8,996 research outputs found

    Purchasing and consumption of over-the-counter antibiotics:a mixed-method approach to secondary data

    Get PDF
    This research explores the reasons for antibiotic purchasing and consumption at retail pharmacies in rural China. Although an increasing amount of policy recommendations are put forward, empirical studies are still lacking on antibiotic purchasing over the counter and consumption of over the counter (OTC) antibiotics in China. My research addresses this evidence gap.Firstly, a quantitative analysis was conducted on the structured observations data from the mixed-method research project Pathways to optimising antibiotic use in rural China: identifying key determinants in community and clinical settings ‘Antibiotic Pathways study’. The aim was to investigate the prevalence of OTC antibiotics dispensing and consumption and the characteristics of medical encounters in retail pharmacies. Secondly, I conducted a qualitative analysis of in-depth interviews from the same research project. The aim was to explore the purchasing and consumption of antibiotics from retail pharmacies and to provide an in-depth exploration of customers’ experience of OTC antibiotic consumption.The findings suggest that local access to antibiotics for residents remains prevalent, as a result of the lack of restrictions on purchasing antibiotics without prescription at the lower levels of the healthcare system. Customers’ perception of the ’convenient’ purchase of antibiotics over the counter, short medical encounters and easy access in the retail sector, and policy implementation contributed to the prevalent purchasing and consumption of over-the-counter antibiotics.This study provides additional support for policy recommendations on antibiotic stewardship in the retail sector. The findings suggest that addressing antibiotic stewardship in lower levels of the healthcare system requires a focus on policy implementation, and the variability of healthcare resources across regions should be taken into consideration to ensure the effective implementation of antibiotic stewardship in China

    Clinical Decision Support System for Unani Medicine Practitioners

    Full text link
    Like other fields of Traditional Medicines, Unani Medicines have been found as an effective medical practice for ages. It is still widely used in the subcontinent, particularly in Pakistan and India. However, Unani Medicines Practitioners are lacking modern IT applications in their everyday clinical practices. An Online Clinical Decision Support System may address this challenge to assist apprentice Unani Medicines practitioners in their diagnostic processes. The proposed system provides a web-based interface to enter the patient's symptoms, which are then automatically analyzed by our system to generate a list of probable diseases. The system allows practitioners to choose the most likely disease and inform patients about the associated treatment options remotely. The system consists of three modules: an Online Clinical Decision Support System, an Artificial Intelligence Inference Engine, and a comprehensive Unani Medicines Database. The system employs advanced AI techniques such as Decision Trees, Deep Learning, and Natural Language Processing. For system development, the project team used a technology stack that includes React, FastAPI, and MySQL. Data and functionality of the application is exposed using APIs for integration and extension with similar domain applications. The novelty of the project is that it addresses the challenge of diagnosing diseases accurately and efficiently in the context of Unani Medicines principles. By leveraging the power of technology, the proposed Clinical Decision Support System has the potential to ease access to healthcare services and information, reduce cost, boost practitioner and patient satisfaction, improve speed and accuracy of the diagnostic process, and provide effective treatments remotely. The application will be useful for Unani Medicines Practitioners, Patients, Government Drug Regulators, Software Developers, and Medical Researchers.Comment: 59 pages, 11 figures, Computer Science Bachelor's Thesis on use of Artificial Intelligence in Clinical Decision Support System for Unani Medicine

    Practitioner based inquiry: taking the case of homeopathy.

    Get PDF
    After twenty years of practising and teaching homeopathy, I am concerned that research into treatment by professional homeopaths has become stifled by evidence based medicine discourse. Homeopathy’s distinguishing features are obscured by erroneous assumptions that a homeopathic prescription is subject to the same biochemical pathways as pharmacological medication. Homeopaths are urged by external parties to ‘prove homeopathy works’ on biomedical terms. This reflexive inquiry is an attempt to redress the balance. From postmodern and pragmatic perspectives I reflexively engage with professional experiences (Smith, 2009) as a means of articulating practitioner based knowledge (Freshwater and Rolfe, 2001, Rolfe et al., 2001). The subjectivity of the practitioner researcher is transformed from a research problem into an opportunity to critically examine practitioner experience (Lees and Freshwater, 2008). The research process is a focus for the inquiry itself, with the intention of creating an open text that invites participation from the reader (Denzin and Lincoln, 1994). I ‘take the case’ of my own practice and its wider context, and enact a synergy of homeopathic practice and research methodologies. The thesis is organised around the eight principles of homeopathy. Case vignettes and homeopathy’s visual iconography (Cherry, 2008) are used to integrate clinical experience into the thesis. Multiple analytical strategies evolved, including discourse analysis, action research, narrative analysis and writing as inquiry. These are not applied to pre-existing professional experiential data (Lees, 2005), but engaging with these strategies has shaped data creation and the inquiry itself. Use of multiple methods is not an attempt to triangulate, rather the dissonance between them is essential to achieving competing and multiple perspectives on professional experience. There is no intention to present a discrete set of findings. The inquiry is framed through the inquiry process, creating an innovative approach to practitioner based inquiry as a collage of reflexive, experiential interpretations and interactions with professional practice. I redefine evidence as being the inquiry process itself and the practitioner as integral to knowledge creation and application in practice. The open dialogic text invites practitioners to adapt this model of practitioner based research in their own practices. The self-critical iterative dialogue gives voice to the practitioner researcher in discourses that are congruent with homeopathic practice. I make original contributions to knowledge by examining homeopathic practice from different theoretical and experiential perspectives, including observations on the connections between homeopathy’s enduring popularity and how the patients’ own belief systems about health and illness are still influenced by the old humoural system of medicine

    Organisational culture and its influence on physicians’ consultation style in Hong Kong

    Get PDF
    Chronic diseases are considered to be a global health system challenge, contributing to 60% of all deaths worldwide in 2005. There is a recognised need for patients with chronic diseases to make regular medication decisions with their GPs as an essential part of consultations. A growing body of evidence from the UK, the United States and China has suggested a link between GPs’ involvement of patients and information sharing in treatment decisions and improved communication and clinical performance. Charles and colleagues (1999) proposed a continuum of consultation models with increasing patient engagement, the one-way GP-dominant “paternalistic” style, the two-way “shared decision-making” (SDM) style, and the one-way patient-dominant “informed” style. These models illustrate various levels of involvement and knowledge sharing between GPs and patients in the treatment decision-making process. Yet, there is a lack of evidence to determine how organisational culture drives different consultation styles and improves decisional communication in Asian countries. Therefore, this qualitative study explored GPs and primary care managers’ perceptions of organisational culture within public and private healthcare organisations in Hong Kong, and how these perceptions influence GPs’ consultation style during medication consultations with patients with chronic diseases. Themes were generated from in-depth individual interviews with fourteen GPs and five primary care managers, based on two analytical frameworks, the Hofstede cultural dimension theory (2001/2011) and Hofstede’s multi-focus model of organisational culture (1990). Four themes concerning national culture, organisational culture, the system-, practice- and individual factors, as well as the financing and service level initiatives to drive cultural changes, were identified as influencing GPs’ consultation styles. The study highlighted that an engaging management style and customer-focused and mandatory learning cultures within healthcare organisations promoted greater use of two-way consultation styles by GPs during the consultation. In contrast, the study also found that authoritative, profit-driven and voluntary learning cultures within healthcare organisations promoted more one-way consultation styles, such as the paternalistic or informed styles. Thus, this study contributes to a better understanding of the positive and negative influences of national and organisational cultures on GPs’ practice of SDM with patients in discussions of chronic disease management across public and private healthcare organisations in an Eastern Asian country. Further research on the national culture of health care financing and patients’ influences on consultation styles is needed before the association between organisational culture and consultation style can be comprehensively understood

    Conceptualising the spirituality of Chinese older adults: a Delphi study

    Get PDF
    Free Paper Session II : Mental Health / End-Of-Life CareINTRODUCTION: Service provision in geriatric health and social care is increasingly guided by holistic principles, in which many aspects, including physical, psychological, social, and spiritual aspects, are equally emphasized to enhance well-being and enrich life. However, little is known about the degree of consensus among multidisciplinary professionals in the Chinese context on the central components of spirituality that most promote spiritual well-being among Chinese older adults. This study is intended to identify the core components of ...published_or_final_versio

    Living alone but not lonely: a selection, optimisation, and compensation analysist

    Get PDF
    Free Paper Session IV: Long-Term CareINTRODUCTION: One observation of the ageing population in Hong Kong is the increasing percentage of older adults living alone over the past few decades. Although the image of older adults living alone is often associated with feelings of isolation and loneliness, not every older adult who lives alone feels lonely. This paper is intended to answer the following question: “How can older adults live alone and not feel lonely?” Specifically, the text examines the orchestrating process adopted by those in Hong Kong for living alone without generating feelings of loneliness; this examination is guided by a selection 
published_or_final_versio
    • 

    corecore