Chinese Strategies for Getting Health Care: Guanxi and its Alternatives

Chinese citizens are accustomed to dealing with risk and making choices about how to get things done. Such choices are evident in popular responses to hypothetical situations corresponding to three typical unethical practices in Chinese hospitals: overprescribing medicines not covered by insurance, encouraging patients to take unnecessary diagnostic tests, and taking bribes (“red envelopes” or hong bao) for treatment which has already formally been paid for. Using nationally representative survey data, this study examines public perceptions of the likelihood of encountering these practices in local county or district hospitals as well as preferences between different strategies for dealing with them. We develop and test hypotheses about the social structural determinants of preferred strategies: focussing on urban versus rural contexts, level of development, gender, age, education and income. The conclusion considers the implications of the findings for policies designed to mitigate unethical practices

Survey of Italian pediatricians on awareness, experiences and beliefs regarding direct-to-consumer genetic testing in minors

Background: Our study wanted to assess Italian pediatricians’ awareness, experience and beliefs regarding directto- consumer (DTC) genetic tests (GT) in minors, with a focus on those for predisposition to complex disease, lyfestyle, athletic ability and other inborn talents. Methods: A 28-item questionnaire was administered through the SurveyMonkey® web platform to the 9,086 members of the Italian Society of Pediatrics for which a valid email address was available. The survey was opened from April through November 2017. Statistical analyses were performed using the Graphpad software package. Results: 36.2% of the 442 respondents were aware of DTC-GT, but only 23.1% of them felt adequately prepared to meet families’ information needs. The first three sources of knowledge were the Internet (20.98%), magazines/ newspapers (16.78%) and TV/Radio (14.33%), while companies’ direct marketing activity influenced knowledge only in 2.45% of the cases. Only 16.4% of the aware respondents had been already approached for advice. More than 95% of the pediatricians who were aware would not advise DTC-GT for lifestyle, athletic performance or other inborn skills. 69.2% was unfavourable to susceptibility tests for complex diseases. Most of them expressed an interest in learning more and indicated as preferred sources of information public policies issued by professional societies. Conclusion: The low awareness and experience and the vendors’ tiny contribution to knowledge suggest a still limited penetration of DTC-GT companies in Italy. A great interest in learning more was found. Scientific societies are best positioned to support health professionals in this educational goal thanks to their role of trusted sources of information and guidance

An expert system for a local planning environment

In this paper, we discuss the design of an Expert System (ES) that supports decision making in a Local Planning System (LPS) environment. The LPS provides the link between a high level factory planning system (rough cut capacity planning and material coordination) and the actual execution of jobs on the shopfloor, by specifying a detailed workplan. It is divided in two hierarchical layers: planning and scheduling. At each level, a set of different algorithms and heuristics is available to anticipate different situations.\ud \ud The Expert System (which is a part of the LPS) supports decision making at each of the two LPS layers by evaluating the planning and scheduling conditions and, based on this evaluation, advising the use of a specific algorithm and evaluating the results of using the proposed algorithm.\ud \ud The Expert System is rule-based while knowledge (structure) and data are separated (which makes the ES more flexible in terms of fine-tuning and adding new knowledge). Knowledge is furthermore separated in algorithmic knowledge and company specific knowledge. In this paper we discuss backgrounds of the expert system in more detail. An evaluation of the Expert system is also presented