A probabilistic, simplerandom sample composed of 67 records of patients with Parkinson's disease whoparticipated in a rehabilitation program, between March of 2009 and April of 2013.The research was conducted in three stages, in which the nursing terms were mappedto natural language and crossed with the Nursing Interventions Classification. a total of 1,077 standard interventions that, after crossing with the taxonomyand refinement performed by the experts, resulted in 32 interventions equivalentto the Nursing Interventions Classification (NIC) system. The NICs, "Education:The process of the disease.", "Contract with the patient", and "Facilitation ofLearning" were present in 100% of the records. For these interventions, 40activities were described, representing 13 activities by intervention.  the cross mapping allowed for the identification of corresponding terms with thenursing interventions used every day in rehabilitation nursing, and compared themto the Nursing Interventions Classification. In recognition of the first descriptions performed by James Parkinson in 1817,Parkinson's disease (PD) was thus entitled years later by Jean-Martin Charcot. The meanage of onset of symptoms is 60 years of age, and the incidence increases with age andmay affect up to 5% of the population over 79 years of age. The mean duration of thedisease, from diagnosis through death, is 15 years, and the relationship of mortality inmales to females is two to one-The causal relationships remain as evasive as when described in 1817, however,pathological signs related with genetic and environmental components are stronglydiscussed In this sense, the nursing care provided to the individual with this disease, permeatesthrough the aspects of this condition related to symptomatology; it is considered to bemultisystemic, progressive, and incurable. In the rehabilitation context, the nurse, asa professional member of the multidisciplinary team, has an important role in healthpromotion, treatment of complications, and adaptation to the limitations imposed by thedisease. The nurse directs the plan of care to meet the needs of each patient andfamily, guiding the search for the patient's independence in relation to his/herphysical, cognitive and behavioral limits through an appreciation of his/herpotential-In this scenario, the adoption of standardized nursing care prevails, based on legal,ethical, scientific and methodological premises. Thus, care grounded in the nursingprocess enables interactivity, since it is based on mutual relationships of nurses, themultidisciplinary team, the patient and the familyThe Nursing Interventions Classification (NIC) is among the various classificationsystems referring to the interventions to be used with the nursing process. -This taxonomy, of North American origin and worldwide scope, was developed in order todocument and communicate nursing care by integration of data in computer systems, andprovides a source of data for research-Therefore, the importance of studies that address the nursing interventions in therehabilitation of patients with PD, structured in an elected classification system, isundeniable. The nursing research that addresses this issue converges on the currentglobal trend to better understand the disease, its symptoms and treatment, contributingto the scientific progress in this area, which will be reflected in improved patientcare. However, currently, it is observed that nursing scientific production in thiscontext remains scarceBased on the above, this study aimed to perform the nursing language term cross-mappingof the records of rehabilitation patients with Parkinson's disease, with the NursingInterventions Classification (NIC) system.,,This was a descriptive, quantitative study, developed in accordance with the technicalprocedure of documentary research, using records as a primary source of data collection.The methodological framework uses concepts and principles of cross-mapping. This methodwas chosen because it allows the linguistic comparison and semantics betweennon-standardized terminologies with the chosen classification systemThe International Center for Neurorehabilitation and Neuroscience in the city of Rio deJaneiro, Brazil, was the scenario for this research. Children and adults withneurological sequelae, originating from congenital or acquired central nervous systeminjury, receive care in the rehabilitation area of this center. The team isinterdisciplinary and patient care includes contextualized and individualized guidance,recommending the involvement of family members and caregivers.This center has electronic medical records of patients in which the care provided by thenurse is documented without the use of standardized language. For this research, theauthors considered the records containing nursing interventions described as nursingterms in natural language.From the inauguration of this Centre, in March 2009, until the beginning of thisresearch, in April 2013, there were 1,266 patients admitted who were diagnosed with PD:796 had nursing assessments. To determine the sample, the inclusion criteria includedthose patients whose chart contained five or more nursing records, totaling 167. Therecords of patients who, in addition to the diagnosis of PD, had a medical diagnosisthat characterized other parkinsonian syndromes, such as secondary Parkinsonism, forexample, were excluded. Thus, 148 records were obtained. From this total, thecalculation for a probability sample of the simple random type was calculated using theformulaIn this case: N = 148 records (population size), E = 9% (tolerable sampling error), n0 =123 records (first approximation of the sample size) and n = 67 records (samplesize).Thus, the sample consisted of 67 patient charts, which represented 45% of the totalpopulation, and 9% of sampling error. Of these, the last five nursing assessments wereconsidered for this study, totaling 335 analyzed nursing assessments..The study limitation is the adoption of a 9% error, instead of 5% that is usually usedas maximum error. However, this limitation was considered by the multiplicity of nursingrecords obtained in each medical chart, which provided significant data collection forthe researchers.After conducting three pilot tests, for training and improvement of three researchers onthe method, the cross-mapping was completed, simultaneously, from June to December of2013, in three stages: 1) extraction and standardization of terms, 2) separation andcomparison of non-standardized terms with those standardized by the NIC, and 3)evaluation and refinement of the mapping.The first stage was conducted from August to November of 2013, in which the threeresearchers performed the electronic extraction of information that comprised thedatabase containing: 1) patient data, 2) medical diagnosis and the progression of PD, 3)parts of nursing assessment containing the context of the intervention, and 4)separation of the nursing language terms that indicated or excluded interventionhypotheses (verbs). For example; in the part of the nursing evaluation, which wasdescribed "Performing bladder re-education", the term "bladder re-education" washighlighted after the fragmentation of the record. Similarly, in the part in which therewas the description, "The patient was instructed regarding home adaptation strategies topromote greater safety for the performance of daily activities", the words: "Instructed""Home adaptation" and " Safety" were highlighted in the database.Data were arranged in an Excel spreadsheet for Windows, and then, normalized accordingto the adequacy of verbal tenses, spelling correction, standardization of gender andnumber, and the exclusion of repetitions, synonyms and casual expressions that do notdesignate particular concepts.From December of 2013 to May of 2014, three researchers proceeded to the second stagethrough cross-mapping of the terms identified in the previous step, with the NICtaxonomy. The following rules of cross-mapping were considered: 1- mapping the "meaning"of the words, not just the words, 2- using the "keyword" in the intervention to map tothe NIC intervention, 3- using verbs as "keywords" in the intervention, 4-mapping theintervention from the NIC intervention label for the activity, 5- maintainingconsistency between the intervention being mapped and the NIC definition of theintervention, 6- using the more specific NIC intervention label and 7- mappinginterventions that have two or more verbs for the two or more corresponding NICinterventionsThe nursing terms in natural language were compared with the NIC interventions. Thecategorization of the nursing terms was performed with a combination of analyses, where:when the term found, was matched with the classification system term, it was categorizedas an exact match, and when that term had similar concepts, synonyms and related terms,it was categorized as a partial match. For presentation of the results, the exact andpartial matches were considered to have the same value.In the examples previously cited, the term "bladder reeducation", extracted after thefragmentation of parts of the nursing record, and assumed to be a nursing intervention,was considered to be an exact match with NIC. However, the terms "oriented", " homeadaptation "and "safety" were considered to be partial matches, and were correlated tothe standardized NIC intervention, "Environmental Management: Safety." In this case, aconsistency was observed between the context of the intervention described in thepatient record, with the definition of the intervention proposed by NIC, which is:"Monitoring and manipulation of the physical environment to promote safety"The data of this stage were organized under the title of the intervention, definition,non-standardized terms and standard NIC terms that corresponded to confirmatory clinicalevidence for the presence of the intervention.From June of 2014, the third stage was achieved by means of the evaluation andrefinement of cross-mapping. At this stage, expert nurses analyzed the collected data;two were experts in nursing classification and three in the PD rehabilitation. Forselection of these nurses, a minimum clinical experience of five years, or a doctoratewith experience in research on nursing classification systems was required. Therelationship between the contexts of interventions, the non-standardized terms and NICinterventions was established through the agreement of experts. This step was conductedin individual cycles and in-group. In the second cycle, the consensus of experts wasobtained, and the statistical agreement analysis was not necessary.Data were analyzed considering their absolute frequency, percentage, means and standarddeviations. The development of the study met the national and international standards ofethics in research involving human subjects (Protocol No 691310).The characteristic profile of the 67 patients of the sample was: 63% male, mean age of69.3 (± 10). The progression of PD ranged from one to 24 years, with a higherrepresentation of those who had one to eight years of disease progression (75%).In the case of nursing interventions, there were1,077 standard interventions identifiedin the 67 patient charts analyzed, representing a mean of 16 interventions per patient.The highest concentration of interventions was focused on the context of healthpromotion. After cross-mapping with the taxonomy, and refinement made by the experts, 32interventions equivalent to the NIC terminology emerged. Of these, nine (28%) had afrequency of occurrence higher than 50%. The interventions, "Teaching: Disease Process,""Patient Contracting," " Learning Facilitation," and "Teaching: Group" were present inall patient charts, with a mean of 2.6 repetitions. This occurred because nurses indifferent contexts implemented these interventions. During the analysis of the patient records, it was possible to identify that nursesperformed all steps of the nursing process. With regard to interventions, these wereperformed in two ways: interventions of an individual character and interventionsconducted with a group of patients.For individual assistance, the nurse performs consultations based on the nursingprocess, guided by clinical reasoning. However, even without the adoption of astandardized language, the nursing diagnoses, interventions and expected outcomes areestablished, which are described in the patient records. In the planning step, the nurseevaluates whether the result to be achieved requires intervention by means of individualor group approach. However, guided by clinical reasoning many patients were included bynurses for both approaches,. In other words, for those patients who had not achieved theexpected outcomes, these were also individually addressed after group intervention, andvice versa.The data shown in In addition, the standardization of the approaches with patient groups was identified,represented by lectures, interactive sessions, and providing illustrative teachingmaterials. The topics of the lectures focused on the interrelationship of thepathophysiological aspects, pharmaco-therapeutics and lifestyle, in the context ofrehabilitation. Thus, the theme of each class was focused on: the PD; the risk factorsfor cerebrovascular diseases, such as hypertension, diabetes mellitus and dyslipidemia;bowel constipation; and, activities of daily living. For all of these, In terms of characteristics of the sample of this research, the findings converge withstudies showing that PD tends to occur more frequently in men, especially in the agegroup over 60 yearsRegarding the progression of the disease, the results of this study haverepresentativeness, showing that the neurodegenerative process of PD is nonlinear, butit is concerned with individual aspects,With regard to nursing interventions, the results demonstrate effectiveness of themethodological tools used in this study, which enabled the achievement of objectives.The cross-mapping identified nursing language terms prescribed by nurses in the recordsof patients with PD who participated in the rehabilitation program, and compared them tothe standardized NIC language, which is globally recognized. This method is a viabletool in the standard language implementation process in health services, as it allowsthe nurses to compare data consistently and generalizableFurthermore, nursing interventions, as part of the nursing process, are recognized inthe care plan, which is developed in order to eliminate or minimize a nursing diagnosis,seeking to achieve the goal or pre-established outcomeThus, the interventions mapped and described in this study are highlighted, which weredirectly linked to educational practice, and used by nurses as the main tool for healthpromotion. Health promotion, as a change strategy in technical healthcare models, hasbeen used for decades as an alternative for expanding the quality of health and life ofthe population, by intervention with individuals and the understanding of thehealth/disease process, such as social productionIn the context of neurological rehabilitation, the actions for health promotion areaimed toward recovery, but, mainly, for the adaptation to limitations imposed by thedisability, according the needs of each patient/family. These actions are primarilyguided by functional, motor, psychosocial and spiritual aspectsThe nursing interventions related to intestinal disorders, which in this study wererepresentatively described, lead to research showing that among the non-motors symptomsof PD, bowel constipation is the most prevalent. This alteration is present in 70-80% ofthese individuals, and is mainly related to neuronal degeneration occurring in the vagalcenter of bowel control, and which may be present at any stage of neurodegenerationHowever, these measures depend on change in the patient's lifestyle. The nurses usereferences beyond the biological in their work methodology, and recognize that theactions required for adherence to long-term treatment and care are deeply interrelatedwith the culture, i.e., with the lifestyle, habits, routines and rituals in the lives ofpatients, converging with contemporary scientific referencesIn the analysis of the activities developed, educational actions based on contextualunderstanding to guide the individual / family are carried out according to the maininterventions. However, a multiplicity of alternatives and the creativity of nursesinvolved are evident in the rehabilitation process of the patient with PD, which bymeans of generalized actions, attempts to address the peculiarities inherent to eachindividual/family. They seek to empower patients to work effectively on their socialreintegration. This provides a dynamic movement and permanent redefinition of knowledgefor acquiring skills and attitudes that are better for a quality of life, by acquisitionof a critical-reflexive attitudeThe application of the nursing process in the practice of neurorehabilitation isevidenced by the results of this study, through the expression of the clinical methodused by nurses in the rehabilitation of patients with PD. The performance of thefollowing specific steps of the nursing process  provided the nursing care to the individual / family, in order to considertheir singularities, and in an extended mode, converge with professional recommendationswidely discussed in the nursing literatureDuring the analysis of records, the recognition of the nurses about their role in therehabilitation process with the patient who progresses with a neurodegenerative,multisystem and still incurable disease was clear.. Their full involvement in thisprocess allowed for prescribing interventions, mostly permeated with the principles ofhealth promotion. Thus, rehabilitation was based on the search for patient potential,aimed at his/her restoration through reciprocal and realistic goals. These actions maylead to the opportunity for a life with better quality, reemergence of self-esteem,independence and family involvement, which confirms the principles ofneurorehabilitation, as discussed in the scientific community areaThe cross-mapping enabled the comparison of existing information in the patient recordsof patients with PD with the standardized interventions of the NIC. In addition, thenursing interventions used in the clinical practice of rehabilitation nurses wereidentified, with actions grounded in health promotion and family involvement.Standardization of language is encouraged to enable documentation of nursinginformation, contributions to patient care and facilitation of communication betweennurses and other health professionals. The use of the NIC terminology can contribute tostandardizing nursing care within the rehabilitation of patients with PD, in order toensure quality of the professional care, leading to significant benefits for theprofession.The existing gaps in scientific knowledge about the effectiveness of nursinginterventions in this population constitute the main limitation of this study, sincethere was no possibility of such comparative data due to the lack of studies in thisarea. Furthermore, further studies are needed, with more representative sample sizes, tominimize the possibility of error.


Nowadays, hepatitis is of the most important health priorities around the world, where information plays a very significant role in specialized diseases prevention planning, and policy- and decision-making processes. Thus, this study addressed challenges of hepatitis information management and investigated the outcomes of establishing a hepatitis information management system to overcome such challenges. To this end, this research intended to study the implementation of an Electronic hepatitis information management system.This is an applied-developmental study with following specifications and procedures: preparation of study proposal and design, justification of the design’s stakeholders, approval of the design by the Postgraduate Education Council of Faculty, determination of pilot hepatitis control center, software development, deciding on control, prevention, and treatment centers, and finally development of a network-based system for collecting and managing hepatitis information.Results indicated that the inconsistency and lack of integrity of data, as well as the lack of communication between related units prevented timely information register of viral hepatic patients and services that are provided to them. This inhibited the possibility of considering a follow-up process. However, the implementation of this system and involvement of relevant units greatly solved these problems.Results show that the implementation of an electronic system for the management of hepatitis control, prevention, and treatment is a regional and national requirement; since, this system with its empowered infrastructure is capable in providing desired services to all laboratories, counseling and health centers, specialized clinics, and physicians connected to the hepatitis network. This enables them to follow up and monitor patients’ conditions. That mentioned system paves the way for the analysis of gathered information, managers’ and specialists’ access in different regions to the data for making appropriate and accurate decisions. Nowadays, viral hepatitis, especially the blood-borne types (i.e. B and C), and hepatitis prevention are widely recognized significant health priorities, since 5-10% and more than 50% of hepatitis B and C cases develop chronic diseases and liver cancer . HepatitAlthough the fecal-oral-borne viral hepatitis and water-borne hepatitis (i.e. A and E) do not develop chronic hepatitis, they are responsible for several mortalities and morbidities around the world. Studies in Iran also present their endemic status. Hepatitis A and E are epidemic in countries with low rank on levels of health. Iran is an endemic area for hepatitis A and E infection .Economically, hepatitis is among the most costly diseases. A study into hepatitis B  related outpatients in China, 2010, has estimated a direct treatment cost of 43,311/28#, carrying a significant financial burden on the patient and society .An effective disease management requires the disease surveillance system design and implementation to investigate determinant factors in disease incidence and distribution, specify the infected different ages and sex groups and disease process, predict and reach an early diagnosis of epidemics, and contribute to the design and evaluation of health interventions .Despite the development of disease management centers in many developed and developing countries, data standardization and creation of registries and healthcare systems structure have been given less attention . ConsequIn this regard, the lack of an information management system for hepatitis control has led to sporadic data collection; as a result, there is not any comprehensive system for gathering, processing, monitoring, and controlling such data . AccordiConsequently, this study was conducted aiming at designing and implementing an electronic hepatitis information management system to approach the mentioned limitations.This is an applied-developmental study with following specifications and procedure: preparation of study proposal and design, justification of the design’s stakeholders, approval of the design by the Postgraduate Education Council of Faculty, adoption of the Control, Prevention, and Treatment Center of Zabol as the pilot center, determination of affiliate centers, analysis of the current and future situation, system design and development, and eventually implementation of a network-based system for collecting and managing hepatitis information.As a result, after the development of desired software, the measure was taken to implement it in affiliated centers including laboratories, consulting and health centers, and hospitals, under the hepatitis network of Zabol University of Medical Sciences. The aim was to record the information of patients with viral hepatitis from the early diagnosis phase in the system electronically. Indeed, a profile similar to the electronic health record is created, where demographic information, risk factors, infection diagnostic practice, early diagnosis signs, family information, paraclinical measures, signs and symptoms of diseases, physical examination, tests, healthcare plan, and follow-up outcomes are precisely recorded. All users, including nurses and physicians, can record and manage the information if their access to the system is given.The regional organizations and institutions participating in the research are as follows:1)The Health Deputy of University2)The Health Consulting Center3)The Hepatitis Control, Prevention, and Treatment Center4)The Blood Transfusion Center5)The Reference Laboratory6)The university affiliated health centersAfter the implementation of the design, following results were achieved: setting up the electronic hepatitis information management system in the Hepatitis Control Center of Zabol and other related health centers at the regional level, connecting the system to referral centers, creation of electronic profile during the diagnosis, treatment, and consulting processes in case of diagnosed infection, providing the affiliates with the system accessibility to get informed about and involved in healthcare team, and preparation of required reports.After system setting up, one-year information of patients with hepatitis B was recorded from March 21, 2014 to March 21, 2015. Then, the epidemiological information was obtained from the system and analyzed in Excel in form of statistics and tables. A number of this information is provided as some examples.According to the one-year information recorded in the system, the age groups of HBV infected patients were 15-19 to upper than 60. Improvement of health information systems is the first step in progressive health system management capabilities. The healthcare decision makers at every managerial level should gain maximum benefit from information to be capable of making precise data-based decisions and policies, and meeting managerial requirements of healthcare service providers , 2013b.Results showed that the majority of developed and developing countries require such systems for promoting the level of health, making correct policies and developing micro and macro plans. They have managed to meet their needs by setting up information management and record systems. The electronic system for hepatitis information management, like any other system software such as operation systems and database management systems, should be periodically improved to either eliminate its errors or add new functions . To be eEpiTrax software is an example for performance challenges in system implementation; since, contrary to its rapid and successful implementation, it has not become fully operational, due to system performance problems, especially when large forms are attached to the cases. The other reported challenge is connected with data accessibility and the applications of business intelligence system .The electronic healthcare system for specific diseases is also associated with performance limitations including short history of the company development, limited management capabilities such as patient tracking and reporting .It is noticeable that the evaluation process in form of system epidemiological output analysis is among the dynamic and [currently] developing methods . RegardiConsidering that Sistan and Baluchestan Province, along with Golestan Province, has the highest rate of hepatitis B (38/3)  April, tIn this study, 60.3% of the infected people were male, and the majority of the involved patients were in the 20-29 age group. Other studies also suggest infection age reduction in recent years . This maOn the one hand the main research objective is the design and implementation of healthcare information management system for patients with viral hepatitis in regional Hepatitis Prevention, Control, and Treatment Centers. On the other hand, addressing this and similar subjects is a mission of healthcare system at different healthcare and policy levels. So, it is concluded that national micro and macro policy-making and planning in the healthcare area urgently require integrated, comprehensive, accurate, and updated information. This is not possible without the necessary information systems.Due to the lack of information integrity, information inconsistency, and disconnection between relevant units and service provision authority, viral hepatic patients’ information is not recorded and controlled timely. Although, by operating this system and collaborative participation some of the problems are solved, involvement of specialists and researchers in the areas that hepatitis information is recorded and management is required. In general, findings of this study suggest the hepatitis information management system as a solution to many challenges and problems of patients, physicians, and decision-makers in healthcare area. For further improvement and development, this study provides following recommendations: broader participation of relevant specialists, and greater coordination among healthcare policy- and decision-makers in implementation of specified and approved tasks. These allow us to take more effective step in prevention, control, and treatment of viral hepatitis and to perform more efficiently in favor of national health promotion.Additionally, cooperation among laboratories, the blood transfusion centers, and academic network affiliated consulting, healthcare, and medical centers in accurate, timely, and software-based information record and delivery can greatly contribute to the reduction of time and money expenditures.Another important point is helping patients through covering all medical and particularly specialized laboratory measures by responsible organizations via trust infrastructure. Equipping the Healthcare System with an electronic system for specialized service providing can help it in supporting the patients registered in the designed information management system by providing accurate information of them. Finally, the use of this system not only prevents significant financial burden on the society but also facilitates and accelerates the follow-up and healthcare processes.


Community-Acquired Pneumonia. European Respiratory Monographs. Sheffield: European Respiratory Society; 2014, ISBN 978-1-849-84049-1.Chalmers JD, Pletz MW, Aliberti S (Eds):  Community-acquired pneumonia (CAP) is the most common cause of death from infectious disease worldwide, and over the past 25 years there has been dramatic progress in research about all aspects of this disease. The European Respiratory Monograph devoted to this topic is a comprehensive review of the topic aimed at a broad range of health professionals, including critical care physicians.The 20 chapters of this monograph span topics from CAP epidemiology to bacteriology, pathogenesis, risk assessment, diagnosis, therapy and prevention. As is emphasized in the introduction by Tobias Welte, the future management of this illness will focus on prevention and personalized care, modified to account for individual variations in the immune response. However, for the present we need to manage this disease on a daily basis, and the discussions in the book provide much practical information for those assessing and treating patients with severe CAP.The topics of interest to ICU physicians include: assessment of illness severity, with a discussion of prognostic scoring systems; empiric therapy selection, with a good review of the role of dual-agent therapy for severe pneumonia; management of acute respiratory failure, with particular caution about the judicious use of non-invasive ventilation for pneumonia patients, and the need for timely intubation in selected patients; and the management of sepsis due to CAP. The discussion of sepsis nicely summarizes the literature about early goal-directed therapy, the selection of the type of fluid to support blood pressure, the use of vasopressors, and the role of corticosteroids in sepsis. Several other chapters include topics of vital interest in the ICU, such as the assessment of response to therapy, the use of non-antibiotic therapies, and the role of macrolides as anti-inflammatory agents. There is also an important discussion of the cardiovascular complications of CAP, a recently appreciated area of interest, which can explain some of the long-term sequelae of this illness.Community-Acquired Pneumonia is comprehensive and inclusive, most of the authors are European and they have interpreted some of the data and controversies from a perspective that is not always consistent with a North American viewpoint. Most notable among these issues is the commentary about the lack of utility of the concept of healthcare-associated pneumonia, yet very few concrete recommendations are given about how to manage this population of patients, if they are to be considered suffering a form of CAP. Other omissions include a limited discussion of the epidemiology of pneumonia in the ICU, the role of dual antibiotic therapy in pneumococcal bacteremia, the management of influenza in the ICU, and the importance of hospital-based immunization.Although Community-Acquired Pneumonia is an excellent, balanced and comprehensive summary of an important and common illness; providing a great resource for physicians of all types, including those who work in critical care.On balance, CAP: community-acquired pneumonia.The author declares that he has no competing interests.


It is well known by specialists and others that traumatic brain injury (TBI) is the main cause of death in young people under 40 years old and, at the same time, represents the cause of approximately two-thirds of post-traumatic deaths.Data from the World Health Organization show that 11,5 million Europeans who have survived traumatic brain injuries currently present physical disabilities or cognitive and emotional disorders.The main types of traumatic brain injuries include the following: brain fractures, brain contusions, brain dilacerations, diffuse axonal injuries, and extradural, subdural and intracerebral hematomas. The official data show a growing incidence of the traumatic brain injuries.Annually, there are almost 245,000 individuals hospitalized with such traumas, and 66,000 of these patients die due to complications.The number of cases of traumatic brain injury in Romania is continually rising. With an incidence of 300 cases per 100,000 citizens, our country annually registers over 60,000 new TBI cases. Every 8 minutes, a Romanian has a traumatic brain injury. TBI represents 36-40% of the total traumas, and when the association with other traumas is considered, the share rises to 60-65%. Moreover, TBI represents 25-30% of the invalid segment of the population. In addition, 75% of the individuals who die due to road accidents have a traumatic brain injury.According to the official data, Romania is at the top of the list for TBI among the EU countries, with a death rate due to road accidents of 92 deaths per one million citizens, which is greater than the average of the number of 52 deaths for other countries. Prof. Dafin Mureșanu, MD, the President of the Romanian Society of Neurology (RSN) and President of the Society for the Study of Neuroprotection and Neuroplasticity (SSNN) declared “The number of traumatic brain injuries is continually rising due to many factors, starting with the development of the auto industry and the way technology evolves in transportation and ending with the growth of the rate of domestic accidents. From the data we have at present, we can state that the incidence oscillates between 1,4 million and 1,6 million in Europe, with most of the victims being treated in emergency situations. Traumatic brain injuries must be treated seriously and carefully because they usually have critical medical-social, economic and judicial implications. However, Romania faces some problems in these cases. First, there is a lack of neuropsychologists. We do not have specialists in memory recovery. It is not enough to be able to move again. It is at least as important to be able to communicate and reintegrate in the society. There are only a few centers in Romania in which the patient is treated by multidisciplinary neurorehabilitation teams. There should be a center in every town and a community neurorehabilitation strategy, and a private system of alternative care should be developed.”Just as TBI treatment has undergone exponential development the field of neurological recovery, which has obviously generated an acceleration of research efforts during the last several years.12th Annual Conference of the Academy for Multidisciplinary Neurotraumatology (AMN), organized by the Society for the Study of Neuroprotection and Neuroplasticity (SSNN), which took place in Dubai, during the 14th and 17th of November 2014.The new discoveries in TBI and also in cognitive recovery, together with many other important themes, represent the main subject of one of the most important medical events of the year 2014. The event is the “The event had a large number of participants, including medical personalities from Europe, Asia and the United States of America, and had a complex scientific program, which included actual themes regarding the evaluation of the progress achieved in the treatment of traumatic brain injuries. The importance of the Congress was great because it reunited people with a vast professional experience who have managed to integrate the information offered from interdisciplinary perspectives as a whole”, the distinguished Prof. Dafin Mureșanu, MD, declared.The Society for the Study of Neuroprotection and Neuroplasticity (SSNN) was founded in 2005 by an international team of doctors and researchers at the initiative of Prof. Dafin Mureșanu, MD, from “Iuliu Hațieganu” University of Medicine and Pharmacy in Cluj-Napoca and Prof. Ovidiu Băjenaru, MD, from “Carol Davila” University of Medicine and Pharmacy in Bucharest. It is a scientific organization dedicated to fundamental and clinical research with the purpose of creating a discussion forum for a better understanding of the endogen neurobiological processes, as well as the development of pharmacological and non-pharmaceutical therapeutic strategies in the field of neuroprotection and neuroregeneration.10th Edition of the Congress of the Society for the Study of Neuroprotection and Neuroplasticity, which was held in Athens and was organized by the Society for the Study of Neuroprotection and Neuroplasticity (SSNN) and presented in the Editorial of the last issue of the Journal of Medicine and Life, 2014.The Congress was very important because it took place only two weeks from another resonant event: The Romania was represented in the 12th AMN Congress 2014 by Prof. Dafin Fior Mureșanu, MD, the President of the Society for the Study of Neuroprotection and Neuroplasticity in Romania, Prof. Gelu Onose, MD, President Co-founder of the Romanian Society for Neurorehabilitation and Prof. Dorel Săndesc, MD, Secretary of State in the Ministry of Health-Care and President of the Romanian Society of Anesthesia and Intensive Care.The Congress had great international participation, reuniting well-known specialists from Argentina, Hong Kong, Austria, Switzerland, the USA, Germany, and the Netherlands. Dafin Mureșanu – Romania, Wai Poon – Hong Kong, Volker Hömberg – Germany and Suhail Abdulla Al-Rukn – United Arab Emirates were in charge of the welcome address at this important event.Prof. Dafin Mureșanu, MD, presented the advances in brain protection and recovery in traumatic brain injury.The well-known specialist Volker Hömberg, Chairman of the scientific program committee of the AMN, from the Department of Neurology, Heinrich Heine University, Dusseldorf, and one of the representatives of Germany, discussed the future of scientific meetings: what new formats are needed.Jan-Peter Jantzen, Head of the Department of Anesthesiology, Intensive Care Medicine and Pain Management, Academic Teaching Hospital Hannover, Nordstadt, Germany, presented, during the debates session, the problem of ICU management of traumatic brain injury - therapeutic coma, bringing important arguments for the application of this method.Moreover, Johannes Vester, Department of Biometry and Clinical Research, IDV Data Analysis and Study Planning, Krailling, Germany, presented the multidimensional approach in clinical neuroscience research – advances and challenges.Dorel Săndesc, Secretary of State in the Ministry of Health-Care in Romania and President of the Romanian Society of Anesthesia and Intensive Care (Romania) underlined the most important aspects of the brain death concept as well as organ transplantation.Prof. Gelu Onose, MD, President and Co-founder of the Romanian Society for Neurorehabilitation in Romania discussed neuroprotection – with the use of some main related molecules – in patients with subacute/ subchronic conditions following severe central nervous system lesions.Russell Andrews, Ames Associate, Ames Research Center in California, one of the representatives of the USA, discussed the disaster response: an opportunity to improve global healthcare in the 21st century, and Karin Diserens, Head of the Unit for acute Neurorehabilitation, Service de Neurologie, Departement Neurosciences Clinique, Lausanne, the representative of Switzerland, discussed the disorders of consciousness in early neurorehabilitation.Nicole von Steinbüchel, Vice President of the AMN, Institute of Medical Psychology and Medical Sociology, University Medical Center, Georg-August University, Göttingen, Germany, discussed the outcome of individuals after mild traumatic brain injury.Thanks to an excellent organization and organizational team, which has outdone itself, the Congress had the expected outcome, ensuring exquisite accommodations and working conditions to all the participants. After the end of the highly interesting and complex scientific sessions, the participants visited the most important places in Dubai.In addition, we should mention the contribution of the “RoNeuro” Institute for Neurological Research and Diagnostics of “Iuliu Hatieganu” University of Medicine and Pharmacy in Cluj-Napoca, Romania, as well as the contribution of the Academy of Medical Sciences in Romania in the process of organizing the resonant congress.Executive EditorAssoc. Prof. Dr. Eng. Victor Purcarea


Recommendations are offered regarding interventions for child care centers, primary and middle schools, high schools and colleges, outdoor occupational or recreational and tourism settings, and mass media and multicomponent communitywide campaigns. Summaries and links to the individual recommendations are available at Established in 1996 by the U.S. Department of Health and Human Services, the task force is an independent, nonfederal, uncompensated panel of public health and prevention experts whose members are appointed by the Director of CDC. The task force provides information for a wide range of decision makers on programs, services, and policies aimed at improving population health. Although CDC provides administrative, research, and technical support for the task force, the recommendations developed are those of the task force and do not undergo review or approval by CDC.


Hand surgery in Malaysia began modestly with the correction of claw deformity in leprosy patients early in the last century, and began to evolve over the years into the treatment of injuries in plantation and industrial workers, at home and then in road crashes.With training of some of our surgeons in various overseas centres, particularly in the UK and then in USA and Singapore, hand and microsurgery began to be developed in General Hospital Kuala Lumpur and University Malaya Hospital, when they returned home.An international three-day conference on hand surgery in Kuala Lumpur in the mid-1980's created greater awareness on the topic and helped to bring hand surgery to the fore-front, with setting up hand clinics, training in micro-surgery, and so on, in the major hospitals in Kuala Lumpur initially.Today, there are dedicated hand surgeons, technicians and hand therapists in the major government and private hospitals throughout the country, providing excellent services in this specialised and demanding area of trauma and reconstructive surgery.


Knemidocoptic, from the Greek knemid  and koptein (to cut), refers to the morphology and pathogenesis of mites of the genus Knemidocoptes, which are burrowing mites of birds. Commonly known as scaly face, scaly legs, or tassel foot, knemidocoptiasis affects primarily the face and legs of birds around the world worldwide and can be fatal.From the Latin


Health Information Economy (HIE) is one of the broader, more complex, and challenging and yet important topics in the field of health science that requires the identification of its dimensions for planning and policy making. The aim of this study was to determine HIE concept dimensions.This paper presents a systematic methodology for analyzing the trends of HIE. For this purpose, the main keywords of this area were identified and searched in the databases and from among 4775 retrieved sources, 12 sources were studied in the field of HIE.Information Economy (IE) in the world has passed behind four paradigms that involve the information evaluation perspective, the information technology perspective, the asymmetric information perspective and information value perspective. In this research, the fourth perspective in the HIE was analyzed. The main findings of this research were categorized in three major groups, including the flow of information process in the field of health , and information applications in the same field  and the underlying fields.According to the findings, HIE has already developed a theoretical and conceptual gap that due to its importance in the next decade would be one of the research approaches to health science. Stiglitz declared that in the field of economics, perhaps the most important break with the past lies in the Information Economy (IE) theories . IE is oIn various literature, the IE is expressed as one of the basic needs for economic development , qualityIE has passed behind different paradigms that can be divided in four approaches. These approaches are information evaluation, information technology evaluation, asymmetric information, and information value perspective.The first approach of IE theory is based on information sector evaluation. Machlup and Port performed two main studies in this field. Their famous studies determine the flow of movement from an industrial society to an information society, and try to show the characteristics of the information society . Porat aThe second paradigm in IE, is information technology economy, that can be observed in the reports of the next decades of the Organization for Economic Co-operation and Development (OECD) and activities of United Nations Conference in Trade And Development (UNCTAD). In fact, the IE has the approach of information technology. UNCTAD’s annual reports from 2005 to 2012 are in this aspect .The third paradigm is a conceptual approach. This approach is Information asymmetry. Information asymmetry deals with the study of decision in transaction where one party has more or better information than the other. Akerlof demonstrated how a market can collapse if critical pieces of information are missing. In 2001 the Nobel Prize in Economics was awarded to George Akerlof, Michael Spence, and Joseph E. Stiglitz for their analyses of markets with asymmetric information . In addiThe other type of conceptualization of the IE to emerge focuses on the information value . ShapiroThis can give rise to a new approach in the IE. From the perspective of information value, the overflow of information and access to information on the current location plays an important role in marketing information. The approach to information as a commodity is considered independent and different from other goods .This discussion illustrates the magnitude, complexity and, importance of the IE and at the same time indicates that the next decade will be the decade of IE research and policy age. The HIE is also more complex topics due to the health information and clinical data. Despite of HIE importance, research showed the lack of theory criticism in this field. The aim of this study was to evaluate different views on the economy of the world’s health information in order to determine the dimensions of the field. A systematic review was undertaken in order to provide understanding of the global status of HIE theoretical dimensions.In This paper, a systematic review was used of the HIE literature, using a structure strategy in English and Persian language from 1964 to 2014. Search strategies were performed the following databases:Scopus, Web Of Science, Pubmed, Science Direct, Doaj, Ebsco, OCLC, Google Scholar, Yahoo, Eric, Google books, Proquest, Jstore.Major search keywords consist of: HIE, health information economics, health economy of information, health economics of information and medical data economy.Publications selected based on the inclusion /exclusion criteria.Inclusion criteria includes criteria pertaining to publication characteristics, such as full text publication, peer reviewed publication, English and Persian language publication.Exclusion criteria includes duplicate publications, asymmetric information and research with a focus on information and communication technology removed.The inclusion/exclusion results of the search are shown in The databases search yield, 4775 papers. However, review of the title excluded 2488 duplicated studies. After reviewing abstract and full text studies, in total 12 studies met the inclusion criteria. The selected studies information is presented in The main subjects of HIE categorized in seven major groups expressed in In this study, the results were presented in seven categories:The First, production of information, the Second, data collection, third, data processing, fourth information dissemination or distribution, fifth, applications of information (usage), sixth, information economy contextual aspects, and finally, information attributes are selected groups.Health data and information applications consist of education, research, health industry, policy, legislation, and decision-making .HIE contextual aspects underlay factors such as security, privacy, copyright, and the role of technology.Finally, the end of this research is to study the characteristics of the information as an economic commodity.Dimensions of HIE have controversial approaches in selected studies. Therefore, all of the seven topics in HIE aspects demonstrated in conclusion part based on systematic review studies.In this study, Major topics of HIE categorized in seven groups. The first step is the production of information. This aspect mentioned in many studies . The terNowadays information is available so quickly, and so expensively and broadly. The problem is not information production or information access but information overload. Nobel Prize winner economist Herbert Simon believes that “A wealth of information creates a poverty of attention” . Health data and information applications consist of education, research, health industry, policy, legislation, and decision-making   depends on the accuracy, correctness and trustworthiness of the information, and the privacy and security to control the disclosure of personal information .In many studies , information unusual attributes as a commodity, and security and safety are major controversial dimension in HIE.We believe that HIE has already developed a theoretical and conceptual gap that due to its importance in the next decade would be one of the important research approaches to health science.


The following information is missing from the Funding section: This paper is part of the PhD thesis project of S. Romero-Cordoba, a student of the Biomedical Sciences PhD Program of the Autonomous National University of Mexico.The complete, correct Funding statement is: This work was funded by the National Institute of Genomic Medicine (INMEGEN/CI/019/2009). S. Romero-Cordoba, RRV, and RAL received a PhD scholarship from the Mexican National Council of Science and Technology. This paper is part of the PhD thesis project of S. Romero-Cordoba, a student of the Biomedical Sciences PhD Program of the Autonomous National University of Mexico. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


Globally, there are growing efforts to address diseases through the advancement in health research and development (R&D), strengthening of regional cooperation in science and technology (particularly on product discovery and development), and implementation of the World Health Assembly Resolution 61.21 (WHA61.21) on the Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property (GSPA-PHI). As such, the Association of Southeast Asian Nations (ASEAN) is responding to this through the establishment of the ASEAN-Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation (ASEAN-NDI). This is important in the ASEAN considering that infectious tropical diseases remain prevalent, emerging, and reemerging in the region. This paper looks into the evolution of the ASEAN-NDI from its inception in 2009, to how it is at present, and its plans to mitigate public health problems regionally and even globally. Please see Additional file The Association of Southeast Asian Nations (ASEAN) has a continuum of member nations at different stages of economic and health development, with the majority of the countries belonging to the middle- and low-income categories .While there are ASEAN member states that are more advanced in terms of health systems and programs, the majority still suffer from communicable and non-communicable diseases ,3. InfecThese tropical infectious diseases form part of the neglected tropical diseases (NTDs) alluded to by international organizations. These diseases include infections that have shown low economic returns for investments in health products R&D. However, from a human capital perspective, these so-called NTDs not only place a significant burden on the health system, but they also adversely affect productivity and efficiency of human capital in their respective societies .Budgetary limitations for health research also cause difficulty in pursuing R&D initiatives. With scarce resources for health research, efforts to pursue health research activities in many of the ASEAN nations are limited .In terms of human resources, the ratio of R&D personnel to the population varies across the ASEAN nations with countries including Singapore, Malaysia, and Thailand having more R&D personnel than the rest of the ASEAN nations. The proportion of researchers to population is also much higher in the more developed nations in the ASEAN  compared to those which are less economically developed . It is aConsidering all of these public health challenges and hindrances to providing better quality of health in the ASEAN, activities towards the establishment of a regional health innovation network were initiated with the goal of enhancing product discovery and providing a sustainable essential health R&D through intraregional collaboration—a framework suggested by the World Health Assembly (WHA) Resolution 61.21, Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property (GSPA-PHI) ,8.The ASEAN Network for Drugs, Diagnostics, Vaccines, and Traditional Medicines Innovation (ASEAN-NDI) was founded in 2009 in line with the objectives of the GSPA-PHI, which include promotion of R&D, development of North–South and South–South partnerships to support capacity building, and establishment of strategic research networks to facilitate better coordination of stakeholders. It was conceptualized to parallel the African Network for Drugs and Diagnostics Innovation (ANDI), a network championed by the World Health Organization Special Programme for Research and Training in Tropical Diseases (WHO-TDR), which started the idea of establishing regional innovation networks.th Meeting of the ASEAN Sub-Committee on Biotechnology (SCB) in Bali, Indonesia on 25–26 May 2009, and was later adopted by the ASEAN Committee on Science and Technology (COST) as its own initiative. The ASEAN, through the COST, approved the creation of the ASEAN-NDI in 2009. Start-up funds to support the establishment of the Network were provided by the WHO-TDR. The Philippine Council for Health Research and Development (PCHRD) of the Department of Science and Technology (DOST) served as the secretariat of the ASEAN-NDI, with its Executive Director, Dr. Jaime Montoya, as the overall coordinator , which results in duplication and wastes time and resources. This shows that although collaborating ventures may have limitations imposed by funding/sponsoring partners, the ASEAN member states need to explore and expand collaborative engagements to other ASEAN member states with the end goal of enhancing capacity in the region and minimizing duplication of efforts.Asia, including the ASEAN, is a major player in the future of pharmaceuticals. The recent slowdown in major Western countries has led to the outsourcing of developmental work in developing countries including the ASEAN  and the creation of a Task Force (TF) that will serve as an ad hoc group who will guide the development of the plan. On 20 October 2011, the first ASEAN-NDI Task Force meeting was held in Manila, Philippines where the initial outline of the draft SBP and timelines were discussed.human resources, technological capacity, and financing to ensure sustainable health, development, and security. These inputs will be translated into research and eventually into the production of innovative health products and services that will be made available within and even outside the ASEAN. The vision, mission, and objectives of the ASEAN-NDI are summarized in Table The ASEAN-NDI is envisioned to become Asia’s premier facilitator for collaborative innovation in R&D for health products, benefiting primarily the ASEAN but more open to global markets. As a network involving the ten ASEAN member countries, the ASEAN-NDI will build the needed The R&D and delivery value chain structure  basic research, (2) assay/model development, (3) compound/candidate screening, (4) lead generation/optimization, (5) pre-clinical trials, (6) clinical trials, and (7) manufacturing and delivery/access. It is regional and even global in extent, involving private enterprises, public sector institutions and governments, non-profit organizations, and donor agencies, which may have done related work on the priority disease areas in the past, and may be willing to collaborate .The governance structure will comprise a policy-making and strategic direction setting by a 14-person Governing Council and a four-person Executive Committee. The ASEAN-NDI is to be designed to operate in a hub-and-spokes model  will also be established. The most important outcome of the ICs will be the coordinated and cooperative strategy that the stakeholders develop through the sharing of best practices, and R&D knowledge to meet the common challenge at hand.Details regarding the SBP were presented during the First ASEAN-NDI Stakeholders Meeting in Manila on 5 June 2013. Future plans for the ASEAN-NDI, including the proposed collaborative activities, were also discussed, taking advantage of the presence of representatives from the WHO, and the Africa and China NDIs. These activities include holding joint regional consultations on the development of demonstration projects, collaborating in setting up a global health R&D observatory, and forming a wider network composed of the regional innovation networks.The ASEAN-NDI will improve health R&D by driving innovation through collaboration not only among the ASEAN member states but with other networks and health R&D institutions. Engagement of non-ASEAN stakeholders is also vital considering that infectious diseases and NTDs are emerging in European countries and other Western states. In Europe, a surprisingly high incidence of NTDs was recorded among more than 150 million Europeans, especially those living below the poverty line ,17.The same is the case in the Middle East and North Africa where parasitic infections such as fascioliasis, leishmaniasis, and schistosomiasis are prevalent, and viral infections such as dengue and Rift Valley fevers have emerged .In a recent study by Hotez and Papageorgiou (2013), it was deduced that one way to address NTDs and infections of poverty is to establish a center for fundamental and translational research in which product development activities including R&D on drugs, diagnostics, and vaccines are conducted . This isThe ASEAN-NDI will coordinate research by partnering with research networks, developing capacity-building initiatives, supporting R&D infrastructural improvement, advocating for more research investment, and enhancing regional access to health products. It will start by enhancing collaboration among the ASEAN member states to address the specific health needs of the ASEAN, but collaboration with other countries will soon follow. This is consistent with the GSPA-PHI goal of making a network of networks wherein the ASEAN-NDI can partner up with other NDIs  that have been established and form the nucleus for South-South collaboration . With a Through regional network collaboration, global health problems will be addressed by properly channeling resources and partnering on projects according to collective needs. This will capacitate the different regions to contribute to the advancement of global health R&D while providing solutions for their own health challenges.The roadmap for the ASEAN-NDI has been laid out. The ASEAN is now awaiting its full implementation to achieve its goal of becoming the premier facilitator for collaborative research in health products in Southeast Asia.The stage is set for all its stakeholders—government institutions, public and private research institutions, the private sector, non-government organizations, and international organizations—to unleash their full potential in health R&D in the ASEAN region, particularly in the areas of drugs, diagnostic kits, traditional medicine, and vaccine development, for the benefit of all.Next steps for the establishment of the ASEAN-NDI include: (1) Setting up the permanent Secretariat office in the Philippines; (2) establishing the governance structure, including the selection of the Governing Council members and the ASEAN-NDI country hubs; (3) conducting fundraising activities; (4) developing/screening the first set of projects and programs of the Network, and (5) the application of the Network to be an official ASEAN-affiliated office.APAST: ASEAN Plan of Action on Science and Technology; ASEAN: Association of Southeast Asian Nations; ASEAN-NDI: ASEAN Network for Drugs, Diagnostics, Vaccines, and Traditional Medicine Innovation; COST: Committee on Science and Technology; DOST: Department of Science and Technology; GSPA-PHI: Global Strategy and Plan of Action on Public Health, Innovation, and Intellectual Property; IC: Innovation Communities; NTD: Neglected Tropical Disease; PCHRD: Philippine Council for Health Research and Development; R&D: Research and Development; SARS: Severe Acute Respiratory Syndrome; SBP: Strategic Business Plan; SCB: Subcommittee on Biotechnology; UNESCO: United Nations Educational, Scientific, and Cultural Organization; WHA: World Health Assembly; WHO: World Health Organization; TDR: Special Programme for Research and Training in Tropical Diseases; TF: Task Force.All authors have no competing interests.All authors gave substantial contributions to the study conception and design, and in the acquisition, analysis, and interpretation of the data. NCP and CLR prepared the draft manuscript, while BR and JCM revised it critically for important intellectual content. All authors contributed, read, and approved the revision and the final draft.Multilingual abstracts in the six official working languages of the United Nations.Click here for file


However, their incorporation into the National Health Service havebeen limited because it can not provide access and universal coverage to healthservices in an equitable manner throughout its territorial extension and in thedifferent levels of care. the implementation of the right to health is complex and will require mobilizationof the state and political financial, educational, technological, housing,sanitation and management actions, as well as ensuring access to health, anduniversal coverage. Talking about the right to health implies reference to a set of legalnorms that establish the rights and obligations of the state, collectively and alsoindividually, regulating and monitoring the relationships between them. It also refers to access and universal coverage of health services, inquality and quantity for the whole population.The right to health is part of the context of social rights, one of the most difficultrights to protect, especially when civil and political rights are considered, as it een them. It als(-). In this context, the health systems and their governments, to guaranteethis coverage, should act on the social and environmental determinants ofhealth(-), pointing out that the performance of these factors should be a task of allstate sectors.Universal health service coverage should offer high quality services and access, alsoprioritizing promotion, prevention, treatment, rehabilitation and palliativecare-4. Infhealth-5, po. All of these barriers contribute to the deprivation of the right to healthof populations.In many countries, especially developing countries such as Mozambique, there are severalobstacles to accessing healthcare services, which are an obstacle to universal coverage.Among these are: lack of sanitary infrastructure, insufficient human resources, lack ofequipment, higher demand, difficulty of paying users for the services performed,professional attitudes and characteristics of health services. All of.The independence of Mozambique from Portuguese domination in 1975 did not necessarilymean the full exercise of the right to health for most of the population. Rather, thegreat challenge is exactly to improve the high rate of chronic malnutrition, especiallyin children, high food insecurity, low levels of education of women, poor access to safedrinking water, inadequate levels of availability to basic sanitation and access to highquality health services, and the equitable distribution of health care professionals inurban, peripheral and rural areas where health needs are higher.(-). Access to health services becomes effective when accompanied by universalcoverage, understood as the development of health financing systems by the State thatallow people to use services and health actions without financial burden, such as directdisbursement to obtaining needed health care. This requires that services are provided equitably, regardless ofgeographic location, cultural values, beliefs, religion and ethnicity. Lack of accessand universal coverage constitutes a barrier for realization of the right to health inMozambique.These are some of the challenges that reveal the difficulties of the State inoperationalizing coverage targets and universal access to health, caused also by thelack of funds for the health system, deficient information systems, negativerelationships between health professionals and the people, and late referral for morespecialized care of patients with certain conditions from the clinics of lower levels ofcare -5. Aclth care,6. ThScopus , however, no article on Mozambique was found. For academiccontribution to this discussion, legislation about the right to health was used,elaborating some questions that will guide this reflective study: what international andregional instruments ratified the right to health in Mozambique? What are the legalinstruments in Mozambique that include the right to health? With what theoretical, legaland social frameworks can the gap between theory and practice on the right to health inMozambique be understood? To answer these questions, the article presents as itsobjective the discussion on the right to health, incorporation into legal instrumentsand the deployment in practice in the National Health System in Mozambique.Aiming at deepening this subject, a literature review was performed in the databases ofthe Latin American and Caribbean Literature in Health Sciences - (LILACS), PubMed and and Viswambharan and Priya, taking documentary analysis as an analytical process, from documentarysources, which enables the identification, verification and examination of documents,expanding and questioning the background. The use of document analysis extends theknowledge, whose understanding requires a contextual historical approach, allowing thecomprehension of the processes of evolution of practices, behaviors, trends andapplication of certain measures.This was a documentary analysis of a qualitative approach, which followed the guidelinesof Souza, Kamorski and Luis and Visnd Priya, takingmeasures.For this study, all official legislation of Mozambique on the right to health publishedin the Bulletin of the Republic of Mozambique between 1975 and 2010, were used, inaddition to the Constitution. The African Charter on Human and Peoples' Rights and theInternational Covenant on Economic, Social and Cultural Rights were also consulted. After exhaustive reading of the documents, three empirical categories were established:"instruments of humans rights and their interrelationship with the development of theright to health"; "the national health system in Mozambique"; and "gaps between theoryand practice in the consolidation of the right to health in the country."Five national legislative documents were analyzed: the Constitution of the Republic ofMozambique, 2004; a decree-law; and three laws. Then, the three empirical categories were analyzed, mobilizing the bibliography thatshows the situation of the existence of the right to health or lack thereof, coverageand access to health services.When the nation, a member of the World Health Organization and the African Union,approved instruments affirming the right to health, Mozambique was still a Portuguesecolony, without the legal structure to include this prerogative into the rule of law.But, with its independence in 1975, Mozambique acceded to several international andregional human rights instruments that directly or indirectly addressed the guarantee ofthe right to health. For a better illustration, Mozambique participates as a member state of several international and regional treatiesrelevant to the implementation of the right to health, although it has not ratified theInternational Covenant on Economic, Social and Cultural Rights. , which explicitly states the responsibility of the State to provide accessto health services for all Mozambicans in Article 49, "all citizens have the right tomedical and health care, according to the law and the duty to promote and protect publichealth". Although the previously mentioned article refers to the guarantee to health,the Constitution does not clearly explain the country's obligation to provide equitablehealth services to all.In the domestic context, Mozambique has important tools that are able to guarantee theright to health, especially the 2004 Constitution of the Republic, which , although, it does not indicate which instruments, or constitutional- orintra-constitutional instruments the state will use for social participation.In addition to the constitutionality of guaranteeing the right to health for thepopulation, Mozambique, through its Constitution, emphasizes the importance of socialparticipation in health, especially on the promotion and protection of public health,with the involvement of Community bases, althou. The Charter implies the mission of any member state to the commitment toensure the health of its population, while it does not assure the guarantee as aresponsibility or duty of the state, however, it reinforces individual freedom to enjoythe best health that one is capable of obtaining.Regarding the State's responsibility, the African Charter on Human and Peoples' Rights,ratified by the government of Mozambique, mentions in Article 16 that "everyone has theright to enjoy the best health that he is able to achieve" and reinforces also that "themember states of this charter are committed to taking the necessary measures to protectthe health of their populations and to assure medical care in case ofillness". The Ch. Mozambique still faces major challenges to the equitable offering of the status of rightto health, not only in improving health services, but in ensuring effective and broadactions, which act positively on the social determinants that affect the right tohealth. In this sense, the actions for the fight against food insecurity, public safety,supply and access to clean water, sanitary measures in private and public environments,access to basic and higher education, environmental sanitation, poverty reductionpolicies, and the consumption of alcohol, drugs and tobacco, which are socialdeterminants that limit access and universal coverage for health services,5. , nationalized the private clinics that existed during the colonial period,in order to maximize resources by offering greater access to health care services thatprovided indiscriminate assistance to Mozambican citizens. The Decree, in Article 1,states that "all activities relating to the prevention and treatment of disease as wellas the technical preparation of the staff team must be exclusively performed by theState". Therefore, all activities of primary, secondary and tertiary care became thesole and exclusive responsibility of the State, which became the sole provider andpromoter of health services for the entire country, thereby assuming control ofPortuguese hospitals and private clinics. This context is derived from a political position of a government withsocialist characteristics, which emphasizes access to health and pharmaceutical care forthe Mozambican population through the principles of equality and equity.Upon the independence of Mozambique, the Council of Ministers, through Decree-Law N.5/75 of 19 August 1975, nation clinics. This c, which emphasizes in Article 1 the gratuity of prophylactic health actions.In this regard, the Ministry of Health (MoH) adopted a payment criterion with a fixedvalue for medical and pharmaceutical appointments in the 11 provinces of the country,considered affordable prices for everyone.In 1977 this situation changed as a result of Law N. 2/77, which , factors that occasioned misinformation and the impossibility of havingwhat was established by the MoH. Associated with these facts, most of the populationlived in rural areas where health services were less available, further aggravating theright to access to health.The adoption of participation through payments used to limit access of the population tohealth services, as the country at that time had a high unemployment rate (30%) and ahigh illiteracy rate (68%), factorin light of the Republic Constitution of 1990, which established the rightto medical and health care for all citizens through the MoH. Its goal was healthpromotion, disease prevention, care and rehabilitation, associated with training ofhuman resources and research for its continued development. Thus, the NHS established ahealth organization at different levels of care: primary level - consists of healthcenters and units, each comprising its respective areas of health; secondary level -consists of district general and rural hospitals; tertiary level - consists ofprovincial hospitals; and quaternary level - consists of central and specializedhospitals. The institutions that are part of the NHS under the MoH management are thehygiene centers, vocational training institutions, specialized laboratories and researchinstitutions.In 1991 new changes are perceived through the creation of the National Health System(NHS), Law N. 25/91in lightThe NHS centralizes financial resources and organizes the technical instructions of theMoH hierarchically by the provincial guidelines. Thus, the Central Government determinesthe percentage of the State's general budget for the MoH, which varies from year toyear, and the State distributes it to the provinces. This centralization means thatfinancial resources are channeled mostly to health facilities in the tertiary andquaternary levels, to the detriment of health centers, which are mostly in rural andperipheral areas of the cities, thereby reducing access of the population to healthfacilities, which interferes with the full right of access to health services for thepopulation living far from urban centers.(-).Another factor that must be considered is that the MoH depends on donations ofinternational organizations and partner countries, especially Western, to perform itsactions. These resources do not always meet the needs for coverage and access to healthservices for the population, not only because they are scarce, but also because they arenot geographically allocated equitably, giving privileges to high-complexity hospitals,directly interfering with the population's right to health-6..Resuming the discussions on nationalization, in 1991 during the advent of thedemocratization, the NHS admitted its inability to be the only provider of healthservices, resuming the activities of private health care, which had been nationalizedafter the independence of the State. On the other hand, in 2004, the State officiallyrecognized the need for activities of practitioners of traditional medicine by approvingthe traditional medicine policy and its implementation strategy, whose main objectivewas its integration to the NHS to guarantee access to primary health care and qualityfor the entire Mozambican population.. This recognition does not seem to be necessarily valuing this healthpractice and the importance of traditional physicians, but rather highlights alimitation of the NHS in offering universal access to health services and coverage tothe entire population, since in this period the NHS covered only 40% of services, andthe rest were covered by traditional health practitioners and private health care. Itshould be noted that even given every effort by the State, the NHS had covered onlyabout 50% by 2013.This recognition represents advances that the State has been providing since itsindependence for the consolidation of the traditional medicine area, with the creationof the Traditional Medicine Research Office in 1977, and the creation of the Associationof Traditional Physicians of Mozambique. This ry 2013,.The fact that traditional medicine has been recognized as an NHS participant undoubtedlyadds value to the right to health and respect for local culture, to the extent thatpeople can consult traditional physicians freely. However, there is still no effectiveintegration of these health practices within the NHS, thereby not ensuring theregulation of the MoH on the supply of these services and systematized protocols withreferral and counter-referral that enable the coordination of care in a more articulatemanner, making the guarantee to the right to health even more difficult. It is importantto note that traditional medicine covers 100% of all of the Mozambican population,namely, even people who have access to the NHS also access the traditional medicinesystem.(-).Although the right to health depends on specific legislation to ensure rights andduties, it requires mutual efforts to function. In this context, the importance ofavailability is emphasized, which involves the construction of infrastructure and theexistence of health care services in a sufficient amount for the whole population;accessibility, which involves health care services that are available to the entirepopulation without discrimination; physical accessibility, in which health facilitiesare available to all, including the reduction of distances and means of transportationavailable to meet the needs of users, greater attention to the most vulnerable people inthe communities; and accessibility, which implies the recognition of the difficulties ofaccess to work, and greater equity in payments, which should be as accessible aspossible for all when they exist; the population's access to information withoutdiscrimination and the duty of health professionals to respect medical ethics andrecognize the cultural issues in the contexts in which they work can be an obstacle incare-6.. In Mozambique, where most of the population is unemployed, and althoughthe payment amounts are "symbolic", they interfere with access and universal healthcoverage of services, in costs of medical consultation, medicines, and mainly intransportation for those who live in locations that are far from health facilities.Finally, in order to ensure this right, there must be quality services, equipment andhuman resources. In Moz. In this context, the States make an effort to implement the right tohealth, according to its financial conditions, as stated by Pact 1966: "each MemberState in the present Pact is committed to adopting measures, (...) especially in theeconomic plans and technical contexts, to the maximum of its available resources inorder to progressively achieve (...), the full realization of the rights recognized inthe present Pact, including (...) the adoption of legislative measures". Most importantly, in this process of right to health, is the recognitionthat the State has an immediate duty to fulfill essential obligations, having asresponsibilities to regulate, design and implement policies and mobilize financialresources.The right to health has been established as a regulated and progressive implementationright, as the lines or principles for the fulfillment of State programs areconceived. In thieasures". Most i. A community-based intervention would also be important to guarantee accessto a wide variety of promotional, preventive, curative and rehabilitative healthservices(-).For the right to health to be effectively implemented for the population, empowermentwould be required, including universal access to education, health, employment,promotion of equality of gender within ethnic groups, and the institutional ability torespond-,,11. Aservices-4..But what happens in Mozambique? In order to have the right to health, financialresources for the various levels of the NHS and other health subsystems are essential.among other factors; political decentralization in the implementation and coordination,so that decisions are made at other levels ; andmedical technology, which involves a set of tools and processes that effectively respondto health care needs.. Although the gross domestic product (GDP) has been growing in recentyears, around 7% per year, the budget allocated to the NHS state is 6.6%, below therecommended 15%in the Africa region .The challenges presented, and one of the aspects to be considered, relate to thefinancing arranged by the Mozambican state, one of the lowest in the Southern Africanregion, with an external dependence for about 66% of their spending. Mozambique spendsapproximately 39 dollars per capita on health, representing much less compared to theregional average. Althou region .. The country lacks quantity and quality medical technology, materials andprocesses; therefore it does not have sufficient infrastructure to fully meet theaccess to diagnostic tools that are able to respond safely to the laboratory diagnosisof different diseases that affect the population. Although the coverage of healthservices has improved, it is still low to meet all the health needs of thepopulation.This decentralization and transparency are not well defined by the MoH, since there isno visibility on accountability for the population as a whole, although there is a setof policies, strategies, laws and regulations,,12. Tcesses-,15; tlation,, 17.; but the state of the right to health is still far from being effectedwithin the whole population. Other factors associated with lack of coverage of healthservices in countries such as Mozambique are related to social inequalities, governmentpolitical systems(-) and, in the case of the African countries, political and economicinstability is added. For countries with these characteristics, the universal servicecoverage requires reforming systems, promoting the principles of equity, solidarity andcollective action to overcome inequalities(-), since the absence of all this cannot guarantee universal access andcoverage and consequently, the right to health.One cannot deny the improvements in some health areas, such as the increase of birthsattended by health professionals, set at 54.3%; reducing poverty by almost 50%; andreducing neonatal mortality from 50% to 30.4%,,; but thystems- and, inThe theme of the right to health is complex, as permeated by various spheres, includinghealth, law, financial policies, education, technology, housing, sanitation andmanagement.In Mozambique, the State's actions, represented by the NHS, show the gap between therecommended policies and health practices, with an incipient focus on equity andquality, although there is an increased demand for health services systematically.The difficulties of access and universal coverage, and hence the establishment of theright to health, is a reflection of: underfunding in health; difficulties decentralizingcare processes and medical technologies; minimal coverage of NHS; lack of qualifiedprofessionals and a pricing policy to maintain these professionals; difficulty with workconditions and processes in health care; few activities in the interdisciplinary andteamwork fields; and systematic practice of professionals, such as nurses.For the people to have the right to health, in addition to the actions implemented bythe government, there is also the need for participation of the population, by usingsocial control mechanisms, requiring greater access and coverage of health services bythe State.For the general population of Mozambique, traditional medicine practices can consist ofan expansion of universal access and coverage of health services that are contracted,supervised and regulated by the State.


Recommendations for HIV Prevention with Adults and Adolescents with HIV in the United States, 2014, is now available online at http://stacks.cdc.gov/view/cdc/26062. This guideline was developed by CDC, the Health Resources and Services Administration (HRSA), the National Institutes of Health (NIH), and five nongovernmental organizations: the American Academy of HIV Medicine, the Association of Nurses in AIDS Care, the International Association of Providers of AIDS Care, the National Minority AIDS Council, and the Urban Coalition for HIV/AIDS Prevention Services. The recommendations are intended to advance the goals of the National HIV/AIDS Strategy for the United States: prevent new HIV infections, increase the proportion of persons with HIV who are aware of their infection, prevent HIV-related illness and death, and reduce HIV-related health disparities  includes dozens of practical decision-support tools, training aids, fact sheets, and other materials that can support implementation of these recommendations.A companion resource library web site (available at


The author of the above-mentioned paper would like to make the following correction to the first paragraph of the Acknowledgments section on page 16.“The author received editorial support in the preparation of this report from Kristin Carlin and Jennifer Schwinn, Peloton Advantage, LLC, Parsippany, NJ, USA, funded by Celgene Corporation, Summit, NJ, USA. The author, however, directed and is fully responsible for all content and editorial decisions for this manuscript. The named author meets the ICMJE criteria for authorship for this manuscript, takes responsibility for the integrity of the work as a whole, and has given final approval for the version to be published.”


Professor Glyn Humphreys was born 28 December 1954 and passed away 14 January 2016.Prof. Glyn Humphreys's early career was spent at the University of Bristol from where he was awarded his B.Sc. (1976) and Ph.D. (1980) in Psychology. At the early age of 24, Glyn was appointed to his first lectureship in the Department of Psychology in Birkbeck College, University of London. Almost all of his students were older than him! Through intellect and hard work, he made rapid academic progress, and was appointed as Professor of Psychology in 1988. While at Birkbeck, he was appointed the Ronald Tress Prize for advancements in his field, the first of many such awards. During his time in Birkbeck an equally important step in his life was made by meeting his wife Jane. Both of them moved to the University of Birmingham in 1989 where Glyn became the Head of the Department of Psychology, a position that kept for 15 years steering the department to the elite of institutes in the UK and worldwide. Most recently Glyn was the Watts Professor and Head of Experimental Psychology Department in Oxford University.Glyn's contributions to research were enormous: he contributed to many areas including cognitive psychology, cognitive neuropsychology, computational modeling, social cognitive neuroscience, neuro-rehabilitation and cognitive diagnostics. Most notably his work on understanding the cognitive effects of stroke led to the development of the Birmingham Cognitive Screen in 2012. Glyn was also the president of Experimental Psychology Society from 2002 to 2004 and editor of three international journals. Glyn's work was recognized by numerous awards from the British Psychological Society , Humboldt Research, 1998, Royal Society , University of Hong Kong  and European Society for Cognitive Psychology . He was a fellow of the Royal Society of Medicine, the Humboldt Foundation, Ecoles des Hautes Etudes en Sciences Sociales and the British Academy. He was awarded an Honorary Life Fellowship of the Belgian Association for Psychological Science in 2002 and the British Psychological Society in 2012. Most recently, Glyn was awarded a Lifetime Achievement Award by the British Psychological Society in 2015.Glyn was a giant in research and he collaborated with huge number of researchers from all over the world including Birkbeck, Birmingham, Oxford. His lab was notable for its “family feeling,” where new ideas were encouraged, fostered and supported. He was a mentor rather than supervisor, and his generous nature inspired those around him to aim higher, to think deeper, to be more responsible, to respect colleagues, to be compassionate and kind. Notably, the neuropsychological patients he worked with felt so respected and honored by him that they felt privileged to contribute to his research. In short Prof. Glyn Humphreys was a giant in science, humanity and kindness, and inspiration to many individuals around the globe.Glyn survived by his wife Jane, his daughter Katie, his sons Iain and Alec and his grandchildren, Madeleine, Jake and Freddie.The author confirms being the sole contributor of this work and approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


International Journal of Qualitative Studies on Health and Well-being's thematic cluster on Health, Physical Activity and Lifestyle, it is our privilege to introduce the theme and six original articles included in the cluster. The papers address some central aspects of the theme  from psychological, sociological, pedagogical, medical, and also interdisciplinary perspectives through implementation of different qualitative research approaches  and designs . The author team is internationally representing Sweden, Denmark, and the United Kingdom. Two review papers open the cluster and are followed by four research papers.As guest editors of the Physical activity, or the lack of it, is a major public health issue in many countries. The World Health Organization (WHO) has reported that physical inactivity is one of the ten leading causes of death in developed countries resulting in about 1.9 million preventable deaths worldwide annually WHO, . ConsideInternational  paper, Staveborg Kerkelä, Jonsson, Lindwall, and Strand  provide In the fourth paper, Lindqvist, Kostenius, Gard, and Rutberg  exploredIn the fifth (single case study) paper, Stelter  shared hIn the sixth (research) paper, Papathomas, Williams, and Smith  used narInternational Journal of Qualitative Studies on Health and Well-being and attract more researchers in the sport/exercise sciences to contribute to the journal in future.Finally, as guest editors we wholeheartedly thank the authors for their tireless efforts in creating interesting and high-quality contributions, and all the reviewers for their constructive comments that contributed to raise the scientific quality of the thematic cluster. Our deep thanks also go the editors of the journal and the publisher, for smooth cooperation during the preparation process. We do hope that this thematic cluster will contribute to expanding the scope of the Urban Johnson Sport and Exercise Psychology School of Health and Welfare Halmstad University, Halmstad, Sweden E-mail: urban.johnson@hh.sNatalia Stambulova School of Health and Welfare Halmstad University Halmstad, Sweden


By the time of his death on 23 November 2012, Michael (Mike) E. Robbins had gained a national and, indeed, international, reputation as a leader in the field of radiation-induced normal tissue effects. For the final decade or so of his career, Mike had been based at Wake Forest Medical Center, an institution where he had developed a world-class research program looking at the prevention and treatment of radiation-associated tissue injury, with a specific interest in radiation-induced brain injury. Although the impact of Mike's body of work in the latter area of research is clearly highlighted in the paper proffered by Prasanna et al. , his deaBorn in London, UK, in 1954, Mike began his academic career at Thames Polytechnic, London (now the University of Greenwich), and received his bachelor's degree in Applied Biology in 1976. He remained at Thames Polytechnic for his postgraduate studies, investigating the effects of parathyroid hormones on the kidney in domestic fowl, and obtained his PhD in 1980. That same year, Mike joined the staff of the Churchill Hospital Research Institute, University of Oxford, as a post-doctoral fellow, where he was first introduced to the world of radiation biology. He readily integrated his prior knowledge of kidney function with the tenets of radiation biology and, in parallel with prestigious research groups such as Moulder et al. , helped In 1993, Mike moved to the United States, where his initial appointments were as Associate (subsequently full) Professor in the Department of Radiology and the Director of Research for the Free Radical and Radiation Biology Program at the University of Iowa. While in Iowa, his reputation as an innovative researcher within the radiation biology and the wider scientific communities continued to grow. Although his overall interests in normal tissue injury remained relatively broad until the time of his death, it was during this period that medical problems within Mike's family, most notably with regard to his wife, Lucy, brought a deeper focus to Mike's research on brain radiation biology: For example, he began to more closely investigate the response of both brain tumor and normal tissue to radiation therapy, and how interactions between the two, dependently and independently, affect late outcomes.With his move to the Wake Forest School of Medicine in 2001, as a Professor in the Department of Radiation Oncology and Section Head of Radiation Biology, Mike continued this work, developing a senior leadership role in the Thomas K. Hearn Brain Tumor Center of Excellence. He fostered strong collaborative ties and gained the respect of investigators from both inside and outside his home institution, for example with the Blomgren  and, with her support, continued his scientific initiatives against cancer, up to and even during his own illness. In addition to research, Mike had other passions, including racing/sport motorcycles, World War II history, traveling, and hiking with his wife and dogs, Dash, Chase, and Stella. For many of us within the radiation biology community, Mike was a beloved friend and colleague and will be greatly missed, especially for his keen scientific mind, his passion and enthusiasm, his mentoring and counsel, and for his dry sense of humor.Mike is survived by his wife Pam, his mother, Liliane, his brother, Mark and sister, Monique.


The report, which focuses on cardiovascular disease, is available at http://www.thecommunityguide.org/annualreport/index.html.The Community Preventive Services Task Force recently posted its Established in 1996 by the U.S. Department of Health and Human Services, the task force is an independent, nonfederal, unpaid panel of public health and prevention experts whose members are appointed by the Director of CDC. The task force provides information for a wide range of decision makers on programs, services, and policies aimed at improving population health. Although CDC provides administrative, research, and technical support for the task force, the recommendations developed are those of the task force and do not undergo review or approval by CDC.


Department of Health and Human Services, the task force is an independent, nonfederal, uncompensated panel of public health and prevention experts whose members are appointed by the Director of CDC. The task force provides information for a wide range of decision makers on programs, services, and policies aimed at improving population health. Although CDC provides administrative, research, and technical support for the task force, the recommendations developed are those of the task force and do not undergo review or approval by CDC.


The information is available at Established in 1996 by the U.S. Department of Health and Human Services, the task force is an independent, nonfederal, uncompensated panel of public health and prevention experts whose members are appointed by the Director of CDC. The task force provides information for a wide range of decision makers on programs, services, and policies aimed at improving population health. Although CDC provides administrative, research, and technical support for the task force, the recommendations developed are those of the task force and do not undergo review or approval by CDC.