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In this article, we explore China’s social security system, which is especially complex because it is organized at the regional level. While the formal social security system only covers urban workers, some rural workers who move to the cities to work (the so-called “floating population”) are also covered. On account of China’s sheer size and legal diversity, the country’s social insurance system is among the most difficult in the world to navigate. The social security system in China consists of five different types of insurance, plus one mandatory housing fund, introduced in the chart below. How companies register and deregister their employees often varies depending upon the city and the employee’s location or residency. In many large cities (with some notable exceptions such as Beijing), the registration and deregistration of most employees can be completed online. Similar to withholding tax, companies can make monthly contributions to the fund via direct debit.
Patient Advisory for Stem Cell Therapy and Medical Tourism As stakeholders in cellular therapy, the undersigned professional organizations believe it is necessary to share the following important message with patients and families contemplating cell therapy or experimental stem cell procedures. In this document, best practices are outlined to assist patients and family members in their healthcare decisions. Controlled innovation in the context of patient safety is paramount as potential therapeutic products or procedures are researched, tested, advanced and proven. Our organizations have received questions and concerns from patients and this document presents an opportunity to address them. Introduction Advancement of clinical therapies is best done in the setting of rigorous and formal clinical trials and in a structured regulatory framework. This helps assure that safety considerations, professional peer review, and the management of patient rights and obligations are considered and addressed. Some procedures would be considered standard of care, because scientific studies have shown that they are safe and effective. Not all procedures offered to patients in all regions of the world are tested in this manner and not all geographical regions have regulations for cellular therapies or patient protection. Additionally, it is possible that some practitioners may offer stem cell procedures without following the existing regulations. Patients may be seeking treatment for incurable, potentially untreatable diseases and may be susceptible to false promises or may not have access to all of the information needed to make this important decision. As patients and families contemplate voluntarily accepting new procedures, some of which may be unproven or...
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Our objective was to demonstrate that, despite recognition by both the gastroenterology and headache communities, abdominal migraine (AM) is an under-diagnosed cause of chronic, recurrent, abdominal pain in childhood in the USA. Background.—Chronic, recurrent abdominal pain occurs in 9-15% of all children and adolescents. After exclusion of anatomic, infectious, inﬂammatory, or other metabolic causes, “functional abdominal pain” is the most common diagnosis of chronic, idiopathic, abdominal pain in childhood. Functional abdominal pain is typically categorized into one, or a combination of, the following 4 groups: functional dyspepsia, irritable bowel syndrome, AM, or functional abdominal pain syndrome. International Classiﬁcation of Headache Disorders—(ICHD-2) deﬁnes AM as an idiopathic disorder characterized by attacks of midline, moderate to severe abdominal pain lasting 1-72 hours with vasomotor symptoms, nausea and vomiting, and included AM among the “periodic syndromes of childhood that are precursors for migraine.” Rome III Gastroenterology criteria (2006) separately established diagnostic criteria and conﬁrmed AM as a well-deﬁned cause of recurrent abdominal pain. Methods.—Following institutional review board approval, a retrospective chart review was conducted on patients referred to an academic pediatric gastroenterology practice with the clinical complaint of recurrent abdominal pain. ICHD-2 criteria were applied to identify the subset of children fulﬁlling criteria for AM. Demographics, diagnostic evaluation, treatment regimen and outcomes were collected. Results.—From an initial cohort of 600 children (ages 1-21 years; 59% females) with recurrent abdominal pain, 142 (24%) were excluded on the basis of their ultimate diagnosis. Of the 458 patients meeting inclusion criteria, 1824 total patient ofﬁce visits were reviewed. Three hundred eighty-eight (84.6%) did not meet criteria for AM, 20 (4.4%) met ICHD-2 formal criteria for AM and another 50 (11%) had documentation lacking at least 1 criterion, but were otherwise consistent with AM (probable AM). During the observation period, no children seen in this gastroenterology practice had received a diagnosis of AM. Conclusion.—Among children with chronic, idiopathic, recurrent abdominal pain, AM represents about 4-15%. Given the spectrum of treatment modalities now available for pediatric migraine, increased awareness of cardinal features of AM by pediatricians and pediatric gastroenterologists may result in improved diagnostic accuracy and early institution of both acute and preventative migraine-speciﬁc treatments. Key words: abdominal migraine, pediatric, children (Headache 2011;51:707-712)
It is important to distinguish between a paralegal certificate and certification. The terms are often confused. The terms are not interchangeable and have separate meaning. A certificate verifies that a student has successfully completed a paralegal educational program. Generally, these programs are offered at universities and colleges. The prerequisites may vary but many require the entering student to have an associate or bachelor’s degree in another area. For example, if a program offers a post‐baccalaureate paralegal certificate, the student will have obtained a bachelor’s degree in an area other than paralegal studies. It is possible that the student will take only legal specialty courses since they have completed their general education requirements during the pursuit of their associate or bachelor’s degree. Upon successful completion of the institution’s educational requirements, the student is issued a certificate of completion. The student is now certificated in paralegal studies. A certified paralegal is one that has successfully completed a certification exam or other requirements of the certifying organization. Certification is the process through which an organization grants formal recognition to an individual that meets certain established requirements. This may include meeting educational requirements, prior work experience as a paralegal and passing an examination. Once the paralegal has met these criteria, they may use a special designation namely, “certified paralegal”. Currently, all certification programs in the United States are voluntary. Therefore, a paralegal may work in the field without obtaining certification. Two of the national paralegal organizations, the National Association of Legal Assistants, or NALA, and the National Federation of Paralegal Associations, or NFPA, offer certification. Some state bar associations, such as The Florida Bar Registered Paralegal Program, The North Carolina State Bar Certified Paralegal Program, and The Ohio State Bar Association Paralegal Certification Program, offer voluntary certification, or registration, for paralegals working in those states. In addition, the Texas Board of Legal Specialization Paralegal Certification Program certifies paralegals in six select areas of law. The scope, duration and requirements for the certification credential vary with each organization. Check with the organization offering the credential to determine the requirements.
The paralegal profession has grown significantly since its humble beginnings in the 1960’s. Overworked and harried lawyers typically handled many of the routine tasks performed by paralegals. Now these tasks can be passed directly to a person who has the skills, training and education in the legal field and who can complete assignments in a quick and efficient manner. Although the paralegal profession has gained recognition in the legal community, there are no formal educational requirements for entering the profession. Anyone can “walk” in the door of your law firm and identify himself/herself as a paralegal, without having to produce a certificate or license showing that he/she is qualified in any sort of legal capacity. Many paralegals in the Greater Cincinnati area have graduated from colleges and universities and others have also obtained a paralegal certificate from an ABA approved program. However, how is the employer able to “ferret out” the “walk-in” paralegals from the “genuine product?” One way might be to have the Ohio State Bar Association or some other regulatory agency institute a certification program for paralegals. Currently there is no regulation for paralegals in Ohio, although other states have adopted voluntary certification. North Carolina’s certification is voluntary and Wisconsin’s Supreme Court is reviewing proposed certification. California and Maine have laws that regulate nonlawyers who perform specific legal tasks. Today there are three nationally recognized paralegal associations that offer voluntary certification programs, namely the American Alliance of Paralegals (“AAPI”), the National Association of Legal Assistants (“NALA”) and the National Federation of Paralegals (“NFPA”). NALA and NFPA offer a testing program, while AAPI’s standards require a college degree and a minimum of five years’ substantive paralegal experience. Once the paralegals attain the certification they must acquire a minimum number of continuing legal education credits each year, including ethics, to maintain the certification. The Paralegal/Legal Assistant Committee of the Ohio State Bar Association has been looking into the benefits to be gained by employers and paralegals, if such a voluntary certification program were put in place in Ohio. The five paralegal associations in Ohio (Cincinnati, Cleveland, Columbus, Dayton and Toledo) have unanimously agreed that guidelines and standards for the education and professional conduct of paralegals are important to the profession. A voluntary program would identify individuals who are qualified by education and training and who have demonstrated knowledge, skills and proficiency to perform substantive legal work, supervised by a lawyer. So, what would be the quid pro quo? What would lawyers gain by employing a ...