Changes In Life Expectancy Research Articles

Probabilistic population projections for countries with generalized HIV/AIDS epidemics

In 2015, the United Nations (UN) issued probabilistic population projections for all countries up to 2100, by simulating future levels of total fertility and life expectancy and combining the results using a standard cohort component projection method. For the 40 countries with generalized HIV/AIDS epidemics, the mortality projections used the Spectrum/Estimation and Projection Package (EPP) model, a complex, multistate model designed for short-term projections of policy-relevant quantities for the epidemic. We propose a simpler approach that is more compatible with existing UN projection methods for other countries. Changes in life expectancy are projected probabilistically using a simple time series regression and then converted to age- and sex-specific mortality rates using model life tables designed for countries with HIV/AIDS epidemics. These are then input to the cohort component method, as for other countries. The method performed well in an out-of-sample cross-validation experiment. It gives similar short-run projections to Spectrum/EPP, while being simpler and avoiding multistate modelling.

Between \u2018Pioneers\u2019 of the Cardiovascular Revolution and Its \u2018Late Followers\u2019: Mortality Changes in the Czech Republic and Poland Since 1968

After several decades of stagnation, mortality in most Central European countries started to decrease after 1989. The Czech Republic and Poland were the first former Communist countries in this region to experience a rapid and sustained increase in life expectancy. This study focuses on the trends in cause-of-death mortality that have contributed to the recent progress in these two countries. The analysis is based on the cause-of-death time series (1968–2013) reconstructed in accordance with the 10th ICD revision, which makes the data fully comparable over the full period under study. Actual trends in cause-specific mortality are presented, and age, sex and causes of death components of life expectancy changes are disentangled. In both countries, the reduction in cardiovascular mortality at adult and old ages was crucial for the increase in life expectancy after 1991. Results are discussed in the context of institutional changes that occurred after the fall of Communism, such as the reorientation of health policies and the emergence of non-governmental organizations. Changes in health-related attitudes and behaviours as well as structural changes in societies, notably the rising share of persons with tertiary education, are also discussed.

A Century of Demographic Ageing in Arctic Canada (1950–2050)

The aim of this study is to identify the major characteristics of demographic ageing in the Canadian Arctic - Yukon, Nunavut, and Northwest Territories (NWT) - in the period 1950 to 2050. We measure ageing first conventionally, based on "chronological" age, as a point of comparison for results obtained applying new measures of ageing based on "prospective" age. The latter takes into account upward changes in life expectancy and longevity over recent decades. The findings are discussed for the territories with the oldest and youngest average ages, the regions ageing the fastest and slowest, for both sexes and (to some extent) across ethnic differences. The paper considers whether the territories of Arctic Canada are converging or diverging in their ageing pathways and the links between the northern and nationwide patterns were traced. We find that NWT and Nunavut are the youngest and are diverging from nationwide ageing dynamics while Yukon is no longer different from the rest of Canada. The results of this study can help devise policies for coping with the population ageing in the Arctic part of Canada.

Life expectancy and healthy life expectancy changes between 2000 and 2015: an analysis of 183 World Health Organization member states

To analyze the changes and inequalities in life expectancy (LE) and healthy life expectancy (HLE) of 183 World Health Organization (WHO) member states between 2000 and 2015, focusing on gender differences. An exploratory study was carried out. The database containing information about male and female LE and HLE at birth and at the age of 60 years old, for the years 2000 and 2015, was gathered for each country from WHO’s global health observatory. Countries with low LE (respectively HLE) are obtaining greater gains in LE (respectively HLE), overcoming infant mortality, while countries with greater LE (respectively HLE) are improving the elderly’s survivorship. Gains in LE are expected to be followed by gains in HLE, but such gains are getting smaller over time. The female-male LE gap is strongly correlated with the female-male HLE gap. A regression towards the mean is observed regarding the gender gap. Monitoring of LE and HLE indicators is important to assess the health situation in countries across time, detecting both successful and unsuccessful cases. In our analysis, we noticed that African countries are overcoming the bad results of the 1990s and that army conflicts are the main cause of losses in LE in the third millennium.

Progress in Building Integration: Lessons from Great Britain, Northern Ireland and the Basque Country

The integration of health and social care has been a constant policy goal of successive UK governments for over 40 years and is a contemporary priority now supported in Great Britain by legislation. It has been noted that the ‘imperative to integrate and transform has never been greater’ (NHS Confederation/Local Government Association, 2016). The main rationales for the importance of integration have also been largely accepted relating to; a holistic approach; facilitating a more person centred approach; producing a better experience and outcomes for users; reducing the complexity of organisational divisions, responding to more complex conditions and delivering more effective and efficient use of resources. Integration is also accepted as an appropriate response to increasing demands on both health and social care services. The challenges to transforming delivery are a consequence of well-established factors. Demographic change, with larger numbers of older people, changes in life expectancy, the needs of people with multiple health problems and complex conditions and large increases in the numbers of older people without a child to care for them if needed. The importance of integration has also been enhanced by the broader direction of change relating to health provision and the desirability of making a shift from acute hospital provision and institutional care to more community based provision covering community health services and social care. Integration is thus part of the envisaged transformation in care in health related areas. Other challenges have come from the impact of economic recession and austerity policy with reductions in the funding resources and increasing costs of services. The task of producing effective integrated care involves in Great Britain bringing together two separate institutional configurations, the NHS and local authority social services and also developing the delivery of integrated services and integrated practice. Numerous policy and delivery initiatives have been developed but generally progress has been piecemeal and limited. The Commission on the Future of Social Care (2014) noted the compelling case for bringing health and social care together, enabling better alignment of the two systems and leading to transformational change. In 2015 much closer integration of health and social care was identified as one of the three major challenges faced by the NHS (Ham, 2015). The Nuffield Trust (2015) has identified five factors to pursue in improving UK health care, each of which relates to integrated approaches, the NHS and social care reform; the quality of care; the workforce; new models of care delivery and older people and complex care. The existing, research on integrated care concludes that there is no one size fits all for achieving this ambition for integration, although factors such as leadership, financial incentives, clinical pathways and aligned IT systems have emerged as significant factors. This paper draws on the authors’ experiences of health and social care in Northern Ireland and the Basque country to suggest the key factors that drive transformation in healthcare systems and ensure that they achieve their full potential.

The Dominance of Food Supply in Changing Demographic Factors across Africa: A Model Using a Systems Identification Approach

Demographic indicators linked to general health have been strongly linked to economic development. However, change in such indicators is also associated with other factors such as climate, water availability, and diet. Here, we use a systems modelling approach, bringing together a range of environmental, economic, dietary, and health factors, to seek possible dominant causes of demographic change across Africa. A continent-wide, north-south transect of countries allows for the exploration of a range of climates, while a longitudinal transect from the Atlantic to the Red Sea provides a range of socio-economic factors within the similar climatic regime of Sahelian Africa. While change in national life expectancy and death rate since 1960 is modelled to be linked to a varying number and type of factors across the transects, the dominant factor in improving these demographic indicators across the continent is food availability. This has been strongly modulated by HIV infection rates in recent decades in some countries.

The epidemiological transition in Eastern and Western Europe: a historic natural experiment.

The continent of Europe has experienced remarkable changes in the past 25 years, providing scope for natural experiments that offer insight into the complex determinants of health. We analysed trends in life expectancy at birth in three parts of Europe, those countries that were members of the European Union (EU) prior to 2004, countries that joined the European Union since then, and the twelve countries that emerged from the Soviet Union to form the Commonwealth of Independent States (CIS). The contribution of deaths at different ages to these changes was assessed using Arriaga's method of decomposing changes in life expectancy. Europe remains divided geographically, with an East-West gradient. The former Soviet countries experienced a marked initial decline in life expectancy and have only recovered after 2005. However, the situation for those of working ages is little better than in 1990. The pre-2004 EU has seen substantial gains throughout the past 25 years, although there is some evidence that this may be slowing, or even reversing, at older ages. The countries joining the EU in 2004 subsequently began to see some improvements in the early 1990s, but have experienced larger gains since 2000. Europe offers a valuable natural laboratory for understanding the impact of political, economic, and social changes on health. While the historic divisions of Europe are still visible, there is also evidence that individual countries are doing better or worse than their neighbours, providing many lessons that can be learned from.

Automatics adjusment on private pension fund for Asian Mathematics Conferences

This paper discussed about how the automatic adjustment mechanism in the pension fund with defined benefits in case conditions beyond assumptions - assumptions that have been determined. Automatic adjustment referred to in this experiment is intended to anticipate changes in economic and demographic conditions. The method discuss in this paper are indexing life expectancy. In this paper discussed about how the methods on private pension fund and how’s the impact of the change of life expectancy on benefit.

Contribution of Opioid-Involved Poisoning to the Change in Life Expectancy in the United States, 2000-2015

This study uses US National Vital Statistics mortality data to assess change in US life expectancy from 2000 to 2015 attributable to opioid-involved poisonings.

Estimated Changes in Life Expectancy and Adult Mortality Resulting from Declining PM2.5 Exposures in the Contiguous United States: 1980-2010.

Background: precursor emissions have declined over the course of several decades, following the implementation of local, state, and federal air quality policies. Estimating the corresponding change in population exposure and risk of death prior to the year 2000 is made difficult by the lack of monitoring data.Objectives:We used a new technique to estimate historical concentrations, and estimated the effects of changes in population exposures on mortality in adults (age ), and on life expectancy at birth, in the contiguous United States during 1980–2010.Methods:We estimated annual mean county-level concentrations in 1980, 1990, 2000, and 2010 using universal kriging incorporating geographic variables. County-level death rates and national life tables for each year were obtained from the U.S. Census and Centers for Disease Control and Prevention. We used log-linear and nonlinear concentration–response coefficients from previous studies to estimate changes in the numbers of deaths and in life years and life expectancy at birth, attributable to changes in .Results:Between 1980 and 2010, population-weighted exposures fell by about half, and the estimated number of excess deaths declined by about a third. The States of California, Virginia, New Jersey, and Georgia had some of the largest estimated reductions in deaths. Relative to a counterfactual population with exposures held constant at 1980 levels, we estimated that people born in 2050 would experience an increase in life expectancy at birth, and that there would be a cumulative gain of 4.4 million life years among adults of age.Conclusions:Our estimates suggest that declines in exposures between 1980 and 2010 have benefitted public health. https://doi.org/10.1289/EHP507

Diverging Life Expectancies and Voting Patterns in the 2016 US Presidential Election.

To assess whether voting patterns in the 2016 US presidential election were correlated with long-run trends in county life expectancy. I examined county-level voting data from the 2008 and 2016 presidential elections and assessed Donald Trump's share of the 2016 vote, change in the Republican vote share between 2008 and 2016, and changes in absolute numbers of Democratic and Republican votes. County-level estimates of life expectancy at birth were obtained for 1980 and 2014 from the Institute for Health Metrics and Evaluation. Changes in county life expectancy from 1980 to 2014 were strongly negatively associated with Trump's vote share, with less support for Trump in counties experiencing greater survival gains. Counties in which life expectancy stagnated or declined saw a 10-percentage-point increase in the Republican vote share between 2008 and 2016. Residents of counties left out from broader life expectancy gains abandoned the Democratic Party in the 2016 presidential election. Since coming to power, the Trump administration has proposed cuts to health insurance for the poor, social programs, health research, and environmental and worker protections, which are key determinants of population health. Health gaps likely will continue to widen without significant public investment in population health.

Meat consumption reduction in Italian regions: Health co-benefits and decreases in GHG emissions.

IntroductionAnimal agriculture has exponentially grown in recent decades in response to the rise in global demand for meat, even in countries like Italy that traditionally eat a Mediterranean, plant-based diet. Globalization related dietary changes are contributing to the epidemic of non-communicable diseases and to the global climate crisis, and are associated with huge carbon and water footprints.The objective of the study is to assess inequalities in health impacts and in attributable greenhouse gases-GHG emissions in Italy by hypothesizing different scenarios of reduction in red and processed meat consumption towards healthier consumption patterns more compliant with the recommendations of the Mediterranean food pyramid.MethodsWe used demographic and food consumption patterns from national surveys and risk relationships between meat intake and cardiovascular and colorectal cancer mortality from IARC and other meta-analyses.From the baseline data (year 2005–2006, average 406 gr/week beef and 245 gr/week processed meat), we considered hypothetical meat reduction scenarios according to international dietary guidelines such as the Mediterranean pyramid targets. For each geographical area (Northwest, Northeast, Centre, and South) and gender, we calculated the number of avoidable deaths from colorectal cancer, and cardiovascular disease among the adult population. Moreover, years of life gained by the adult population from 2012 to 2030 and changes in life expectancy of the 2012 birth cohort were quantified using gender-specific life tables.GHG emission reductions under Mediterranean scenario were estimated only for beef by applying the Global Warming Potential (GWP) coefficient to total consumption and to a low carbon food substitution in adult diet.ResultsThe deaths avoidable (as percentage change compared to baseline) according to the three reduction scenarios for beef consumption were between 2.3% and 4.5% for colorectal cancer, and between 2.1% and 4.0% for cardiovascular disease; higher benefits would be observed in Northwestern areas and among males. In parallel, 5% and 6.4% of colorectal cancer and CVD deaths would be avoided if the Italian population ate the advised quantity of processed meat. Life table analysis suggests that the scenario that is fully compliant with the Mediterranean diet model would save 5 million years of life lost prematurely among men and women over the next 18 years and would increase average life expectancy of future generations by over 7 months.Considering the environmental impact, emissions associated with the actual total intake of beef range from 12,900 to 21,800 Gg CO2 eq; emissions saved according to the Mediterranean scenario are in the range 8000–14000 Gg CO2 eq per year. The per capita reduction is 263 KgCO2eq/year/person with higher reductions in Northwestern and Central areas.ConclusionsIn Italy, scenarios for reducing beef consumption are consistent with significant health and environmental co-benefits on current and future generations. Results support introducing policies to promote healthier behavior towards red and processed meat in the adult population within an overall balanced and healthy dietary pattern. Interventions should address gender, vulnerable population groups, and geographical differences in order to be more effective.

(Population Aging of Reunified Korea)

Korean Abstract: 본 연구에서는 남북한 통일 이후 북한지역의 출산율과 기대여명 변화에 대한 다양한 시나리오를 설정하고, 코호트 요인법(Cohort Component Method)을 이용하여 남북한 인구를 추계함으로써 시나리오별 인구고령화의 전개양상을 비교하였다. 남북한 통일 이후 북한지역의 출산율과 기대여명 변화에 대한 시나리오는 독일 통일 이후 나타났던 인구변동 사례를 토대로 하였다. 독일의 경우 통일 이후 동독지역의 출산율이 절반수준으로 하락하고 기대여명이 서독수준으로 수렴하였는데, 이를 반영하여 통일 이후 북한지역의 출산율이 하락하고 기대여명이 남한수준으로 수렴하는 경우를 시나리오로 설정하였다. 또한, 남북한 통일의 특수성을 감안하여 통일 이후 북한지역의 보육환경, 보건의료 여건 등이 개선됨에 따라 출산율이 상승하는 경우도 시나리오로 도입하였다. 통일 이후 인구고령화와 관련하여 본 연구의 주요 결론은 다음과 같다. 통일로 인한 남북한 인구통합은 남한의 고령화를 경감시키는 효과가 있으나, 북한지역의 출산율이 급락하고 기대여명이 남한수준으로 상승하는 경우 고령화 경감 효과는 부분적으로 축소되어 장기적으로는 남한의 고령화 수준으로 수렴한다. 다만, 북한의 기대여명이 남한수준으로 상승하더라도 북한지역의 출산율이 상승하는 경우 고령화 경감 효과가 지속되는 것으로 나타났다. English Abstract: This study introduces various scenarios of changes in fertility rates and life expectancy of North Korea after Korean reunification, and compares the development of population aging by scenario based on demographic projections calculated by the cohort component method. These scenarios are set up in consideration of the demographic changes in Germany, observed after its Reunification: the fertility rate of East Germany dropped by half right after unification; and its life expectancy converged to the level of West Germany. Therefore, the fertility shock and the convergence of life expectancy are reflected in the scenarios of North Korean population after unification. Besides, this study assumes a scenario where the fertility rate of the North could increase due to an improvement in child-care environment and public health, considering the distinct features of the inter-Korean unification. The main finding of this study is as follows. The population integration of the two Koreas may alleviate the burden of population aging of South Korea. This positive impact, however, may be gradually reduced if the North’s fertility rate sharply drops and life expectancy converges to the level of the South. Yet, the level of population aging may be continuously reduced in case the fertility rate of the North raises even though its life expectancy converges to the level of the South.

Progress in closing the gap in life expectancy at birth for Aboriginal people in the Northern Territory, 1967-2012.

To compare long term changes in mortality and life expectancy at birth (LE) of Aboriginal people in the Northern Territory and of the overall Australian population; to determine the contributions of changes in mortality in specific age groups to changes in LE for each population. Retrospective trend analysis of death and LE data for the NT Aboriginal and Australian populations, 1967-2012. LE estimates based on abridged life tables; mortality estimates (deaths per 100 000 population); and age decomposition of LE changes by sex and time period. Between 1967 and 2012, LE increased for both NT Aboriginal and all Australians; the difference in LE between the two populations declined by 4.6 years for females, but increased by one year for males. Between 1967-1971 and 1980-1984, LE of NT Aboriginal people increased rapidly, particularly through reduced infant mortality; from 1980-1984 to 1994-1998, there was little change; from 1994-1998 to 2008-2012, there were modest gains in older age groups. Decomposition by age group identified the persistent and substantial contribution of the 35-74-year age groups to the difference in LE between NT Aboriginal people and all Australians. Early gains in LE for NT Aboriginal people are consistent with improvements in nutrition, maternal and infant care, and infectious disease control. A rapid epidemiological transition followed, when LE gains in younger age groups plateaued and non-communicable diseases became more prevalent. Recent LE gains, across all adult age groups, are consistent with improved health service access and chronic disease management. If LE is to continue improving, socio-economic disadvantage and its associated risks must be reduced.

Benchmarking life expectancy and cancer mortality: global comparison with cardiovascular disease 1981-2010

Objective To quantify the impact of cancer (all cancers combined and major sites) compared with cardiovascular disease (CVD) on longevity worldwide during 1981-2010.Design Retrospective demographic analysis using aggregated data.Setting National...

PCSK9 Inhibitors Show Value for Patients and the US Health Care System

BackgroundProprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors were approved by the US Food and Drug Administration (FDA) as cholesterol-lowering therapies for patients with familial hypercholesterolemia or atherosclerotic cardiovascular disease. ObjectivesTo estimate the long-term health and economic value of PCSK9 inhibitors for Americans (51 years and older). MethodsWe conducted simulations using the Future Elderly Model, an established dynamic microsimulation model to project the lifetime outcomes for the US population aged 51 years and older. Health effects estimates and confidence intervals from published meta-analysis studies were used to project changes in life expectancy, quality-adjusted life-years, and lifetime medical spending resulting from the use of PCSK9 inhibitors. We considered two treatment scenarios: 1) current FDA eligibility and 2) an extended eligibility scenario that includes patients with no pre-existing cardiovascular disease but at high risk. We assumed that the price of PCSK9 inhibitors was discounted by 35% in the first 12 years and by 57% thereafter, with gradual uptake of the drug in eligible populations. ResultsUse of PCSK9 inhibitors by individuals covered by current FDA approval would extend life expectancy at the age of 51 years by an estimated 1.1 years and would yield a lifetime net value of $5800 per person. If use was extended to those at high risk for cardiovascular disease, PCSK9 inhibitors would generate a lifetime net benefit of $14,100 per person. ConclusionsExpanded access to PCSK9 inhibitors would offer positive long-term net value for patients and the US health care system at the current discounted prices.

Pension Reforms in the EU since the Early 2000's: Achievements and Challenges Ahead

Most EU Member States have carried out substantial pension reforms over the last decades in order to enhance fiscal sustainability, while maintaining adequate pension income. The intensity of pension reforms has been particularly strong since 2000. These reforms have been implemented through a wide range of measures that have substantially modified the pension system rules and parameters. One of the most important elements of pension reforms, aside of whether countries engaged or not in a systemic change, has been the introduction of mechanisms aimed at automatically adjusting (indexing) the key pension parameters (pension age, benefits, financing resources) to demographic pressure (e.g. changes in life expectancy, increase in the dependency ratio). Indeed, since the mid-1990's, half of the EU Member States have adopted either automatic balancing mechanisms, sustainability factors and / or automatic links between retirement age and life expectancy. All these pension reforms are projected to have a substantial impact on containing future pension expenditure trends. According to the latest long-term projections in the 2015 Ageing Report, public pension expenditure is projected to be close to 11% of GDP over the long run in the EU, almost the same as in 2013. However, the fiscal impact of ageing is still projected to be substantial in many EU countries, becoming apparent already over the course of the next two decades. This is also due to the very gradual phasing in of already legislated reforms, an issue that raises questions about the intergenerational fairness of the reforms and poses some doubt on the time-consistency of their implementation. Indeed, the sustainability-enhancing pension reforms legislated in a majority of EU countries will lead to a reduction of generosity of public pension schemes for future generations of retirees. But to make sure that these reforms will not have to face political and social resistance and risk of reversal in the moment they start to be implemented in full, other flanking policy measures are likely to be necessary: for example, reforms that boost retirement incomes by effectively extending working lives and employability of older workers (also through flexible working arrangements that allow people to keep working beyond current formal retirement age and to step down gradually from full-time to part-time to very part-time work) and provide other means of retirement incomes (e.g. private pensions) and appropriate social-safety nets to avoid that low-wage people follow back in poverty at old age.

Breast Cancer Patient Navigation Program in a Resource-Constrained Health Care Setting in Asia

Abstract 23 Background: Breast cancer incidence is rapidly increasing in Asia as a result of changes in life expectancy and lifestyle factors. In Malaysia, incidence is expected to double in the next decade and survival is poor (50% to 75%) because of late presentation and poor adherence to treatment. This burden is greater for women in underserved communities, but few studies have examined systematic approaches to reduce late presentation and poor treatment adherence. We sought to determine whether a patient navigation program (PNP) could be a community-based solution to improve outcomes of patients with breast cancer, particularly in a resource-constrained setting. Methods: PNP was implemented in a secondary hospital that serves a suburban area near Kuala Lumpur. A decision aid, which incorporated local key messages, was developed. Nurses and community workers in the program received skills training in navigation, communications, patient management, and resource identification and utilization. Data were retrieved from baseline questionnaires and a patient tracking system and was analyzed by using descriptive statistics. Results: In the first year of the program, 225 women were served, of whom 137 were patients with breast cancer. Compared with the prior year, more patients in the PNP received diagnoses within 14 days of their first visit (67.7% v 62.4%; P = .516) and had surgery within 28 days from diagnosis (68.4% v 61.3%; P = .487). There were also fewer reported patients who experienced default in the PNP (4.4% v 6.6%; P = .797). Conclusion: This 1-year evaluation showed that patient navigation is feasible in a resource-constrained setting, but longer follow-up is required to determine the impact on outcomes. Moving forward, we seek to increase the efficiency of patient navigation by increasing access to palliative care and improving interdepartment coordination and patient tracking systems. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST Maheswari Jaganathan No relationship to disclose Dhiauddin Hai No relationship to disclose Nur Hidayati Zainal No relationship to disclose Nadia Rajaram No relationship to disclose Mohamed Yusof No relationship to disclose Soo-Hwang Teo Honoraria: AstraZeneca Consulting or Advisory Role: AstraZeneca Speakers' Bureau: AstraZeneca Research Funding: AstraZeneca Travel, Accommodations, Expenses: AstraZeneca

Phytochemicals for the Prevention of Photocarcinogenesis.

Ultraviolet (UV) exposure has an array of damaging effects and is the main cause of skin cancer in humans. Nonmelanoma skin cancer (NMSC), including basal cell carcinoma and squamous cell carcinoma, is the most common type of cancer. Incidence of NMSC has increased due to greater UV radiation, increased life expectancy and other changes in lifestyle; the annual cost of skin cancer treatment in the United States has increased concurrently to around eight billion dollars. Because of these trends, novel approaches to skin cancer prevention have become an important area of research to decrease skin cancer morbidity and defray the costs associated with treatment. Chemoprevention aims to prevent or delay the development of skin cancer through the use of phytochemicals. Use of phytochemicals as chemopreventive agents has gained attention due to their low toxicity and anticarcinogenic properties. Phytochemicals also exhibit antioxidant, anti-inflammatory and antiproliferative effects which support their use as chemopreventive agents, particularly for skin cancer. Preclinical and human studies have shown that phytochemicals decrease UV-induced skin damage and photocarcinogenesis. In this review article, we discuss the selected phytochemicals that may prevent or delay UV-induced carcinogenesis and highlight their potential use for skin protection.

The Effect of Patient-Physician Relationship on Health Information Seeking Behavior of Diabetic Patients

The Effect of Patient-Physician Relationship on Health Information Seeking Behavior of Diabetic Patients