The perception that “obtaining medicalcare is both expensive and difficult” was revealed on public opinion polls , and the Chinese government responded with setting up equitable, affordable and easily accessible primary health care system by establishing community health centers (CHCs), with the intended objective of directing urban patients’ reliance on hospital services towards primary care services and ensuring universal access to basic primary and public health services. Our data indicated that patients inBeijing under-utilized the services of CHCs (only 43 did so out of 217 who considered seeking medicalcare) suggesting there is widespread dissatisfaction with the provision of services in CHCs and with the quality ofmedical services being provided, and this is in agreement with previous published results [8,30]. In order to uplift the quality of General Practice in CHCs, the basic medical training of General Practitioners has to be raised and the scope of training has to be widened and designed to suit the important role of a Primary Care Provider with gate-keeping functions. This will mean additional period of post-graduate supervised mentorship. To encourage urban patients towards utilizing primary health care services, a two-way referral procedure, between secondary/tertiary hospitals and CHCs, was proposed by the State Council in 2006. As one ofthe first pilot cities, Beijing health authorities realized a well-functioning referral system can decrease cost, increase utilization of CHCs and enhance equity, while the lack of administrative supervision can restrict the development of two-way referral system . Driven by profit earning, hospitals have no motivation to actively transfer patients back to CHCs facilities for follow-up treatment. In term of primary care, the gate- keeping and referral roles have not yet been fully established.
Based on the results presented, the rate of adolescent pregnancies remains high. Various analyzes can be made inthe light of bioethical principles and concepts, especially considering the beneficence, non-maleficence and autonomy ofthe adolescent in relation to their sexual and reproductive life. These issues should be weighed and tackled by health professionals and managers in an ethical manner, considering that young women often suffer interpersonal violence from their own family. This situation, still common in several regions ofthe country, is only a small part ofthe secondary problems that can affect young women.
The health care system for mental and somatic problems inthe Netherlands is well devel- oped with easy access for patients. The aim is to provide integrated health care with a well- developed primary care system. Inthe Netherlands the term elective psychiatric treatment is used for planned comprehensive psychiatric care including medication, psychotherapy, work rehabilitation, family involvement and hospitalization when appropriate . The elective psy- chiatric care for schizophrenia is performed by Functional ACT teams. The acute psychiatric care is organized separately and includes emergency ambulatory care, acute home visits, carein police stations and reference to a psychiatric hospital when necessary. Inpatient care is defined as psychiatric treatment during hospitalization.
scenes that made some not recommended conducts ofmedical students during paient carein teaching environments widely known, signaling to the need of greater awareness ofthe ones responsible to the introducion of measures to prevent such behaviors. Inthe present study, the presence of laws of con- duct in students was evident. These, although rare, implied some diiculies inthe student-paient-rela- ionship, indicaing the urgent need for orientaion by the course coordinaion and/or by preceptor physicians. In this context, the convenience of pre- venive measures, through a broad approach ofthe theme in disciplines dealing with the relaionship with paients in preparatory stages to ambulatory clinical pracice – especially during the teaching of bioethics –, so that these conducts are not repeated with the future paients ofthe insituion. In con- sonance with the recommendaions ofthe present study, the AMU has recently approved a norm 24 with
Parental care (any non-genetic contribution by a parent that appears likely to increase the fitness of its offspring) is a widespread trait exhibited by a broad range of animal taxa. In addition to influencing the fitness of parent(s) and offspring, parental care may be inextricably involved in other evolutionary processes, such as sexual selection and the evolution of endothermy. Yet, recent work has demonstrated that bias related to taxonomy is prevalent across many biological disciplines, and research in parental care may be similarly burdened. Thus, I used parental care articles published in six leading journals of fundamental behavioral sciences (Animal Behaviour, Behavioral Ecology, Behavioral Ecology and Sociobiology, Ethology, Hormones and Behavior, and Physiology & Behavior) from 2001–2010 (n = 712) to examine the year-to- year dynamics of two types of bias related to taxonomy across animals: (1) taxonomic bias, which exists when research output is not proportional to the frequency of organisms in nature, and (2) taxonomic citation bias, which is a proxy for the breadth of a given article—specifically, the proportion of articles cited that refer solely to the studied taxon. I demonstrate that research on birds likely represents a disproportionate amount of parental care research and, thus, exhibits taxonomic bias. Parental care research on birds and mammals also refers to a relatively narrow range of taxonomic groups when discussing its context and, thus, exhibits taxonomic citation bias. Further, the levels of taxonomic bias and taxonomic citation bias have not declined over the past decade despite cautionary messages about similar bias in related disciplines— in fact, taxonomic bias may have increased. As in Bonnet et al. (2002), my results should not be interpreted as evidence of an ‘ornithological Mafia’ conspiring to suppress other taxonomic groups. Rather, I generate several rational hypotheses to determine why bias persists and to guide future work.
Muitos abortos são feitos clandestinamen- te ou de forma perigosa, como pela ingestão de substâncias químicas e até mesmo a introdução dessas substâncias no canal vaginal, o que coloca em risco a saúde da adolescente. A International Federation of Gynecology and Obstetrics (Figo) defende o princípio bioético do direito da mulher à autonomia, propondo o acesso a abortamentos seguros, sem discriminação étnica ou social, entre outros pontos. Como parte integrante dessa ga- rantia, a Figo declara que os governantes devem se
Patients of Japanese origin who sought medicalcareinthe outpatient clinics ofthe Chronic Coronary Heart Disea- se Clinical Unit ofthe Instituto do Coração oftheMedical School ofthe University of São Paulo were retrospectively studied. A total of 432 Japanese and Japanese descendents were selected through information obtained from their me- dical records considering ethnicity, family name, place of birth, and name of parents. Those patients had sought the outpatient clinics from July 1977 to April 1998 and had been clinically and angiographically diagnosed with coronary heart disease. After selection through themedical records, the patients were divided into 2 groups as follows: Japanese group - comprising the individuals who had been born in Japan and immigrated to Brazil; and the Nisei group – com- prising the Brazilian children of those Japanese. The Ja- panese group comprised 128 patients, 82 males and 46 fe- males. The Nisei group comprised 304 patients, 80 females and 224 males. Data were then collected and the following variables of interest for the comparative study were ob- tained: sex, nationality, date, and age ofthe patients on the day ofthe first ambulatory consultation. The age at which coronary heart disease began was determined by the first event or its first suggestive manifestation, either characte- rized by angina pectoris or myocardial infarction 13,14 . The
Muchos abortos son realizados clandestina- mente o de forma peligrosa, como a través de la ingesta de sustancias químicas y hasta incluso la introducción de esas sustancias en el canal vaginal, lo que pone en riesgo la salud de la adolescente. La International Federation of Gynecology and Obstetrics (FIGO) defiende el principio bioético del derecho de la mujer a la autonomía, proponiendo el acceso a abortos seguros, sin discriminación étnica o social, entre otros puntos. Como parte integrante de esta garantía, la FIGO, no obstante, declara que los gobernantes deben empeñarse seriamente en
ages 55-64 (7%). Adoption of mHealth is higher in developing economies than in developed economies. A study conducted by McKinsey & Company  on global healthcare revealed that, mobile healthcare solutions were being deployed more rapidly in emerging markets than in developed economies with 59% of emerging-market patients using at least one mHealth application or service, compared with 35% inthe developed world. Among those who do not, emerging-market residents were more interested in starting. The study further revealed that these trends would imply that the larger developed economies could end up spending nearly 15 percent of their GDP on healthcare within the next two decades. McKinsey  conducted a market survey of 3,000 people inthe US, China, Germany, South Africa, India, and Brazil. Participants were asked about their willingness to adopt and pay for mHealth services, specifically SMS medication reminders; remote medical advice, phone-prompted drug delivery, and health watch (remote monitoring of factors such as blood pressure and pulse). The survey revealed that a sizeable proportion of consumers were willing to pay USD 15 to 58 a month for a remote monitoring solution (inthe survey the health watch), with interest in both emerging and developed markets. If the results are extrapolated to organization for economic co-operation and development (OECD) and BRIC countries (considering the different populations), we can estimate an untapped consumer-led market potential of up to USD 30 to 35 billion. The world of apps is set to transform healthcare inthe coming years. It is estimated that some 30 percent of smartphone users are likely to use wellness apps by 2015, while the smartphone and tablet are becoming the most popular technological development for doctors since the invention ofthe stethoscope (Boston Consulting Group [BCG], 2012). The drivers of mHealth in each country are thus different. For Indian respondents, the three biggest attractions are cost reduction (cited by 58%), convenience of access (55%)and ability to obtain otherwise unavailable information (40%). Convenience is the biggest consideration of British patients (49%), but this is followed by a desire to take greater control of their own health (43%). Cost reduction (25%) is far down the list .
The view ofthe drop ofthe solidification bronze on plaster mould and the fragments of plaster mould from the side ofthe contact with the melted drop show on Figure 8. Conducted analy- ses on station to the investigations of processes setting on the surface ofthe mould under the influence ofthe liquid bronze, inthe normal weather condition of surroundings confirm that the considerable quantity of gases gives off inthe process ofthe decomposition ofthe anhydrite. The large quantity of gas cavities testifies about this inside the drop ofthe solidification bronze on the surface ofthe plaster mould and characteristic shape and the colour ofthe surface ofthe plaster mould under the drop.
Checking the dependency of attributes is done to omit the un- necessary attributes, the step which can be of crucial importance in optimising the decision-making process. A smaller number of attributes means less of a dialogue with the user and quicker search ofthe rule base looking for adequate procedure of reason- ing. Inthe case of decision tables that contain very large sets of redundant attributes (created during the operations associated with data mining), the possibilities of reduction can become critical elements in building of a knowledge base. A totally different situation occurs when the decision table is created by knowledge engineers in a controlled manner, based on e.g. literature, expert knowledge, and/or standards, when the set of attributes is authori- tatively created basing on the available knowledge about the phenomena. In this case, the reduction of attributes is not neces- sary, as it can be assumed that the number of unnecessary attributes (if any) shall not deteriorate the model classificability.
Arterial ageing is a process that can be quantiied, at least to some degree, by measurement of pulse wave velocity along the aorta, the largest elastic artery, as a marker of arterial stifness. In recent years the new concept of early vascular ageing (EVA) has been developed by a group of mostly European researchers and some reviews have been published. Based on a lecture given at the European Association for the Study of Diabetes (EASD) Meeting in Vienna 2014, this review was written to describe recent developments in research dedicated to EVA and new emerging aspects found in studies of families at high cardiovascular (CV) risk. This brings new perspectives related to genetics, telomere biology, and the role of gut microbiota. Even if EVA has been described in general terms there is still no unifying deinition available and no direct treatment, only recommendations for conventional CV risk factor control. However, a new intervention study (SPARTE) is ongoing in France with a randomised design to treat arterial stifness in patients with hypertension versus conventional treatment strategies. Results are expected in a few years and will be of importance in deining the role of arterial stifness, a core feature of EVA, as a target for treatment.
where is a set of linear restrictions that transforms the unrestricted model (1) on restricted model (2). 8 In our case, the restriction implies that the age, trend and (orthogonal) time dummies are sufficient to explain the behavior of each estimated statistic order across cells and over time. Imposing the restrictions means estimating weighted least squares regressions on the grouped data, for each quantile and education group separately. This procedure will give us consistent estimates of . Under the null that the restrictions are valid, the minimized value follows a chi-square distribution with degrees of freedom equal to the number of restrictions. In order to construct the test statistics, we only have to sum up the weighted squared residuals, that is, the estimated percentiles minus the predicted values minus the orthogonal time dummies.
Relative advantage is defined as the extent to which a person views an innovation as offering an advantage over previous ways of performing the same task (Roger, 1983; Agarwal & Prasad, 1997). Because Internet banking services allow customers to access their banking account from any location 24 hours a day and 7 days a week, it provides an enormous advantage and convenience to users (Tan & Teo, 2000). It also gives customers greater control over managing their finances, as they are able to check their accounts easily. Besides, a customer’s Internet experience, his or her banking needs can affect his adoption. As there are more financial products and services, it is expected that individuals with many financial accounts and who subscribe to many banking services will be more inclined to adopt Internet banking. Tan and Teo (2000) has reported that potential adopters of Internet banking services are likely to own multiple banking accounts and subscribe to various banking services. Rogers argues that potential adapters, who are allowed to experiment with an innovation will feel more comfortable with the innovation and are more likely to adopt it. Thus, if customers have the opportunity to try the innovation, certain fears ofthe unknown may be minimized. Government policy could also aid or hinder Internet diffusion (Mbarika, 2002). This is consistent with the national systems of innovation theory that posits that government policies may encourage or mandate technology development and adoption (King et. al., 1994; Wolcott et. al., 2001). Tan and Teo (2000) suggest that the greater the extent of government support for Internet commerce, the more likely Internet banking will be adopted, thus, confirming Goh’s (1995) suggestion that governments can play an interventionist and leading role inthe diffusion of innovation. Potential users in turn would view new applications such as Internet banking services more favorably and hence be more like to use them. Thus, the second alternative hypothesis is:
The increasing demand of coal for meeting the requirement ofthe country paved to exploit the coal by opencast mechanized mining at ever increasing stripping ratio. While shovel has been the most widely used equipment, increasing use of dragline is being made in view of high capacity and lower operating cost of a dragline. The replacement ofthe teeth in shovel and dragline has been a matter of serious concern for the mine operators due to its associated cost and the idling of these equipment. Every Ground Engaging Tool (GET) manufacturing company claims good life of teeth, but such data relates to ideal condition and generally far from the actual condition ofthe mine. In actual conditions the life of a tooth is much less than what the manufacturing companies claim. Bucket teeth require replacement under the following two conditions:- i) Breakage of tooth