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.
In recent years, technology has advanced so much that it is so widespread and the internet is being used by 53.7% of Indonesia's population. This paper reviewed how privacy violations occur, their ...potential impacts, and their prevention methods personally such as individuals and organizations through literature review. Overall, it can be concluded that in general. There are two methods to prevent privacy violations, which are by using computer security software and end user awareness training.
A novel simple-component polymeric powder based ready-to-use bioadhesive with good adaptability to irregular size wounds, robust wet tissue adhesion, good anti-postoperative adhesion, low ...inflammation, broad-spectrum bactericidal ability and matched biodegradability to wound healing process for sutureless wound closure & healing.
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•Simple component self-gelling polymeric powders as new multifunctional bioadhesive.•The AMA/AASB powders features robust & stable adhesion to non-planar wet tissues.•Integration of AASB powder enabled excellent anti-postoperative tissue adhesion.•The physical crosslinked powders have good antibacterial & biodegradable ability.•The powders can seal and repair gastric defects well while reducing tissue adhesion.
For decades, bio-adhesives have gained great attention due to their potency to replace sutures. However, facile fabrication of asymmetric bioadhesives simultaneously with robust adhesion to non-planar wet tissues, effective resistance to postoperative tissue adhesion and bacterial associated infection remains a great challenge. Here, we report a simple component & ready-to-use self-gelling adhesive powder (copolymer of acrylic acid and 2-aminoethyl methacrylate, AMA) combined with an anti-adhesive powder (a mixture of zwitterionic sulfobetaine copolymer and an acrylic homopolymer, AASB) as the multifunctional tissue adhesive for sutureless wound closure & healing. The adhesive powder is capable of forming a physically cross-linked hydrogel within 5 s by absorbing water and strongly sticking to diverse non-planar wet tissues (adhesion strength up to 63 kPa, bursting pressure up to 350 mmHg within 24 h) with a broad-spectrum bactericidal efficiency (99.4 %, 96.2 % and 99.9 % against S. aureus, E. coli and MRSA). The integrated AASB hydrogel layer can effectively prevent cell/tissue adhesion and suppress hemolysis ratio & inflammation of the adhesive. Moreover, the AMA/AASB Janus hydrogel adhesive exhibited durable adhesive/anti-adhesive capability (at least for 30 days) and good biodegradability (within 60 days) in vivo, comparable sealing & repairing of gastric defects but superior anti-postoperative tissue adhesion to the clinic used fibrin glue. Such a simple-component, ready-to-use and multifunctional powder based adhesive offer new opportunities for minimal invasive sutureless tissue sealing in many clinical applications.
This article provides a re-theorization of the Prevent strategy as racialized bordering. It explores how knowledge regarding the racist logics of British counter-terrorism are supressed through ...structures of white ignorance and how International Relations scholarship is implicated in this tendency to ‘whitewash’ Prevent’s racism. Building on the use of science fiction in International Relations, the article uses China Miéville’s novel The City and the City to undertake the analysis. Miéville evokes a world where the cities of Ul Qoma and Besźel occupy the same physical space but are distinct sovereign jurisdictions. Citizens are disciplined to ‘see’ their city and ‘unsee’ the other city to produce borders between the two. The themes of coding signifiers of difference and seeing/unseeing as bordering practices are used to explore how Prevent racializes Muslims as outsiders to a white Britain in need of defending. Muslim difference is hypervisibilized or seen as potentially threatening and coded as part of racialized symptoms which constitute radicalization and extremism. This article shows how the racial bordering of Prevent sustains violence perpetrated by white supremacists, which is subsequently ‘unseen’ through the case of Thomas Mair.
When Britain imposed the "Prevent duty", a legal duty on education, health and social welfare organisations to report concerns about individuals identified as at-risk of radicalisation, critics ...argued it would accentuate the stigmatisation of Muslim communities, "chill" free speech, and exacerbate societal securitisation. Based on 70 interviews with educational professionals and a national online survey (n = 225), this article examines their perceptions of how the duty has played out in practice. It then provides an explanation for why, contrary to expectations, not only has overt professional opposition been limited, but there has been some evidence of positive acceptance. It is argued that these findings neither simply reflect reluctant policy accommodation nor do they simply reflect straightforward policy acceptance, but rather they comprise the outcome of multi-level processes of policy narration, enactment and adaptation. Three processes are identified as being of particular importance in shaping education professionals' engagement with the duty: the construction of radicalisation as a significant societal, institutional and personal risk; the construction of continuity between the Prevent duty and existing professional practices; and the responsibilisation of first-line professionals. The conclusion reflects on the wider public and policy implications of these findings.
The study of occupational risk analysis is a technique that has been gaining ground among companies that care about the health and safety of their employees. This study has as its main objective to ...identify and analyze the probable risks in a trade in the Center of Manaus, in order to prevent accidents and propose improvements to make the work environment adequate for the activities. This study basically consists of three steps: visual description where it was observed through site visit; Risk identification and proposed improvements to address the problem. As a result, it was found that commerce has ergonomic and accident risks. And it was proposed safety measures and use of PPE to prevent occupational accidents.
•The coal sample heat-treated under nitrogen produced strip-shaped fractures and debris under the action of thermal stress.•Nitrogen will reduce the process of coal-oxygen reaction to a certain ...extent.•The coal sample heat-treated under air atmosphere melted and produced more pores.•As the temperature increased, the pore volume of the heat-treated coal sample under air first increased and then decreased.
To study the evolution law of pores and fractures in the process of injecting nitrogen to prevent and extinguish fire in the goaf of coal mines. With the help of a self-built high-temperature tube furnace, the coal samples were processed under different temperatures and gas atmospheres. Through comprehensive use of electron microscope scanning, low temperature nitrogen adsorption, and 13C NMR, the pores and fractures development rules of coal before and after heat treatment were researched. The coal samples heated in nitrogen atmosphere produced many strip-shaped fractures and coal debris, while the coal samples heated in air atmosphere produced many pores and an evident melting phenomenon. In addition, the proportion of carboxyl groups in coal samples heated in nitrogen atmosphere was always greater than that of the coal heated in air atmosphere. The pore specific surface area and volume of coal samples heated under air atmosphere increased significantly, while the degree of development was significantly reduced in nitrogen atmosphere. Thereby weakening the coal-oxygen reaction to a certain extent and inhibiting the generation of harmful gases (CO, CH4, etc.), which is conducive to preventing coal spontaneous combustion disasters.
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