Фармакоэкономический анализ лекарственных средств и медицинских изделий, используемых при лечении некоторых заболеваний органов дыхания

ДЫХАТЕЛЬНЫХ ПУТЕЙ БОЛЕЗНИЛЕКАРСТВ

Life of a partnership: The process of collaboration between the National Tuberculosis Program and the hospitals in Yogyakarta, Indonesia

Public–private partnerships (PPP) for improving the health of populations are currently attracting attention in many countries with limited resources. The Public–Private Mix for Tuberculosis Control is an example of an internationally supported PPP that aims to engage all providers, including hospitals, to implement standardized diagnosis and treatment. This paper explores mainly the local actors’ views and experiences of the process of PPP in delivering TB care in hospitals in Yogyakarta Province, Indonesia. The study used a qualitative research design. By maximum variation sampling, 33 informants were purposefully selected. The informants were involved in the Public–Private Mix for Tuberculosis Control in Yogyakarta Province. Data were collected during 2008–2009 by in-depth interview and analyzed using content analysis techniques. Triangulation, reference group checking and peer debriefing were conducted to improve the trustworthiness of the data. This analysis showed that the process of partnership was dynamic. In the early phase of partnership, the National Tuberculosis Program and hospital actors perceived barriers to interaction such as low enthusiasm, lack of confidence, mistrust and inequality of relationships. The existence of an intermediary actor was important for approaching the National Tuberculosis Program and hospitals. After intensive interactions, compromises and acceptance were reached among the actors and even enabled the growth of mutual respect and feelings of programme ownership. However, the partnership faced declining interactions when faced with scarce resources and weak governance. The strategies, power and interactions between actors are important aspects of the process of collaboration. We conclude that good partnership governance is needed for the partnership to be effective and sustainable

Työkaluja näyttöön perustuvien menetelmien käyttöönoton edistämiseksi

Näyttöön perustuvien menetelmien käyttöönotolla eli implementoinnilla pyritään parantamaan terveydenhuollon vaikuttavuutta ja laatua. Ohjelmat menetelmien jalkauttamiseksi organisaatioiden palveluvalikoimaan kohtaavat usein haasteita, kuten puutteellista yhteisymmärrystä eri sidosryhmien välillä. Implementointiohjelmien tuloksellisuudessa olisikin usein toivomisen varaa, ja menetelmien pysyvyyden varmistaminen palveluvalikoimassa on osoittautunut erityisen vaativaksi. Yhteisymmärrystä voidaan rakentaa ohjelman yhteisellä valmistelulla tärkeimpien sidosryhmien kesken. Oleellista on löytää yhteinen näkemys kysymyksiin miksi, mitä ja miten on tarkoitus implementoida. Linjajohdolla on keskeinen rooli ohjelmien tuloksellisessa läpiviennissä. Käyttöön otetut menetelmät ja muut toiminnot pysyvät terveydenhuollon organisaation palveluvalikoimassa implementointiohjelmien jälkeen vain, jos organisaatio on luonut niitä ylläpitävät pysyvät rakenteet ja työnjohdolliset menettelyt, esimerkiksi koulutuspolun uusille työntekijöille.publishedVersionPeer reviewe

Sialosyllactotetraosylceramide, a novel ganglioside antigen detected in human carcinomas by a monoclonal antibody

AbstractA novel ganglioside was detected in a small cell lung carcinoma by TLC-immunostaining of gangliosides with a monoclonal antibody, the C-50 MAb. Structural characterization showed this ganglioside to be IV3NeuAc-LcOse4Cer, a hitherto unknown ganglioside. This ganglioside has also been detected as a minor component in many different carcinomas using the C-50 MAb. The normally dominant CA-50 ganglioside antigen is IV3NeuAc. III4Fuc-LcOse4Cer. Based upon solid-phase binding to IV3NeuAc, III4-LcOse4Cer and IV3NeuAc-LcOse4Cer it is concluded that the C-50 MAb recognizes an epitope present in sialylated type I carbohydrate chains

Overvåking av vassdrag på Romerike 2009

Rapporten gir en fremstilling av biologiske og vannkjemiske data innsamlet i 2009 i vassdragene Leira og Nitelva på Romerike. Dataene utgjør andre året av en treårig overvåkning, igangsatt i henhold til avtale med Interkommunal Innkjøpsordning Nedre Romerike (IINR). Dataene er vurdert i forhold til tilstandskriterier gitt i EUs Rammedirektiv for vann (Vanndirektivet). Data for flere andre mindre vassdrag i regionen er også presentert. 30 stasjoner er gitt en foreløpig klassifisering av økologisk tilstand etter både biologiske og kjemiske støtteparametre, ytterligere 26 er gitt en foreløpig klassifisering etter kjemiske støtteparametre, og 3 stasjoner er gitt en foreløpig klassifisering kun etter biologiske parametere. Årets data indikerer at bare de øverste stasjonene i Leira og Nitelva befinner seg over grensen mellom god/moderat økologisk tilstand. De nedre delene av vassdragene er utsatt for eutrofiering. Metodiske vanskeligheter med klassifisering av leirvassdrag drøftes.Interkommunal Innkjøpsordning Nedre Romerike (IINR

Acute exercise does not induce an acute phase response (APR) in Standardbred trotters

The purpose of the study was to investigate whether acute strenuous exercise (1600- to 2500-m race) would elicit an acute phase response (APR) in Standardbred trotters. Blood levels of several inflammatory markers [serum amyloid A (SAA), haptoglobin, fibrinogen, white blood cell count (WBC), and iron], muscle enzymes [creatinine kinase (CK) and aspartate transaminase (AST)], and hemoglobin were assessed in 58 Standardbred trotters before and after racing. Hemoglobin levels increased and iron levels decreased 12 to 14 h after racing and haptoglobin concentrations, white blood cell counts, and iron levels were decreased 2 and/or 7 d after racing. Concentrations of CK, AST, SAA, and fibrinogen were unaltered in response to racing. Acute strenuous exercise did not elicit an acute phase reaction. The observed acute increase in hemoglobin levels and decreases in haptoglobin and iron levels may have been caused by exercise-induced hemolysis, which indicates that horses might experience a condition similar to athlete’s anemia in humans. The pathogenesis and clinical implications of the hematological and blood-biochemical changes elicited by acute exercise in Standardbred trotters in the present study warrant further investigation

Psyyke plus ja päihteitä mukana : päihdepsykiatrisen potilaan arviointi perusterveydenhuollossa

Päihdepsykiatriset ongelmat yleistyvät myös perusterveydenhuollon potilailla. Tällaisten potilaiden arvioiminen nopeatahtisessa terveyskeskustyössä on haasteellinen tehtävä. Vastaanoton kulkua jäsentävät menetelmät voivat auttaa hahmottamaan monimutkaisesta kokonaisuudesta potilaan pääasiallisen ongelman. Päihde- ja mielenterveysongelman tarkempi kartoittaminen voidaan aloittaa erilaisten seulakyselyjen avulla. Kokonaisarvioinnissa voidaan käyttää Kuutio-arviointia, joka ottaa huomioon myös toimintakyvyn. Päihdepsykiatrisen potilaan hoidon suunnittelussa keskitytään aluksi pääasiallisen ongelman auttamiseen ja yhteistyön jatkuessa tehdään erikseen tarkempi päihde- ja mielenterveysongelman kartoitus. Hoidossa on syytä huomioida potilaan kokonaistilanne ja välttää hoidon pilkkomista keskittymään joko päihde- tai mielenterveyshäiriön hoitoon. Psykoottisten päihdepotilaiden arviointi kuuluu psykiatrille ja hoito useimmiten erikoissairaanhoitoon

Процессный подход в управлении аптечной организацией

АПТЕКИФАРМАЦИЕЙ УПРАВЛЕНИ

Making implementation programmes better : mixed methods case study of an implementation process for two evidence-based brief psychotherapies

publishedVersionPeer reviewe