Summary Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective ...medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions ( r =0·83), and human resources for health per 1000 ( r =0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Findings Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. Interpretation This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Funding Bill & Melinda Gates Foundation.
Foreign relations Gabaccia, Donna R
2012., 20120312, 2012, 2012-03-12, 20120101, Volume:
19
eBook
Histories investigating U.S. immigration have often portrayed America as a domestic melting pot, merging together those who arrive on its shores. Yet this is not a truly accurate depiction of the ...nation's complex connections to immigration. Offering a brand-new global history of the subject,Foreign Relationstakes a comprehensive look at the links between American immigration and U.S. foreign relations. Donna Gabaccia examines America's relationship to immigration and its debates through the prism of the nation's changing foreign policy over the past two centuries. She shows that immigrants were not isolationists who cut ties to their countries of origin or their families. Instead, their relations to America were often in flux and dependent on government policies of the time.
An innovative history of U.S. immigration,Foreign Relationscasts a fresh eye on a compelling and controversial topic.
In this report, we analyze historical and forecast infections for COVID-19 death based on Reduced-Space Gaussian Process Regression associated to chaotic Dynamical Systems with information obtained ...in 82 days with continuous learning, day by day, from January 21th, 2020 to April 12th. According last results, COVID-19 could be predicted with Gaussian models mean-field models can be meaning- fully used to gather a quantitative picture of the epidemic spreading, with infections, fatality and recovery rate. The forecast places the peak in USA around July 14th 2020, with a peak number of 132,074 death with infected individuals of about 1,157,796 and a number of deaths at the end of the epidemics of about 132,800. Late on January, USA confirmed the first patient with COVID-19, who had recently traveled to China, however, an evaluation of states in USA have demonstrated a fatality rate in China (4%) is lower than New York (4.56%), but lower than Michigan (5.69%). Mean estimates and uncertainty bounds for both USA and his cities and other provinces have increased in the last three months, with focus on New York, New Jersey, Michigan, California, Massachusetts, ... (January e April 12th). Besides, we propose a Reduced-Space Gaussian Process Regression model predicts that the epidemic will reach saturation in USA on July 2020. Our findings suggest, new quarantine actions with more restrictions for containment strategies implemented in USA could be successfully, but in a late period, it could generate critical rate infections and death for the next 2 month.
Lynch mobs in late nineteenth- and early twentieth-century America exacted horrifying public torture and mutilation on their victims. InLynching and Spectacle, Amy Wood explains what it meant for ...white Americans to perform and witness these sadistic spectacles and how lynching played a role in establishing and affirming white supremacy. Lynching, Wood argues, overlapped with a variety of cultural practices and performances, both traditional and modern, including public executions, religious rituals, photography, and cinema, all which encouraged the horrific violence and gave it social acceptability. However, she also shows how the national dissemination of lynching images ultimately fueled the momentum of the antilynching movement and the decline of the practice. Using a wide range of sources, including photos, newspaper reports, pro- and antilynching pamphlets, early films, and local city and church records, Wood reconfigures our understanding of lynching's relationship to modern life.Wood expounds on the critical role lynching spectacles played in establishing and affirming white supremacy at the turn of the century, particularly in towns and cities experiencing great social instability and change. She also shows how the national dissemination of lynching images fueled the momentum of the antilynching movement and ultimately led to the decline of lynching. By examining lynching spectacles alongside both traditional and modern practices and within both local and national contexts, Wood reconfigures our understanding of lynching's relationship to modern life.
Freedom Bound is about the origins of modern America – a history of colonizing, work and civic identity from the beginnings of English presence on the mainland until the Civil War. It is a history of ...migrants and migrations, of colonizers and colonized, of households and servitude and slavery, and of the freedom all craved and some found. Above all it is a history of the law that framed the entire process. Freedom Bound tells how colonies were planted in occupied territories, how they were populated with migrants – free and unfree – to do the work of colonizing and how the newcomers secured possession. It tells of the new civic lives that seemed possible in new commonwealths and of the constraints that kept many from enjoying them. It follows the story long past the end of the eighteenth century until the American Civil War, when – just for a moment – it seemed that freedom might finally be unbound.
Type 1 diabetes (T1DM) is a common chronic disease in childhood. Increasing insulin resistance in puberty gives rise to higher doses of insulin usage in treatment. Of this reason new approaches in ...treatment are needed. Noopept researches suggest it to have anti-diabetic properties. We tried to determine the effects of noopept on pubertal diabetes.
The research was made with 60 prepubertal, 28 day-old, male, Sprague Dawley rats. The rats were divided into randomised 6 groups (n = 10/group). i) Control, ii) Diabetes Control, iii) Noopept Control, iv) Diabetes + Noopept, v) Diabetes + Insulin, vi) Diabetes + Insulin + Noopept. T1DM model was induced by streptozotocin on postnatal 28th day. 0.5 mg/kg noopept and 1 IU insulin were administered intraperitoneally for 14 days. Blood glucose and body weight measurements, puberty follow-up and MWM tests were performed. Hippocampus, hypothalamus and testis were evaluated histologically. Hypothalamic GnRH and kisspeptin were studied immunohistochemically. Serum LH, FSH and insulin, hippocampal homogenate NGF and BDNF levels were determined by ELISA.
Delayed puberty was normalized by noopept (p < 0.05). Blood glucose levels were lower in noopept-administered diabetic groups (p < 0.05). Noopept decreased HOMA-IR in insulin administered diabetic group (p < 0.05). Number of degenerated cells in hippocampus and testis were higher in diabetes control group when compared with other groups (p < 0.05). GnRH immunoreactivity in Diabetes + Noopept group was increased when compared to insulin + noopept group (p = 0.018). There was no difference in kisspeptin, serum LH, FSH, hippocampal NGF-BDNF levels and spatial learning assessment among groups (p > 0.05).
Noopept may have positive effect in treatment of pubertal diabetes.
The U.S. Environmental Protection Agency (EPA)'s PM2.5 Chemical Speciation Network (CSH) and the Interagency Monitoring of Protected Visual Environments (IMPROVE) network use X-ray fluorescence (XRF) ...analysis to quantify trace elements in samples of fine particles less than 2.5 microns in aerodynamic diameter (PM2.5). Methods for calculating uncertainty values for XRF results vary considerably among laboratories and instrument makes and models. To support certain types of modeling and data analysis, uncertainty estimates are required that are consistent within and between monitoring programs, and that are independent of the laboratories that performed the analyses and the analytical Instrumentation used. The goal of this work was to develop a consensus model for uncertainties associated with XRF analysis of PM2.5 filter samples. The following important components of uncertainty are included in the model described herein: variability in peak area, calibration, field sampling, and attenuation of X-ray intensity for light elements. This paper includes a detailed analysis of how attenuation uncertainties for light elements are derived. For the remaining uncertainty components included in the model, an approach and recommendations are presented to ensure that laboratories performing this type of analysis can use similar equations and parameterizations. By applying this uniform approach, it is illustrated how the uncertainties reported by the CSN and IMPROVE network laboratories can be brought into very good agreement. The proposed method is best applied at the time of data generation, but retrospective estimation of uncertainties in existing datasets is also possible. This paper serves to document the equations used for calculating the uncertainties in speciated PM2.5 data currently being posted on EPA's Air Quality System database for the PM2.5 CSN program.
The increasing production of ethanol has been established as an important contributor to future energy independence. Although ethanol demand is increasing, a growing economic trend in decreased ...profitability and resource conflicts have called into question the future of grain-based ethanol production Growing emphasis is being placed on utilizing cellulosic feedstocks to produce ethanol, and the need for renewable resources has made the development of cellulosic ethanol a national priority. Cellulosic ethanol production plants are being built in many areas of the United States to evaluate various feedstocks and processes. The waste streams from many varying processes that are being developed contain a variety of components. Differences in ethanol generation processes and feedstocks are producing waste streams unique to biofuel production, which could be potentially harmful to the environment if adequate care is not taken to manage those risks. Waste stream management and utilization of the cellulosic ethanol process are equally important components of the development of this industry.
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