This document summarizes an economics perspective on sex work in developing countries. It discusses three main points:
1) Sex work plays an integral role in the spread of HIV/AIDS due to unprotected commercial sex being a major transmission vector. HIV prevalence is much higher among sex workers than other groups in many countries.
2) Sex work provides employment for many women in poor countries and involves large financial flows. It is a significant source of income for women in developing nations.
3) Prior policy prescriptions aimed at educating sex workers on health risks have had limited success because they do not address the demand side incentives. Sex workers may rationally choose to engage in risky unprotected sex if clients are willing
Quality vs. Access case study Complete a full paper outline incl.docxmakdul
Quality vs. Access case study
Complete a full paper outline including each of the headings below. Make sure to touch upon the following items in your outline:
· Introduction: Briefly introduce the case study-Quality vs. Access (details attached). In addition, clearly state the purpose of the analysis and what you hope to prove in the report.
· Stakeholders: Identify the stakeholders who are involved in your case study. Discuss the entities who have an interest in the situation. How do their interests affect your ability to find a solution
· Overview: Provide a succinct overview of the current situation relating to your case study.
· Analysis: Provide an analysis of the situation. Make sure to discuss the incentives or lack thereof. How have the current incentives caused the problem? Address the specific questions posed in your chosen case study. Apply the concepts you have been exposed to throughout the course to aid in your analysis.
· Recommendations: Based upon your analysis, make appropriate recommendations that could alleviate or solve the presented problem.
· Conclusion
· References: Make sure to support your claims with reputable resources. All citation should follow the most current version of AMA style.
Background info:
Case Study: Quality vs. Access
The Affordable Care Act raised the Medicaid reimbursement levels to Medicare levels, resulting in improved appointment availability for Medicaid recipients. One of the components of the Affordable Care Act now coming into effect is the reporting of quality measurements and tying these into reimbursement. Some of the measurements are subjective, such as patient satisfaction, while others are quantitative, such as percentage of patients with their diabetes under control. Patient adherence to treatment plans has been shown to be as low as 40%. Opponents of the rating system say this system will result in more difficult and low socio-economic group patients being turned away by providers.
· How could the payment system be modified to reward quality of care but not result in reduced access to those in lower socio-economic groups or with poorer health?
Resources:
Wherry, Laura R., and Sarah Miller. "Early coverage, access, utilization, and health effects associated with the Affordable Care Act Medicaid expansions: A quasi-experimental study." Annals of internal medicine (2016). http://annals.org.une.idm.oclc.org/aim/article/2513980/early-coverage-access-utili zation-health-effects-associated-affordable-care-act
Martin, Leslie R., et al. "The challenge of patient adherence." Ther Clin Risk Manag 1.3 (2005): 189-199.
https://www-ncbi-nlm-nih-gov.une.idm.oclc.org/pmc/articles/PMC1661624/
Rubric
Introduction
Meets the
“Satisfactory” criteria and utilizes course concepts and reputable resources to support claims
Stakeholders
Meets the
“Satisfactory” criteria and utilizes course concepts and reputable resources to support claims
Overview
Meets the
“Satisfactory” crit ...
Animal disease control and value chain practices: Incorporating economics and...ILRI
Presented by Karl M. Rich, ILRI, at the 5th Food Safety and Zoonoses Symposium of Asia Pacific, Global Health Institute 2018, Chiang Mai, Thailand, 6-7 July 2018
Preventing discrimination & harassment in the workplace - by Roddy Shaw, Principal Consultant of Diversity Factor at CSR Wednesday Briefing organized by CSR-Asia
Quality vs. Access case study Complete a full paper outline incl.docxmakdul
Quality vs. Access case study
Complete a full paper outline including each of the headings below. Make sure to touch upon the following items in your outline:
· Introduction: Briefly introduce the case study-Quality vs. Access (details attached). In addition, clearly state the purpose of the analysis and what you hope to prove in the report.
· Stakeholders: Identify the stakeholders who are involved in your case study. Discuss the entities who have an interest in the situation. How do their interests affect your ability to find a solution
· Overview: Provide a succinct overview of the current situation relating to your case study.
· Analysis: Provide an analysis of the situation. Make sure to discuss the incentives or lack thereof. How have the current incentives caused the problem? Address the specific questions posed in your chosen case study. Apply the concepts you have been exposed to throughout the course to aid in your analysis.
· Recommendations: Based upon your analysis, make appropriate recommendations that could alleviate or solve the presented problem.
· Conclusion
· References: Make sure to support your claims with reputable resources. All citation should follow the most current version of AMA style.
Background info:
Case Study: Quality vs. Access
The Affordable Care Act raised the Medicaid reimbursement levels to Medicare levels, resulting in improved appointment availability for Medicaid recipients. One of the components of the Affordable Care Act now coming into effect is the reporting of quality measurements and tying these into reimbursement. Some of the measurements are subjective, such as patient satisfaction, while others are quantitative, such as percentage of patients with their diabetes under control. Patient adherence to treatment plans has been shown to be as low as 40%. Opponents of the rating system say this system will result in more difficult and low socio-economic group patients being turned away by providers.
· How could the payment system be modified to reward quality of care but not result in reduced access to those in lower socio-economic groups or with poorer health?
Resources:
Wherry, Laura R., and Sarah Miller. "Early coverage, access, utilization, and health effects associated with the Affordable Care Act Medicaid expansions: A quasi-experimental study." Annals of internal medicine (2016). http://annals.org.une.idm.oclc.org/aim/article/2513980/early-coverage-access-utili zation-health-effects-associated-affordable-care-act
Martin, Leslie R., et al. "The challenge of patient adherence." Ther Clin Risk Manag 1.3 (2005): 189-199.
https://www-ncbi-nlm-nih-gov.une.idm.oclc.org/pmc/articles/PMC1661624/
Rubric
Introduction
Meets the
“Satisfactory” criteria and utilizes course concepts and reputable resources to support claims
Stakeholders
Meets the
“Satisfactory” criteria and utilizes course concepts and reputable resources to support claims
Overview
Meets the
“Satisfactory” crit ...
Animal disease control and value chain practices: Incorporating economics and...ILRI
Presented by Karl M. Rich, ILRI, at the 5th Food Safety and Zoonoses Symposium of Asia Pacific, Global Health Institute 2018, Chiang Mai, Thailand, 6-7 July 2018
Preventing discrimination & harassment in the workplace - by Roddy Shaw, Principal Consultant of Diversity Factor at CSR Wednesday Briefing organized by CSR-Asia
The dos and don'ts of user and employee engagement, with case studies from business and a focus on engagement in health and care - including measurement and stakeholders engagement planning.
The Lancet Series on Violence Against Women and GirlsTheLancetWeb
Every day, millions of women and girls worldwide experience violence. This abuse takes many forms, including intimate physical and sexual partner violence, female genital mutilation, child and forced marriage, sex trafficking, and rape. The Lancet Series on Violence against women and girls shows that such abuse is preventable. Five papers cover the evidence base for interventions, discuss the vital role of the health sector in care and prevention, show the need for men and women to be involved in effective programmes, provide practical lessons from experience in countries, and present a call for action with five key recommendations and indicators to track progress.
View Series on TheLancet.com: http://www.thelancet.com/series/violence-against-women-and-girls
VBP, Delivery System Reform, and Health and Social ServicesAndré Thompson, MPA
How are the services and supports you provide related to health, how valuable are your services and interventions for maintaining health, how would your services change if you were getting paid based on value rather than fee-for-service?
Presentation delivered at the Assoication of Police and Crime Commissioners conference in Manchester 20 June 2013: Working with multiple and complex needs.
Case Study "The Tipping Point: Moving DIRECTly from Availability to Adoption"
Featuring: Dawn FitzGerald, Chief Executive Officer, Qsource
As part of the American Recovery and Reinvestment Act (ARRA), awards were made to states to create the necessary infrastructure for widespread adoption of Direct technology. In partnership with the State of Tennessee, Department of Finance and Administration, and Office of eHealth Initiatives, Qsource was contracted to provide technical assistance to healthcare professionals in selecting, implementing and using certified Direct technology to improve the quality and value of healthcare.
A key component of the project was the selection of pilot communities in which to identify, develop and implement use cases that were sufficient to create a social and behavioral threshold for universal community-based adoption of Direct technology. Together with ICA as our Direct technology vendor, Qsource implemented the pilot over 5 months, culminating in a report of lessons learned from these pilots. These lessons learned are being used to inform Tennessee’s statewide roll out of Direct with the goal of achieving 4,000 users by February, 2014. This presentation will highlight best practices and lessons learned with regard to Direct implementation, along with up to date information on the status of Tennessee’s statewide rollout of Direct technology.
Learning Objectives:
∙ Attendees will be able to describe three general principals of expanding provider adoption
∙ Attendees will receive a brief review of Rogers’ Innovation Adoption Curve and the various incentives that are effective promoting early IT adoption
along that curve
∙ Attendees will hear valuable lessons learned in IT adoption from three distinct healthcare communities
Exploring the Reality of Self-Directed SupportCitizen Network
Simon Duffy explores the lessons that can be drawn from the UK experience of self-directed support. He outlines the key features of a good system for people, families and professionals in Perth, WA.
Advantages & Challenges of collecting & using longitudinal studies for research and policy.
Marta Favara, Senior Research Officer & Paul Dornan, Senior Policy Officer
Young Lives, University of Oxford
DFID Statistics Conference
6 September 2016
The dos and don'ts of user and employee engagement, with case studies from business and a focus on engagement in health and care - including measurement and stakeholders engagement planning.
The Lancet Series on Violence Against Women and GirlsTheLancetWeb
Every day, millions of women and girls worldwide experience violence. This abuse takes many forms, including intimate physical and sexual partner violence, female genital mutilation, child and forced marriage, sex trafficking, and rape. The Lancet Series on Violence against women and girls shows that such abuse is preventable. Five papers cover the evidence base for interventions, discuss the vital role of the health sector in care and prevention, show the need for men and women to be involved in effective programmes, provide practical lessons from experience in countries, and present a call for action with five key recommendations and indicators to track progress.
View Series on TheLancet.com: http://www.thelancet.com/series/violence-against-women-and-girls
VBP, Delivery System Reform, and Health and Social ServicesAndré Thompson, MPA
How are the services and supports you provide related to health, how valuable are your services and interventions for maintaining health, how would your services change if you were getting paid based on value rather than fee-for-service?
Presentation delivered at the Assoication of Police and Crime Commissioners conference in Manchester 20 June 2013: Working with multiple and complex needs.
Case Study "The Tipping Point: Moving DIRECTly from Availability to Adoption"
Featuring: Dawn FitzGerald, Chief Executive Officer, Qsource
As part of the American Recovery and Reinvestment Act (ARRA), awards were made to states to create the necessary infrastructure for widespread adoption of Direct technology. In partnership with the State of Tennessee, Department of Finance and Administration, and Office of eHealth Initiatives, Qsource was contracted to provide technical assistance to healthcare professionals in selecting, implementing and using certified Direct technology to improve the quality and value of healthcare.
A key component of the project was the selection of pilot communities in which to identify, develop and implement use cases that were sufficient to create a social and behavioral threshold for universal community-based adoption of Direct technology. Together with ICA as our Direct technology vendor, Qsource implemented the pilot over 5 months, culminating in a report of lessons learned from these pilots. These lessons learned are being used to inform Tennessee’s statewide roll out of Direct with the goal of achieving 4,000 users by February, 2014. This presentation will highlight best practices and lessons learned with regard to Direct implementation, along with up to date information on the status of Tennessee’s statewide rollout of Direct technology.
Learning Objectives:
∙ Attendees will be able to describe three general principals of expanding provider adoption
∙ Attendees will receive a brief review of Rogers’ Innovation Adoption Curve and the various incentives that are effective promoting early IT adoption
along that curve
∙ Attendees will hear valuable lessons learned in IT adoption from three distinct healthcare communities
Exploring the Reality of Self-Directed SupportCitizen Network
Simon Duffy explores the lessons that can be drawn from the UK experience of self-directed support. He outlines the key features of a good system for people, families and professionals in Perth, WA.
Advantages & Challenges of collecting & using longitudinal studies for research and policy.
Marta Favara, Senior Research Officer & Paul Dornan, Senior Policy Officer
Young Lives, University of Oxford
DFID Statistics Conference
6 September 2016
Bixby Lecture
Introduction to Honorable Justice Dr. Dingake presentation
"Gender Discrimination in Sexual & Reproductive Health Rights - The Role of the Judiciary in Southern Africa
February 4, 2019
UCLA, Bixby Center Lecture
"From horror to humor: Abortion on American television"
Gretchen Sisson, PhD
Advancing New Standards in Reproductive Health (ANSIRH)
UCSF Bixby Center for Global Reproductive Health
Bixby Center Lecture
"Homeless and Vulnerable Youth in Los Angeles: Sexual and Reproductive Helth Challenges"
November 29, 2017
by Carrie Mounier, LCSW
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...
Shah 12 4-13
1. The Economics of Sex Work:
A Developing Country Perspective
Manisha Shah
Department of Public Policy
UCLA
2. Motivation
Why should we as economists/social scientists care
about sex market?
1. Integral role in spread of disease including HIV/AIDS
3. Unprotected Commercial Sex is a
Major HIV Transmission Vector
• Each day 20,000 people become infected with
HIV (UNAIDS, 2002)
• More new cases in developing countries
– Condoms are effective defense against infection
– Large amounts spent on education of SWs
– Still many SWs risk infection by not using condoms
• SW HIV infection rates are high, esp in countries
with epidemic
5. Motivation
Why should we as economists/social scientists care
about sex market?
1. Integral role in spread of disease including HIV/AIDS
2. Source of employment for many women in poor
countries (micro/macro implications)
6. COUNTRY
Africa
Benin
Burkina Faso
Cameroon
Ivory Coast
Niger
Ethiopia
Kenya
Madagascar
Location
Area
% FSW
Cotonou
Capital
1.20%
Ouagadougou Capital
4.30%
Yaoundé
Capital
2.20%
Abidjan
Capital
0.70%
Niamey
Capital
2.60%
Addis Ababa Capital
2.10%
Kisumu
Provincial town 3.00%
Busia, Mumias Provincial town 6.90%
Diego-Suarez Provincial town 12.00%
Year
2001
2000–03
1997
2000
2004
2002
1997
1999
2001
Asia
India
Nepal
Indonesia
Cambodia
Mumbai
Kathmandu
Jakarta
Phnom Penh
Capital of State
District
Province
Province
0.50%
1.00%
1.40%
2.80%
2001
2001
2002
2003
Latin America
Dom Republic
Belize
Haiti
Bolivia
Colombia
Peru
Venezuela
–
–
–
–
–
–
–
–
–
–
–
–
–
–
1.80%
7.40%
2.00%
0.20%
0.70%
0.30%
1.50%
2001
2001
2001
2001
2001
2001
2001
Source: J Vandepitte, R Lyerla, G Dallabetta, F Crabbé, M Alary, A Buvé. (2006)
"Estimates of the number of female sex workers in different regions of the world,"
BMJ.
7. Labor market issues
• Huge source of employment for women in developing
countries, and growing (see BMJ table)
• Financial turnover of sex sector is quite large
– Indonesian financial turnover of sex sector was estimated at
between U.S 1.2 and 3.3 billion, or between 0.8 and 2.4% of the
country's GDP (Lim, 1998).
– Thailand, close to US 300 million was transferred annually from
urban SWs to rural areas in the form of remittances (Lim, 1998).
8. Motivation
Why should we as economists/social scientists care
about sex market?
1. Integral role in spread of disease including HIV/AIDS
2. Source of employment for many women in poor
countries (micro/macro implications)
3. Failure of policy prescriptions
9. Today we will….
•
Discuss three questions from an economists
perspective:
1. Why do sex workers engage in non-condom use?
(Gertler, Shah, Bertozzi, JPE 2005; Rao et. al JDE 2003)
10. Today we will….
•
Discuss three questions from an economists
perspective:
1. Why do sex workers engage in non-condom use?
(Gertler, Shah, Bertozzi, JPE 2005; Rao et. al JDE 2003)
2. Why do women enter the sex market?
(Robinson and Yeh, 2011; Edlund and Korn, JPE 2002;
Arunachalam and Shah, AER 2008)
11. Today we will….
•
Discuss three questions from an economists
perspective:
1. Why do sex workers engage in non-condom use?
(Gertler, Shah, Bertozzi, JPE 2005; Rao et. al JDE 2003)
2. Why do women enter the sex market?
(Robinson and Yeh, 2011; Edlund and Korn, JPE 2002;
Arunachalam and Shah, AER 2008)
3. How can public policy/laws/regulations related to sex
market impact the spread of disease? (Gertler and Shah JLE
2011, Shah and Cunningham 2013)
•
Use economic methods to investigate these
questions
12. Question:
• Do you think a sex worker should get more or less
money from a client when she does not use a
condom?
– Why or why not?
13. 1. Why do SWs engage in non-condom use?
Conventional Wisdom: Sex Workers do not use
Condoms because …
• Sex workers uninformed of risks
– Would protect themselves if understood risks
• Condoms not available or in short supply,
especially when needed
• Forced
– Physical-economic threats
– Psychological & social norms
14. Alternatively: SWs may be willing to
risk infection if compensated
• Could be rational response to client demand
– Clients value unprotected sex & are willing to pay for it
– SWs take risk if adequately compensated
• Happens in other sectors
– Compensating wage differentials for risky work
• Ex: police, firemen
15. Public Agencies Focus
Interventions on Supply Side
• Supply side interventions
– Educating SWs about risks and how to protect themselves
– Creating safe and supportive work environment – social capital
– Creating accessible supply of condoms
• However, supply-side alone will not stop unprotected sex
– If clients are willing to pay, SWs will take risk if compensated
• Alternatives
– Educate clients & lower demand for unprotected sex as well
16. We Investigate Whether SWs are
“Rationally” Responding to Incentives
• Are Sex Workers charging more to take the risk of
providing unprotected services?
17. Data Source
• Summer of 2001, wrote, piloted and attached economic
questionnaire to UNAIDS “Second Generation” study in
Mexico
• 2nd generation study tried to map universe of sex workers
in cities in 2 states
– Used this as a sampling frame
– How good was it?
• Sample of about 1034 sex workers
• Information on details of last 3-4 transactions for 3,884
observations
18. Transaction Specific Information
•
•
•
•
•
Price paid by client & received by sex worker
Services: vaginal, oral, anal, talk, dance, strip, massage
Condom use & who suggested
Non condom use & who suggested
CSW report of client characteristics: appearance,
wealth, education, personality, hygiene
• Alcohol & Drug use during transaction
• Client abused/hit sex worker
19. Table 2. Sex Worker Characteristics (N=1034)
Characteristics
Age
Age of first sexual experience
Years in sex work
Have had STIs/vaginal problems (=1)
Sex Worker is Very Attractive (=1)
Have Children (=1)
Education
Ever gone to school (=1)
Some secondary school or more (=1)
Civil Status
Single (=1)
Married or in Partnership (=1)
Divorced or Widowed (=1)
Primary Work Site
Bar/Club (=1)
Street (=1)
Other (=1)
Mean
27.82
15.65
6.04
0.17
0.21
0.62
0.84
0.36
0.41
0.22
0.38
0.82
0.12
0.06
St. Dev
7.77
2.36
6.83
20. Table 3. Client Characteristics Reported By Sex Worker (N=3837)
Regular Client (=1)
Age
Nice or Pleasant Personality (=1)
Wealth
Poor (=1)
Average Wealth (=1)
Above Average Wealth (=1)
Very Wealthy (=1)
Attractiveness
Handsome (=1)
Average (=1)
Ugly (=1)
Cleanliness
Dirty (=1)
Clean (=1)
Very Clean (=1)
Mean
0.64
36.04
0.66
0.17
0.70
0.08
0.05
0.10
0.66
0.24
0.10
0.73
0.17
Std. Dev.
11.01
21. Conducted focus groups with SWs
& Clients to Describe Market
• Clients
–
–
–
–
May not know prices or quality
Clients approach SW based on physical characteristics
Obtain information about prices & services
Clients value SW physical & personality characteristics
(e.g. beauty); pay more for these
– Client heterogeneity in tastes
– High search costs (time)
22. Sex Workers Negotiate Prices
• High search costs & client heterogeneity
able
to charge different prices to different clients
• Collects info based on appearance & conversation
to determine willingness to pay
–
–
–
–
Clothes, car, rings, cleanliness,…
Job, married, hotel, etc…
How much client likes SW …
Regular client gets charged more
23. Negotiation up front & renegotiate
as client preferences revealed
• Heterogeneity in timing of negotiation
• Some SWs (or agents) try to negotiate everything
up front – prices, services & condom use
• Terms almost always renegotiated in room
because clients ask for more or different services
• Condom use negotiated by SW and client
– Heterogeneity in client & SW preferences for condoms
24. A Bargaining Model
• Two agents
– A client who we will call “Richard”
– A sex worker called “Julia”
• Negotiate over Price & Condom Use
– Payoff functions
– Recursive solution
• Condom use
• Prices
25. Our Approach is Estimate a
Transaction Model
• Data: survey of 1050 SWs in Mexico
– Collected information on last 3-4 transactions
– Price, services, condom use & client characteristics
• Have SW panel where i indexes Sex Worker and t indexes
the transaction
• Estimate SW Fixed Effects models to control for selection
on SW characteristics
• Control for client characteristics with SW reports of client
looks, wealth, cleanliness, risk preferences
26. Table 5. Basic Log Price Fixed Effects Regressions
Whole Sample
Random
Effects
No Condom
Used
0.093
(3.91)***
Hausman Test
Fixed
Effects
Exclude
SWs Who
Never Use
Condoms
Exclude SWs
Who Always
Use
Condoms
Fixed
Effects
Fixed Effects
Exclude
Both Always
& Never
Condom
Users
Fixed
Effects
496.51***
0.132
(5.52)***
0.133
(4.19)***
0.135
(4.19)***
27.86***
F Stat SW FEs
0.131
(5.49)***
27.72***
16.09**
15.36**
# of Obs
3,837
3,837
3,753
1,309
1,225
# of SWs
1,029
1,029
1,007
363
341
27. Policy Implications (1)
• Strong evidence that
– SWs are willing to take the risk of providing
unprotected sex for a higher price
• Suggests why just educating sex workers has not
stopped HIV transmission thru unprotected sex
• Need to educate clients or provide financial
incentives for condom use to offset client WTP
28. 2. Why might women enter the sex
market?
•
•
Economic shocks/Poverty (Robinson and Yeh,2011)
Sex work pays well
(Edlund and Korn Marriage market hypothesis)
•
•
Lack of outside option
Force, kidnapping, trafficking (not discussed too
much in economics lit as we tend to assume free
choice)
29. Sex Work as a Response to Risk in Western Kenya
(Robinson and Yeh, 2011)
• Collect daily self-reported data on sexual
behavior, income shocks, expenditures, and labor
supply for sample of 237 women Western Kenya.
• Find significant day-to-day fluctuations in sex
worker decisions
• Women engage in sex-for-money transactions in
part to deal with unexpected non-labor income
shocks.
30. Pays Well
Sex work puzzle: Female dominated, low skilled,
low education—yet it pays really well.
31. Table 1: Summary statistics
Last week’s earnings
Age
None/some primary(%)
Completed primary(%)
Secondary(%)
High School(%)
University + (%)
Observations
Ecuador
(1)
Female
SWs
113.5
(154.6)
27.9
(8.01)
4.1
41.3
50.4
2.2
1.2
2782
Ecuador
(2)
Female
NSWs
50.7
(66.3)
36.2
(12.2)
2.5
23.8
40.4
1.5
31.6
1872
Ecuador
(3)
Domestic
Worker NSWs
37.6
(44.6)
37.1
(12.8)
4.1
35.8
45.2
0.7
14.0
1020
Ecuador
(4)
Male
SWs
80.4
(134.1)
24.0
(6.92)
2.3
25.6
63.2
3.8
4.5
574
Ecuador
(5)
Male
NSWs
67.1
(123.2)
36.7
(12.8)
1.9
32.5
42.9
1.1
21.4
3319
Mexico
(6)
Female
SWs
3886
(9785)
27.7
(7.6)
16.2
46.8
28.5
6.4
1.7
1038
Mexico
(7)
Female
NSWs
2117
(4101)
33.3
(11.3)
11.1
20.0
40.4
11.5
17.0
2454
Earnings from Ecuador are in US dollars and Mexican earnings are in pesos. Standard deviations are given in parenthesis.
11
32. Edlund-Korn (2002)
Marriage Market Hypothesis
• First formal model of prostitution in economics
• Draws intriguing link between labour and marriage
market that holds for one profession: prostitution
• Central assumption of model is that sex workers
cannot marry--in choosing SW, women relinquish
compensation otherwise received in marriage.
• Compensating differential due to foregone opportunity
to “sell” their fertility in marriage market.
33. Empirical test of the model
• Arunachalam and Shah, 2008 American Economic
Review P&P test the model
• Major findings:
– Sizable earnings premium for sex work (around 33%)
– Fail to find support for Edlund-Korn explanation
– Sex workers are actually more likely to be married than
non-sex workers at younger ages—when the earnings
premium for sex work is highest.
35. 1
Marriage rate by age
0
.2
.4
.6
.8
10
20
30
40
Age
Fitted sex workers
Fitted non−sex workers
Non−sex workers
50
60
95% CI
Sex workers
Figure 2: Marriage rates of female workers in Ecuador
70
36. An alternative hypothesis?
• Data seem to contradict prima facie case for marriage
market explanation for high returns to prostitution
• Natural competing explanation is compensating differential
due to risk
• Ecuador female sex worker data includes disease results
– Calculate DALYs lost due to observed increase in disease burden
from STIs
– Implies a compensating differential of at least 8% of sample
average earnings for sex work
• Sex work, like policework or other risky professions,
draws hazard pay.
37. Policy Implications (2)
• Programs to get women out of sex industry will
fail if alternatives don’t pay as well (most likely
won’t)
• How might we improve women’s outside option
in the labor market?
• Access to credit, savings, health insurance
(address these market failures) may reduce risky
sex and increased sex work labor supply
38. New Indonesia Project: Promoting Public Health
Through Savings for Sex Workers in Indonesia
• Provide mobile banking savings accounts to sex workers in
Indonesia
• Randomize into 3 groups:
1.
2.
3.
Control (business as usual)
T1: Offer savings account
T2: Offer savings account + financial incentive
• Follow sex workers for year, collecting daily data to test
hypotheses like:
1.
2.
3.
Do formal savings accounts increase savings for FSWs?
Do formal savings accounts improve strategies for coping with negative income shocks?
Do formal savings accounts decrease risky behavior among FSWs during commercial sex
transactions?
39. 3. How can public policy/laws/regulations impact
the spread of disease?
• Ecuador project: Collected data on 2000 SWs in 8
cities (plus biologicals) and collected data from
police about # of enforcement visits of carnet laws
• Increased enforcement in street decreases STI
prevalence but increases in brothel sector
– Why?
• Marginal woman on street moves to brothel sector (less risky,
less disease). Street prices increase, clients decrease
• Marginal woman from brothel moves to street
40. Rhode Island Study
• Indoor prostitution decriminalized “accidentally”
from 2003-2009 in RI
• Indoor sex sector grows—supply increases
• Gonorrhea incidence decreases