An evaluation of health systems equity in Indonesia: Study protocol

© 2018 The Author(s). Background: Many low and middle income countries are implementing reforms to support Universal Health Coverage (UHC). Perhaps one of the most ambitious examples of this is Indonesia's national health scheme known as the JKN which is designed to make health care available to its entire population of 255 million by end of 2019. If successful, the JKN will be the biggest single payer system in the world. While Indonesia has made steady progress, around a third of its population remains without cover and out of pocket payments for health are widespread even among JKN members. To help close these gaps, especially among the poor, the Indonesian government is currently implementing a set of UHC policy reforms that include the integration of remaining government insurance schemes into the JKN, expansion of provider networks, restructuring of provider payments systems, accreditation of all contracted health facilities and a range of demand side initiatives to increase insurance uptake, especially in the informal sector. This study evaluates the equity impact of this latest set of UHC reforms. Methods: Using a before and after design, we will evaluate the combined effects of the national UHC reforms at baseline (early 2018) and target of JKN full implementation (end 2019) on: progressivity of the health care financing system; pro-poorness of the health care delivery system; levels of catastrophic and impoverishing health expenditure; and self-reported health outcomes. In-depth interviews with stakeholders to document the context and the process of implementing these reforms, will also be undertaken. Discussion: As countries like Indonesia focus on increasing coverage, it is critically important to ensure that the poor and vulnerable - who are often the most difficult to reach - are not excluded. The results of this study will not only help track Indonesia's progress to universalism but also reveal what the UHC-reforms mean to the poor

Eating disorders: Reflecting on the sociocultural variables / Trastornos de la conducta alimentaria: Reflexionando en torno a las variables socioculturales

Abstract. Eating disorders (ED) are illnesses that had awakened enormous interest in social and health media in the last years. Thus now days, it is spoken of authentic epidemics, in which the diagnosis is late, existing multiple management difficulties and numerous risks in their development. This article aims to install a reflection on the importance of a socio-cultural context, since cultural beliefs and values associated to beauty and food would be linked to the subjectivity that surrounds this disease. In this sense, the characteristic symptoms of this disorder occur in a cultural reference framework that has to be analyzed.   Key words: Eating Disorders, treatment, culture.   Resumen. Los trastornos de la conducta alimentaria (TCA) son enfermedades que han despertado, en los últimos años, enorme interés en medios sociales y sanitarios. En la actualidad se habla de auténticas epidemias, donde el diagnóstico es tardío, existiendo múltiples dificultades de manejo y numerosos riesgos en su evolución. Este artículo tiene como objetivo instalar una reflexión en torno a la importancia de rescatar el contexto sociocultural, ya que las creencias y valores culturales asociados a la belleza y a la comida, estarían vinculados a la subjetividad que rodea dicha patología. En ese sentido, la sintomatología característica de este trastorno se da en un marco referencial cultural importante de ser analizado.   Palabras clave: Trastornos alimentarios, tratamiento, cultura

Bankruptcy Treatment of Intellectual Property Assets: An Economic Analysis

With the rise of intellectual property in the modern economy, bankruptcy treatment of intellectual property assets has taken on ever greater importance. The law in this area must balance different approaches to asset management. Viewing the world from an ex ante perspective, intellectual property laws seek to foster investment in research and development. Freedom of contract plays a central role in maximizing the potential value of intellectual property by encouraging a robust licensing market to exploit the value of intellectual creativity. By contrast, the bankruptcy system generally views asset management from an ex post standpoint, focusing narrowly on how to maximize the value of a failing or failed enterprise. Thus, bankruptcy law affords trustees and debtors substantial leeway to rescind contracts and reorder the affairs of the failed entity. This article examines the rather complex rules governing the treatment of intellectual property assets in bankruptcy and suggests various reforms that could better promote economic efficiency

Laminin production by murine melanoma cells: possible involvement in cell motility

Three lines of B16 melanoma cells (B16-F1, B16-F10 and B16-BL6) were examined for motility in the micropore filter assay and for synthesis in culture of the basal lamina glycoprotein laminin. All three lines synthesized laminin as judged by the incorporation of [ 35 S]methionine into immunoreactive laminin and secreted (or shed) laminin into the culture medium as indicated by biosynthetic labeling studies and enzyme-linked immunosorbent assays. Immunoreactive laminin was also seen on the surface of the cells as indicated by immunofluorescence staining and by complement-mediated killing. Analysis of [ 35 S]methionine-labeled laminin immunoprecipitates by sodium dodecylsulfatepolyacrylamide gel electrophoresis (SDS-PAGE) both with and without reduction of intersubunit disulfide bonds revealed that all three cell lines produced a similar array of laminin forms, and that the M r =950kD laminin molecule (but not the uncombined subunits) was secreted into the culture medium. Laminin biosynthesis appeared to be limited by the availability of the M r =400kD A subunit as shown by the intracellular accumulation of excess B subunit in the form of uncombined B subunit ( M r =200kD) and as a disulfide-linked B dimer ( M r =400 kD). The motility of all three cell lines was stimulated four- to five-fold by the addition of either exogenous laminin from the EHS sarcoma or culture medium from the B16 cells containing the secreted laminin. The stimulated motility was inhibited by antilaminin serum. These observations suggest that the laminin synthesized by the B16 melanoma cells themselves may facilitate their motility.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/42594/1/10585_2004_Article_BF00133591.pd

Eating Disorders: Reflecting on the socio-cultural variables

Eating disorders (ED) are illnesses that had awakened enormous interest in social and health media in the last years. Thus now days, it is spoken of authentic epidemics, in which the diagnosis is late, existing multiple management difficulties and numerous risks in their development. This article aims to install a reflection on the importance of a socio-cultural context, since cultural beliefs and values associated to beauty and food would be linked to the subjectivity that surrounds this disease. In this sense, the characteristic symptoms of this disorder occur in a cultural reference framework that has to be analyzed.Los trastornos de la conducta alimentaria (TCA) son enfermedades que han despertado, en los últimos años, enorme interés en medios sociales y sanitarios. En la actualidad se habla de auténticas epidemias, donde el diagnóstico es tardío, existiendo múltiples dificultades de manejo y numerosos riesgos en su evolución. Este artículo tiene como objetivo instalar una reflexión en torno a la importancia de rescatar el contexto sociocultural, ya que las creencias y valores culturales asociados a la belleza y a la comida, estarían vinculados a la subjetividad que rodea dicha patología. En ese sentido, la sintomatología característica de este trastorno se da en un marco referencial cultural importante de ser analizado