简介:【摘要】特殊疫情,扰乱孩子生活作息,家长常反馈孩子作息不规律,如:晚上不肯睡、早上起不来等。为改变孩子现状,通过“354”策略架构,3—三式预约:点对点预约、计划性预约、同伴式预约;5—五个行动:一本计划书、一张任务卡、一个闹钟、一处阅读角、一面心愿墙;4—四步推进:学会倾听、积极鼓励、丰富生活、共同执行,通过“354”策略架构和实施,帮助幼儿规律作息,同幼儿一起畅聊宅家生活,并针对不同家庭的实施情况进行指导,优化幼儿一日生活,科学合理地安排与实践自己宅家生活,促进亲子关系和谐发展。
简介:摘要:目的:研究我院出现药品不良反应的主要特征和基本规律,以此为实践临床应用提供有效依据。方法:系统整理我院在2021年到2022年期间,收集到的354例药品不良反应报告,按照病人的年龄、性别、药品种类、临床表现、给药途径等基础信息进行统计研究。结果:在354例研究报告中,出现药品不良反应现象的原因有静脉给药方式、病人年龄偏大、应用抗感染药、中药注射剂质量等,其中最常出现药品不良反应的就是静脉滴注给药途径,会对病人的皮肤及其附件造成损伤。结论:要进一步增强医患人员和病人及其家属对药品不良反应的监测意识,注重优化有关报告的分析管理制度,以此在临床应用中实现合理用药。
简介:摘要:国内国有大型工程建设项目EPC总承包通常为固定总价合同,由于目前招标市场主观及客观的原因,该模式存在一定风险分摊不均问题。本文介绍澳大利亚某项目独特的计价模式,为国有大型工程建设项目EPC总承包合同计价调整措施提供思路,以降低自然、法律、政策和经济方面的风险,推进造价管理机制创新。
简介:AbstractBackground:Nucleic acid test (NAT) could effectively control the spread of COVID-19 caused by large-scale sports competitions. However, quantitative analysis on the appropriate frequency of NAT is scarce, and the cost-effectiveness and necessity of high-frequency NAT remain to be fully explored and validated. This study aims to optimize the COVID-19 surveillance strategies through cost-effectiveness analysis for the Tokyo 2020 Olympic Games and the upcoming Beijing 2022 Olympic Winter Games.Methods:A total of 18 scenarios were designed regarding the NAT frequency, symptom monitoring, and strengthening close-contact control. An agent-based stochastic dynamic model was used to compare the cost-effectiveness of different NAT scenarios and optimize the surveillance strategies. The dynamics of the proposed model included the arrival and departure of agents, transmission of the disease according to Poisson processes, and quarantine of agents based on regular NATs and symptom onset. Accumulative infections, cost, and incremental cost-effectiveness ratio (ICER) were simulated in the frame of the model. ICER was used to compare the cost-effectiveness of different scenarios. Univariate sensitivity analysis was performed to test the robustness of the results.Results:In Scenario 16, where the competition-related personnel (CRP) received NAT daily and national sports delegation (NSD) with quarantined infections accepted an additional NAT daily, accumulative infection was 320.90 (90 initial infections), the total cost was (United States Dollar) USD 8 920 000, and the cost of detecting out each infection was USD 27 800. Scenario 16 would reduce the total cost by USD 22 570 000 (avoid 569.61 infections), USD 1 420 000 (avoid 47.2 infections) compared with Scenario 10 (weekly NAT, strengthened close contact control) and Scenario 7 (daily NAT, no strengthened close contact control), respectively. Sensitivity analysis showed that the result was most sensitive to the change in basic reproductive number.Conclusions:High-frequency NATs such as bidaily, daily, and twice a day were cost-effective. NAT daily for CRP with strengthening close-contact control could be prioritized in defense against COVID-19 at large-scale sports competitions. This study could assist policymakers by assessing the cost-effectiveness of NAT scenarios and provide the host country with an optimal COVID-19 surveillance strategy.
简介:AbstractBackground:Continuing progress in the global pediatric human immunodeficiency virus (HIV) response depends on timely identification and care of infants with HIV. As countries scale-out improvements to HIV early infant diagnosis (EID), economic evaluations are needed to inform program design and implementation. This scoping review aimed to summarize the available evidence and discuss practical implications of cost and cost-effectiveness analyses of HIV EID.Methods:We systematically searched bibliographic databases (Embase, MEDLINE and EconLit) and grey literature for economic analyses of HIV EID in low- and middle-income countries published between January 2008 and June 2021. We extracted data on unit costs, cost savings, and incremental cost-effectiveness ratios as well as outcomes related to health and the HIV EID care process and summarized results in narrative and tabular formats. We converted unit costs to 2021 USD for easier comparison of costs across studies.Results:After title and abstract screening of 1278 records and full-text review of 99 records, we included 29 studies: 17 cost analyses and 12 model-based cost-effectiveness analyses. Unit costs were 21.46-51.80 USD for point-of-care EID tests and 16.21-42.73 USD for laboratory-based EID tests. All cost-effectiveness analyses stated at least one of the interventions evaluated to be cost-effective. Most studies reported costs of EID testing strategies; however, few studies assessed the same intervention or reported costs in the same way, making comparison of costs across studies challenging. Limited data availability of context-appropriate costs and outcomes of children with HIV as well as structural heterogeneity of cost-effectiveness modelling studies limits generalizability of economic analyses of HIV EID.Conclusions:The available cost and cost-effectiveness evidence for EID of HIV, while not directly comparable across studies, covers a broad range of interventions and suggests most interventions designed to improve EID are cost-effective or cost-saving. Further studies capturing costs and benefits of EID services as they are delivered in real-world settings are needed.
简介:摘 要:随着工程造价市场的不断深化改革,定额和工程造价资质的取消,工程造价咨询企业要“破茧重生”,工程造价数据库的建立显得十分重要。论文将工程造价咨询企业数据库的建立作为核心进行探究,首先简要介绍了工程造价数据库, 然后指出了数据库建立中存在的问题,最后提出了做好数据库建设的措施,希望能够为此类项目提供一定参考。