71 research outputs found
A BERT-based dual embedding model for Chinese idiom prediction
Chinese idioms are special fixed phrases usually derived from ancient
stories, whose meanings are oftentimes highly idiomatic and non-compositional.
The Chinese idiom prediction task is to select the correct idiom from a set of
candidate idioms given a context with a blank. We propose a BERT-based dual
embedding model to encode the contextual words as well as to learn dual
embeddings of the idioms. Specifically, we first match the embedding of each
candidate idiom with the hidden representation corresponding to the blank in
the context. We then match the embedding of each candidate idiom with the
hidden representations of all the tokens in the context thorough context
pooling. We further propose to use two separate idiom embeddings for the two
kinds of matching. Experiments on a recently released Chinese idiom cloze test
dataset show that our proposed method performs better than the existing state
of the art. Ablation experiments also show that both context pooling and dual
embedding contribute to the improvement of performance.Comment: COLING 202
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Measuring Access to Medicines: A Survey of Prices, Availability and Affordability in Shaanxi Province of China
Objective: To measure the prices and availability of selected medicines in Shaanxi Province after the implementation of new healthcare reform in 2009. Methods: Data on the prices and availability of 47 medicines were collected from 50 public and 36 private sector medicine outlets in six regions of Shaanxi Province, Western China using a standardized methodology developed by the World Health Organization and Health Action International from September to October 2010. Medicine prices were compared with international reference prices to obtain a median price ratio. Affordability was measured as the number of days’ wages required for the lowest-paid unskilled government worker to purchase standard treatments for common conditions. Findings: The mean availabilities of originator brands and lowest-priced generics were 8.9% and 26.5% in the public sector, and 18.1% and 43.6% in the private sector, respectively. The public sector procured generics and originator brands at median price ratios of 0.75 and 8.49, respectively, while patients paid 0.97 and 10.16. Final patient prices for lowest-priced generics and originator brands in the private sector were about 1.53 and 8.36 times their international retail prices, respectively. Public sector vendors applied high markups of 30.4% to generics, and 19.6% to originator brands. In the private sector, originator brands cost 390.7% more, on average, than their generic equivalents. Generic medicines were priced 17.3% higher in the private sector than the public sector. The lowest-paid government worker would need 0.1 day’s wages to purchase captopril for lowest-priced generics from private sector, while 6.6 days’ wages for losartan. For originator brands, the costs rise to 1.2 days’ wages for salbutamol inhaler and 15.6 days’ wages for omeprazole. Conclusions: The prices, availability and affordability of medicines in China should be improved to ensure equitable access to basic medical treatments, especially for the poor. This requires multi-faceted interventions, as well as the review and refocusing of policies, regulations and educational interventions
Access to aff ordable medicines after health reform: evidence from two cross-sectional surveys in Shaanxi Province,western China
Background Limited access to essential medicines is a global problem. Improving availability and aff ordability of
essential medicines is a key objective of the National Essential Medicine Policy (NEMP) in China. In its initial
implementation in 2009, the NEMP targeted primary hospitals with policies designed to increase availability of
essential medicines and reduce patients’ economic burden from purchasing medicines. We assessed medicine
availability and price during the early years of the health reform in Shaanxi Province in underdeveloped western
China.
Methods We undertook two public (hospitals) and private (pharmacy) sector surveys of prices and availability of
medicines, in September, 2010 and April, 2012, by a standard methodology developed by WHO and Health Action
International. We measured medicine availability in outlets at the time of the surveys and infl ation-adjusted median unit
prices (MUPs), taking 2010 as the base year. We used general estimating equations to calculate the signifi cance of
diff erences in availability from 2010 to 2012 and the Wilcoxon signed rank test to calculate the signifi cance of diff erences
in adjusted median prices.
Findings We collected data from 50 public sector hospitals and 36 private sector retail pharmacies in 2010 and 72 public
hospitals and 72 retail pharmacies in 2012. Mean availability of surveyed medicines was low in both the public and
private sectors; availability of many essential medicines decreased from 2010 to 2012, particularly in primary hospitals
(from 27·4% to 22·3% for lowest priced generics; p<0·0001). The MUPs of originator brands and their generic
equivalents decreased signifi cantly from 2010 to 2012 in primary hospitals in comparison with secondary and tertiary
hospitals. In the public sector, the median adjusted patient price was signifi cantly lower in 2012 than in 2010 for
16 originator brands (diff erence –11·7%; p=0·0019) and 29 lowest-priced generics (–5·2%; p=0·0015); the median
government procurement price for originator brands also decreased signifi cantly (–10·9%; p=0·0004), whereas the
decrease in median procurement price for lowest-priced generics was not signifi cant (–4·9%; p=0·17). In the private
sector, the median percentage decrease in price between 2010 and 2012 for 38 lowest-priced generics was 4·7%
(IQR 6·3–13·2), compared with 7·9% (4·9–13·9) for 16 originator brands.
Interpretation Although infl ation-adjusted medicine prices were numerically lower, there were concerning decreases
in availability of lowest-priced generic medicines in both the public and private sectors in 2012 from already low availability in 2010. A long-term, stable, and consistent information system is needed to monitor eff ects of further implementation of the Chinese Essential Medicine Policy
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Access to Paediatric Essential Medicines: A Survey of Prices, Availability, Affordability and Price Components in Shaanxi Province, China
Objective: To evaluate the prices and availability of paediatric essential medicines in Shaanxi Province, China. Methods: Price and availability data for 28 paediatric essential medicines were collected from 60 public hospitals and 60 retail pharmacies in six areas of Shaanxi Province using a standardised methodology developed by the World Health Organization and Health Action International, during November to December 2012. Affordability was measured as the number of days’ wages required for the lowest-paid unskilled government worker to purchase standard treatments for common conditions. Data on medicine price components were collected from hospitals, wholesalers and distributors to obtain price mark-ups. Findings: The mean availabilities of originator brands (OBs) and lowest-priced generics (LPGs) were 10.8% and 27.3% in the public hospitals and 11.9% and 20.6% in the private pharmacies. The public procurement and retail prices were 2.25 and 2.59 times the international reference prices (IRPs) for three OBs, and 0.52 and 0.93 times for 20 LPGs. In the private sector, the final prices for OBs and LPGs were 3.89 and 1.25 times their IRPs. The final price in the private sector was 2.7% lower than in the public sector for OBs, and 14.1% higher for LPGs. Generally, standard treatments cost less than 1 day’s wages in both sectors. Distribution mark-ups applied to brand salbutamol in Xi'an was 65.5%, and up to 185.3% for generic. Cumulative mark-ups for LPGs in Ankang were also high, from 33% to 50%. The manufacturer’s selling price is the largest contributor to the final price in both areas. Conclusions: The government should approve a list of national paediatric essential medicines. The availability, price and affordability of these should be improved in both public hospitals and private pharmacies to enable children to obtain effective treatment. Measures should be taken to improve the efficiency of the centralised medicine purchasing system
Perspective of key healthcare professionals on antimicrobial resistance and stewardship programs: A multicenter cross-sectional study from Pakistan
Copyright © 2020 Hayat, Rosenthal, Gillani, Chang, Ji, Yang, Jiang, Zhao and Fang. Background: Antimicrobial resistance (AMR) is an increasing global threat, and hospital-based antimicrobial stewardship programs (ASPs) are one of the effective approaches to tackle AMR globally. This study was intended to determine the attitude of key healthcare professionals (HCPs), including physicians, nurses, and hospital pharmacists, towards AMR and hospital ASPs. Methods: A cross-sectional study design was used to collect data from HCPs employed in public teaching hospitals of Punjab, Pakistan, from January 2019 to March 2019. A cluster-stratified sampling method was applied. Descriptive statistics, Mann Whitney and Kruskal Wallis tests were used for analysis. Results: A response rate of 81.3% (881/1083) for the surveys was obtained. The majority of the physicians (247/410, 60.2%) perceived AMR to be a serious problem in Pakistani hospitals (p \u3c 0.001). Most of the HCPs considered improving antimicrobial prescribing (580/881, 65.8%; p \u3c 0.001) accompanied by the introduction of prospective audit with feedback (301/881, 75.8%; p \u3c 0.001), formulary restriction (227/881, 57.2%; p = 0.004) and regular educational activities (300/881, 75.6%; p = 0.015) as effective ASP methods to implement hospital ASPs in Pakistan. A significant association was found between median AMR and ASP scores with age, years of experience, and types of HCPs (p \u3c 0.05). Conclusions: The attitude of most of the HCPs was observed to be positive towards hospital-based ASPs regardless of their poor awareness about ASPs. The important strategies, including prospective audit with feedback and regular educational sessions proposed by HCPs, will support the initiation and development of local ASPs for Pakistani hospitals
A guideline for economic evaluations of vaccines and immunization programs in China.
This study aimed to develop a consensus framework for economic evaluations of vaccines as a national guideline in China. Some unique and important aspects were particularly emphasized. Nineteen Chinese experts in the field of health economics and immunization decision-making were nominated to select and discuss relevant aspects of vaccine economic evaluations in China. A workshop attended by external experts was held to summarize unique and important aspects and formulate consensus recommendations. There were ten unique and/or important aspects identified for economic evaluations of vaccines in China, including study perspectives, comparator strategies, analysis types, model choices, costing approaches, utility measures, discounting, uncertainty, equity, and evaluation purposes. Background information and expert recommendations were provided for each aspect. Economic evaluations of vaccines should play an important role in China's immunization policy-making. This guideline can help improve the quality of economic evaluations as a good practice consensus
Parental Preferences of Influenza Vaccination for Children in China: A National Survey with a Discrete Choice Experiment
The influenza vaccination coverage among children is low in China. We aimed to conduct a nationwide survey to quantify parental preferences and willingness to pay (WTP) for influenza vaccination for their children. Parents with children aged six months to 18 years from six provinces in China were investigated by a discrete choice experiment regarding six influenza vaccination attributes. Mixed logit models were used to estimate the relative importance of vaccine attributes and parents’ WTP. Interaction analysis and subgroup analysis were conducted to explore preference heterogeneity. A total of 1206 parents were included in the analysis. Parents reported vaccine effectiveness as the most important vaccine attribute. The mode of vaccine administration had no significant impact on parents’ preferences. Parents aged over 30 years with higher education or income levels were more likely to prefer no influenza vaccination for their children. The largest marginal WTP (CNY 802.57) for vaccination and the largest increase in vaccine uptake (41.85%) occurred with improved vaccine effectiveness from 30% to 80%. Parents from central regions or mid-latitude areas had a relatively lower WTP than those from other regions. No significant difference in the relative importance of vaccine attributes were observed among parents from various regions of China
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