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简介：AbstractBackground:Lymphatic filariasis (LF) remains one of the world’s most debilitating parasitic infections and is a major contributor to poor health in many endemic countries. The provision of continuing care for all those affected by LF and its consequences is an important component of the United Nations’ Sustainable Development Goals. The aim of this study is to integrate lymphedema care into the primary health care system of the State by developing lymphedema clinics at each district, through training of health personnel to fulfill WHO recommendation for morbidity management and disability prevention.Methods:Selected health care providers from all the districts in Kerala State of India participated in intensive training sessions endorsed by the State’s health administration. The six training sessions (from 5 June 2017 to 25 May 2018) included appropriate self-care information and development of individual plans for each participating institution to provide instruction and care for their lymphoedema patients. The learning achieved by attendees was assessed by pre- and post-training tests. The number of lymphoedema patients receiving care and instruction from the post-training activities of each participating institution was assessed from local records, 6 months after the conclusion of the training sessions.Results:One hundred and eighty-four medical personnel (91 doctors and 93 nurses) from 82 medical institutions were trained which quickly led to the establishment of active lymphoedema clinics providing the essential package of care (EPC) for lymphoedema patients at all the participating institutions. Six months after the training sessions the number of previously unidentified lymphoedema patients registered and receiving care at these clinics ranged from 296 to almost 400 per clinic, with a total of 3,477 new patients receiving training in EPC.Conclusions:Generalist health personnel, when appropriately trained, can provide quality lymphoedema care in public health settings and patients when provided services close to their home, are willing to access them. This is a feasible strategy for integrating long term care for LF patients into the national health system, and is a clear example of moving towards equity in health care for the medically underserved, and thus successfully addresses a major goal of the global program to eliminate lymphatic filariasis.

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简介：Healthcareisindeedacomplexservicesystem,onerequiringthetechnobiologyapproachofsystemsengineeringtounderpinitsdevelopmentasanintegratedandadaptivesystem.Ingeneral,healthcareservicesarecarriedoutwithknowledge-intensiveagentsorcomponentswhichworktogetherasprovidersandconsumerstocreateorco-producevalue.Indeed,theengineeringdesignofahealthcaresystemmustrecognizethefactthatitisactuallyacomplexintegrationofhuman-centeredactivitiesthatisincreasinglydependentoninformationtechnologyandknowledge.Likeanyservicesystem,healthcarecanbeconsideredtobeacombinationorrecombinationofthreeessentialcomponents–people(characterizedbybehaviors,values,knowledge,etc.),processes(characterizedbycollaboration,customization,etc.)andproducts(characterizedbysoftware,hardware,infrastructures,etc.).Thus,ahealthcaresystemisanintegratedandadaptivesetofpeople,processesandproducts.Itis,inessence,asystemofsystemswhichobjectivesaretoenhanceitsefficiency(leadingtogreaterinterdependency)andeffectiveness(leadingtoimprovedhealth).Integrationoccursoverthephysical,temporal,organizationalandfunctionaldimensions,whileadaptationoccursoverthemonitoring,feedback,cyberneticandlearningdimensions.Insum,suchservicesystemsashealthcareareindeedcomplex,especiallyduetotheuncertaintiesassociatedwiththehuman-centeredaspectsofthesesystems.Moreover,thesystemcomplexitiescanonlybedealtwithmethodsthatenhancesystemintegrationandadaptation.

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简介：关键词艾灸治疗-健康提升艾灸-预防的药鍏抽敭璇？鐏告硶-淇濆仴鐏?-棰勯槻鍖诲CLC数字R245.8资金项目：中国的国家基本研究节目(973编程序，2009CB522904)；湖南省(08C633)作者的教育部门的工程：YANJie(1941鈥?，女性，教授，博士优异通讯作者：吴焕干(1956鈥?，男性，教授，博士上级

简介：知道的人天生的钟工作允许理解什么时候并且治疗为什么是有效的。守夜chronotypes决心和尊重允许避免学者失败。表演取决于chronotypes和时间变化。夜里睡觉周期的最小、最大的持续时间源于在内长、外长的钟之间的相互作用。我们的ecoexotope被是为endophysiotope钟的synchronisers的太阳、月亮、陆上的节奏组织。人夜里睡觉变化取决于月亮的周期乘火车。睡觉分析指向作为控制过去常证实大约每月月亮的大约年度的太阳的节奏。为了证实生理的回答，单个纵的记录被使用。到证据lithotherapeutic效果，刺激回答根据一个双窗帘被测试控制安慰剂的调查。什么矿物质到选择?，为什么?，怎么对待?，什么时候？与控制相比，硬玉的一种或软玉与醒来和泌尿的15褶层减少提高夜里睡觉质量。最高的安慰剂效果在4褶层增加下面。取决于矿物质和踪迹元素，性质变化。矿物质水晶结构被证实有一个行动。有皮肤的接触区域是一个限制因素。安慰剂效果在日子阶段期间是更大的。红碧石处理提高日报的物理工作的数字和紧张。矿物质以一种剂量依赖者方式并且在协同作用行动。赤铁矿脚底给安慰剂效果，但是由15褶层价值增加serpentinite的效果。在一个钟网络以内，全部的潜伏阶段比每只钟的最短的潜伏阶段短，提高系统反应。

简介：HealthcarefraudisanincreasinglylargeproblemintheUnitedStatesforpatients,taxpayers,andthegovernment,withtheNationalHealthcareAnti-FraudAssociation(NHCAA)estimatingthecoststobemorethantensofbillionseachyear(NHCAA,2018).Toaddressthisissue,governmentagenciesandinsurerscanutilizedataanalyticstodetectandpreventhealthcarefraud.TheAmericanSeniorCommunities(ASC)caseisarecentexampleofacomplexhealthcarefraudschemecommittedbyseveralhighrankingofficersinvolvingkickbacks,fictitiousvendors,andmoneylaunderingthroughshellcompanies.Theindictmentdetailshow$16millionwasstolenisparticularlygiventhepopulationcaredforbyASC—theelderly,individualswithdisabilities,lowincomeadults,pregnantwomenandchildren.Thiscasedemonstratesseveralwayshealthcarefraudcanbeperpetrated,highlightstheroleoftheauditor,andintroducesstudentstotheimportanceofemployingdataanalyticstopreventanddetectfraud.

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简介：2008年4月14日，全球领先的生命科学产品供应商通甩电气医疗集团生命科学部（GEHCLifeSciences）在中国科学院文献情报中心会议中心举办。挑战性蛋白质纯化讲座。北京站的活动，会议中心座无虚席．来自北京大学．清华大学．中国科学院．中国医学科学院等大学研究机构的专家学者出席了讲座，

简介：这份报纸联合队和数据包封分析(DEA)的理论设计机制最佳地在公共保健分配资源。在它的统治下面的一个法令的权威和公共医院作为一个队，其成员寻求在公共保健是公众的分享的机构的限制下面高效地操作被解释好。单个公共医院利用DEA最大化自己发薪，到对方公众医院的发薪不从外部效果掉落并且从而减去的队条件的题目由保健的公共供应创造了。产生team-DEA答案，它被显示是两个一个别地有效并且team-satisficing平衡并且以一个会聚的算法可计算出来，然后能被权威使用在公共保健决定资源的最佳的分配。一个盒子基于中国数据被介绍说明team-DEA模型准备好了的operationalization和计算。

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简介：StateAdministrationofTraditionalChineseMedicine(SATCM),jointlywithNationalHealthandFamilyPlanningCommission(NHFPC),issuedresultsofsurveyonhealthcareliteracyoftraditionalChinesemedicine(TCM)onMarch31.Asthefirstnationalspecialsurveyonsciencepopularizationof

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简介：Primaryesophagealadenocarcinoma(PEAC)isararemalignantdiseaseofesophagus.Becauseofitslowerincidence,theknowledgeaboutitislimitedandtherearesomeproblemsrequiringfurtherstudy.Duringrecent30years,106patientswithPEAChadbeentfeatedsurgicallyinourdepartment...

简介：Cardiovasculardisease(CVD)istheleadingcauseofdeathworldwide.ThisarticlefocusesoncurrentguidelinesfortheprimarypreventionofCVDandaddressesmanagementofkeyriskfactors.Dietarymodification,weightloss,exercise,andtobaccousecessationarespecificareaswherefocusedeffortscansuccessfullyreduceCVDriskonbothanindividualandasocietallevel.Specificareasrequiringmanagementincludedyslipidemia,hypertension,physicalactivity,diabetes,aspirinuse,andalcoholintake.Thesepreventiveeffortshavemajorpublichealthimplications.Astheglobalpopulationcontinuestogrow,healthcareexpenditureswillalsorise,withthepotentialtoeventuallyoverwhelmthehealthcaresystem.ThereforeitisimperativetoapplyourcollectiveeffortsonCVDpreventiontoimprovethecardiovascularhealthofindividuals,communities,andnations.