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| 1 | 中国患医不信任的恶性循环:医务人员的观点、制度性利益冲突以及通过医疗专业精神构建信任显示文摘为了调查中国患医关系中的不信任现象,作者团队在中国广东省开展了一项质性研究,该研究对包括医生、护士和卫生系统行政人员在内的107位相关人士进行了半结构访谈和小组座谈。当前,医务人员陷入了一种不信任的恶性循环。患医不信任(特别是医生对患者及其亲属的不信任)所导致的医生的恐惧心理和自我保护意识,加剧了医患之间的沟通困难;从而不仅加重了医生的工作负担,也引发了医生强烈的不公正感和受害者意识。最终会对医疗效果产生严重的负面影响,引起病人强烈的不满甚至愤怒情绪,矛盾和冲突不断升级,媒体的负面报道频出,而所有这一切最终又会导致更大程度的患医不信任。这种不信任的恶性循环不仅是患医关系的危机,也是医学作为一种专业和建制(制度)的危机。其背后的根本原因在于医疗卫生系统内部固有的利益冲突,即医务人员和医疗机构以创利创收为目的。这一制度性的利益冲突使医疗专业精神中的基础性原则'患者利益至上',以及中国传统'医乃仁术'的理念受到了严重损害。为了重建病人对医务人员和医疗机构的的信任,就必须扭转这种制度性的利益冲突,并通过一系列有效政策和实践举措推动医疗专业精神的发展。 | 聂精保 程瑜 邹翔 龚霓 Joseph D.Tucker Bonnie Wong 凯博文 | 2018 | 东南大学学报(哲学社会科学版)2018，20，4： | 9 |
| 2 | Pay-it-forward gonorrhea and chlamydia testing among men who have sex with men in China:a study protocol for a three-arm cluster randomized controlled trial显示文摘Background:Gonorrhea and chlamydia testing rates are poor among Chinese men who have sex with men(MSM).A quasi-experimental study suggested that a pay-it-forward strategy increased dual gonorrhea/chlamydia testing among MSM.Pay-it-forward offers an individual a gift(e.g.,a free test)and then asks the same person if they would like to give a gift to another person.This article reports the protocol of a randomized controlled trial to evaluate dual gonorrhea/chlamydia test uptake and other outcomes among MSM in three arms-a pay-it-forward arm,a pay-what-you-want arm,and a standard of care arm.Methods:Three hundred MSM will be recruited at three HIV testing sites in Guangzhou and Beijing.Testing sites include two hospital-based MSM sexually transmitted diseases clinics and one MSM community-based organization.Eligible participants will be born biologically male,aged 16 years or older,reporting previous anal sex with another man,having never participated in the pay-it-forward program,without previous gonorrhea and chlamydia testing in the past 12 months,and residing in China.Following a cluster randomized design,every cluster of ten participants will be randomly allocated into one of three arms:(1)a pay-it-forward arm in which men are offered free gonorrhea and chlamydia testing and then asked whether they would like to donate('pay it forward')toward testing for future testers;(2)a pay-what-you-want arm in which men are offered free testing and told to decide how much to pay after receiving the test;(3)a standard of care arm in which men can pay the full price for dual gonorrhoea and chlamydia testing.The primary outcome is dual gonorrhoea/chlamydia testing as verified by administrative records.Secondary outcomes include incremental cost per test,incremental cost per diagnosis,community connectedness,and social cohesion.Primary outcome will be calculated for each arm using intention-to-treat and compared using one-sided 95%confidence intervals with a margin of 20%increase defined as superiority.Discussion:This study will examine the pay-it-forward strategy in comparison to the standard of care in improving test uptake for gonorrhea and chlamydia.We will leverage the cluster randomized controlled trial to provide scientific evidence on the potential effect of pay-it-forward.Findings from this study will shed light on novel intervention methods for increasing preventive health service utilization and innovate ways to finance it among communities.Trial registration:ClinicalTrials.gov,NCT03741725.Registered on 12 November 2018. | Tiange P.Zhang Fan Yang Weiming Tang Marcus Alexander Laura Forastiere Navin Kumar Katherine Li Fei Zou Ligang Yang Guodong Mi Yehua Wang Wenting Huang Amy Lee Weizan Zhu Peter Vickerman Dan Wu Bin Yang Nicholas A.Christakis Joseph D.Tucker | 2019 | Infectious Diseases of Poverty2019，8，4： | 1 |
| 3 | On the Nesting of Snowbirds:A Question About Seasonal and Permanent Migrants显示文摘 | Charles F.Longino Jr Victor W.Marshall Larry C.Mullins Richard D.Tucker | | 0，，2： | 1 |
| 4 | HIV/AIDS Clinician Training Needs in China:A Review显示文摘THE URGENCY OF the HIV epidemic in China has created substantial interest in the prevention,treatment,care,and advocacy of HIV and AIDS. China has invested large portions of its public health structure to curb the spread of the HIV epidemic within its borders. however,training and education of physicians has been traditionally less emphasized, stalled at the intersection between health education,clinical science,and public health.^2 The emerging HIV/AIDS clinician training needs must be revisited in light of the historical and biological context of HIV in China.This brief review of the clinician training needs in China will examine the history of STDs in China,the biological corollaries important to training,and the endpoints of recent studies assessing Chinese HIV and sexually transmitted disease (STI)clinician training. | Joseph D.Tucker | 2002 | Chinese Journal of Sexually Transmitted Infections2002，2，2： | 0 |
| 5 | Crowdsourcing in health and medical research:a systematic review显示文摘Background:Crowdsourcing is used increasingly in health and medical research.Crowdsourcing is the process of aggregating crowd wisdom to solve a problem.The purpose of this systematic review is to summarize quantitative evidence on crowdsourcing to improve health.Methods:We followed Cochrane systematic review guidance and systematically searched seven databases up to September 4th 2019.Studies were included if they reported on crowdsourcing and related to health or medicine.Studies were excluded if recruitment was the only use of crowdsourcing.We determined the level of evidence associated with review findings using the GRADE approach.Results:We screened 3508 citations,accessed 362 articles,and included 188 studies.Ninety-six studies examined effectiveness,127 examined feasibility,and 37 examined cost.The most common purposes were to evaluate surgical skills(17 studies),to create sexual health messages(seven studies),and to provide layperson cardiopulmonary resuscitation(CPR)out-of-hospital(six studies).Seventeen observational studies used crowdsourcing to evaluate surgical skills,finding that crowdsourcing evaluation was as effective as expert evaluation(low quality).Four studies used a challenge contest to solicit human immunodeficiency virus(HIV)testing promotion materials and increase HIV testing rates(moderate quality),and two of the four studies found this approach saved money.Three studies suggested that an interactive technology system increased rates of layperson initiated CPR out-ofhospital(moderate quality).However,studies analyzing crowdsourcing to evaluate surgical skills and laypersoninitiated CPR were only from high-income countries.Five studies examined crowdsourcing to inform artificial intelligence projects,most often related to annotation of medical data.Crowdsourcing was evaluated using different outcomes,limiting the extent to which studies could be pooled.Conclusions:Crowdsourcing has been used to improve health in many settings.Although crowdsourcing is effective at improving behavioral outcomes,more research is needed to understand effects on clinical outcomes and costs.More research is needed on crowdsourcing as a tool to develop artificial intelligence systems in medicine. | Cheng Wang Larry Han Gabriella Stein Suzanne Day Cedric Bien-Gund Allison Mathews Jason JOng Pei-Zhen Zhao Shu-Fang Wei Jennifer Walker Roger Chou Amy Lee Angela Chen Barry Bayus Joseph D.Tucker | 2020 | Infectious Diseases of Poverty2020，9，1： | 0 |
| 6 | Social innovation in diagnostics:three case studies显示文摘Background:Diagnostics are essential for identifying and controlling diseases.However,limited access to diagnostics hinders public health efforts in many settings.Social innovation may provide a framework for expanding access to diagnostics in the global south.Here social innovation is defined as implementing a known public health tool via a novel,community-driven technique.Main Body:In this article,we discuss three diverse cases that show the potential for using social innovation in diagnostics.The cases chosen for inclusion here demonstrate the importance of social innovation in diagnostics across different geographic,cultural,and health system contexts.They include malaria testing via schools in Malawi,cervical human papillomavirus(HPV)sample self-collection in Peru,and crowdsourcing human immunodeficiency virus(HIV)testing in China.For each case,we present the public health problem and the impact of using social innovation to increase accessibility of diagnostics.We discuss implications of each diagnostic approach and the importance of social innovation in creating these potential solutions.We argue that social innovation is useful in improving the delivery of essential diagnostic tools in low-and middle-income countries.Conclusions:Interventions in Malawi,Peru,and China suggest social innovation increases uptake of diagnostics.The same tools and principles utilized in these cases can be adapted for use in other contexts.Such diagnostic innovations may help improve identification of and linkage to care for many diseases.The approach presents a unique opportunity to better address public health issues and increase accessibility in LMIC health systems. | Megan L.Srinivas Eileen J.Yang Priyanka Shrestha Dan Wu Rosanna W.Peeling Joseph D.Tucker | 2020 | Infectious Diseases of Poverty2020，9，1： | 0 |
| 7 | 梅毒螺旋体阿奇霉素耐药的分子生物学检测方法的建立显示文摘目的建立梅毒螺旋体阿奇霉素耐药的分子生物学检测方法。方法为了提高检测的敏感性和特异性,应用套式聚合酶链反应(Nested-PCR)扩增样本DNA;限制性酶切反应检测阿奇霉素耐药突变;并对PCR产物和酶切产物进行测序以验证实验结果。结果套式PCR能很好地扩增样本DNA,耐阿奇霉素的菌株经酶切后形成188bp和440bp两个片段,而不耐药者不发生酶切反应。测序结果显示,耐药者的2058位DNA从A突变为G,而野生型者无此突变。结论利用套式PCR和限制性酶切分析法,成功建立了梅毒螺旋体阿奇霉素耐药的分子生物学检测方法 ,为梅毒螺旋体的耐药监测以及进一步的分子流行病学研究,提供了实验室基础。 | 卜今 尹跃平 魏万惠 王红春 Joseph D.Tucker 陈祥生 | 2010 | 中国艾滋病性病2010，16，4： | 0 |
| 8 | Correlates of HIV self-testing among female sex workers in China: implications for expanding HIV screening显示文摘Background:Human immunodefciency virus(HIV)self-testing may help improve test uptake among female sex workers.China has implemented many HIV self-testing programs among men who have sex with men,creating an opportunity for promotion among female sex workers.However,there is a limited literature on examining HIV selftesting among female sex workers.This study aimed to examine HIV self-testing experiences and its determinants among female sex workers in China.Methods:A venue-based,cross-sectional study was conducted among Chinese female sex workers in 2019.Participants completed a survey including social-demographic characteristics,sexual behaviors,and HIV self-testing history,the distribution of which were analyzed using descriptive analysis.Multivariable logistic regression was conducted to identify associations with HIV self-testing.Results:Among 1287 Chinese female sex workers,1072(83.3%,95%confdence interval[CI]81.2-85.3%)had ever tested for HIV,and 103(8.0%,95%CI 6.6-9.6%)had ever used HIV self-testing.More than half reported that the selftest was their frst HIV test(59.2%,61/103),around one-ffth reported HIV self-testing results infuenced the price of sex(21.4%,22/103).A minority of individuals reported ever experiencing pressure to undertake HIV self-testing(6.8%,7/103).After adjusting for covariates,HIV self-testing was positively associated with receiving anal sex in the past month(adjusted odds ratio[aOR]=2.2,95%CI 1.4-3.5),using drugs before or during sex(aOR=2.8,95%CI 1.8-4.5),injecting drugs in the past 6 months(aOR=2.6,95%CI 1.2-6.0),being diagnosed with other sexually transmitted infections(aOR=1.6,95%CI 1.0-2.5),tested for other sexually transmitted infections in the past six months(aOR=3.4,95%CI 2.1-5.5),ever tested in the hospital(aOR=3.4,95%CI 2.0-5.6),and ever tested in the community(aOR=1.5,95%CI 1.2-1.9).Conclusions:Our fndings suggest that HIV self-testing could expand overall HIV testing uptake,increase HIV testing frequency,reach sub-groups of high-risk female sex workers and has limited potential harms among female sex workers.HIV self-testing should be incorporated among Chinese female sex workers as a complement to facility-based HIV testing services. | Cheng Wang Ya‑Jie Wang Joseph D.Tucker Ming‑Zhou Xiong Hong‑Yun Fu M.Kumi Smith Wei‑Ming Tang Jason J.Ong He‑Ping Zheng Bin Yang | 2020 | Infectious Diseases of Poverty2020，9，5： | 0 |
| 9 | 植物生长调节剂在佛州柑桔生产中的作用显示文摘植物生长调节剂是调节植物生长发育和子实体的物质.这些物质是活性的,数量非常少,通常在百万分之几(ppm)以至十亿分之几(ppb)范围内。一个 ppb 相当于在25000拖车白肉葡萄柚中有一个红肉葡萄柚!激素是天然存在的生长调节剂。植物生长调节剂也可通过人工合成生产.植物生长调节剂对生根、开花、结实。 | F.Davies D.Tucker 许生吉 | 1991 | 国外农学(果树)1991，，2： | 0 |
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