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بررسی عوامل مؤثر در ترک موفق سوءمصرف مواد مخدر با رویکرد گراندد تئوری
Full text linkموفق، انجام شد.
روش: پژوهش حاضر به روش کیفی، گراندد تئوری در سال 1395 در شهر زنجان انجام شد. 15 نفر با سابقه سوءمصرف مواد که حداقل 4 سال از زمان ترک آنان سپریشده بود، با نمونهگیری گلوله برفی انتخاب شدند؛ و مصاحبه نیمه ساختاریافته جهت گردآوری دادهها صورت گرفت. روش تجزیهوتحلیل دادهها با استفاده از تحلیل مقایسهای مداوم، بهوسیله نسخه 10 نرمافزار Nvivo انجام شد.
یافتهها: با انجام کدگذاری باز، محوری و انتخابی، مقوله مرکزی این پژوهش، گامهای معطوف به ترک موفق سوءمصرف مواد مخدر نامیده شد. شرایط زمینهای شامل نگاه بدون سانسور به زندگی، امید برای بازگشت و آگاهی از مسیر بازگشت بود و شرایط علّی شامل درماندگی انگیزاننده، منابع انگیزشی، ویژگیهای شخصیتی و انتخاب روش کارآمد ترک بود. شرایط میانجی مقولههای دین و مذهب، منابع یاریگری و تغییر نگرش بود. استراتژیها شامل مکانیسمهای خود افشایی، تمسک به خداوند، دوری جستن از محیطهای مساعد مصرف، یادآوری دوران سخت اعتیاد و شبکهسازی اجتماعی بود؛ از سوی دیگر بازیابی مسئولیتهای گذشته، درک لذتهای جدید زندگی، شکلگیری و رشد ویژگیهای کارآمد شخصی پیامدهای ترک موفق عنوان شد.
نتیجهگیری: ترک موفق پدیدهای دفعی نیست، نیازمند شکلگیری برخی شرایط و انجام برخی استراتژیها است؛ که منجر به پیامدهایی محسوسی میگردد؛ که فرد را در ادامه مسیر ترک تقویت نموده و موجب ثبات در ترک میگردد
It’s Time to Finally Kill the Zombies; Comment on “Universal Pharmacare in Canada”
Full text linkThe movement for a national pharmacare plan in Canada is growing, but at the same time the multinational pharmaceutical companies and their supporters are critical of such a move. The three major arguments that they make are that all that is needed is to “fill in the gaps,” ie, cover those who currently are uninsured or underinsured, that private drug plans are superior to public ones because they cover a larger number of drugs and that Canada cannot afford pharmacare. This commentary examines each of these arguments and makes the case that none of them is valid and that it is time to get on with implementing pharmacare
A Decomposition of Life Expectancy and Life Disparity: Comparison Between Hong Kong and Japan
Full text linkBackground: Life expectancy and life disparity are 2 useful indicators to assess the health condition of a society. Both Hong Kong and Japan have one of the longest life expectancies in the world. Recently, Hong Kong has overtaken Japan and topped the life expectancy rankings. However, whether Hong Kong has also outperformed Japan in life disparity is still unknown.Methods: Decomposition analyses have been conducted to evaluate age-specific contributions to the changes in life expectancy and life disparity for each of the populations. Furthermore, the differences between the 2 populations were examined over the period 1977-2016.Results: Reduction in mortality of the adult and the old age groups contributes most to the increase in life expectancy for the study period. Hong Kong has a higher life disparity than Japan, and due to the great improvement in reducing premature deaths, the Hong Kong-Japan gap has been narrowing. However, in recent years, further reduction in mortality of the oldest elderly in Hong Kong has actually contributed to the increase in its disparity, thus widening its gap with Japan again.Conclusion: Increasing dominant influence of “saving lives at late ages” is very likely to cause the reemergence of increasing life disparity in these 2 long-lived populations
The Potential for Early Health Economic Modelling in Health Technology Assessment and Reimbursement Decision-Making; Comment on “Problems and Promises of Health Technologies: The Role of Early Health Economic Modeling”
Full text linkGrutters et al recently investigated the role of early health economic modelling of health technologies by undertaking a secondary analysis of health economic modelling assessments performed by their group. Our commentary offers a broad perspective on the potential utility of early health economic modelling to inform health technology assessment (HTA) and decision-making around reimbursement of new health technologies. Further we provide several examples to compliment Grutters and colleagues’ observations
Understanding the Battle for Universal Pharmacare in Canada; Comment on “Universal Pharmacare in Canada”
Full text linkDrug coverage in Canada is a patchwork; an inequitable inefficient and unsustainable patchwork with no coherence or purpose. Some people think that we can solve the problem by adding more patches, but the core of the problem is that it is a patchwork. For the working population, access to medicines is still organized as privileges offered by employers to their employees. Universal pharmacare would not only provide better access to needed prescription drugs, but also eliminate waste, ensure value-for-money and help improve drug safety and appropriate prescribing. Opponents fear that a universal pharmacare plan would ration drugs, and impede drug access for some patients. However, these claims misunderstand the reality of drug coverage, pricing and access. Opponents propose, instead, to “fill the gap” of current drug coverage by implementing catastrophic coverage, which would serve commercial interests without maximizing health outcomes for the Canadian population. In spite of overwhelming evidence and consensus in the academic community in favour of universal pharmacare, the battle is far from over