Out-of-Pocket Health Care Expenditures in Uzbekistan: Progress and Reform Priorities

Over the past twenty years, Uzbekistan’s health system changed drastically from the inherited Soviet health system. This research aims to examine the main aspects of the Uzbek health financing system and policy process that led to out-of-pocket (OOP) health care expenditures by using a mixed-method case study approach. Qualitative findings reveal that the covered basic benefit package is limited. Health care evaluation methods and accessible information on health quality are lacking. This leads to inefficient use of resources and a risk of using unnecessary or low-quality health services. Quantitative findings reveal that especially the chronically ill have high OOP. Furthermore, alcohol use, health status of the household head, money saved in the past and place of residence proved to be significant factors. This research showed that the limited benefit package, lacking evaluation methods, and inaccessible information on health care led to high OOP. Policies remain inefficient at addressing OOP due to limited civilian participation, lack of data, and limited evidence-based decision making. This research suggests that the benefit package should be expanded to cover the chronically ill

Food safety in Latin American informal food establishments

Background and aimInformal food establishments are an important source of food due to their increased affordability of products and convenience. Food security and safety are two key factors that must coexist for a proper functioning of the food system. In Latin America, the safety of food is less analyzed than food security, although it is central to people’s health, as well as to their personal sustainability. Since informal food establishments are popular food sources in Latin America, this research aims to examine the presence of foodborne pathogens in food products from such establishments.MethodsThis research will be conducted as narrative literature review, collecting data from all publications in Spanish-speaking countries in Latin America between January 1, 2018, and May 31, 2023. The databases searched were PubMed and Web of Science. The search included pathogens such as bacteria, parasites and viruses. The languages of the articles assessed were English and Spanish.ResultsThe analysis was based on 32 articles focusing on seven of all Spanish-speaking countries in Latin America. The pathogens found belonged either to a bacteria type, or to a parasite. No viruses were investigated within the selection of articles. The widest variety of pathogens was among bacteria. The most frequently identified bacteria belonged to the family Enterobacteriaceae. The food products examined ranged from animal products to fruit and vegetables, fish, seafood and already-prepared dishes or juices. The informal food establishments where the studies conducted their analyses were markets, backyard selling points, street establishments or convenience food stores.ConclusionIdentifying pathogens in food products commercialized at different informal retail points has impacts for the safety of the food from personal sustainability viewpoint. Therefore, efforts need to be directed toward better support of the informal food sector in their provision of safe food. Further investigation could trace the exact sources of infection, while public health officials can implement safety programs in cooperation with food vendors

Auricular conchal cartilage for treatment of empty nose syndrome

Empty nose syndrome is an uncommon complication of turbinoplasty and other nasal operations. It presents with various manifestations, with the most common symptom being paradoxical nasal obstruction. Here, we report the case of a 67-year-old male patient diagnosed with empty nose syndrome 20 years after turbinoplasty. Autologous auricular conchal cartilage was harvested and implanted into the lateral wall of the inferior turbinate to reduce nasal volume. The patient experienced significant relief from subjective nasal obstruction symptoms immediately after surgery. Over a 23-month follow-up period, no side effects or symptom recurrence was reported

Acetonitrile­{3-[bis­(2-pyridyl­methyl-κN)amino-κN]propanol-κO}(perchlorato-κO)copper(II) perchlorate

In the title compound, [Cu(ClO4)(C2H3N)(C15H19N3O)]ClO4, the CuII ion is coordinated by three N atoms and a hydroxyl-O atom of the tetra­dentate ligand, an O atom of a perchlorate ion and an N atom of an acetonitrile ligand giving a tetra­gonally distorted octa­hedral environment around the copper(II) atom. There is an offset inter-complex face-to-face π–π inter­action [centroid–centroid distance = 3.718 (2) Å] involving one of the pyridine rings of the ligand as well as an intra-complex O—H⋯O hydrogen-bonding inter­action between the coordinated hydroxyl group of the ligand and the perchlorate counter-ion

The association of relational and organizational job stress factors with sleep disorder: analysis of the 3rd Korean working conditions survey (2011)

BACKGROUND: Sleep disorder is a disease that causes reduction in quality of life and work efficiency of workers. This study was performed to investigate the relationship between job-related stress factor and sleep disorder among wageworkers in Korea. METHODS: This study was based on analysis of the 3rd Korean working conditions survey. We analyzed 35,902 workers whose employment status is wageworker. We classified the job-related stress factor into 12 sections. Logistic regression was performed to estimate the relationship between job-related stress factor and sleep disorder and Odds ratio and 95 % CI were calculated using the SPSS version 23.0 program. RESULTS: Many categories of Job-related stress factor were correlated with sleep disorder (8 of 12 for women, 10 of 12 for men). The results of the regression analysis, corrected for general and occupational characteristics, indicated that sleep disorder was significantly correlated with the following categories of job-related stress: discrimination experience (OR 3.37, 95 % CI = 2.49 ~ 4.56 in women, OR 1.96, 95 % CI = 1.53 ~ 2.51 in men), direct customer confrontation (OR 2.72, 95 % CI = 1.91 ~ 3.86 in women, OR 1.99, 95 % CI = 1.45 ~ 2.72 in men), emotional stress (OR 2.01, 95 % CI = 1.30 ~ 3.09 in men), work dissatisfaction (detailed) (OR 1.99, 95 % CI = 1.36 ~ 2.93 in men), work dissatisfaction (overall) (OR 2.30, 95 % CI = 1.66 ~ 3.20 in women, OR 2.40, 95 % CI = 1.88 ~ 3.08 in men), expression of opinion difficulty (OR 0.66, 95 % CI = 0.48 ~ 0.92 in women, OR 0.57, 95 % CI = 0.45 ~ 0.73 in men). CONCLUSION: A number of studies have reported that stress affects sleep disorder. In this study, many factors suspected to increase the risk of sleep disorder were added to previously known job stress factors. In particular, this study found a strong correlation between work-associated sleep disorder and relational and organizational job stress factors. Sleep disorder may lead to large decreases in workers’ quality of life and work efficiency. Awareness and interventions are therefore required to reduce workplace stress; additional research of this topic is also required. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40557-016-0131-2) contains supplementary material, which is available to authorized users

Staphylococcal enterotoxin sensitization in a community-based population : a potential role in adult-onset asthma

Background: Recent studies suggest that Staphylococcus aureus enterotoxin sensitization is a risk factor for asthma. However, there is a paucity of epidemiologic evidence on adult-onset asthma in community-based populations. Objective: We sought to evaluate the epidemiology and the clinical significance of staphylococcal enterotoxin sensitization in community-based adult populations. Methods: The present analyses were performed using the baseline data set of Korean adult population surveys, consisting of 1080 adults (mean age=60.2years) recruited from an urban and a rural community. Questionnaires, methacholine challenge tests, and allergen skin tests were performed for defining clinical phenotypes. Sera were analysed for total IgE and enterotoxin-specific IgE using ImmunoCAP. Results: Staphylococcal enterotoxin sensitization (0.35kU/L) had a prevalence of 27.0%. Risk factors were identified as male sex, current smoking, advanced age (61years), and inhalant allergen sensitization. Current asthma was mostly adult onset (18years old) and showed independent associations with high enterotoxin-specific IgE levels in multivariate logistic regression tests. In multivariate linear regressions, staphylococcal enterotoxin-specific IgE level was identified as the major determinant factor for total IgE level. Conclusions and Clinical Relevance: Staphylococcal enterotoxin sensitization was independently associated with adult-onset asthma in adult community populations. Strong correlations between the enterotoxin-specific IgE and total IgE levels support the clinical significance. The present findings warrant further studies for the precise roles of staphylococcal enterotoxin sensitization in the asthma pathogenesis