DEVELOPMENT AND TESTING OF A SOUND SIMULATOR FOR ACTIVE MUSIC THERAPY

Abstract. the objective of this paper is to substantiate the developed sensory neuropsychological simulator for active music therapy (AMTS), functioning according to the program of the comprehensive author's methodology of systematization of auditory means of influence on the functional state of a person. This is a new psychocorrectional tool used to develop sanogenic thinking and the formation of functional comfort in people with disabilities. From the point of view of the system-structural approach, the theoretical and methodological basis of the correction tool, flow chart of the device and layout manufacture, the interface design of the mobile application from the point of view of UX design are presented. The simulator contains built-in sound samples developed on the basis of the author's method “Profiling of the psychoacoustic effect of musical means of expressiveness”, which is based on a system of concepts, models and methods for identifying a person’s psychological profile. The reliability of the results is presented by a number ofneurobiological studies both in laboratory and in real life conditions.Keywords: functional comfort, sanogenic thinking, accessible environment, universal design, music therapy,psychoacoustics

A New Apporoach to the Defenition of Intangible Results of Innovation Performance

The paper discusses the definition of the results of innovation performance through the analysis of this concept, singles out its main features and basic notions that characterize and define their internal relationships. This analysis allowed the authors to give the definition of the concept of the results of innovation performance and introduce a new approach to the definition of intangible results of innovation performance, which is considered as a total of intangible forms of the idea implemented as a result of innovation performance or in the process of this kind of performance. The intangible results are regarded as additional unaccounted resources and opportunities that reduce risks when the value of the enterprise future cash flows is calculated by the Gordon Growth method, i.e., it leads to the increase of the enterprise`s value. In this article authors suggest the classification of intangible results of innovation performance, which are achieved not only within the organization, but also in the surrounding business environment in order to get unique competitive advantages and sustain the company`s value. Finally, this research focuses on the intangible results of innovation performance, particularly, their more detailed classification, explanation of their nature and development of evaluation methods. DOI: 10.5901/mjss.2015.v6n5s4p43

УПРАВЛЕНИЕ НЕМАТЕРИАЛЬНЫМИ РЕЗУЛЬТАТАМИ ИННОВАЦИОННОЙ ДЕЯТЕЛЬНОСТИ ПРЕДПРИЯТИЯ С УЧЕТОМ РИСКОВ

The article is devoted to the analysis of existing assessment tools of intangible results of innovative performance that are used to manage the innovative development of the enterprise. The authors consider the most common methods for determining the risk premium when calculating the discount rate. The study shows that existing methods take into account intangible results to a different extent. At the same time, not all intangible results of innovative performance and not in all methods are taken into account properly, this proves that accounting of intangible results can change the discount rate and affect the future cash flows of the enterprise and, as a consequence, the value of the enterprise.Purpose: analysis of existing methods of estimated risk correction development of «factor model for calculating the risk premium» taking into account intangible results of innovative performance.Methods and Methodology: complex of methods of theoretical research (description, comparison, analysis and synthesis), empirical research (expert assessment).Results: development of “factor model for calculating the risk premium taking into account the intangible results of innovation”, which allows more reliable calculation of the risk premium, and as a consequence of the discount rate, which makes it possible to make management decisions reasonably and promptly.Practical implications: It is advisable for economic entities to use the obtained results. That can help them expand the number of analyzed intangible results of innovative activity within the framework of a particular risk factor in order to increase the reliability of calculating the risk premium and, as a result, the discount rate.Статья посвящена анализу существующих инструментов оценки нематериальных результатов инновационной деятельности, использующихся для управления инновационным развитием предприятия с учетом рисков. Авторами рассматриваются наиболее распространенные методики определения премии за риск при расчете ставки дисконтирования. Проведенное исследование показывает, что существующие методики в разной степени учитывают нематериальные результаты. При этом не все нематериальные результаты инновационной деятельности и не во всех методиках учитываются должным образом, это доказывает, что учет нематериальных результатов может изменить ставку дисконта и оказать влияние на будущие денежные потоки предприятия и, как следствие, на стоимость предприятия.Цель исследования: анализ существующих методов оценки поправки на риск, разработка факторной модели расчета премии за риск с учетом нематериальных результатов инновационной деятельности.Методы и методология: комплекс методов теоритического исследования (описание, сравнение, анализ и синтез), эмпирическое исследование (экспертные оценки).Результатом анализа стала разработка «факторной модели расчета премии за риск с учетом нематериальных результатов инновационной деятельности», которая позволяет более достоверно рассчитать премию за риск, и как следствие ставки дисконта, что дает возможность обоснованно и оперативно принимать управленческие решения.Область применения результатов. Полученные результаты целесообразно использовать экономическим субъектам, которые могут расширять число анализируемых нематериальных результатов инновационной деятельности в рамках того или иного фактора риска с целью повышения достоверности расчета премии за риск и, как следствие, ставки дисконта

ADAPTATION OF LEAN PRODUCTION TOOLS TO EDUCATIONAL ACTIVITIES OF UNIVERSITIES

O uso de tecnologias enxutas pode melhorar a qualidade dos serviços e a eficiência dos gastos com recursos disponíveis, estimular o desenvolvimento da economia do país e melhorar o padrão de vida da população. As autoridades prestam especial atenção à modernização do ensino superior. Nesse sentido, é aconselhável introduzir tecnologias enxutas no processo educacional das instituições de ensino superior, o que nos permitirá identificar e desenvolver a capacidade dessas estruturas de auto- desenvolvimento, não apenas devido ao influxo de informações e finanças externas, mas através do uso de suas fontes internas. A introdução de princípios de produção enxuta nas atividades das universidades pode ajudar a aumentar a eficiência do processo educacional e sua competitividade. Com base nisso, o artigo discute o processo de introdução de ferramentas de manufatura enxuta nas atividades educacionais. É feita uma tentativa de analisar ferramentas de manufatura comparativamente enxutas e a possibilidade de sua aplicação nas atividades educacionais da universidade. O artigo enfatiza que a replicação da experiência existente na implementação de ferramentas de manufatura enxuta garantirá um crescimento constante dos principais indicadores de desempenho e permitirá a formação de um modelo enxuto sustentável de comportamento da população com base na popularização da cultura de economia entre os estudantes.El uso de tecnologías lean puede mejorar la calidad de los servicios y la eficiencia del gasto en recursos disponibles, estimular el desarrollo de la economía del país y mejorar el nivel de vida de la población. Las autoridades prestan especial atención a la modernización de la educación superior. En este sentido, es aconsejable introducir tecnologías lean en el proceso educativo de las instituciones de educación superior, lo que nos permitirá identificar y desarrollar la capacidad de estas estructuras para el autodesarrollo no solo debido a la entrada de información y las finanzas externas, sino a través del uso de sus fuentes internas. La introducción de principios de producción ajustada en las actividades de las universidades puede ayudar a aumentar la eficiencia del proceso educativo y su competitividad. Basado en esto, el artículo discute el proceso de introducción de herramientas de manufactura esbelta en actividades educativas. Se intenta analizar herramientas de fabricación comparativamente esbeltas y la posibilidad de su aplicación en las actividades educativas de la universidad. El artículo enfatiza que la replicación de la experiencia existente en la implementación de herramientas de manufactura esbelta asegurará un crecimiento constante de los indicadores clave de desempeño y permitirá la formación de un modelo lean sostenible de comportamiento poblacional basado en la popularización de la cultura del "ahorro" entre los estudiantes.The use of lean technologies can improve the quality of services and the efficiency of available resource spending, stimulate the development of the country economy and improve the living standards of the population. Authorities pay particular attention to the modernization of higher education. In this regard, it is advisable to introduce lean technologies in the educational process of higher educational institutions, which will allow us to identify and develop the ability of these structures to self-development not only due to the influx of information and external finances, but through the use of their internal sources. The introduction of lean production principles in the activities of universities can help increase the efficiency of the educational process and their competitiveness. Based on this, the article discusses the process of lean manufacturing tool introduction into educational activities. An attempt is made to analyze comparatively lean manufacturing tools and the possibility of their application in the educational activities of the university. The article emphasizes that the replication of existing experience of lean manufacturing tool implementation will ensure a steady growth of key performance indicators and will allow the formation of a sustainable lean model of population behavior based on the popularization of the culture of “thrift” among students

Tax Risks in the Company's Accounting System: Essence, Identification and Control

The article considers issues on reduction of the tax risk in the framework of management accounting. The main characteristics that are inherent in tax risk have been determined; taxpayers' behavior patterns have been distinguished. The authors have examined the relationship of tax planning and tax risk and determined its particular importance in order to reduce tax risk. Modern problems of management of company's tax risks as an integral part of the common management decision-making system have been also considered. The necessity of scientific research, the use of different methods of reducing tax risks in the company, the development of risk management strategies in the form of risk prediction have been proved. Tax risk functions have been identified and measures of their accounting, in order to reduce tax risks have been proposed. The main principles of tax risks assessment associated with the concept of acceptable risk, specifying risk threshold amount, and calculation of the value of economic damage of indicators that are necessary for risk management have been revealed. Keywords: Risk Management, Tax Planning, Tax Risk JEL Classification: F15; M41; G1

Multiple Myeloma Treatment in Real-world Clinical Practice : Results of a Prospective, Multinational, Noninterventional Study

Funding Information: The authors would like to thank all patients and their families and all the EMMOS investigators for their valuable contributions to the study. The authors would like to acknowledge Robert Olie for his significant contribution to the EMMOS study. Writing support during the development of our report was provided by Laura Mulcahy and Catherine Crookes of FireKite, an Ashfield company, a part of UDG Healthcare plc, which was funded by Millennium Pharmaceuticals, Inc, and Janssen Global Services, LLC. The EMMOS study was supported by research funding from Janssen Pharmaceutical NV and Millennium Pharmaceuticals, Inc. Funding Information: The authors would like to thank all patients and their families and all the EMMOS investigators for their valuable contributions to the study. The authors would like to acknowledge Robert Olie for his significant contribution to the EMMOS study. Writing support during the development of our report was provided by Laura Mulcahy and Catherine Crookes of FireKite, an Ashfield company, a part of UDG Healthcare plc, which was funded by Millennium Pharmaceuticals, Inc, and Janssen Global Services, LLC. The EMMOS study was supported by research funding from Janssen Pharmaceutical NV and Millennium Pharmaceuticals, Inc. Funding Information: M.M. has received personal fees from Janssen, Celgene, Amgen, Bristol-Myers Squibb, Sanofi, Novartis, and Takeda and grants from Janssen and Sanofi during the conduct of the study. E.T. has received grants from Janssen and personal fees from Janssen and Takeda during the conduct of the study, and grants from Amgen, Celgene/Genesis, personal fees from Amgen, Celgene/Genesis, Bristol-Myers Squibb, Novartis, and Glaxo-Smith Kline outside the submitted work. M.V.M. has received personal fees from Janssen, Celgene, Amgen, and Takeda outside the submitted work. M.C. reports honoraria from Janssen, outside the submitted work. M. B. reports grants from Janssen Cilag during the conduct of the study. M.D. has received honoraria for participation on advisory boards for Janssen, Celgene, Takeda, Amgen, and Novartis. H.S. has received honoraria from Janssen-Cilag, Celgene, Amgen, Bristol-Myers Squibb, Novartis, and Takeda outside the submitted work. V.P. reports personal fees from Janssen during the conduct of the study and grants, personal fees, and nonfinancial support from Amgen, grants and personal fees from Sanofi, and personal fees from Takeda outside the submitted work. W.W. has received personal fees and grants from Amgen, Celgene, Novartis, Roche, Takeda, Gilead, and Janssen and nonfinancial support from Roche outside the submitted work. J.S. reports grants and nonfinancial support from Janssen Pharmaceutical during the conduct of the study. V.L. reports funding from Janssen Global Services LLC during the conduct of the study and study support from Janssen-Cilag and Pharmion outside the submitted work. A.P. reports employment and shareholding of Janssen (Johnson & Johnson) during the conduct of the study. C.C. reports employment at Janssen-Cilag during the conduct of the study. C.F. reports employment at Janssen Research and Development during the conduct of the study. F.T.B. reports employment at Janssen-Cilag during the conduct of the study. The remaining authors have stated that they have no conflicts of interest. Publisher Copyright: © 2018 The AuthorsMultiple myeloma (MM) remains an incurable disease, with little information available on its management in real-world clinical practice. The results of the present prospective, noninterventional observational study revealed great diversity in the treatment regimens used to treat MM. Our results also provide data to inform health economic, pharmacoepidemiologic, and outcomes research, providing a framework for the design of protocols to improve the outcomes of patients with MM. Background: The present prospective, multinational, noninterventional study aimed to document and describe real-world treatment regimens and disease progression in multiple myeloma (MM) patients. Patients and Methods: Adult patients initiating any new MM therapy from October 2010 to October 2012 were eligible. A multistage patient/site recruitment model was applied to minimize the selection bias; enrollment was stratified by country, region, and practice type. The patient medical and disease features, treatment history, and remission status were recorded at baseline, and prospective data on treatment, efficacy, and safety were collected electronically every 3 months. Results: A total of 2358 patients were enrolled. Of these patients, 775 and 1583 did and did not undergo stem cell transplantation (SCT) at any time during treatment, respectively. Of the patients in the SCT and non-SCT groups, 49%, 21%, 14%, and 15% and 57%, 20%, 12% and 10% were enrolled at treatment line 1, 2, 3, and ≥ 4, respectively. In the SCT and non-SCT groups, 45% and 54% of the patients had received bortezomib-based therapy without thalidomide/lenalidomide, 12% and 18% had received thalidomide/lenalidomide-based therapy without bortezomib, and 30% and 4% had received bortezomib plus thalidomide/lenalidomide-based therapy as frontline treatment, respectively. The corresponding proportions of SCT and non-SCT patients in lines 2, 3, and ≥ 4 were 45% and 37%, 30% and 37%, and 12% and 3%, 33% and 27%, 35% and 32%, and 8% and 2%, and 27% and 27%, 27% and 23%, and 6% and 4%, respectively. In the SCT and non-SCT patients, the overall response rate was 86% to 97% and 64% to 85% in line 1, 74% to 78% and 59% to 68% in line 2, 55% to 83% and 48% to 60% in line 3, and 49% to 65% and 36% and 45% in line 4, respectively, for regimens that included bortezomib and/or thalidomide/lenalidomide. Conclusion: The results of our prospective study have revealed great diversity in the treatment regimens used to manage MM in real-life practice. This diversity was linked to factors such as novel agent accessibility and evolving treatment recommendations. Our results provide insight into associated clinical benefits.publishersversionPeer reviewe

Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016

Background: A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97\ub71 (95% UI 95\ub78-98\ub71) in Iceland, followed by 96\ub76 (94\ub79-97\ub79) in Norway and 96\ub71 (94\ub75-97\ub73) in the Netherlands, to values as low as 18\ub76 (13\ub71-24\ub74) in the Central African Republic, 19\ub70 (14\ub73-23\ub77) in Somalia, and 23\ub74 (20\ub72-26\ub78) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91\ub75 (89\ub71-93\ub76) in Beijing to 48\ub70 (43\ub74-53\ub72) in Tibet (a 43\ub75-point difference), while India saw a 30\ub78-point disparity, from 64\ub78 (59\ub76-68\ub78) in Goa to 34\ub70 (30\ub73-38\ub71) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4\ub78-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20\ub79-point to 17\ub70-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17\ub72-point to 20\ub74-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view-and subsequent provision-of quality health care for all populations

Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016

Copyright © 2018 The Author(s). Published by Elsevier Ltd. Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8-98·1) in Iceland, followed by 96·6 (94·9-97·9) in Norway and 96·1 (94·5-97·3) in the Netherlands, to values as low as 18·6 (13·1-24·4) in the Central African Republic, 19·0 (14·3-23·7) in Somalia, and 23·4 (20·2-26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1-93·6) in Beijing to 48·0 (43·4-53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6-68·8) in Goa to 34·0 (30·3-38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view - and subsequent provision - of quality health care for all populations

Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016.

BACKGROUND: A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. METHODS: Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita