Suchergebnisse

Transformation project in health which started to be implemented in 2003, has been implemented by the ministry of health quickly, this system which includes a very different point of view from the previous period and implementation in health, has been realized sometimes despite everybody, by means of the approval and acceptance of health staff in high percent. However, current implemantation mistakes and and lacks at the accepted speed, even getting worse in the system have created a dissatisfaction feeling at the each step and rank of the health staff. World Health Organization has described the health as not having an illness and weakness and having a well-being in physical, in soul and in social completely (WHO 1946 ). Health system is the general name of health service which has been given to life which is the most precious thing in universe and to the human being who is the most valuable within all the living creatures. As versatile matrix structure is very technical and needs expertise, the lack at the each point of this structure and the value of the served living creatures, chaos is a complex system which can lead to a crise. At our research, a questionnare has been implemented for specialist doctors working at the second rank state institutions (Hospitals). In this study, a survey of specialist physicians working for government agencies in hospitals has been applied. In this survey, the major issues of concern Specialist Physicians as a summary of the study 1) Additional payment distribution in the Injustice 2) One physician on call of thread and care of Emergency Medicine out of shift hours. 3) Physicians pensions 4) Health personnel carried out actual attacks have been evaluated and their proposed solutions and rational solutions compiled suggestions and it discussed. This survey of major problems existing in our health system, for example, comprise the solution. This article is the first research study conducted in Turkey in its field, it is considered the most versatile and comprehensive study will encourage other. Özet2003 yılı itibarıyla uygulamaya konulan Sağlıkta Dönüşüm Projesi, Sağlık Bakanlığınca hızla yürürlüğe konulmuş, önceki dönemden çok farklı bir bakış açısı ve sağlıkta uygulama içeren bu sistem, bazen herkese rağmen, önemli oranda da sağlık personelinin vicdanen tasdiki ve kabulüyle gerçekleşmiştir. Ancak sistem içerisinde mevcut uygulama hataları, mevzuat eksiklikleri ve bu eksikliklerin ve hataların beklenen hızda düzeltilemeyip adeta müzminleşmesi, sağlık personeli içerisinde her basamak ve kademede memnuniyetsizlik hissi oluşturmuştur. Dünya Sağlık Örgütü, sağlığı herhangi bir hastalık ve güçsüzlük halinin olmaması ve bedenen, ruhen ve sosyal bakımdan tam bir iyi olma durumudur olarak tanımlamaktadır (WHO 1946). Sağlık sistemi, evrende en kıymetli şey olan hayata ve hayat sahibi canlılar içinde en kıymetlisi insana verilen sağlık hizmetinin genel adıdır. Çok yönlü matrix yapısı, çok teknik oluşu ile uzmanlık gerektirmesi ve bu yapının her bir noktasındaki eksikliklerin hizmet verilen canlının kıymeti nedeniyle, kaos, kriz oluşturabildiği kompleks bir sistemdir. Bu çalışmamızda 2.basamak devlet kurumlarında çalışan uzman hekimlere yönelik bir anket çalışması uygulanmıştır. Bu anket çalışmasında özet olarak uzman hekimleri ilgilendiren başlıca sorunlar olan 1) Ek Ödeme dağıtımında ki adaletsizlikler 2) Tek hekim icapçılığı konusu ve icap hekimliği 3) Hekim emekli maaşları 4) Sağlık personeline yapılan fiili Saldırılar değerlendirilmiş ve onların önerdiği çözüm yolları ve rasyonel çözüm önerileri derlenmiş ve tartışılmıştır. Bu anket çalışması sağlık sistemimizde mevcut önemli sorunların, örnek çözümlerini içermektedir.

27 p., tablas, gráficos, ilustraciones -- El artículo tiene 2 apéndices comprimidos en un archivo WinRAR. -- Postprint del artículo publicado en Journal of Ethnopharmacology. Versión revisada y corregida. -- Este es un artículo distribuido bajo los términos de la licencia Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España (CC BY-NC-ND 3.0 ES) -- ; Ethnopharmacological relevance: Ethnobotany takes into account past uses to be projected into the present and future. Most current ethnobotanical research is focused, especially in industrialised countries, on obtaining information of plant uses from elderly people. Historical ethnobotany is less cultivated, although papers have demonstrated its interest. Particularly poor, but potentially very relevant, is the attention paid to historical herbaria as a source of data on useful plants. ; Aims of the study: Bearing this in mind, we studied the herbarium of the Catalan pharmacist and naturalist Francesc Bolòs (1773–1844), which contains information on medicinal uses and folk names, with the aim of establishing a catalogue of plants and uses and tracing them through old and contemporary literature. ; Methodology: The ca. 6000 plant specimens of this herbarium were investigated to assess those including plant uses and names. These taxa have been thoroughly revised. The data have been tabulated, their biogeographic profile, possible endemic or threatened status, or invasive behaviour have been assessed, and the content regarding medicinal uses, as well as folk names, has been studied. The medicinal terms used have been interpreted as per current days' medicine. The popular names and uses have been compared with those appearing in a certain number of works published from 11th to 20th centuries in the territories covered by the herbarium and with all the data collected in 20th and 21st centuries in an extensive database on Catalan ethnobotany. ; Results: A total of 385 plant specimens (381 taxa) have been detected bearing medicinal use and folk names information. We collected data on 1107 reports of plant medicinal properties (in Latin), 32 indications of toxicity, nine reports of food use, and 123, 302 and 318 popular plant names in Catalan, Spanish and French, respectively. The most quoted systems are digestive, skin and subcutaneous tissue (plus traumatic troubles) and genitourinary. Relatively high degrees of coincidence of plant names and uses in the herbarium and the literature comparison set have been found. Of the taxa contained in this medicinal herbarium, 294 were native to the Iberian Peninsula, and 86 were alien. Neither endemic nor threatened taxa have been detected, whereas a considerable portion of the alien taxa shows invasive behaviour at present. ; Conclusions: Our analyses indicate a certain degree of consistency between the medicinal uses of plants recorded in this 18th and 19th century herbarium and the records found in the literature and in recent ethnobotanical datasets, accounting for the robustness of pharmaceutical ethnobotanical knowledge in the area considered. Data appearing on the specimen labels are numerous, pointing out the herbarium as a relevant source of ethnopharmacological information. Special attention should be paid to some original uses contained in the herbarium's labels for further investigation on plant properties and drug design. ; This research was supported by projects 2014SGR00514 from the Generalitat de Catalunya (Catalan government) and CSO2014-59704-P from the Spanish government. ; Peer reviewed

Long-term prediction of time series from chaotic systems is a difficult task but required in various fields such as economics, medicine, government, etc. In recent years, several studies have turned their attention to reuse prior knowledge with the aim of combining models and improving prediction. The process of learning from previous results is called meta-learning. On the context of model combination, the meta-learning strategy lets to automatically generate an expert, able to recommend an appropriate combination of models to predict a time series in particular. However, the process of meta-learning in time series imposes nontrivial challenges such as: analyzing model behavior with time series data, look for models that can be combined with each series and even generate new methods of meta-learning those consider variations of model performance over time. This research focuses on the problem of meta-learning of model combination, using self-organization and an automatic analysis of the behavior of the models. The goal is to improve the accuracy on long-term prediction achieved by state of the art algorithms in chaotic time series. The main contribution of this work is a new method, based on meta-features and self-organized maps neural networks, capable of generating combinations of prediction models considering the accuracy of the models and their diversity of behavior over time. The developed method was compared with other methods of the state of the art, and validated using synthetic series and series obtained from real applications, that have a chaotic and non-chaotic behavior. ; La predicción a largo plazo de series de tiempo de sistemas caóticos es una tarea difícil pero requerida en diversos dominios como economía, medicina, gobierno, etc. En los últimos años, varias investigaciones han puesto su atención en reutilizar conocimiento previo a fin de combinar modelos y mejorar la predicción. El proceso de aprender a partir de resultados previos es denominado meta-aprendizaje. En el contexto de combinación de modelos, la estrategia de meta-aprendizaje permite generar automáticamente un experto, capaz de recomendar una combinación de modelos apropiada para predecir una serie de tiempo en particular. Sin embargo, el proceso de meta-aprendizaje en series de tiempo impone retos no triviales tales como: analizar el comportamiento de los modelos con los datos, buscar modelos que puedan combinarse adecuadamente para cada serie, e incluso generar nuevos métodos de meta-aprendizaje, que consideren las variaciones de desempeño de los modelos en el tiempo. Esta investigación se centra en el problema de meta-aprendizaje de combinación de modelos, utilizando auto-organización y un análisis automático del comportamiento de los modelos. La meta es mejorar la exactitud en predicción a largo plazo alcanzada por los algoritmos del estado del arte en series de tiempo caóticas. La principal contribución de este trabajo es un nuevo método, basado en meta-características y en las redes neuronales de mapas auto-organizados, capaz de generar combinaciones de modelos de predicción considerando la exactitud de los modelos y su diversidad de comportamiento en el tiempo. El método desarrollado fue comparado con otros métodos del estado del arte, y validado utilizando series sintéticas y series obtenidas de aplicaciones reales, que presentan comportamientos tanto caóticos como no caóticos.

Background The effectiveness of post-deployment screening for mental disorders has not been assessed in a randomised controlled trial. We aimed to assess whether post-deployment screening for post-traumatic stress disorder (PTSD), depression, anxiety, or alcohol misuse was effective. We defined screening as the presumptive identification of a previously unrecognised disorder using tests to distinguish those who probably had the disorder from those who probably did not so that those people with a probable disorder could be referred appropriately, and assessed effectiveness and consequences for help-seeking by the odds ratio at follow-up between those receiving tailored help-seeking advice and those who received general mental health advice. Methods We did a cluster randomised controlled trial among Royal Marines and Army personnel in the UK military after deployment to Afghanistan. Platoons were randomly assigned (1:1 initially, then 2:1) by stratified block randomisation with randomly varying block sizes of two and four to the screening group, which received tailored help-seeking advice, or the control group, which received general mental health advice. Initial assessment took place 6–12 weeks after deployment; follow-up assessments were done 10–24 months later. Follow-up measures were the PTSD Checklist–Civilian Version, Patient Health Questionnaire-9, Generalised Anxiety Disorder-7 scale, Alcohol Use Disorder Identification Test (AUDIT), and self-reported help-seeking from clinical and welfare providers comparing those receiving tailored advice and those receiving only general advice. All participants and all investigators other than the person who analysed the data were masked to allocation. The primary outcomes were PTSD, depression or generalised anxiety disorder, and alcohol misuse at follow-up. A key secondary outcome was assessment of whether post-deployment screening followed by tailored advice would modify help-seeking behaviour. Comparisons were made between screening and control groups, with primary analyses by intention to treat. This trial is registered with the ISRCTN Registry, number ISRCTN19965528. Findings Between Oct 24, 2011, and Oct 31, 2014, 434 platoons comprising 10 190 personnel were included: 274 (6350 personnel) in the screening group and 160 (3840 personnel) in the control group. 5577 (88%) of 6350 personnel received screening and 3996 (63%) completed follow-up, whereas 3149 (82%) of 3840 received the control questionnaire and 2369 (62%) completed follow-up. 1958 (35%) of 5577 personnel in the screening group declined to see the tailored advice, but those with PTSD (83%) or anxiety or depression (84%) were more likely than non-cases (64%) to view the advice (both p<0·0001). At follow-up, there were no significant differences in prevalence between groups for PTSD (adjusted odds ratio 0·92, 95% CI 0·75–1·14), depression or anxiety (0·91, 0·71–1·16), alcohol misuse (0·88, 0·73–1·06), or seeking support for mental disorders (0·92, 0·78–1·08). Interpretation Post-deployment screening for mental disorders based on tailored advice was not effective at reducing prevalence of mental health disorders nor did it increase help-seeking. Countries that have implemented post-deployment screening programmes for mental disorders should consider monitoring the outcomes of their programmes. Funding The US Army Medical Research and Materiel Command–Military Operational Medicine Research Program (USAMRMC–MOMRP).

ABSTRACT Health is a human right. Everyone has the right to live worthily, including getting better health. Therefore, the government passed a law regulating the health service for the society as regulated in Law Number 36 Year 2014 on Health. Today many people are addicted to buying drugs other than over-the-counter and over-the-counter medicines without having to go to see a doctor and many of the people who are addicted to antibiotics. Society easy to find drugs according to complaints and not a few who come to the pharmacy to buy hard drugs without a prescription. Pharmacists as one of the health professions should play the role of informer regardless of merely profit. Consumers also have the right and should be aware of the side effects they will receive if taking antibiotics carelessly so that consumers are more critical in the purchase of antibiotics. In this thesis the author uses normative legal research methods. Data analysis used is qualitative analysis. Data collection in this study using literature study method and documentation, which consists of written materials that researchers collect from various sources of primary, secondary and tertiary data contained in the library or other electronic media. Severe drugs/Gevaarlijk drug can be purchased easily in pharmacies even without recipe, one reason is the patient's lack of awareness of the dangers of the drug. The opportunity provided by pharmacies that sell hard drugs freely and weak regulation and existing sanctions leads to an increase in the use of hard drugs without a recipe. Pontianak City Health Office, Drug and Food Control Center and the Association of Indonesian Pharmacists have conducted guidance and supervision to pharmacies in the city of Pontianak. However, the guidance and supervision conducted by the institution has not been comprehensive. Keywords: Consumer Protection, Severe Drugs/Gevaarlijk Drug, Antibiotics ABSTRAK Kesehatan merupakan hak asasi manusia. Setiap orang mempunyai hak untuk hidup layak, termasuk didalamnya mendapatkan kesehatan yang baik. Oleh kerena itu, pemerintah mengeluarkan undang-undang yang mengatur tentang pelayanan kesehatan bagi masyarakat yang diatur dalam Undang-Undang Nomor 36 Tahun 2014 tentang Kesehatan. Dewasa ini banyak masyarakat yang kecanduan membeli obat selain obat bebas dan obat bebas terbatas tanpa memeriksakan dirinya dahulu ke dokter dan banyak dari kalangan masyarakat yang kecanduan antibiotik. Masyarakat mudah mencari obat sesuai keluhan dan tak sedikit yang datang ke apotek untuk membeli obat keras tanpa resep dokter. Apoteker sebagai salah satu profesi kesehatan sudah seharusnya berperan sebagai pemberi informasi (drug informer) tanpa memperhatikan keuntung semata. Konsumen juga berhak dan harus tahu atas efek samping yang akan mereka terima jika mengkonsumsi antibiotik sembarangan agar konsumen lebih kritis dalam pembelian antibiotik. Obat keras dapat dibeli dengan mudah di apotek walau tanpa resep dokter, salah satu alasannya adalah kurangnya kesadaran pasien akan bahaya dari obat keras tersebut. Adanya peluang yang diberikan oleh apotek yang menjual obat keras secara bebas dan lemahnya peraturan serta sanksi yang ada menyebabkan terjadinya peningkatan dalam penggunaan obat keras tanpa resep dokter. Dinas Kesehatan Kota Pontianak, Balai Pengawasan Obat dan Makanan serta Ikatan Apoteker Indonesia sudah melakukan pembinaan dan pengawasan kepada apotek di Kota Pontianak. Namun pembinaan dan pengawasan yang dilakukan lembaga tersebut belum menyeluruh. Kata Kunci : Perlindungan Konsumen, Obat Keras, antibiotik

Considerations on women's preventive and occupational health have traditionally focused on the exclusive assessment of reproductive aspects (in particular, actual situations –not potential ones– related to pregnancy, childbirth, puerperium and breastfeeding). However, biomedical research has been defining deep gender differentials between women and men, which calls into question both the classical therapeutic protocols and traditional preventive medicine. Correlatively, this change of perspective is also appreciated in the configuration of the criteria and technical protocols in the field of occupational health elaborated by the specialized public and private bodies, at national, European and international level. Despite of this substantive evolution, and also, the requirements integrated in the Law of Prevention of Occupational Risks, due to the modification operated ten years ago by the DA twelfth of the L.O. 3/2007, for effective equality between women and men, the Spanish legislation on occupational safety and health keeps dragging secular inertia and reveals deep misalignments incompatible with the right to effective protection to which the working men and women have the right ex art. 14 LPRL. The present work addresses a critical analysis – without prejudice to a certain systematizing purpose – of the regulation of the prevention of women's occupational risks, both of "classic" ones related to maternity protection, and of the new occupational risks based on gender, revealed by the pressure of the antidiscrimination regulations and the revision of the biomedical and preventive androcentric standards that, still inexplicably, are fundamentally based on the regulatory development of the Law of Prevention of Occupational Risks. ; La consideración preventiva y de salud laboral de las mujeres se ha centrado, tradicionalmente, en la valoración exclusiva de los aspectos reproductivos (y, en particular, las situaciones actuales –no tanto las potenciales– relacionadas con aquéllos: embarazo, parto, puerperio y lactancia). Sin embargo, la investigación biomédica viene definiendo profundos diferenciales de sexo y género entre mujeres y hombres, lo que pone en cuestión tanto los protocolos terapéuticos clásicos como la medicina preventiva tradicional. Correlativamente, ese cambio de perspectiva viene apreciándose también en la configuración de los criterios y protocolos técnicos en materia de salud laboral que elaboran los organismos especializados, públicos y privados, tanto en el ámbito nacional como europeo e internacional. A pesar de esta evolución sustantiva, y no obstantes, también, las exigencias integradas en la Ley de Prevención de Riesgos Laborales, merced a la modificación operada hace ya diez años por la DA duodécima de la L.O. 3/2007, para la igualdad efectiva entre mujeres y hombres, la normativa española sobre seguridad y salud laboral sigue arrastrando inercias seculares y revelando profundos desajustes incompatibles con el derecho a la protección eficaz del que las personas trabajadoras, mujeres y hombres, son acreedoras ex art. 14 LPRL. El presente trabajo aborda un análisis crítico –sin perjuicio de un cierto propósito sistematizador– de la normativa reguladora de la prevención de los riesgos laborales de las mujeres, tanto de aquéllos "clásicos" relacionados con la protección de la maternidad, cuanto de los nuevos riesgos laborales "de género", revelados gracias a la presión de la normativa antidiscriminatoria y de la revisión de los estándares biomédicos –y preventivos– androcéntricos que, todavía e inexplicablemente, fundamentan –en lo esencial– el desarrollo reglamentario de la Ley de Prevención de Riesgos Laborales.

Education plays a vital role in national development. All nations of the world are trying their best for their survival in the race of development and progress, and "Education "is being considered as a key element for the purpose. Since independence we are facing challenges to establish a good and strong education system. Various governments tried to establish new and effective education policies in the system but they were not sufficient for our country. Still Indians are facing lot of problems in our Education System. Indian government recognizes that the new global scenario poses unrivalled challenges for the higher education system. The UGC stated that a whole range of skills will be demanded from the graduates of commerce, humanities, natural sciences and social science, as well as from the various professional disciplines such as hospitality, tourism, agriculture, law, management, medicine or engineering. There are many basic problems faced by higher education system in India. The above discussion highlights the necessity of enhancing educational opportunities in India both for growth prospects and breaking the vicious circle of poverty. In order to provide education to the large number of young people of India, educational institutions should be increased in a large scale. Recently, the Indian Government has passed the Right to Education Act. It means that the government will provide free and universal primary education to all children of 6-14 years age group. To meet the enhanced demand from universal primary and upper primary education, the school infrastructure will be multiplied in many folds. A large number of teachers have to be recruited to make the schools are functioning. It is estimated that more than 2.5 million teachers will be recruited. In view of non-availability of sufficient trained teachers, many of untrained and under-qualified teachers may be recruited. Exactly at this juncture the Distance Education Institutions will play a significant role by providing educational opportunities to such untrained and under –qualified teachers to improve their educational qualifications. The Govemment of India is spending on education about 3 percent of its Gross Domestic Product. It has been promising to enhance this share to 6percent since very long time. The 1991 policy of economic reforms of Liberalization and privatization influenced the government to reduce investment, particularly on social sectors like education .Out of this 3 percent; just 0.8percent is being spent on higher education. The rest goes for primary and secondary education. With small budget allotment, it is impossible to establish 1500 universities in near future. Mean while, the Distance Education Mode may be helpful in extending the higher education opportunities before the required formal institutions are established. The Distance Education Institutions will operate by utilizing the idle capacity of existing formal educational institutions to the maximum extent possible. They organize instruction on week-ends, holidays and vacations without affecting the functioning of regular ones. This paper makes an attempt to examine the major characteristics of higher education in India and identified the weakness of the formal system. It focuses attention on the emergence of Distance education and its present status and suggest ways and means for better functioning of the distance education to reach as many as needy people by providing better services.

Метою дослідження, результати якого наведено у статті, стало здійснення аналізу сучасного стану нормативно-правового регулювання паліативної допомоги в Україні.У роботі використано методи наукового аналізу, зокрема, системно-аналітичний, контент-аналіз, прийоми узагальнення та групування.Результати дослідження. Аналіз сучасних нормативних документів ВООЗ, який здійснено у роботі, дозволив визначити стратегічні напрями розвитку паліативної та хоспісної допомоги на національному та міжнародному рівнях. Сформульовано позитивні аспекти чинного вітчизняного законодавства з питань надання паліативної допомоги. До них належать визначення паліативної допомоги як окремого виду медичної допомоги, законодавче закріплення термінів «паліативна допомога», «паліативне лікування», «паліативний пацієнт», застосування мультидисциплінарного підходу в наданні паліативної допомоги хворим на ВІЛ-інфекцію, включення до складу восьмого випуску Державного формуляру лікарських засобів (додаток 8), лікарські препарати для надання паліативної й хоспісної допомоги.Визначено недоліки законодавчих та нормативно-правових актів, що регламентують паліативну допомогу в Україні, зокрема фрагментарність регулюючих норм, відсутність переліку нозологій для паліативної допомоги, відповідно до них затверджених протоколів лікування, методики розрахунку потреби у лікарських засобах, реєстру паліативних хворих, тощо. Запропоновано першочергові заходи з удосконалення вітчизняного законодавства в аспекті надання паліативної допомоги в Україні за організаційним, медико-фармацевтичним, соціально-фармацевтичним та освітянським напрямом.Висновки. Першочерговим завданням зі впровадження ефективної моделі паліативної допомоги в Україні є формування адекватної нормативно-правової бази з урахуванням мультидисциплінарного підходу, рекомендацій ВООЗ та досвіду провідних країн світу. Основою зазначених перетворень є, зокрема, прийняття «профільного» закону із чітким визначенням класифікації паліативної допомоги, медичної, фармацевтичної, соціальної складової паліативної допомоги, джерел, механізмів та обсягів її фінансування ; The aim of the study, resulting in the article, was to analyze the current state of legal regulation of palliative care in Ukraine.The scientific analysis methods, in particular, system analytical, content analysis, methods of generalization and grouping, were used in the present research.Results. The analyzed current WHO regulations during the research, allowed defining the strategic directions of development of palliative and hospice care at both national and international levels. Positive aspects of the current national legislation concerning palliative care were formulated. They include the definition of palliative care as a separate type of care, legislative confirmation of the terms "palliative care", "palliative treatment", "palliative patient", the use of a multidisciplinary approach to provide palliative care to HIV patients, implementation to the eighth issue of the State Drug Formulary (Appendix 8), and remedies for palliative and hospice care.The shortcomings of legislative acts regulating palliative care in Ukraine, in particular regulatory norms fragmentation, the absence of nosologies list for palliative care, in accordance with approved protocols of treatment, methods for calculating the need for medicines, the register of palliative patients, etc., were determined. The priority measures to improve the national legislation in the aspect of palliative care in Ukraine for the organizational, medical and pharmaceutical, social and pharmaceutical, as well as educational directions were offered.Conclusion. The prior purpose concerning the implementation of an effective model of palliative care in Ukraine is to form an adequate legal and regulatory framework, considering the multidisciplinary approach, WHO recommendations and the experience of the leading countries of the world. The "profile" law adoption with a clear definition of palliative care classification, medical, pharmaceutical, and social components of palliative care, sources, mechanisms and the amount of its financing is the basis of the mentioned changes

Early Childhood Caries (ECC) is a serious disease that is about much more than cavities on baby teeth. In Canada, it is a growing public health problem with adverse long-term effects on children's physical, emotional and intellectual well-being. The failure to invest in preventive care has resulted in reactive, rather than proactive, measures against this disease. These measures are expensive and a needless drain on costs in the public health-care system. Children with severe ECC end up in hospital; in fact, in Canada, this disease is the most common reason children undergo day surgery. From 2010 to 2012, one in 100 children under age five required day surgery for ECC, with approximately 19,000 of these surgeries performed each year on children under age six. Canadian hospital costs for ECC day surgery in children aged one to five ranged from $1,271 to $1,963 per child, totalling $21.2 million between 2010 and 2012. Children from low-income families, along with aboriginal, immigrant and refugee children are disproportionately affected by dental disease, with between 50 per cent and 90 per cent of suffering from some form of ECC. This compares to an average of 57 per cent of children affected in the general population. A recent Alberta study indicates that when municipalities cease fluoridating their water supplies, children suffer increased levels of tooth decay. This has reignited the discussion around whether municipalities should add fluoride to the drinking water, or reinstate it in places where the water used to be fluoridated. While fluoridation can be an effective prevention strategy, this study also shows that fluoride alone is not enough. To reduce the costs and developmental consequences associated with severe ECC and improve well-being, oral health policies focused on disease prevention and health promotion are still necessary. This briefing paper provides background on the etiology, risk factors and prevalence of ECC in Canada to provide scope for the magnitude of this preventable disease in children. To address the avoidable socioeconomic costs, three areas require policy development. First is the need for increased public education and access to ECC prevention services for at-risk populations. Parents need to know they should reduce their children's intake of sweet drinks, and avoid filling bottles with sugar water, juice or soft drinks, especially at night. They should also clean an infant's gums with a soft toothbrush or cloth and water starting at birth. When the baby's first tooth erupts, parents should commence daily brushing with toothpaste and book a first dental visit. Second is the need to empower health-care professionals to integrate ECC prevention in their early visits with parents of young children. Such visits are more common in family medicine, and these primary care providers can play a critical role in educating parents and promoting children's oral health. Curriculum and continuing education for these health professions should be enhanced to emphasize ECC's long-term health effects. Third, government should invest in preventive oral health services for children rather than relying on emergency dental care. Children should have access to early preventive dental services to instill in them habits for lifetime oral health. Provinces without universal public funding for children's preventive dental health should remove the access barriers that children without dental insurance face.

Gómez, J. A. (2016) Análisis de caso sobre las problemáticas ambientales de los residuos sólidos urbanos en Villa Jardín, partido de Lanús provincia de Buenos Aires (Trabajo final integrador). Universidad Nacional de Quilmes, Bernal, Argentina ; Esta investigación abordará la problemática ambiental de los Residuos Sólidos Urbanos (RSU) en la comunidad de Villa Jardín, Lanús ya que el inadecuado manejo y disposición de los RSU generan diversos efectos en la salud (debido a que existen distintos vectores que provocan enfermedades asociado con la inadecuada gestión de los RSU), en el medio ambiente (los residuos contaminan el suelo, el agua y el aire cuando se quema o se produce basurales a cielo abierto),y en la economía (ya que las enfermedades ocasionan menor rendimiento en lo laboral y un gasto económico que implica la compra de medicamentos). El aumento de la población y el desarrollo de las sociedades industrializadas han activado la degradación del medio ambiente, debido entre otros factores, a la gran cantidad de residuos generados, que han alterado el equilibrio de la naturaleza. El crecimiento de la población, la actividad económica y los cambios culturales en el consumo afectan negativamente el espacio público generando una debilidad en la región integral en los residuos sólidos urbanos. Este trabajo basa su enfoque en la noción, establecido por el principio 10 de la Declaración de la Cumbre de las Naciones Unidas sobre Medio Ambiente y Desarrollo, realizada en el año 1992 en Río de Janeiro, que remarca "la inseparable relación entre participación ciudadana en la gestión del ambiente, el acceso a la información pública y el acceso a la justicia, así como la obligación del estado de garantizar esos derechos" (FARN 2010). Para identificar la eficacia de los espacios participativos se pon énfasis en la participación de individuos en condición de ciudadanos hacia la gestión de los residuos sólidos urbanos. ; This research addresses a specific environmental issue, namely Municipal Solid Waste (RSU, for ist Spanish acronym) in the neighborhood Villa Jardin in the district of Lanús, since the improper use and disposal of RSU cauce several health affections (due to the different vectors causing diseases associated with the improper management of the RSU), in the environment (as waste pollutes the soil, water and air when it is burned or when rubbish dumps are created in the apen air), and in the economy (since diseases cause a lower performance at work and expenses for medicines). The increase in population and the development of industrialized societies have activated the environmental degradation, due to the large of waste produced which has altered the balance in nature, among other factors. The population growth, theeconomic activity and the cultural changes in the negatively affect public spece and produce a weakness in the comprehensive region regarding RSU. This paper is focused on the nation established by the principle 10 of the Rio Declaration on Environment and Development 1992, which emphasizes "the inseparable relationship between civil participation in the environment decision-making process, access to public information and access to justice, as well as the governments duty those rights" (FRAN, 2010). In order to identify the affectitiveness of participatory spaces, the emphasis is placed the participapion of indiduals as citizens toward the RSU management.

The analysis of information sources about the history and current peculiarities of the regulatory framework and functioning of the ethical review system for biomedical research in Lithuania are presented in this paper. The information used in this article has been obtained during the visit of Pakharyna S.V. to the Republic of Lithuania partially supported by the Fogarty International Center, National Institute of Health (NIH), US Grant No.R25 TW007084. It has been found that nowadays there is a two-level system of biomedical research ethical review in Lithuania. In accordance with the local regulatory requirements any biomedical research should be subjected to ethical review and can be started only after receiving the approval from the regional (for local studies) or central (for trials of medicines, medical devices or other multicenter studies) Ethics Committee. The peculiarities of the Lithuanian ethical review system are the legislative framework that is constantly updating and regulating all major types of biomedical research; studies with the broad ethical support and moderate cost of resources; transparency of the Lithuanian Bioethics work. As a result of our analysis a number of approaches for public discussion and implementation in practice of the Ukrainian system of biomedical research ethical review have been suggested. ; Проведен анализ информационных источников об истории создания, современных особенностях регуляторной базы и о функционировании системы этической экспертизы биомедицинских исследований в Литве. Информация, использованная в данной статье, получена в ходе визита Пахарины С.В. в Литовскую Республику при частичной поддержке Международного Центра Фогарти, Национального Института Здоровья (NIH), США, грант №R25 TW007084. Установлено, что в настоящее время в Литве функционирует двухуровневая система этической экспертизы биомедицинских исследований. В соответствии с локальными регуляторными требованиями любое биомедицинское исследование должно быть подвергнуто этической экспертизе и может начаться только после получения положительного заключения регионального (для локальных исследований) или центрального (для исследований лекарственных препаратов, медицинских устройств или других многоцентровых исследований) этического комитета. Особенностями литовской системы этической экспертизы являются: постоянно обновляемая законодательная база, регулирующая проведение всех основных видов биомедицинских исследований, широкое покрытие этическим сопровождением исследований при умеренных затратах ресурсов, прозрачность функционирования Литовского Биоэтического Комитета. В результате проведенного анализа предложен ряд подходов для общественного обсуждения и внедрения в практику украинской системы этической экспертизы биомедицинских исследований. ; Проведено аналіз інформаційних джерел щодо історії створення, сучасних особливостей регуляторної бази та про функціонування системи етичної експертизи біомедичних досліджень в Литві. Дані, наведені в цій статті, отримана в ході візиту Пахарини С.В. до Литовської Республіки за часткової підтримки Міжнародного Центру Фогарті, Національного Інституту Здоров'я (NIH), США, грант №R25 TW007084. Встановлено, що в теперішній час у Литві функціонує дворівнева система етичної експертизи біомедичних досліджень. Відповідно до локальних регуляторних вимог будь-яке біомедичне дослідження повинно бути піддане етичній експертизі і може розпочатися тільки після отримання позитивного висновку регіонального (для локальних досліджень) або центрального (для досліджень лікарських препаратів, медичних пристроїв або інших багатоцентрових досліджень) етичного комітету. Особливостями литовської системи етичної експертизи є: постійно оновлювана законодавча база, що регулює проведення всіх основних видів біомедичних досліджень, широке покриття етичним супроводом досліджень при помірних витратах ресурсів, прозорість функціонування Литовського біоетичного комітету. В результаті проведеного аналізу запропонований ряд підходів для громадського обговорення та впровадження в практику української системи етичної експертизи біомедичних досліджень.

The article deals with the relation of modernization and counter components of modernization in Islam. The author stated that the feature of Islam was and still is the fusion of the spiritual and temporal power, ierokratii and political administration. In one of the Islamic countries did not have an organized church, which would be the institutional and separate from the state. In practice, this leads to the merging of the Muslim clergy of interest with the administrative policy of the government. «Misalliance» between them there rather improbable fiction than everyday social and practical. In the Muslim world and never had a church, which is on the level of korporatizovanosti priesthood have likened the Catholic and Orthodox churches, religious and defending the interests of the church clergy, that would be delimited by ordinary believers. Unlike Christianity, Islam was formed in the conditions of the primitive society, which was also characteristic of religious and political holism in the aspect of intertwining of political and religious leadership of the Emirate and Caliphate with the charismatic warlordism. These circumstances make it difficult to unilateral reception values of Western culture and creates the preconditions for the adaptation of the secular institutions of the economy, education, medicine, etc. a trinity of «religion-politics-society». ; Статья посвящена проблеме соотношения модернизационных и контрмодернизационных составляющих в исламе. Автором констатировано, что особенностью ислама было и остается слияние духовной и светской власти, иерократии и политической администрации. Ни в одном исламском государстве не было организованной церкви, которая была бы институционально-отделенной от государства. На практике это приводит к слиянию интересов мусульманского духовенства с политикой административного руководства страны. «Мезальянс» между ними есть, скорее, маловероятной выдумкой, чем социально-практической повседневностью. В мусульманском мире также никогда не было церкви, которая по уровню корпоратизованости священства уподоблялась бы католической или православной церквям, отстаивая религиозно-церковные интересы клира, который был бы отграниченным от простых верующих. В отличие от христианства, ислам формировался в условиях примитивного общества, которому был и есть присущим религиозно-политический холизм в аспекте переплетения политического и религиозного лидерства, эмирата и халифата с харизматичным вождизмом. Указанные обстоятельства затрудняют одностороннюю рецепцию ценностей западной культуры и создают предпосылки для приспособления секулярных институтов экономики, образования, медицины и т.п. в триединстве «религия-политика-общество». ; Статтю присвячено проблемі співвідношення модернізаційних і контрмодернізаційних складників в ісламі. Авторкою констатовано, що особливістю ісламу було і залишається злиття духовної і світської влади, ієрократії і політичної адміністрації. В жодній з ісламських держав не існувало організованої церкви, яка була б інституційно-відокремленою від держави. На практиці це призводить до злиття інтересів мусульманського духовенства з політикою адміністративного керівництва країни. «Мезальянс» між ними є, скоріше, малоймовірною вигадкою, ніж соціально-практичним повсякденням. В мусульманському світі також ніколи не існувало церкви, яка за рівнем корпоратизованості священства уподібнювалася б католицькій або православній церквам, відстоюючи релігійно-церковні інтереси кліру, який був би відмежованим від простих вірян. На відміну від християнства, іслам формувався в умовах примітивного суспільства, якому був і є притаманним релігійно-політичний холізм в аспекті переплетення політичного та релігійного лідерства, емірату та халіфату із харизматичним вождизмом. Зазначені обставини утруднюють однобічну рецепцію цінностей західної культури і створює передумови для пристосування секулярних інституцій економіки, освіти, медицини і т.п. до триєдності «релігія-політика-громада».

Автор статьи проблематизирует язык донорства, ставший общеупотребительным для описания практик передачи женских половых клеток в текстах законов, профессиональных этических рекомендациях, в обиходной речи врачей и пациентов. Передача половых клеток от одного человека к другому сравнивается с трансплантацией соматических клеток и тканей. Развитие трансплантологии и репродуктивной медицины требовало и продолжает требовать обеспечение потока биологических материалов от здоровых людей, не имеющих в самой процедуре трансплантации органов (или оплодотворении половых клеток и имплантации эмбриона) очевидного интереса, к больным, нуждающимся в лечении («терапии бесплодия»). Язык дара, солидарности, альтруизма стал тем клеем, который собрал эти кирпичики, позволяя, с одной стороны, легитимировать в глазах общества практики обмена человеческим биологическим материалом, и, с другой, уберечь последний от выпадения в область профанного, овеществленного, безличного, процесса, которому сопротивляются базовые культурные интуиции западного человека. На материалах количественного опроса европейских доноров, нескольких глубинных интервью с донорами в разных странах, а также наблюдениях в московской клинике репродукции в 2010-2011 г., мы показываем спектр значений, которые женщины-доноры придают своим действиям: от эмпатии и решения психологических проблем до зарабатывания денег. Анализ этих мотиваций вкупе с анализом законодательства (главным образом российского и британского) и этических рекомендаций врачей позволяет увидеть, что практики донорства производятся силовыми полями, которые сильно отличаются в разных национальных контекстах. В заключение мы схлопываем два уровня анализа языка и практик, чтобы показать, насколько язык донорства устарел для описания реально происходящего, насколько он не позволяет решить те проблемы, которые были перед ним поставлены. В конце статьи мы приходим почти что к нормативному выводу: нужен новый язык, основанный на не менее сильной и общественно значимой метафорике, чуткий к реальным практикам и рефлексивный по отношению к тому, чьи интересы он отстаивает. ; The author challenges the language of donation that became common in describing practices of exchange of female reproductive cells in the texts of laws, professional ethical recommendations, habitual speech of doctors and patients. Transfer of gametes from one person to another is compared to transplantation of somatic cells and tissues. Development of transplantology and reproductive medicine required and keep. on requiring a constant flow of biological materials from healthy individuals not interested in transplantation procedure (or embryo implantation) to the sick in need of treatment (infertility therapy). The language of donation, solidarity, altruism became a sort of glue piecing together these bricks. This allowed, on the one hand, to legitimize practices of human biological materials exchange, and, on the other, to prevent the latter from rolling off to the realm of the profane, objectified, impersonal the process resisted by core western cultural intuitions. Using the data from a multi-site European survey, several in-depth interviews with egg donors from different regions, as well as observations I did in a Moscow fertility clinic in 2010-2011, we show a spectrum of meanings attributed by women-donors to their actions: from empathy and solving psychological problems to earning money. Analysis of these motivations, together with analysis of legislature (first of all, Russian and British), allows us to see that donation practices are produced by fields of forces that vary greatly among different countries. In the end we combine two levels of analysis language and practices to show that the language of donation is largely outdated to properly describe real state of things, to solve the issues that he was created to tackle.

В статье обращается внимание на то, что при существующем правовом регулировании сферы здравоохранения, в результате проводимой в течение последних лет оптимизации этой сферы, по данным Счетной палаты Российской Федерации количество больничных учреждений в стране сократилось с 10 704 в 2000 году до 4398 в 2013 году. За этот же период в два раза сократилось число специализированных диспансеров. В результате 17,5 тысяч населенных пунктов вообще не имеют медицинской инфраструктуры, что ведет к дезорганизации медицинской помощи населению и ограничению доступности для нуждающихся в ней. В целях недопущения ухудшения ситуации в этой сфере автор предлагает внести конкретные изменения в Федеральный закон от 21 ноября 2011 г. «Об основах охраны здоровья граждан в Российской Федерации». В статье рассматриваются проблемы несовершенства правового регулирования в вопросах оказания высокотехнологичной медицинской помощи, лекарственного обеспечения граждан, страдающих орфанными заболеваниями, а также невыполнения требования Закона Российской Федерации от 2 июля 1992 г. «О психиатрической помощи и гарантиях прав граждан при ее оказании» в части создания государством независимой от органов исполнительной власти в сфере охраны здоровья службы защиты прав пациентов, находящихся в медицинских организациях, которые оказывают психиатрическую помощь в стационарных условиях, что является одним из факторов, обуславливающих непрекращающиеся нарушения в этой сфере. Автор присоединяется к позиции Федеральной антимонопольной службы Российской Федерации о необходимости принятия постановления Правительства Российской Федерации, которое на основе закрепления критериев качества оказания медицинской помощи должно установить систему контроля качества. В статье делается акцент на необходимости установления в Российской Федерации бюджетного правила, согласно которому объем финансирования здравоохранения в стране должен быть не 3,6 % от валового внутреннего продукта, а более 5 % на чем настаивает Всемирная организация здравоохранения. ; The author points out that in terms of existing legal regulation in health care and consequently to the optimization of this field happening over the last few years, according to data of the Audit Chamber of the Russian Federation a number of hospitals has reduced from 10704 in 2000 to 4398 in 2013. Over this period a number of specialized health centers reduced twice. As a result, 17 5000 settlements are deprived of medical infrastructure, which leads to disorganization of medical assistance and restriction of access for those who need medical help. In order to prevent worsening of this situation the author suggests introducing particular amendments to the Federal Law of November 21, 2011 "On Fundamental Healthcare Principles in the Russian Federation". The article considers problems of imperfect legal regulation in high-technology medical help, medicine assistance to people suffering from orphan diseases and a failure to comply with requirements of the Russian Federation Law of July 02, 1992 "On Psychiatric Care and Guarantees of Citizens' Rights during Its Provision" in terms of establishment of Patients' Rights Protection Service independent from executive authorities and located within medical institutions rendering psychiatric help, which is one of factors causing persistent violation in this field. The author shares a position of the Federal Antimonopoly Service of the Russian Federation on the need for ratification of a Decree of the Russian Government called forth to establish a quality control system on the basis of strengthening quality criteria when rendering medical assistance. The author emphasizes a need for laying down budgetary rules, according to which the amount of financing in health care in the Russian Federation will be not 3.6 % of GDP, but more than 5 % as it is suggested by the World Health Organization.

The author points out that in terms of existing legal regulation in health care andconsequently to the optimization of this field happening over the last few years, accordingto data of the Audit Chamber of the Russian Federation a number of hospitals hasreduced from 10704 in 2000 to 4398 in 2013. Over this period a number of specializedhealth centers reduced twice. As a result, 17 5000 settlements are deprived of medicalinfrastructure, which leads to disorganization of medical assistance and restriction ofaccess for those who need medical help. In order to prevent worsening of this situationthe author suggests introducing particular amendments to the Federal Law of November21, 2011 "On Fundamental Healthcare Principles in the Russian Federation".The article considers problems of imperfect legal regulation in high-technologymedical help, medicine assistance to people suffering from orphan diseases and a failureto comply with requirements of the Russian Federation Law of July 02, 1992"On Psychiatric Care and Guarantees of Citizens' Rights during Its Provision" in termsof establishment of Patients' Rights Protection Service independent from executive authoritiesand located within medical institutions rendering psychiatric help, which is oneof factors causing persistent violation in this field. The author shares a position of theFederal Antimonopoly Service of the Russian Federation on the need for ratification of aDecree of the Russian Government called forth to establish a quality control system onthe basis of strengthening quality criteria when rendering medical assistance. The authoremphasizes a need for laying down budgetary rules, according to which the amount offinancing in health care in the Russian Federation will be not 3.6 % of GDP, but morethan 5 % as it is suggested by the World Health Organization. ; В статье обращается внимание на то, что при существующем правовом регули-ровании сферы здравоохранения, в результате проводимой в течение последних летоптимизации этой сферы, по данным Счетной палаты Российской Федерации коли-чество больничных учреждений в стране сократилось с 10 704 в 2000 году до 4398 в2013 году. За этот же период в два раза сократилось число специализированныхдиспансеров. В результате 17,5 тысяч населенных пунктов вообще не имеют меди-цинской инфраструктуры, что ведет к дезорганизации медицинской помощи насе-лению и ограничению доступности для нуждающихся в ней. В целях недопущенияухудшения ситуации в этой сфере автор предлагает внести конкретные изменения вФедеральный закон от 21 ноября 2011 г. «Об основах охраны здоровья граждан вРоссийской Федерации». В статье рассматриваются проблемы несовершенства пра-вового регулирования в вопросах оказания высокотехнологичной медицинской по-мощи, лекарственного обеспечения граждан, страдающих орфанными заболева-ниями, а также невыполнения требования Закона Российской Федерации от 2 июля1992 г. «О психиатрической помощи и гарантиях прав граждан при ее оказании» вчасти создания государством независимой от органов исполнительной власти всфере охраны здоровья службы защиты прав пациентов, находящихся в медицин-ских организациях, которые оказывают психиатрическую помощь в стационарныхусловиях, что является одним из факторов, обуславливающих непрекращающиесянарушения в этой сфере. Автор присоединяется к позиции Федеральной антимоно-польной службы Российской Федерации о необходимости принятия постановленияПравительства Российской Федерации, которое на основе закрепления критериевкачества оказания медицинской помощи должно установить систему контроля ка-чества. В статье делается акцент на необходимости установления в Российской Фе-дерации бюджетного правила, согласно которому объем финансирования здраво-охранения в стране должен быть не 3,6 % от валового внутреннего продукта, а бо-лее 5 % на чем настаивает Всемирная организация здравоохранения.