COMPARATIVE ANALYSIS OF WOMEN’S HEALTHCARE ON A GLOBAL SCALE

The purpose of this research paper is to compare the three health care systems of the following highly advanced industrialized countries: The United States of America, Canada, and Germany. The first segment of the research paper will focus on the description of health care systems in the above-mentioned countries, while the second part will analyze, evaluate, and compare the three systems on their initiative to address global health issues as they pertain to women. Lastly, an overview of proposed future reforms for the U.S. will be provided. I will start by providing a general description of global health

Chemical and Biological Study of Iraqi Kurdistan Chamomile Flower (Matricaria recutita L)

In this study, the chamomile flowers (Matricaria recutitaL) which grow in Iraqi Kurdistan region during the seasons of (2008) are collected. The percentage of essential oil was determined by using steam distillation and the extraction of flowers performed with petroleum ether (70-80) ºC and methanol 70% using ultrasonic extraction. Total phenolic compounds were determined from methanol extracts by using Folin-Ciocalteu method. The extracts were evaluated by thin layer chromatography, ultraviolet absorption and the biological activities were evaluated through their antibacterial action against two types of bacteria using hole method. The flowers showed a composition of 0.071% ash, 0.4% essential oil, 3.2% non oily compounds, 4% oil, 1.9% moisture and 0.19% total phenols. The results showed that the flowers contain biological active compounds and they can be used for treatment of diseases

Evaluating the Current State of Quality Measure Reporting in the Merit-Based Incentive Payment System

The Merit-Based Incentive Payment System (MIPS) requires physicians to report quality measures along with other metrics that are used to determine an annual percentage adjustment to physician Medicare Part B payments. Unfortunately, physicians have been forced to choose from an ineffective, limited set of quality measures. This has led to an overreliance on process measures, which fail to stratify physician performance effectively; it has also led to differences in the number of reporting options across specialties, resulting in unequal opportunity for physicians to succeed in MIPS. Using Centers for Medicare and Medicaid Services (CMS) public use file data from 2021-2024, we found that the number of quality measures available for reporting has declined annually since 2021, and that process measures accounted for a majority, 59% or more, of yearly measures. More than 33% of yearly measures failed to stratify physician performance effectively, and significant variability in the number of 2024 reporting options existed across specialties. Policymakers should ensure that future modifications to the MIPS program provide equal opportunity for physicians to achieve a positive Medicare Part B payment adjustment

Editorial: Glycans: molecules at the interface of immunity and disease

© 2024 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/Peer reviewe

Effects of Marijuana Use in Patients Undergoing Abdominal Free Flap Breast Reconstruction

PURPOSE: Marijuana use is associated with incidence of vascular inflammation and clotting, resulting in endothelial damage and arteritis. As marijuana use rises, few studies have evaluated its impact on surgical outcomes, wound healing, and vascular anastomoses in free flap breast reconstruction. METHODS: A retrospective cohort study of patients undergoing abdominal free flap breast reconstruction between 2016 and 2022 at a large metropolitan healthcare system was performed. Patient demographics, comorbidities, procedural details, and complications were analyzed. Minor complications were defined as skin necrosis, any wound requiring management in the clinic, hematoma, seroma, or fat necrosis that did not require intervention. Major complications were defined as re-operation, flap loss, thromboembolic events, or hospital readmission. Active marijuana users were those with marijuana use within 12 weeks of surgery. Those who utilized nicotine within 12 weeks of surgery were excluded from analysis. RESULTS: 149 patients underwent 241 deep inferior epigastric artery-based flaps for breast reconstruction. There were 17 active marijuana users. There were no significant differences in patient age, race, BMI, cancer treatment, cancer stage, or operative details. However, there were significantly higher rates of anxiety/depression, tobacco and narcotic use, and hypertension in the marijuana use group (P CONCLUSION: Marijuana use appears to not impact surgical outcomes in breast free flap reconstruction. Advising marijuana abstinence pre-operatively may not alter patient outcomes. This study may be limited by power and further evaluation will be needed

Internet Addiction and Its Relationship with Depression and Academic Performance: A Cross-Sectional Study at a Medical School in Pakistan

Background: Excessive Internet use may induce depression, influence relationships, and decrease academic performance. There is scarce information about Internet addiction in Pakistan. This study aimed to determine prevalence of Internet addiction and its relationship with depression and academic performance. Methods: A study based on a self-administered survey was carried out at a medical school in Peshawar, Pakistan. Participants were medical students (MBBS) and a non-randomized convenience sampling technique was utilized for data collection. We collected demographic information, last professional exam score, Internet addiction, and depression scores using the Young’s Internet Addiction Test (YIAT) and the Beck’s Depression Inventory (BDI), respectively. The analysis included binomial 95% confidence intervals (95% CI) estimations and linear and logistic regressions to assess variables relations. Results: We analyzed responses from 231 participants (380 students approached and 250 responded: response rate=65.79%, 19 excluded), 64.07% were male and the age average was 21±2 years. Profound and slight addiction to the Internet was found in 9.09% (95%CI=5.71-13.56) and 41.99% (95%CI=35.55-48.64) of students, respectively. Frequency of depression (mild-severe) was 59.74% (95%CI=53.11-66.12). Levels of Internet addiction and depression were found associated after adjusting by sex and age (?=0.27, R2=0.03, p-value=0.009). Internet addiction (OR=0.54, 95%CI=0.2-1.49, p-value=0.23) and depression (OR=0.62, 95%CI=0.36-1.09, p-value=0.10) were not significantly associated with low grades after adjusting by sex and age. Conclusion: More than half of the students are having excessive Internet usage which could result in despondency and academic performance deterioration. Internet addiction should be considered an emerging challenge and appropriate mitigation measures should be taken opportunely

Complications of Breast Reconstruction: Does the Area Deprivation Index Predict Risk?

INTRODUCTION: Despite mandated post-mastectomy reconstruction coverage since the Women’s Health and Cancer Rights Act (1998), vulnerable populations may be prone to breast reconstruction complications. The Area Deprivation Index (ADI) reflects neighborhood socioeconomic status utilizing US census data. This study investigates ADI\u27s relationship to breast reconstruction complications.METHODS: A retrospective study of immediate pre-pectoral direct-to-implant reconstruction patients at a metropolitan healthcare system from 2018-2022 was conducted. Patients were stratified by ADI: \u3c50th percentile (ADI=1-5) and ≥50th percentile (ADI=6-10). Demographics, medical history, treatment history, and postoperative outcomes were compared. Descriptive statistics identified differences between ADI groups. Minor complications were defined as incidence of hematoma, seroma, superficial wounds, full thickness necrosis, or oral antibiotic-treated cellulitis. Major complications were defined as incidence of hospital readmission or return to OR. Long-term complications were defined as incidence of capsular contracture or ≥3 revisions. Logistic regression assessed ADI’s predictive value, accounting for confounds between cohorts.RESULTS: Of 195 patients, 147 had low ADI and 48 had high ADI. Significant differences in BMI and race were found between groups. Low ADI demonstrated higher BMI (p\u3c0.01) and black patient representation (p\u3c0.01). No differences were found for any complications.CONCLUSIONS: Contradictory to the literature highlighting greater surgical complication rates in low ADI patients, our results show comparable outcomes to high ADI patients. Our multidisciplinary breast cancer program delivers high quality standardized care with early plastic surgeon consultation and patient education throughout multiple hospital systems with racial, ethnic, and socioeconomic diversity. Education, support, and access are provided equally regardless of ADI

The conditions of Total Quality Management (TQM) using the Principal Component Analysis (PCA) (An Algerian case study)

Total Quality Management (TQM) is a relatively recent concept which constitutes an important parameter in any company’s competitivity. Today, quality concerns every Algerian company since it must rival big companies in terms of the economic liberation policy. For effective application, TQM requires the availability of a certain number of conditions and leadership qualities. Therefore, the purpose of this study was to determine these conditions and qualities. For this purpose and according to their organizational levels, the studied companies were classified into three groups using the Principal Component Analysis (PCA): quality control, quality assurance, and TQM to identify the criteria governing each company in each level, and then deduct the conditions of quality management. As a result, the study found that although some Algerian companies have ISO certificates, they do not apply some of the crucial quality elements like leadership and lack the strategic vision of quality. It is recommended that the companies execute global quality management rules and their requirements to earn the ISO certificate and encourage teamwork and managers’ individual initiatives by giving them more independency