Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.
We described 4 human infection cases of zoonotic fish-tapeworm, Diphyllobothrium nihonkaiense, identified with morphological and molecular characters and briefly reviewed Chinese cases in consideration of it as an emerging parasitic disease in China. The scolex and mature and gravid proglottids of some cases were seen, a rosette-shaped uterus was observed in the middle of the mature and gravid proglottids, and the diphyllobothriid eggs were yellowish-brown in color and displayed a small knob or abopercular protuberance on the opposite end of a lid-like opening. The average size of the eggs was recorded as $62-67{\times}42-45{\mu}m$. The parasitic materials gathered from 4 human cases were morphologically identified as belonging to the genera Diphyllobothrium and Adenocephalus. The phylogenetic analysis based on the nucleotide sequences of cytochrome c oxidase subunit 1 gene of the etiologic agents confirmed that the 4 cases were D. nihonkaiense infection. The finding of 4 additional D. nihonkaiense cases suggests that D. nihonkaiense might be a major causative species of human diphyllobothriasis in China. A combined morphological and molecular analysis is the main method to confirm D. nihonkaiense infection.
Li, Chengcheng;Peng, Meng;Liao, Man;Guo, Shuangshuang;Hou, Yongqing;Ding, Binying;Wu, Tao;Yi, Dan
Asian-Australasian Journal of Animal Sciences
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v.33
no.9
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pp.1444-1454
/
2020
Objective: Cold stress induces oxidative damage and impairs energy status of broilers. N-acetylcysteine (NAC) exhibits antioxidant properties and modulates energy metabolism of animals. This study was conducted to investigate the effects of NAC on energy status and antioxidant capacity of heart and liver in the cold-stressed broilers. Methods: The experiment consisted of 4 treatments in a 2×2 factorial arrangement with two diets (basal diet or plus 0.1% NAC) and two ambient temperatures (thermoneutral [conventional ambient temperature] or cold stress [10℃±1℃ during days 15 to 42]). Results: No ascites were seen in cold-stressed broilers. NAC did not attenuate the impaired growth performance of stressed birds. However, NAC decreased plasma asparagine but increased aspartate levels in cold-stressed birds (p<0.05). NAC reduced hepatic adenosine triphosphate (ATP) but elevated adenosine diphosphate contents in unstressed birds (p<0.05). The hepatic ratio of adenosine monophosphate (AMP) to ATP was increased in birds fed NAC (p<0.05). NAC decreased plasma malondialdehyde (MDA) level and cardiac total superoxide dismutase (T-SOD) activity in unstressed birds, but increased hepatic activities of T-SOD, catalase and glutathione peroxidase in stressed birds (p<0.05). NAC down-regulated hepatic AMP-activated protein kinase but up-regulated cardiac heme-oxigenase mRNA expression in stressed birds, and decreased expression of hepatic peroxisome proliferator-activated receptor coactivator-1α as well as hypoxia-inducible factor-1α in liver and heart of birds. Conclusion: Dietary NAC did not affect energy status but enhanced the hepatic antioxidant capacity by increasing the activities of antioxidant enzymes in cold-stressed broilers.
Journal of the Korea Academia-Industrial cooperation Society
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v.14
no.1
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pp.206-213
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2013
This study aims at finding which change there is of oral health promotion as investigating the oral health status in quality, diagnosing which effects knowledge and attitude of oral health has before and after the oral health education as developing and conducting the oral health education program for international marriage migrant women to form their oral health belief for improving oral health. This study consisted of each 51 of the experimental group and the controlled group at the multi-cultural family support center from $26^{th}$ of March, 2012 to $30^{th}$ of June, 2012 as the subjects, and pre-to-post investigated knowledge of oral and cognition. Also as it took follow-up examination of the clients who visited to the dentist with changing of their cognition, conducted matched-pair sample t-test and analysis of repeated measure variance. As the result, there were always the changes at the field of knowledge about oral, periodontal disease and toothbrush in awareness of oral health, and at the field of periodontal disease, dental caries, toothbrush, fluorine and bad breath in knowledge of oral health. The change of DMFT index, DT index has been reduced and FT index has been increased. As the result above, the oral health education program for international marriage migrant women has led to change awareness of oral health and knowledge, and the change of knowledge has influenced to a behavior, so there were the changes of periodontal status and DMFT index as well. This has been showing the importance of the program for oral health of international marriage migrant women. Moreover, while the oral health education program is developed in various aspects by offering the information for developing the oral health education program in future, it needs to run parallel prevention with treatment.
Activation Plan for International Health Care through the Resolution of Medical Disputes with Foreign Patients. The field of international health care is currently being expanded and developed into the new industrial field of medical tourism through the convergence of medicine - a public sector - and tourism - a private sector. This study examines problems with medical law regarding the prevention of medical disputes that may occur when attracting foreign patients and the resolution of these disputes. It also introduces the current most ideal resolution plan for medical disputes. Advanced measures for the prevention of medical disputes with foreign patients are as follows: First, when conducting international health care, the obligation to explain a medical treatment should be applied at higher standards for foreign patients. Second, all medical treatment procedures, including appointments, treatments, discharge, post-operation consultations, and follow-up treatments of foreign patients should be charted and recorded. A checklist regarding precautions for each procedure along with a response manual for problems should also be established. These regulations can prevent unexpected conflicts in advance when medical disputes occur. If a medical dispute with a foreign patient occurs despite thorough advance prevention, it can be resolved through reconciliation, mediation, and arbitration. The government and the medical field along with its related industries and authorities should put their efforts into developing these priori/posteriori measures for the activation of international medical health care. The laws and technological/human capabilities in medicine should also be improved in order to activate international medical health care.
Objectives: This paper is aimed to study the satisfaction level and course effects of web-based PBL of the Graduate school of Public Health. Methods: Web-based PBL was implemented from March 1 to June 22 on 19 students and a survey on the satisfaction level of the lessons was taken and analyzed. For the analysis, SAS 9.1 was carried out. Results: The relation of effectiveness of the lessons according to the satisfaction level of each evaluation items, shows a significance according to satisfaction of professors, whether or not the students were satisfied in evaluating themselves (correlation, p<0.05). The satisfaction level of the evaluation on teachers and whether or not the students were satisfied in evaluating themselves shows significant influence on the effectiveness of the lessons (simple regression, p<0.05), more specifically in active class participation and understanding by the students themselves (stepwise multiple regression, p<0.05). Conclusions: In this study the attitudes of professors and students toward the lessons are major influences on the effectiveness of the lessons. Specifically, active class participation and understanding by the students themselves are the most important influences.
Asian Branches of International Life Science Institute (ILSI), i.e. China, India, Japan, Korea and South East Asian Region, identified five key public health issue priorities of each region and compared the results. In case of China, India and South East Asian countries (Indonesia, Malaysia, Philippines, Thailand etc. ASEAN countries), communicable diseases were the first priority issue, while elderly issue and food safety were prime issues for Japan and Korea, respectively. Malnutrition was the second priority issue for India and ASEAN countries, whereas non-communicable disease like cancer and degenerative diseases was for Korea and China, and obesity far Japan. Typical issues were smoking for China, nutrition education for China and Japan, biotechnology aiming GMO for India, and functional food causing health claim problem for Korea and Japan. Although the priority varied with the socioeconomic situation of each county, food and water safety recorded the highest priority of all the countries. The key public health issues of Korea were discussed in detail.
Background Interest in global health and international mission trips among medical student and resident trainees is growing rapidly. How these electives and international mission experiences affect future practice is still being elucidated. No study has identified if participation in international surgical missions during residency is a predictor of participation in international surgical missions in practice after training completion. Methods All trainees of our plastic surgery residency program from 1990 to 2011, during the implementation of optional annual international surgical missions, were surveyed to determine if the graduate had gone on a mission as a resident and as a plastic surgeon. Data were compared between graduates who participated in missions as residents and graduates who did not, from 1990 to 2011 and 1990 to 2007. Results Of Plastic Surgery graduates from 1990 to 2011 who participated in international missions as residents, 60% participated in missions when in practice, versus 5.9% of graduates participating in missions in practice but not residency (P<0.0001). When excluding last 5 years, graduates participating in international missions in practice after doing so as residents increases to 85.7%, versus 7.41% who participate in practice but not residency P<0.002. Conclusions Results reveal plastic surgeons who participate in international surgical missions as residents participate in international surgical missions in practice at higher rates than graduates who did not participate in missions during residency. International missions have significant intrinsic value both to trainee and international communities served, and this opportunity should be readily and easily accessible to all plastic surgery residents nationwide.
I. Background and Purpose Health Indicator system and measurement of health status are an important fields in national health fields. This study reviewed the overall concepts of health and health indicators, health indicator system. The purposes of this study are to build the conceptual health framework, and suggest a health indicator system, in order to correspond to the situation of national health and the demand of International organizations. II. Scope and Contents The scope of this study ; - Review of tile conceptual health framework, health indicators, and health Indicator system - Selection and development of tile new individual health indicators - Suggestion of tile revised health indicator system III. Results of Study This study intented to build the conceptual and framework of national health and provide the measurement tools of health status. This study developed the health indicator system through the conceptual and hierarchial approach to national health. The health indicator system contains 6 concern: areas and each sub-areas. The major concern areas are health state and behavior, deathㆍdiseaseㆍdisability, health care utilization, health resources, health expenditure and finance, other affecting factors on health. This health indicator system is corresponding to the situation of health status patterns and the demand of international organizations. And this health indicator system is considering the present health data production system and the availability of health data.
The Journal of Korean Academic Society of Nursing Education
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v.17
no.3
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pp.501-513
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2011
Purpose: On the basis of the theoretical framework of a combination of Roy's adaptation theory and Lazarus & Folkman's theory of stress - appraise coping, the purpose of this study was to predict effect factors of adaptation to university life of Chinese international students in Korea. After this, a model of adaptation to university life of Chinese international students in Korea was constructed. Methods: A questionnaire was used to survey 369 Chinese international students from one university in Korea, which was analyzed by using PASW Statistics 18.0 and LISREL 8.7. Results: This theoretical model explained adaptation to university life of Chinese international students at 75.0% in Korea. Physical symptoms, loneliness, acculturation stress and self-efficacy directly affected the adaptation to university life. Korean language proficiency indirectly affected adaptation to university life through self-efficacy. Conclusion: Results of this study provided theoretical basis for the future health care of university- centered health centers. For improving adaptation to university life of Chinese international students in Korea, education and nursing measures for reducing physical symptoms, loneliness and acculturation stress, and improving Korean language proficiency and self-efficacy are proposed for further research and development.
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