1.WTO DDA and Negotiations on Healthcare Servics.
Journal of the Korean Medical Association 2002;45(9):1080-1089
The multilateral trading system embodied in the World Trade Organization has contributed significantly to economic growth, development and employment throughout the past fifty years. We are determined, particularly in the light of the global economic slowdown, to maintain the process of reform and liberalization of trade policies, thus ensuring that the system plays its full part in promoting recovery, growth, and development. The negotiations on trade in services shall be conducted with a view to promoting the economic growth of all trading partners and the development of developing and least-developed countries. The General Agreement on Trade in Services (GATS) is among the World Trade Organization's most important agreements. The accord, which came into force in January 1995, is the first and only set of multilateral rules covering international trade in services. Ig has been negotiated by the Governments themselves, and it sets the framework within which firms and individuals can operate. The GATS has two part: the framework agreement containing the general rules and disciplines ; and the notional "schedules" which list individual countries' specific commitments on access to their domestic markets by foreign suppliers. Each WTO Member lists in its national schedule those services for which it wishes to guarantee access to foreign suppliers. All commitments apply on a non-discriminatory basis to all other Members. There is complete freedom to choose which services to commit. In addition to the services committed, the schedules limit the degree to which foreign services providers can operate in the market. For example, a country making a commitment to allow foreign banks to operate in its territory may limit the number of banking licenses to be granted (a market access limitation). It might also fix a limit on the number of branches a foreign bank may open (a national treatment limitation). The GATS covers all internationally-traded services with two exception : services provided to the public in the exercise of governmental authority, and , in the air transport sector, traffic rights and all services directly related to the exercise of traffic rights and all services directly related to the exercise of traffic rights. The GATS also defines four ways in which a service can be traded, known as "modes of supply" Services supplied from one country to another (e.g international telephone calls), officially known as "cross-border supply"; Consumers from one country making use of a service in another country(e.g tourism), officially known as "consumption abroad"; A company from ton country setting up subsidiaries or branches to provide services in another country (e.g a bank from one country setting up operations in another country), officially known as "commercial presence" ; and Individuals travelling from their own country to supply services in another (e.g an actress or construction worker), officially known as "movement of natural persons". Trade liberalization, and even economic growth, are not the ends in themselves. The ultimate aim of Government is to promote human welfare in the broadest sense, and trade policy is only one of many instruments Governments use in pursuing this goal. But trade policy is nevertheless very important, both in promoting growth and in preventing conflict. The building of the multilateral trading system over teh past 50 years has been one of the most remarkable achievements of international cooperation in history. The system is certainly imperfect, which is one of the reasons why periodic negotiations are necessary, but the world would be a far poorer and more dangerous place without it. In January 2000, WTO Member Governments started a new round of negotiations to promote the progressive liberalization of trade in services. The GATS agreement specifically states that the negotiations "shall take place with a view to promoting the interests of all participants on a mutually advantageous basis" and "with due respect for national policy objectives and the level of development of individual Members". The pace and extent of these negotiations are set by the WTO's 140 Member Goverments themselves according to their different national policy priorities. Recently, however, the negotiations and the GATS itself have become the subject of ill-informed and hostile criticism. Scare stories are invented and unquestioningly repeated, however implausible. It is claimed for example that the right to maintain public services and the power to enforce health and safty standards are under threat, though both are explicitly safeguarded under the GATS. How have serious people come to believe what is, on the face of it, out of the question? Why should any Government, let alone 140 Governments, agrees to allow themselves to be forced, or force each toher, to surrender of compromise powers which are important to them, and to all of us? Decision-making in open societies presupposes informed public discussion. It must be based on fact rather than fiction. The purpose of this booklet is to contribute to this discussion and to a greater public understanding of the GATS by correcting statements made in some recent publication which we believe are misleading the public and undermining support for international economic cooperation. It must not be assumed that becuase we have disputed some allegations we accept that others are well-founded: these are merely examples.
Appointments and Schedules
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Delivery of Health Care*
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Economic Development
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Employment
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Financing, Organized
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Freedom
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Humans
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International Cooperation
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Licensure
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Linear Energy Transfer
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Negotiating*
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Pamphlets
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Publications
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Telephone
2.Effects of spontaneous agonal respiration on coronary perfusion pressure during untreated cardiac arrest in swine model
Tongying LIU ; Luning WANG ; Manhong ZHOU ; Lijing SAN ; Kaili WU
Chinese Journal of Emergency Medicine 2013;22(10):1112-1116
Objective To investigate the effects of spontaneous agonal respiration on coronary perfusion pressure (CPP) during untreated cardiac arrest (ventricular fibrillation) in swine model.Methods Ten male healthy domestic swines (25.0 ± 1.5) kg were anaesthetised,intubated and mechanically ventilated.The catheterizations were separately inserted into the right atrium and thoracic aorta to monitor aortic pressure (AOP) and right atrial pressure (RAP).A pacing electrode was inserted into the right ventricle to induce ventricular fibrillation (VF).VF was induced by intra-ventricular stimulation withalternating electric current and untreated for 8 minutes.AOP and RAP were recorded until respiratory activity ceased.The CPP before and after agonal respiration was calculated and analyzed by paired-sample T test.Results All animals presented with agonal respiration from 1 to 6 minutes after VF during the first attempt.The CPP was (7.18 ±4.22) mmHg at 1 sec before agonal respiration,(11.78 ±5.16) mmHg at 0 sec after agonal respiration,(8.75 t:4.38) mmHg at 5 sec after agonal respiration and (8.23 ± 4.55)mmHg at 6 sec after agonal respiration.The CPP at 0 sec after agonal respiration was higher than that before agonal respiration (t =-3.140,P =0.012).The CPP at 5 sec after agonal respiration was higher than that at 1 sec before agonal respiration (t =-2.828,P =0.020).There was no difference in CPP between at 6 sec after agonal respiration and at 1 sec before agonal respiration (t =-1.778,P =0.109).Conclusions Agonal respiration accompanies ventricular fibrillation.After agonal respiration,the coronary perfusion pressure is increased for 5 seconds being in favor of cardiaopulmonary resuscitation.
4.Current status of the study of the mechanism of epidermal growth factor receptor targeting drug therapy and their related markers.
Yan WANG ; Jian-ming XU ; San-tai SONG
Chinese Journal of Oncology 2005;27(9):573-576
Antibodies, Monoclonal
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administration & dosage
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Antibodies, Monoclonal, Humanized
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Antineoplastic Agents
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administration & dosage
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Carcinoma, Non-Small-Cell Lung
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drug therapy
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Cetuximab
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Drug Delivery Systems
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Humans
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Lung Neoplasms
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drug therapy
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Protein Kinase Inhibitors
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administration & dosage
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Quinazolines
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administration & dosage
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Receptor, Epidermal Growth Factor
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antagonists & inhibitors
8.The effects of respiratory training on off-respirator pulmonary function and depression in patients with chro- nic obstructive pulmonary disease
Rui NIU ; Qiang-San SUN ; Wei WANG ; Bo LIU ;
Chinese Journal of Physical Medicine and Rehabilitation 2003;0(07):-
Objective To study the influence of systematic respiratory training of patients with chronic ob- structive pulmonary disease(COPD)on their off-respirator pulmonary function and emotional depression.Methods Sixty COPD patients were divided into a treatment group and a control group.The patients in both groups were given routine treatment,while those in the treatment group were also given respiratory training in addition for 9-12 months after ceasing the mechanical ventilation.The index of pulmonary function such as FEV1 and depression(SDS score) were evaluated before and after the respiratory training.All data was analyzed by using SPSS 10.0.Results The FEVI of all patients was improved after 9-12 months of respiratory training(P
9.Effect of pre-pregnancy body mass index and gestational weight gain on birth weight of infants: a prospective cohort study
Ya-wen WANG ; Ya-hui FENG ; San-san WU ; Shu-ya CAI ; Liang- kun MA ; Yu JIANG
Chinese Journal of Disease Control & Prevention 2020;24(3):314-318,364
Objective To analyze the relationship between pre - pregnancy body mass index ( BMI) ,gestational weight gain ( GWG) and the birth weight of infants,and explore the effect of weight change before and during pregnancy on low birth weight ( LBW) and macrosomia. Methods Women were enrolled by the Chinese Pregnant Women Cohort Study during first trimester. Each respondent's weight before and during pregnancy and the birth weight of infant were collected after fellow up. Prepregnancy BMI was divided into underweight,normal and overweight /obesity groups and GWG was divided into suitable, insufficient and excessive groups. Multivariate Logistic regression was adopted to explore the relationship be- tween pre-pregnancy BMI,GWG and newborn's birth weight. Results Women's prepregnancy BMI and GWG were associated with neonatal birth weight ( all P<0. 05) . Prepregnancy overweight or obesity ( OR=2. 339,95% CI: 1. 674-2. 282,P<0. 001) and excessive GWG ( OR= 1. 398,95% CI: 1. 188-1. 978,P= 0. 048) were shown as risk factors for macrosomia. Insufficient GWG increased LBW risk ( OR = 1. 479, 95% CI: 1. 461-1. 679,P= 0. 035) while excessive GWG declined LBW risk ( OR= 0. 428,95% CI: 0. 225 -0. 817,P= 0. 010) . Under weight-insufficient GWG was risk factor of LBW ( OR= 1. 335,95% CI: 1. 048 -2. 319,P= 0. 048) while normal BMI-excessive GWG ( OR= 1. 088,95% CI: 1. 016-1. 675,P= 0. 038) and overweight /obesity-excessive GWG ( OR= 1. 498,95% CI: 1. 244-2. 017,P= 0. 046) were associated with higher risk of delivering macrosomia. Conclusions Prepregnancy BMI and GWG were associated with infant's birth weight and women were suggested to maintain their weight in recommended range before and during pregnancy.
10.Clinical efficacy of surgical therapy in patients with advanced gastric cancer after pre-operative neoajnvant chemotherapy
Qi-San WANG ; Hai-Jiang WANG ; Jing-Dong WANG ; Xin-Hui YANG ; Dong YIN ;
China Oncology 2000;0(06):-
Background and purpose:It is difficult to diagnose gastric cancer at an early stage,thus the resectable probability of gastric cancer is low.This study was to explore the efficacy of neoajuvant chemotherapy in terms of resectablity for the patients with advanced gastric cancer.Methods:Eighty-six patients with advanced gastric cancer were randomly divided into routine surgical operation group and neoajuvant chemotherapy+surgical operation group.The patients were examined by CT before surgery.The patients in neoajuvant chemotherapy+surgical operation group received two cycles of neoajuvant chemotherapy,and then were evaluated by CT.Results:In routine surgical operation group,the overall resectability rate was 83.7%(36/43),and the curative resection rate was 46.5%(20/43), 16.3%(7/43)was done by exp.lap.In neoajuvant chemotherapy+surgical operation group,the overall resectability rate was 93.0%(40/43),and the curative resection rate was 69.8%(30/43),only 7.0%(3/43)was exp.lap.No mortality was observed.There were no significant difference between both groups in terms of toxicities.Conclusions:The overall resectability rate and the curative resection rate are increased in patients with advanced gastric cancer aider neoajuvant chemotherapy.