Dissecting the illegal pangolin trade in China: An insight from seizures data reports

Wildlife trafficking poses a major threat to global biodiversity. Species such as pangolins are particularly vulnerable and trade continues almost unabated despite numerous interventions aimed at eradicating illegal wildlife trade. Despite restrictions on the pangolin trade, thousands of pangolins continue to be intercepted annually. We focused on China because of the recent delisting of pangolins from the Chinese pharmacopeia, and their removal from healthcare insurance, despite deeply ingrained traditions of having pangolins for ethno-medicinal use. We collated pangolin interception data from public online media seizure reports to characterize the pangolin trade within China, and found that a total of 326 independent seizures equivalent to 143,130 pangolins (31,676 individuals and 222,908 kg of scale) were reported in 26 provinces. Pangolin domestic seizures are greatest in the southern cities of Dehong, Fangchenggang, and Guangzhou. Also, we found 17 countries within the global pangolins range which were the major source of the pangolin shipments to China. The number of arrests and convictions was much lower than the number of pangolin incidents reported. Our results show a significant increase in the volume of scales and number of live pangolin seizures after amended endangered species law came into effect in 2018, and recorded the highest number of individual pangolin interceptions. China has shown increasing wildlife seizures over time, owing partly to emergent trends in the international wildlife trade as well as increasing global demand for ethnomedicine. The future eradication of illegal wildlife trade in China is dependent not only on stringent border control and offender prosecution but also the; removal of other threatened species from the pharmacopeia and healthcare insurance which includes wildlife derivatives. Furthermore, our work highlights importance of current policy intervention to combat the pangolin trade within China, and the need for further interventions both within China and in export countries.

The Private Healthcare Insurance sector: A victim of fraud

Regardless of the jurisdiction research has repeatedly highlighted that the ‘public’ see the insurance sector as an acceptable business to defraud. This article builds on this work but is different in that we draw on primary research, of which there is little, into the private healthcare insurance sector as a victim of fraud. We start by highlighting the types and volumes of fraud that the insurance sector encounters. This is followed with an examination of policing private insurance fraud in a neo-liberal context where individuals and organisations are responsible for risks. Then, we consider if the private healthcare insurance sector is precipitating and participating in its own victimisation. The methods used in this research to secure data are then explained. Finally we analyse how the key elements of the data might point to the private healthcare insurance sector potentially precipitating and participating in its own victimisation.

A Mathematical Approach to Healthcare Insurance Data Analytics

The emergence of big data analytics as a way of deriving insights from data has brought excitement to mathematicians, statisticians, computer scientists and other professionals. However, the near absence of a mathematical foundation for analytics has become a real challenge amidst the flock of big data marketing activities, especially in healthcare insurance. This paper developed a mathematical model for the analytics of healthcare insurance data using set theory. A prototype for the model was implemented using Java Programming Language, MapReduce Framework, Association Rule Mining and MongoDB. Also, it was tested for accuracy using data from the National Health Insurance Scheme in Nigeria with a view to reducing delays in the processes of the Scheme. The result showed that the accuracy level was 97.14% on average, which depicts a higher performance for the model. This result implies that delays affecting the processing of data submitted by the providers and enrollees to the HMOs reduced drastically leading to the improvement in the flow of resources.

EPID-07. EPIDEMIOLOGICAL CHARACTERISTICS AND SURVIVAL OF PATIENTS WITH DIFFUSE GLIOMA IN BRAZIL: PRELIMINARY RESULTS OF A MULTICENTRIC RETROSPECTIVE STUDY - LACOG 0619

INTRODUCTION In Brazil, most of the 9,196 deaths due to brain cancers in 2017 were gliomas. There is a dearth of epidemiological data on diffuse glioma in Brazil. METHODS LACOG 0619 is a multicentric retrospective cohort study, which included patients from nine tertiary oncology centers. Patients aged ≥18 years with histologically proven astrocytoma, oligodendroglioma, oligoastrocytoma or glioblastoma diagnosed from June 2010 to June 2019 were included. The study protocol was approved by each Institutional Review Board. RESULTS 642 patients were included in the analysis. Median age was 51.0 (19-91) years. Most patients were male (n=364, 56.8%), 175 (27.3%) had ECOG 0-1, and 480 (74.8%) had private healthcare insurance. Neurological symptoms were present in 568 (88.5%) patients at diagnosis, and 263 (41.0%) had a history of seizure before surgery. Regarding histology, 361 (56.2%) had glioblastoma, 162 (25.2%) had astrocytoma, 90 (14.0%) had oligodendroglioma, and 23 (3.6%) had glioma NOS. Gross total resection was performed in 168 (26.2%), subtotal resection in 292 (45.5%), biopsy in 108 (16.8%), conventional radiotherapy in 380 (59.2%), and hypofractionation in 44 (6.9%) patients. Concomitant chemoradiotherapy was administered to 370 (57.6%) patients, mostly with temozolamide (n=362, 97.8%). Furthermore, 434 (67.7%) patients received maintenance chemotherapy, 398 with temozolamide (< 6 cycles in 112 [28.4%], 6 cycles in 75 [18.8%], and >6 cycles in 214 [3.8%]). Median follow-up was 29 months (26-33). Median OS according to histology was: 35 months (95%CI 26-46) for glioblastoma, 91 months (95%CI 35-NR) for glioma NOS, and not reached for astrocytoma and oligodendroglioma. Median OS by number of temozolamide maintenance cycles was 18 months (95%CI 15-24) for < 6 cycles and not reached for 6 cycles or more. CONCLUSIONS This is the first multicentric cohort evaluating Brazilian patients with diffuse glioma, providing important data on epidemiology, treatment patterns, and survival in the country.

Social Injustice by Prescription?

Since independence, Tanzania has instituted healthcare reforms in the quest for improving availability, quality, and social equity in access to public medical services. The extent to which the most recent healthcare reforms have impacted the existing patterns of medicinal prescription writing is largely opaque in the literature. This paper relies on data from two hospitals in Dar es Salaam. It emerges that the practice of categorising healthcare seekers into groups depending upon their varied health status and their entitlement to benefits has resulted in differential prescription allocations that might be interpreted as inequitable. The majority of very low income patients finance their healthcare through out-of-pocket payments and support of the Community Health Fund; this group receives a greater ratio of services with zero prescriptions, less poly-pharmacy and fewer prescribed generic medications than the proportion received by well-to-do patients with healthcare insurance. However, the medical and non-medical determinants of this differential in prescription allocation remain unclear, and so too, the ethical implications of such patterns in Tanzania’s out-patient medical service system are inconclusive.