(C) 2012 Elsevier Ireland Ltd. All rights reserved.”
“Chronic stress can result in frequent or persistent challenges of the hypothalamic-pituitary-adrenal (HPA) axis resulting in abnormal cortisol patterns and increased risk for cardiovascular disease (CVD). Police work is an environment replete with stress.

The present article describes associations between cortisol, a biomarker of stress, and brachial artery flow mediated dilation (FMD) in police officers. A random sample stratified on gender (n = 100, 33% women) was generated from officers in a mid-sized urban department. Four salivary cortisol parameters were derived: after awakening, following a standardized Torin 2 datasheet high protein meal challenge, during the Silmitasertib ic50 entire day, and after a

dexamethasone suppression test. Continuous scan B-Mode ultrasound was used to measure percent change in brachial artery FMD following occlusion and release. Elevated cortisol secretion after awakening was significantly associated with impaired FMD in women, reflected by an inverse trend. Adjustment for age, smoking, and alcohol consumption did not appreciably alter this trend. A similar result was not evident among male officers. Responses of other cortisol challenges to the HPA axis were not associated with FMD. In conclusion, increased cortisol secretion after awakening was independently associated with impaired FMD in female police officers only, indicating a possible link between HPA axis stress response and subclinical CVD. However, because associations were not found with other cortisol parameters and were not evident in male officers, replication of these findings with a prospective study design may be warranted. (C) 2008 Elsevier Ireland Ltd. All rights reserved.”
“China’s 3 year, CN(sic)850 Necrostatin-1 billion (US$125 billion) reform plan, launched in 2009, marked the first phase towards achieving comprehensive universal health coverage by 2020. The government’s undertaking of systemic reform and its affirmation of its role in financing health care together with priorities for prevention, primary care, and redistribution

of finance and human resources to poor regions are positive developments. Accomplishing nearly universal insurance coverage in such a short time is commendable. However, transformation of money and insurance coverage into cost-effective services is difficult when delivery of health care is hindered by waste, inefficiencies, poor quality of services, and scarcity and maldistribution of the qualified workforce. China must reform its incentive structures for providers, improve governance of public hospitals, and institute a stronger regulatory system, but these changes have been slowed by opposition from stakeholders and lack of implementation capacity. The pace of reform should be moderated to allow service providers to develop absorptive capacity.