The French Health Care System; What can We Learn?

All public systems look for the best organizational structure to funnel part of their national income into healthcare services. Appropriate policies may differ widely across country settings. Most healthcare systems fall under one of two broad categories, either Bismark or Beveridge systems. There is no simple ideal model for the organization of health services, but most healthcare systems that follow the Beveridge healthcare model are poor performers. The Libyan Health system is a low responsive, inefficient and underperforming system that lacks goals and/or SMART. (Specific, Measurable, Achievable, Realistic, Time specific) objectives. A look at different organization models in the world would reinforce efforts to reorganize and improve the performance of the Libyan National Healthcare services. The French Health Care System (FHCS) ranked first according to the WHO and the European Health Consumer Powerhouse. The FHCS was described to have a technically efficient, generous healthcare system that provides the best overall health care. This makes the FHCS a practical model of organization having many of the essential aspects of a modern national health service. In this review, we describe the main features of the FHCS, current challenges and future trends with particular attention paid to aspects that could be of importance to the Libyan Healthcare System

The preparation and characterization of chitosan/poly (vinyl alcohol) blended films : mechanical, thermal and surface investigations

In this study, blends of chitosan (CS) and polyvinyl alcohol (PVA) (CS/PVA) having various proportions were prepared and characterized by universal mechanical tester, the differential scanning calorimetry (DSC) and contact angle measurements. Studying the mechanical properties of the films showed that blending improved the tensile strength, which increased with increasing PVA content up to 40% while the elongation% at break of the blends was decreased compared to that of the pure components. The obtained results of DSC suggested that some interaction between chitosan and PVA mostly took place. Static water contact angle measurements showed an improvement in the wettability of the obtained films

The cost-effectiveness of celecoxib versus non-steroidal anti-inflammatory drugs plus proton-pump inhibitors in the treatment of osteoarthritis in Saudi Arabia

Background: Cyclooxygenase (COX)-2 inhibitors including celecoxib are as effective as non-selective non-steroidal anti-inflammatory drugs (ns-NSAIDs) in the treatment of osteoarthritis (OA) and have less gastrointestinal toxicity. Although they are associated with higher treatment costs, COX-2 inhibitors may simultaneously reduce costs associated with adverse events, hence, their overall economic benefit should be assessed. Objective: To evaluate the incremental cost effectiveness ratio (ICER) of celecoxib versus ns-NSAIDs, with/without proton-pump inhibitor (PPI) co-therapy, for managing OA in Saudi Arabian subjects aged Ï65 years. Methods: The National Institute for Health and Care Excellence health economic model from the UK, updated with relative risks of adverse events using CONDOR trial data, was adapted. Patients received celecoxib or ns-NSAIDs, with/without omeprazole. The effectiveness measure was quality-adjusted life years (QALYs) gained per patient. The analysis was conducted from the patient's perspective. Frequencies of resource use for adverse events were based on data collected in July 2012 from seven private hospitals in Jeddah, Saudi Arabia. Probabilistic sensitivity analysis was performed to construct cost-effectiveness acceptability curves (CEACs). Results: Over a 6-month treatment duration, QALYs gained per patient were higher with celecoxib (0.37) and celecoxib plus PPI (0.40) versus comparators. Ibuprofen plus PPI showed the lowest expected cost per patient (US$1,314.50 versus US$ 1,422.80 with celecoxib plus PPI and US$1,543.50 with celecoxib). Celecoxib plus PPI was the most cost-effective option with an ICER of US$ 1,805.00, followed by celecoxib (ICER, US$7,633.33) versus ibuprofen plus PPI. Over 2- and 5-year treatment durations, celecoxib plus PPI, and celecoxib, showed higher QALYs gained/patient and lower ICERs versus comparators. These ICERs are <1 gross domestic product/capita in Saudi Arabia in 2013 (US$ 25,961). CEACs over 6 months' treatment showed a significantly higher likelihood that celecoxib plus PPI and celecoxib alone would be more cost effective versus comparators once the willingness to pay is over US$ 2,000.00. Conclusion: After considering new adverse event risks, celecoxib with/without PPI co-therapy was deemed very cost effective for medium- and long-term use in Saudi Arabian OA patients aged Ï65 years

Using Shabby Chic Style in Contemporary Clothing Accessories to Achieve the Principles of Sustainable Development

The research team is keen to provide a new thinking approach characterized by creativity and innovation to achieve the principles of sustainable development, both environmentally and economically. Thus, the team thought about how to preserve the environment by using worn-out clothes and accessories that are not usable again or through recycling instead of disposing of them permanently in a way that harms the environment while emphasizing the economic aspect and reducing the cost. The research team invented artworks with an antique touch as accessories to contemporary clothes, based on the Shabby Chic style, which is one of the economical styles that reuses old worn-out items and mixes them with simple modern ones to create an atmosphere of simplicity and elegance. It is a method used in interior design that combines elements of old furniture with simple design, soft colors, and classic touches that give the house a comfortable and attractive atmosphere. This is the reason why the research team applied the rules of this style with clothes and their accessories attempting to provide inexpensive and creative solutions to be the basis of a small successful project that goes with the new trend of entrepreneurship, in line with the events that the whole world is witnessing nowadays; and this is the most prominent goal of the research. The research followed the descriptive approach with analysis and application. It included a questionnaire to measure the opinions of experts about the suggested designs, and a questionnaire to identify the opinions of consumers about the suggested designs as well. The findings suggest that Shabby Chic Style could be used to create contemporary designs for clothing accessories that meet the principles of sustainable development and entrepreneurship

SOME α-OPERATORS VIA IDEALS

Abstract: The aim of this paper is to introduce some types of α-operators via ideals. We further study some properties of these types. Some propositions, remarks and examples are offered to explain these concepts

An Artistic Vision of Using Polyurethane Foam in Drapping Fictional Costumes Designs to Achieve Sustainable Development

One of the aspects of the modern era is leaving more room for imagination and experimentation. Costumes design in general and fictional costumes design in particular are among the areas that need a lot of experimentation, especially with new, non-traditional materials. This is what encouraged the researchers to choose the polyurethane foam as a non-traditional material to design fictional costumes in order to achieve sustainable development goals. The research aims at clarifying the characteristics of the polyurethane foam and it’s Forming instead of plastic capabilities in the field of Costumes design, and providing proposals for fictional costumes designs with this material, in addition to achieving the sustainable development goals; such as, adopting sustainable production and consumption patterns, and stimulating innovation. The research findings state the possibility of achieving new visions of using the polyurethane foam to design and create fictional costumes in order to achieve the goals of sustainable development

Human bone marrow-derived mesenchymal stem cells

Mesenchymal stem cells (MSCs) have elicited a great clinical interest, particularly in the areas of regenerative medicine and induction of tolerance in allogeneic transplantation. Previous reports demonstrated the feasibility of transplanting MSCs, which generates new prospects in cellular therapy. Recently, injection of MSCs induced remission of steroid-resistant acute graft-versus-host disease (GVHD). This review summarizes the knowledge and possible future clinical uses of MSCs

Extensions of Weak PS-Rings

In this paper, we prove that, under mild conditions, if R is a right weak PS-ring, then so does the skew inverse power series ring R[[x−1;α,δ]], the skew generalized power series ring R[[S,ω]], and the differential inverse power series ring R[[x−1;δ]]

In-Situ Continuous Production of Hydrogen Gas from Molasses Using Mutated Enterobacter aerogenes ADH43 for Fuel Cell Application

The performance of the continuous stirred tank reactor (CSTR) for the in-situ production of hydrogen gas (H2) integrated with a polymer electrolyte membrane fuel cell (PEMFC) was investigated. Facultative anaerobe fermentation of Enterobacter aerogenes ADH-43 was conducted into CSTR 50 rpm of agitation speed , 37 0C of temperature, 6.3 of pH, and 0.15, 0.3, 0.45, 0.60 h-1 of dilution rate. Bio-H2 produced was assesed after inserting it into a fuel cell to generate electricity and measuring voltages. The system was integrated with a ceramic membrane having 0.2 µm pore size for recycling the retentate cell into reactor and separating the permeate supernatant during the fermentation. The obtained H2 was purified from CO2 by absorption in Ca(OH)2 solution prior to feed to PEMFC. The CSTR was initially operated on batch basis to increase the bacterial cell density to ensure the production of sufficient H2 and develop a feeding culture strategy for the continues operation mode. The result showed that the highest H2 production was achieved at continuous system resulted in 0.30 h-1 of optimum dilution rate. The maximum H2 volume of 9.76 l H2/l sugar , the yield of 1.84 mol H2/mol sugar, and the flow rate of 115 ml H2/min were obtained. Furthermore, colony count of 9.81 log cfu/ml, pH of 5.73, maximum electrical current of 0.38 Ampere, electrical power of 2.20 Watt, and electrical voltage of 5.75 volt after given resistance using LED of 25 ohm was also reached