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The challenges to achieving universal health coverage (UHC) are obvious yet vast in their scope: leading these is a lack of strong primary health care (PHC) systems and a global shortage of well-trained health care professionals. Addressing these challenges is paramount, as it is well-trained health care professionals who will build the strong PHC systems that are necessary for UHC. Due to the continuing spread and evolution of information and communications technology (ICT) in health care and education, ICT should be considered as an essential tool for innovative primary health care education. Many nations face a distinct lack of UHC, grossly unequal health services and an acute shortage of suitably qualified family doctors, nurses and allied health care professionals that constitute the primary health care team. It is estimated that by 2035, the world will have a shortage of 12.9 million health care professionals, however an additional 1.9 billion people will require health care. Recruiting, educating and retaining these primary health care teams is therefore fundamental to meet ongoing demands. Family doctors contribute to high quality, cost-effective and accessible primary health care. However, PHC faces considerable challenges, including a preference from policymakers, the public, and members of the health care community for specialisation. Specialist-focused care may be attractive, but it is often economically unsustainable and absorbs resources that are necessary for PHC. Yet, cooperation between primary and secondary care is essential for delivering the best care to patients and communities. It should not be a matter of choosing between primary and secondary care, but rather of recognising and adequately supporting the unique attributes and skillsets that each has to offer. Family medicine lies at the heart of primary health care. The key to producing skilled family doctors is good family medicine training, particularly at a postgraduate level. There is great potential to improve the scale and quality of family medicine training, starting with exposure to the field as early as possible. For the delivery of primary care to be effective – and lead to the achievement of universal health coverage – the composition of the primary care team should reflect the demography and health needs of the local population. Thus, the composition of the primary care team will differ from location to location, depending on the age/sex/ health needs of the local population. Family doctors and all of the PHC professionals should have a set of universal core skills, in addition to skills specific to the population and geography they serve. To provide effective care, health professionals need to understand the importance of social factors in influencing population health; therefore, training curricula must be adapted to local contexts Career development through postgraduate training strongly motivates health professionals to stay in their own localities, as well as being vital for patient safety and improved outcomes. Yet, despite a thirst for postgraduate training among family doctors and other primary health care professionals, it is often difficult to access. ICT may be used to address recruitment and retention issues by providing easily accessible and good quality education. This report examines a key question: Can ICT facilitate the education of PHC professionals worldwide in order to address the challenges facing PHC and UHC? Through in-depth literature reviews, analysis, and targeted interviews with key experts, the report concludes that ICT can indeed support, enhance and accelerate the education of the primary health care team's members, in six key ways: 1. It is an effective means of developing workforce capacity. By overcoming geographical barriers and supplementing traditional instruction with online delivery from international and regional tutors, ICT can substantially increase health care professionals' access to postgraduate education without the need for travel, thus helping to avoid disruption to healthcare delivery. 2. It helps to recruit and retain professionals. E-learning overcomes issues of access and isolation, and can be done flexibly to suit the learner. By providing access to specialist support, postgraduate courses and mentoring opportunities, e-learning and telehealth encourage in-country and rural retention of health care workers. 3. It is cost-saving. Traditional models of health professional education are expensive, both for the provider and for health care professionals. Developing ICT solutions may entail high initial costs but these are reduced over time, and with more users, achieve economies of scale. 4. It facilitates social and collaborative learning which has been shown to have the greatest impact on patient outcomes. A blend of synchronous and asynchronous e-learning is likely to be the most effective way of achieving interprofessional learning. Communities of practice are encouraged using ICT and social media, reducing professional isolation and improving collaboration. 5. It can help to bring contextualised care to where it is needed. For example, simulation-based medical education enables problem-based, interactive and contextualised learning. End-user (including patient) participation is paramount when designing ICT-based educational programmes. 6. It improves the quality of care by facilitating access to evidence-based medicine and reflective learning. Email alerts can support education by reaching a large audience and providing trustworthy information tailored to individual needs; social media can aid in streamlining vast amounts of information into a small number of tailored-to-the-individual articles; blogs and electronic portfolios can encourage reflective life-long learning. Capturing these opportunities will require stakeholders to consider the following: a) Securing political and financial support to establish and maintain strong PHC systems b) Adopting a collaborative interprofessional approach between health professionals, from medical school through to the workplace c) Providing education and training relevant to the context and to user needs d) Improving recruitment and retention through training e) Encouraging the standardisation and accreditation of health professional education f) Investing in ICT training for learners, educators and patients g) Planning and developing programmes that use technology meaningfully to improve care quality, cost-effectiveness, accessibility, equity and patient safety h) Recognise and consolidate the interdependence of all the health professionals in the PHC setting.

Статья посвящена теоретическим аспектам научного исследования «Механизмы преодоления ментальных барьеров инклюзии социально уязвимых категорий населения для активизации процессов модернизации регионального сообщества» (грант РНФ № 16-18-00078). Авторами дан анализ сущности категории «социально уязвимые группы населения» с точки зрения правового, экономического и социологического подходов. Показано, что экономический подход, использующий при определении уязвимых слоев населения критерий «уровень доходов и накопленного имущества», является превалирующим в практике государственного управления. Правовое поле категории с опорой на экономический подход определено понятием «малоимущие и социально незащищенные категории граждан». На основе анализа теоретико-методологических аспектов данной проблемы показано, что эти критерии служат необходимым, но недостаточным условием для отнесения населения к категории социально уязвимого. В зарубежной литературе феномен уязвимости связывается с понятием рисков, возможностью ответа на них со стороны домохозяйств и вероятностью потери благосостояния (теории бедности; научные направления, связанные с источниками средств к существованию и т.д.). В концепции активов (аsset-based approaches) уязвимость соотносится с состоянием бедности, возникающим вследствие недостаточного доступа к материальным и нематериальным активам. Социологические теории, представленные концепцией социального исключения, уделяют большое внимание распаду социальных связей как источнику уязвимости. Сущность социального исключения состоит в невозможности людей участвовать в важных для них аспектах социальной жизни (в политических процессах, рынках труда, системах образования и здравоохранения, культурной жизни общества и т.п.), на которые у них есть все права. Различие концепций эксклюзии и бедности проявляется в смещении акцента с неравенства доходов на ограничение доступа к правам. Социальная эксклюзия характеризуется ситуацией и состоянием исключения, которое связано с социальным статусом и самовосприятием человека и выражено чувствами неполноценности, озлобленности, страха, отчаяния, подавленности, стыда. Статус социального исключения имеет множество критериев: бедность, ограниченные возможности трудоустройства и образования, недостаточный доступ к социальным и общественным сетям и мероприятиям, невозможность планировать собственную жизнь. Объяснительная концепция социальной эксклюзии опирается на процессы конструирования отношения к социально уязвимым слоям населения как к обесцененному социальному статусу. Барьерами социальной инклюзии становится формирование негативного образа представителя данной категории населения в глазах более благополучного окружения и причинность этого явления состоит в индивидуальных особенностях личности: недостаточной целеустремленности, безволии, лени, низкой мотивации к труду и обучению, во вредных привычках. Сложившийся социальный стереотип способствует стратификации целых семей, включая детей, которые заранее лишаются важнейших экономических, политических и культурных ресурсов общества, блокируя им возможности восходящей мобильности. Непринятие мер по преодолению социального исключения может привести к тому, что часть населения будет выпадать из процессов общественного развития, скатываясь в состояние стагнации и полной социальной зависимости. Концепция социальной инклюзии смещает приоритеты социальной политики государства с выделения социальных трансфертов на активное изменение образа мышления в обществе. ; The article considers theoretical aspects of a scientific research "The Mechanisms for Overcoming Mental Barriers of Inclusion of Socially Vulnerable Categories of the Population for the Purpose of Intensifying Modernization in the Regional Community" (RSF grant No. 16-18-00078). The authors analyze the essence of the category of "socially vulnerable groups" from the legal, economic and sociological perspectives. The paper shows that the economic approach that uses the criterion "the level of income and accumulated assets" when defining vulnerable population groups prevails in public administration practice. The legal field of the category based on the economic approach is defined by the concept of "the poor and socially unprotected categories of citizens". With the help of the analysis of theoretical and methodological aspects of this issue, the authors show that these criteria are a necessary but not sufficient condition for classifying the population as being socially vulnerable. Foreign literature associates the phenomenon of vulnerability with the concept of risks, with the possibility of households responding to them and with the likelihood of losing the well-being (poverty theory; research areas related to the means of subsistence, etc.). The asset-based approaches relate vulnerability to the poverty that arises due to lack of access to tangible and intangible assets. Sociological theories presented by the concept of social exclusion pay much attention to the breakdown of social ties as a source of vulnerability. The essence of social exclusion consists in the inability of people to participate in important aspects of social life (in politics, labor markets, education and healthcare, cultural life, etc.) though they have all the rights to do so. The difference between the concepts of exclusion and poverty is manifested in the displacement of emphasis from income inequality to limited access to rights. Social exclusion is characterized by the situation and state of exception that is linked to social status and self-perception of human rights and expressed through the senses of inferiority, anger, fear, despair, depression, shame. The status of social exclusion has many criteria: poverty, limited opportunities for employment and education, lack of access to social and community networks and activities, inability to plan one's own life. The explanatory concept of social exclusion is based on the construction of the attitude toward socially vulnerable layers as the devalued social status. The barrier of social inclusion consists in the formation of a negative image of a representative of this category of the population in the eyes of more secure population groups; and the reason for this phenomenon lies in individual characteristics of an individual: lack of purpose, apathy, laziness, low motivation to labor and training, and bad habits. The prevailing social stereotype contributes to the stratification of entire families, including children, who are in advance deprived of the most important economic, political and cultural resources of society, and have no opportunities for the upward mobility. If no measures are taken to overcome social exclusion, it can lead to the fact that part of the population will fall out of social development and slip into a state of stagnation and complete social dependence. The concept of social inclusion shifts the priorities of state social policy from the allocation of social transfers to actively changing the mindset in society.

Organ and tissue donation is a societal issue that demands the positive engagement of all stakeholders in civil society for its successful implementation and for achieving its goal of allowing "more lives to be saved and improve the quality of others"1 The publication of a White Paper and the launching of a public consultation, before legislating on the matter, can actually motivate individuals, associations and institutions to look at the current practice and see what is at stake and what is the reasonable way forward to improve it. The Government's initiative is a major step forward especially as it sets to regulate a practice that has been carried out in Malta for many years. The objective of the whole exercise is certainly good, since an adequate supply of tissues and especially organs will make a big difference to people who need them to stay alive or to improve the quality of their life. This position paper, which has been prepared at the request of the Maltese Episcopal Conference by a group that includes experts in the field of clinical medicine, psychology, philosophy and theology, is a response to the Government's call to all stakeholders in society to participate in the development and formulation of a healthcare policy on organ and tissue donation. The paper contains the following five sections: 1. The Current Policy: The current practice of organ and tissue procurement compares very well with that of other EU Member States. According to a recent study, Malta places second in the EU for organ donation. Moreover, statistical information shows that the present system is functioning well and, accordingly, provides a sound basis for further development. Therefore, a new legislative framework should improve rather than overhaul the current system. 2. Organ Donation as an Act of Giving: A person's decision to donate his/her organs should always be an expression of uncompelled generosity and altruism since it is an act of giving. One cannot receive a gift from the other if the other has not freely consented to the giving. Without that free consent, the practice becomes taking and getting rather than giving and receiving organs. Since the first successful transplant procedure in the early fifties, the Catholic Church has explicitly supported both living organ donation and the procurement of organs from the dead. Organ donation is justified by the principles of charity and solidarity. The system that safeguards the dimension of gift in the act of organ donation is the opt-in system. On the contrary, the opt-out system precludes the person from expressing freely his/her decision to donate his/her tissues and organs, thus undermining the dimension of gift that requires the explicit and free informed consent of the human person. In an opt-out system there is the risk that what should be considered as a "donation" loses its significance as an act of giving and can also be interpreted as lacking in the respect (pietas) that the living ought to give to the deceased. 3. Ethical Issues: The paper raises the following five ethical issues: i) The paradigm of ownership used in both the opt-in system and the opt-out system is inadequate since the body is neither the property of the individual nor that of the State. The body is rather the mode in which we are present to each other and communicate with each other. ii) Tissue and organ donations from living persons may be justified solely for therapeutic reasons, taking into account various clinical factors as specified by the Oviedo Convention, such as urgency, the probability of successful transplant surgery given the patient's condition, the prospect that the organ will thrive and the order of priority of the request. iii) The commercialization of the human body is against the human dignity and integrity of the human person. Financial remuneration should therefore be prohibited. vi) The ethical principles framed by the Live Organ Transplant Advisory Committee (LOTAC) – to which the White Paper refers – should form part of the criteria of live organ transplants. v) The allocation of organs should be based on distributive justice. Clear guidelines should be drawn up with regard to eligibility and relative need of patients on renal replacement therapy. 4. Concerns: The following five concerns are raised: i) An opt-out system distorts the nature of organ donation as a gift and may create fear in peoples' mind on perceiving that the State is taking ownership rights over their bodies. ii) The criteria to ascertain the death of a human person must be clear. . The brain death principle, to be understood as the death of the whole brain (brain and brain stem), is by far (according to medical and scientific knowledge to date), the most adequate to determine the death of a human person since the complete and irreversible loss of all the functions of the brain and brain stem mark the end of the person's life as a living organism. iii) The practice of retrieving organs from non-hearth beating bodies raises the ethical issue of when to withdraw artificial respiratory support. iv) The issue of the age threshold of consent to register as organ donors requires more thought. The proposal that twelve-year-olds should be considered legally competent to become an organ or tissue donor is not in line with psychological findings and does not reflect legal provisions in Malta on matter related to minors. v) The harvesting of organs from anencephalic newborns raises a serious ethical issue concerning the applicability of brain-death criteria. 5. Recommendations: The concept of organ donation, being a voluntary gift, must be retained and protected. Thus, the new legislation should strengthen the opt-in system. The document offers the following set of recommendations that spell out the measures that need to be taken: i) to promote the opt-in system ii) to manage it more effectively iii) to ensure an on-going review. ; non peer-reviewed

In the United States, health insurance is often necessary for access to regular, affordable health care. With only eight of every hundred Americans buying private insurance plans on the individual market, the main sources for health insurance traditionally have been employers and the government. As new laws are being debated and introduced to reform an expensive health care industry in which nearly one-sixth of the population is uninsured, research is needed in order to evaluate the costs and benefits of these policy changes and to predict their success. To this end, in addition to understanding how likely individuals are to adopt new health insurance policies, we also should be interested in knowing how the demand for health insurance and changes in its accessibility will affect non-medical decisions. Specifically, labor market choices have been theorized to be directly related to decisions involving insurance coverage. If the availability of health insurance distorts a workers' job-related decisions, then the changing the landscape for how to access insurance may reverberate in employment outcomes. My dissertation focuses on understanding the factors that influence the demand for health insurance and the role that health insurance plays in an individual's decision to work, where to work, and how much to work. Specifically, I focus on the following three related questions: how does the demand for insurance affect labor market decisions such as when to exit unemployment? what drives insurance demand, and in particular, what motivators work best to increase demand for health coverage among the uninsured? and lastly, what are the supply-side employment responses to the provision of free or reduced-cost public health insurance? My first chapter explores how the demand for health insurance can change re-employment decisions among the unemployed, as well as the speed at which individuals return to work. Past research on this issue focuses on job-to-job switches and "job lock" but has yet to focus on individuals looking for work. This chapter uses data on laid-off individuals from the Medical Expenditure Panel Survey to compare the job search behavior and outcomes of individuals who differ in their demand for health insurance. I use three proxies for demand, based on spousal health and past insurance offer take-up decisions. Although each is potentially confounded by unobserved determinants of job search, I use a difference-in-differences and propensity score designs to isolate plausibly causal effects. I find consistent patterns across all three proxies (despite different potential omitted variables biases). Overall unemployment durations do not vary with demand for insurance, but this masks variation in the types of jobs taken. Individuals with higher demand for insurance have higher hazards for exiting unemployment into a job with insurance, but lower hazards for exiting to a job without insurance. This points to effects of insurance demand on both search effort and reservation wages, and to potentially important distorting effects of employer-linked health insurance. Whereas the first chapter takes variation in demand for insurance as a given, my second chapter digs deeper into the basis for this variation and whether it can be affected. In this chapter, I investigate the reasons the uninsured choose to forego insurance coverage and the impact of different messages on their insurance demand. Working with Enroll America, a large non-profit dedicated to decreasing the number of uninsured Americans, I conducted a stratified experiment to determine the best communication strategies to encourage participation in the healthcare exchanges. We test a combination of the following behavioral and information treatments: a risk treatment that emphasizes the average financial risk for someone without health insurance; a norms treatment that alerts our participants that staying uninsured will be against the law; a savings treatment that highlights the average savings available at the exchanges; a wording treatment where we refer to the Affordable Care Act (ACA) as "Obamacare"; and lastly, a cost-calculator treatment that allows individuals to explore the likely cost of insurance based on their own characteristics. Among the uninsured, we find that the cost-calculator treatment, the risk treatment, and the mandate are most effective in increasing intention to purchase insurance. The cost-calculator and the risk treatment increase informedness among this population, but the cost-calculator (when paired with the savings treatment) is the only treatment that increases willingness to pay for insurance. We use the information on willingness to pay to construct sub-group price elasticities of demand to compare to previous work interested in the demand for health insurance. Overall, the results of this chapter highlight the importance of informational campaigns to increase awareness of the costs and benefits of health coverage, particularly after large changes such as those implemented by the ACA.My third chapter continues by looking at the changes that have been introduced as a result of the ACA. Specifically, it explores whether expanding access to government-provided insurance affects individuals' decisions regarding employment and overall hours of work. Recent findings have suggested that increasing access to health insurance outside of employment has a sizable, negative impact on labor force participation. Along these lines, the Congressional Budget Office predicted that the expansion of Medicaid and private health insurance will cause a 1.5 to 2% reduction in hours worked in the first ten years. Comparing states by whether they chose to expand Medicaid under reforms introduced by the ACA, I look at changes in the probability a childless adult receives Medicaid, as well as changes in this group's employment likelihood and hours of work. Using household survey data from the CPS monthly survey and ASEC Supplement, I confirm a marked increase in the percent of childless adults insured by Medicaid but find no statistically significant changes in employment outcomes. I compare these results to other estimates of "employment lock" in recent literature. These results, though imprecise, align with the findings in Chapter 1 which suggest that overall employment is not drastically affected by insurance demand.

Background: The spectrum of disorders of the brain is large, covering hundreds of disorders that are listed in either the mental or neurological disorder chapters of the established international diagnostic classification systems. These disorders have a high prevalence as well as short- and long-term impairments and disabilities. Therefore they are an emotional, financial and social burden to the patients, their families and their social network. In a 2005 landmark study, we estimated for the first time the annual cost of 12 major groups of disorders of the brain in Europe and gave a conservative estimate of €386 billion for the year 2004. This estimate was limited in scope and conservative due to the lack of sufficiently comprehensive epidemiological and/or economic data on several important diagnostic groups. We are now in a position to substantially improve and revise the 2004 estimates. In the present report we cover 19 major groups of disorders, 7 more than previously, of an increased range of age groups and more cost items. We therefore present much improved cost estimates. Our revised estimates also now include the new EU member states, and hence a population of 514 million people. Aims: To estimate the number of persons with defined disorders of the brain in Europe in 2010, the total cost per person related to each disease in terms of direct and indirect costs, and an estimate of the total cost per disorder and country. Methods: The best available estimates of the prevalence and cost per person for 19 groups of disorders of the brain (covering well over 100 specific disorders) were identified via a systematic review of the published literature. Together with the twelve disorders included in 2004, the following range of mental and neurologic groups of disorders is covered: addictive disorders, affective disorders, anxiety disorders, brain tumor, childhood and adolescent disorders (developmental disorders), dementia, eating disorders, epilepsy, mental retardation, migraine, multiple sclerosis, neuromuscular disorders, Parkinson's disease, personality disorders, psychotic disorders, sleep disorders, somatoform disorders, stroke, and traumatic brain injury. Epidemiologic panels were charged to complete the literature review for each disorder in order to estimate the 12-month prevalence, and health economic panels were charged to estimate best cost-estimates. A cost model was developed to combine the epidemiologic and economic data and estimate the total cost of each disorder in each of 30 European countries (EU27 + Iceland, Norway and Switzerland). The cost model was populated with national statistics from Eurostat to adjust all costs to 2010 values, converting all local currencies to Euro, imputing costs for countries where no data were available, and aggregating country estimates to purchasing power parity adjusted estimates for the total cost of disorders of the brain in Europe 2010. Results: The total cost of disorders of the brain was estimated at €798 billion in 2010. Direct costs constitute the majority of costs (37% direct healthcare costs and 23% direct non-medical costs) whereas the remaining 40% were indirect costs associated with patients' production losses. On average, the estimated cost per person with a disorder of the brain in Europe ranged between €285 for headache and €30,000 for neuromuscular disorders. The European per capita cost of disorders of the brain was €1550 on average but varied by country. The cost (in billion €PPP 2010) of the disorders of the brain included in this study was as follows: addiction: €65.7; anxiety disorders: €74.4; brain tumor: €5.2; child/adolescent disorders: €21.3; dementia: €105.2; eating disorders: €0.8; epilepsy: €13.8; headache: €43.5; mental retardation: €43.3; mood disorders: €113.4; multiple sclerosis: €14.6; neuromuscular disorders: €7.7; Parkinson's disease: €13.9; personality disorders: €27.3; psychotic disorders: €93.9; sleep disorders: €35.4; somatoform disorder: €21.2; stroke: €64.1; traumatic brain injury: €33.0. It should be noted that the revised estimate of those disorders included in the previous 2004 report constituted €477 billion, by and large confirming our previous study results after considering the inflation and population increase since 2004. Further, our results were consistent with administrative data on the health care expenditure in Europe, and comparable to previous studies on the cost of specific disorders in Europe. Our estimates were lower than comparable estimates from the US. Discussion: This study was based on the best currently available data in Europe and our model enabled extrapolation to countries where no data could be found. Still, the scarcity of data is an important source of uncertainty in our estimates and may imply over- or underestimations in some disorders and countries. Even though this review included many disorders, diagnoses, age groups and cost items that were omitted in 2004, there are still remaining disorders that could not be included due to limitations in the available data. We therefore consider our estimate of the total cost of the disorders of the brain in Europe to be conservative. In terms of the health economic burden outlined in this report, disorders of the brain likely constitute the number one economic challenge for European health care, now and in the future. Data presented in this report should be considered by all stakeholder groups, including policy makers, industry and patient advocacy groups, to reconsider the current science, research and public health agenda and define a coordinated plan of action of various levels to address the associated challenges. Recommendations: Political action is required in light of the present high cost of disorders of the brain. Funding of brain research must be increased; care for patients with brain disorders as well as teaching at medical schools and other health related educations must be quantitatively and qualitatively improved, including psychological treatments. The current move of the pharmaceutical industry away from brain related indications must be halted and reversed. Continued research into the cost of the many disorders not included in the present study is warranted. It is essential that not only the EU but also the national governments forcefully support these initiatives.

O acesso a medicamentos essenciais a preços acessíveis de forma sustentável é um dos indicadores do cumprimento dos Objectivos de Desenvolvimento do Milénio e pode ser considerado como parte do direito universal à saúde. Tal como acontece com outros bens essenciais, o acesso aos medicamentos depende de múltiplos factores, como a sua disponibilidade, preços e capacidade de aquisição por parte da população. Na última década, foram efectuados mais de 50 estudos para avaliar esses factores, em países de baixos e médios rendimentos, utilizando uma metodologia desenvolvida pela Organização Mundial de Saúde e a organização Health Action International, numa tentativa de compreender as possíveis causas para o baixo acesso aos medicamentos. Os resultados destes estudos revelam uma baixa disponibilidade de medicamentos essenciais de um modo geral, sobretudo no sector público, e preços elevados, sobretudo no sector privado. O objectivo deste estudo foi descrever a disponibilidade, os preços e a capacidade de aquisição de medicamentos essenciais em Timor-Leste, com recurso à metodologia da OMS/HAI. Foram recolhidos dados sobre a disponibilidade e os preços de uma lista de medicamentos em hospitais, centros de saúde e farmácias comunitárias. Embora os resultados pareçam apontar para uma disponibilidade global razoável de medicamentos genéricos no sector público (59,2%), algumas substâncias activas e classes terapêuticas encontravam-se sistematicamente esgotadas em vários pontos do país. Nas unidades situadas em locais mais remotos, a disponibilidade de medicamentos chegava a descer para valores na ordem dos 47,5%. Verificou-se que a disponibilidade de medicamentos nas farmácias privadas era ainda mais baixa do que nos serviços públicos (38,0%). Os medicamentos são dispensados gratuitamente nos hospitais e centros de saúde, mas nas farmácias privadas chegam a ultrapassar 40 vezes os seus preços de referência internacionais, mesmo como genéricos. Consequentemente, estima-se por exemplo, que um funcionário público que utilize diclofenac para o tratamento crónico da artrose, tenha de trabalhar durante mais de 2 dias para pagar o seu tratamento mensal com o medicamento genérico, ou 12,5 dias, se for prescrito o medicamento de marca. Durante o estudo, foram detectados vários outros problemas que podem comprometer a qualidade e segurança dos medicamentos. Apesar das limitações inerentes a uma investigação deste tipo, foi possível concluir através do presente estudo que, ao contrário da tendência geral observada em países similares, o sector público de cuidados de saúde em Timor-Leste parece ter um melhor desempenho do que o privado. No entanto, as condições limitadas da maioria das unidades de saúde públicas pode forçar alguns doentes a recorrer ao sector privado, onde os preços pagos pelos tratamentos são inaceitavelmente elevados. A ausência de regulamentação do sector farmacêutico (e fiscalização insuficiente da existente) parece estar a contribuir para a estagnação do sector privado e a encorajar indirectamente a falta de transparência nas práticas farmacêuticas. Dada a escassez de estudos sobre este assunto em Timor-Leste, espera-se que o presente trabalho forneça evidências importantes que possam ser utilizadas em estudos subsequentes e como base a uma intervenção por parte das autoridades com o objectivo de melhorar a disponibilidade de medicamentos no sistema público e de encorajar o desenvolvimento do sector privado como alternativa viável, segura e de custo aceitável. ; Access to affordable essential medicines on a sustainable basis is one of the indicators of compliance with the Millennium Development Goals, and can be regarded as part of the human universal right to health. As with other basic commodities, access to medicines depends on multiple factors, like their availability, prices and affordability. Over the last decade, more than 50 surveys using a methodology developed by the World Health Organization and Health Action International have been carried out in low- and middle-income countries, to assess these parameters in an attempt to understand the causes underlying poor access to medicines. Findings typically reveal low availability of essential medicines, particularly in the public health system, and high prices, especially in the private forprofit sector. The objective of the present study was to describe the availability, prices and affordability of essential medicines in Timor-Leste using the WHO/HAI methodology. Data on the availability and prices of a drug tracer list was collected from a sample of hospitals, community health centres and private retail pharmacies. Although results seem to show a reasonable overall availability of generic medicines in the public sector (59.2%), some active substances and therapeutic classes were found to be consistently out of stock across the country. In facilities located in more remote areas, availability could be as low as 47.5%. Drug availability in private pharmacies was found to be even lower (38.0%). Medicines are dispensed free of charge in public health facilities, but in private pharmacies they were found to cost up to 40 times their international reference price, even as generics. As a result, it is estimated that a common government worker using diclofenac to treat chronic arthritis, for instance, would have to work 2.3 days to pay for his monthly treatment with the generic drug, or 12.5 days if the originator brand was prescribed. Other problems affecting medicines quality and safety were also detected throughout the study. Despite its limitations, the present study concluded that, contrarily to the general trend observed in similar countries, the public healthcare system in Timor-Leste seems to perform better than private. Nevertheless, the far from ideal conditions of most public health facilities can still push some patients to the private sector where costs of treatment are unacceptably high. The lack of regulation of the pharmaceutical sector (and inefficient monitoring/inspection of the existing one) seems to be contributing to the private sector's stagnation and indirectly encouraging lack of transparency in pharmacy practice. Given the paucity of studies on the subject in Timor-Leste, it is hoped that the present work will provide an important evidence base for subsequent studies, and government intervention to better regulate the pharmaceutical sector, with the ultimate objective to improve the public drug supply, and encourage the growth of the private sector as a viable, affordable and safe alternative.

New industries are recognized as new impetus to national wealth. At the same time, they are increasingly becoming geographically concentrated in some well defined areas. But current studies on the emergence of industrial clusters tend to analyze favorable driving factors. This dissertation takes the example of a Chinese endogenous industrial cluster, the traditional Chinese medicine (TCM) cluster at Tonghua, a small peripheral city in Northeastern China, to contribute to the theoretical understanding of the emergence of industrial cluster as a co-evolutionary process of organizations, institutions and firms, or, to put it more broadly, as economic evolution embedded in complex socio-economic contexts. The recent advance in evolutionary and co-evolutionary economics which considers the economy and economic landscape as dynamic process instead of equilibrium can be regarded as a part of broader and more intellectual turn of quest for history in social sciences. Although the principle of "history matters" is widely acknowledged, it tends to be reduced to a quite simple concept of "path dependence". However, path dependence cannot offer space for new path creation, except from an external shock. Accordingly, the role of human conscious action or Schumpeterian innovation should be added to path analysis through the concept of path creation. Furthermore, and more importantly, history should be understood as context, and historical context can be explored through the understanding of multi-paths and interaction among them over time. So path inter-dependence (co-evolution between paths) would be useful to better understand the complexity of real history. Since the industrial cluster is composed of interconnected firms and is also subject to changes in institution and technology, I will focus on the multi-way causal relationship between firm, institution and technology. The theorizing is not entirely new, but most of the theoretical and empirical discussions are at the national or industrial level, not regional or local one. A competitive cluster can be regarded as a co-evolutionary hotspot in which multiple populations actively interact and are interconnected. Co-evolution itself is a dynamic and evolutionary process. So I will adopt a dynamic and evolutionary view to examine co-evolutionary degree or co-evolutionary effects in the Tonghua pharmaceutical cluster through time. After a brief introduction which deals with the national institutional changes that are highly associated with new venture creation, entrepreneurship, and innovation, with registrations on drug and healthcare system, and with changes in market demand of China's pharmaceutical industry and geographical distribution, I will collect evidences from three aspects based upon field survey and second hand data, i.e., the history of the enterprises, the origin of entrepreneurship, and the knowledge of evolution, linking their respective generative relationships through the genealogical method. In this volume, the evolution of the Tonghua pharmaceutical firm organization, the formation of local entrepreneurship, historical accumulation of knowledge, and particular knowledge of transfer among generations of firms will be discussed, then I will probe into co-adaption and co-evolution between local formal and informal institutions and organizations in Tonghua's TCM industry. In addition, I will try to understand the co-evolutionary process at different geographical levels (namely, national and local). In summary, my main findings include the following several points. Firstly, in the course of the emergence of Tonghua's pharmaceutical industry, local social networks and the traditional alliance between enterprises and government have played important roles. Secondly, the most important factor that influences the evolution of endogenous industrial clusters such as the Tonghua pharmaceutical industry in transitional countries is not the change in technology, but the change in fundamental national institutions. Thirdly, the success of the Tonghua pharmaceutical industry can be ascribed to the creation of multiple paths largely based on initial conditions, which implies that economic policy should have historical consciousness, namely, new economic innovation should make full use of both historical legacies and existing assets. Finally, it is co-adaption and co-selection of firm organization, institution, and technology that have jointly made Tonghua's pharmaceutical industry become highly competitive, which means that whether one region can grasp new opportunities partially depends on its capabilities to coordinate a varity of development agents. ; Neue Industrien werden im Allgemeinen als Impuls der Entwicklung zu nationalem Wohlstand verstanden. Zugleich sind sie überwiegend an einigen geographisch genau definierten Orten konzentriert. Aktuelle Studien zur Emergenz dieser Industrie-Cluster neigen dazu, entsprechende begünstigende Faktoren zu analysieren. Mit dem Beispiel eines endogenen Clusters in China, dem Cluster der Traditionellen Chinesischen Medizin (TCM) in Tonghua, will diese Dissertation zum theoretischen Verständnis der Emergenz von Industrie-Clustern unter der Perspektive eines ko-evolutorischen Prozesses von Form der Organisation, Institutionen und Unternehmen beitragen. Oder, um es etwas breiter auszudrücken, diese Emergenz als ökonomische Evolution zu verstehen, die in einen komplexen sozio-ökonomischen Kontext eingebettet ist. Obgleich der Vorstellung, Geschichte habe eine Bedeutung ("history matters"), überwiegend in der Forschung zugestimmt wird, bleibt diese oft auf das Konzept der Pfadabhängigkeit beschränkt. Das aber eröffnet keinen Raum für die Betrachtung endogener Pfad-Bildung. Dem Konzept der Pfad-Bildung entsprechend sollte jedoch die Pfadanalyse ergänzt werden um bewusste Handlungen des Menschen oder auch um Innovationen im Schumpeterschen Sinn. Wichtiger ist außerdem, dass Geschichte als ein Kontext verstanden werden sollte, in dem mehrere Pfade ko-existieren und im Zeitverlauf auch interagieren. So wäre ein Konzept der Pfad-Interdependenz (oder der Ko-Evolution von Pfaden) nützlich zum besseren Verständnis der Komplexität "wirklicher" Geschichte. Weil das Industriecluster sich aus untereinander verflochtenen Unternehmen zusammen setzt und zugleich Gegenstand von Änderungen in den Institutionen und der Technologie ist, konzentriert sich die Dissertation auf vielseitige kausale Beziehungen von Unternehmen, Institutionen und Technologie. Ein wettbewerbsfähiges Cluster kann aus geographischer Sicht als ein "hot spot" der Ko-evolution betrachtet werden, in dem verschiedenartige Populationen aktiv untereinander agieren und daher miteinander verflochten sind. Ko-Evolution selbst ist dann ein dynamischer und evolutorischer Prozess. Die Arbeit wählt diese Perspektive, um das Maß und die Wirkungen der Ko-Evolution im Pharma-Cluster von Tonghua im Zeitverlauf zu analysieren. Die Dissertation fußt auf empirischen Erhebungen, ergänzt um eine Dokumenten-Analyse, zur Geschichte der Unternehmen, der Herkunft der Unternehmerschaft sowie der Evolution von Wissen. Sie diskutiert die Evolution in den Organisationsformen der Pharma-Unternehmen in Tonghua, die Bildung einer lokalen Unternehmerschaft, die historische Akkumulation von Wissen und den besonderen Wissenstransfer zwischen Generationen von Unternehmen. Schließlich untersucht sie die Ko-Adaption und Ko-Evolution von lokalen formalen und informellen Institutionen und Organisationen der TCM-Industrie in Tonghua. Die folgenden Punkte betreffen die wichtigsten Ergebnisse der Dissertation: Erstens haben sehr langfristige und dichte lokale soziale Netzwerke eine erhebliche Rolle im Lauf der Emergenz der Pharma-Industrie in Tonghua gespielt. Zweitens ist der wichtigste Faktor in der Pharma-Industrie nicht im technologischen Fortschritt durch Anstrengungen bei Forschung und Entwicklung (FuE) zu sehen, sondern im institutionellen Wandel sowohl auf nationaler als auch auf lokaler Ebene. Drittens kann der Erfolg der Pharma-Industrie in Tonghua der Bildung multipler Pfade zugeschrieben werden, die auf bestimmten Anfangsbedingungen gründen. Das bedeutet, dass die neue ökonomische Entwicklungspolitik sowohl das historische Erbe als auch bestehende Aktivposten in vollem Umfang nutzen sollte. Schließlich ist festzustellen, dass Ko-Adaption und Ko-Selektion der Unternehmens-Organisation, von Institutionen und Technologie zusammen die Pharma-Industrie von Tonghua in hohem Maße wettbewerbsfähig gemacht haben. Ob eine Region neue Gelegenheiten ergreifen kann, hängt folglich teilweise von ihrer Fähigkeit ab, eine Vielfalt von Entwicklungs-Agenten zu koordinieren.

ABSTRACT - The authors' main purpose is to present ideas on defining Health Law by highlighting the particularities of the field of Health Law as well as of the teaching of this legal branch, hoping to contribute to the maturity and academic recognition of Health Law, not only as a very rich legal field but also as a powerful social instrument in the fulfillment of fundamental human rights. The authors defend that Health Law has several characteristics that distinguish it from traditional branches of law such as its complexity and multidisciplinary nature. The study of Health Law normally covers issues such as access to care, health systems organization, patients' rights, health professionals' rights and duties, strict liability, healthcare contracts between institutions and professionals, medical data protection and confidentiality, informed consent and professional secrecy, crossing different legal fields including administrative, antitrust, constitutional, contract, corporate, criminal, environmental, food and drug, intellectual property, insurance, international and supranational, labor/employment, property, taxation, and tort law. This is one of the reasons why teaching Health Law presents a challenge to the teacher, which will have to find the programs, content and methods appropriate to the profile of recipients which are normally non jurists and the needs of a multidisciplinary curricula. By describing academic definitions of Health Law as analogous to Edgewood, a fiction house which has a different architectural style in each of its walls, the authors try to describe which elements should compose a more comprehensive definition. In this article Biolaw, Bioethics and Human Rights are defined as complements to a definition of Health Law: Biolaw because it is the legal field that treats the social consequences that arise from technological advances in health and life sciences; Bioethics which evolutions normally influence the shape of the legal framework of Health; and, finally Human Rights theory and declarations are outlined as having always been historically linked to medicine and health, being the umbrella that must cover all the issues raised in the area of Health Law. To complete this brief incursion on the definition on Health Law the authors end by giving note of the complex relations between this field of Law and Public Health. Dealing more specifically on laws adopted by governments to provide important health services and regulate industries and individual conduct that affect the health of the populations, this aspect of Health Law requires special attention to avoid an imbalance between public powers and individual freedoms. The authors conclude that public trust in any health system is essentially sustained by developing health structures which are consistent with essential fundamental rights, such as the universal right to access health care, and that the study of Health Law can contribute with important insights into both health structures and fundamental rights in order to foster a health system that respects the Rule of Law. --- RESUMO – O objectivo principal dos autores é apresentar ideias sobre a definição de Direito da Saúde, destacando as particularidades desta área do direito, bem como do ensino deste ramo jurídico, na esperança de contribuir para a maturidade e para o reconhecimento académico do mesmo, não só como um campo juridicamente muito rico, mas, também, como um poderoso instrumento social no cumprimento dos direitos humanos fundamentais. Os autores defendem que o Direito da Saúde tem diversas características que o distinguem dos ramos tradicionais do direito, como a sua complexidade e natureza multidisciplinar. O estudo do Direito da Saúde abrangendo normalmente questões como o acesso aos cuidados, a organização dos sistemas de saúde, os direitos e deveres dos doentes e dos profissionais de saúde, a responsabilidade civil, os contratos entre instituições de saúde e profissionais, a protecção e a confidencialidade de dados clínicos, o consentimento informado e o sigilo profissional, implica uma abordagem transversal de diferentes áreas legais, incluindo os Direitos contratual, administrativo, antitrust, constitucional, empresarial, penal, ambiental, alimentar, farmacêutico, da propriedade intelectual, dos seguros, internacional e supranacional, trabalho, fiscal e penal. Esta é uma das razões pelas quais o ensino do Direito da Saúde representa um desafio para o professor, que terá de encontrar os programas, conteúdos e métodos adequados ao perfil dos destinatários, que são normalmente não juristas e às necessidades de um currículo multidisciplinar. Ao descrever as várias definições académicas de Direito da Saúde como análogas a Edgewood, uma casa de ficção que apresenta um estilo arquitectónico diferente em cada uma de suas paredes, os autores tentam encontrar os elementos que deveriam compor uma definição mais abrangente. No artigo, Biodireito, Bioética e Direitos Humanos são descritos como complementos de uma definição de Direito da Saúde: o Biodireito, dado que é o campo jurídico que trata as consequências sociais que surgem dos avanços tecnológicos na área da saúde e das ciências da vida; a Bioética cujas evoluções influenciam normalmente o quadro jurídico da Saúde; e, por fim, a teoria dos Direitos Humanos e as suas declarações as quais têm estado sempre historicamente ligadas à medicina e à saúde, devendo funcionar como pano de fundo de todas as questões levantadas na área do Direito da Saúde. Para finalizar a sua breve incursão sobre a definição de Direito da Saúde, os autores dão ainda nota das complexas relações entre este último e a Saúde Pública, onde se tratam mais especificamente as leis aprovadas pelos governos para regular os serviços de saúde, as indústrias e as condutas individuais que afectam a saúde das populações, aspecto do Direito da Saúde que requer uma atenção especial para evitar um desequilíbrio entre os poderes públicos e as liberdades individuais. Os autores concluem afirmando que a confiança do público em qualquer sistema de saúde é, essencialmente, sustentada pelo desenvolvimento de estruturas de saúde que sejam consistentes com o direito constitucional da saúde, tais como o direito universal ao acesso a cuidados de saúde, e que o estudo do Direito da Saúde pode contribuir com elementos importantes para a realização de um sistema de saúde que respeite o Estado de Direito e os Direitos Fundamentais. ; publishersversion ; published

The National Aboriginal Community Controlled Health Organisation (NACCHO) welcomes the Rudd Governments commitment to build a better primary health care system for all Australians through the development of Australia's first National Primary Health Care Strategy. In this submission we provide an important Introduction which sets the context and the definitions that underpin the recommendations for a national primary health care strategy that can best close the gap in life expectancy and health outcomes for Aboriginal peoples. The National Aboriginal Community Controlled Health Organisation believes that the success of a primary health care system should be judged by how effectively, those who are most needy are able to access quality care. The matter is not just about access per se, but also about who is accessing the health system. A strategy that supports health service provision to those who are already good users of the health system will not make gains in health outcomes for Aboriginal peoples. Access to primary health care is identified as a core obligation under the International Covenant for Economic Social and Cultural Rights (ICESCR). Within this core obligation is the understanding that Indigenous peoples have a right to design, deliver and control health services for them in order to achieve health gains. To this end, Australian Governments and non-government institutions have supported Aboriginal primary health care through Aboriginal Community Controlled Health Services (ACCHSs). The Rudd Governments definition of partnership means involving: "Indigenous people in the design and delivery of programs locally and regionally, and share responsibility for outcomes… This strategy is firmly based on the principle of working in partnership with the Aboriginal and Torres Strait Islander community-controlled health sector." The primary health care delivered by Aboriginal community-controlled health services is culturally appropriate because they are: 'An incorporated Aboriginal organisation, initiated by a local Aboriginal community, based in a local Aboriginal community, governed by an Aboriginal body which is elected by the local Aboriginal community, delivering a holistic and culturally appropriate health service to the community which controls it Services that are not Aboriginal community-controlled, by definition, cannot deliver culturally appropriate primary health care. However, services that are not Aboriginal community-controlled can be encouraged to deliver healthcare that is culturally secure. A definition and program prepared by the ACCHS sector for the delivery of Aboriginal cultural safety training for mainstream health services should be supported. NACCHO wishes to impart the message that the Strategy affirm the critical role and impact that accessible and culturally appropriate primary health care can make to close the gap in Aboriginal health standards by 2018 (Rudd Governments Statement of Intent), and for the Strategy to support the required actions needed to realise that objective. In this regard, NACCHO provides numerous recommendations under each of the 10 elements of the Discussion Paper: Towards a National Primary Health Care Strategy. Principal of these recommendations is that ACCHSs are the preferred service model in the delivery of comprehensive primary health care to Aboriginal peoples across Australia. Unless ACCHSs are supported as the key providers in a strategy to close the gap, through an appropriately resourced Capacity Building Plan, the disparities in Aboriginal people's health status will not be alleviated. A systematic framework for working towards a primary health care system for Aboriginal peoples that maximises local community control (such as through a national plan aligned with the Northern Territory Aboriginal Health Forum 'Pathways to Community Control'1) should underwrite a 5 year Capacity Building Plan for ACCHSs. Resourcing pathways to community control for primary health care services will require pooling of all Aboriginal–specific primary health care funds currently being directed to State Governments, Divisions of General Practice and other private health care providers. This will maximize the potential of primary health care to close the gap in life expectancy for Aboriginal peoples. Such fund pooling should be governed by an appropriate mechanism, requiring the involvement of, and endorsement by, the NACCHO Aboriginal leadership. Capacity building will require capital and recurrent funding and workforce strategies to train, recruit and retain staff including measures to address the vast salary disparities which currently prevent staff recruitment within ACCHSs. It will require resourcing based on the model of the Primary Health Care Access Program (PHCAP). A systematic approach towards defining the core deliverables for Aboriginal primary health care services (ie what funding would buy with an acceptable per capita benchmark funding allocation) is needed. ACCHSs funding should be based on a weighted population basis, according to need. A resource allocation formula that reflects the actual cost of ACCHSs providing the agreed core services at particular locations must be agreed to by NACCHO and Affiliates. Progressing such a Plan will require a formalised partnership between the Department of Health and Ageing and the NACCHO leadership, particularly in the form of a new National Framework Agreement. The expert advisory group is encouraged to read the full evidence-based NACCHO submission, but in summary, we draw attention to the following core requirements in order to expand ACCHSs: 1. A long-term plan of action for the expansion of ACCHSs developed in partnership between the Department of Health and Ageing and NACCHO and Affiliates (see Element 1), which meets specified targets and is measured by the indicators identified at the National Indigenous Health Equality Summit (2008) (Element 5). 2. Joint governance of an expansion program based on a National Framework Agreement (see Element 3). 3. The plan to support the adoption of core functions for ACCHSs across Australia (see Elements 2 & 10). 4. A workforce support program (see Elements 2, 8 & 9). 5. An evidence-based, ethical and acceptable quality assurance and performance management program developed by ACCHSs and for ACCHSs (see Elements 5 &6) 6. A funding base for ACCHSs that utilises: • funding on a weighted population basis according to need • pooling of all Aboriginal-specific primary health care funds (including those to State Governments, Divisions of General Practice and other private providers). See Element 10.

Surveillance of work-related asthma in selected U.S. states using surveillance guidelines for state health departments : California, Massachusetts, Michigan, and New Jersey, 1993-1995: PROBLEM/CONDITION: Cases of work-related asthma (WRA) are sentinel health events that indicate the need for preventive intervention. WRA includes new-onset asthma caused by workplace exposure to sensitizers or irritants and preexisting asthma exacerbated by workplace exposures. REPORTING PERIOD: This report reviews cases of WRA identified by state health departments from January 1, 1993, through December 31, 1995, as well as follow-up investigations of cases and associated workplaces conducted through June 30, 1998. DESCRIPTION OF THE SYSTEMS: State-based surveillance and intervention programs for WRA are conducted in California, Massachusetts, Michigan, and New Jersey as part of the Sentinel Event Notification Systems for Occupational Risks (SENSOR) cooperative agreement program, initiated by CDC's National Institute for Occupational Safety and Health (NIOSH). RESULTS: From 1993 through 1995, a total of 1,101 cases of WRA were identified by SENSOR surveillance staff members in California, Massachusetts, Michigan, and New Jersey. Of these 1,101 cases, 19.1% were classified as work-aggravated asthma, and 80.9% were classified as new-onset asthma. Objective evidence substantiating asthma work-relatedness was documented in the medical records of 3.4% of WRA cases identified in the two states (Michigan and New Jersey) where medical records are routinely reviewed for this information. Indoor air pollutants, dusts, cleaning materials, lubricants (e.g., metalworking fluids), and diisocyanates were among the most frequently reported causes of WRA. In addition, a well-recognized cause of occupational asthma - natural rubber latex - was identified in a new setting, the healthcare industry. The most common industries associated with WRA cases included transportation equipment manufacturing (19.3%), health services (14.2%), and educational services (8.7%). Air sampling for agents known to induce occupational asthma was performed in Michigan for comparison with established federal time-weighted average exposure limits. Sixteen (13.4%) of 119 workplaces tested had airborne concentrations exceeding NIOSH recommended exposure limits (RELs); 11 (9.1%) of 121 workplaces had concentrations exceeding permissible exposure limits (PELs) of the Michigan Occupational Safety and Health Act (MIOSHA) program. INTERPRETATION: The surveillance data findings confirm well-recognized causes of asthma and have identified new putative causes (e.g., cleaning materials and metalworking fluids). Because the surveillance program depends on physicians' recognizing asthma work-relatedness and reporting diagnosed cases, the data are considered an underestimate of the magnitude of the WRA problem. The data also indicate that physicians are not commonly performing objective physiologic tests to substantiate a WRA diagnosis. Workplace findings suggest a need to evaluate existing exposure standards for specific agents known to induce occupational asthma (e.g., diisocyanates). Case-based surveillance can help improve the recognition, control, and prevention of WRA. The SENSOR model also provides a mechanism for workers and physicians to request workplace investigations aimed at primary prevention for other workers. PUBLIC HEALTH ACTION: NIOSH and state health department representatives are working to establish a long-term agenda for state-based surveillance of work-related conditions and hazards. The results from the SENSOR WRA programs described in this report support inclusion of WRA as a priority condition warranting surveillance at the state level ; State laws on tobacco control, United States, 1998: PROBLEM/CONDITION: State laws addressing tobacco use, the leading preventable cause of death in the United States, are summarized. Laws address smoke-free indoor air, minors' access to tobacco products, advertising of tobacco products, and excise taxes on tobacco products. REPORTING PERIOD COVERED: Legislation effective through December 31, 1998. DESCRIPTION OF SYSTEM: CDC identified laws addressing tobacco control by using an on-line legal research database. CDC's findings were verified with the National Cancer Institute's State Cancer Legislative Database. RESULTS: Since a previous surveillance summary on state tobacco-control laws published in November 1995 (covering legislation effective through June 30, 1995), several states have enacted new restrictions or strengthened existing legislation that addresses smoke-free indoor air, minors' access to tobacco, tobacco advertising, and tobacco taxes. Five states strengthened their smoke-free indoor air legislation. All states and Washington, D.C., continued to prohibit the sale and distribution of tobacco products to minors; however, 21 states expanded minors' access laws by designating enforcement authorities, adding license suspension or revocation for sale to minors, or requiring signage. Since the 1995 report, eight additional states (a total of 19 states and Washington, D.C.) now ban vending machines from areas accessible to minors. Thirteen states restrict advertising of tobacco products, an increase of four states since the 1995 report. Although the number of states that tax cigarettes and smokeless tobacco did not change, 13 states increased excise taxes on cigarettes, and five states increased excise taxes on smokeless tobacco products. The average state excise tax on cigarettes is 38.9 cents per pack, an increase of 7.4 cents compared with the average tax in the 1995 report. INTERPRETATION: State laws addressing tobacco control vary in relation to restrictiveness, enforcement and penalties, preemptions, and exceptions. ACTIONS TAKEN: The data summarizing state tobacco-control laws are available through CDC's State Tobacco Activities Tracking and Evaluation (STATE) System; the laws are collected and updated every quarter. The STATE System also contains state-specific data on the prevalence of tobacco use, tobacco-related deaths, and the costs of tobacco use. Information from the STATE System is available for use by policy makers at the state and local levels to plan and implement initiatives to prevent and reduce tobacco use. In addition, CDC is using this information to assess the ongoing impact of tobacco-control programs and policies on tobacco use. . ; Reports published in CDC Surveillance Summaries since January 1, 1988 -- Surveillance of work-related asthma in selected U.S. states using surveillance guidelines for state health departments : California, Massachusetts, Michigan, and New Jersey, 1993-1995 / Ruth Ann Romero Jajosky, et al. -- State laws on tobacco control, United States, 1998 / Julie A. Fishman, et al. ; June 25, 1999. ; Includes bibliographical references.

Tau phosphorylated at threonine 181 (p-tau181) measured in blood plasma has recently been proposed as an accessible, scalable, and highly specific biomarker for Alzheimer's disease. Longitudinal studies, however, investigating the temporal dynamics of this novel biomarker are lacking. It is therefore unclear when in the disease process plasma p-tau181 increases above physiological levels and how it relates to the spatiotemporal progression of Alzheimer's disease characteristic pathologies. We aimed to establish the natural time course of plasma p-tau181 across the sporadic Alzheimer's disease spectrum in comparison to those of established imaging and fluid-derived biomarkers of Alzheimer's disease. We examined longitudinal data from a large prospective cohort of elderly individuals enrolled in the Alzheimer's Disease Neuroimaging Initiative (ADNI) (n = 1067) covering a wide clinical spectrum from normal cognition to dementia, and with measures of plasma p-tau181 and an 18F-florbetapir amyloid-β PET scan at baseline. A subset of participants (n = 864) also had measures of amyloid-β1-42 and p-tau181 levels in CSF, and another subset (n = 298) had undergone an 18F-flortaucipir tau PET scan 6 years later. We performed brain-wide analyses to investigate the associations of plasma p-tau181 baseline levels and longitudinal change with progression of regional amyloid-β pathology and tau burden 6 years later, and estimated the time course of changes in plasma p-tau181 and other Alzheimer's disease biomarkers using a previously developed method for the construction of long-term biomarker temporal trajectories using shorter-term longitudinal data. Smoothing splines demonstrated that earliest plasma p-tau181 changes occurred even before amyloid-β markers reached abnormal levels, with greater rates of change correlating with increased amyloid-β pathology. Voxel-wise PET analyses yielded relatively weak, yet significant, associations of plasma p-tau181 with amyloid-β pathology in early accumulating brain regions in cognitively healthy individuals, while the strongest associations with amyloid-β were observed in late accumulating regions in patients with mild cognitive impairment. Cross-sectional and particularly longitudinal measures of plasma p-tau181 were associated with widespread cortical tau aggregation 6 years later, covering temporoparietal regions typical for neurofibrillary tangle distribution in Alzheimer's disease. Finally, we estimated that plasma p-tau181 reaches abnormal levels ∼6.5 and 5.7 years after CSF and PET measures of amyloid-β, respectively, following similar dynamics as CSF p-tau181. Our findings suggest that plasma p-tau181 increases are associated with the presence of widespread cortical amyloid-β pathology and with prospective Alzheimer's disease typical tau aggregation, providing clear implications for the use of this novel blood biomarker as a diagnostic and screening tool for Alzheimer's disease. ; M.J.G. is supported by the "Miguel Servet" program [CP19/00031] of the Spanish Instituto de Salud Carlos III (ISCIII-FEDER). T.K.K. holds a research fellowship from the Brightfocus Foundation (#A2020812F), and is further supported by the Swedish Alzheimer Foundation (Alzheimerfonden; #AF-930627), the Swedish Brain Foundation (Hjärnfonden; #FO2020-0240), the Swedish Dementia Foundation (Demensförbundet), the Agneta Prytz-Folkes & Gösta Folkes Foundation (#2020-00124), the Aina (Ann) Wallströms and Mary-Ann Sjöbloms Foundation, the Anna Lisa and Brother Björnsson's Foundation, Gamla Tjänarinnor, and the Gun and Bertil Stohnes Foundation. A.S. is supported by the Paulo Foundation and the Orion Research Foundation. M.S.C. received funding from the European Union's Horizon 2020 Research and Innovation Program under the Marie Sklodowska-Curie action grant agreement No 752310, and currently receives funding from Instituto de Salud Carlos III (PI19/00155) and from the Spanish Ministry of Science, Innovation and Universities (Juan de la Cierva Programme grant IJC2018-037478-I). H.Z. is a Wallenberg Scholar supported by grants from the Swedish Research Council (#2018-02532), the European Research Council (#681712), Swedish State Support for Clinical Research (#ALFGBG-720931), the Alzheimer Drug Discovery Foundation (ADDF), USA (#201809-2016862), and the UK Dementia Research Institute at UCL. K.B. is supported by the Swedish Research Council (#2017-00915), the Alzheimer Drug Discovery Foundation (ADDF), USA (#RDAPB-201809-2016615), the Swedish Alzheimer Foundation (#AF-742881), Hjärnfonden, Sweden (#FO2017-0243), the Swedish state under the agreement between the Swedish government and the County Councils, the ALF-agreement (#ALFGBG-715986), and European Union Joint Program for Neurodegenerative Disorders (JPND2019-466-236). M.S. is supported by the Knut and Alice Wallenberg Foundation (Wallenberg Centre for Molecular and Translational Medicine; KAW 2014.0363), the Swedish Research Council (#2017-02869), the Swedish state under the agreement between the Swedish government and the County Councils, the ALF-agreement (#ALFGBG-813971), and the Swedish Alzheimer Foundation (#AF-740191). Data collection and sharing for this project was funded by the Alzheimer's Disease Neuroimaging Initiative (ADNI) (National Institutes of Health Grant U01 AG024904) and DOD ADNI (Department of Defense award number W81XWH-12-2-0012). ADNI is funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, and through generous contributions from the following: AbbVie, Alzheimer's Association; Alzheimer's Drug Discovery Foundation; Araclon Biotech; BioClinica, Inc.; Biogen; Bristol-Myers Squibb Company; CereSpir, Inc.; Cogstate; Eisai Inc.; Elan Pharmaceuticals, Inc.; Eli Lilly and Company; EuroImmun; F. Hoffmann-La Roche Ltd and its affiliated company Genentech, Inc.; Fujirebio; GE Healthcare; IXICO Ltd.; Janssen Alzheimer Immunotherapy Research & Development, LLC.; Johnson & Johnson Pharmaceutical Research & Development LLC.; Lumosity; Lundbeck; Merck & Co., Inc.; Meso Scale Diagnostics, LLC.; NeuroRx Research; Neurotrack Technologies; Novartis Pharmaceuticals Corporation; Pfizer Inc.; Piramal Imaging; Servier; Takeda Pharmaceutical Company; and Transition Therapeutics. The Canadian Institutes of Health Research is providing funds to support ADNI clinical sites in Canada. Private sector contributions are facilitated by the Foundation for the National Institutes of Health (www.fnih.org). The grantee organization is the Northern California Institute for Research and Education, and the study is coordinated by the Alzheimer's Therapeutic Research Institute at the University of Southern California. ADNI data are disseminated by the Laboratory for Neuro Imaging at the University of Southern California.

NOTICIAS / NEWS ("Transfer", 2016) 1) CONGRESOS / CONFERENCES: 1. Languages & the Media – Agile Mediascapes: Personalising the Future, Hotel Radisson Blu, Berlín, 2-4 Nov. 2016 www.languages-media.com 2. Third Chinese Drama Translation Colloquium Newcastle University, UK, 28-19 Junio 2016. www.ncl.ac.uk/sml/about/events/item/drama-translation-colloquium 3. 16th Annual Portsmouth Translation Conference – Translation & Interpreting: Learning beyond the Comfort Zone, University of Portsmouth, UK, 5 Nov. 2016. www.port.ac.uk/translation/events/conference 4. 3rd International Conference on Non-Professional Interpreting & Translation (NPIT3) Zurich University of Applied Sciences, Suiza
5-7 Mayo 2016. www.zhaw.ch/linguistics/npit3 5. 3rd Postgraduate Symposium – Cultural Translation: In Theory and as Practice. University of Nottingham, UK, 18 Mayo 2016. Contact: uontranslation2016@gmail.com 6. 3rd Taboo Conference – Taboo Humo(u)r: Language, Culture, Society, and the Media, Universitat Pompeu Fabra (Barcelona) 20-21 Sep. 2016.
https://portal.upf.edu/web/taco 7. Postgraduate Conference on Translation and Multilingualism Lancaster University, UK, 22 Abril 2016. Contacto: c.baker@lancaster.ac.uk 8. Translation and Minority University of Ottawa (Canadá), 11-12 Nov. 2016. Contacto: rtana014@uottawa.ca 9. Translation as Communication, (Re-)narration and (Trans-)creation Università di Palermo (Italia), 10 Mayo 2016 www.unipa.it/dipartimenti/dipartimentoscienzeumanistiche/convegni/translation 10. From Legal Translation to Jurilinguistics: Interdisciplinary Approaches to the Study of Language and Law, Universidad Pablo de Olavide, Sevilla,
27-28 Oct. 2016. www.tinyurl.com/jurilinguistics 11. Third International Conference on Research into the Didactics of Translation. Universitat Autònoma de Barcelona, 7-8 Julio 2016 http://grupsderecerca.uab.cat/pacte/en/content/second-circular-1 12. EST Congress – Expanding the Boundaries or Strengthening the Bases: Should Translation Studies Explore Visual Representation? Aarhus University (Dinamarca), 15-17 Sep. 2016 http://bcom.au.dk/research/conferencesandlectures/est-congress-2016/panels/18-expanding-the-boundaries-or-strengthening-the-bases-should-translation-studies-explore-visual-representation/ 13. Tourism across Cultures: Accessibility in Tourist Communication Università di Salento, Lecce (Italia). 25-27 Feb. 2016 http://unisalento.wix.com/tourism 14. Translation and Interpreting Studies at the Crossroad: A Dialogue between Process-oriented and Sociological Approaches – The Fourth Durham Postgraduate Colloquium on Translation Studies Durham University, UK. 30 Abril – 1 Mayo 2016. www.dur.ac.uk/cim 15. Translation and Interpreting: Convergence, Contact, Interaction Università di Trieste (Italia), 26-28 Mayo 2016 http://transint2016.weebly.com 16. 7th International Symposium for Young Researchers in Translation, Interpreting, Intercultural Studies and East Asian Studies. Universitat Autònoma de Barcelona, 1 Julio 2016. http://pagines.uab.cat/simposi/en 17. Translation Education in a New Age The Chinese University of Hong Kong, Shenzhen, China 15-16 Abril 2016. Contact: Claire Zhou (clairezhou@cuhk.edu.cn) 18. Audiovisual Translation: Dubbing and Subtitling in the Central European Context, Constantine the Philosopher University, Nitra (Eslovaquia). 15-17 Junio 2016. https://avtnitraconference.wordpress.com 19. Cervantes, Shakespeare, and the Golden Age of Drama Madrid, 17-21 Oct. 2016 http://aedean.org/wp-content/uploads/Call-for-papers.pdf 20. 3rd International Conference Languaging Diversity – Language/s and Power. Università di Macerata (Italia), 3-5 Marzo 2016 http://studiumanistici.unimc.it/en/research/conferences/languaging-diversity 21. Congreso Internacional de Traducción Especializada (EnTRetextos) Universidad de Valencia, 27-29 Abril 2016 http://congresos.adeituv.es/entretextos 22. Translation & Quality 2016: Corpora & Quality Université Charles de Gaulle Lille 3 (Francia), 5 Feb. 2016 http://traduction2016.sciencesconf.org/?lang=en 23. New forms of feedback and assessment in translation and interpreting training and industry. 8th EST Congress – Translation Studies: Moving Boundaries, Aarhus University (Dinamarca), 15-17 Sep. 2016. www.bcom.au.dk/est2016 24. Intermedia 2016 – Conference on Audiovisual Translation University of Lodz (Polonia), 14-16 Abril 2016 http://intermedia.uni.lodz.pl 25. New Technologies and Translation Université d'Algiers (Argelia). 23-24 Feb. 2016 Contacto: newtech.trans.algiers@gmail.com 26. Circulation of Academic Thought - Rethinking Methods in the Study of Scientific Translation. 11 - 12 Dec. 2015, University of Graz (Austria).https://translationswissenschaft.uni-graz.at/de/itat/veranstaltungen/circulation-of-academic-thought 27. The 7th Asian Translation Traditions Conference Monash University, Malaysia Campus, 26-30 Sep. 2016. http://future.arts.monash.edu/asiantranslation7 28. "Translation policy: connecting concepts and writing history" 8th EST Congress – Translation Studies: Moving Boundaries Aarhus University (Dinamarca), 15-17 Sep. 2016 http://bcom.au.dk/research/conferencesandlectures/est-congress-2016/panels/13-translation-policy-connecting-concepts-and-writing-history 29. International Conference – Sound / Writing: On Homophonic Translation. Université de Paris (Francia), 17-19 Nov. 2016 www.fabula.org/actualites/sound-writing-on-homophonic-translationinternational-conference-paris-november-17-19-2016_71295.php 30. Third Hermeneutics and Translation Studies Symposium – Translational Hermeneutics as a Research Paradigm Technische Hochschule, Colonia (Alemania), 30 Junio-1 Julio 2016 www.phenhermcommresearch.de/index.php/conferences 31. II International Conference on Economic Financial and Institutional Translation. Université du Québec à Trois-Rivières (Canadá), 17-18 Agosto 2016. www.uqtr.ca/ICEBFIT 32. International Congress - liLETRAd 2016-Cátedra LILETRAD. Literature Languages Translation, Universidad de Sevilla, 6-8 Julio 2016. https://congresoliletrad.wordpress.com 33. Transmediations! Communication across Media Borders Linnæus University, Växjö (Suecia), 13–15 Oct. 2016 http://lnu.se/lnuc/linnaeus-university-centre-for-intermedial-and-multimodal-studies-/events/conferences/transmediations?l=en 34. Translation Education in a New Age, 15-16 Abril 2016. School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen. Contacto: chansinwai@cuhk.edu.cn 35. Translation and Time: Exploring the Temporal Dimension of Cross-cultural Transfer, 8-10 Diciembre 2016. Departamento de Traducción, The Chinese University of Hong Kong. Contacto: translation-and-time@cuhk.edu.hk. 36. Du jeu dans la langue. Traduire les jeux de mots / Loose in Translation. Translating Wordplay, 23-24 Marzo 2017, Université de Lille (France) https://www.univ-lille3.fr/recherche/actualites/agenda-de-la-recherche/?type=1&id=1271. Contacto: traduirejdm@univ-lille3.fr, julie.charles@univ-lille3.fr 37. Translation and Translanguaging across Disciplines. EST Congress 2016 "Translation Studies: Moving Boundaries", European Society for Translation Studies, Aarhus (Dinamarca), 15-17 Sep. 2016 http://bcom.au.dk/research/conferencesandlectures/est-congress-2016/panels/12-translation-and-translanguaging-across-disciplines/ Contacto: nune.ayvazyan@urv.cat; mariagd@blanquerna.url.edu; sara.laviosa@uniba.it http://bcom.au.dk/research/conferencesandlectures/est-congress-2016/submission/ 38. Beyond linguistic plurality: The trajectories of multilingualism in Translation. An international conference organized jointly by Bogaziçi University, Department of Translation and Interpreting Studies, and Research Group on Translation and Transcultural Contact, York University, Bogaziçi University, 1-12 Mayo 2016. Contacto: sehnaz.tahir@boun.edu.tr, MGuzman@glendon.yorku.ca 39. "Professional and Academic Discourse: an interdisciplinary perspective". XXXIV IConferencia Internacional de la Sociedad Española de Lingüística Aplicada (AESLA), 14-16 Abril 2016. Interuniversity Institute for Applied Modern Languages (IULMA) / Universidad de Alicante. http://web.ua.es/aesla2016. Contacto: antonia.montes@ua.es. 2) CURSOS, SEMINARIOS, POSGRADOS / COURSES, SEMINARS, MASTERS: 1. Seminario: Breaking News for French>English and English>French Translators King's College Cambridge, UK, 8-10 Agosto 2016 Contacto: translateincambridge@iti.org.uk 2. Curso on-line: Setting Up as a Freelance Translator Enero – Marzo 2016. Institute of Translation & Interpreting, UK https://gallery.mailchimp.com/58e5d23248ce9f10c161ba86d/files/Application_Form_SUFT_2016.pdf?utm_source=SUFT+December+Emailer&utm_campaign=11fdfe0453-Setting_Up_as_a_Freelance_Translator12_7_2015&utm_medium=email&utm_term=0_6ef4829e50-11fdfe0453-25128325 3. Curso: Using Interpreters for Intercultural Communication and Other Purposes (COM397CE) http://darkallyredesign.com/what-we-do/using-interpreters-for-intercultural-communication 4. Workshop: How to Write and Publish Your Scholarly Paper In cooperation with the European Association of Science Editors (EASE) New Bulgarian University, Sofia (Bulgaria), 21-23 Marzo 2016 www.facebook.com/events/1511610889167645 http://esnbu.org/data/files/resources/ease-nbu-seminar-march-2016-fees.pdf 5. Posgrado: II Postgraduate Course on Spanish Law Taught in English "Global study". Universidad Internacional de Andalucía / Colegio de Abogados de Málaga. www.unia.es/cursos/guias/4431_english.pdf 3) CURSOS DE VERANO / SUMMER COURSES: 1. STRIDON – Translation Studies Doctoral and Teacher Training Summer School, Piran (Eslovenia), 27 Junio – 8 Julio 2016 www.prevajalstvo.net/doctoral-summer-school 2. Training in Translation Pedagogy Program School of Translation and Interpretation, University of Ottawa (Canadá), 4-29 Julio 2016. https://arts.uottawa.ca/translation/summer-programs 3. 2016 Nida School of Translation Studies. Translation, Ecology and Entanglement, San Pellegrino University Foundation, Misano Adriatico, Rimini (Italia), 30 Mayo – 10 Junio 2016. http://nsts.fusp.it/Nida-Schools/NSTS-2016 4. TTPP - Intensive Summer Program in Translation Pedagogy University of Ottawa (Canadá), 4-29 Julio 2016. http://arts.uottawa.ca/translation/summer-programs-2016/ttpp 5. CETRA Summer School 2016. 28th Research Summer School University of Leuven, campus Antwerp (Bélgica), 22 Agosto – 2 Sep. 2016. Contacto: cetra@kuleuven.be. http://www.arts.kuleuven.be/cetra 4) LIBROS / BOOKS: 1. Varela Salinas, María-José & Bernd Meyer (eds.) 2016. Translating and Interpreting Healthcare Discourses / Traducir e interpretar en el ámbito sanitario. Berlín : Frank & Timme. www.frank-timme.de/verlag/verlagsprogramm/buch/verlagsprogramm/bd-79-maria-jose-varela-salinasbernd-meyer-eds-translating-and-interpreting-healthcare-disc/backPID/transued-arbeiten-zur-theorie-und-praxis-des-uebersetzens-und-dolmetschens-1.html 2. Ordóñez López, Pilar and José Antonio Sabio Pinilla (ed.) 2015. Historiografía de la traducción en el espacio ibérico. Textos contemporáneos. Madrid: Ediciones de Castilla-La Mancha. www.unebook.es/libro/historiografia-de-latraduccion-en-el-espacio-iberico_50162 3. Bartoll, Eduard. 2015. Introducción a la traducción audiovisual. Barcelona: Editorial UOC. www.editorialuoc.cat/introduccion-a-la-traduccion-audiovisual 4. Rica Peromingo, Juan Pedro & Jorge Braga Riera. 2015. Herramientas y técnicas para la traducción inglés-español. Madrid: Babélica. www.escolarymayo.com/libro.php?libro=7004107&menu=7001002&submenu=7002029 5. Le Disez, Jean-Yves. 2015. F.A.C.T. Une méthode pour traduire de l'anglais au français. París: Ellipses. www.editions-ellipses.fr/product_info.php?cPath=386&products_id=10601 6. Baker, Mona (ed.) 2015. Translating Dissent: Voices from and with the Egyptian Revolution. Londres: Routledge. www.tandf.net/books/details/9781138929876 7. Gallego Hernández, Daniel (ed.) 2015. Current Approaches to Business and Institutional Translation / Enfoques actuales en traducción económica e institucional. Berna: Peter Lang. www.peterlang.com/download/datasheet/86140/datasheet_431656.pdf 8. Vasilakakos, Mary. 2015. A Training Handbook for Health and Medical Interpreters in Australia. www.interpreterrevalidationtraining.com/books-and-resources.html 9. Jankowska, Anna & Agnieszka Szarkowska (eds) 2015. New Points of View on Audiovisual Translation and Media Accessibility. Oxford: Peter Lang. www.peterlang.com/index.cfm?event=cmp.ccc.seitenstruktur.detailseiten&seitentyp=produkt&pk=83114 10. Baer, Brian James (2015). Translation and the Making of Modern Russian Literature, Londres: Bloomsbury. Translation and the Making of Modern Russian Literature is the inaugural book in a new Translation Studies series: Bloomsbury's "Literatures, Cultures, Translation." 11. Camps, Assumpta. 2016. La traducción en la creación del canon poético (Recepción de la poesía italiana en el ámbito hispánico en la primera mitad del siglo XX). Berna: Peter Lang. 5) REVISTAS / JOURNALS: 1. JoSTrans, The Journal of Specialised Translation, nº especial sobre Translation & the Profession, Vol. 25, Enero 2016. www.jostrans.org 2. Translation and Interpreting – Nº especial sobre Community Interpreting: Mapping the Present for the Future www.trans-int.org/index.php/transint. 3. inTRAlinea – Nº especial sobre New Insights into Specialised Translation. www.intralinea.org/specials/new_insights 4. Linguistica Antverpiensia NS-Themes in Translation Studies, 2015 issue, Towards a Genetics of Translation. https://lans-tts.uantwerpen.be/index.php/LANS-TTS/issue/view/16 5. Quaderns de Filologia, Nº especial sobre Traducción y Censura: Nuevas Perspectivas, Vol. 20, 2015. https://ojs.uv.es/index.php/qdfed/issue/view/577 6. The Translator – Nº especial sobre Food and Translation, Translation and Food, 2015, 21(3). www.tandfonline.com/eprint/ryqJewJUDKZ6m2YM4IaR/full 7. Current Trends in Translation Teaching and Learning E, 2015, 2 www.cttl.org/cttl-e-2015.html 8. Dragoman Journal of Translation Studies. www.dragoman-journal.org 9. Current Trends in Translation Teaching and Learning E. Edición especial sobre Translation Studies Curricula Across Countries and Cultures. www.cttl.org 10. International Journal of the Sociology of Language, Nº especial sobre Translation Policies and Minority Languages: Theory, Methods and Case Studies http://fouces.webs.uvigo.es/CallForPapersIJSLTranslationPolicies.pdf 11. Nº especial de The Interpreter and Translator Trainer 11(2) – Employability and the Translation Curriculum www.tandfonline.com/doi/full/10.1080/1750399X.2015.1103092 12. InTRAlinea. Nº especial sobre Building Bridges between Film Studies and Translation Studies www.intralinea.org/news/item/cfp_building_bridges_between_film_studies_and_translation_studies 13. Nº especial de TranscUlturAl: Comics, BD & Manga in translation/en traduction https://ejournals.library.ualberta.ca/index.php/TC/announcement/view/290 14. The Journal of Translation Studies 2015, 16(4) Nº especial sobre Translator and Interpreter Training in East Asia Contacto: Won Jun Nam: wjnam@hufs.ac.kr, wonjun_nam@daum.net 15. TRANS Revista de Traductología, 19(2), 2015. www.trans.uma.es/trans_19.2.html 16. Between, 9, 2015 – Censura e auto-censura http://ojs.unica.it/index.php/between/index 17. Translation Studies, Nº especial sobre Translingualism & Transculturality in Russian Contexts of Translation http://explore.tandfonline.com/cfp/ah/rtrs-cfp3 18. Translation & Interpreting, 7:3, 2016 www.trans-int.org/index.php/transint/issue/view/38 19. "The translation profession: Centres and peripheries" The Journal of Specialised Translation (Jostrans), Nº. 25, Enero 2016. The Journal of Translation Studies is a joint publication of the Department of Translation of The Chinese University of Hong Kong and the Chinese University Press. Contact: jts.tra@cuhk.edu.hk, james@arts.cuhk.edu.hk 19. Nuevo artículo: "The Invisibility of the African Interpreter" por Jeanne Garane, Translation: a transdisciplinary journal http://translation.fusp.it/. Contact: siri.nergaard@gmail.com.

Conventional wisdom would have it that presidential elections are not decided on foreign policy, and that Black Americans, like the majority of the American population, vote primarily on domestic issues.Both statements are partially true. However, based on a recent survey conducted by the Carnegie Endowment's American Statecraft Program, African Americans do not vote primarily on foreign policy, but they are paying attention to how candidates describe the US's role in the world. In other words, foreign policy may not be the deciding factor for how the masses of Black Americans vote in 2024, but it stands to have an impact on voter enthusiasm and turnout.The Carnegie Endowment survey, comprised of a representative sample of Black Americans, revealed that economy and jobs registered as the most important issue with 29 % of respondents selecting that option. This finding tracks with a recent polling that found that the majority of Americans view the economy as the most important issue facing the country. Considering that increased inflation and the overall cost of living has placed hardships on many American families, this shouldn't come as a surprise..Our survey contained three options related to foreign policy: National Security, Immigration (which some argue cuts across international and domestic politics), and US foreign policy/role of the U.S .in the world. None of these choices cracked double digits. National Security received 5% of the vote, followed by immigration at 3%, rounded out by the U.S.'s role in the world at 2%. Despite these findings, evidence shows that Black Americans can see the importance of global developments, even when facing domestic issues. Respondents were asked if a President's foreign policy agenda matters to them when they vote. Interestingly, four in ten (39%) respondents said that it is "very important" and a plurality (44%) reported that it is "somewhat important." Across party lines, 43% of both Black Democrats (who comprised 70% of the sample) and Black Republicans reported that a president's foreign policy agenda mattered a great deal when they vote.Education attainment proved salient here, with 59% of African Americans with a postgraduate degree reporting that a president's foreign policy platform was "very important" when voting compared to 39% of all Black respondents who felt the same way. The same held true for respondents' familiarity with foreign policy issues. Forty five percent of Black Americans with postgraduate education reported being "very familiar" with foreign policy matters compared to 25% of all Black respondents that reported similarly.It should be noted, regardless of political affiliation, two of the top three most important issues to African American voters — economy and healthcare — have an international component. For instance, jobs and economic growth are impacted by trade agreements and foreign supply lines, and the response to the COVID-19 pandemic (which disproportionally impacted communities of color) required significant international cooperation. Even for foreign policy topics that did not rank high for respondents, such as immigration and National Security, there is evidence that these issues will weigh heavily on the minds of some Black voters. Take for example, the crisis at the southern border. While few African Americans see migrants as a critical threat (only 29% of African Americans see immigrants and refugees as a critical threat compared to 44% of White Americans), some African American communities may view the accommodation of migrants into historically underserved neighborhoods as reason to be concerned with Biden's handling of illegal immigration and border security.For instance, as the city of Chicago plans to turn a community center in the predominantly Black northwest neighborhood of Galewood into a migrant housing facility, Chicago CBS reported that many Black residents feel their already scarce community resources are being allocated elsewhere. One resident stated "the thing that we're most concerned about is our children, our Black children, the football, the soccer, and all the things that they do… and now they're going to take this part beautiful part and give it to migrants."On the topic of national security and US military intervention, only two in ten (20%) Black Americans are supportive of possibly sending troops to assist Ukraine or help Taiwan defend itself from a hypothetical Chinese invasion. This, of course, is partly due to the community's perennial concern with the material and human costs associated with major war. Moreover, research conducted by the Chicago Council for International Affairs reveals that 46% of Black Americans feel the US should urge Ukraine to settle for peace as soon as possible so that the costs aren't so great for American households, compared to 38% of the American public that feel the same way. According to the numbers, Black Americans are supportive of assistance to Ukraine, but many are cautious that an incipient forever war would potentially require imbalanced human and material costs from the community, or even draw attention and resources from domestic challenges. Perhaps it will prove beneficial if messaging around support for Ukraine for "as long as it takes" is coupled with a peace plan or pathways towards de-escalation.On collective action issues such as climate change, a majority of African Americans (54 %) believe the US should take the lead in combating the issue, at an even higher rate than White Americans (42 %). With concerns regarding Black voter enthusiasm and turnout in the 2024 presidential election, it might be beneficial for candidates addressing Black voters to tie together how mutual cooperation on shared global challenges will impact the economic wellbeing of the Black community. One potential solution to solving the disconnect between Black voters and the foreign policy establishment lies in connecting with Black American civil society. The same manner in which Vice President Kamala Harris tapped into the Black sorority network (which serve as some of the Black community's oldest advocacy organizations) to galvanize the Black vote, it can prove beneficial for political parties to connect with historically Black fraternities and sororities and explicate how foreign policy translates into domestic wellbeing for the Black American community. Much more in terms of foreign policy messaging will be required, of course, but it is a first step.What is clear is that solely using messaging that addresses Black American domestic concerns without addressing America's role in the world will leave many Black voters feeling they are getting more of the same.

Psychotic disorders like schizophrenia have a typical onset in early adulthood with symptoms of hallucinations and disturbances of thought. Despite knowledge on what constitutes effective schizophrenia care, more than 70% of treatment attempts fail in Sweden, sometimes leading to early death. An appraisal of schizophrenia care shows a lack of ways to jointly plan and evaluate care, and an absence of a trustworthy theory-of-change. The Learning Health System (LHS) is a vision that has been translated into theories and models associated with improved outcomes for patients with other chronic conditions. The aim of this thesis is to enhance the understanding of the applicability of the LHS vision in the context of schizophrenia care, from the perspectives of both individuals and the health system in enabling coproduction of better health by addressing two research questions: i) How can improvement of health for individuals with schizophrenia and improvement of system performance be supported by coproduction in an LHS model? ii) Can an LHS-based intervention, i.e. the use of a point of care dashboard, contribute to better health for individuals with schizophrenia? Studying the existing published knowledge of LHS show that the concept has not yet been applied in mental healthcare settings but has potential to increase patient coproduction, continuous improvement and better health. Different forms of coproduction are supported in the most comprehensive LHS models and applications, ranging from dashboards at point of care to platforms that can help facilitate improvement initiatives. A case study, focused on studying the use and usefulness of a point-of-care dashboard at patient visits in outpatient care at the Department of Schizophrenia Spectrum Disorders at Sahlgrenska University Hospital in western Sweden. Use of the dashboard is associated with improved communication and health for patients. Assessment of the dashboard-project's complexity using the Non-adoption, abandonment, scale-up, spread and sustainability complexity assessment tool (NASSS-CAT) was perceived as helpful in evaluating challenges and provided insight that can guide future development. An LHS model, that builds on both the reviewing of the literature and practical testing, is proposed. Further research is proposed in two areas, exploration of how dashboard initiatives can support coproduction and better health for individuals with complex chronic conditions and further development of LHS models by studying different LHS initiatives regarding system properties, forms of coproduction at play and effects on health outcomes for individuals and populations. ; Schizofreni och liknande psykossjukdomar debuterar vanligtvis i ung vuxen ålder med symtom som vanföreställningar och tankestörningar, vilket bidrar till svårigheter av många slag, t ex att etablera och upprätthålla relationer. Dessa tillstånd har omfattande påverkan på individers hälsa och välbefinnande, och genererar stora samhällskostnader. Trots att det finns kunskap om vad som utgör effektiva behandlingar så avbryts över 70% av behandlingsförsök i förtid i Sverige, vilket ibland leder till för tidig död. En kartläggning av psykos- och schizofrenivård i några regioner visar på svårigheter för både patienter och behandlare att systematiskt navigera mot bättre hälsa för individer. Detta beror dels på bristande sätt att gemensamt planera och utvärdera vård, och på avsaknad av en trovärdig teori om hur förändring kan drivas. Visionen om det lärande hälsosystemet (eng. Learning Health System, LHS) har omsatts till teorier och modeller som använts för att systematiskt förbättra hälsoutfall för patienter med andra kroniska tillstånd. Syftet med denna avhandling är att öka förståelsen för LHS och dess användbarhet inom schizofreni- och psykosvård i samskapandet av bättre hälsa, både ifrån patientens och hälso- och sjukvårdssystemets perspektiv. Detta syfte adresseras genom två forskningsfrågor: i) Hur kan förbättring av hälsa för individer med schizofreni och förbättring av systemets funktion stödjas genom samskapande (eng. coproduction) i en LHS modell? ii) Kan en LHS-baserad intervention, användningen av en digital patientöversikt under vårdbesök, bidra till bättre hälsa för individer med schizofreni? Två processer med olika forskningsdesign har använts. Den första processen har fokuserat på att samla, kartlägga, diskutera och utvärdera tillgänglig forskningslitteratur om LHS funktionalitet och karaktäristika genom att använda olika metoder för litteraturgenomgång. I den andra processen tillämpas fallstudiemetodik, grundat på den första processen, fast med fokus på att utvärdera lokal utveckling och testning inom psykosvård på Sahlgrenska universitetssjukhuset i Göteborg, av nya arbetssätt som bygger på idéer om LHS. Detta gjordes genom att studera användning och nytta aven patientöversikt för schizofreni utformad för att användas av patienter och behandlare under vårdbesök inom öppenvård. Litteraturgenomgången visar att LHS idéer ännu inte tillämpats inom psykiatrisk vård, men att det finns potential att öka samskapande, kontinuerliga förbättringar och stödja bättre hälsa. Olika former av samskapande stöds i de mest kompletta LHS modellerna och dess tillämpningar i praktiken. De stödjer mobilisering av intressenters resurser och engagemang i strävan mot ett gemensamt mål, med stöd av teknologier, allt från patientöversikter till stöd under besök till sociala-medie-liknande plattformar som kan stödja kommunikation, utbyte av material och gemensamma förbättringsinitiativ. Fallstudien visade positiva resultat associerade till förbättrad kommunikation och hälsa för individer i psykosvård, när de använde patientöversikten under besök i vården. Kartläggning av patientöversiktsprojektets komplexitet med verktyget NASSS-CAT (the Non-adoption, Abandonment, Scale-up, Spread and Sustainability-Complexity Assessment Tool) uppfattades som användbart för att förstå och utvärdera utmaningar och bidrog till insikter som stödjer den fortsatt utvecklingen. Utifrån avhandlingens delarbeten föreslås en modell som grund för fortsatt utveckling av ett LHS för psykiatri. LHS egenskaper som kan guida fortsatt utveckling har identifierats genom arbetet med denna avhandling: i) identifiera systemet som ett komplext adaptivt system, ii) stödja samskapande mellan aktörer, iii) använda stödjande teknik, iv) för att möjliggöra fullständiga lärcykler, v) och använda utfallsmått för att guida förbättringar. Identifierade svårigheter, såväl i litteraturen som i empiriska studier, i att omsätta LHS-idéer, beror sannolikt på olika syn på kunskap, och om komplexitet adresseras eller inte. Framtida forskning föreslås inom två områden. För det första, fortsatt utforskande av olika patientöversiktsinitiativ för att undersöka vilka egenskaper, funktioner och former för samarbete som stödjer samskapande av bättre hälsa för individer med komplexa kroniska tillstånd. För det andra, teorier och modeller över hur förändring kan drivas blir aldrig färdiga utan kan kontinuerligt utvecklas. En LHS-modell, som den som föreslås i denna avhandling, kan användas och fortsätta utvecklas genom att studera olika LHS-initiativ när det gäller systemegenskaper, olika former av samskapande och effekter på hälsoutfall för individer och populationer.

Alzheimer's Disease Neuroimaging Initiative. ; [Importance] Plasma phosphorylated tau at threonine 181 (p-tau181) has been proposed as an easily accessible biomarker for the detection of Alzheimer disease (AD) pathology, but its ability to monitor disease progression in AD remains unclear. ; [Objective] To study the potential of longitudinal plasma p-tau181 measures for assessing neurodegeneration progression and cognitive decline in AD in comparison to plasma neurofilament light chain (NfL), a disease-nonspecific marker of neuronal injury. ; [Design, Setting, and Participants] This longitudinal cohort study included data from the Alzheimer's Disease Neuroimaging Initiative from February 1, 2007, to June 6, 2016. Follow-up blood sampling was performed for up to 8 years. Plasma p-tau181 measurements were performed in 2020. This was a multicentric observational study of 1113 participants, including cognitively unimpaired participants as well as patients with cognitive impairment (mild cognitive impairment and AD dementia). Participants were eligible for inclusion if they had available plasma p-tau181 and NfL measurements and at least 1 fluorine-18–labeled fluorodeoxyglucose (FDG) positron emission tomography (PET) or structural magnetic resonance imaging scan performed at the same study visit. Exclusion criteria included any significant neurologic disorder other than suspected AD; presence of infection, infarction, or multiple lacunes as detected by magnetic resonance imaging; and any significant systemic condition that could lead to difficulty complying with the protocol. ; [Exposures] Plasma p-tau181 and NfL measured with single-molecule array technology. ; [Main Outcomes and Measures] Longitudinal imaging markers of neurodegeneration (FDG PET and structural magnetic resonance imaging) and cognitive test scores (Preclinical Alzheimer Cognitive Composite and Alzheimer Disease Assessment Scale–Cognitive Subscale with 13 tasks). Data were analyzed from June 20 to August 15, 2020. ; [Results] Of the 1113 participants (mean [SD] age, 74.0 [7.6] years; 600 men [53.9%]; 992 non-Hispanic White participants [89.1%]), a total of 378 individuals (34.0%) were cognitively unimpaired (CU) and 735 participants (66.0%) were cognitively impaired (CImp). Of the CImp group, 537 (73.1%) had mild cognitive impairment, and 198 (26.9%) had AD dementia. Longitudinal changes of plasma p-tau181 were associated with cognitive decline (CU: r = –0.24, P < .001; CImp: r = 0.34, P < .001) and a prospective decrease in glucose metabolism (CU: r = –0.05, P = .48; CImp: r = –0.27, P < .001) and gray matter volume (CU: r = –0.19, P < .001; CImp: r = –0.31, P < .001) in highly AD-characteristic brain regions. These associations were restricted to amyloid-β–positive individuals. Both plasma p-tau181 and NfL were independently associated with cognition and neurodegeneration in brain regions typically affected in AD. However, NfL was also associated with neurodegeneration in brain regions exceeding this AD-typical spatial pattern in amyloid-β–negative participants. Mediation analyses found that approximately 25% to 45% of plasma p-tau181 outcomes on cognition measures were mediated by the neuroimaging-derived markers of neurodegeneration, suggesting links between plasma p-tau181 and cognition independent of these measures. ; [Conclusions and Relevance] Study findings suggest that plasma p-tau181 was an accessible and scalable marker for predicting and monitoring neurodegeneration and cognitive decline and was, unlike plasma NfL, AD specific. The study findings suggest implications for the use of plasma biomarkers as measures to monitor AD progression in clinical practice and treatment trials. ; This work was supported by the "Miguel Servet" program grant CP19/00031 of the Spanish Instituto de Salud Carlos III (Dr Grothe); research fellowship A202f0812F from the Brightfocus Foundation, grant AF-930627 from the Swedish Alzheimer Foundation, grant FO2020-0240 from the Swedish Brain Foundation, grant 2020-00124 from the Agneta Prytz-Folkes & Gösta Folkes Foundation, and support from the Swedish Dementia Foundation, the Aina (Ann) Wallströms and Mary-Ann Sjöbloms Foundation, the Anna Lisa and Brother Björnsson's Foundation, Gamla Tjänarinnor, and the Gun and Bertil Stohnes Foundation (Dr Karikari); the Paulo Foundation and the Orion Research Foundation (Dr Snellman); grant 752310 from the European Union's Horizon 2020 Research and Innovation Program under the Marie Skłodowska-Curie action grant agreement, grant PI19/00155 from the Instituto de Salud Carlos III, and grant IJC2018-037478-I from the Spanish Ministry of Science, Innovation and Universities (Juan de la Cierva Programme) (Dr Suárez-Calvet); grant 2018-02532 from the Swedish Research Council, 681712 from the European Research Council, ALFGBG-720931 from the Swedish State Support for Clinical Research, 201809-2016862 from the Alzheimer Drug Discovery Foundation USA, and the UK Dementia Research Institute at University College London (Dr Zetterberg); grant 2017-00915 from the Swedish Research Council, RDAPB-201809-2016615 from the Alzheimer Drug Discovery Foundation USA, AF-742881 from the Swedish Alzheimer Foundation, FO2017-0243 from Hjärnfonden, Sweden, the Swedish state under the agreement between the Swedish government and the County Councils, ALFGBG-715986 from the ALF-agreement, and JPND2019-466-236 from the European Union Joint Program for Neurodegenerative Disorders (Dr Blennow); KAW 2014.0363 from the Knut and Alice Wallenberg Foundation (Wallenberg Centre for Molecular and Translational Medicine, 2017-02869 from the Swedish Research Council, ALFGBG-813971 from the Swedish state under the agreement between the Swedish government and the County Councils, the ALF-agreement, and AF-740191 from the Swedish Alzheimer Foundation (Dr. Schöll). Data collection and sharing for this project was funded by the Alzheimer's Disease Neuroimaging Initiative (ADNI) (grant AG024904) and Department of Defense ADNI (grant W81XWH-12-2-0012). ADNI is funded by the National Institute on Aging, the National Institute of Biomedical Imaging and Bioengineering, and through generous contributions from the following: AbbVie, Alzheimer's Association; Alzheimer's Drug Discovery Foundation; Araclon Biotech; BioClinica, Inc; Biogen; Bristol-Myers Squibb Company; CereSpir, Inc; Cogstate; Eisai Inc; Elan Pharmaceuticals, Inc; Eli Lilly and Company; EuroImmun; F. Hoffmann-La Roche Ltd and its affiliated company Genentech, Inc; Fujirebio; GE Healthcare; IXICO Ltd; Janssen Alzheimer Immunotherapy Research & Development, LLC; Johnson & Johnson Pharmaceutical Research & Development LLC; Lumosity; Lundbeck; Merck & Co, Inc; Meso Scale Diagnostics, LLC; NeuroRx Research; Neurotrack Technologies; Novartis Pharmaceuticals Corporation; Pfizer Inc; Piramal Imaging; Servier; Takeda Pharmaceutical Company; and Transition Therapeutics. The Canadian Institutes of Health Research is providing funds to support ADNI clinical sites in Canada. Private sector contributions are facilitated by the Foundation for the National Institutes of Health (www.fnih.org). The grantee organization is the Northern California Institute for Research and Education, and the study is coordinated by the Alzheimer's Therapeutic Research Institute at the University of Southern California. ; Peer reviewed