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nd financial support for trainings, statistically significant increases in LARC uptake occurred at only 2 of the 8 health centers; indicating the influence of weak health systems, poor quality of voluntary FP services and a ceiling effect. Scale-up processes must consider potential bottlenecks of weak health systems and availability of financial resources by addressing these as crucial elements in any systematic scale-up framework. © 2020 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http//creativecommons.org/ licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.China's estimated 114 million people with diabetes pose a massive challenge for China's health policy-makers who have significantly extended health insurance coverage over the past decade. What China is doing now, what it has achieved, and what remains to be done should be of interest to health policy-makers, worldwide. We identify the challenges posed by China's two principal strategies to tackle diabetes (1) A short-term pilot strategy of health promotion, detection and control of chronic diseases in 265 national demonstration areas (NDAs); and (2) A long-term strategy to extend health promotion and strengthen primary care capacity and health system integration throughout China. selleck products Finally, we consider how Chinese innovations in artificial intelligence (AI) and Big Data may contribute to improving diagnosis, controlling complications and increasing access to care. Health system integration in China will require overcoming the fragmentation of a system that still places excessive reliance on local government financing. Moreover, what remains to be done resembles deeper challenges faced by healthcare systems worldwide the need to upgrade primary care and reduce inequalities in access to health services. © 2020 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http//creativecommons.org/ licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Iron deficiency (ID) is recognized as an important comorbidity in patients undergoing cardiac surgery; however, it still remains under-diagnosed and under-treated in clinical practice. This study aims at comparing efficacy and the effects on exercise capacity of intravenous ferric carboxymaltose (FCM) versus ferric gluconate (FG) in patients with ID anemia (IDA) resulting from cardiac surgery. We retrospectively analyzed data from our records of in-hospital patients with IDA after cardiac surgery undergoing cardiac rehabilitation. Group I was treated with FG, group II with FCM. Efficacy measures included changes (baseline vs discharge) in hemoglobin (Hb) and in distance traveled at six-minutes walking test (6MWT). Data from 74 in-patients (mean age 67.5±10.4 years, 43% women) were analyzed. At discharge, patients treated with FCM showed higher levels of Hb (11.1±1.2g/dl vs 10.2±1.1 g/dl; p=0.001), greater distance traveled at 6MWT (279.2±108.8 meters vs 236.3±72.7 meters; p=0.048), and lower in-hospital rehabilitation length of stay (20.3±7 vs 25.3±11.7 days; p=0.043) as compared to FG group. At multivariate analysis, the most powerful predictors of Hb increase >1 g/dl at discharge were transferrin levels (p=0.019) and treatment with FCM (p100 meters) at discharge (p=0.13 and p=0.003, respectively). In patients with IDA following cardiac surgery, intravenous FCM is effective in restoring Hb levels and in improving exercise capacity after cardiac surgery.Presumptive pulmonary tuberculosis (PTB) patients whose sputum are detected to be smear negative for acid fast bacilli (AFB) present a significant challenge for a treating physician. Initiating these patients on anti tuberculous treatment (ATT) on empirical basis is not a good strategy as many were found to be sputum culture for tuberculosis negative on further evaluation according to many previous studies. In India due to resource limited settings and lack of knowledge about newest diagnostic modalities patients are often initiated only on the basis of characteristic clinical symptoms and chest radiographic abnormalities. This study was conducted to identify the advantage of application of sputum cartridge based nucleic acid amplification test (CBNAAT) in sputum AFB smear negative presumptive pulmonary TB patients. Our study concluded that clinical symptoms and radiological characteristics cannot differentiate TB patients from non-TB patients. Treating patients only on empirical basis would have resulted in unnecessary treatment of 41 patients.Objectives Since exposure to sexual contents and early sex initiation among adolescents have become serious social issues in Korea, an in-depth analysis on the prevalence of sexual experience trends among Korean adolescent is necessary to project trends and policies required for the next 10 years. The objective of this study was to identify the contributions of age, period, and birth cohort effects on sex experience prevalence in Korean. Methods We analyzed the trend of age, period, and birth cohort specific sex experience prevalence of 911,502 adolescents (469,593 boys, 51.5%; 441,909 girls, 48.5%) aged 12 to 17 years from the 2006 to 2017 Korean Youth Risk Behavior Web-based Survey (KYRBS). Joinpoint regression analysis was conducted to examine significant changes in prevalence of sexual experience and find optimal number and location of places where trends changed. Results Generally, the prevalence of sex experience generally increased by age in all period in both boys and girls. In boys, the prevalence of sex experience increased in recent period, especially in age group 12 and 13, while the prevalence of while the prevalence of sex experience decreased in age group 16 and 17. In girls, the age group of 12 and 13 showed increased prevalence of sex experience in recent period. However, the prevalence showed a decreasing trend in age group aged 16 and 17. Conclusions In boys and girls, sex experience increased with age. However, the tendency has slowed in the recent cohort. Therefore, early sex education is needed.