233,115 research outputs found
Scaling up hepatitis B vaccination with the support of GAVI in China : lessons learned for introduction of new vaccines and for the future of hepatitis B control
No full textBackground: Hepatitis B virus (HBV) infection is a leading cause of illness and death in China. In 1992, 60% of the population had a history of HBV infection and 9.8% were chronically infected with HBV. Each year, an estimated 263,000 persons died from HBV-related hepatocellular carcinoma or cirrhosis, accounting for 37%-50% of HBV-related deaths worldwide before 1992. In 1992, the Ministry of Health introduced hepatitis B vaccine into the management system of the Expanded Programme on Immunization (EPI) as a cost-effective way to prevent HBV infection. The schedule included a timely birth dose (within 24 hours of birth, to prevent perinatal infections that are most strongly associated with long term chronic infections and adverse outcomes) and subsequent doses at one month and six months. However, this introduction into the EPI management system only meant that the Government took responsibility over administration and coverage monitoring, but not funding support: The cost of vaccination was covered out of pocket. As a result, coverage was lower in rural areas, in Western provinces (low economic status) and among females. In 2002, the Ministry of Health fully integrated free hepatitis B vaccine into EPI with funding from the Global Alliance for Vaccines and Immunization (GAVI). The GAVI China project financially supported vaccine and auto-disable syringes in Western provinces and poverty-affected counties of Central provinces (Chapter 1). As the GAVI China project was completed in 2010, we compiled all evaluation work conducted to understand how input and process lead to output and outcomes that impacted the heavy HBV associated burden in China.
Methods: We compiled data from GAVI China project areas between 2002 and 2009, reviewed cross-sectional studies conducted in 2004 and 2006 and conducted a final evaluation survey in 2010. These investigations covered input (funds invested into the project for vaccine and AD syringes), process (integration of the vaccine in EPI, increase in institutional births, introduction of auto-disable syringes for vaccination and training), output (immunization coverage for third dose and timely birth dose, use of auto-disable syringes for immunization), outcome (immunity in the population, safe injection practices) and impact (prevalence of HBV surface antigen among children included in the vaccination cohort).
Results: With respect to hepatitis B immunization, input included 27 million USD provided by the GAVI China project to funds hepatitis B vaccine between 2002 and 2007. These funds came from the international GAVI Alliance (50%) and the Government of China (50%). In addition, the Chinese government provided an additional 21.5 million USD in government co-funding of subsidies from central to provincial to health care workers in provinces between 2007 and 2009 so that the vaccine could be administered without user fees. The health system efficiently processed these resources. First, in GAVI-supported areas, the increase in the HepB3/DPT3 ratio (increased from 57% in 2002 to 94% in 2009), indicated indicating that EPI absorbed well the new vaccine. Second, institutionalized deliveries increased to reach 96% nationwide in 2009, indicating that maternal and child health services created conditions to maximize coverage of the timely birth dose. As a result, from 2002 to 2009, the national three-dose hepatitis B vaccine coverage progressed from 71% to 93% (Chapter 5) and the timely birth dose coverage progressed from 60% to 91% (Chapter 7) with a reduction of inequities between Eastern and Western areas. Both of these resulted in immunity among vaccinated cohorts (85% of anti-HBs among children 12 to 23 months of age in the national 2006 serological survey) (Chapter 2). One key factor strongly associated with being HBsAg negative is receiving timely birth dose of hepatitis B vaccine as early as possible (Chapter 4).
With respect to injection safety, input included 14 million USD of GAVI funds to supply auto-disable syringes, safety boxes and needle cutters. In 2009, auto-disable syringes and safety boxes were used in 78% and 79% facilities in GAVI supported areas of the Western areas, respectively (Chapter 6). In terms of output, sterilizable injection devices disappeared and attempts to re-use disposable injection equipment became rare (0% in the 2010 final evaluation). However, no data regarding the incidence of injection-associated infections were available to evaluate the outcome of the progress in injection safety.
With respect to social mobilization and training, 10 million USD were assigned to training between 2002 and 2009. Most of those were not directly funded by GAVI China. These funds were provided by the Government because of the leverage effect of the GAVI China project. These were used in 28,753 training workshops for health care workers that resulted in better knowledge among health care workers (In 2010, 98% of them knew that hepatitis B virus can be transmitted from mother to child) and guardians (In 2010, 89% of them knew that the first dose of hepatitis B vaccine had to be given in the first 24 hours of life). This higher level of knowledge also contributed to higher immunization coverage and safer injections.
Ultimately, the elements of the GAVI China project combined at the impact level to prevent HBV infections. The 2006 national serological survey documented these achievements and pointed to 1% prevalence of HBsAg among children under five years of age, a decrease of 90% from the 9.8% prevalence in the same age group in 1992 (Chapter 3). These infections prevented will lead to the future prevention of cirrhosis, hepatocellular carcinoma. Those should result in early deaths prevented and benefits in terms of disability-adjusted life years (DALYs). However, in 2010, it was too early to measure these longer term effects and the final impact of the project on HBsAg prevalence had not yet been quantified.
Conclusion: The introduction of hepatitis B vaccine into the national immunization programme was successful and the strategies and policy used for the GAVI China project provided a successful case study for the introduction of other new vaccines in China. The determinants of the success of the GAVI China included (1) a well documented disease burden, (2) a good collaboration between the government of China and the international GAVI Alliance that resulted in a strong national GAVI China project, (3) local production of vaccine and AD syringes, (4) solid processes for implementation and (5) leverage of additional support through national and provincial levels co-funding. Remaining challenges include (1) the persistence of an estimated 80,000 perinatal HBV infections each year in China, (2) the lack of homogeneous regulations to harmonize injection practices, (3) the absence of a scaled implementation for the national policy that recommends vaccination of health care workers, (4) the weak specificity and sensitivity of acute hepatitis B surveillance and (5) the absence of policy and plans for the management of chronic hepatitis B infection. We recommended that China (1) maintain universal hepatitis B infant vaccination, with a high priority to reach all infants, especially for those living in remote, mountain areas (2) make additional efforts to strengthen the health system and further improve hospital delivery rates to increase timely birth dose coverage and decrease perinatal HBV transmission, (3) develop clear surveillance guidelines to monitor acute hepatitis B rates (4) immunize health care workers, with an emphasis on pre-service delivery (5) collect manage sharps waste in a way that is safe for the health care workers, the community and the environment, and (6) screen pregnant women to administer adapted immuno-prophylaxis (including hepatitis B immune globulin, HBIG) for children born to those HBsAg positive. These should prepare the country for the next phase of a policy for the prevention and control of hepatitis B, which should ultimately include screening and treatment of patients with chronic infections, particularly those of older age cohorts who were born before the era of universal immunizatio
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Financial Security of Elders in China
No full textChina is one of the largest countries in the world in terms of both geography and population size, with lower economic levels compared to the developed countries, and great regional differences. This paper introduces the rapid demographic changes of the Chinese population and the current financial security of elders in China. The World Bank’s multi-pillar model is used to explain the financial security of elders in China, which includes the current pension and health care systems in urban and rural areas in China respectively. The important issues of financial security of elders which the Chinese government should address in the near future are also discussed. The paper concludes with a consideration of the results of social welfare system reforms by the Chinese government and future research interests from a geographer’s perspective.Financial security, elders, social welfare system, China
Dispelling the Myths Behind First-author Citation Counts
No full textWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
Beyond trade & investment : a contextual analysis of the misgivings over the 'B & R' practices
No full textWhile the ‘One Belt One Road’ (hereinafter ‘B & R’) Initiative and its practices are welcome by many (especially the business communities) in many countries, various concerns and questions have also been raised by governments and/or their agencies, NGOs, local communities and, of course, academics. These misgivings, often broader in nature than that of economic issues, range from questioning the motivation of the Initiative to concerns for actual welfare of local communities, as well as debating on development models. At a strategic level, the stake is high as the ‘B & R’ Initiative is seen as a geo-political and geoeconomic strategy, requiring repositioning and rebalancing of powers from all concerned. For the ‘B & R’ Initiative to be successful, participants – governments, business, or other parties – must take these misgivings seriously. We need to analyse them objectively and respond to them carefully. This paper examines these concerns and questions, often expressed in apprehension and misgivings, in context, but from a distance and as an outside observer. It is suggested that participants in the ‘B & R’ Initiative look beyond trade and investment issues in decision-making, considering not just supportive views but also misgivings raised by all interested parties, as trade and investment are indeed much more than trade and investment per se
Role of band-index-dependent transport relaxation times in anomalous Hall effect
No full textWe revisit model calculations of the anomalous Hall effect (AHE) and show that, in isotropic Rashba-coupled two-dimensional electron gas with pointlike potential impurities, the full solution of the semiclassical Boltzmann equation (SBE) may differ from the widely used 1/tau(parallel to) and 1/tau(perpendicular to). solution [Schliemann and Loss, Phys. Rev. B 68, 165311 (2003)]. Our approach to solving the SBE is consistent with the integral equation approach [Vyborny et al., Phys. Rev. B 79, 045427 (2009)] but in the present case, we reduce the description to band-index-dependent transport relaxation times. When both Rashba bands are partially occupied, these are determined by solving a system of linear equations. Detailed calculations showthat, for intrinsic and hybrid skewscatterings the difference between 1/tau(parallel to) and 1/tau(perpendicular to) and the full solution of SBE is notable for large Fermi energies. For coordinate-shift effects, the side-jump velocity acquired in the interband elastic-scattering process is shown to be more important for larger Rashba coupling and may even exceed the intraband one for the outer Rashba band. The coordinate-shift contribution to AHE in the considered case notably differs from that in the limit of smooth disorder potential analyzed before.National Natural Science Foundation of China [11274013, 11274018]; Ministry of Science and Technology of the People's Republic of China [2012CB921300]SCI(E)ARTICLE39
Project TIG-26B, Operation Plan "B", motor transport operations in China.
No full textConsists of 6 folders: 1st Folder - 26B Operation Plan "B" motor transportation operation in China, copy #32. 2nd Folder - 5D operation plan American barge lines, copy #25. 3rd Folder - 5E American barge lines, copy #26. 4th Folder - Railway map of India, 1944. 5th Folder - Map of Bengal Assam L of C. 6th Folder - Summary of agreements for the operation of portions of the B & A Railway by the USAF, MRS
European Union Foreign Direct Investment in China: Evidence from a Panel Study of EU Manufacturing Firms, 1998-2007
No full textThe paper examines determinants of the EU‘s FDI into the China by using a newly available Manufacturing firm-level data set for the period 1998-2007 from the State Statistical Bureau of China. The theoretical framework of the paper builds on Dunning's ownership–location–internalization (OLI) paradigm, incorporating the institutional determinants to test international production by EU firms in emerging market. The paper analyses recent trends and patterns of EU FDI and its firms‘ characteristics in China. This study applies both static and dynamic panel data approaches (fixed effects and GMM system estimators) to test the presence of agglomeration effect of past FDI. It finds that EU FDI in China is positively associated with export intensity and labour cost. However, technology and profitability of the firm show unexpected results, not lining with theory in the study. The results further suggest that locational factors with regard to macroeconomic and legal environment are also considered by EU firms when deciding on FDI in China. The findings have important implications for practitioners and policymaking
Industry's Response to Market Liberalization in China: Evidence from Jiangsu Province
No full textAddresses the question of whether market liberalization in China has improved economic conditions by examining changes in production patterns in industry as a measure of specialization and by estimating industrial productivity as a proxy for efficiency.Originally published in:
Penelope B. Prime , "Industry's Response to Market Liberalization in China: Evidence from Jiangsu Province," Economic Development and Cultural Change 41, no. 1 (Oct., 1992): 27-50. DOI: 10.1086/451993
Posted with the permission of the University of Chicago Press.</p
Physical origin of Davydov splitting and resonant Raman spectroscopy of Davydov components in multilayer MoTe2
No full textWe systematically study the high-resolution and polarized Raman spectra of multilayer (ML) MoTe2. The layer-breathing (LB) and shear (C) modes are observed in the ultralow-frequency region, which are used to quantitatively evaluate the interlayer coupling in ML MoTe2 based on the linear chain model, in which only the nearest interlayer coupling is considered. The Raman spectra on three different substrates verify the negligible substrate effect on the phonon frequencies of ML MoTe2. Ten excitation energies are used to measure the high-frequency modes of N-layer MoTe2 (NL MoTe2; N is an integer). Under the resonant excitation condition, we observe N-dependent Davydov components in ML MoTe2, originating from the Raman-active A(1)' (A(1g)(2)) modes at similar to 172 cm(-1). More than two Davydov components are observed in NL MoTe2 for N > 4 by Raman spectroscopy. The N-dependent Davydov components are further investigated based on the symmetry analysis. A van der Waals model only considering the nearest interlayer coupling has been proposed to well understand the Davydov splitting of high-frequency A(1)' (A(1g)(2)) modes. The different resonant profiles for the two Davydov components in 3L MoTe2 indicate that proper excitation energy of similar to 1.8 - 2.2 eV must be chosen to observe the Davydov splitting in ML MoTe2. Our work presents a simple way to identify layer number of ultrathin MoTe2 flakes by the corresponding number and peak position of Davydov components. Our work also provides a direct evidence from Raman spectroscopy of how the nearest van der Waals interactions significantly affect the frequency of the high-frequency intralayer phonon modes in multilayer MoTe2 and expands the understanding on the lattice vibrations and interlayer coupling of transition metal dichalcogenides and other two-dimensional materials.National Basic Research Program of China [2013CB921901, 2012CB932703]; National Natural Science Foundation of China [11225421, 11434010, 11474277, 61125402, 51172004, 11474007]SCI(E)[email protected]; [email protected]
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