National Verification Regulations and Calibration Specifications of Measuring Instruments of P.R.China in 2010(2010 No.131)

General Administration of Quality Supervision,Inspection and Quarantine of P.R.China has approved the following 8 national measuring verification regulations in 2010 and publicize now.

The Next Era:Flourish of National Health Care & Medicine with the World Leading Artificial Intelligence

MODERN medical diagnosis and practice heavily rely on biological data and information from patients’ body.The progress of biomedical sensor,material and mathematical technology provided ever-increasing methods to gather data.While providing more choices and more comprehensive picture of patients’ conditions to doctors and practitioners,these progresses also require more labor efforts to read,analyze,and make decisions based on those data.It is very difficult for the medical human resources to grow at a speed that matches such need for diagnosis-related expert knowledge.The shortage of expertise has caused long waiting time for check report and fatal misjudged diagnosis in public health system,and it will compromise our ability to move towards a more precise,more personalized and more efficient future of medicine.

National Verification Regulations and Calibration Specifications of Measuring Instruments of P.R.China in 2008 2008 NO.35

General Administration of Quality Supervision,Inspection and Quarantine of P.R.China has approved the following 11 national measuring verification regulations in 2008 and publicize now.

National Verification Regulations and Calibration Specifications of Measuring Instruments of P.R.China in 2008

General Administration of Quality Supervision,Inspection and Quarantine of P.R.China hasapproved the following 24 national measuring verification regulations in 2008 and publicize now.

National Verification Regulations and Calibration Specifications of Measuring Instruments of P.R.China in 2008 2008 No.22

General Administration of Quality Supervision,Inspection and Quarantine of P.R.China has approved the following 10 national measuring verification regulations in 2008 and publicize now.

Low skeletal muscle mass is associated with non-alcoholic fatty liver disease in Korean adults： the Fifth Korea National Health and Nutrition Examination Survey

BACKGROUND： Sarcopenia and non-alcoholic fatty liver dis- ease （NAFLD） share similar pathophysiological mechanisms, and the relationship between sarcopenia and NAFLD has been recently investigated. The study investigated whether low skel- etal muscle mass is differentially associated with NAFLD by gender in Korean adults. METHODS： We conducted a cross-sectional analysis of the data from the Fifth Korea National Health and Nutrition Examination Survey. The skeletal muscle index （SMI） was obtained by the appendicular skeletal muscle mass divided by the weight. NAFLD was defined as a fatty liver index （FLI） 〉60 in the absence of other chronic liver disease. RESULTS： Among the included subjects, 18.3% （SE： 1.4%） in men and 7.0% （SE： 0.7%） in women were classified as having FLI-defined NAFLD. Most of the risk factors for FLI-defined NAFLD showed a significant negative correlation with the SMI in both genders. Multiple logistic regression analysis showed that low SMI was associated with FLI-defined NAFLD, inde- pendent of other metabolic and lifestyle parameters in both genders [males： odds ratio （OR）=1.35; 95% confidence inter- val （CI）： 1.17-1.54; females： OR=1.36; 95% CI： 1.18-1.55]. The magnitude of the association between FLI-defined NAFLD and low SMI was higher in middle aged to elderly males （OR-1.50; 95% CI： 1.22-1.84） than in males less than 45 years of age （OR=1.25; 95% CI： 1.02-1.52） and in premenopausal females （OR=l.50; 95% CI： 1.12-2.03） than in postmenopausal females （OR-1.36; 95% CI： 1.20-1.54）.CONCLUSIONS： Low SMI is associated with the risk of FLI- defined NAFLD independent of other well-known metabolic risk factors in both genders. This association may differ ac- cording to age group or menopausal status. Further studies are warranted to confirm this relationship.

Effects of China's National Essential Medicines Policy on the Use of Injection in Primary Health Facilities

The overuse of injection exists more than 20 years since economic reform in China.It is a persistent problem and seems becoming a new challenge in the new health reform period.This study was designed to assess the effect of national essential medicines policy(NEMP) on injection use at primary health facilities in China by investigating their prescription information.Questionnaires were designed and disseminated to collect empirical data on injection use at 120 primary health facilities in 6 provinces from January to September in 2010 and 2011.The injection use was measured as the indicator as the percentage of prescriptions with one or more injections.The results showed that the percentage of prescriptions with one or more injections was decreased from 38.91% to 36.82%(2 =11.158,P=0.001) in the all survey areas during the NEMP reform.The difference in level of the injection use in 2011 was significant among the eastern,central and western regions(2 =223.584,P=0.000);level of the injection use in western region was the lowest(27.73%),while that in the central region was the highest(43.10%).The level of the injection use in 2011 among different provinces was also of great difference(26.00%-58.25%,range:32.25%).The level of the injection use in 2011 was still much higher than the standard suggested by WHO for developing countries(13.4%-24.1%).It was concluded that NEMP has improved injection use in China,but the injection abuse situation remains serious,indicating that one of the priorities to the next stage of NEMP is to promote the rational use of drugs,especially the injection use.

An Assessment of Occupational Health and Safety Regulations in Ghana: A Study of the Construction Industry

Occupational health and safety continues to be a major component of the built environment. The study investigates the effectiveness of occupational health and safety laws and regulations in the construction industry in Ghana and identifies the influencing factors. Face-to-face interviews were conducted among 49 stakeholders from four relevant groups—regulatory institutions, consultants, contractors, artisans and labourers. The findings of the study suggest that the existing occupational health and safety legal and regulatory framework is barely effective. Stakeholders were aware of the existence of some laws and regulations but mostly could not identify the specific laws and their relevant contents. Consequently, compliance is found to be irregular. The key recurring factors affecting effectiveness of occupational health and safety laws and regulations include: negligence and lack of priority for occupational health and safety, lack of training, lack of funds for occupational health and safety, lack of capacity of regulatory and supervisory institutions, and lack of occupational health and safety education within construction firms. The findings of the study are foundational in strategic interventions aimed at improving compliance with occupational health and safety laws and regulations in the construction industry of Ghana.

Assessment and regulation of ocean health based on ecosystem services: Case study in the Laizhou Bay, China

The ecosystem-based management of nearshore waters requires integrated assessment of ocean health and scientific guidance on artificial regulations to promote sustainable development. Quantitative approaches were developed in this paper to assess present and near-term ocean health based on ecosystem services. Results of the case study in the Laizhou Bay of China showed that the index score of ocean health was 0.785 6 out of 1.0 at present and was expected to range from 0.555 1 to 0.804 1 in the near-term future depending on different intensities of artificial regulation of negative pressures. Specifically, the results of ocean health at present mainly indicated that cultural services and provisioning services performed essentially perfectly while supporting services and regulating services functioned less well. It can be concluded that this nearshore ecosystem would partially lose supporting and regulating services in the near-term future if the increasing pressures were not wellregulated but that all of these categories of ecosystem services could be slightly improved if the negative pressures were fully controlled. Additionally, it is recommended that publicity and education on ecosystem services especially on cultural services and regulating services should be further strengthened. The analytical process and resulting quantification provide flexible tools to guide future development of regulations so as to facilitate ecosystem-based management in the coastal zone.

Overview of the South African mine health and safety standardization and regulation systems

Outlined the South African mine health and safety regulatory framework,in- cluding the roles of government,tripartite council,service agencies,mine enterprises, rescue stations and workers unions,analyzed the institutional structures of South African mine health and safety standardization,including the South African standard and specifi- cation systems and standard development processes,and characterized the South African mine health and safety standardization and regulation systems.Intended to provide some suggestions for the transformation and improvement of mine health and safety standardi- zation and regulation systems in China or in similar situations.

The synergies between international health regulations and One Health in safeguarding global health security

The World Health Organization established International Health Regulations (IHRs) to give nations a legal framework for preventing, identifying, and responding to public health threats of international concern. On the other hand, One Health advocates for integrated approaches to health risks, acknowledging the interdependence of human, animal, and ecosystem health. By integrating these frameworks, stakeholders can leverage their respective strengths to enhance surveillance, early detection, and response mechanisms, as well as promote sustainable development and resilience against emerging health threats. This article explores the shared objectives, interconnectedness of health systems, collaborative mechanisms, and capacity-building initiatives that indicate the synergistic effects of IHRs and One Health in safeguarding global health security.

Examining the Relationship of Optimism and Emotion Regulation Strategies with General Health among Students of University of Sistan and Baluchestan

Background and Objective: Individuals apply various emotion regulation strategies, some of which are adaptive and others are maladaptive affecting people’s general health. Moreover, individual life-orientation including favorable expectancies about future (optimism) is associated with health-related behaviors. The purpose of the present study was to investigate the relationship of optimism and emotion regulation strategies with general health of university students. Materials and Methods: This was a correlational study. In this regard, 182 students of University of Sistan and Baluchestan (70 males and 112 females) were chosen. The statistical population of the present study consisted of all undergraduate students of the university of Sistan and Baluchestan in the second semester of the 2009-2010 academic year. Considering the nature of the current study, the correlational method was applied. Based on Krejcie and Morgan’s table, a sample of 200 subjects was selected from students majored at different fields including human sciences, basic sciences and technical-engineering through applying multi-stage random sampling method. Eighteen incomplete questionnaire forms were excluded. Finally, data obtained from 182 subjects (112 females, 70 males) were analyzed. The mean age was 21.1 year-old and standard deviation of the sample was 2.06. Samplings were assessed using the Revised Life-Orientation Test (LOT-R), Emotion Regulation Questionnaire (ERQ) and General Health-28 Questionnaire (GHQ-28). Data were analyzed using the Pearson correlation coefficient and regression analysis. Results: Findings showed that there was a significant positive relationship between optimism and general health (r = 0.22, p < 0.01). Among all research variables, i.e. optimism and emotion regulation strategies (cognitive reappraisal and expressive suppression), only optimism was able to predict 0.06 percent of variance of general health (p < 0.001). Conclusion: Optimists have higher general health and consistent with other findings, optimism is associated with higher levels of applying coping strategies and lower levels of avoidance.

Hospice and Palliative Care Services in South Korea Supported by the National Health Insurance (NHI) Program

Previous main body of research on end-life-care in South Korea has focused on developing services quality in hospital settings or service payment system in National Health Insurance Program. The delivery system of hospice and palliative care services has evolved in diverse ways but there is little research on reviewing the past history of development and whole picture of them so far. So, the aim of this study is to review the old hospice and palliative care system and also to introduce the current one supported by the National Health Insurance Program in South Korea. The palliative care or hospice services in South Korea have been available in diverse settings and provided by different organizations (i.e. catholic hospitals or charity organizations). Finally, it was set up in 2004 that the hospice team or official Palliative Care Units (PCUs) was established in hospitals, in order to meet the end-of-life care for the patients with terminal cancer under the Cancer Control Act. The current hospice and palliative care services such as pain management, bereavement services, and counselling can be reimbursed by National Health Insurance program since 2008. Nevertheless hospice and palliative care services are available to dying patients, yet the utilization rate of hospice and palliative care services or the length of stay in the palliative care unit (PCU) is still relatively short compared to other country systems. South Korea is undergoing several efforts to expand the services in PCU along with the development of quality indicators for PCU. Hospice and palliative care services are still new in the health care system and unfamiliar to the public so it requires raising awareness for medical professionals and the public as well as further research.

Prevalence and associations of non-retinopathy ocular conditions among older Australians with self-reported diabetes:The National Eye Health Survey

AIM:To determine the prevalence and associations of non-retinopathy ocular conditions among older Australian adults with diabetes.METHODS:Multistage random-cluster sampling was used to select 3098 non-indigenous Australians aged 50 y or older(46.4%male)and 1738 indigenous Australians aged 40 y or older(41.1%male)from all levels of geographic remoteness in Australia.Participants underwent a standardised questionnaire to ascertain diabetes history,and a clinical examination to identify eye disease.We determined the prevalence of uncorrected refractive error,visually significant cataract,cataract surgery,age-related macular degeneration,glaucoma,ocular hypertension,retinal vein occlusion and epiretinal membrane among those with and without self-reported diabetes.RESULTS:Participants with self-reported diabetes had a higher prevalence of cataract surgery than those without diabetes(28.8%vs 16.9%,OR 1.78,95%CI:1.35-2.34 among non-indigenous Australians,and 11.3%vs 5.2%,OR 1.62,95%CI:1.22-2.14 among indigenous Australians).Diabetic retinopathy(DR)increased the odds of cataract surgery among self-reported diabetic indigenous and nonindigenous Australians(OR 1.89,P=0.004 and OR 2.33,P<0.001 respectively).Having diabetes for≥20 y and having vision-threatening DR increased the odds of cataract surgery among indigenous Australians with diabetes(OR 3.73,P=0.001 and 7.58,P<0.001,respectively).CONCLUSION:Most non-retinopathy ocular conditions are not associated with self-reported diabetes.However,to account for Australia’s worsening diabetes epidemic,interventions to reduce the impact of diabetes-related blindness should include increased cataract surgery services.

Exploring health workforce regulation practices and gaps in Ethiopia:a national cross-sectional study

Background:Health workforce regulation plays key roles in ensuring the availability of competent health workers and improving performance of the health system.In 2010,Ethiopia established a national authority aiming to ensure competence and ethics of health professionals.Subsequently,subnational regulators were established and regulatory frameworks were developed.Although there were anecdotal reports of implementation gaps,there was lack of empirical evidence to corroborate the reports.We conducted a national study to explore health professional regulation practices and gaps focusing on registration,licensing,ethics,scope of practice,and continuing professional development.Methods:We conducted a mixed methods cross-sectional survey using structured interview with a national representative sample of health professionals and key informant interviews with health regulators and managers.We used two stage stratified cluster sampling to select health professionals.The quantitative data were subjected to descriptive and multivariable logistic regression analysis.We conducted thematic analysis of the qualitative data.Results:We interviewed 554 health professionals in the quantitative survey.And 31 key informants participated in the qualitative part.Nearly one third of the respondents(32.5%)were not registered.Many of them(72.8%)did not renew their licenses.About one fifth of them(19.7%)did nothing against ethical breaches encountered during their clinical practices.Significant of them ever practiced beyond their scope limits(22.0%);and didn’t engage in CPD in the past 1 year(40.8%).Majority of them(97.8%)never identified their own CPD needs.Health regulators and managers stressed that regulatory bodies had shortage of skilled staff,budget and infrastructure to enforce regulation.Regulatory frameworks were not fully implemented.Conclusions:Health professionals were not regulated well due to limited capacity of regulators.This might have affected quality of patient care.To ensure effective implementation of health professional regulation,legislations should be translated into actions.Draft guidelines,directives and tools should be finalized and endorsed.Capacity of the regulators and health facilities needs to be built.Reinstituting health professionals’council and regulation enforcement strategies require attention.Future studies are recommended for assessing effects and costs of weak regulation.

Role of Community Health Practitioners in National Development: The Nigeria Situation

This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of social welfare services provision among others for the citizens of a country over time, with particular emphasis on medical care component of such index aimed at reduction in diseases and poverty in the population. The objective of the review work is to determine the extent to which Community Health Practice, particularly by Community Health Practitioners is capable of ensuring National Development in democratic governance or otherwise, in the context of our country, Nigeria. The methodology applied was traditional review of published literatures concerning the subject and findings of operational research of programme implemented by Community Health Practitioners at the Primary Health Care facilities and household level in the communities. This paper emphasizes on Primary Health Care services delivery contribution to National Development, since it is the level where Community Health Practitioners are mainly commissioned to render their services. Home-Based Care Strategy for Integrated Maternal, Newborn and Child Health piloted in three (3) local government areas (Ahoada West, Etche and Oyigbo) in Rivers State, Nigeria, in 2012 and implemented by Community Health Practitioners, aimed at reducing maternal, newborn and child morbidity and mortality by 20% by 2015 in line with the United Nations (UN) Millennium Development Goals 4 and 5, had been shown to achieve an average of 26% improvement in utilization of maternal and newborn health services, an average of 27% overall reduction in maternal malnutrition status, an average of 14% overall improvement in under 5 years malnutrition status among others in 2013 on comparing with baseline indicators. Nigeria also attained 80% coverage in routine immunization in most vaccine preventable diseases except Tetanus Toxiod (TT) 2 (54%) in 2013 to achieve herd immunity of the community to prevent transmission of disease pathogen to cause a disease. Community Health Practitioners are the frontline Primary Health Care Professionals charged with the responsibility of implementation of immunization programmes in Nigeria and therefore contributing significantly to the prevention and control of targeted vaccine preventable diseases in Nigeria Health System. Our findings on factors militating against Community Health Practitioners’ Roles in National Development as elicited in this paper may form basis for empirical studies to determine the level of significance of each of these factors. In conclusion, it is when the Community Health parameters are adequately addressed that we can ensure sustainable National Development and we can say we have succeeded in our various strategic agenda of government at whatever level that makes up the complex whole. This brings to fore, the importance of the roles of Community Health Practitioners in health care delivery to National Development in the context of our country, Nigeria.

Immigrants’ Satisfaction from the National Health System in Greece: In the Quest of the Contributing Factors

Immigrants deserve special attention as they constitute a very sensitive social group, facing an increasing risk of social exclusion. The access of immigrants to health services is one of the most important factors, which contributes to their integration into the society of induction. The purpose of this study is to track and assess the immigrants’ satisfaction from the health services provided by the Greek National Health System (NHS). The satisfaction level assessment is examined in conjunction with demographic and socio-economic characteristics of the study participants, as well as with the characteristics that are related to their personal experience with the National Health System in Greece. The research was conducted from March 2012 to May 2013. The sample of the research comprises of 126 “first-generation” immigrants on legal permit of residence in Greece, who lived in the prefecture of Attica. It is panel study based on “snowball sampling” and the statistical analysis was conducted with the use of the Stata (ver. 11), while the statistical analysis used probit estimation techniques. The demographic and social variables—particularly the variables of gender, “understanding the Greek language”, “education”, “participation in the community of origin” and “insurance”—the variables of “health” and specifically “long-term diseases” and the variable of “trust” are found to be highly related with immigrants’ satisfaction degree from the Greek health system. Our research concludes that health is a fundamental, human right and immigrants’ access to health services is essential not only for their instant and effective treatment of their health problems and the improvement of their lives but also for ensuring the public health in Greece. In order to properly incorporate immigrants in Greece in particular, the health policy decision-makers have to pay attention to the contributing factors.

Prevalence of Non-Communicable Diseases and Number of Comorbidities According to Differences in Household Income Levels in Japan: Analysis from National Health and Nutrition Survey

Though it has been reported that in Western developed countries socioeconomic status is associated with non-communicable diseases (NCD), there are sparse evidence from Japan, midst an income gap that has been pointed out in recent years. Therefore, we examined the presence or absence of NCD and the number of comorbidities according to household income in Japanese, using data from the National Health and Nutrition Survey of 2010. 1287 men and 1659 women aged 20 - 79 years from households at 3 income levels (<2, 2 - 5.9, ≥6 million yen) were analyzed. Participants completed questionnaires regarding whether they had been diagnosed with NCD, as well as undergoing clinical laboratory tests. Logistic regression analyses were used for statistical analysis with adjustment for age, gender, household size, and population of municipalities. The prevalences of participants with high, medium, and low income were 22.3%, 57.6%, and 20.2%, respectively. Participants with the lowest income had the highest odds of hypertension (OR [95% confidence interval (CI)] = 1.71 [1.29 - 2.26], p p = 0.041), and stroke (5.07 [2.04 - 12.60] p < 0.001). Additionally, prevalences of participants with 2 or 3 NCD (hypertension, diabetes, and hypercholesterolemia) were 15.0% and 33.0% in high and low income levels, respectively. A low income could contribute to a high prevalence of NCD and large number of comorbidities among Japanese. Establishing a health policy in Japan is needed to enable an optimal health condition and lifestyle regardless of socioeconomic disparities.

On the Role of Consumer Preferences in the Coordination among Health Insurers under Regulated Competition

This paper addresses the coordination problem of price and quality setting insurers, arising on the health insurance market under regulated competition, as introduced, for instance, in the Netherlands in 2006. We use an experimental study to gain novel insights on the impact of the uncertainty about consumer preferences on the coordination problem. This fundamental uncertainty implies uncertainty about the identity of the payoff dominant equilibrium, while the risk dominant equilibrium is independent of the state of the world. The experimental results show that insurers are more likely to coordinate on the payoff dominant equilibrium under incomplete information. When insurers face not only strategic but also fundamental uncertainty in the coordination problem, they delay the response to the risk dominant strategy, and persist longer in trying to coordinate on the payoff dominant equilibrium. For the market we study, this implies that the co-ordination under incomplete information will result in consumers paying higher prices, in contrast to the original objectives of the regulated competition.