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National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

Last February little Nikita Moses's play date with friends turned to tragedy when a neighbour's pitbull attacked her. The other children ran to safety up a tree in the yard while a neighbour grabbed Nikita's ankles in an attempt to pry her from the animal's hold. That skin had to be removed in order to place the tissue expanders under the scars that are located above her ears on both sides of her head. \"This is the next step in reconstruction. We first place the balloon under her skin and let it stretch the skin and, once it is taken out, the excess skin will cover the area.\"

\"The real tragedy is that many parents don't know their baby might have a heart defect,\" said Professor Pamela Naidoo, the foundation's chief executive. An anomaly scan is the best way to rule out the big causes of CHD, [Liesl Zuhlke] said. \"CHD will usually present itself in the baby within the first month or six weeks. Babies either have excessive sweating, don't grow well, have short, rapid breaths or turn blue because of poor circulation. \"Low levels of oxygen in the (baby's) blood can be a sign of CHD. Ninety percent of the lesions can be operated on and the survival rate of surgery is 95 to 96 percent,\" she said.

\"This is a really big deal for us,\" said [Jason Zuhlke], who served in the Marine Corps and was stationed in the Middle East. \"We had hoped to get an armed vehicle like this.\" \"This is not an assault vehicle,\" Zuhlke stressed. \"This is a rescue vehicle that will provide protection from small arms fire.\" \"If there is a person down, our officers will be able to attend to them even if there is gunfire,\" Zuhlke explained. \"It's a mobile wall of armor; nothing is going to penetrate it.\"

[Kelly Zuhlke] was charged with assault with a weapon in Gallatin Gatway in 2008 after prosecutors said he slashed another man's throat outside a transmission shop.

\"It's certainly unusual,\" said [Whittier] police spokesman Jason Zuhlke. \"It's definitely out of the ordinary.\" \"It's always a possibility,\" Zuhlke said, adding that the circumstances surrounding the crime were still being investigated. \"Being that it was Sunday morning, there was not a whole lot going on (in that area),\" Zuhlke said. \"It's an industrial area. It is pretty remote ... most likely not a whole lot of people were around.\"

He locked the door and pulled the security gate shut. [Jason Zuhlke] said the robber took $200 from one register and demanded the keys to another cash register. Zuhlke said the suspects might have driven away in a white Chevrolet Astro van that a witness saw nearby.

\"Apparently the back door was left ajar to let the air in,\" said police spokesman Officer Jason Zuhlke. \"The victim was at the apartment by himself at the time. His uncle was not there.\" \"They tied him up and beat him up,\" Zuhlke said. \"They ransacked the apartment and found some cash,\" Zuhlke said. He estimated the amount taken to be less than $1,000.

\"Apparently the back door was left ajar to let the air in,\" said police spokesman Officer Jason Zuhlke. \"The victim was at the apartment by himself at the time. His uncle was not there.\" \"They tied him up and beat him,\" Zuhlke said. \"They ransacked the apartment and found some cash,\" Zuhlke said. He estimated the amount taken to be less than $1,000.

\"He was bleeding profusely and was in and out of consciousness,\" [Jason Zuhlke] said. Janet Ortiz, spokeswoman for the Santa Fe Springs Department of Fire-Rescue, said firefighters found the man lying on the ground with \"neck trauma\". She said the man was treated and taken by ambulance to the hospital. \"He claims he was assaulted by numerous people for unknown reasons,\" Zuhlke said.