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This study examined the effects of public hospitals' privatization on financial performance. We used a sample of nonfederal acute care public hospitals from 1997 to 2013, averaging 434 hospitals per year. Privatization was defined as conversion from public status to either private not-for-profit (NFP) or private for-profit (FP) status. Financial performance was measured by operating margin (OM) and total margin (TM). We used hospital level and year fixed effects linear panel regressions with nonlagged independent and control variables (Model 1), lagged by 1 year (Model 2), and lagged by 2 years (Model 3). Privatization to FP was associated with 17% higher OM (Model 2) and 9% higher OM (Model 3), compared with 3%, 4%, and 6% higher OM for privatization to NFP for all three Models, respectively. Privatization to FP was associated with 7% higher TM (Model 2) and privatization to NFP was associated with 2% higher TM (Model 3).

This study assessed the impact of public hospitals' privatization on payer-mix. We used a national sample of nonfederal, acute care, public hospitals in 1997 and followed them through 2013, resulting in a cohort of 492 hospitals (8,335 hospital-year observations). Privatization to for-profit (FP) status was associated with a greater increase in Medicare payer-mix (β = 0.13; p ≤ .001), compared with a smaller increase for privatization to not-for-profit (NFP) status (β = 0.02; p ≤ .05). FP privatization was associated with a greater decrease in Medicaid payer-mix (β = −0.09; p ≤ .001), compared with NFP privatization (nonsignificant). There is a larger change in payer-mix after FP privatization than after NFP privatization.

COVID-19 (otherwise known as coronavirus disease 2019) is a life-threatening pandemic that has been combatted in various ways by the government, public health officials, and health care providers. These interventions have been met with varying levels of success. Ultimately, we question if the preventive efforts have reduced COVID-19 deaths in the United States. To address this question, we analyze data pertaining to COVID-19 deaths drawn from the Centers for Disease Control and Prevention (CDC). For this purpose, we employ incidence rate restricted Poisson (IRRP) as an underlying analysis methodology and evaluate all preventive efforts utilized to attempt to reduce COVID-19 deaths. Interpretations of analytic results and graphical visualizations are used to emphasize our various findings. Much needed modifications of the public health policies with respect to dealing with any future pandemics are compiled, critically assessed, and discussed.

COVID-19 (otherwise known as coronavirus disease 2019) is a life-threatening pandemic that has been combatted in various ways by the government, public health officials, and health care providers. These interventions have been met with varying levels of success. Ultimately, we question if the preventive efforts have reduced COVID-19 deaths in the United States. To address this question, we analyze data pertaining to COVID-19 deaths drawn from the Centers for Disease Control and Prevention (CDC). For this purpose, we employ incidence rate restricted Poisson (IRRP) as an underlying analysis methodology and evaluate all preventive efforts utilized to attempt to reduce COVID-19 deaths. Interpretations of analytic results and graphical visualizations are used to emphasize our various findings. Much needed modifications of the public health policies with respect to dealing with any future pandemics are compiled, critically assessed, and discussed.

Restoring East Asia's dynamism -- Contents -- List of Tables -- List of Figures -- Acknowledgements -- List of Contributors -- Foreword -- Introduction by Seiichi Masuyama -- 1. From Currency to Economic Crisis by Yoopi Abimanyu -- 2. The Banking System and the Savings Rate in the Philippines by Victor A. Abola, Emilio Neri, Jr. and Richard Supangan -- 3. Corporate Governance in Thailand: From Crisis to Recovery by Deunden Nikomborirak and Somkiat Tangkitvanich -- 4. Exports and Economic Recovery A Malaysian Perspective by Ong Hong Cheong -- 5. Reform of China's State-owned Enterprises in Face of the Asian Financial Crisis by Hu Jiangyun -- 6. Regaining International Competitiveness: Hong Kong after the Asian Financial Crisis by Edward K.Y. Chen and Raymond Ng -- 7. Singapore's Response to the Challenges of the Asian Crisis and Globalisation by Chia Siow Yue -- 8. The Past and Future Role of Small and Medium-Sized Enterprises in Taiwan's Economic Development by Jiann-Chyuan Wang -- 9. The Role of Japan's Direct Investment in Restoring East Asia's Dynamism: Focus on ASEAN by Seiichi Masuyama -- Appendix 9.A: Case Study: Japan's Direct Investment and the Electronics Industry in ASEAN Hisami Mitarai -- Appendix 9.B: Case Study: Impact of the Crisis on the Automobile Industry in ASEAN and Outlook for the Future by Y. Iwasa -- 10. A Re-Evaluation of Asian Values by Phillip Wonhyuk Lim -- The Editors.

En Afrique tropicale, dans les plantations forestières, la majorité des espèces autochtones ont été délaissées au profit d'espèces exotiques à croissance initiale rapide. Cette tendance est encore plus marquée dans les zones soudanienne et soudano-guinéenne à longue saison sèche. Ainsi s'explique le manque de connaissances sur les potentialités et la sylviculture des espèces d'arbres autochtones ou " locales ". Pour contribuer à l'acquisition de ces connaissances indispensables, un arboretum de 2,56 ha a été installé en 1990 à proximité de Korhogo dans le nord de la Côte d'Ivoire. Sa particularité réside dans la mise en place de grandes parcelles de 1 596 m² avec 224 plants par espèce afin d'y mener une sylviculture qui conserverait de 10 à 16 arbres adultes de chaque espèce, exploitables notamment pour le bois d'oeuvre, au terme de la révolution. Par manque de maîtrise des techniques de pépinière pour certaines espèces, seules 12 espèces sur 22 ont été plantées avec les 224 plants prévus au départ. Les résultats sont présentés pour l'ensemble des espèces testées, aussi bien en pépinière qu'en plantation. Cet arboretum a été régulièrement suivi jusqu'en 1999 puis ne l'a plus été en raison des évènements politiques qui ont perturbé la bonne administration du pays. Une campagne de mesures a été diligentée en novembre 2019 qui a permis notamment de tirer des conclusions intéressantes sur l'aptitude de 15 espèces à croître en peuplements équiennes monospécifiques, dont deux (Pterocarpus erinaceus Poir. et Anogeissus leiocarpa (DC.) Guill. & Perr.) qui montrent une productivité remarquable. L'ensemble des données recueillies depuis la récolte des graines et tout au long de la vie de l'arboretum sont présentées ici et discutées dans l'espoir que les sylviculteurs de cette zone phytogéographique en tirent le meilleur profit. Les enseignements acquis doivent servir à la restauration des forêts et des paysages grâce aux reboisements auxquels les États se sont engagés pour lutter contre les variations climatiques, la perte de biodiversité et la dégradation des services écosystémiques aux populations.

Human papillomavirus (HPV) vaccine coverage remains low in the USA. The Society for Behavioral Medicine (SBM) supports the goals outlined by Healthy People 2020, the President's Cancer Panel, and the National Vaccine Advisory Committee to increase vaccination coverage among both males and females. SBM makes the following recommendations in support of efforts to reduce structural and other barriers to HPV vaccination services in order to increase rates of series completion. We encourage legislators and other policymakers to improve administration authority, insurance coverage, and reimbursement rates to healthcare providers who make the HPV vaccine available to adolescents; provide instrumental support to fund the development of school curricula on HPV vaccination; and increase public awareness that HPV vaccination can prevent cancer. We urge healthcare providers and healthcare systems to increase the strength, quality, and consistency of HPV vaccination recommendations for all eligible patients; to treat HPV vaccination as a routine preventive service; employ culturally appropriate communication strategies in clinical settings to educate eligible patients, parents, and guardians about the importance, effectiveness, and safety of HPV vaccination; and to strengthen and better coordinate the use of electronic medical records and immunization information systems.

This research was supported by a grant from the National Research Foundation of Korea (NRF), which is funded by the Korean government (MEST, grant no.2015M2A2A7055063); a grant of the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (H14C3459); and the National R&D Program through the Dong-nam Institute of Radiological and Medical Sciences (DIRAMS) funded by the Ministry of Education, Science, and Technology (50595–2016). The funding bodies had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. ; Abstract Background Lung cancer survivors are more likely to develop colorectal and stomach cancer than the general population. However, little is known about the current status of gastrointestinal cancer screening practices and related factors among lung cancer survivors. Methods We enrolled 829 disease-free lung cancer survivors ≥40 years of age, who had been treated at two hospitals from 2001 to 2006. The patients completed a questionnaire that included stomach and colorectal cancer screening after lung cancer treatment, as well as other sociodemographic variables. Results Among lung cancer survivors, correlations with stomach and colorectal screening recommendations were 22.7 and 25.8%, respectively. Of these, 40.7% reported receiving physician advice to screen for second primary cancer (SPC). Those who were recommended for further screening for other cancers were more likely to receive stomach cancer screening [adjusted odds ratios (aOR) = 1.63, 95% confidence interval (CI), 1.16–2.30] and colorectal cancer screening [aOR = 1.37, 95% CI, 0.99–1.90]. Less-educated lung cancer survivors were less likely to have stomach and colorectal cancer screenings. Conclusions Lack of a physician's advice for SPC screening and lower educational status had negative impact on the gastrointestinal cancer screening rates of lung cancer survivors. ; This work was supported by the National Cancer Center Grant 0710410 and grants from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (1320330). The design of the study and collection, analysis, and interpretation of data and in writing the manuscript are independent from the funding sources.

The physical demands on U.S. service members have increased significantly over the past several decades as the number of military operations requiring overseas deployment have expanded in frequency, duration, and intensity. These elevated demands from military operations placed upon a small subset of the population may be resulting in a group of individuals more at-risk for a variety of debilitating health conditions. To better understand how the U.S Veterans health outcomes compared to non-Veterans, this study utilized the U.S. Centers for Disease Control and Prevention (CDC) Behavioral Risk Factor Surveillance System (BRFSS) dataset to examine 10 different self-reported morbidities. Yearly age-adjusted, population estimates from 2003 to 2019 were used for Veteran vs. non-Veteran. Complex weights were used to evaluate the panel series for each morbidity overweight/obesity, heart disease, stroke, skin cancer, cancer, COPD, arthritis, mental health, kidney disease, and diabetes. General linear models (GLM's) were created using 2019 data only to investigate any possible explanatory variables associated with these morbidities. The time series analysis showed that Veterans have disproportionately higher self-reported rates of each morbidity with the exception of mental health issues and heart disease. The GLM showed that when taking into account all the variables, Veterans disproportionately self-reported a higher amount of every morbidity with the exception of mental health. These data present an overall poor state of the health of the average U.S. Veteran. Our study findings suggest that when taken as a whole, these morbidities among Veterans could prompt the U.S. Department of Veteran Affairs (VA) to help develop more effective health interventions aimed at improving the overall health of the Veterans.

International audience ; BackgroundThe present study aimed to perform a deep phenotypic and genotypic analysis of 15 clinical carbapenem-resistant Acinetobacter baumannii (CRAb) strains isolated in Madagascar between 2008 and 2016 from diverse sources.MethodsCRAb isolates collected from the Clinical Biology Centre of the Institut Pasteur of Madagascar, from the neonatal unit of Antananarivo military hospital, and from intensive care units of Mahajanga Androva and Antananarivo Joseph Ravoahangy Andrianavalona (HJRA) hospitals were subjected to susceptibility testing. Whole-genome sequencing allowed us to assess the presence of antibiotic-resistance determinants, insertion sequences, integrons, genomic islands and potential virulence factors in all strains. The structure of the carO porin gene and deduced protein (CarO) were also assessed in CRAb isolates.ResultsAll isolates were found to be multidrug-resistant strains. Antibiotic-resistance genes against six classes of antimicrobial agents were described. The four carbapenem-resistance genes: blaOXA-51 like, blaOXA-23, blaOXA-24, and blaOXA-58 genes were detected in 100, 53.3, 13.3, and 6.6% of the isolates, respectively. Additionally, an ISAba1 located upstream of blaOXA-23 and blaADC-like genes was observed in 53.3 and 66.7% of isolates, respectively. Further, Tn2006 and Tn2008 were found associated to the ISAba1-blaOXA-23 structure. An 8051-bp mobilizable plasmid harbouring the blaOXA-24 gene was isolated in two strains. In addition, 46.7% of isolates were positive for class 1 integrons. Overall, five sequences types (STs), with predominantly ST2, were detected. Several virulence genes were found in the CRAb isolates, among which two genes, epsA and ptk, responsible for the capsule-positive phenotype, were involved in A. baumannii pathogenesis.ConclusionsThis study revealed the presence of high-level carbapenem resistance in A. baumannii with the first description of OXA-24 and OXA-58 carbapenemases in Madagascar. This highlights the importance of better monitoring and controlling CRAb in Madagascan hospitals to avoid their spread.