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1.
J Am Heart Assoc ; 13(8): e034506, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38606773

RESUMO

BACKGROUND: Clinical practice guidelines (CPGs) offer disease management recommendations based on scientific evidence. However, financial conflicts of interest between CPG developers and the pharmaceutical industry could bias these recommendations, potentially affecting patient care. Proper management of these conflicts of interest is particularly crucial for maintaining the integrity of CPGs. The study aimed to evaluate the extent of financial relationships between the pharmaceutical industry and authors of CPGs for cardiovascular diseases in Japan. METHODS AND RESULTS: The study analyzed personal payments from the pharmaceutical industry to authors of cardiovascular disease CPGs published by the Japanese Circulation Society from January 2015 to December 2022. Payment data, including speaking, consultancy, and writing fees from 2016 to 2020, were extracted from a publicly available database containing personal payments disclosed by all major pharmaceutical companies. A total of 929 unique authors from 37 eligible Japanese Circulation Society CPGs were identified. Notably, 94.4% of these authors received personal payments from pharmaceutical companies, totaling >US $70.8 million. The mean±SD payment per author was US $76 314±138 663) and the median payment per author was US $20 792 (interquartile range: US $4262-US $76 998) over the 5-year period. Chairs of CPGs received significantly higher payments than other authors. More than 80% of authors in each CPG received personal payments. CONCLUSIONS: The study elucidated that there were considerable financial relationships between pharmaceutical companies and cardiology CPG authors in Japan. This finding deviates from international conflict of interest management policies, suggesting the need for more stringent conflict of interest management strategies by the Japanese Circulation Society to ensure the development of trustworthy and evidence-based CPGs.


Assuntos
Cardiologia , Doenças Cardiovasculares , Humanos , Japão , Conflito de Interesses , Apoio Financeiro , Autoria , Indústria Farmacêutica , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/terapia , Preparações Farmacêuticas
2.
BMC Public Health ; 24(1): 920, 2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38553686

RESUMO

BACKGROUND: With the intensification of China's aging population, the demand for elderly care services has become increasingly prominent. At the same time, rapid development of internet technology provides more convenience and possibilities for the elderly. However, the coordinated development between the internet and elderly care services still faces challenges. This study aims to measure the level of coupling and coordinated development between the internet and elderly care services in China, and analyze the influencing factors, in order to provide reference for promoting elderly care services. METHODS: In this paper, the entropy method and coupling coordination degree model were used to measure the coupling coordination development index of the internet and elderly care services in China from 2012 to 2021. In addition, considering that the coordinated development between the two is affected by many factors, the Tobit model was used to analyze the main factors affecting the integration of the internet and elderly care services. RESULTS: (1) The coupling and coordination of the Internet and senior care services is in its infancy, but the coupling and coordination of the two is on the rise, and there is still a lot of room for development in the future. (2) In terms of time scale, the coupling coordination development level between the internet and elderly care services in China has gone through three stages of "disorder recession-transition coordination-coordinated development". (3) In terms of influencing factors, government management ability has a more positive impact on the development of the integration of the Internet and senior care services, financial support, scientific and technological investment and the level of innovation play a mild pulling role, while the level of informatization to a certain extent restricts the level of integration of the Internet and senior care services. CONCLUSION: In order to promote the coordinated development of China's Internet and senior care services, it is necessary to comprehensively understand the current situation and development space of China's Internet and senior care services coupling coordination degree, accurately grasp the dynamic trend of China's Internet and senior care services coupling and coordinated development, promote the stage of leapfrogging, and fully consider the influencing factors, so as to realize the optimal allocation of policies and resources. These measures will help to promote a more coordinated and sustainable development of the internet and elderly care services in China.


Assuntos
Envelhecimento , Apoio Financeiro , Humanos , Idoso , China , Governo , Internet , Desenvolvimento Econômico
3.
Artigo em Inglês | MEDLINE | ID: mdl-38530870

RESUMO

OBJECTIVES: Drawing on the intergenerational solidarity framework and life course perspective, the authors assessed how mother-child closeness across different life stages is associated with adult children's time and financial assistance to mothers in later life. METHODS: Using children's reports of their perceived closeness to mothers from Waves 1 to 4 of the National Longitudinal Study of Adolescent to Adult Health (Add Health) and mothers' reports about adult children's time and financial assistance from Wave 2 of the Add Health Parent Study (AHPS) in the United States, the authors investigated how mother-child closeness during adolescence, emerging adulthood, and young adulthood is related to midlife adult children's support with a focus on difference between mother-daughter (N = 934) and mother-son (N = 899) dyads. RESULTS: Closeness during young adulthood was an important determinant of adult children's time assistance to their mothers, regardless of child's gender. Daughters' closeness with mothers during young adulthood also had a direct association with their financial support to mothers but not sons'. In contrast, sons' perceived closeness during emerging adulthood had a direct association with their financial support later in life. Closeness during adolescence had no direct association with later-life transfers of time or money but had an indirect association through its influence on mother-child relationships at subsequent life stages. DISCUSSION: Mother-child closeness is a continuously evolving process. Although mother-child bond formed during adolescence has no direct influence on help to mothers later in life, it shapes the progression of mother-child interactions over time that eventuates in support.


Assuntos
Filhos Adultos , Relações Mãe-Filho , Humanos , Feminino , Relações Mãe-Filho/psicologia , Masculino , Adulto , Adolescente , Estudos Longitudinais , Filhos Adultos/psicologia , Estados Unidos , Adulto Jovem , Pessoa de Meia-Idade , Apoio Financeiro , Fatores Sexuais
4.
Vet Rec ; 194(6): 219, 2024 03 16.
Artigo em Inglês | MEDLINE | ID: mdl-38488579
7.
Health Policy Plan ; 39(1): 87-93, 2024 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-37987720

RESUMO

Family planning (FP) programmes in low and lower-middle income countries are confronting the dual impact of reduced external donor commitments and stagnant or reduced domestic financing, worsened by economic consequences of the COVID-19 pandemic. Co-financing-a donor-government agreement to jointly fund aspects of a programme, with transition towards the government assuming increasing responsibility for total cost-can be a powerful tool to help build national ownership, fiscal sustainability and programme visibility. Using Gavi's successful co-financing model as reference, the current paper draws out a set of key considerations for developing policies on co-financing of FP commodities in resource-poor settings. Macroeconomic and contextual sensitivities must be incorporated while classifying countries and determining co-financing obligations-using the actual GNI per capita on a scale or sovereign credit ratings, in conjunction with programmatic indicators, may be preferred. It is also important for policies to allow sufficiently long time for countries to transition-dependent on the country context, may be up to 10 years as allowed under the US Agency for International Development FP graduation policy and flexibility to revisit the terms following externalities that can influence the fiscal space for health. Incentivizing new domestic financing to pay for co-financing dues is critical, so as not to displace government funding from related health or social sector programs. Pragmatic ways to ensure country compliance can include engaging both the ministries of health and finance as co-signatories to identify and address known administrative and fiscal challenges; establishing dedicated co-financing account with the finance ministry; and instituting a mutual monitoring mechanism. Lastly, the overall process of policymaking can benefit from an alignment of goals and interests of the key development partners.


Assuntos
Serviços de Planejamento Familiar , Administração Financeira , Humanos , Pandemias , Apoio Financeiro , Financiamento da Assistência à Saúde , Países em Desenvolvimento
11.
Int J Circumpolar Health ; 83(1): 2298015, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38157432

RESUMO

Globally, self-employed people were among the hardest hit by the repercussions of the COVID-19 pandemic and faced hardships such as financial decline, restrictions, and business closures. A plethora of financial support measures were rolled out worldwide to support them, but there is a lack of research looking at the effect of the policy measures on self-employed people. To understand how different governmental financial support measures enhanced the resilience of the self-employed and improved their ability to manage the pandemic, we conducted a mixed-method study using policy analysis and semi-structured interviews. The documents described policies addressing governmental financial support in Sweden and Canada during the pandemic, and the interviews were conducted with Swedish and Canadian self-employed people to explore how they experienced the support measures in relation to their resilience. The key results were that self-employed people in both countries who were unable to telework were less resilient during the pandemic due to financial problems, restrictions, and lockdowns. The interviews revealed that many self-employed people in hard-hit industries were dissatisfied with the support measures and found them to be unfairly distributed. In addition, the self-employed people experiencing difficulties running their businesses reported reduced well-being, negatively affecting their business survival.


Assuntos
COVID-19 , Resiliência Psicológica , Humanos , Suécia , Canadá , Pandemias , Controle de Doenças Transmissíveis , Apoio Financeiro
13.
PLoS One ; 18(10): e0291296, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37816020

RESUMO

The integration of rural industries will inevitably lead to new business forms and new models, which put forward new requirements for traditional agricultural finance. The development of digital inclusive finance will provide new momentum for the integration of rural industries. Based on the provincial panel data from 2011 to 2020, the evaluation index system is constructed from three dimensions: industrial integration method, integration subject and integration format, and the development index of rural industrial integration is calculated. This paper establishes double fixed effect model and intermediary effect model to test the effect and path of digital inclusive finance on the integration of rural industries, and further explores the regulatory role and spatial difference of financial support. The results show that: (1) The integration of rural industries shows a growing trend, the eastern region develops more rapidly, while the central and western regions develop more slowly; (2) The digital inclusive finance can promote the integration of rural industries, digitization degree is remarkable, but coverage breadth and using depth are not significant, increasing the rate of per capita electricity consumption and urbanization can promote the integration of rural industries, consumption has limited pulling effect on the integration of rural industries, the per capita investment in fixed assets has no significant effects on the integration of rural industries; (3) The financial availability and the agricultural digitization play a complete intermediary effect; (4) Financial support has a negative moderating effect on the relationship between the two; (5) The eastern and central regions have a significant promoting effect, while the western region has a negative effect.


Assuntos
Comércio , Indústrias , Agricultura , Eletricidade , Apoio Financeiro , China , Desenvolvimento Econômico
14.
Front Public Health ; 11: 1219703, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37680270

RESUMO

Background: Depression is a major factor affecting the happiness of older rural residents. With the increasing aging of the Chinese population, overage labor is becoming more prevalent in rural areas of China. This study aimed to assess whether, and if so, how, overage labor affects depression status in older rural residents. Methods: Using data from the China Health and Retirement Longitudinal Study, this study explored the association between overage labor and depression among older rural residents by using ordinary least squares and moderated mediation models. Results: The results show that overage labor significantly reduced levels of depression in older rural residents. This result remained robust after using propensity score matching and double machine learning. Furthermore, the improvement of older rural residents' depression via overage labor is mainly achieved through work income, but this mediating effect is negatively moderated by intergenerational financial support. This implies that in traditional Chinese rural society, intergenerational financial support from children plays an important role in reducing depression among older rural residents. Conclusion: Our findings have potential policy implications for China and other developing countries in terms of addressing issues related to aging and depression in older adults.


Assuntos
Envelhecimento , Depressão , Criança , Humanos , Idoso , Depressão/epidemiologia , Estudos Longitudinais , China/epidemiologia , Apoio Financeiro
15.
BMJ Open ; 13(8): e070451, 2023 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-37597863

RESUMO

OBJECTIVE: This study aimed to model the long-term cost associated with expanding public health insurance coverage in Tanzania. DESIGN, SETTING AND PARTICIPANTS: We analysed the 2016 claims of 2 923 524 beneficiaries of the National Health Insurance Fund in Tanzania. The analysis focused on determining the average cost per beneficiary across 5-year age groups separated by gender, and grouped by broad health condition categories. We then modelled three different insurance coverage scenarios from 2020 to 2050 and we estimated the associated costs. OUTCOME MEASURES: Average cost per beneficiary and the projected financing requirements, projected from 2020 to 2050. RESULTS: The analysis revealed that the average per beneficiary cost for insurance claims was $38.58. Among males over 75 years, the average insurance claims costs were highest, amounting to $125. The total estimated annual cost of claims in 2020 was $151 million. Under the status quo coverage scenario, total claims were projected to increase to $415 million by 2050. Increasing coverage from 7% to 50% would result in an additional financing requirement of $2.27 billion. If coverage would increase by 10% annually, reaching 56% of the population by 2050, the additional financing need would amount to $2.84 billion. CONCLUSION: This study highlights the critical importance of assessing the long-term financial viability of health insurance schemes aimed to cover large segments of the population in low-income countries. The findings demonstrate that even without expansion of coverage, financing requirements for insurance will more than triple by 2050. Furthermore, increasing coverage is likely to substantially escalate the cost of claims, potentially requiring significant government or external contributions to finance these additional costs. Policymakers and stakeholders should carefully evaluate the sustainability of insurance schemes to ensure adequate financial support for expanding coverage and improving healthcare access in low-income settings.


Assuntos
Apoio Financeiro , Governo , Masculino , Humanos , Tanzânia , Cobertura do Seguro , Programas Nacionais de Saúde
16.
Int J Health Policy Manag ; 12: 7643, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37579479

RESUMO

Tuberculosis (TB) still represents a major public health problem in many regions of the world. TB control can only be achieved through a comprehensive and inclusive response which takes into account both upstream and downstream coordinated interventions related to structural determinants such as poverty, nutrition, sanitation, housing and access to healthcare as well as timely diagnosis and support throughout the course of treatment. Several social and financial support strategies have been proposed to improve TB treatment adherence, including conditional cash transfers (CCTs). In this context, demonstrating that social protection directly improves a specific health outcome using routinely collected data, incomplete registries or surveillance reports brings about many methodological challenges. We briefly discuss this paper and some limitations, describe main findings from our own research in this area and make a call to expand social protection interventions to address structural conditions of those most affected.


Assuntos
Tuberculose , Humanos , Apoio Financeiro , Pobreza , Saúde Pública , Política Pública , Tuberculose/prevenção & controle , Tuberculose/diagnóstico
17.
Jpn J Infect Dis ; 76(6): 365-371, 2023 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-37648486

RESUMO

This study examined which factors, including the regular financial social support program, influence tuberculosis (TB) treatment outcomes and success rates. Patients with TB registered during 2018-2019 were included in this retrospective cohort study. We classified them into 2 groups: those who received financial support for at least one month, and those who did not. Of the 22,867 sampled patients, 5,033 received financial social support and 17,834 did not. The success rate was 11.9% higher among patients who received financial social support than among those who did not (97.34% versus 85.40%). After controlling for other factors, the success rate among all patients was 1.3 times higher for female, 2.6 times higher for those under 50 years, 1.5 times higher for extra-pulmonary TB, 1.5 times higher for a new case, 5.9 times higher for drug susceptible TB, and 5.8 times higher for those who received financial support. Crucially, this is the first study from Türkiye evaluating the effect of a regular financial social support program on TB treatment outcomes since the program began in 2018. We recommend regular financial support for patients with TB in all countries.


Assuntos
Tuberculose , Humanos , Feminino , Estudos Retrospectivos , Tuberculose/tratamento farmacológico , Apoio Social , Apoio Financeiro , Resultado do Tratamento , Antituberculosos/uso terapêutico
19.
J Affect Disord ; 339: 767-775, 2023 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-37437743

RESUMO

OBJECTIVE: Aimed to investigate the effect of intergenerational financial support on depressive symptoms among older adults over time. METHODS: Data were obtained from China Health and Retirement Longitudinal Study (CHARLS) 2011, 2013, 2015, and 2018. A finite distributed lag (FDL) model was employed, long-run cumulative effect was evaluated. 1426 respondents followed in four waves were included in FDL model. CES-D score was used to measure depressive symptoms, intergenerational financial support was defined as financial support received from older adults' children or grandchildren. Sociodemographic characteristics, health behaviors, social insurance, and social contact factors were controlled in the model. RESULTS: More than a third older adults in China had a CES-D score of 10 or higher. Intergenerational financial support has a significant long-run cumulative negative effect on older adults' depressive symptoms (CES-D scores: coef. = -0.674, P < 0.001; % with CES-D scores ≥10: Coef. = -0.154, P = 0.018). While, the intergenerational financial support in previous period exhibited a significant negative association with depressive symptoms, the 2, 3, and 4 periods did not reach statistical significance. CONCLUSIONS: Intergenerational financial support has a significant negative effect on older adults' depressive symptoms over time, while the effect may diminish. Programs need to be explored to support home-based eldercare to mitigate this diminished effect.


Assuntos
Depressão , Aposentadoria , Criança , Humanos , Idoso , Estudos Longitudinais , Depressão/epidemiologia , Depressão/diagnóstico , Apoio Financeiro , China/epidemiologia
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