Search

Background & Aims: We aim to capture the economic impact of a potential cure for chronic hepatitis B infection (CHB) in three countries (USA, China and Australia) with different health systems and epidemics to estimate the threshold drug prices below which a CHB cure would be cost‐saving and/or highly cost‐effective. Methods: We simulated patients' hepatitis B progression, under three scenarios: current long‐term suppressive antiviral therapy, functional cure defined as sustained undetectable HBsAg and HBV DNA, and partial cure defined as sustained undetectable HBV DNA only after a finite, 48‐week treatment. Results: Compared with current long‐term antiviral therapy, a 30% effective functional cure among patients with and without cirrhosis in the USA, China and Australia would yield 17.50, 17.32 and 20.42 QALYs per patient, and 20.61, 20.42 and 20.62 QALYs per patient respectively. In financial terms, for CHB patients with and without cirrhosis, this would be cost‐saving at a one‐time treatment cost under US$11 944 and US$6694, respectively, in the USA, US$1744 and US$1001 in China, and US$12 063 and US$10 983 in Australia. Conclusion: We show that in purely economic terms, a CHB cure will be highly cost‐effective even if effective in only 30% of treated patients. The threshold price for cure is largely determined by the current antiviral drug costs, since it will replace a daily antiviral pill that is inexpensive and effective, although not curative. The likely need for combination therapies to achieve cure will also present cost challenges. While cost‐effectiveness is important, it cannot be the only consideration, as cure will provide many benefits in addition to reduced liver disease and HCC, including eliminating the need for a long‐term daily pill and reducing stigma often associated with chronic viral infection. [ABSTRACT FROM AUTHOR]

Objective: This study aims to evaluate the treatment effect of a mindfulness-based intervention for Chinese breast cancer patients across outcome domains, including symptom-related, psychosocial, and quality of life outcomes. Methods: Following the Cochrane Systematic Review guideline, we searched across five electronic databases, reference lists of eligible studies, professional websites, and major academic journals in Chinese. Publication bias was assessed using funnel plot and Vevea and Woods sensitivity analysis, and risk of bias was evaluated using the revised Cochrane risk of bias tool for randomized trials and risk of bias in non-randomized studies of interventions. A meta-analysis of Hedges' g was conducted using meta-regression with robust variance estimation. Results: Final analysis included a total of 45 controlled trials containing 286 effect size estimates. Across outcome domains, studies reported an overall large and statistically significant treatment effect, d = 0.921, 95% CI (0.805, 1.040), p < 0.001. Subgroup analyses of specific domains of outcome reported overall significant treatment effects for (1) symptom-related outcomes, d = 0.885, 95% CI (0.657, 1.110), p < 0.001; (2) psychosocial wellness outcomes, d = 0.984, 95% CI (0.879, 1.090), p < 0.001; and (3) quality of life, d = 0.990, 95% CI (0.776, 1.200), p < 0.001. Moderator analysis did not identify any significant moderator. Conclusion: Chinese literature reported an overall statistically significant and large treatment effect of a mindfulness-based intervention for breast cancer patients in China. Except for physical symptom outcomes, e.g., nausea/vomiting and pain, a mindfulness-based intervention was effective across outcome domains among Chinese breast cancer patients. [ABSTRACT FROM AUTHOR]

Over the last 15 years, a set of ideas now referred to as "thinking and working politically" (TWP) has coalesced into a "second orthodoxy" about how to take context into account when implementing development interventions. This approach stresses the importance of obtaining a better understanding of the local context ("thinking politically") in order to support local actors to bring about sustainable developmental change ("working politically"). However, the evidence base to justify this new approach remains thin, despite a growing number of programmes which purport to be implementing it. Officials in development agencies struggle with putting it into practice and it is unclear how TWP differs—or not—from similar approaches, such as Problem Driven Iterative Adaptation (PDIA) and Doing Development Differently (DDD). This Special Issue sheds light on what TWP means in practice by examining a set of initiatives undertaken by both development partners and government departments in Nigeria, the Occupied Palestinian Territories, China and India. This overview article outlines, in brief, each of the Special Issue's four papers and then draws out five lessons—for funders and for practitioners—from across all the papers. Our five lessons are: (1) the fundamental importance of undertaking political economy analysis (PEA) to adapt programmes to their contexts; (2) the importance of having a realistic level of ambition for interventions; (3) the need to support local ownership—not just "agreement ownership" (between a donor agency and government) or local "management ownership" of the programme, but critically "driver ownership" by generating trust with the key local actors driving change; (4) the need for a more effective set of tools for measuring results in complex programmes that attempt to achieve improvements in long‐run governance; and, (5) that although the political economy of donors is often seen as a barrier to applying TWP, the articles show how much can be done with a TWP approach if the analysis takes into account the political economy of donors as well as that of the local context. We conclude with a set of operational recommendations for donors and implementors, as well as suggestions of avenues for further research. [ABSTRACT FROM AUTHOR]

Purpose: Given the critical role of parental care for pediatric cancer patients, this pilot study evaluated the feasibility and effectiveness of a hospital-based solution-focused brief therapy (SFBT) intervention for reducing psychological distress among parents of pediatric cancer patients in China. Differences between treatment and active control (AC) groups were assessed on dimensions of psychological distress. Parents' level of hope was also assessed.Methods: Participants (N = 44) were randomly assigned to SFBT or AC. Parents received four sessions of SFBT twice a week delivered by graduate-level hospital social workers. Pre- and post-intervention assessments measured change in distress (depression, anxiety, and somatization symptoms) of parents as well as their level of hope.Results: Analysis of covariance (ANCOVA) indicated the SFBT group had better outcomes than the AC group on overall distress of somatic, anxiety, depression symptoms and level of hope. Within- and between-group treatment effects reported significantly greater effect of the SFBT group than of the AC group.Conclusions: Considering the inherent limits of a pilot feasibility study, results suggest that SFBT is a feasible, culturally compatible, and promising intervention for alleviating distress among Chinese parents of children with cancer. Additional comprehensive trials are needed to draw more definitive conclusions.Relevance: SFBT may be beneficial for improving the critical support systems of parents of pediatric cancer patients. Thus, SFBT may have the potential to enhance children's well-being during cancer treatment and recovery. [ABSTRACT FROM AUTHOR]

Investigates the agricultural trade liberalization and poverty dynamics in Vietnam, China and Zambia. Trade reforms in Vietnam; Liberalization of the urban rationing and compulsory procurement system in China; Cohort regression of consumption growth in Zambia.

Chinese anti-poverty policy stresses the long-term structural nature of rural poverty. This paper shows that poverty in rural Sichuan during 1991–95 was both dynamic and persistent. A new measure of chronic poverty is defined––as a high vulnerability to being poor––and compared with traditional interpretations of chronic poverty as low mean consumption. Households are highly vulnerable to falling into poverty even when their average consumption is some distance above the poverty line. The determinants of low mean consumption and high vulnerability appear however to be similar suggesting that policies to increase mean consumption will also reduce vulnerability. [Copyright &y& Elsevier]

• We conducted surveys across China and South Korea for natural enemies of hydrilla. • DNA barcoding identified 14 chironomid midge species. • Four distinct Hydrellia (Ephydridae) clades were identified. • Our results help clarify the species status of the collected material. • They also suggest hypotheses for further testing through additional structured sampling and screening. Biological control is considered the best management option against the aquatic weed Hydrilla verticillata , one of the most damaging invasive plants in the United States. The search for natural enemies is ongoing. Larval flies from two families (Ephydridae and Chironomidae) were collected feeding on H. verticillata during recent surveys across China and Korea (the possible origin of both the monoecious and dioecious forms of this weed found in the United States). DNA barcoding was used to provide initial identifications, using the Barcode of Life database. In addition, we assessed the genetic structuring and geographic distribution of each provisionally identified species. Four distinct Hydrellia (Ephydridae) clades were identified. The species identity of these clades could not be confirmed, although two form part of the Hydrellia pakistanae species group. Significant genetic structuring was observed within the most widespread clade , suggesting it may comprise several species, although further investigation is required. Fourteen distinct chironomid clades were identified, nine of which correspond to previously described species. Genetic diversity within the chironomid species was low, even across a broad spatial scale, though some genetic structuring was observed in Cricotopus sylvestris. The results of this study provide direction for additional sampling of H. verticillata across China and Korea. Specifically, we recommend further surveys in Zhouzhuang (China), Yeonpori, Yangsancheon, and Deokeuwonri (all Korea). These surveys should be complemented with structured population genetics screening of both plant and insect material; this will help resolve the species status and host associations of the discrete mitochondrial lineages identified in this study. [ABSTRACT FROM AUTHOR]