CT Findings as A Predictor of Prognosis in Spontaneous Intracerebral Heamorrhage

Stroke is one of the foremost causes of high morbidity and mortality for many nations of the world, posing a major socioeconomic challenge in the occupational and neurorehabilitational programmes of stroke survivors although there has been a general decline in incidence of stroke including ICH due to improved detection and treatment of hypertension, the economic burden that stroke imposes has diverted attention to newer concepts in stroke pathophysiology and strategies for stroke prevention have assumed global importance. CT is the investigation of choice for intra cerebral heamorrhages. Even small volume of hemorrhage can be detected with CT, it shows the location of hemorrhage, IV extension, mass effect and brain herniation. The highest incidence of intracerebral heamorrhage incidence in the 6th and 7th decades. Focal neurological signs are the most common presenting complaints followed by loss of consciousness. Hypertension is the major risk factor for spontaneous intra cerebral haemorrhage CT allows a straight forward diagnosis of Intracerebral haemorrhage.

Recent trends in the commercialization of medical care in China.

Commercialization of healthcare is a global trend and many healthcare systems all over the world are affected by it. Privatization, marketization and liberalization are generally distinguished from commercialization in that while the former indicate a shift from state-led provisioning to market-led provisioning or the transfer of state-owned assets to private hands, the latter also takes into account the behaviour of public-owned institutions.1 Commercialization of health services has mainly occurred when low levels of public investment have created a space for private interests to grow. It has also arisen from a generalized crisis due to the rising costs of medical care. These trends have coincided with the rise of neo-liberalism that argues that government-funding of social services is inefficient and called for an enhanced role for the market. Much of the scholarly writing on the roles of the market and the State during the post- 1970s has tended to look upon these two spheres as discrete. However, Mackintosh and Koivusalo1 have argued that this kind of analysis does not capture the interrelatedness of the two sectors and the underlying processes which drive them. They define commercialization as the ‘increasing provision of healthcare services through market relationships to those able to pay; the associated investment in and production of those services for the purpose of cash income or profit; and an increase in the extent to which healthcare finance is derived from payment systems based in individual payment or private insurance.’1 For over three decades there has been an increasing trend towards the commercialization of health services in China. There are discernible phases in this shift, which began with the commercialization of public hospitals and has led to the more recent growth of private for-profit hospitals in the major cities. The Chinese commercialized their health sector fairly rapidly from the mid-1980s. The rationale given by the government was the inability of the State to meet the rising costs of healthcare. Various measures were taken to garner resources for the ailing hospital sector. These ranged from the introduction of user fees to the setting up of State-owned enterprises (SOEs)1 which brought in organizational reforms, finally leading to the autonomization of hospitals. An SOE is a legal entity created by the government. It is partially or wholly owned by the government but is able to participate in commercial activities. Autonomization is a complex process aimed at financial autonomy and autonomy in governance. It has created a distinct separation between administrative

Challenges for Regulating the Private Health Services in India for Achieving Universal Health Care.

Commercial interests pose a serious challenge for universalizing health-care. This is because “for-profi t” health-care privileges individual responsibility and choice over principles of social solidarity. This fundamentally opposing tendency raises ethical dilemmas for designing a health service that is universal and equitable. It is an inadequate to merely state the need for regulating the private sector, the key questions relate to what must be done and how to do it. This paper identifi es the challenges to regulating the private health services in India. It argues that regulation has been fragmented and largely driven by the center. Given the diversity of the private sector and health being a state subject, regulating this sector is fraught with the technical and socio-political factors.

Critical perspectives on the NIMH initiative “Grand Challenges to Global Mental Health”.

In July 2011 Nature carried a Comment titled “Grand Challenges to Global Mental Health”announcing research priorities to benefit people with mental illness around the world. The essay called for urgent action and investment. However, many professionals, academics, and service user advocate organisations were concerned about the assumptions embedded in the approaches advocated and the potential for the project to do more harm than good as a result. Nature refused to print a letter (sent on 20th August 2011) protesting against the issue, citing ‘lack of space’ as the reason. This letter is an effort to critique the initiative through wide participation and consensus