Towards comprehensive malaria planning: the effect of government capacity, health policy, and land use variables on malaria incidence in India.

We present what we believe is the first empirical research that accounts for subnational government capacity in estimating malaria incidence. After controlling for relevant extrinsic factors, we find evidence of a negative effect of state government capacity on reported malaria cases in Indian states over the period 1993-2002. Government capacity is more successful in predicting malaria incidence than potentially more direct indicators such as state public health expenditures and economic development levels. We find that high government capacity can moderate the deleterious health effects of malaria in rice producing regions. Our research also suggests that government capacity may have exacerbated the effectiveness of the World Bank Malaria Control Project in India over the period studied. We conclude by proposing the integration of government capacity measures into existing planning efforts, including vulnerability mapping tools and disease surveillance efforts.

A system out of breath: how hypoxia possibly contributes to the pathogenesis of systemic sclerosis.

Systemic sclerosis (SSc) is an autoimmune disease characterized by vascular alterations and immunological disturbances and fibrosis, the order of which remains to be fully determined. Clinically, patients show clear signs of hypoxia in skin and internal organs. The low oxygen tension is potentially caused by a yet to be indentified circuitry involving the three features that typify SSc. In addition, once present, the hypoxia creates a vicious circle of ongoing pathology. In this paper, we provide an overview of the evidence that points towards the mechanisms causing hypoxia in SSc. In addition, data that suggest how hypoxia itself may orchestrate worsening of symptoms is presented. Altogether, it is clear that hypoxia is an important hallmark in SSc patients. By providing an overview of the mechanisms at play and the possible therapeutic avenues that have emerged, we hope to stimulate researchers to provide novel clues into the conundrum in SSc patients.

Capturing your charity care: 5 recommendations.

To identify all charity care patients, hospitals should: Communicate with patients at the point of service. Make qualification for charity care as simple as possible. Use electronic databases to check patient ability to pay. Use predictive modeling techniques. Identify the frequent users of the emergency department.