination along with body weight and estimated glomerular filtration rate as significant covariates on clearance. The population typical values of the PK parameters were as follows: clearance 0.12 L/kg/h, central compartment distribution volume 0.17 L/kg, peripheral compartment distribution volume 0.38 L/kg, and intercompartmental clearance 0.35 L/kg/h. Logistic analysis showed that the ratio of area under the concentration-time curve over 24 hours (AUC0-24 ) to minimum inhibitory concentration (MIC) had the strongest correlation with clinical efficacy, and at least 80% clinical efficiency could be achieved when AUC0-24 /MIC ≥ 221.06 was defined as the target. Monte Carlo simulation results suggested that a higher dose was required for this pediatric population in order to reach the target. The dosing regimen was optimized based on the final model. A population PK model of NVCM was first characterized in children with hematologic malignancy, and an evidence-based approach for NVCM dosage individualization was provided.


Assuntos
Antibacterianos/farmacologia , Neoplasias Hematológicas/tratamento farmacológico , Vancomicina/análogos & derivados , Adolescente , Antibacterianos/administração & dosagem , Antibacterianos/sangue , Antibacterianos/farmacocinética , Área Sob a Curva , Peso Corporal , Criança , Pré-Escolar , Simulação por Computador , Esquema de Medicação , Vias de Eliminação de Fármacos , Neutropenia Febril/complicações , Neutropenia Febril/tratamento farmacológico , Feminino , Taxa de Filtração Glomerular , Neoplasias Hematológicas/complicações , Humanos , Lactente , Recém-Nascido , Infusões Intravenosas , Masculino , Testes de Sensibilidade Microbiana , Modelos Biológicos , Método de Monte Carlo , Resultado do Tratamento , Vancomicina/administração & dosagem , Vancomicina/sangue , Vancomicina/farmacocinética , Vancomicina/farmacologia
13.
Eur J Cancer Care (Engl) ; 28(2): e12965, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30499193

RESUMO

Accurately measuring health state utilities is crucial for health economic evaluation. This study empirically investigated both indirect approaches (including using the latest version of five-level EQ-5D questionnaire, EQ-5D-5L and the popular SF-6D), as well as a direct approach (the time trade-off, TTO) for eliciting utilities in breast cancer patients. A valid sample of 608 breast cancer patients (48% TNM Stages III/IV) in mainland China was analysed. Mean utilities elicited from the TTO, EQ-5D-5L and SF-6D were 0.80, 0.83 and 0.65 respectively. There is poor to fair agreement between direct and indirect approaches on measuring health state utilities with breast cancer patients. The absolute agreement was higher between EQ-5D-5L and SF-6D utilities (intraclass correlation coefficient, ICC = 0.55) than between TTO and EQ-5D-5L/SF-6D utilities (ICCs < 0.3). Regression analyses found that both EQ-5D-5L and SF-6D utilities were responsive to five out of eight breast cancer-specific symptom and functional scales. In sum, criterion and known-group validities of three health state utility measures which were investigated in this research suggest that, the EQ-5D-5L is currently the optimal approach (followed by the SF-6D) to elicit health state utilities from breast cancer patients in mainland China.


Assuntos
Neoplasias da Mama/terapia , Indicadores Básicos de Saúde , Nível de Saúde , Adulto , Idoso , Neoplasias da Mama/etnologia , Sobreviventes de Câncer , China/etnologia , Feminino , Humanos , Pessoa de Meia-Idade , Anos de Vida Ajustados por Qualidade de Vida , Inquéritos e Questionários
14.
Medicine (Baltimore) ; 96(34): e7840, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28834893

RESUMO

There is an increasing trend globally to develop country-specific tariffs that can theoretically better reflect population's preferences on health states for preference-based health-related quality-of-life instruments, also known as multiattribute utility instruments. This study focused on the most recently developed 5-level version of EuroQol-5 Dimension (EQ-5D) questionnaire, 1 of the world's most well-known multiattribute utility instruments, and aimed to empirically explore the agreements and known-group validities of applying the country-specific tariff versus tariffs developed from other countries using a sample of psoriasis vulgaris patients in Mainland China.A convenience sampling framework was adopted to recruit patients diagnosed with psoriasis vulgaris from Xiangya Hospital, Central South University, China, between May 2014 and February 2015. The 5-level EuroQol-5 dimensions (EQ-5D-5L) utilities were scored by using the Chinese, Japanese, and UK tariffs. Health state utilities were compared using a range of nonparametric test. The intraclass correlation coefficients and Bland-Altman plots were used to examine the agreements among the 3 EQ-5D-5L scores. Health state utility decrements between known groups were investigated using both effect size and a regression analysis.In all, 350 patients (aged 16 years or older) were recruited. There were significant differences among the 3 national tariff sets. Overall, 3 tariffs showed excellent agreements (intraclass correlation coefficient >0.90); however, the wide limits of agreement from the Bland-Altman plots suggest that these tariffs cannot be used interchangeably. The EQ-5D-5L scores using the Chinese-specific tariff showed the best known-group validity than the other 2 tariffs in this Chinese patient sample. The evidence from this study supports the choice of the country-specific tariff to be used in Mainland China.


Assuntos
Competência Cultural , Psoríase/psicologia , Qualidade de Vida/psicologia , Inquéritos e Questionários/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China , Análise Custo-Benefício/métodos , Análise Custo-Benefício/normas , Avaliação da Deficiência , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Preferência do Paciente , Anos de Vida Ajustados por Qualidade de Vida , Análise de Regressão , Fatores Socioeconômicos , Reino Unido , Adulto Jovem
15.
Drug Alcohol Depend ; 170: 174-180, 2017 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-27951424

RESUMO

BACKGROUND: Given the growing legalization of recreational marijuana use and related increase in its prevalence in the United States, it is important to understand marijuana's appeal. We used a behavioral economic (BE) approach to examine whether the reinforcing properties of marijuana, including "demand" for marijuana, varied as a function of its perceived quality. METHODS: Using an innovative, Web-based marijuana purchase task (MPT), a sample of 683 young-adult recreational marijuana users made hypothetical purchases of marijuana across three qualities (low, mid and high grade) at nine escalating prices per joint, ranging from $0/free to $20. RESULTS: We used nonlinear mixed effects modeling to conduct demand curve analyses, which produced separate demand indices (e.g., Pmax, elasticity) for each grade of marijuana. Consistent with previous research, as the price of marijuana increased, marijuana users reduced their purchasing. Demand also was sensitive to quality, with users willing to pay more for higher quality/grade marijuana. In regression analyses, demand indices accounted for significant variance in typical marijuana use. CONCLUSIONS: This study illustrates the value of applying BE theory to young adult marijuana use. It extends past research by examining how perceived quality affects demand for marijuana and provides support for the validity of a Web-based MPT to examine the appeal of marijuana. Our results have implications for policies to regulate marijuana use, including taxation based on the quality of different marijuana products.


Assuntos
Cannabis , Comércio/economia , Fumar Maconha/economia , Percepção , Economia Comportamental , Feminino , Humanos , Internet , Masculino , Reforço Psicológico , Adulto Jovem
16.
Int J Environ Res Public Health ; 12(8): 9714-25, 2015 Aug 18.
Artigo em Inglês | MEDLINE | ID: mdl-26295246

RESUMO

BACKGROUND: Despite the large volume of research dedicated to health-related behavior change, chronic disease costs continue to rise, thus creating a major public health burden. Health literacy, the ability to seek, understand, and utilize health information, has been identified as an important factor in the course of chronic conditions. Little research has been conducted on the relationship between health literacy and health-related behaviors and health status in elderly Chinese. The aim of this study was to elucidate the relationship between health literacy and health-related behaviors and health status in China. METHODS: The subjects enrolled in this study were selected based on a stratified cluster random sampling design. Information involving >4500 older adults in 44 pension institutions in Urumqi, Changji, Karamay, and Shihezi of Xinjiang between September 2011 and June 2012 was collected. The Chinese Citizen Health Literacy Questionnaire (China Health Education Centre, 2008) and a Scale of the General Status were administered and the information was obtained through face-to-face inquiries by investigators. A total of 1452 respondents met the inclusion criteria. A total of 1452 questionnaires were issued and the valid response rate was 96.14% (1396 of 1452). Factors affecting health literacy and the relationship to health literacy were identified by one-way ANOVA and a multiple linear regression model. RESULTS: The average health literacy level of the elderly in nursing homes was relatively low (71.74 ± 28.35 points). There were significant differences in the health literacy score among the factors of age, gender, race, education level, household income, marital conditions, and former occupation (p < 0.001). The health literacy score was significantly associated with smoking, drinking, physical exercise, and health examination (p < 0.001). The elderly with higher health literacy scores were significantly less likely to have risky behaviors (smoking, regular drinking, and lack of physical exercise), and in turn significantly more likely to undergo health examinations regularly, report good self-rated health, and significantly more likely to access sufficient health information from multiple sources (p < 0.001). No differences were noted between the health literacy score and BMI (p > 0.05). Multiple linear regression analysis showed that the independent influencing factors of health literacy included education level, race, former occupation, household income, age, physical exercise, health examination, smoking, and health information access (p < 0.001). CONCLUSIONS: Health literacy was significantly associated with health-related behaviors in elderly Chinese. Further longitudinal studies are needed to help confirm that improving health literacy in the elderly may be effective in changing health-related behaviors. To reduce risky habits, educational interventions to improve health literacy should be simultaneously conducted in health promotion work.


Assuntos
Povo Asiático/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Letramento em Saúde/estatística & dados numéricos , Nível de Saúde , Idoso , Idoso de 80 Anos ou mais , Consumo de Bebidas Alcoólicas , China , Escolaridade , Exercício Físico , Feminino , Promoção da Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Ocupações , Inquéritos e Questionários
17.
Exp Clin Psychopharmacol ; 22(3): 211-21, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24467370

RESUMO

In the United States, marijuana is the most commonly used illicit drug. Its prevalence is growing, particularly among young adults. Behavioral economic indices of the relative reinforcing efficacy (RRE) of substances have been used to examine the appeal of licit (e.g., alcohol) and illicit (e.g., heroin) drugs. The present study is the first to use an experimental, simulated purchasing task to examine the RRE of marijuana. Young-adult (M age = 21.64 years) recreational marijuana users (N = 59) completed a computerized marijuana purchasing task designed to generate demand curves and the related RRE indices (e.g., intensity of demand-purchases at lowest price; Omax-max. spent on marijuana; Pmax-price at which marijuana expenditure is max). Participants "purchased" high-grade marijuana across 16 escalating prices that ranged from $0/free to $160/joint. They also provided 2 weeks of real-time, ecological momentary assessment reports on their marijuana use. The purchasing task generated multiple RRE indices. Consistent with research on other substances, the demand for marijuana was inelastic at lower prices but became elastic at higher prices, suggesting that increases in the price of marijuana could lessen its use. In regression analyses, the intensity of demand, Omax, and Pmax, and elasticity each accounted for significant variance in real-time marijuana use. These results provide support for the validity of a simulated marijuana purchasing task to examine marijuana's reinforcing efficacy. This study highlights the value of applying a behavioral economic framework to young-adult marijuana use and has implications for prevention, treatment, and policies to regulate marijuana use.


Assuntos
Imaginação , Fumar Maconha/economia , Fumar Maconha/psicologia , Autorrelato , Adolescente , Adulto , Economia Comportamental , Feminino , Seguimentos , Humanos , Masculino , Estudos Prospectivos , Adulto Jovem
18.
Multivariate Behav Res ; 49(2): 178-92, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-26741176

RESUMO

Behavioral economic demand curves (Hursh, Raslear, Shurtleff, Bauman, & Simmons, 1988) are innovative approaches to characterize the relationships between consumption of a substance and its price. In this article, we investigate common analytical issues in the use of behavioral economic demand curves, which can cause inconsistent interpretations of demand curves, and then we provide methodological suggestions to address those analytical issues. We first demonstrate that log transformation with different added values for handling zeros changes model parameter estimates dramatically. Second, demand curves are often analyzed using an overparameterized model that results in an inefficient use of the available data and a lack of assessment of the variability among individuals. To address these issues, we apply a nonlinear mixed effects model based on multivariate error structures that has not been used previously to analyze behavioral economic demand curves in the literature. We also propose analytical formulas for the relevant standard errors of derived values such as P max, O max, and elasticity. The proposed model stabilizes the derived values regardless of using different added increments and provides substantially smaller standard errors. We illustrate the data analysis procedure using data from a relative reinforcement efficacy study of simulated marijuana purchasing.

19.
Sci China Life Sci ; 57(3): 336-339, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24292885

RESUMO

By nature, biomarker is the measurable change associated with a physiological or pathophysiological process. Unlike blood which has mechanisms to minimize changes and to keep the internal environment homeostatic, urine is more likely to reflect changes of the body and is a better biomarker source. Because of its potential in biomarker discovery, urinary proteins should be preserved comprehensively as the duration of the patients' corresponding medical records. Here, we propose a method to adsorb urinary proteins onto a membrane we named Urimem. This simple and inexpensive method requires minimal sample handling, uses no organic solvents, and is environmentally friendly. Urine samples were filtered through the membrane, and urinary proteins were adsorbed onto the membrane. The proteins on the membrane were dried and stored in a vacuum bag, which keeps the protein pattern faithfully preserved. The membrane may even permit storage at room temperature for weeks. Using this simple and inexpensive method, it is possible to begin preserving urine samples from all consenting people. Thus, medical research especially biomarker research can be conducted more economically. Even more objective large-scale prospective studies will be possible. This method has the potential to change the landscape of medical research and medical practice.


Assuntos
Biomarcadores/metabolismo , Membranas Artificiais , Polivinil/química , Proteinúria/metabolismo , Adsorção , Biomarcadores/química , Eletroforese em Gel de Poliacrilamida , Filtração/instrumentação , Filtração/métodos , Humanos , Estabilidade Proteica , Reprodutibilidade dos Testes
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