Petrography and mineralgy of gachsaran formation in west of Bandar-e-Abbas, Kuh-e-Namaki Khamir section, south of Iran

Gachsaran Formation is the most important cap rock of hydrocarbon reservoir in Iran and has important deposits of salt, sulfur and gypsum. A section of Gachsaran formation (Early to Middle Miocene) in south- east of zagros area, west of Bandar- e- Abbas province, was studied from sedimentary geology view. Gachsaran Formation in studied section, with 310 m thickness consist of Chehel, Champeh and Mol members and consist of gypsum/anhydrite, limestone and marl lithofacies. fourty- four samples has been taken from this section for microscopic examinations and X Ray Diffraction analysis.This research showed that evaporative deposits in Kuh-e- Namaki Khamir section, contain of gypsum, anhydrite, dolomite and halite minerals and marl deposits contain of palygorskite, dolomite and calcite minerals and carbonate deposits contain of dolomite and calcite minerals. The mineralogical composition and lithological characteristics, confirm that Gachsaran Formation in the study area has deposited in lagoonal to Sabkha environment with warm and dry climate and limit regress and progress of sea.Keywords: Petroghraphy, Mineralogy, Bandar e Abbas, Gachsaran Formatio

Insured clients out-of-pocket payments for health care under the national health insurance scheme in Ghana

BACKGROUND: In 2003, Ghana implemented a National Health Insurance Scheme (NHIS) designed to promote universal health coverage and equitable access to health care. The scheme has largely been successful, yet it is confronted with many challenges threatening its sustainability. Out-of-pocket payments (OOP) by insured clients is one of such challenges of the scheme. This study sought to examine the types of services OOP charges are made for by insured clients and how much insured clients pay out-of-pocket. METHODS: This was a descriptive cross-sectional health facility survey. A total of 2066 respondents were interviewed using structured questionnaires at the point of health care exit in the Ashanti, Northern and Central regions of Ghana. Health facilities of different levels were selected from 3 districts in each of the three regions. Data were collected between April and June 2018. Using Epidata and STATA Version 13.1 data analyses were done using multiple logistic regression and simple descriptive statistics and the results presented as proportions and means. RESULTS: Of all the survey respondents 49.7% reported paying out-of-pocket for out-patient care while 46.9% of the insured clients paid out-of-pocket. Forty-two percent of the insured poorest quintile also paid out-of-pocket. Insured clients paid for consultation (75%) and drugs (63.2%) while 34.9% purchased drugs outside the health facility they visited. The unavailability of drugs (67.9%) and drugs not covered by the NHIS (20.8%) at the health facility led to out-of-pocket payments. On average, patients paid GHS33.00 (USD6.6) out-of-pocket. Compared to the Ashanti region, patients living in the Northern region were 74% less at odds to pay out-of-pocket for health care. CONCLUSION AND RECOMMENDATION: Insured clients of Ghana's NHIS seeking health care in accredited health facilities make out-of-pocket payments for consultation and drugs that are covered by the scheme. The out-of-pocket payments are largely attributed to unavailability of drugs at the facilities while the consultation fees are charged to meet the administrative costs of services. These charges occur in disadvantaged regions and in all health facilities. The high reliance on out-of-pocket payments can impede Ghana's progress towards achieving Universal Health Coverage and the Sustainable Development Goal 3, seeking to end poverty and reduce inequalities. In order to build trust and confidence in the NHIS there is the need to eliminate out-of-pocket payments for consultation and medicines by insured clients

Socio-economic inequality and inequity in use of health care services in Kenya: evidence from the fourth Kenya household health expenditure and utilization survey

BACKGROUND: Kenya is experiencing persistently high levels of inequity in health and access to care services. In 2018, decades of sustained policy efforts to promote equitable, affordable and quality health services have culminated in the launch of a universal health coverage scheme, initially piloted in four Kenyan counties and planned for national rollout by 2022. Our study aims to contribute to monitoring and evaluation efforts alongside policy implementation, by establishing a detailed, baseline assessment of socio-economic inequality and inequity in health care utilization in Kenya shortly before the policy launch. METHODS: We use concentration curves and corrected concentration indexes to measure socio-economic inequality in care use and the horizontal inequity index as a measure of inequity in care utilization for three types of care services: outpatient care, inpatient care and preventive and promotive care. Further insights into the individual and household level characteristics that determine observed inequality are derived through decomposition analysis. RESULTS: We find significant inequality and inequity in the use of all types of care services favouring richer population groups, with particularly pronounced levels for preventive and inpatient care services. These are driven primarily by differences in living standards and educational achievement, while the region of residence is a key driver for inequality in preventive care use only. Pro-rich inequalities are particularly pronounced for care provided in privately owned facilities, while public providers serve a much larger share of individuals from lower socio-economic groups. CONCLUSIONS: Through its focus on increasing affordability of care for all Kenyans, the newly launched universal health coverage scheme represents a crucial step towards reducing disparities in health care utilization. However in order to achieve equity in health and access to care such efforts must be paralleled by multi-sectoral approaches to address all key drivers of inequity: persistent poverty, disparities in living standards and educational achievement, as well as regional differences in availability and accessibility of care

An Optimizing Method for Performance and Resource Utilization in Quantum Machine Learning Circuits

Quantum computing is a new and advanced topic that refers to calculations based on the principles of quantum mechanics. Itmakes certain kinds of problems be solved easier compared to classical computers. This advantage of quantum computingcan be used to implement many existing problems in different fields incredibly effectively. One important field that quantumcomputing has shown great results in machine learning. Until now, many different quantum algorithms have been presented toperform different machine learning approaches. In some special cases, the execution time of these quantum algorithms will bereduced exponentially compared to the classical ones. But at the same time, with increasing data volume and computationtime, taking care of systems to prevent unwanted interactions with the environment can be a daunting task and since thesealgorithms work on machine learning problems, which usually includes big data, their implementation is very costly in terms ofquantum resources. Here, in this paper, we have proposed an approach to reduce the cost of quantum circuits and to optimizequantum machine learning circuits in particular. To reduce the number of resources used, in this paper an approach includingdifferent optimization algorithms is considered. Our approach is used to optimize quantum machine learning algorithms forbig data. In this case, the optimized circuits run quantum machine learning algorithms in less time than the original onesand by preserving the original functionality. Our approach improves the number of quantum gates by 10.7% and 14.9% indifferent circuits and the number of time steps is reduced by three and 15 units, respectively. This is the amount of reduction forone iteration of a given sub-circuit U in the main circuit. For cases where this sub-circuit is repeated more times in the maincircuit, the optimization rate is increased. Therefore, by applying the proposed method to circuits with big data, both cost andperformance are improved

The intergenerational relationship between conditional cash transfers and newborn health

BACKGROUND: Lack of nutrition, inadequate housing, low education and limited access to quality care can negatively affect children's health over their lifetime. Implemented in 2003, the Bolsa Familia ("Family Stipend") Program (PBF) is a conditional cash transfer program targeting poor households in Brazil. This study investigates the long-term benefits of cash transfers through intergenerational transmission of health and poverty by assessing the early life exposure of the mother to the PBF. METHODS: We used data from the 100M SINASC-SIM cohort compiled and managed by the Center for Data and Knowledge Integration for Health (CIDACS), containing information about participation in the PBF and socioeconomic and health indicators. We analyzed five measures of newborn health: low (less than 2,500 g) and very low (less than 1,500 g) birth weight, premature (less than 37 weeks of gestation) and very premature (less than 28 weeks of gestation) birth, and the presence of some type of malformation (according to ICD-10 codes). Furthermore, we measured the early life exposure to the PBF of the mother as PBF coverage in the previous decade in the city where the mother was born. We applied multilevel logistic regression models to assess the associations between birth outcomes and PBF exposures. RESULTS: Results showed that children born in a household where the mother received BF were less likely to have low birth weight (OR 0.93, CI; 0.92-0.94), very low birth weight (0.87, CI; 0.84-0.89), as well as to be born after 37 weeks of gestation (OR 0.98, CI; 0.97-0.99) or 28 weeks of gestation (OR 0.93, CI; 0.88-0.97). There were no significant associations between households where the mother received BF and congenital malformation. On average, the higher the early life exposure to the PBF of the mother, the lower was the prevalence of low birth weight, very low birth weight and congenital malformation of the newborn. No trend was noted for preterm birth. CONCLUSION: The PBF might have indirect intergenerational effects on children's health. These results provide important implications for policymakers who have to decide how to effectively allocate resources to improve child health

Study on chemical and fatty acid modifications of cow's milk in relation to fat globules diameter

Studies regarding the range of values for variations in the size of milk fat globules have been conducted over the years by various Authors, based on objective observation and mathematical extrapolation. In 1969,Walstra calculated the existence of a population of globules smaller than 1 μm and identified a population of larger globules, distributed in a "Gaussian" manner and showing a peak at a diameter of around 3-4 micrometers; later Timmen e Patton (1988) separated the cream from the rest of the milk by centrifugation and classified the fat globules into small and large sizes

Community perceptions of enrolment of indigents into the National Health Insurance Scheme in Ghana: a case study of the Livelihood Empowerment against Poverty Programme

BACKGROUND: The Livelihood Empowerment against Poverty (LEAP) programme in Ghana as part of its beneficiary programme, identifies the poor/indigents for exemptions from premium payments in the National Health Insurance Scheme (NHIS). This paper sought to understand community perceptions of enrolling the poor in the NHIS through LEAP in order to inform policy. METHODS: The study adopted a descriptive cross-sectional study design by using a qualitative approach. The study was conducted in three geographical regions of Ghana: Greater Accra, Brong-Ahafo and Northern region representing the three ecological zones of Ghana between October 2017 and February 2018. The study population included community members, health workers, NHIS staff and social welfare officers/social development officers. Eighty-one in-depth interviews and 23 Focus Group Discussions were conducted across the three regions. Data were analysed thematically and verbatim quotes from participants were used to support the views of participants. RESULTS: The study shows that participants were aware of the existence of LEAP and its benefits. There was, however, a general belief that the process of LEAP had been politicized and therefore favours only people who were sympathizers of the ruling government as they got enrolled into the NHIS. Participants held the view that the process of selecting beneficiaries lacked transparency, thus, they were not satisfied with the selection process. However, the study shows the ability of the community to identify the poor. The study reports varying concepts of poverty and its identification across the three ecological zones of Ghana. CONCLUSION: There is a general perception of politicization and lack of transparency of the selection of the poor into the NHIS through the LEAP programme in Ghana. Community-based approaches in the selection of the indigent are recommended to safeguard the NHIS-LEAP beneficiary process

Positioning the national health insurance for financial sustainability and universal health coverage in Ghana: a qualitative study among key stakeholders

INTRODUCTION: The National Health Insurance Scheme (NHIS) was introduced in 2003 to reduce "out-of-pocket" payments for health care in Ghana. Over a decade of its implementation, issues about the financial sustainability of this pro-poor policy remains a crippling fact despite its critical role to go towards Universal Health Coverage. We therefore conducted this study to elicit stakeholders' views on ways to improve the financial sustainability of the operations of NHIS. METHODS: Twenty (20) stakeholders were identified from Ministry of Health, Ghana Health Services, health workers groups, private medical practitioners, civil society organizations and developmental partners. They were interviewed using an interview guide developed from a NHIS policy review and analysis. All interviews were recorded and transcribed verbatim. The data were analysed thematically with the aid of NVivo 12 software. RESULTS: Stakeholders admitted that the NHIS is currently unable to meet its financial obligations. The stakeholders suggested first the adoption of capitation as a provider payment mechanism to minimize the risk of providers' fraud and protection from political interference. Secondly, they indicated that rapid releases of specific statutory deductions and taxes for NHIS providers could reduce delays in claims' reimbursement which is one of the main challenges faced by healthcare providers. Aligning the NHIS with the Community-based Health Planning and Services and including preventive and promotive health is necessary to position the Scheme for Universal Health Coverage. CONCLUSION: The Scheme will potentially achieve UHC if protected from political interference to improve the governance and transparency that affects the finances of the scheme and the expansion of services to include preventive and promotive services and cancers