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Purpose
Two of the crucial components of health care service utilisation are the type of health care services received (government, private, others) and the place visited (same village, another village, another district/town, a metro city, abroad, etc.). The association between health care facilities and gender is important for understanding the disparities between males and females. Thus, the primary objective of this study was to reassess the gender differences in the type and place of health care utilisation.Methods
Data from the second round of the India Human Development Survey (2011–2012) were used for this study. Analysis was done using both bi- and multivariate techniques (multinomial logistic regression).Results
Results indicate an improvement in the female health care-seeking behaviour. We found that females have a higher tendency to visit private health care centres, whereas a higher percentage of males used government health care services for the treatment of both long- and short-term morbidities. Males and females reported visiting health care centres within the village, in another village, in another district/town and in a metro area/abroad for treatment approximately to the same extent.Conclusion
The analysis of the male and female treatment-seeking behaviour revealed a clear picture of proliferating gender neutrality. The increase in the health care-seeking behaviour of women can be considered an upshot of improved female education and increased awareness among males regarding female empowerment. Government interventions in different sectors have also improved the plight of women directly or indirectly.54.
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Kyle B. Woodward Hong Zhao Pradeep Shrestha Lalit Batra Min Tan Orlando Grimany‐Nuno Laura Bandura‐Morgan Nadir Askenasy Haval Shirwan Esma S. Yolcu 《American journal of transplantation》2020,20(5):1285-1295
We have previously shown that pancreatic islets engineered to transiently display a modified form of FasL protein (SA‐FasL) on their surface survive indefinitely in allogeneic recipients without a need for chronic immunosuppression. Mechanisms that confer long‐term protection to allograft are yet to be elucidated. We herein demonstrated that immune protection evolves in two distinct phases; induction and maintenance. SA‐FasL‐engineered allogeneic islets survived indefinitely and conferred protection to a second set of donor‐matched, but not third‐party, unmanipulated islet grafts simultaneously transplanted under the contralateral kidney capsule. Protection at the induction phase involved a reduction in the frequency of proliferating alloreactive T cells in the graft‐draining lymph nodes, and required phagocytes and TGF‐β. At the maintenance phase, immune protection evolved into graft site‐restricted immune privilege as the destruction of long‐surviving SA‐FasL‐islet grafts by streptozotocin followed by the transplantation of a second set of unmanipulated islet grafts into the same site from the donor, but not third party, resulted in indefinite survival. The induced immune privilege required both CD4+CD25+Foxp3+ Treg cells and persistent presence of donor antigens. Engineering cell and tissue surfaces with SA‐FasL protein provides a practical, efficient, and safe means of localized immunomodulation with important implications for autoimmunity and transplantation. 相似文献
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Background
Repair of primary and recurrent giant incisional herniae is extremely challenging and more so in the face of surgical field contamination. Literature supports the single- and multi-staged approaches including the use of biological meshes for these difficult patients with their associated benefits and limitations.Patients and methods
This is a retrospective analysis of a prospective study of five patients who were successfully treated through a multi-staged approach but in the same hospital admission, not previously described, for the repair of contaminated primary and recurrent giant incisional herniae in a district general hospital between 2009 and 2012. Patient demographics including their BMI and ASA, previous and current operative history including complications and follow-up were collected in a secure database. The first stage involved the eradication of contamination, and the second stage was the definitive hernia repair with the new generation-coated synthetic meshes.Results
Of the five patients, three were men and two women with a mean age of 58 (45–74) years. Two patients had grade 4 while the remaining had grade 3 hernia as per the hernia grading system with a mean BMI of 35 (30–46). All patients required extensive adhesiolysis, bowel resection and anastomoses and wash out. Hernial defect was measured as 204* (105–440) cm2, size of mesh implant was 568* (375–930) cm2 and the total duration of operation (1st + 2nd Stage) was 354* (270–540) min. Duration of hospital stay was 11* (7–19) days with a follow-up of 17* (6–36) months.Conclusion
We believe that our multi-staged approach in the same hospital admission (for the repair of contaminated primary and recurrent giant incisional herniae), excludes the disadvantages of a true multi-staged approach and simultaneously minimises the risks and complications associated with a single-staged repair, can be adopted for these challenging patients for a successful outcome (* indicates mean). 相似文献58.
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Jisoo Park Yuwen Li Seon-Hwan Kim Keum-Jin Yang Gyeyeong Kong Robin Shrestha Quangdon Tran Kyeong Ah. Park Juhee Jeon Gang Min Hur Chul-Ho Lee Dong-Hoon Kim Jongsun Park 《Metabolism: clinical and experimental》2014