Baz Luhrman’s Romeo and Juliet: Movie Review

Romeo + Juliet Film review The film â€Å"Romeo + Juliet† was released in 1996, with Baz Luhrman as director. This is one of the most famous love plays written by Shakespeare, screenplay was by Craig Pearce. Romeo and Juliet is a film about forbidden love and how tragic love can end. The film was shot in Miami, but most of all in Mexico. The main actors are Leonardo DiCaprio as Romeo and Claire Danes as Juliet. Romeo and Juliet is about two teenagers that fall madly and deeply in love in Verona, italy, it takes place in the present time.Romeo is an 18 years old, poor rebel and son of the Montague family. He has chestnut hair, soft olive skin, charming blue eyes and a determined but kind mind. Juliet is an 18 years old, rich daughter of the Capulets. Juliet has long dark hair, gorgeous green eyes and clear pearl skin. She doesn’t like being pushed into doing things she cant decide for herself. Juliet loves Romeo and vise versa. As if it weren’t enough problems wit h relationships at a young age, their families were great enemies. This makes it physically impossible to for them to be together.This particular film is a renewed version of the actual story written by Shakespeare. Therefore you can relate a bit more to the actors actions and drama. Romeo is a smart guy, and come up with some clever ideas for the two of them to meet. In one of his last attempts to end the â€Å"war† between their families, something goes totally wrong and destroys their chances forever. The music and sound was made and set by Nellee Hooper. The sound effects were really intense and aggressive, but that only made the story come more to life.The way they talked was extremely special, it set the mood of Shakespeare’s originality and realness. The message the film wanted to give was that you should always follow what you want. Forbidden love is possible to make just love, you just have to fight with everything you have. When teenagers get determined about something they do not forget it easily. â€Å"Romeo + Juliet† will always be an incredible and beautiful love story, that many can relate to. I loved the tension between the two families and the problems that kept on coming during the film.I was really exited every time Romeo and Juliet were secretly meeting. The frighting thought about being caught and killed was constantly there. The only thing that was difficult to understand was the language. In the film they talked the original â€Å"old english† that Shakespeare used in his time. It was not easy to understand everything they said. Since I had heard about the story and read it before, I knew what was going to happen. Over all Romeo & Juliet is a beautiful love story that will never be forgotten.

Captain scott

Robert Falcon Scott was born on June 6,1868. Everyday he rode to school by his pony, Beep. Sometimes he slipped from his horse, but he never afraid with that. At the age of fifteen Scott became a midshipman. He began to conquered his bodily weakness and his childish faults in the navy. In 1891 he graduate from the amnion and he get a lieutenant. Scott was plan this trip to south pole with Sir Clement and everything will prepared. Scott has a high standard of conduct, Intelligence, scientific, knowledge and qualities of adventure in the Antarctic.In the other hand Scott was assured of a fine career in the Ana and he realized that the expedition to the pole would give him new and exciting experience, and also opportunities for scientific research, so he accepted the advice of Sir Clement. Everything will prepared seriously because this Journey became extreme round trip, so it make him very busy. Actually he ship, it was brought from Scotland to London, named â€Å"Discovery'. The expe dition began from London through Atlantic Ocean and arrived in new Zealand.Then over Rose sea, for the further journey they took several dogs, ponies, sledge and another thing they need. In the first expedition Scott lose three member of his party. Trip or the pole was got extreme weather and it become serious problem to us. They study everything in south pole, one of this are about magnetism, meteorological observations, and animal live, also any other aspect. Aftermath they were sail for home and Scott had done splendidly, and he return to find himself famous. The year between first and second Journey, coot married with Miss Kathleen Bruce, artist and sculptor in 1908.On September 14, 1909 coot's son was born and name Peter Markham Scott. In the second Journey he took another ship, named â€Å"Terra nova† and he prepared all with seamen. The second trip need more power because it happen in winter,and it like the first. When they arrived the centre pole they put country flag . In the other hand they get a new experience, but in another hand they got difficulties return from the pole. Winter season make them very ill,day by day conditions grew worse and sometimes they took ore than an hours to drag the sledge a mile.Even in this condition they still to write anything about their condition it seem that they will die. In fact Just only few alive on the return Journey. Comment I think the story is very attractive to know because about the explore to Antarctic. Perhaps hardly ever everyone go there. The story give us about description in the Antarctic. Antarctic is the centre of magnetism and have extreme temperature that somebody never alive in there. It also get us information about discipline to arrange everything we need.

Who Fired at Lexington and Concord

Who Fired At Lexington? Who fired first at Lexington? This question seems to remain a mystery until now, but after much research, and answer has been decided. After scouring through many affidavits, maps, paintings, and such, I have learned that the most logical answer is that the King’s troops, or the British, were the ones who opened fire unto the colonial troops. There is credible testimony as well as a piece of art that leads to this conclusion. To begin with, there are two witnesses to the Battle at Lexington and Concord that openly admit to the British being the ones to first open fire.John Parker, the commander of the militia in Lexington, accounts that upon hearing that the British troops were approaching he gave orders to his men to â€Å"disperse and not to fire†. He then also recalls that his men were rushed by the British troops who opened fire and killed eight of their party without receiving any provoking from the militia in Lexington. Another man, Simon W inship gives account of his experience on the night of the Battle at Lexington and Concord.He states that he was riding his horse on the public road in Lexington, unarmed, when he was approached by the British troops and ordered to dismount his horse. When he asked why, he was removed from his horse by force from the British commanders. The commanding men ordered Winship to march with the troops. He refused, but somehow ended up marching with them for half of a quarter of a mile. The troops were told to halt, prime and load their weapons. The troops then marched on until they came into contact with Captain Parker’s militia.He then recounts that an officer at the head of the said British troops, â€Å"flourished his sword, and with a loud voice, giving the word fire, fire, which was instantly followed by a discharge of arms from said troops†. Winship accounts that he is positive that there was no discharge of arms from either side until the word fire was given by the sa id officer. A painting also gave credible representation of the events that occurred that night. The painting clearly displays the King’s regiment, marching into the space that was occupied by the colonists.The Colonial troops, dispersed and held their ground without provoking the red coats to attack. The commander of the British troops, is shown atop his horse waving his sword in the air as to commence the attack on the Colonial troops. It is obvious as demonstrated by the evidence, that the King’s troops were the offending party which opened fire on the Colonial troops. Even though there was testimony accounting that the Colonial troops were the ones to open fire, they were discounted as credible due to their biased position.

EXTENDING NUMERACY Essay Example | Topics and Well Written Essays - 1500 words

EXTENDING NUMERACY - Essay Example It is believed that mathematical thinking is the process of logical thought, as highlighted by DFES (1999) is a process of ‘Logical reasoning, problem solving and the ability to think in abstract ways (DFES, 1999, p.60-61).’ Development of this method of thought can be aided through the art of speaking and listening, alongside group and collaborative work. Children using and applying their skills equates into mathematical thinking, as agreed by the National Curriculum (1999) which states that ‘mathematics trains children with a ‘uniquely powerful set of tools’ to understand and develop the world (Directgov, 2010).’ The National Numeracy Strategy, introduced by the Department of Education and employment, lays down a framework for the curriculum to be followed in all schools while teaching mathematics for children attending Reception to Year 6 (National Numeracy Strategy, 1999). Compiled in 1999, The National Numeracy Strategy set out four main ap proaches to the teaching of mathematics, viz.: Dedicated mathematics lessons every day Direct teaching and interactive oral work with the whole class and groups An emphasis on mental calculation Controlled differentiation, with all pupils engaged in mathematics relating to a common theme (National Numeracy Strategy, 1999). The National Numeracy Strategy has outlined guidelines for numeracy to be taught nationwide which has to be utilised by teachers within the classroom (National Numeracy Strategy, 1999). ... In order to calculate either cognitively or use written algorithms, it is necessary to have basic numeracy skills. These include: remembering and recalling number facts, relationships of numbers, and problem solving using mental visualization and/or previously learned strategies. Mental mathematics is the foundation to all mathematical methodologies. The ability to count or at least know place value is all cognitive during which memory is used to recall numerical facts or obtain new ones, therefore this skill should be nurtured and emphasised. There are several educationalists who are proponents of encouraging children to engage in more mental calculations rather than just solving problems on paper. In this regard, Askew (1998) states that, ‘Ultimately, mathematics is a mental activity. While practical mathematics can help children develop mental images, written work on its own is not sufficient (Askew, 1998)’. This statement agrees with the principle laid down in the Na tional Numeracy Strategy, which states that â€Å"an ability to calculate mentally lies at the heart of numeracy (National Numeracy Strategy, 1999)’ It is of truth, and it is of little use if a child can complete a page of sums, but does not know how to tackle a problem that has not been written down. The National Numeracy Strategy emphasizes that pupils need to be given opportunities to develop flexible methods of working with numbers mentally that enables them to use known information to derive facts that they cannot recall (National Numeracy Strategy, 1999).   Differentiation within education largely relates to the differences between comparable things, for example, building a picture for the children that

Developing leadership and Global Recession Essay

Developing leadership and Global Recession - Essay Example However, countries which are wealthy were able to cope with recession to an extent. According to AusAID(2010)â€Å"Those  with stronger economies and more financial resources  were able to implement effective policy responses to support the economy and weathered the global recession relatively well†. In combating a worldwide threat like global recession, an organization needs to make visible changes in their leadership styles and business strategies. The issue of global recession demands a leader to change his attitude in conducting business in order to be flexible and realistic. Global recession is a serious issue and threatens the financial structure of a company and its profitability. As per Sawan(2008) â€Å"A recession normally takes place when consumers lose confidence in the growth of the economy and spend less† . In such a condition the objectives and aim of a business needs to be revised and reconsidered according to the demands of the situation. Implicatio n of Leadership on Global Recession a) Autocratic Leadership: This is a leadership style in which the whole decision making process of the business is vested with a single individual. Here the whole group members in an organization are monitored by the autocrat leader. In the event of global recession, the leaders should make effort to increase the confidence of share holders along with motivating staff to achieve maximum profit returns. An autocratic leader has more visionary skills and can implement strategies with less time and effort as consultation with other employees are not required. As an autonomous authority, he can analyze the prospects of the product market and make alternative choices to increase the demand for the product. As per Kiselev(2007)â€Å"An autocratic leader likes to make decisions himself. This leader relies on personal experience and input he has sought, not the voluntary contributions of others†. This kind of leadership is not viable with global re cession concept as co-operation and co – ordination wit all employees can solely achieve long term success for business. b) Democratic Leadership: A democratic leader is one who considers everyone’s opinion and solution on a specific problem before taking a decision. In this kind of leadership, the leader conducts meeting with group members and discuss the complexities of the business in the event of economical downturn. The conclusions are drawn considering the suggestion of all mangers and experts in the organization. During a recession period, most of the organization cut off employees in order to reduce cost, so a declarative leader must plan with organizational heads to retain experienced and skilled employees and disown employees who are less productive. According to Hansen(2011,pg.268)â€Å" Democratic style displays the leadership strength of the leader and usually generates respect from the team member c) Laissez –faire Leadership: In laissez – faire leadership, the decision making power is least vested with a particular individual. The decision making authority is distributed among various employees of the organization and they have strong hold on the business activity of an organization. In times of recession, it will be valuable if many employees have freedom to exercise their power to take action on relevant areas of an organization. In recession period, the organization has to take instant decisions to

How is Soviet montage is revolutionary With the reference to the work Essay

How is Soviet montage is revolutionary With the reference to the work of Soviet Russian film directors Sergei Esienstein and - Essay Example The creation of expression with culture and politics as well as the understanding of how to use specific techniques in this time period were all associated with the construction of the film. While both directors had specific styles, there were more associations with the new creation of film and the experimentation of how one could communicate specific messages to the viewers. Defining the Soviet Montage The concept of the Soviet montage began in the 1920s with the focus on editing specific scenes within movies and combining this with other scenes to create fractured images for the overall plot line. This specific concept emerged out of the Russian Revolution of 1917, which was based on the objection to socialism. The propaganda of socialism was the main component; however, many began to overlook this and believe that the values of socialism were a detriment to society and would lead to strict rules and regulations within society, as opposed to building a stronger ability for citizens to work within society1. The symbolic objective which was established was based on having a free flowing thought of narrative, as opposed to a strict establishment, such as many believed was a component of socialism. This was followed by combining the plotline into one which didn’t require techniques to be consistent or for the plot line to have the established, chronological order that was expected within cinema2. The concept of revolution in the montage was one of the most important factors in using this technique. While this was based on methodologies and techniques for the arts, film producers considered it a way of getting a message across based on the Russian Revolution as well as the politics and economy of the time. The meanings which were established through the broken edits created a political and intellectual agenda that those in the Soviet region could look at and change their understanding about. The narrative and content that was used became important in establ ishing a sense of a political and intellectual revolution, specifically which was believed to be a vehicle for social change. Most of the content which was used in this form was able to take place in an abstract way. However, the meaning which was established allowed for the meaning to relate to the political and economic difficulties of the time, specifically which linked to the voice that was based on the revolution of Russia3. The first historical presence of the montage began with editing between scenes, specifically which would move from long shots that would be followed by a cut in black. This would then lead to a narrative flow that would link specific types of vocabulary and philosophies that were within a specific film area. The main ideal was to create a sense of space, which then held some connections but was able to move into a different narrative direction within the film. As this evolved, it moved into specialized techniques, such as mise-en-scene, where movements were the main component linking together the edits, while the narrative was able to continue in the same direction4. The rules which were established included an established shot in a specific scene, followed by a long shot to create a sense of orientation of where one was as well as to position the performers and objects. This was known

Cognitive biases and decision making Essay Example | Topics and Well Written Essays - 1000 words

Cognitive biases and decision making - Essay Example ob applicant, an interviewer may give a high rating to another applicant who is average at best because they appear more qualified than the previous applicant. Adjustment and anchoring biases may also influence decision making, especially in cases where the individual tends to make judgments on the basis of their initial assessments as anchor, while failing to make sufficient later adjustments (Das & Teng, 1999: p760). For example, an interviewer who has a high-caliber anchor or descriptions of the perfect job candidate may give average applicants substantially higher scores than the interviewer who has anchors of a lower caliber. In this case, evaluation and judgment is not dependent on competence but, rather, on anchors (Das & Teng, 1999: p760). Availability bias also influences the process of decision making, specifically as a result of inaccurate evaluation of event frequency based on the ease of memory recall. The aspects of a specific issue that are unusual and, as a result, more memorable, are more easily recalled and occur more frequently, which negatively influences the process of decision making in most cases. For instance, an interviewer may be influenced more by unfavorable and negative information as compared to more positive information. In such a scenario, availability biases is referent to a condition in which imaginations and beliefs of what could or should happen leads to the ind ividual making the decision remembering similar past situations and applying them to the current situation (Das & Teng, 1999: p760). Confirmation biases also have a unique impact on the decision making process and outcomes. In this case, there is a tendency for the decision-maker to look for evidence in order to confirm pre-conceptions, while ignoring any information that contradicts these pre-conceptions. One scenario that is especially liable to cognitive bias but can be improved through using the right decision making process is an evaluation of appropriate climate

The Vitality of Personal Planning Essay Example | Topics and Well Written Essays - 1000 words

The Vitality of Personal Planning - Essay Example According to researchers and thinkers, planning is a vital element in an individual’s life. If one establishes goals and develops a desire to attain them without proper and efficient planning, he or she would not be able to achieve them. As per my own experience, I have witnessed that planning is undoubtedly a strong factor in making things right and leading them in the right direction. It helps me grow more in every field of life, and whenever I am unplanned and do not have a proper strategy for a certain task, either at college or work, I sometimes fail, or even if I am able to do it, then it is not as effective as I would have done it with proper planning and scheme(Ferzoco). The significance and vitality of planning have been discussed by many writers, authors, and other intellectuals and philosophers. In the article ‘In Praise of the Urban Sandbox’, which was published in April 2011 in the Magazine of the American Planning Association, the importance of plann ing in context with video games and digital gaming has been emphasized. Jeff Ferzoco, the writer of the article, has discussed planning in a brief manner, which is at the same time interesting to read(Ferzoco). The main emphasis of Ferzoco in the article revolves around the idea that planning can lift the standards and can turn the directions of certain things from negative to positive. By giving examples of games, he has stressed on the fact that games are not a bad medium which just consumes hours of people and keeps them busy for no good. In fact, games have turned out as a good medium for people and encourage them to rethink towards certain aspects of life. They teach them by getting them involved in real-life situations while they are in games(Ferzoco). I have learned a lot and games such as ‘cities in motion’ and ‘Cityville’ which has changed my concept and perspective completely. It is very well said that games, particularly computer games cannot be considered just as games, in fact, they are effective learning medium. However, it has all been made possible with proper and effective planning of game designers and planners. While I am playing games, I become curious and possessive regarding many things and want to make them work in a correct and appropriate manner. For example, if I see a long line of unhappy people waiting at a bus station in my city, I will try to divert that crowd to other station or will allocate another bus for them on an immediate basis so that they get to their destinations on time. Similarly, if I witness a decrease in economic and financial sources in my city, I will set up new industries and buildings so that it raises the economy. However, this seems possible only in games and is better said than done; but at least it gives me an idea of how to tackle situations and what actually is going on. The game planners design games so efficiently that they almost portray real life situations and issues(Ferzoco ). Ferzoco has also given different examples from different games in the article; those games which have made people learn, such as Farmville, CityVille on Facebook by Zynga, Sincity, and many others role-playing games.

Latin America Essay Example | Topics and Well Written Essays - 500 words - 3

Latin America - Essay Example Indigenous culture of the South Americans originates from the Incan empire. This empire was established in the year 1438 in the city of Andean for a period of 100 years. Communication was made easier in this region through the building of an expansive network of roads. The Incas built ports, signal towers and food storage facilities along this highway. This allowed the Incas to dominate the western part of the continent. Cultural landscape of South America changed immediately after the importation of African slaves. Most of the African slaves were brought to Brazil. This led to the integration of the African culture to that of indigenous Indian beliefs. Other historical cultures developed with both physical and cultural landscape (Keen & Haynes, 2012). Cowboy culture developed in pampas in the mid 18th century where they hunted herds’ of horses and cattle that roamed freely in the land (Un-Habitat, 2012). The rich history of South America is explored by contemporary cultures. Many organizations are trying to bring audience globally in order to spread social and political messages that will generate revenue from tourism and investment. The aim of these organizations is to ensure sustainable development in South America. Currently they are working on issues like environmental legislation, leadership training and cultural representation. Religious practices remain the stronghold of many South American cultures. Catholicism has dominated the entire continent while other spiritual beliefs dominate the secular activities. Carnival of Reo De Janeiro is an important secular practice that is celebrated 40 days before Easter. This is an important event in the catholic calendar and one of the largest revenue-generating events in Reo (Keen & Haynes, 2012). The Rio carnival is an important event in South America because it attracts many Brazilians and foreigners. During this time, the hotel

After the Revolutionary War Essay Example for Free

After the Revolutionary War Essay After the Revolutionary War, many Americans realized that the government established by the Articles of Confederation was not working. America needed a new form of government. It had to be strong enough to maintain national unity over a large geographic area, but not so strong as to become a tyranny. Unable to find an exact model in history to fit Americas unique situation, delegates met at Philadelphia in 1787 to create their own solution to the problem. Their creation was the United States Constitution. Before the Constitution could become the supreme law of the land, it had to be ratified or approved by at least nine of the thirteen states. When the delegates to the Philadelphia Convention signed the Constitution on September 17, 1787, they knew ratification would not be easy. Many people were bitterly opposed to the proposed new system of government. A public debate soon erupted in each of the states over whether the new Constitution should be accepted. More important, it was a crucial debate on the future of the United States. The Federalist Papers Nowhere was the furor over the proposed Constitution more intense than in New York. Within days after it was signed, the Constitution became the subject of widespread criticism in the New York newspapers. Many commentators charged that the Constitution diminished the rights Americans had won in the Revolution. Fearful that the cause for the Constitution might be lost in his home state, Alexander Hamilton devised a plan to write a series of letters or essays rebutting the critics. It is not surprising that Hamilton, a brilliant lawyer, came forward at this moment to defend the new Constitution. At Philadelphia, he was the only New Yorker to have signed the Constitution. The other New York delegates had angrily left the Convention convinced that the rights of the people were being abandoned. Hamilton himself was very much in favor of strengthening the central government. Hamilton’s Constitution would have called for a president elected for life with the power to appoint state governors. Hamilton soon backed away from these ideas, and decided that the Constitution, as written, was the best one possible. Hamilton published his first essay in the New York Independent Journal on October 27, 1787. He signed the articles with the Roman name Publius. (The use of pseudonyms by writers on public affairs was a common practice.) Hamilton soon recruited two others, James Madison and John Jay, to contribute essays to the series. They also used the pseudonym Publius. James Madison, sometimes called the Father of the Constitution, had played a major role during the Philadelphia Convention. As a delegate from Virginia, he participated actively in the debates. He also kept detailed notes of the proceedings and drafted much of the Constitution. Unlike Hamilton and Madison, John Jay of New York had not been a delegate to the Constitutional Convention. A judge and diplomat, he was serving as secretary of foreign affairs in the national government. Between October 1787 and August 1788, Publius wrote 85 essays in several New York newspapers. Hamilton wrote over 60 percent of these essays and helped with the writing of others. Madison probably wrote about a third of them with Jay composing the rest. The essays had an immediate impact on the ratification debate in New York and in the other states. The demand for reprints was so great that one New York newspaper publisher printed the essays together in two volumes entitled The Federalist, A Collection of Essays, written in favor of the New Constitution, By a Citizen of New York. By this time the identity of Publius, never a well-kept secret, was pretty well known. The Federalist, also called The Federalist Papers, has served two very different purposes in American history. The 85 essays succeeded by helping to persuade doubtful New Yorkers to ratify the Constitution. Today, The Federalist Papers helps us to more clearly understand what the writers of the Constitution had in mind when they drafted that amazing document 200 years ago.

Synthesis of Aquasomes With Different Compositions

Synthesis of Aquasomes With Different Compositions Executive Summary of Research Proposal (maximum 300 words) (Please include the problem statement, objectives, research methodology, expected output/outcomes/implication, and significance of output from the research project) The last three decades have witnessed remarkable and breathtaking advances in the field of biotechnology, biochemistry, molecular biology and peptide synthesis. These developments have facilitated the pharmaceutical industry to make remarkable progress in the development of peptide and proteins as drugs. Since proteins are known to be involved in essentially all biological processes and reactions, they represent a promising class of therapeutics. Administration of these classes of drugs to humans is formidable challenge for biotechnologist as well as pharmacist. The biggest problems lying in their governance are physical and chemical instability, poor bioavailability and lack of knowledge for delivering them. These problems can be solved by using the aquasomes. Aquasomes combines biotechnology and nanotechnology approaches. These sugar balls are the recent addition in delivery systems that have wider applications in peptide and protein delivery. Aquasomes are three-layered self-assem bled nanostructures. They contain solid nanocrystalline core lile calcium phosphate coated with polyhydroxy oligomers over which peptide and protein are adsorbed. The carbohydrate coating protects the peptide from dehydration and stabilizes the active peptide molecules. Structural stability is provided by solid core. Aqausomes maintains the conformational integrity of peptide which makes it ideal carrier system for delivery of peptides. In the proposed work Aquasomes, a novel nano drug delivery system compassing of hydroxy apatite (HA) core having carbohydrate coating will be prepared. Urokinase will be immobilized on these nanostructures for thromobolytic therapy. The prepared systems will be characterized for size, shape, size distribution, enzyme loading efficiency, and in vivo performance. The in vivo performance of the formulated aquasome will be compared with standard urokinase preparation. In Aquasome the steric hindrance is provided by polyhydroxyoligomers between enzyme and blood component (Plasma protein). Later RES cells assist in removing exogenous material from blood stream .The polyhydroxy oligomers maintain three dimensional conformation of enzyme and also helps in deferring recognizition from RES cells. Therefore it is proposed that aquasome not only act as dehydroprotectant but also preserve the three dimensional conformation of enzyme in blood, which enhanced dramatically the half-life of enzyme. So it is expected that proposed system can add new dimension in delivery of urokinase through its rapid onset of action, maximal efficacy and safety Research background including Problem Statement, Hypothesis/Research Questions, Literature Reviews, Related References and Relevance to Goverment Policy, if any. Problem statement Urokinase is a serine protease enzyme which is widely used as an anti-thromboembolic drug in thrombolytic therapy. Urokinase is a strong plasminogen activator. Activation of plasmin activates a proteolysis cascade which breaks down the fibrin polymers of blood clots. This makes urokinase a very important drug against vascular diseases.Urokinase has a half-life of 10-20 mins in plasma. Due to which it is needed to given patient in a short time span for treatment.2 These problems can be solved by using the aquasomes. Aquasomes combines biotechnology and nanotechnology approaches. These sugar balls are the recent addition in delivery systems that have wider applications in peptide and protein delivery. Aquasomes are three-layered self-assembled nanostructures. They contain solid nanocrystalline core like calcium phosphate coated with polyhydroxy oligomers over which peptide and protein are adsorbed. The carbohydrate coating protects the peptide from dehydration and stabilizes the active peptide molecules. Structural stability is provided by solid core. Aqausomes maintains the conformational integrity of peptide which makes it ideal carrier system for delivery of peptides.3,4 Hypothesis Urokinase is a thrombolytic enzyme having half life of 10-20 minutes. In the present work is an attempt is to retain the spatial properties of streptokinase i.e. three-dimensional conformation, which is a freedom internal molecular rearrangement generated by intermolecular interaction and a freedom of bulk movement. Using aquasomes a high degree of molecular preservation may be achieved by virtue of the significant degree of retained biological activity. The aquasomes also avoid the elimination of drug by reticuloendothelial system therefore sustained delivery of drug may be achieved, and a circulating bioreactor could possibly be developed which may be used as preventive measure to avoid probable vascular embolism Research Questions Is it possible to immobilize Urokinase on aquasomes? Do Aquasmoes will be able to preserve the activity of Urokinase? Is it possible to achieve sustain release of urokinase with aquasomes after PEGylation? Is it possible to use similar platform for other peptide drugs? Literature review Current status of research and development in the subject Kossovsky et al.5( 1995) reported first synthesis of aquasomes for delivery of protein antigen and mussel adhesive protein. After that around fifteen research publications were appeared in scientific community utilizing aquasomes for peptide and drug delivery. Recently Aquasomes were used in delivery of peptide and drugs like insulin6 and indomethacin.7 Vyas et al.8 also used aquasomes for hepatitis antigen delivery. The relevance and expected outcome of the proposed study Venous thromboembolism (VTE) is a common and potentially life threatening condition which is still under diagnosed and undertreated.VTE treatment is full of risk as patient requires precise dosing of drugs with careful monitoring.9 Due to these problems in last decade lot of studies were done for developing novel antithrombotic agents. Urokinase is a serine protease (EC 3.4.21.73) enzyme which is also called urokinase-type plasminogen activator (uPA). It is a thromobolytic agent. It was originally isolated from human urine, but it is also found in blood stream and the extracellular matrix. Urokinase directly activates conversion of plasminogen to plasmin which is a primary protein accountable for fibrinolysis.10 Urokianse has a half-life of 10-20 mins due to which it is not available in body for longer time. There is urgent need of a carrier which can carry the urokinase for longer time. Aquasomes is an answer for this need. As it carry the peptide with full retention of therapeutic activity for longer time. So there is a need of developing a drug delivery system for delivery of Urokinase in sustain manner11 It is projected that propose system can add new dimension in delivery of urokianse through its rapid onset of action, maximal efficacy and safety. References Degim IT, Celebi N. Controlled delivery of peptides and proteins. Curr Pharm Des 2007;13:99-117 Erdogan S, Ozer AY, and Bilgili H. In vivo behaviour of vesicular urokinase. Int. J. Pharm.2005 295: 1–6 Juliano RL. Microparticulate drug carriers: liposomes, microspheres and cells. In: Robinson JR, Lee VHL, editors. Controlled drug delivery. 2nd ed. New York: Marcel Dekker, Inc.; 2005. p. 555-80. Rawat M, Singh D, Saraf S, Saraf S. Nanocarriers: promising vehicles for bioactive drugs. Biol Pharm Bull 2006; 29:1790-8. Kossovsky N, Gelman A, Rajguru S, Nguyan R, Sponsler E, Hnatyszyn CK, et al. Control of molecular polymorphism by a structured carbohydrate/ceramic delivery vehicle-aquasomes. J Control Release 1996; 39:383-8. Cherian AK, Rana AC, Jain SK. Self-assembled carbohydrate-stabilized ceramic nanoparticles for the parenteral delivery of insulin. Drug Dev Ind Pharm 2000;26:459-63. Oviedo RI, Lopez SAD, Gasga RJ, Barreda CTQ. Elaboration and structural analysis of aquasomes loaded with indomethecin. Eur J Pharm Sci 2007; 32:223-30. Vyas SP, Goyal AK, Rawat A, Mahor S, Gupta PN, Khatri K.Nanodecoy system: a novel approach to design hepatitis B vaccine for immunopotentiation. Int J Pharm 2006; 309:227-33. Agarwal S, Lee AD, Raju RS, Stephen E. Venous thromboembolism: A problem in the Indian/Asian population? Indian J Urol 2009; 25:11-6. Agarwal Y.K, Vaidya H, Bhatt H, Manna K, Brahmkshatriya P Recent Advances in the Treatment of Thromboembolic Diseases: Venous Thromboembolism Medicinal Research Reviews, 2007 ; 27:891-914, Kaur K,Kush P,Pandey RS,Madan J,Jain UK,Katare OP Stealth lipid coated aquasomes bearing recombinant human interferon-ÃŽ ±-2b offered prolonged release and enhanced cytotoxicity in ovarian cancer cells.2015; 59 :267–276 (b) Objective (s) of the Research Urokinase is an unstable (half-life of 10-20 mins) enzyme. Pharmacist plays and important role in their stabilization, formulation and effective delivery. Over all aim of this study is to develop urokinase immobilized aquasome. Aquasome will protect urokinase from degradation and dehydration. It will also enhance and sustain its thrombolytic activity with reduced side effects. Specific objectives will be 1. To synthesize aquasomes having different compositions. Aquasomes with different sugar coating will be synthesized. Sucrose, Trehalose , Lactose and Pyrodoxial-5-phospahte will be used for sugar coating. Characterization of these nanoparticulte system will done using Transmission electron microscopy, Scanning electron microscopy, Zetasizer and X-ray powder diffractometry (XRPD). Determination of particle morphology and distribution size analysis of nanoparticles will be performed. 2 To immobilize urokinase on aquasomes and coating of PEGylated phospholipids Optimization of aquasome formulations for maximum loading of enzyme will be performed. Enzyme activity will be measured for immobilized enzyme and later they will be coated with PEGylated phospholipids for sustain release. 3. Characterization of these nanoparticulte systems after immobilization will be performed using Transmission electron microscopy, Scanning electron microscopy and Zetasizer 3. In-Vitro evaluation of aquasomal formulations Aquasomal formulations will evaluated for protein (Urokinase) release. (c) Methodology The envisaged work shall be undertaken on the following lines (1) Preformulation studies 1.1. Identification test for proteins IR spectroscopy SDS PAGE 1.2. Identification Test of Formulation Adjuvants (Sugars) Molish Test Moore’s Test Polarimetric determination of sugars 1.3. Preparation of calibration curve of adjuvants (Trehalose and Cellobiose) 1.4. Preparation of calibration curve of Enzyme as a Protein 1.5 Preparation of Calibration curve of Enzyme in PBS (pH 7.4) and Plasma (2) Preparation and Characterization of Hydroxy Apatite 2.1 Optimization of the method for the preparation of Hydroxy Apatite 2.1.1 Characterization of Hydroxy Apatite prepared by self-precipitation Size and Shape e.g TEM and SEM Crystal properties e.g XRD 2.1.2 Preparation and Characterization of Aquasome 2.1.3 Optimization of the poly hydroxyl Oligomers concentration on Hydroxy Apatite 2.1.4 Optimization of drying condition 2.1.5 Optimization of Protein concentration 2.16 Characterization of Optimized Aquasome formulation. Confirmation of poly hydroxyl Oligomers coating by Zeta Potential measurement Determination of loading efficiency of various Aquasome formulations In-vitro release rate studies Assessment of Biodegradability of Different Formulation Retention of Enzyme Activity Reaction Kinetics of Aquasome adsorbed Urokinase Urokinase specific Antibody Detection (3) Stability studies of prepared formulation SDS-PAGE Storage Stability Expected Results/Benefit It is expected that proposed formulation will retain the spatial properties of urokinase i.e. three-dimensional conformation, which is basically achieved by freedom of internal molecular rearrangement for intermolecular interaction and without any bulk movement. Using carbohydrate based aquasomes a high degree of molecular preservation may be achieved by virtue of the significant degree of retained biological activity. The aquasomes also avoid the elimination of drug by reticuloendothelial system therefore sustained and controlled delivery of drug may be achieved. Therefore, it is aim to develop an Aquasome system being streptokinase to protect drug from degradation and dehydration as well as to enhance and sustain its biological activity with reduced side effects. It will help us in getting preliminary results which will be very useful in writing big research project grants to other funding agencies. It is also expected that this research work will allows us to publish quality publications.

Public Health Delivery In Mauritius

Public Health Delivery In Mauritius As the saying goes health is wealth, the provision of proper healthcare is extremely important as this implies well-being, happiness, and a good quality of life. A healthy population is essential for the growth and prosperity of a country. A nations health system should thus aim at providing quality healthcare to its population. The Ministry of Health Quality of Life, to whom an overall yearly budget of Rs 5 billion is allocated, provides public healthcare in Mauritius as a welfare service. (Source: Newsletter Ministry of Health Quality of Life July 2009). As at the year ended 2008, health services were provided through 13 public hospitals including 5 specialised ones, 22 Area Health Centres and 108 Community Health Centres located throughout the country. (Source: Ministry of Health Quality of Life). Free healthcare provided by the Ministry of Health Quality of Life has improved the health situation of the citizens of Mauritius. This is shown in table 1.2 below. Table 1.2: Health Indicators in Mauritius for the years 1990 and 2008 (Source: Ministry of Health Quality of Life) The health indicators in Table 1.2 show favourable changes in the health situation of Mauritians in 2008 compared to 1990. Apart from providing health services to the citizens of Mauritius through its hospitals and health centres, The Ministry of Health Quality of Life being highly concerned about the well-being of the Mauritian population, tries to create awareness amongst them by carrying out several welfare activities. The latter include the launching of a Mobile Clinic which was done on 7 May 2009, public demonstration of physical activities such as yoga, aerobics, Tai Chi and physical exercise that are organised to encourage people to adopt a healthy lifestyle, tips given with regards to a healthy nutrition so as to fight obesity, organising empowerment programmes to sensitise the population on the adverse effects of tobacco and alcohol, talks on stress management and a National Cancer Control Programme has been developed to fight against cancer. (Source: Newsletter Ministry of Health Quality of Life July 2009) Furthermore, The Ministry of Health Quality of Life aims at improving the quality of healthcare provided to the citizens of Mauritius. Recently, on 27 April 2009, it introduced the implementation of the ISO 9001: 2008 in health services so as to increase customer satisfaction and meet the needs of the Mauritian population. (Newsletter Ministry of Health Quality of Life July 2009). The future plans of the Ministry include the setting up of Medical Schools where proper training will be given to healthcare providers and improving the hospitality and catering services provided in its hospitals. (Source: Newsletter Ministry of Health Quality of Life March 2009) From the above, it can be noted that The Ministry of Health Quality of Life is highly concerned with the health of the citizens of Mauritius. However despite all the efforts of The Ministry of Health Quality of Life, the Mauritian population does not seem to be fully satisfied with its healthcare services. Patients are increasingly filing medical malpractice cases which nowadays are repeatedly seen as being the headline of many newspapers. Media reporting has created an increased awareness of harm related to healthcare errors. Additionally, despite the fact that industrialisation and economic growth during the last years have positively changed the lifestyle and the standard of living of the Mauritian population, the latter is highly exposed to diseases such as diabetes, hypertension, obesity, cancer, HIV/AIDS and so forth. Research has shown that 1 out of 5 Mauritians aged 30 and above has diabetes that is mostly caused due to obesity, unhealthy eating habits, lack of physical activity and alcohol abuse. (Source: Newsletter Ministry of Health Quality of Life July 2009) The HIV/AIDS status in Mauritius is quite high with 3792 cases registered from October 1987 to March 2009. This has resulted in 249 deaths as at March 2009. Prior to 2000, 20 to 30 new cases of HIV were being reported annually. However over the period of 2001 2005 the number had increased by almost twice annually: 55 in 2001, 98 in 2002, 225 in 2003, 525 in 2004 and 921 in 2005. The 538 new cases registered in 2008 showed that in spite of all the efforts of the Ministry of Health Quality of Life, HIV in Mauritius is on a rising trend. (Source: Ministry of Health Quality of Life: An analysis of Health Situation in Mauritius as at year ended 2008) Furthermore each year more than 1400 new cases of cancer are registered in Mauritius. In 2008, 12% of all deaths were due to this disease. (Source: Newsletter Ministry of Health Quality of Life July 2009) Heart diseases and Diabetes mellitus were the first two main causes of mortality in 2008. Comparing the causes of death in 2008 with those of 1975: Causes 1975 2008 All diseases related to the circulatory system including heart diseases 28.4% 35.0% Diabetes Mellitus 2.7% 22.8% Table 1.3: Causes of death in the years 1975 and 2008 (Source: Ministry of Health Quality of Life: An analysis of Health Situation in Mauritius for the year ended 2008) Table 1.3 shows a rapid increase in death due to heart diseases and diabetes mellitus over the last three decades. This can be explained by a change in the lifestyle and eating habits of the citizens of Mauritius which is making them become more prone to such non-communicable diseases. Morbidity in Mauritius and the litigation/complaints concerning medical mal-practice therefore indicate that the Ministry of Health Quality of Life is not meeting the needs of the Mauritian population. The healthcare system in Mauritius is getting bigger and more complex as the expectations of the population are increasing. The citizens of Mauritius who are now better educated, have become highly demanding in terms of choice, access, quality of care and service. They furthermore feel that the system is deteriorating and becoming less responsive to their needs as the press only publicises the bad points. Such negative media comments definitely demoralise the health care providers. The aim of this project is to investigate the problems faced by the public health care sector of Mauritius. This will be done through an empirical study at Flacq Hospital, one of the well-known general hospitals operated by the Ministry of Health Quality of Life. Throughout this study, it is intended to assess the healthcare quality provided at Flacq Hospital and analyse the factors linked to service experience and patient satisfaction. By evaluating patient experience important information can be obtained for identifying problems and taking appropriate measures for quality improvement in health-care facilities (Labarere and Franà §ois, 1999; Batchelor et al., 1994). Improving the quality of service in hospitals will thus be beneficial to everybody namely patients, physicians, nursing staff, management and tax-payers. Such a win-win situation will be advantageous to the whole country.

The Nature of a Crazy Family in Faulkner’s As I Lay Dying :: Faulkner’s As I Lay Dying

The Nature of a Crazy Family in Faulkner’s As I Lay Dying "My mother is a fish." (p. 79) I think that this statement typifies the entire family. There is something not-quite-right about all of them. Vardeman, as Cora Tull says on page 70, is "outen his head with grief and worry" for his mother. He has confused her with the fish because they both died on the same day. In his child's mind he cannot differentiate between the two. Throughout the novel he refers to his mother as a fish, as on page 196. In this scene, he is looking at the vultures that have gathered over the wagon. Darl and Cash are trying to get Cash's broken leg situated better for the rest of the ride. Vardeman thinks that his "mother is not in the box. My mother does not smell like that. My mother is a fish." Darl is slowly going crazy. He is referred to as being "queer, lazy, pottering about the place no better than Anse" on page 24. However, his true madness is not shown until his monologue at the end of the novel after he has been arrested for burning the barn. Cash believes he did so to try to rid them of Addie's body, but Darl never reveals his motivations. In his final section he seems to be looking in on himself. He refers to his body as Darl, and he asks himself "'What are you laughing at?'" All the answer he gets is "'Yes yes yes yes yes'" (253). Dewey Dell is obsessed with sex and her unwanted pregnancy. Every man that looks at her she looks at with "her eyes kind of blaring up and going hard like [they] had made to touch her" as she does with Tull on page 124. Even in trying to get rid of the fetus, however, she is confronted with sex. She is none the wiser to the wiles of the ‘doctor’ until afterwards when she says, â€Å"’It won’t work [ . . . ] I just know it won’t’† (252). Jewel has some less-than-healthy fascination with his horse. While he frequently beats it about the head, he still refers to it as a â€Å"’sweet son of a bitch’† (13). He was willing to work all night every night for weeks in order to buy the horse, and he disappears for a while when Anse barters it for the new team.

Macbeth: Shakespeare’s Two Key Motifs Essay example -- weather, blood,

The play â€Å"Macbeth†, by Shakespeare, contains many motifs. Two very powerful motifs that Shakespeare illustrates in this play are blood, and weather. Blood is important because it shows that this play is violent, and the blood physically shows that these characters in the play are warriors. Weather plays an important role because it usually foreshadows events that are about to take place. For example, a storm usually foreshadows terrible things, like death and destruction. A major motif in â€Å"Macbeth† is blood. Blood is talked about everywhere in Macbeth. Blood is found when Macbeth kills his own relative, King Duncan, in order to gain power and to become the king himself. After Macbeth carries out Duncan’s murder, he is crowned King of Scotland. As Macbeth and Lady Macbeth’s murderous journey begins, the death toll rises; and with each death, the amount of blood on Macbeth metaphorically and literally increases. Guilt starts to control Macbeth. When King Duncan is killed, Macbeth is convinced that â€Å"all great Neptune’s oceans† would not wash the blood clean from his hands. Guilt is eating away at Macbeth, and his desire and ambition for power is what leads to him to carry out many more murders. Blood is found several times in the text: â€Å"may thick my blood†, â€Å"the sleepy grooms with blood†, â€Å"Will all great Neptune's ocean wash this blood clean from my hand?†, â€Å"Would to the bleeding and the grim alarm excite the mortified man.† Blood appears in â€Å"Macbeth† in two ways: It appears in the text, and it also appears literally, due to the many deaths in the play. In a lot of ways, blood symbolizes a person’s bravery. For example, In Act I, after the battle, Duncan asks the wounded sergeant, "Wh... ...re. Another Major motif in the play is weather. Sunshine and clear skies are not discussed at all in the play. Shakespeare wanted to create a dark and gloomy background. Most of the descriptions about the weather indicate storm-like conditions such as rain, thunder, and lightning. The three witches are also associated with the weather motif. Right before the first scene of the play, it is stated in the text: â€Å"Thunder and lightning. Enter three witches.† Thunder and lightning usually represents an unnatural presence. Shakespeare wrote this play with intention on giving the reader this lesson. Too much greed can consume you and make you do something that you will possibly regret. Works Cited http://intensivemacbeth.wikispaces.com/The+Motif+of+Blood http://www.studymode.com/essays/Blood-Motif-In-Macbeth-64386.html http://britlit4.wikispaces.com/Macbeth+Motif-+Blood

Education in Bolivia for the past 50 years Essay

In the year 1989, education in Bolivia was not considered as a right by many people. However, it was observed as a means to control the lives of the masses by the ruling sector. The government restricted the release of funds to education because it gave more attention in other branches of the society. As a result, the illiteracy rate was very high. A country which has 13-14% illiteracy rate, Bolivia is regarded as the worst in the South Americas. The Bolivian government allocates 23% of its yearly budget to education which is actually the highest percentage in South American countries despite of its small budget. However, this did not help improve the literacy level of the country as a whole. According to the Bolivian National Statistics Institute in 2002, the rate of absolute literacy level is about 20%, functional literacy rate is about 35%, with totality of 55% only. There are about 11. 8% literacy rate in men were proven and this increases to a relatively high 27. 7% for women (Carlos Santander-Maturana, 2007). Nowadays, the absentee rate is very high learner for children in the primary school from six to eight years. It is comparably lower on children aged nine, but increases significantly when on children aged 12 (Santander-Maturana, C. 2007). A very familiar explanation for this growing dilemma is that the majority poor families, which comprise the leading portion in the Bolivian people, force their kids to stop from going to school in order to help their parents increase the family income. Similar thing is true to the other students who are in the secondary and tertiary level as is confirmed in Country Studies (2007): Only 1/3 of the first graders completed the 5th grade, 20% started secondary school, 5% began their postsecondary studies, and just 1% received a university degree. Dropout rates were higher among girls and rural children. Only about 40% of rural youngsters continued their education beyond the third grade (Country Studies, 2007). This astounding percentage is the worst among the South American countries and the government is now trying its best in combating this central problem in education. As years go by, parents of poor families started seeing education as a means to save them and their future generation from poverty. But as a family strives hard for survival, problems will always remain as problems no matter how they manage to resolve them. The current economic condition of the family is one of the many causes of their being illiterate. As of now, the literacy condition is getting more and more improved because people are paying much attention in education more than they did before. The government is also in support of the projects to make education better. Many programs are now laid out and are being implemented to secure the future of the country. The Bolivian style of education compared side by side with the United States’ is quite similar in a few ways. As what is stated in Encyclopedia Britannica (2007): Primary education for children 6 to 13 years of age is free and officially compulsory, although school attendance is difficult to enforce in some areas. Secondary education, lasting up to 4 years, is not compulsory. Most education is state-supported, but private institutions are permitted (Encyclopedia Britannica, 2007). Education in the United States is funded mainly by the government in three levels: federal, state, and local. Primary education, which starts from 5-6 years old and secondary education are both compulsory. College education is still an option because there are still vocational and technical courses being offered by the state. Reading literacy rate in the US is as high as 98% being recognized as one of the best reading literacy all over the world.

Role In Health Sector Reform Health And Social Care Essay

Thailand ‘s economic construction is altering toward more industrialisation and the Gross Domestic Product ( GDP ) increased about 7-9 % yearly from the late 1980s until 1996. The Thai economic system took an unexpected downswing in 1996. The Bank of Thailand forecast the growing rate of Thai economic system would spread out at a rate of 2.0-3.0 per centum merely, caused by the hapless public presentation of exports and private sector investing. Import growing besides declined during 1996. Decelerating the growing in imports entirely can non better the state ‘s current history shortage significantly. The shortage remains an economic job of major concern.A However, the economic stableness believes to be improved as a consequence of abrasiveness policies or outgo cuts and nest eggs acceleration. The budget shortage will be about 40,000 million tical.Factors Determining HealthHealth and Health Status are influenced by assorted factors viz. the state of affairss and tendencie s of economic, societal, political, administrative, physical environment, substructure development and engineering development. In amount, the economic growing and construction have made alterations in the ingestion form of Thai people. Peoples need more wellness attention and pass more for wellness services, both necessary and unneeded attention. The national wellness outgo has been increasing bit by bit, at a rate faster than the Gross Domestic Product ( GDP ) , from 3.5 % of GDP in 1979 to 6.3 % of GDP in 1991. In the twelvemonth 2000 it ‘s expected to be at a rate of 8.1 % of GDP. With the worst scenario of Thai economic system it is expected to be more than 10 % of GDP in future. The outgo largely covered by the family and the hapless have a higher portion of outgo to income than the rich. The disbursal is for remedy instead than preventative and crude attention. Furthermore, the engineerings for medical services are freely imported with some particular revenue enhancement freedom. This consequences in greater purchase and competition in importing the high cost equipment and imbalanced use of this equipment nationally. The Thai economic construction has changed from agribusiness based industry to more fabrication and service based industries. This caused people to travel to industrially based countries or to migrate from rural to urban countries and society faces many societal jobs including occupational wellness. There is a great economic loss due to route accidents and accidents in the mill because of unequal attending to industrial safety. The job of air, H2O, noise and sight pollution in mill and environment and under standard working conditions is increasing. The increasing rate of utilizing modern engineering and chemicals in agricultural activities, i.e. , pesticides, weedkillers, unreal fertiliser has resulted in people having substances toxic to their wellness. Income disparity between the hapless and the rich, the rural and the urban countries, the agricultural and manufacturing sectors affect the wellness system in footings of unfairness in wellness resource allotment. The free trade system besides has impact on pharmaceutical industry: higher monetary value of drugs because of the patent ordinances. Due to the job of alterations in instruction many people have limited abilities to set to the information received through the assorted media. Some change their wellness behavior to follow more hazard to their wellness. There are besides the jobs of catching diseases, chronic disease, and aged disease among the people.Economic Crisis from mid-1997The current economic crisis has tremendous impact on the state and this impact will prevail for at least 4-5 old ages. The immediate effects are unemployment, reduced household income and decreased ingestion outgo. These have societal and wellness effects.Economic Crisis and Health Impactshypertext transfer protocol: //www.econ.chula.ac.th/public/research_center/chealth/im/ChealthCrisis.jpgSome Elementss of Reforms in Health SectorSoft loans from World Bank ( WB ) and Asian Development Bank ( ADB ) were offered to the Government to refill the foreign militias, and to back up indispensable plans. These loans came with certain conditions to co ntinue the safety cyberspace to salvage the vulnerable groups, particularly those unemployed. Under the recent loan from the Asian Development Bank ( ADB ) , there are besides elements of reforms in the wellness sector as conditions of the loan, viz. Redeployment of wellness forces to the rural countries Reform of the referral systems Development of independent infirmaries Policy reform of assorted wellness insurance strategies, i.e. , Civil Service Medical Benefit Scheme ( CSMBS ) , Free Medical Care for the Low Income Household Scheme ( FC/L ) , Free Medical Care for the Aged Scheme ( FC/E ) , Workmen Compensation Scheme ( WCS ) , the Social Security Scheme ( SSS ) and the Voluntary Health Card Scheme ( VHCS ) ( Wibulpolprasert, et Al, 1998 ) .Social Impact and Responseshypertext transfer protocol: //www.econ.chula.ac.th/public/research_center/chealth/im/ChealthImpact.jpgEconomic Crisis:Necessity and Opportunity to reevaluate precedences of Health Services ResourcesWhat the crisis has already told us: The most carefully laid programs are all of a sudden undermined by unannounced national economic loss We have all of a sudden to do new precedences Health sector versus other sectors Within wellness sector Wages Health services installations Capital investing Disease control / preventative activities Health instruction / media Short term versus long term Local, national, regional New enterprises, i.e. , Health Care Financing, Health Care Investment, etc. Equity, i.e. , the rich and the hapless, between sectors, between parts. Major displacements: Fiscal crisis Private infirmaries, some are running out of money, bankruptcy. Drain of work force from public to private: Private wellness sector interrupted consequences in the possible betterment of manpower state of affairs in public sector conditional upon the handiness of money to pay them. Shift of patronage from private to public wellness sector services, due to fall in income or unemployment of people. Attendant overloading of public wellness sector services. Short versus long term deduction issues: Can equilibrate between public and private wellness sector be legislated based on experience of instability of private sector concern methods exposed by crisis. Debt direction, i.e. , local and foreign investing Investing ordinances Work force policy accommodation Equity consideration Can disease controls / preventative activities are Streamlined, so Protected against cuts in crisis so to safeguard against dearly-won additions in disease out interruptions ( catching diseases ) which would ensue in increasing debt load. Time toA readdressA affair of comprehensive national wellness insurance embracing all sectors. This might distribute costs equitably. This would likely ask cut downing the benefits of CSMBS, i.e. , co-payment mechanism, keeping the rule of the wellness card strategy and presenting a compulsory wellness insurance strategy overall etc. The urgency of this is highlighted by the rise in unemployment with loss of employee contributed benefits and sudden addition in the figure of eligible individuals for Social public assistance wellness services to the hapless.Health Economicss: Thai ExperienceThis list summarizes on traveling and completed wellness economic sciences research throughout Thailand. National Health System Research, i.e. Social Motions and Economic Transformation: to analyze the historical development of Thai wellness attention system. Private Hospital Survey Cigarettes and Excise Tax: to analyze the impact of a alteration in the rate of coffin nail excise revenue enhancement. Political Economy of Tobacco Products and Optimal Cigarette Taxation Diagnostic Related Group Study Information System for Health Improvement Computer System for Health Care Providers Government Information Network ( GINet ) Rapid Provincial Health Survey Law and Regulation Decentralization and Health Systems Change Public-Private Mix Essential Health Package Thai Burden of Diseases The Economics of Traffic Accidents: to cipher the economic sciences loss and causes of accident. Beginnings of Economic Growth in Thailand Development, Environment and Health in the Eastern Seaboard Area Healthy City Project Health Financing Research Health insurance in assorted strategies, i.e. , Voluntary Health Insurance. Social Security Scheme. Civil Service Medical Benefit Scheme ( CSMBS ) . National Health Account National Drug Account Hospital Costing: assorted degrees Resource Allotment: Confluent Beginnings of Finance and Reforming Payment Mechanisms for Health Servicess Cost, Resource Use and Financing of District Health Services in Thailand Technology Appraisal Quality Improvement Research, i.e. Assessment the Health Welfare ( Low income ) Card Scheme of Thailand Economicss of Social Welfare Project Management Entire Quality Management Study Health Manpower Development Research, i.e. Scientific and Technical Manpower for Economic Growth: to analyze the human resource development impinges upon proficient capacity in many sectors including those which straight and indirectly affect wellness. Future Pattern of Health Manpower Needed at each degree Forecast the Disease Pattern in Thailand Health Behaviour Research, i.e. Economic Evaluation alongside WHO Antenatal Care Trial Cost Effectiveness, Cost / Performance techniques in assorted wellness programmes Quality of Life Study Alcohol Consumption Study Elderly Care Health Situation and Trend Research, i.e. The diseases control plan, i.e. , Economicss of Leprosy Social and Economic Impact of Dengue Hemorrhagic Fever Economic Evaluation of Village Malaria Volunteer Programme Economic Analysis of Malaria Diagnostic Technology Economicss of Screening for Thalassemia Demographic Impact of the HIV/AIDS Epidemic in Thailand Survey of Elderly in Thailand General Agreement on Trade in Services and the Effects on Health System and Services in Thailand Quantitative Approaches to Analysis and Redefinition of Market Roles in Changing Options for Health Servicess Scheme for Research in Health Economicss: Present and Future † in Enabling Mechanisms for HealthSummary of Health Economics Research TargetsIssues Equity Efficiency Quality Health Insurance Universal Health Insurance Accessibility to Health Care Health Care Behaviour and Utilization Types of Health Care Financing Impact on Utilization and Health Expenditure Essential Package and Outgo Resource Allocation at Various Levels Assess the Standard for Quality of Care Technology Appraisal Technology Diffusion and Distribution Cost-effectiveness for Drug, Medical Equipment and Technology Consumer Protection for Using Health Care/ and Health Servicess Health Manpower Health Manpower Distribution Cost and Number of Health Manpower Quality of Personnel Standard of Providing Care Role of Private and Public Impacts of GATS on Prices and Accessibility Earmarked Taxs Public-Private Mix Optimum usage of Assorted coaction, i.e. , Joint-venture, Contract out Referral System and Network Assess the Standard and its Applications Health impacts of rapid economic alterations in Siam The economic crisis in Thailand in July 1997 had major societal deductions for unemployment, under employment, household income contraction, altering outgo forms, and child forsaking. The crisis increased poorness incidence by 1 million, of whom 54 % were the ultra-poor. This paper explores and explains the short-run wellness impact of the crisis, utilizing bing informations and some particular studies and interviews for 2 old ages during 1998A ±99. The wellness impacts of the crisis are mixed, some being negative and some being positive. Household wellness outgo reduced by 24 % in existent footings ; among the poorer families, institutional attention was replaced by self- medicine. The pre-crisis lifting tendency in outgo on intoxicant and baccy ingestion was reversed. Immunization disbursement and coverage were sustained at a really high degree after the crisis, but studies of additions in diphtheria and whooping cough indicate worsening programme quality. An addition in malaria, despite budget additions, had many causes but was chiefly due to cut down programme effectivity. STD incidence continued the pre-crisis downward tendency. Ratess of HIV hazardous sexual behavior were higher among draftees than other male workers, but in both groups there was lower rubber usage with insouciant spouses. HIV sero-surveillance showed a continuance of the pre-crisis downward tendency among commercial sex workers ( CSW, both whorehouses and non-brothel based ) , pregnant adult females and donated blood ; this tendency was somewhat reversed among male STD patients and more among endovenous drug users. Condom coverage among whorehouses based CSW continued to increase to 97.5 % , despite a 72 % budget cut in free rubber distribution. Poverty and deficiency of insurance coverage are two major determiners of absence of or unequal prenatal attention, and low birth weight. The Low Income Scheme could non adequately cover the hapless but the voluntary Health Card Scheme played a wellness safety net function for maternal and child wellness. Low birth weight and scraggy among school kids were observed during the crisis. The impact of the crisis on wellness was minimal in some sectors but non in the others if the pre-crisis status is efficient and healthy and frailty versa. We demonstrated some cardinal wellness position parametric quantities during the 2-year period after the 1997 crisis but do non hold decisions on the impact of the economic crisis on wellness position, as our observation is excessively short and there is uncertainness on how long the crisis will last. hypertext transfer protocol: //www.business-in-asia.com/medical_tour/images/boi_med1.jpg Siam has good positioned itself to go the medical hub of Asia, with more than four 100 infirmaries offering the most advanced interventions by an internationally trained medical staff. The state boasts the largest infirmary in Southeast Asia and the first of all time to have ISO 9001 enfranchisement, and the first infirmary in Asia to be granted the esteemed Joint Commission International Accreditation ( JCIA ) . In 2005, the figure of foreign patients geting in Thailand, alleged medical tourers, topped one million and reached 1.4 million in 2006. The state has set a mark of 2 million medical tourers by the twelvemonth 2010. With 1000000s of people without wellness insurance in some states, or those merely seeking the best service and attention available, medical touristry continues to be a growing industry for Thailand. The one-year growing rate for the sector has been 14 % , with major surgical processs increasing, every bit good as those seeking standard medical attention. Thai Airways has taken medical touristry one measure farther by boxing medical check-ups as portion of its Royal Orchid Holidays plan. Acknowledging the available market and the state ‘s ability to present medical intervention at international criterions, in 2004 Thailand ‘s authorities adopted a five-year strategic program to develop the state ‘s capacity into the â€Å" Center of Excellent Health of Asia † . This strategic program, advanced by the Ministry of Public Health, focuses on three chief countries of health care: medical services, health care services, which includes watering place, traditional massage and long-stay health care merchandises and services, and 3rd is Thai herbal merchandises. There is a serious committedness on behalf of health care suppliers and the authorities to guarantee that international criterions are met. â€Å" More late, infirmaries in Thailand have opted to besides use for Joint Commission International ( JCI accreditation, which is the international accreditation arm of the U.S. Joint Commission on Accreditation of Healthcare Organizations ( JCAHO ) † , says Mr. Denis Meseroll of Asset Management Systems ( Thailand ) , a company that provides healthcare direction services. hypertext transfer protocol: //www.business-in-asia.com/medical_tour/images/boi_med2.jpg Skyrocketing costs of health care in many western states, along with overladen medical installations in many others, has added great attractive force to Thailand ‘s high quality low cost medical service industry. For illustration, elected surgery in Thailand ‘s best private infirmaries is frequently one tenth the cost of the same process if performed in the United States. With the value of OECD states ‘ wellness attention sector holding been estimated to be every bit high as US $ 3 trillion and the United States at US $ 2 trillion, the potency for Thailand is important. BlueCross BlueShield of South Carolina and Blue Choice of South Carolina, US based health care insurance suppliers, have formed an confederation with one of Bangkok ‘s premier infirmaries to advance medical touristry to its 1.3 million members. In add-on to the cost economy, there is besides the added benefit that intervention and aftercare services are frequently performed in resort like scenes, with a degree of cordial reception non found in other of the universe ‘s medical centres. Doctors are experts in their Fieldss and nurses are registered and good trained. But beyond the medical attractive force, patients are treated to personal service characterized by Thailand ‘s excellence. Patients are non left to linger in infirmary waiting suites for hours, left unattended and uninformed. Some infirmaries will even delegate patients a personal helper who will walk them through the full procedure from the front door, to their assignment with the physician, to the onsite pharmaceutics to make full prescriptions, and to uncluttering all grosss for insurance reimbursement. Patients are kept informed throughout their stay. In fact one of Bangkok ‘s premier infirmary installations boasts a staff of physicians that can talk English, French, Spanish, German, Dutch, Japanese, Cantonese, Mandarin, Hokkien, Hainan, Arabic, Urdu and others, and has 60 translators on its staff. While another has translators in over two twelve linguistic communications, all in order to ease the increasing Numberss of international patients. And many of the state ‘s infirmaries have the most advanced medical equipment, including one which late purchased the MRI 3 Tesla, the first in Asia, which offers better diagnosing without injection of contrast media. While Thailand excels in the medical attention it delivers on a day-to-day footing to patients from over 190 states, the Kingdom is besides deriving acknowledgment as a location for research and for clinical tests of advanced medical specialty and for root cell interventions. Thailand is puting in research and development for tropical diseases, such as dandy fever febrility and malaria, among others ; countries broad unfastened for farther investing. With the exponential growing of Thailand into going a medical hub in the part, considerable chances in related Fieldss are being created. The medical device sector, for one, will go on to see healthy growing to run into the demands of health care installations for new and upgraded medical machinery and devices. Thailand ‘s health care industry is genuinely turning in springs and bounds.HEALTH CARE SYSTEMS IN THAILANDThe bulk of wellness attention services in Thailand is delivered by the populace sector, which includes 1,002 infirmaries and 9,765 wellness Stationss. Universal wellness attention is provided through three plans: the civil service public assistance system for civil retainers and their households, Social Security for private employees, and the Universal Coverage strategy theoretically available to all other Thai subjects. Some private infirmaries are participants in these plans, though most are financed by patient self-payment and private insurance. Harmonizing to t he World Bank, under Thailand ‘s wellness strategies, 99.5 % of the population has wellness protection coverage. The Ministry of Public Health ( MOPH ) oversees national wellness policy and besides operates most authorities wellness installations. The National Health Security Office ( NHSO ) allocates funding through the Universal Coverage plan. Other health-related authorities bureaus include the Health System Research Institute ( HSRI ) , Thai Health Promotion Foundation ( â€Å" Thai Health † ) , National Health Commission Office ( NHCO ) , and the Emergency Medical Institute of Thailand ( EMIT ) . Although there have been national policies for decentalisation, there has been opposition in implementing such alterations and the MOPH still straight controls most facets of wellness attention. Thailand introduced cosmopolitan coverage reforms in 2001, going one of merely a smattering of lower-middle income states to make so. Means-tested wellness attention for low income families was replaced by a new and more comprehensive insurance strategy, originally known as the 30 tical undertaking, in line with the little co-payment charged for intervention. Peoples fall ining the strategy receive a gold card which allows them to entree services in their wellness territory, and, if necessary, be referred for specializer intervention elsewhere. The majority of finance comes from public grosss, with support allocated to Contracting Units for Primary Care yearly on a population footing. Harmonizing to the WHO, 65 % of Thailand ‘s wellness attention outgo in 2004 came from the authorities, while 35 % was from private beginnings. Thailand achieved cosmopolitan coverage with comparatively low degrees of disbursement on wellness but it faces important challenges: rise costs, inequali ties, and duplicate of resources. Although the reforms have received a good trade of unfavorable judgment, they have proved popular with poorer Thais, particularly in rural countries, and survived the alteration of authorities after the 2006 military putsch. Then Public Health Minister, Mongkol Na Songkhla, abolished the 30 tical co-payment and made the UC strategy free. It is non yet clear whether the strategy will be modified farther under the alliance authorities that came to power in January 2008.Public Health IssuesAlthough infective diseases, most notably HIV/AIDS and TB, remain serious public wellness issues, non-communicable diseases and hurts have besides become of import causes of morbidity and mortality. Major infective diseases in Thailand besides include bacterial diarrhoea, hepatitis, dandy fever febrility, malaria, Nipponese phrenitis, hydrophobias, and swamp fever. Human immunodeficiency virus/acquired immune lack syndrome ( HIV/AIDS ) is a serious job in Thailand. The United Nations Programme on HIV/AIDS ( UNAIDS ) reported in November 2004 that the Thai authorities had launched a well-funded, politically supported, and matter-of-fact response to the epidemic. As a consequence, national grownup HIV prevalence has decreased to an estimated 1.5 per centum of all individuals aged 15 to 49 old ages ( or about 1.8 per centum of the entire population ) . It was besides reported that 58,000 grownups and kids had died from AIDS since the first instance was reported in 1984. The authorities has begun to better its support to individuals with HIV/AIDS and has provided financess to HIV/AIDS support groups. Public plans have begun to change insecure behaviour, but favoritism against those septic continues. The authorities has funded an antiretroviral drug plan and, as of September 2006, more than 80,000 HIV/AIDS patients had received such drugs.Food Safet yFood safety panics, like the remainder of developing Asia, are non uncommon to Thailand. Furthermore besides the of all time common microbic taint of street side nutrient left out in the hot Sun and dust-covered roads, every bit good as shop nutrient, taint by banned or toxic pesticides and forge nutrient merchandises is besides common. 3-MCPD, a genotoxic and carcinogenic substance, was found in utmost sums ( 100s to 1000s of times bounds ) in an Asia-wide ( ex Japan and Korea ) acid-hydrolyzed soy sauce dirt in 2001, including exports to Western states, cyanuramide in Thai nutrient merchandises along with 2008 Chinese milk dirt, and July 2012 consumer action groups demanding 4 unlisted toxic pesticides found on common veggies ( which are banned in developed states ) be banned. Chemical companies are bespeaking to add them to the Thai Dangerous Substances Act so they can go on to be used, including on exported Mangifera indicas to developed states which have banned their usage. Medical and Healthcare Services Currently Provided in Thailand:Medical ServicessMedical Examination ( Chulalongkorn Hospital ) Outpatient Department Nursing Department Dentistry Extended Service Clinics Social Security Services ( Chulalongkorn Hospital/Somdej Na Sriracha Hospital ) On-line Consultancy Anonymous Clinic Nurses at Home Project Medical Certificate Services ( Chulalongkorn Hospital/Somdej Na Sriracha Hospital ) Rabiess Clinic Immunological ClinicNew Tract Medicine ServicesImmunological Clinic and Tourist Consultancy Biological Merchandises Chula Excimer Laser Center Ostomy ClinicCommunity Medicine/Community HealthWednesday Club Anti-AIDS Campaign in Slum Communities Elderly Care Project, Klong Toey Slum CommunityEducational ServicessNursing CollegeOther Health related ServicessFirst Aid Training Knowledge for Life Project Home Nursing Training Health Education for the Disadvantaged, Including inmates, no educated kids Rabiess Hot Line Health Restorative Service at Home Consultancy for HIV AIDS infected and householdCatastrophe Relief Services Consumable and Life Pack AidsMobile Medical Unit of measurements First Aid Unit, Medical Supplies and Vehicles Service Coverage ( Map ) â€Å" Princess Pa Project † voluntary Project, the Thai Red Cross SocietyBlood ServicessBlood Bags manufactured by the National Blood Service CenterEye BankEye Bank procedure Cornea in Optisol Cornea in Glycerine Eye Whites Amniotic membrane Fair and Equal-Opportunity Eye AllotmentOrgan Donation Heart,Lung, Liver Allocation Kidney Allocation Child Aids Biological Family Tracking Family Finding Child Follow-Through Adoption Process Chalerm Phrakiat Child Development Center ( For Thai Red Cross Personnel )Human-centered ReliefConsumable AIDSs and life battalions Mobile Medical Unit of measurements First Aid Units Specialized Medicine Unit of measurementsOther Services Dissemination of Red Cross Principles andHuman-centered Laws in young persons Chalerm Prakiat 72 Pansa Iodine Nutrition Project Community Service ActivitiesStrong industry growing mentality several cardinal supportive factorsWe believe Thailand ‘s health care sector has bright chances in visible radiation of the undermentioned supporting factors: Low health care incursion. An ageing population and a lifting decease rate from complex unwellnesss. A limited supply menace due to high entry barriers. Thailand ‘s competitory market place in medical touristry. The first three factors guarantee quickly lifting demand for health care from local people in Thailand. However, we see greater demand chances from provincial countries than from the Bangkok Metropolitan Region ( BMR ) due to the turning urbanization tendency and lower incursion.Local Government Policies and Major Measures to PromoteThe Thai authorities began strategic programs since 2004 to advance Thailand as a premier medical touristry finish. Since so, the state has enjoyed a big figure of visitants in this class. The Department of Export Promotion and the Department of Health Service Support reported a rapid growing of 16.48 % during 2001-2009 for wellness services bringing to aliens: Year No. of Foreign Patients Estimate Income ( Million Baht ) 2007 1,373,807 106,640 2008 1,380,000 107,419 2009 1,390,000 108,197 Thailand is now widely acclaimed among the international community as the medical hub in Asia, with important advantages including the handiness of modern equipment and fortes, easy entryway, competitory monetary values, and great cordial reception from service operators and forces. These, when coupled with the well-established fact that Thailand is a brilliant tourer finish with calm beaches and mountains, fascinating humanistic disciplines and civilization, nutrient, amusement, and shopping, make Thailand a great medical touristry finish.The policies and schemes to advance Thailand as a medical hub of Asia1 ) . Most healthcare service suppliers peculiarly infirmaries participate in travel marketplaces, travel carnivals, trade carnival, exhibitions, seminars, conferences. 2 ) . Using advertizements in travel magazines in states with the back uping from the authorities. With the cooperation from the Ministry of Public Health, Tourism Authority of Thailand ( TAT ) , Ministry of Foreign Affairs, and Department of Export Promotion ( DEP ) organized these activities for advancing health care services to international markets. 3 ) . Other enlightening stuffs are provided such as booklets, brochures, video-cds, paper bags and jersey with Sons were besides used to make consciousness of the available health care services 4 ) . Some healthcare service suppliers build up cooperation with the local institutes, universities, medical schools in other states to set up coaction in instruction, exchange of cognition and preparation every bit good as to advance their option health care services. 5 ) . Advertising about medical and nonmedical services in both local and international media are used by healthcare service suppliers. The advertizement has to be based on Thai Torahs and ordinances about how to publicize health care services. Media such as magazines, newspaper ( both in Thai and English ) , telecasting etc. are used to aim local people and exiles who work in Thailand.FUTURE TRENDSHarmonizing to the KASIKORN RESEARCH CENTER, ASEAN wellness service liberalisation will heighten the chances for Thai medical attention concern investing into ASEAN states. This is because of ASEAN cancellation of all pre-conditions to wellness service markets and enlargement of ASEAN investors ‘ shareholdings of up to 70 per centum beginning in 2010. Positive factors that would back up Thai entry into ASEAN medical concern would include the possible in the first-class direction of Thai infirmaries that have attracted the highest figure of foreign patients in ASEAN. Furthermore, the impact of ASEAN trade and investing liberalisation and the development of transit logistics into the Indochina part will assist ease travel within the part via land transit ; hence, offering greater chances to Thai private sector infirmaries to spread out into other metropoliss in Thailand and back up a turning figure of foreign patients wishing to utilize medical attention services in Thailand. However, the enlargement of Thai medical attention services may confront some challenges in forces deficits within ASEAN, an investing finish – including. It is expected that the effectivity of liberalisation in the motions of medical forces within ASEAN in 2015 will be rather limited and may confront challenges caused by competition with and that besides aim to spread out such investings within ASEAN and would wish to go hubs for medical attention within this part, every bit good. Meanwhile, the enlargement of Thai private infirmaries into other ASEAN states may worsen forces shortages domestically and impact our ability to go a major Asian medical service hub pulling foreign patients to. It is expected that the job of competition in pulling medical forces between service suppliers domestically, authorities and private sector, will go on to escalate, peculiarly if there is an unequal authorities budget for medical Personnel development.Thailand Health Profile studyHealth is related to legion factors. Indispensably, analysis of state of affairs and tendency of the Thai wellness system requires comprehensive consideration on alterations in both single and environmental contexts that influence wellness, e.g. economic system, instruction, human ecology, household characteristic and migration, genetic sciences, value and belief, civilization, political relations and authorities, environment, substructure and engineering, every bit good as wellness services system itself. This inspires the thought of making the Thailand Health Profile study, a study that offers information on Thailand ‘s wellness system integrally connected with its determiners.Siam can be proud to hold achieved most of the eight UN Millennium Development Goals ( MDGs ) , in peculiar the three health-related ends.In 1970, Thailand had an infant mortality rate of 68 per 1,000 unrecorded births, while today it is estimated at 13 per 1,000 unrecorded births. Harmonizing to a 2008 survey published in the medical diary Lancet, Thailand enjoyed the highest one-year rate of decrease in child mortality among 30 low- and middle-income states between 1990 and 2006. The maternal mortality ratio has besides shown a similar decreasing tendency. In add-on, Thailand has been successful at controling new HIV infection rates by 83 per cent since 1991, thanks to the backbreaking attempts made by authoritiess and NGOs. Such impressive wellness results did non happen in isolation from its socio-economic development context. From 1969 to 2009, its gross national income ( GNI ) grew from US $ 210 to $ 3,760 in current figures, or 17 times over 40 old ages. During the 1970s and 1980s, Thailand invested to a great extent in main roads that connect the stray and destitute Northeast and North to Bangkok ; electrification throughout the state ; every bit good as enlargement of school registration for both male childs and misss. As a consequence, the positive spillover effects besides benefited the public wellness sector. As economic growing accelerated in the mid-1980s and 1990s, the state continued to finance substructure undertakings which brought greater connectivity, wider entree to electricity and safe imbibing H2O and clean sanitation, primary and secondary schools, and primary wellness Centres in rural countries across the state. Four decennaries ago when Thailand was still a low-income state, it invested early in wellness attention substructure that has reached the most distant rural communities. Alternatively of concentrating resources to urban third infirmary development, public wellness leaders placed more funding to rural countries from 1982 onwards, which has encouraged greater and low-cost entree to healthcare at the most local degrees. Such investings have paid off. In a survey carried out by the London School of Hygiene and Tropical Medicine and released in Bangkok last month, Thailand featured as one of the states to accomplish â€Å" good wellness at low cost † . Harmonizing to the World Health Organization ( WHO ) , its entire wellness outgos ( THE ) is estimated at 4.1 per cent of its GDP or $ 328 per capita, which is comparatively low for the wellness outcomes achieved. The extended web of primary health care installations implemented through territory wellness systems supplemented by some of the first-class research outfits doubtless played a important function in bettering wellness results particularly for the rural population. In add-on, Thailand has been successful in preparation nurses and physicians for its wellness system, innovatively administering human resources to rural countries by prosecuting new medical alumnuss to function for three old ages in a rural infirmary, and supplying extra pecuniary inducements. In add-on, wellness voluntaries recruited from local communities besides play of import support, bar and sensing functions, and thereby heightening community engagement. Thailand ‘s wellness accomplishments are non limited to impressive indexs, but extend to achieving cosmopolitan wellness coverage ( UHC ) .Globally, the figure of states that have attained UHC is comparatively little, and comprises largely of OECD states. Within Asian, Brunei, Malaysia, Singapore and Thailand have achieved UHC, with the Philippines, Vietnam, and Indonesia nearing full coverage as they embark on reforms. Yet, harmonizing to the International Labour Organization ( ILO ) , merely 5 to 10 per cent of people are covered in sub-Saharan Africa and South Asia, while in middle-income states, coverage rates vary between 20 to 60 per cent. Annually across the universe, about 150 million people suffer fiscal calamity and 100 million are pushed below the poorness line due to regressive payment systems for health care and absence of UHC. In 2002 when Thailand was still a lower-middle income state with a GDP/capita of $ 1,900, the state achieved UHC. This did non go on overnight but bit by bit since the 1970s through the creative activity of three wellness insurance strategies: the Civil Servant Medical Benefit Scheme ( CSMBS ) , Social Security Scheme ( SSS ) Subsequently the Universal Coverage ( UC ) Scheme – once referred to as the â€Å" Bt30 † Scheme. Achieving a coverage rate of 99 per cent of the population is more than merely run intoing a national aim ; it represents a beginning of inspiration to other low- and middle-income states. As a affair of fact, functionaries from assorted wellness ministries and NGOs from Asia and Africa frequently request a visit to Thailand ‘s public wellness establishments such as the National Health Security Office, International Health and Policy Programme, Health Systems Research Institute and the Ministry of Public Health to â€Å" analyze how Thailand did it † . As of now, 99 per cent of the Thai population is covered through a comprehensive health care bundle that ranges from wellness bar and primary attention, to hospitalization due to traffic accidents to renal replacing therapy and entree to ART intervention for HIV. It has been shown that the UC Scheme has contributed significantly to cut downing cases of ruinous health care outgos, particularly in destitute countries of the state. Based on the recent rating of the 10 old ages of the Scheme, the figure of destitute families dropped from 3.4 per cent in 1996 to 0.8-1.3 per cent between 2006 and 2009, therefore lending to poverty decrease, edifice greater fiscal stableness to vulnerable families and improved long-run support security. In add-on, it helps Thailand to achieve the rule of the right to wellness for all. In a state with high income inequality as measured by the Gini Coefficient, entree to low-cost health care is a span that helps extenuate many of the socio-economic unfairnesss that still plague this state. Thailand has demonstrated that UHC may non be an unachievable dream to be experienced by merely the rich states. Low-income states such as Ghana and Rwanda have already made much advancement towards UHC, and states such as India and Bangladesh are working towards developing effectual UHC systems. The biggest individual determiner in this is political committedness. In a round-table conference in Bangkok in November, 2011, UN Secretary-General Ban Ki-moon declared that no states rich or little would hold â€Å" adequate † resources to transport out UHC reform but the challenge for every state is how shortly they can travel into it. This was echoed at the recent Prince Mahidol Award Conference with the subject of UHC. Attended by participants from 68 states, none said that UHC is impossible to accomplish in their contexts. With the right policies – societal, economic and political, it is possible for a low- or middle-income state to ship on the route towards UHC. Although Thailand has achieved cosmopolitan coverage, large challenges remain. These include: how to include foreign migratory workers into the health care system how to unify the three strategies to cut down unfairnesss in benefit bundles how to guarantee sufficient and highly-trained human resources in wellness to run into current deficits how to pull off Thailand ‘s passage into a â€Å" Grey † society in the following decennaries what are the germinating fiscal mechanisms that can be used to better function the population? UHC after all is non an end point in itself, but a journey that moves us closer to better wellness for all. Mushtaque Chowdhury and Natalie Phaholyothin are based at the Rockefeller Foundation ‘s Asia Regional Office in Bangkok. The article reflects the positions of the writers, which do non needfully represent those of the Rockefeller Foundation.Healthcare in ThailandIntroductionOne of the most popular Asiatic states for resettlement is Thailand. The state has a rich historical and cultural background. However, there are some concerns that exiles should be cognizant of, and one of these is the issue of health care.The health care systemMost of the physicians in Thailand are specializers ; that is why it may be difficult to happen a dependable all-around general practician to handle you for minor medical jobs. As an exile, you will hold to travel to a general infirmary, where you will most probably be examined by a physician who is a specializer in one field or another. Since it may be common to hold a figure of smaller medical conditions, it may be hard for a medical specializer to cover with these. The best manner, particularly if you are non rather certain of your job ( s ) , is merely to seek an internist as your first port of call. However, it should be noted that there are still some major infirmaries in Thailand that have household physicians or medical practicians. Most physicians in Thailand do non hold one specific topographic point of work. Thai sawboness and doctors have different working agendas at different infirmaries thatA can beA spread over the whole of Bangkok. Because of this, physicians are likely to travel from one infirmary to another to make their unit of ammunitions. Additionally, these physicians may besides hold private clinics. In visible radiation of this, they tend to work really long hours. It is non hard to conceive of the jobs that this could do. For illustration, if you merely had surgery and a job arises, there is the possibility that your sawbones might be executing another surgery in a different infirmary, or he may be at his private clinic. This may ensue in your physician seeking to work out the state of affairs over the phone.Obstacles in medical exigenciesEmergency conveyance installations in Thailand are non yet to the full developed. Large infirmaries in Thailand have mobile intensive attention units where you can be hold immediate intervention in exigency state of affairss. However, you will seldom see an ambulance rushing the streets of Bangkok. Although traffic accidents are attended to, voluntary organisations are usually the 1s to supply deliverance units. Passers-by will besides help in exigencies. For traffic accidents, you can ever seek aid from the Police Hospital at the Ratchaprasong Intersection ( if you are in the country ) . In footings of exigency conveyance, the chief obstruction in medical exigencies is the traffic in Bangkok. Unwanted holds are ineluctable, unless you are in close propinquity to a infirmary. By and large talking, autos do non automatically give manner to reacting ambulances. Therefore, if you have a medical status that may necessitate immediate attending, where possible, remain in a topographic point which is near to a suited infirmary. Having a wellness service that is able to handle controlled and stable conditions is one thing, but being capable of covering with exigency processs is another. Unfortunately, Thailand needs some major betterments in this respect.Money is of importWhen you are in Thailand, it is of import to hold your medical insurance paperss with you ; either that or another signifier of payment. In the instance of a infirmary admittance, you will be required to pay up forepart for the interventions. It appears thatA moneyA plays an even larger portion than normal when discoursing the health care system of Thailand. In most European states, jobs like these are usually avoided because the patients have compulsory medical insurance and infirmaries can be confident about acquiring paid. It is recommended that you avail of private wellness insurance when sing Thailand as a topographic point to see or populate.Making Business in ThailandIndia has many chances for making concern with Thailand. Priority countries are: aˆ? Advanced Engineering aˆ? Agribusiness aˆ? Education and preparation aˆ? Environment aˆ? Food and Beverage aˆ? Railway aˆ? Power aˆ? Motor vehicle and motor vehicle partsaˆ? Healthcare and Pharmaceutical, Medical Hub is targeted for Thailandaˆ? Petro aˆ? Renewable Energy aˆ? Tourism, athleticss and leisure equipmentHealthcare Sector in ThailandThailand had a population of 69.51 million at the terminal of 2011.Life anticipation is 71 old ages for work forces and 77 old ages for adult females has increased. With a population growing rate of around 0.4 % , Thailand is confronting an aging society. Proportion of the population over age 60 in 2020 is expected to make 17.51 % .Market OverviewThe entire health care market in 2012 is expected to make U.S. $ 13.13bn, while the pharmaceutical and medical devices market forecast market for U.S. $ 4.1bn U.S. $ 9.36bn. However, some medical equipment produced for domestic ingestion in Thailand, the state imported from abroad, 70 % of medical devices. Due to increasing demand from international and local patients, Thailand ‘s first medical substructure in developed states and at a fraction of the cost of similar processs provides the highest possible quality of attention. Thailand is ready to take a serious involvement in this dynamic market ; this is an exciting concern chance for companies.Key chancesThailand in cardinal and emerging chances for Indian companies in the health care include: Medical equipment and instruments Specialist intervention engineering Aging Population Standard Certification Accident Emergency E-Health Geting into the marketMedical equipment and instrumentsThe most popular finishs for medical touristry in Thailand, more than 1,000 public infirmaries and 400 private infirmaries with international criterions are powered on. Turning medical touristry market with a 10-20 % one-year growing in the sector has played an of import function. Both foreign and domestic patients Thai wellness installations continue to spread out due to the increasing demand for wellness intervention. We are besides seeing a new tendency of amalgamations between private infirmaries. Therefore, both private and public infirmaries for medical machinery and equipment, including a turning demand continues to upgrade their installations. Purchase of major medical equipment in public infirmaries, accounting for 60 % of the consumers live.Specialist intervention engineeringDemand for particular intervention in Thailand, non merely because of the figure of foreign patients in Thailand but besides increased health-conscious consumers.Aging PopulationHarmonizing to the analysis of a decease certification, major and increasing cause of decease among Thai citizens of non-communicable diseases, accidents, and HIV / AID. The impact of an aging population opens up many chances. Due to the increasing aging population, we besides take attention of the aged by both the populace and private sector to see an increasing figure of advanced characteristics. The Thai authorities is cognizant of the aging society and provides support for the aged life. The National Science and Technology Development Projects Agency ( NSTDA ) besides on new engineering in these countries are done by collaborating with international organisations.Standard CertificationAn indispensable tool for pulling foreign patients is an internationally recognized commissioned infirmary. Consequently, the Joint Commission International ( JCI ) to better its services to international criterions scheme has gained big private infirmary. However, some private infirmaries to seek other options which allow more flexibleness in the execution procedure of the want.Accident EmergencyEmergency Response therapy has progressively become a precedence in Thailand, as the state ‘s natural catastrophes and political agitation in recent old ages experienced a figure. National Institute of Emergency Medical Services Emergency Medical System is to develop international criterions in this country and has played a major function in natural catastrophes. More preparation and guidance every bit good as experts in the country, include the demand for devices that generate chances.E-HealthThailand is one of a turning figure of smart phones and tablet computing machines have followed the planetary tendency. Some e – wellness undertakings, wellness informations aggregation, wellness position monitoring, etc. In the past few old ages has been the usage of the hand-held device. Commercially available from Q1 2013 due to 3G service, local infirmaries, which will let them to function in distant vitamin E – are cognizant of the wellness benefits. National Health Information System, tele-medicine, for smart places and independent life, the Thai Government Smart Health ‘s National Electronics and Computer Technology Center, with focal point on 3 countries ( NECTEC ) has supported the undertaking launched by.Thailand Health Care IndustryLocal Government Policies and Major Measures to PromoteThe Thai authorities began strategic programs since 2004 to advance Thailand as a premier medical touristry finish. Since so, the state has enjoyed a big figure of visitants in this class. The Department of Export Promotion and the Department of Health Service Support reported a rapid growing of 16.48 % during 2001-2009 for wellness services bringing to aliens: Year No. of Foreign Patients Estimate Income ( Million Baht ) 2007 1,373,807 106,640 2008 1,380,000 107,419 2009 1,390,000 108,197 Beginning: The Royal Thai Embassy, Washington Thailand is now widely acclaimed among the international community as the medical hub in Asia, with important advantages including the handiness of modern equipment and fortes, easy entryway, competitory monetary values, and great cordial reception from service operators and forces. These, when coupled with the well-established fact that Thailand is a brilliant tourer finish with calm beaches and mountains, fascinating humanistic disciplines and civilization, nutrient, amusement, and shopping, make Thailand a great medical touristry finish.The policies and schemes to advance Thailand as a medical hub of Asia1 ) . Most healthcare service suppliers peculiarly infirmaries participate in travel marketplaces, travel carnivals, trade carnival, exhibitions, seminars, conferences. 2 ) . Using advertizements in travel magazines in states with the back uping from the authorities. With the cooperation from the Ministry of Public Health, Tourism Authority of Thailand ( TAT ) , Ministry of Foreign Affairs, and Department of Export Promotion ( DEP ) organized these activities for advancing health care services to international markets. 3 ) . Other enlightening stuffs are provided such as booklets, brochures, video-cds, paper bags and jersey with Sons were besides used to make consciousness of the available health care services 4 ) . Some healthcare service suppliers build up cooperation with the local institutes, universities, medical schools in other states to set up coaction in instruction, exchange of cognition and preparation every bit good as to advance their option health care services. 5 ) . Advertising about medical and nonmedical services in both local and international media are used by healthcare service suppliers. The advertizement has to be based on Thai Torahs and ordinances about how to publicize health care services. Media such as magazines, newspaper ( both in Thai and English ) , telecasting etc. are used to aim local people and exiles who work in Thailand.History of DevelopmentModern medical system in Thailand day of the months back over 100 old ages, during the reigns of King Rama III and King Rama IV when American and British missionaries introduced modern medical specialty in Thailand. However, the promotion of modern medical specialty truly took a immense measure during reign of King Rama V and began to lift steadily from so on. King Rama V initiated the thought to establish Siriraj Hospital to suit people ‘s demands for health care. He founded the Royal Medical School that would subsequently put the foundation of modern medical schools. These enterprises led to constitutions of other infirmaries in Bangkok and big metropoliss. His Royal Highness Prince Mahidol of Songkhla was one of the drive forces that have given Thai modern medical specialty its topographic point among that of developed states. HRH Princess Mahidol of Songkhla received certification in Public Health and subsequently graduated M.D. semen laude from Harvard University, USA. He became the innovator in the Thai modern medical specialty and has been regarded as the â€Å" Father of Thailand ‘s Modern Medicine. † Even though he passed off at the early age of 38 due to deteriorating wellness, he has greatly contributed in modern medical specialty of Thailand. His Majesty King Bhumibol has granted permission to set up the Prince Mahidol Award as a planetary award in award of His Royal Highness Prince Mahidol of Songkhla. The Award is granted to persons or organisations around the universe with outstanding work for humanity in the Fieldss of medical specialty and public wellness. During 1950s, many Thai medical physicians graduated or completed their preparation abroad, in the United States in peculiar. In 1970s and 1980s, a big figure of Thai physicians continued their surveies and preparations in the United States. A big figure of medical physicians moved from public infirmaries to work in private infirmaries. At the same clip, many Thai physicians practising or holding medical licences abroad moved back to Thailand to and other states. During this clip, private infirmaries with international accreditation emerged in work in private infirmaries. One of the major drive forces behind the promotion of Thai modern medical specialty is the constitution of the â€Å" Thai Red Cross Society. † During the economic roar of the 1990s in Thailand, as the economic status improved and personal income degree increased, public demand for good quality wellness attention besides increased consequently. Leading private infirmaries expanded their capacity to suit such demand. Harmonizing to the Ministry of Public Health of Thailand, the entire figure of infirmaries increased from 422 in 1991 to 491 in 1997, and the figure of beds more than doubled, from 14,927 to 38,275 during the same period. However, when the 1997 fiscal crisis hit, the domestic market was significantly affected. Personal wellness outgos were curtailed as economic status declined. Private infirmaries had to do up for the loss of their domestic patients by switching their focal point outside of Thailand and ask foring patients from abroad. Because of the local currency devaluation, every bit good as the low labour and other factor costs, the entire monetary value of the medical intervention in Thailand was less than half that in the United States, even after adding in the costs of travel and adjustments. In the face of worsening gross, Bumrungrad Hospital in Bangkok brought in a new direction squad from outside the state to pull off its plan for international patients and to take the infirmary out of its fiscal troubles. Under this new direction, Bumrungrad became the first internationally commissioned infirmary in Southeast Asia in 2002 and pioneered the medical touristry concern. Its 50,000 international patients in 1997 had gone up to 350,000 in 2005. In this sense, the success of medical touristry in Thailand was a typical factor-driven phenomenon, where people traveled to obtain medical services with the lowest cost.3. Industry Introduction ( SWOT Analysis and Development Status )Thailand is one of the best finishs in Asia for health-conscious tourers. The state has been one of the modern-day innovators of Medical Tourism in Asia, with more than a million foreign patients yearly coming to over 956 public and 309 private infirmaries, 7 of which are JCI commissioned ( as of 2010 ) , and 17 of which are in the grapevine. The international patients will hold entree to the rich pool of over 19,000 medical physicians and 100,000 nurses, many of which have undergone preparations in the United States, UK, Germany, Australia, Japan, and other states. It is besides noteworthy that Thailand has been the leader in holistic intervention attacks, including health care, illness bar, interventions, rehabilitative and renewing attention. These attacks have gained greater attending in the western states. Thailand has convenient entree, beautiful tourer finishs, and superior services. Soon, Thailand is able to offer most comprehensive scope of medical interventions to the universe due to many Thai-Physicians have been studied and forte trained as specializer from abroad since 1960.These Physicians moved back to work in Thai private Hospitals and Clinics. So, they are able to freely offer their expertness and specializers to Thai every bit good as alien patients.The most three popular services in medical touristry consist of:Cosmetic and Fictile Surgery such as Breast Augmentation ( Augmentation Mammoplasty ) , Breast Lift ( Mastopexy ) , Nose Surgery ( Rhinoplasty ) , and Liposuction ( Lipoplasty ) Dentistry such as Dental Bonding, Dental Bridges, Dental Crowns, Dental Filling, Dental Implants, and Teeth Whitening Renaissance mans ramping from Blood Vessel System, Bones, Joint and Tendons, Breast, Cardiology, Diagnostics, and General Surgery