Universal health coverage in the context of population ageing: What determines health insurance enrolment in rural Ghana?

PubMed

Van der Wielen, Nele; Channon, Andrew Amos; Falkingham, Jane

2018-05-24

Population ageing presents considerable challenges for the attainment of universal health coverage (UHC), especially in countries where such coverage is still in its infancy. Ghana presents an important case study on the effectiveness of policies aimed at achieving UHC in the context of population ageing in low and middle-income countries. It has witnessed a profound recent demographic transition, including a large increase in the number of older adults, which coincided with the development and implementation of a National Health Insurance Scheme (NHIS), designed to help achieve UHC. The objective of this paper is to examine the community, household and individual level determinants of NHIS enrolment among older adults aged 50-69 and 70 plus. The latter are exempt from NHIS premium payments. Using the Ghanaian Living Standards Survey from 2012 to 2013, determinants of NHIS enrolment for individuals aged 50-69 and 70 plus living in rural Ghana are examined through the application of multilevel regression analysis. Previous studies have mainly focused on the enrolment of young and middle aged adults and considered mainly demographic and socio-economic factors. The novel inclusion of spatial barriers within this analysis demonstrates that levels of NHIS enrolment are determined in part by the community provision of healthcare facilities. In addition, the findings imply that insurance enrolment increases with household expenditure even for those aged 70 plus who are exempt from the NHIS premium payment. Adequate and appropriate infrastructure as well as health insurance is vital to ensure movement to UHC in low and middle income countries. Overall, the results confirm that there remain significant inequalities in enrolment by expenditure quintile that future policy reform will need to address.

Assessing nutrient flows in septic tanks by eliciting expert judgement: a promising method in the context of developing countries.

PubMed

Montangero, Agnes; Belevi, Hasan

2007-03-01

Simple models based on the physical and biochemical processes occurring in septic tanks, pit and urine diversion latrines were developed to determine the nutrient flows in these systems. Nitrogen and phosphorus separation in different output materials from these on-site sanitation installations were thus determined. Moreover, nutrient separation in septic tanks was also assessed through literature values and by eliciting expert judgement. Use of formal expert elicitation technique proved to be effective, particularly in the context of developing countries where data is often scarce but expert judgement readily available. In Vietnam, only 5-14% and 11-27% of the nitrogen and phosphorus input, respectively, are removed from septic tanks with the faecal sludge. The remaining fraction leaves the tank via the liquid effluent. Unlike septic tanks, urine diversion latrines allow to immobilize most of the nutrients either in form of stored urine or dehydrated faecal matter. These latrines thus contribute to reducing the nutrient load in the environment and lowering consumption of energy and non-renewable resources for fertiliser production.

Physical inactivity, gender and culture in Arab countries: a systematic assessment of the literature.

PubMed

Sharara, Eman; Akik, Chaza; Ghattas, Hala; Makhlouf Obermeyer, Carla

2018-05-18

Physical inactivity is associated with excess weight and adverse health outcomes. We synthesize the evidence on physical inactivity and its social determinants in Arab countries, with special attention to gender and cultural context. We searched MEDLINE, Popline, and SSCI for articles published between 2000 and 2016, assessing the prevalence of physical inactivity and its social determinants. We also included national survey reports on physical activity, and searched for analyses of the social context of physical activity. We found 172 articles meeting inclusion criteria. Standardized data are available from surveys by the World Health Organization for almost all countries, but journal articles show great variability in definitions, measurements and methodology. Prevalence of inactivity among adults and children/adolescents is high across countries, and is higher among women. Some determinants of physical inactivity in the region (age, gender, low education) are shared with other regions, but specific aspects of the cultural context of the region seem particularly discouraging of physical activity. We draw on social science studies to gain insights into why this is so. Physical inactivity among Arab adults and children/adolescents is high. Studies using harmonized approaches, rigorous analytic techniques and a deeper examination of context are needed to design appropriate interventions.

Comparative Comparison of Implementing School-Based Management in Developed Countries in the Historical Context: From Theory to Practice

ERIC Educational Resources Information Center

Moradi, Saeid; Beidokhti, Aliakbar Amin; Fathi, Kourosh

2016-01-01

This paper aims to study the comparative comparison of implementing school-based management in developed countries in the historical context: from theory to practice. School-based management is not by itself and objective but a valuable tool in order to reach sagacity, capabilities and the enthusiasm from most people having shares in school.…

Country-level predictors of vaccination coverage and inequalities in Gavi-supported countries.

PubMed

Arsenault, Catherine; Johri, Mira; Nandi, Arijit; Mendoza Rodríguez, José M; Hansen, Peter M; Harper, Sam

2017-04-25

Important inequalities in childhood vaccination coverage persist between countries and population groups. Understanding why some countries achieve higher and more equitable levels of coverage is crucial to redress these inequalities. In this study, we explored the country-level determinants of (1) coverage of the third dose of diphtheria-tetanus-pertussis- (DTP3) containing vaccine and (2) within-country inequalities in DTP3 coverage in 45 countries supported by Gavi, the Vaccine Alliance. We used data from the most recent Demographic and Health Surveys (DHS) conducted between 2005 and 2014. We measured national DTP3 coverage and the slope index of inequality in DTP3 coverage with respect to household wealth, maternal education, and multidimensional poverty. We collated data on country health systems, health financing, governance and geographic and sociocultural contexts from published sources. We used meta-regressions to assess the relationship between these country-level factors and variations in DTP3 coverage and inequalities. To validate our findings, we repeated these analyses for coverage with measles-containing vaccine (MCV). We found considerable heterogeneity in DTP3 coverage and in the magnitude of inequalities across countries. Results for MCV were consistent with those from DTP3. Political stability, gender equality and smaller land surface were important predictors of higher and more equitable levels of DTP3 coverage. Inequalities in DTP3 coverage were also lower in countries receiving more external resources for health, with lower rates of out-of-pocket spending and with higher national coverage. Greater government spending on heath and lower linguistic fractionalization were also consistent with better vaccination outcomes. Improving vaccination coverage and reducing inequalities requires that policies and programs address critical social determinants of health including geographic and social exclusion, gender inequality and the availability of

Teachers' Conceptions About the Genetic Determinism of Human Behaviour: A Survey in 23 Countries

NASA Astrophysics Data System (ADS)

Castéra, Jérémy; Clément, Pierre

2014-02-01

This work analyses the answers to a questionnaire from 8,285 in-service and pre-service teachers from 23 countries, elaborated by the Biohead-Citizen research project, to investigate teachers' conceptions related to the genetic determinism of human behaviour. A principal components analysis is used to assess the main trends in all the interviewed teachers' conceptions. This illustrates that innatism is present in two distinct ways: in relation to individuals (e.g. genetic determinism to justify intellectual likeness between individuals such as twins) or in relation to groups of humans (e.g. genetic determinism to justify gender differences or the superiority of some human ethnic groups). A between-factor analysis discriminates between countries, showing very significant differences. There is more innatism among teachers' conceptions in African countries and Lebanon than in European countries, Brazil and Australia. Among the other controlled parameters, only two are significantly independent of the country: the level of training and the level of knowledge of biology. A co-inertia analysis shows a strong correlation between non-citizen attitudes towards and innatist conceptions of genetic determinism regarding human groups. We discuss these findings and their implications for education.

15 CFR 806.10 - Determining place of residence and country of jurisdiction of individuals.

Code of Federal Regulations, 2010 CFR

2010-01-01

... DIRECT INVESTMENT SURVEYS § 806.10 Determining place of residence and country of jurisdiction of... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Determining place of residence and country of jurisdiction of individuals. 806.10 Section 806.10 Commerce and Foreign Trade Regulations...

Educating for Location? The Policy Context of "Becoming Asia-Literate" in Five Western Countries/Regions in the 1990s

ERIC Educational Resources Information Center

Pang, David

2005-01-01

This article examines the educational policy responses by five western countries/regions to the "Asian economic miracle" in the 1990s. It begins by stating that the idea of the global economic context has assumed considerable importance in the current educational thinking and debates. It then shows that Asia has been thematized in the…

Sexual behaviour in context: a global perspective.

PubMed

Wellings, Kaye; Collumbien, Martine; Slaymaker, Emma; Singh, Susheela; Hodges, Zoé; Patel, Dhaval; Bajos, Nathalie

2006-11-11

Research aimed at investigating sexual behaviour and assessing interventions to improve sexual health has increased in recent decades. The resulting data, despite regional differences in quantity and quality, provide a historically unique opportunity to describe patterns of sexual behaviour and their implications for attempts to protect sexual health at the beginning of the 21st century. In this paper we present original analyses of sexual behaviour data from 59 countries for which they were available. The data show substantial diversity in sexual behaviour by region and sex. No universal trend towards earlier sexual intercourse has occurred, but the shift towards later marriage in most countries has led to an increase in premarital sex, the prevalence of which is generally higher in developed countries than in developing countries, and is higher in men than in women. Monogamy is the dominant pattern everywhere, but having had two or more sexual partners in the past year is more common in men than in women, and reported rates are higher in industrialised than in non-industrialised countries. Condom use has increased in prevalence almost everywhere, but rates remain low in many developing countries. The huge regional variation indicates mainly social and economic determinants of sexual behaviour, which have implications for intervention. Although individual behaviour change is central to improving sexual health, efforts are also needed to address the broader determinants of sexual behaviour, particularly those that relate to the social context. The evidence from behavioural interventions is that no general approach to sexual-health promotion will work everywhere and no single-component intervention will work anywhere. Comprehensive behavioural interventions are needed that take account of the social context in mounting individual-level programmes, attempt to modify social norms to support uptake and maintenance of behaviour change, and tackle the structural factors

Assessment of goals and priorities in patients with a chronic condition: a secondary quantitative analysis of determinants across 11 countries.

PubMed

Vermunt, Neeltje P C A; Westert, Gert P; Olde Rikkert, Marcel G M; Faber, Marjan J

2018-03-01

To assess the impact of patient characteristics, patient-professional engagement, communication and context on the probability that healthcare professionals will discuss goals or priorities with older patients. Secondary analysis of cross-sectional data from the 2014 Commonwealth Fund International Health Policy Survey of Older Adults. 11 western countries. Community-dwelling adults, aged 55 or older. Assessment of goals and priorities. The final sample size consisted of 17,222 respondents, 54% of whom reported an assessment of their goals and priorities (AGP) by healthcare professionals. In logistic regression model 1, which was used to analyse the entire population, the determinants found to have moderate to large effects on the likelihood of AGP were information exchange on stress, diet or exercise, or both. Country (living in Sweden) and continuity of care (no regular professional or organisation) had moderate to large negative effects on the likelihood of AGP. In model 2, which focussed on respondents who experienced continuity of care, country and information exchange on stress and lifestyle were the main determinants of AGP, with comparable odds ratios to model 1. Furthermore, a professional asking questions also increased the likelihood of AGP. Continuity of care and information exchange is associated with a higher probability of AGP, while people living in Sweden are less likely to experience these assessments. Further study is required to determine whether increasing information exchange and professionals asking more questions may improve goal setting with older patients. Key points   A patient goal-oriented approach can be beneficial for older patients with chronic conditions or multimorbidity; however, discussing goals with these patients is not a common practice. The likelihood of discussing goals varies by country, occurring most commonly in the USA, and least often in Sweden. Country-level differences in continuity of care and questions asked by a

HIV risk behaviors among female IDUs in developing and transitional countries

PubMed Central

Cleland, Charles M; Des Jarlais, Don C; Perlis, Theresa E; Stimson, Gerry; Poznyak, Vladimir

2007-01-01

Background A number of studies suggest females may be more likely to engage in injection and sex risk behavior than males. Most data on gender differences come from industrialized countries, so data are needed in developing countries to determine how well gender differences generalize to these understudied regions. Methods Between 1999 and 2003, 2512 male and 672 female current injection drug users (IDUs) were surveyed in ten sites in developing countries around the world (Nairobi, Beijing, Hanoi, Kharkiv, Minsk, St. Petersburg, Bogotá, Gran Rosario, Rio, and Santos). The survey included a variety of questions about demographics, injecting practices and sexual behavior. Results Females were more likely to engage in risk behaviors in the context of a sexual relationship with a primary partner while males were more likely to engage in risk behaviors in the context of close friendships and casual sexual relationships. After controlling for injection frequency, and years injecting, these gender differences were fairly consistent across sites. Conclusion Gender differences in risk depend on the relational contexts in which risk behaviors occur. The fact that female and male risk behavior often occurs in different relational contexts suggests that different kinds of prevention interventions which are sensitive to these contexts may be necessary. PMID:17908299

Parents Helping Their Children Learn to Read: The Effectiveness of Paired Reading and Hearing Reading in a Developing Country Context

ERIC Educational Resources Information Center

Shah-Wundenberg, Mihika; Wyse, Dominic; Chaplain, Roland

2013-01-01

This paper reports research that investigated parental support for children's reading of English in an inner-city school in the developing country context of an Indian city, Ahmedabad. Children had oral proficiency in the regional language but were beginning to acquire conventional forms of literacy in English. Sociocultural mediation theory…

Trends and determinants of weight gains among OECD countries: an ecological study.

PubMed

Nghiem, S; Vu, X-B; Barnett, A

2018-06-01

Obesity has become a global issue with abundant evidence to indicate that the prevalence of obesity in many nations has increased over time. The literature also reports a strong association between obesity and economic development, but the trend that obesity growth rates may converge over time has not been examined. We propose a conceptual framework and conduct an ecological analysis on the relationship between economic development and weight gain. We also test the hypothesis that weight gain converges among countries over time and examine determinants of weight gains. This is a longitudinal study of 34 Organisation for Economic Cooperation and Development (OECD) countries in the years 1980-2008 using publicly available data. We apply a dynamic economic growth model to test the hypothesis that the rate of weight gains across countries may converge over time. We also investigate the determinants of weight gains using a longitudinal regression tree analysis. We do not find evidence that the growth rates of body weight across countries converged for all countries. However, there were groups of countries in which the growth rates of body weight converge, with five groups for males and seven groups for females. The predicted growth rates of body weight peak when gross domestic product (GDP) per capita reaches US$47,000 for males and US$37,000 for females in OECD countries. National levels of consumption of sugar, fat and alcohol were the most important contributors to national weight gains. National weight gains follow an inverse U-shape curve with economic development. Excessive calorie intake is the main contributor to weight gains. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

19 CFR 356.6 - Receipt of notice of a scope determination by the Government of a FTA country.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Government of a FTA country. 356.6 Section 356.6 Customs Duties INTERNATIONAL TRADE ADMINISTRATION... determination by the Government of a FTA country. (a) Where the Department has made a scope determination, notice of such determination shall be deemed received by the Government of a FTA country when a certified...

19 CFR 356.6 - Receipt of notice of a scope determination by the Government of a FTA country.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Government of a FTA country. 356.6 Section 356.6 Customs Duties INTERNATIONAL TRADE ADMINISTRATION... determination by the Government of a FTA country. (a) Where the Department has made a scope determination, notice of such determination shall be deemed received by the Government of a FTA country when a certified...

19 CFR 356.6 - Receipt of notice of a scope determination by the Government of a FTA country.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Government of a FTA country. 356.6 Section 356.6 Customs Duties INTERNATIONAL TRADE ADMINISTRATION... determination by the Government of a FTA country. (a) Where the Department has made a scope determination, notice of such determination shall be deemed received by the Government of a FTA country when a certified...

19 CFR 356.6 - Receipt of notice of a scope determination by the Government of a FTA country.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Government of a FTA country. 356.6 Section 356.6 Customs Duties INTERNATIONAL TRADE ADMINISTRATION... determination by the Government of a FTA country. (a) Where the Department has made a scope determination, notice of such determination shall be deemed received by the Government of a FTA country when a certified...

19 CFR 356.6 - Receipt of notice of a scope determination by the Government of a FTA country.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Government of a FTA country. 356.6 Section 356.6 Customs Duties INTERNATIONAL TRADE ADMINISTRATION... determination by the Government of a FTA country. (a) Where the Department has made a scope determination, notice of such determination shall be deemed received by the Government of a FTA country when a certified...

Determinants of Prosocial Behavior in Included Versus Excluded Contexts.

PubMed

Cuadrado, Esther; Tabernero, Carmen; Steinel, Wolfgang

2015-01-01

Prosocial behavior (PSB) is increasingly becoming necessary as more and more individuals experience exclusion. In this context it is important to understand the motivational determinants of PSB. Here we report two experiments which analyzed the influence of dispositional (prosocialness; rejection sensitivity) and motivational variables (prosocial self-efficacy; prosocial collective efficacy; trust; anger; social affiliation motivation) on PSB under neutral contexts (Study 1), and once under inclusion or exclusion conditions (Study 2). Both studies provided evidence for the predicted mediation of PSB. Results in both neutral and inclusion and exclusion conditions supported our predictive model of PSB. In the model dispositional variables predicted motivational variables, which in turn predicted PSB. We showed that the investigated variables predicted PSB; this suggests that to promote PSB one could (1) foster prosocialness, prosocial self and collective efficacy, trust in others and affiliation motivation and (2) try to reduce negative feelings and the tendency to dread rejection in an attempt to reduce the negative impact that these variables have on PSB. Moreover, the few differences that emerged in the model between the inclusion and exclusion contexts suggested that in interventions with excluded individuals special care emphasis should be placed on addressing rejection sensitivity and lack of trust.

Determinants of Prosocial Behavior in Included Versus Excluded Contexts

PubMed Central

Cuadrado, Esther; Tabernero, Carmen; Steinel, Wolfgang

2016-01-01

Prosocial behavior (PSB) is increasingly becoming necessary as more and more individuals experience exclusion. In this context it is important to understand the motivational determinants of PSB. Here we report two experiments which analyzed the influence of dispositional (prosocialness; rejection sensitivity) and motivational variables (prosocial self-efficacy; prosocial collective efficacy; trust; anger; social affiliation motivation) on PSB under neutral contexts (Study 1), and once under inclusion or exclusion conditions (Study 2). Both studies provided evidence for the predicted mediation of PSB. Results in both neutral and inclusion and exclusion conditions supported our predictive model of PSB. In the model dispositional variables predicted motivational variables, which in turn predicted PSB. We showed that the investigated variables predicted PSB; this suggests that to promote PSB one could (1) foster prosocialness, prosocial self and collective efficacy, trust in others and affiliation motivation and (2) try to reduce negative feelings and the tendency to dread rejection in an attempt to reduce the negative impact that these variables have on PSB. Moreover, the few differences that emerged in the model between the inclusion and exclusion contexts suggested that in interventions with excluded individuals special care emphasis should be placed on addressing rejection sensitivity and lack of trust. PMID:26779103

Socioeconomic determinants of infant mortality: a worldwide study of 152 low-, middle-, and high-income countries.

PubMed

Schell, Carl Otto; Reilly, Marie; Rosling, Hans; Peterson, Stefan; Ekström, Anna Mia

2007-01-01

To reach the Millennium Development Goals for health, influential international bodies advocate for more resources to be directed to the health sector, in particular medical treatment. Yet, health has many determinants beyond the health sector that are less evident than proximate predictors. To assess the relative importance of major socioeconomic determinants of population health, measured as infant mortality rate (IMR), at country level. National-level data from 152 countries based on World Development Indicators 2003 were used for multivariate linear regression analyses of five socioeconomic predictors of IMR: public spending on health, GNI/capita, poverty rate, income equality (Gini index), and young female illiteracy rate. Analyses were performed on a global level and stratified for low-, middle-, and high-income countries. In order of importance, GNI/capita, young female illiteracy, and income equality predicted 92% of the variation in national IMR whereas public spending on health and poverty rate were non-significant determinants when adjusted for confounding. In low-income countries, female illiteracy was more important than GNI/capita. Income equality (Gini index) was an independent predictor of IMR in middle-income countries only. In high-income countries none of these predictors was significant. The relative importance of major health determinants varies between income levels, thus extrapolating health policies from high- to low-income countries is problematic. Since the size, per se, of public health spending does not independently predict health outcomes, functioning health systems are necessary to make health investments efficient. Potential health gains from improved female education and economic growth should be considered in low- and middle-income countries.

Country- and individual-level socioeconomic determinants of depression: multilevel cross-national comparison.

PubMed

Rai, Dheeraj; Zitko, Pedro; Jones, Kelvyn; Lynch, John; Araya, Ricardo

2013-03-01

The prevalence and correlates of depression vary across countries. Contextual factors such as country-level income or income inequalities have been hypothesised to contribute to these differences. To investigate associations of depression with socioeconomic factors at the country level (income inequality, gross national income) and individual (education, employment, assets and spending) level, and to investigate their relative contribution in explaining the cross-national variation in the prevalence of depression. Multilevel study using interview data of 187 496 individuals from 53 countries participating in the World Health Organization World Health Surveys. Depression prevalence varied between 0.4 and 15.7% across countries. Individual-level factors were responsible for 86.5% of this variance but there was also reasonable variation at the country level (13.5%), which appeared to increase with decreasing economic development of countries. Gross national income or country-level income inequality had no association with depression. At the individual level, fewer material assets, lower education, female gender, economic inactivity and being divorced or widowed were associated with increased odds of depression. Greater household spending, unlike material assets, was associated with increasing odds of depression (adjusted analysis). The variance of depression prevalence attributable to country-level factors seemed to increase with decreasing economic development of countries. However, country-level income inequality or gross national income explained little of this variation, and individual-level factors appeared more important than contextual factors as determinants of depression. The divergent relationship of assets and spending with depression emphasise that different socioeconomic measures are not interchangeable in their associations with depression.

Evidence-based policy-making: the implications of globally-applicable research for context-specific problem-solving in developing countries.

PubMed

Behague, Dominique; Tawiah, Charlotte; Rosato, Mikey; Some, Télésphore; Morrison, Joanna

2009-11-01

In the past 15 or so years, the "evidence-based medicine" (EBM) framework has become increasingly institutionalized, facilitating its transfer across the globe. In the late 1990s, the basic principles of EBM began to have a marked influence in a number of non-clinical public policy arenas. Policy-makers working in these areas are now being urged to move away from developing policies according to political ideologies to a more legitimate approach based on "scientific fact," a process termed "evidence-based policy-making" (EBPM). The conceptual diffusion of EBM to non-clinical arenas has exposed epistemologically destabilizing views regarding the definition of "science," particularly as it relates to the demands of global versus national/sub-national policy-making. Using the maternal and neonatal subfield as an ethnographic case-study, this paper explores the effects of these divergences on EBPM in 5 developing countries (Bangladesh, Burkina Faso, Ghana, Malawi and Nepal). In doing so, our analysis aims to explain why EBPM has thus far had a limited impact in the area of context-specific programmatic policy-development and implementation at the national and sub-national levels. Results highlight that the political contexts in which EBPM is played out promote uniformity of methodological and policy approaches, despite the fact that disciplinary diversity is being called for repeatedly in the public health literature. Even in situations where national EBPM diverges from international priorities, national evidence-based policies are found to hold little weight in countering global policy interests, which some informants claim are themselves legitimated, rather than informed, by evidence. Informants also highlight the way interpretations of research findings are shaped by the broader political context within which donors set priorities and distribute limited resources - contexts that are driven by the need to provide generalisable research recommendations based on

Gender and Autonomy-Supportive Contexts: Theoretical Perspectives of Self-Determination and Goal Setting

ERIC Educational Resources Information Center

Lin, Shinyi; Chen, Yu-Chuan

2013-01-01

In integrating theoretical perspectives of self-determination and goal-setting, this study proposes a conceptual model with moderating and mediating effects exploring gender issue in autonomy-supportive learning in higher education as research context. In the proposed model, goal-setting attributes, i.e., individual determinants, social…

49 CFR 583.8 - Procedure for determining country of origin for engines and transmissions (for purposes of...

Code of Federal Regulations, 2011 CFR

2011-10-01

...) AUTOMOBILE PARTS CONTENT LABELING § 583.8 Procedure for determining country of origin for engines and... engines and transmissions (for purposes of determining the information specified by §§ 583.5(a)(4) and...) Each supplier of an engine or transmission shall determine the country of origin once a year for each...

49 CFR 583.8 - Procedure for determining country of origin for engines and transmissions (for purposes of...

Code of Federal Regulations, 2012 CFR

2012-10-01

...) AUTOMOBILE PARTS CONTENT LABELING § 583.8 Procedure for determining country of origin for engines and... engines and transmissions (for purposes of determining the information specified by §§ 583.5(a)(4) and...) Each supplier of an engine or transmission shall determine the country of origin once a year for each...

49 CFR 583.8 - Procedure for determining country of origin for engines and transmissions (for purposes of...

Code of Federal Regulations, 2013 CFR

2013-10-01

...) AUTOMOBILE PARTS CONTENT LABELING § 583.8 Procedure for determining country of origin for engines and... engines and transmissions (for purposes of determining the information specified by §§ 583.5(a)(4) and...) Each supplier of an engine or transmission shall determine the country of origin once a year for each...

49 CFR 583.8 - Procedure for determining country of origin for engines and transmissions (for purposes of...

Code of Federal Regulations, 2014 CFR

2014-10-01

...) AUTOMOBILE PARTS CONTENT LABELING § 583.8 Procedure for determining country of origin for engines and... engines and transmissions (for purposes of determining the information specified by §§ 583.5(a)(4) and...) Each supplier of an engine or transmission shall determine the country of origin once a year for each...

The Effect of Context-Based Chemical Equilibrium on Grade 11 Students' Learning, Motivation and Constructivist Learning Environment

ERIC Educational Resources Information Center

ilhan, Nail; Yildirim, Ali; Yilmaz, Sibel Sadi

2016-01-01

In recent years, many countries have adopted a context-based approach for designing science curricula for education at all levels. The aim of this study was to determine the effectiveness of a Context-Based Chemistry Course (CBCC) as compared with traditional/existing instruction, on 11th grade students' learning about chemical equilibrium,…

International application of sugar-sweetened beverage (SSB) taxation in obesity reduction: factors that may influence policy effectiveness in country-specific contexts.

PubMed

Jou, Judy; Techakehakij, Win

2012-09-01

Sugar-sweetened beverage (SSB) taxation is becoming of increasing interest as a policy aimed at addressing the rising prevalence of obesity in many countries. Preliminary evidence indicates its potential to not only reduce obesity prevalence, but also generate public revenue. However, differences in country-specific contexts create uncertainties in its possible outcomes. This paper urges careful consideration of country-specific characteristics by suggesting three points in particular that may influence the effectiveness of a volume-based soft drink excise tax: population obesity prevalence, soft drink consumption levels, and existing baseline tax rates. Data from 19 countries are compared with regard to each point. The authors suggest that SSB or soft drink taxation policy may be more effective in reducing obesity prevalence where existing obesity prevalence and soft drink consumption levels are high. Conversely, in countries where the baseline tax rate is already considered high, SSB taxation may not have a noticeable impact on consumption patterns or obesity prevalence, and may incur negative feedback from the beverage industry or the general public. Thorough evaluation of these points is recommended prior to adopting SSB or soft drink taxation as an obesity reduction measure in any given country. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

One Mathematics for All: Can It Be Realized in a Multicultural, Multilingual Country?

ERIC Educational Resources Information Center

Subramanian, Jayasree

2015-01-01

In this paper, situated in the context of elementary and secondary school mathematics curriculum in India, I argue that centrally determined uniform curriculum would have very little to offer a large majority of students in a country that is diverse in many ways.

Social determinants for infant mortality in the Nordic countries, 1980-2001.

PubMed

Arntzen, Annett; Nybo Andersen, Anne Marie

2004-01-01

Social equity in health is an important goal of public health policies in the Nordic countries. Infant mortality is often used as an indicator of the health of societies, and has decreased substantially in the Nordic welfare states over the past 20 years. To identify social patterns in infant mortality in this context the authors set out to review the existing epidemiological literature on associations between social indicators and infant mortality in Denmark, Finland, Norway, and Sweden during the period 1980-2000. Nordic epidemiological studies in the databases ISI Web of Science, PubMed, and OVID, published between 1980 and 2000 focusing on social indicators of infant, neonatal, and postneonatal mortality, were identified. The selected keywords on social indicators were: education, income, occupation, social factors, socioeconomic status, social position, and social class. Social inequality in infant mortality was reported from Denmark, Finland, Norway, and Sweden, and it was found that these increased during the study period. Post-neonatal mortality showed a stronger association with social indicators than neonatal mortality. Some studies showed that neonatal mortality was associated with social indicators in a non-linear fashion, with high rates of mortality in both the lowest and highest social strata. The pattern differed, however, between countries with Finland and Sweden showing consistently less social inequalities than Denmark and Norway. While the increased inequality shown in most studies was an increase in relative risk, a single study from Denmark demonstrated an absolute increase in infant mortality among children born to less educated women. Social inequalities in infant mortality are observed in all four countries, irrespective of social indicators used in the studies. It is, however, difficult to draw inferences from the comparisons between countries, since different measures of social position and different inclusion criteria are used in the

19 CFR 177.23 - Who may request a country-of-origin advisory ruling or final determination.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) ADMINISTRATIVE RULINGS Government Procurement; Country-of-Origin Determinations § 177.23 Who may request a country-of-origin advisory ruling or...

Micro- and Macrolevel Determinants of Women's Employment in Six Arab Countries

ERIC Educational Resources Information Center

Spierings, Niels; Smits, Jeroen; Verloo, Mieke

2010-01-01

We analyzed determinants of women's employment with data for 40,792 women living in 103 districts of 6 Arab countries. We tested a new theoretical framework that addresses the roles of needs, opportunities, and values at multiple levels. At the microlevel (individual, family), socioeconomic factors, care duties, and traditionalism were important;…

Social Determinants of Smoking in Low- and Middle-Income Countries: Results from the World Health Survey

PubMed Central

Hosseinpoor, Ahmad Reza; Parker, Lucy Anne; Tursan d'Espaignet, Edouard; Chatterji, Somnath

2011-01-01

Introduction Tobacco smoking is a leading cause of premature death and disability, and over 80% of the world's smokers live in low- or middle-income countries. The objective of this study is to assess demographic and socioeconomic determinants of current smoking in low- and middle-income countries. Methods We used data, from the World Health Survey in 48 low-income and middle-income countries, to explore the impact of demographic and socioeconomic factors on the current smoking status of respondents. The data from these surveys provided information on 213,807 respondents aged 18 years or above that were divided into 4 pooled datasets according to their sex and country income group. The overall proportion of current smokers, as well as the proportion by each relevant demographic and socioeconomic determinant, was calculated within each of the pooled datasets, and multivariable logistic regression was used to assess the association between current smoking and these determinants. Results The odds of smoking were not equal in all demographic or socioeconomic groups. Some factors were fairly stable across the four datasets studied: for example, individuals were more likely to smoke if they had little or no education, regardless of if they were male or female, or lived in a low or a middle income country. Nevertheless, other factors, notably age and wealth, showed a differential effect on smoking by sex or country income level. While women in the low-income country group were twice as likely to smoke if they were in the lowest wealth quintile compared with the highest, the association was absent in the middle-income country group. Conclusion Information on how smoking is distributed among low- or middle-income countries will allow policy makers to tailor future policies, and target the most vulnerable populations. PMID:21655299

Social determinants of smoking in low- and middle-income countries: results from the World Health Survey.

PubMed

Hosseinpoor, Ahmad Reza; Parker, Lucy Anne; Tursan d'Espaignet, Edouard; Chatterji, Somnath

2011-01-01

Tobacco smoking is a leading cause of premature death and disability, and over 80% of the world's smokers live in low- or middle-income countries. The objective of this study is to assess demographic and socioeconomic determinants of current smoking in low- and middle-income countries. We used data, from the World Health Survey in 48 low-income and middle-income countries, to explore the impact of demographic and socioeconomic factors on the current smoking status of respondents. The data from these surveys provided information on 213,807 respondents aged 18 years or above that were divided into 4 pooled datasets according to their sex and country income group. The overall proportion of current smokers, as well as the proportion by each relevant demographic and socioeconomic determinant, was calculated within each of the pooled datasets, and multivariable logistic regression was used to assess the association between current smoking and these determinants. The odds of smoking were not equal in all demographic or socioeconomic groups. Some factors were fairly stable across the four datasets studied: for example, individuals were more likely to smoke if they had little or no education, regardless of if they were male or female, or lived in a low or a middle income country. Nevertheless, other factors, notably age and wealth, showed a differential effect on smoking by sex or country income level. While women in the low-income country group were twice as likely to smoke if they were in the lowest wealth quintile compared with the highest, the association was absent in the middle-income country group. Information on how smoking is distributed among low- or middle-income countries will allow policy makers to tailor future policies, and target the most vulnerable populations.

The rate of country-level improvements of the infant mortality rate is mainly determined by previous history.

PubMed

Bremberg, Sven G

2016-08-01

Studies of country-level determinants of health have produced conflicting results even when the analyses have been restricted to high-income counties. Yet, most of these studies have not taken historical, country-specific developments into account. Thus, it is appropriate to separate the influence of current exposures from historical aspects. Determinants of the infant mortality rate (IMR) were studied in 28 OECD countries over the period 1990-2012. Twelve determinants were selected. They refer to the level of general resources, resources that specifically address child health and characteristics that affect knowledge dissemination, including level of trust, and a health related behaviour: the rate of female smoking. Bivariate analyses with the IMR in year 2000 as outcome and the 12 determinants produced six statistically significant models. In multivariate analyses, the rate of decrease in the IMR was investigated as outcome and a history variable (IMR in 1990) was included in the models. The history variable alone explained 95% of the variation. None of the multivariate models, with the 12 determinants included, explained significantly more variation. Taking into account the historical development of the IMR will critically affect correlations between country-level determinants and the IMR. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries.

PubMed

de Andrade, Luiz Odorico Monteiro; Pellegrini Filho, Alberto; Solar, Orielle; Rígoli, Félix; de Salazar, Lígia Malagon; Serrate, Pastor Castell-Florit; Ribeiro, Kelen Gomes; Koller, Theadora Swift; Cruz, Fernanda Natasha Bravo; Atun, Rifat

2015-04-04

Many intrinsically related determinants of health and disease exist, including social and economic status, education, employment, housing, and physical and environmental exposures. These factors interact to cumulatively affect health and disease burden of individuals and populations, and to establish health inequities and disparities across and within countries. Biomedical models of health care decrease adverse consequences of disease, but are not enough to effectively improve individual and population health and advance health equity. Social determinants of health are especially important in Latin American countries, which are characterised by adverse colonial legacies, tremendous social injustice, huge socioeconomic disparities, and wide health inequities. Poverty and inequality worsened substantially in the 1980s, 1990s, and early 2000s in these countries. Many Latin American countries have introduced public policies that integrate health, social, and economic actions, and have sought to develop health systems that incorporate multisectoral interventions when introducing universal health coverage to improve health and its upstream determinants. We present case studies from four Latin American countries to show the design and implementation of health programmes underpinned by intersectoral action and social participation that have reached national scale to effectively address social determinants of health, improve health outcomes, and reduce health inequities. Investment in managerial and political capacity, strong political and managerial commitment, and state programmes, not just time-limited government actions, have been crucial in underpinning the success of these policies. Copyright © 2015 Elsevier Ltd. All rights reserved.

19 CFR 356.7 - Request to determine when the Government of a FTA country received notice of a scope determination.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) and (e)(2) with the Secretary of Commerce, Attention: Import Administration, Central Records Unit... name of applicable FTA country] Received Notice of a Scope Determination by first class mail or...

Does country-context matter? A cross-national analysis of gender and leisure time physical inactivity in Europe.

PubMed

Van Tuyckom, Charlotte; Van de Velde, Sarah; Bracke, Piet

2013-06-01

It is well known that European women are less physically active in their leisure time than European men. Attempts to explain this gender difference often do not succeed in raising the problem above the individual level. However, the size of the disadvantage for women varies considerably across countries, proving that leisure time physical (in)activity takes place in a broader societal context and must also be approached as such. In this sense, some authors have explained women's lack of leisure time physical activity in terms of gendered power relations in society. Therefore, the present article postulates that over and above the individual effect of gender, there is an additional impact of a society's gender-based (in)equality distribution. By means of the 2005 Eurobarometer survey (comprising 25,745 adults from 27 European countries), gender differences in leisure time physical inactivity (LTPI) were analysed by means of multilevel logistic regression analysis. National gender-based (in)equality was measured by the Gender Empowerment Measure and the Gender Gap Index. Controlled for compositional effects, gender differences in LTPI varied as a function of gender-related characteristics at the macro-level. In particular, in countries characterized by high levels of gender-based equality, LTPI differences between men and women even disappeared. The findings underscore the need to adopt a society-level approach and to incorporate socio-contextual factors in the study of gender disparities in LTPI.

The Training of Qualified Specialists in the Countries of the Black Sea Region in the Context of Globalization Education Processes

ERIC Educational Resources Information Center

Sheludko, Inna

2017-01-01

The article presents the trends in higher education development in the countries of the Black Sea region, namely, historical, methodological, methodical and technological, which determine the objective and subjective connections and relationships that are common to the system of higher pedagogical education of the countries under study and define…

Determinants of access to health care for depression in 49 countries: A multilevel analysis.

PubMed

Araya, Ricardo; Zitko, Pedro; Markkula, Niina; Rai, Dheeraj; Jones, Kelvyn

2018-07-01

The relative importance of individual and country-level factors influencing access to diagnosis and treatment for depression across the world is fairly unknown. We analysed cross-national data from the WHO World Health Surveys. Depression diagnosis and access to health care were ascertained using a structured interview. Logistic Bayesian Multilevel analyses were performed to establish individual and country level factors associated with: (1) receiving a diagnosis and (2) accessing treatment for depression if a diagnosis was ascertained. The sample included 7870 individuals from 49 countries who met ICD-10 criteria for depressive episode in the past 12 months. A third (32%) of these individuals had ever been diagnosed with depression in their lifetime. Among those diagnosed with depression, 66% reported to have ever received treatment for depression. Although individual factors were more important determinants of access to treatment for depression, country-level factors explained 27.6% of the variance in access to diagnosis and 24.1% in access to treatment. Access to treatment for depression improved with increasing country income. Female gender, better education, the presence of physical co-morbidity, more material assets, and living in urban areas were individual level determinants of better access. Data on other contextual factors was not available. Unmet need was likely underestimated, since only lifetime treatment data was available. This study highlights major inequalities in access to a diagnosis and treatment of depression. Unlike the prevalence of depression, where contextual factors have shown to have less importance, a significant proportion of the variance in access to depression care was explained by country-level income. Copyright © 2018 Elsevier B.V. All rights reserved.

Prevalence, distribution, and social determinants of tobacco use in 30 sub-Saharan African countries.

PubMed

Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Mansingh; Sin, Shwe

2014-12-18

Although the Framework Convention on Tobacco Control prioritizes monitoring of tobacco use by population-based surveys, information about the prevalence and patterns of tobacco use in sub-Saharan Africa is limited. We provide country-level prevalence estimates for smoking and smokeless tobacco (SLT) use and assess their social determinants. We analyzed population-based data of the most recent Demographic Health Surveys performed between 2006 and 2013 involving men and women in 30 sub-Saharan African countries. Weighted country-level prevalence rates were estimated for 'current smoking' (cigarettes, pipe, cigars, etc.) and 'current SLT use' (chewing, snuff, etc.). From the pooled datasets for men and women, social determinants of smoking and SLT use were assessed through multivariate analyses using a dummy country variable as a control and by including a within-country sample weight for each country. Among men, smoking prevalence rates were high in Sierra Leone (37.7%), Lesotho (34.1%), and Madagascar (28.5%); low (<10%) in Ethiopia, Benin, Ghana, Nigeria, and Sao Tome & Principe; the prevalence of SLT use was <10% in all countries except for Madagascar (24.7%) and Mozambique (10.9%). Among women, smoking and SLT prevalence rates were <5% in most countries except for Burundi (9.9%), Sierra Leone (6%), and Namibia (5.9%) (smoking), and Madagascar (19.6%) and Lesotho (9.1%) (SLT use). The proportion of females who smoked was lower than SLT users in most countries. Older age was strongly associated with both smoking and SLT use among men and women. Smoking among both men and women was weakly associated, but SLT use was strongly associated, with education. Similarly, smoking among men and women was weakly associated, but SLT use was strongly associated, with the wealth index. Smoking and SLT use were also associated with marital status among both men and women, as well as with occupation (agriculturists and unskilled workers). Prevalence of smoking among women was much

Health Inequalities in Global Context

PubMed Central

Beckfield, Jason; Olafsdottir, Sigrun

2017-01-01

The existence of social inequalities in health is well established. One strand of research focuses on inequalities in health within a single country. A separate and newer strand of research focuses on the relationship between inequality and average population health across countries. Despite the theorization of (presumably variable) social conditions as “fundamental causes” of disease and health, the cross-national literature has focused on average, aggregate population health as the central outcome. Controversies currently surround macro-structural determinants of overall population health such as income inequality. We advance and redirect these debates by conceptualizing inequalities in health as cross-national variables that are sensitive to social conditions. Using data from 48 World Values Survey countries, representing 74% of the world’s population, we examine cross-national variation in inequalities in health. The results reveal substantial variation in health inequalities according to income, education, sex, and migrant status. While higher socioeconomic position is associated with better self-rated health around the globe, the size of the association varies across institutional context, and across dimensions of stratification. There is some evidence that education and income are more strongly associated with self-rated health than sex or migrant status. PMID:29104292

Health systems context(s) for integrating mental health into primary health care in six Emerald countries: a situation analysis.

PubMed

Mugisha, James; Abdulmalik, Jibril; Hanlon, Charlotte; Petersen, Inge; Lund, Crick; Upadhaya, Nawaraj; Ahuja, Shalini; Shidhaye, Rahul; Mntambo, Ntokozo; Alem, Atalay; Gureje, Oye; Kigozi, Fred

2017-01-01

Mental, neurological and substance use disorders contribute to a significant proportion of the world's disease burden, including in low and middle income countries (LMICs). In this study, we focused on the health systems required to support integration of mental health into primary health care (PHC) in Ethiopia, India, Nepal, Nigeria, South Africa and Uganda. A checklist guided by the World Health Organization Assessment Instrument for Mental Health Systems (WHO-AIMS) was developed and was used for data collection in each of the six countries participating in the Emerging mental health systems in low and middle-income countries (Emerald) research consortium. The documents reviewed were from the following domains: mental health legislation, health policies/plans and relevant country health programs. Data were analyzed using thematic content analysis. Three of the study countries (Ethiopia, Nepal, Nigeria, and Uganda) were working towards developing mental health legislation. South Africa and India were ahead of other countries, having enacted recent Mental Health Care Act in 2004 and 2016, respectively. Among all the 6 study countries, only Nepal, Nigeria and South Africa had a standalone mental health policy. However, other countries had related health policies where mental health was mentioned. The lack of fully fledged policies is likely to limit opportunities for resource mobilization for the mental health sector and efforts to integrate mental health into PHC. Most countries were found to be allocating inadequate budgets from the health budget for mental health, with South Africa (5%) and Nepal (0.17%) were the countries with the highest and lowest proportions of health budgets spent on mental health, respectively. Other vital resources that support integration such as human resources and health facilities for mental health services were found to be in adequate in all the study countries. Monitoring and evaluation systems to support the integration of mental

Secondary Level Teachers: Supply and Demand in Liberia. Country Study No. 6.

ERIC Educational Resources Information Center

Ferns, George W.; And Others

This is one of a series of country studies (ED 045 613-20) concerned with the supply of secondary level teachers in English-speaking Africa. It attempts to analyze the problem of teacher supply within the context of the social and economic factors which largely determine its nature and govern potential solutions. The first part of the document…

What does the closure of context-sensitive constraints mean for determinism, autonomy, self-determination, and agency?

PubMed

Juarrero, Alicia

2015-12-01

The role of context-sensitive constraints - first as enablers of complexification and subsequently as regulators that maintain the integrity of self-organized, coherent wholes - has only recently begun to be examined. Conceptualizing such organizational constraints in terms of the operations of far from equilibrium, nonlinear dynamic processes rekindles old metaphysical discussions concerning primary and secondary relations, emergence, causality, and the logic of explanation. In particular, far-from-equilibrium processes allow us to rethink how parts-to-whole and whole-to-parts - so-called "mereological"- relationships are constituted. A renewed understanding of recursive feedback and the role context-dependence plays in generating the boundary conditions and the internal organization of complex adaptive systems in turn allows us to redescribe formal and final cause in such a way as to provide a meaningful sense of heretofore seemingly intractable philosophical problems such as autonomy, self-determination, and agency. Copyright © 2015. Published by Elsevier Ltd.

Determinants of evidence use in public health policy making: Results from a study across six EU countries.

PubMed

van de Goor, Ien; Hämäläinen, Riitta-Maija; Syed, Ahmed; Juel Lau, Cathrine; Sandu, Petru; Spitters, Hilde; Eklund Karlsson, Leena; Dulf, Diana; Valente, Adriana; Castellani, Tommaso; Aro, Arja R

2017-03-01

The knowledge-practice gap in public health is widely known. The importance of using different types of evidence for the development of effective health promotion has also been emphasized. Nevertheless, in practice, intervention decisions are often based on perceived short-term opportunities, lacking the most effective approaches, thus limiting the impact of health promotion strategies. This article focuses on facilitators and barriers in the use of evidence in developing health enhancing physical activity policies. Data was collected in 2012 by interviewing 86 key stakeholders from six EU countries (FI, DK, UK, NL, IT, RO) using a common topic guide. Content analysis and concept mapping was used to construct a map of facilitators and barriers. Barriers and facilitators experienced by most stakeholders and policy context in each country are analysed. A lack of locally useful and concrete evidence, evidence on costs, and a lack of joint understanding were specific hindrances. Also users' characteristics and the role media play were identified as factors of influence. Attention for individual and social factors within the policy context might provide the key to enhance more sustainable evidence use. Developing and evaluating tailored approaches impacting on networking, personal relationships, collaboration and evidence coproduction is recommended. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Identifying urban infrastructure multi-hazard risk in developing country contexts

NASA Astrophysics Data System (ADS)

Taylor, Faith; Malamud, Bruce; Millington, James

2017-04-01

This work presents a method to coarsely zone urban areas into different infrastructure typologies, from which physical vulnerability to a range of natural hazards and multi-hazard interactions can be estimated, particularly for developing country contexts where access to data can be a challenge. This work builds upon techniques developed for urban micrometeorology for classifying 12 urban typologies (Stewart and Oke, 2011) using Landsat 8 30 m × 30 m remote sensing imagery (Betchel et al., 2015). For each of these 12 urban typologies, we develop general rules about the presence, type and level of service of 10 broad categories of infrastructure (including buildings, roads, electricity and water), which we refer to as 'urban textures'. We have developed and applied this technique to five urban areas varying in size and structure across Africa: Nairobi (Kenya); Karonga (Malawi); Mzuzu (Malawi); Ibadan (Nigeria) and Cape Town (South Africa). For each urban area, a training dataset of 10 samples of each of the 12 urban texture classes is digitised using Google Earth imagery. A random forest classification is performed using SAGA GIS, resulting in a map of different urban typologies for each city. Based on >1200 georeferenced field photographs and expert interviews for Karonga (Malawi) and Nairobi (Kenya), generally applicable rules about the presence, type and level of service of 12 infrastructure types (the 'urban texture') are developed for each urban typology. For each urban texture, we are broadly reviewing how each infrastructure might be physically impacted by 21 different natural hazards and hazard interactions. This can aid local stakeholders such as emergency responders and urban planners to systematically identify how the infrastructure in different parts of an urban area might be affected differently during a natural disaster event.

Linking Science and Statistics: Curriculum Expectations in Three Countries

ERIC Educational Resources Information Center

Watson, Jane M.

2017-01-01

This paper focuses on the curriculum links between statistics and science that teachers need to understand and apply in order to be effective teachers of the two fields of study. Meaningful statistics does not exist without context and science is the context for this paper. Although curriculum documents differ from country to country, this paper…

Self-Determination and Physical Exercise Adherence in the Contexts of Fitness Academies and Personal Training

PubMed Central

Klain, Ingi Petitemberte; de Matos, Dihogo Gama; Leitão, José Carlos; Cid, Luís; Moutão, João

2015-01-01

This research aimed to analyze the validity of the relations hypothesized by the theory of self-determination in predicting adherence to physical exercise in fitness academy users and subjects following personal training. A total of 588 persons from Pelotas / RS / Brazil (405 gym users and 183 subjects following personal training) completed the Portuguese version of the three questionnaires, i.e. the Perceived Autonomy Support Climate Exercise Questionnaire, Basic Psychological Needs in the Exercise Scale and Behavioral Regulation in the Exercise Questionnaire −2. The results support the factorial structure of the questionnaires used in this sample. There was a significant multivariate effect of context on self-determination for physical exercise training [Wilks’ λ = 0.934, F (10, 576.000) = 4.03, p < 0.001, η2 = 0.01]. The hypothesized structural equation model, which considered the self-determination theory, showed a good fit to the data (S-B χ2 = 234.703; p= .001; df = 52; χ2/df = 4.514; SRMS = .049; NNFI = .906; CFI = .926; RMSEA = .077; RMSEA 90% CI = .067 − .088). However, in the comparative analysis, the perception of autonomy support, relatedness and competence were significantly higher in the context of personal training, while the amotivation and external regulation were significantly higher in the context of fitness academies. PMID:26240667

The Social Determinants of Infant Mortality and Birth Outcomes in Western Developed Nations: A Cross-Country Systematic Review

PubMed Central

Kim, Daniel; Saada, Adrianna

2013-01-01

Infant mortality (IM) and birth outcomes, key population health indicators, have lifelong implications for individuals, and are unequally distributed globally. Even among western industrialized nations, striking cross-country and within-country patterns are evident. We sought to better understand these variations across and within the United States of America (USA) and Western Europe (WE), by conceptualizing a social determinants of IM/birth outcomes framework, and systematically reviewing the empirical literature on hypothesized social determinants (e.g., social policies, neighbourhood deprivation, individual socioeconomic status (SES)) and intermediary determinants (e.g., health behaviours). To date, the evidence suggests that income inequality and social policies (e.g., maternal leave policies) may help to explain cross-country variations in IM/birth outcomes. Within countries, the evidence also supports neighbourhood SES (USA, WE) and income inequality (USA) as social determinants. By contrast, within-country social cohesion/social capital has been underexplored. At the individual level, mixed associations have been found between individual SES, race/ethnicity, and selected intermediary factors (e.g., psychosocial factors) with IM/birth outcomes. Meanwhile, this review identifies several methodological gaps, including the underuse of prospective designs and the presence of residual confounding in a number of studies. Ultimately, addressing such gaps including through novel approaches to strengthen causal inference and implementing both health and non-health policies may reduce inequities in IM/birth outcomes across the western developed world. PMID:23739649

Occupational Health Research in Developing Countries: A Partner for Social Justice

PubMed Central

Nuwayhid, Iman A.

2004-01-01

Occupational health remains neglected in developing countries because of competing social, economic, and political challenges. Occupational health research in developing countries should recognize the social and political context of work relations, especially the fact that the majority of developing countries lack the political mechanisms to translate scientific findings into effective policies. Researchers in the developing world can achieve tangible progress in promoting occupational health only if they end their professional isolation and examine occupational health in the broader context of social justice and national development in alliance with researchers from other disciplines. An occupational health research paradigm in developing countries should focus less on the workplace and more on the worker in his or her social context. PMID:15514227

Patterns and determinants of antenatal care utilization: analysis of national survey data in seven countdown countries.

PubMed

Saad-Haddad, Ghada; DeJong, Jocelyn; Terreri, Nancy; Restrepo-Méndez, María Clara; Perin, Jamie; Vaz, Lara; Newby, Holly; Amouzou, Agbessi; Barros, Aluísio Jd; Bryce, Jennifer

2016-06-01

Antenatal care (ANC) is critical for improving maternal and newborn health. WHO recommends that pregnant women complete at least four ANC visits. Countdown and other global monitoring efforts track the proportions of women who receive one or more visits by a skilled provider (ANC1+) and four or more visits by any provider (ANC4+). This study investigates patterns of drop-off in use between ANC1+ and ANC4+, and explores inequalities in women's use of ANC services. It also identifies determinants of utilization and describes countries' ANC-related policies, and programs. We performed secondary analyses using Demographic Health Survey (DHS) data from seven Countdown countries: Bangladesh, Cambodia, Cameroon, Nepal, Peru, Senegal and Uganda. The descriptive analysis illustrates country variations in the frequency of visits by provider type, content, and by household wealth, women's education and type of residence. We conducted a multivariable analysis using a conceptual framework to identify determinants of ANC utilization. We collected contextual information from countries through a standard questionnaire completed by country-based informants. Each country had a unique pattern of ANC utilization in terms of coverage, inequality and the extent to which predictors affected the frequency of visits. Nevertheless, common patterns arise. Women having four or more visits usually saw a skilled provider at least once, and received more evidence-based content interventions than women reporting fewer than four visits. A considerable proportion of women reporting four or more visits did not report receiving the essential interventions. Large disparities exist in ANC use by household wealth, women's education and residence area; and are wider for a larger number of visits. The multivariable analyses of two models in each country showed that determinants had different effects on the dependent variable in each model. Overall, strong predictors of ANC initiation and having a higher

The institutional context of tobacco production in Zambia.

PubMed

Labonté, Ronald; Lencucha, Raphael; Drope, Jeffrey; Packer, Corinne; Goma, Fastone M; Zulu, Richard

2018-01-16

Tobacco production is said to be an important contributor to Zambia's economy in terms of labour and revenue generation. In light of Zambia's obligations under the WHO Framework Convention of Tobacco Control (FCTC) we examined the institutional actors in Zambia's tobacco sector to better understand their roles and determine the institutional context that supports tobacco production in Zambia. Findings from 26 qualitative, semi-structured individual or small-group interviews with key informants from governmental, intergovernmental and non-governmental organisations were analysed, along with data and information from published literature. Although Zambia is obligated under the FCTC to take steps to reduce tobacco production, the country's weak economy and strong tobacco interests make it difficult to achieve this goal. Respondents uniformly acknowledged that growing the country's economy and ensuring employment for its citizens are the government's top priorities. Lacklustre coordination and collaboration between the institutional actors, both within and outside government, contributes to an environment that helps sustain tobacco production in the country. A Tobacco Products Control Bill has been under review for a number of years, but with no supply measures included, and with no indication of when or whether it will be passed. As with other low-income countries involved in tobacco production, there is inconsistency between Zambia's economic policy to strengthen the country's economy and its FCTC commitment to regulate and control tobacco production. The absence of a whole-of-government approach towards tobacco control has created an institutional context of duelling objectives, with some government ministries working at cross-purposes and tobacco interests left unchecked. With no ultimate coordinating authority, this industry risks being run according to the desire and demands of multinational tobacco companies, with few, if any, checks against them.

Psychological determinants of consumer acceptance of personalised nutrition in 9 European countries.

PubMed

Poínhos, Rui; van der Lans, Ivo A; Rankin, Audrey; Fischer, Arnout R H; Bunting, Brendan; Kuznesof, Sharron; Stewart-Knox, Barbara; Frewer, Lynn J

2014-01-01

To develop a model of the psychological factors which predict people's intention to adopt personalised nutrition. Potential determinants of adoption included perceived risk and benefit, perceived self-efficacy, internal locus of control and health commitment. A questionnaire, developed from exploratory study data and the existing theoretical literature, and including validated psychological scales was administered to N=9381 participants from 9 European countries (Germany, Greece, Ireland, Poland, Portugal, Spain, the Netherlands, the UK, and Norway). Structural equation modelling indicated that the greater participants' perceived benefits to be associated with personalised nutrition, the more positive their attitudes were towards personalised nutrition, and the greater their intention to adopt it. Higher levels of nutrition self-efficacy were related to more positive attitudes towards, and a greater expressed intention to adopt, personalised nutrition. Other constructs positively impacting attitudes towards personalised nutrition included more positive perceptions of the efficacy of regulatory control to protect consumers (e.g. in relation to personal data protection), higher self-reported internal health locus of control, and health commitment. Although higher perceived risk had a negative relationship with attitude and an inverse relationship with perceived benefit, its effects on attitude and intention to adopt personalised nutrition was less influential than perceived benefit. The model was stable across the different European countries, suggesting that psychological factors determining adoption of personalised nutrition have generic applicability across different European countries. The results suggest that transparent provision of information about potential benefits, and protection of consumers' personal data is important for adoption, delivery of public health benefits, and commercialisation of personalised nutrition.

Non-communicable diseases and the social determinants of health in the Nordic countries: Findings from the European Social Survey (2014) special module on the social determinants of health.

PubMed

Balaj, Mirza; Huijts, Tim; McNamara, Courtney L; Stornes, Per; Bambra, Clare; Eikemo, Terje A

2017-03-01

Comparative studies examining non-communicable diseases (NCDs) and determinants of health in the Nordic countries are scarce, outdated and focus only on a limited range of NCDs and health determinants. This study is the first to present a comprehensive overview of the distribution of social and behavioural determinants of health and of physical and mental NCDs in the Nordic population. We examined regional, country and gender differences for 17 health outcomes and 20 determinants of health. We use data from the 7th wave of the European Social Survey. All results were age-standardised by weighting up or down the unstandardized (crude) prevalence rates for five year age groups in each country to a common standard. We present pooled estimates for the combined regional samples as well as country-specific results for the Nordic region. Overall, the population of the Nordic region reported among the highest prevalence for one or both genders in 10 out of 17 health outcomes. Despite being the region with the highest prevalence for most health outcomes, overall self-rated health levels tend to be better in the Nordic region. Similarly, we found that the Nordic countries adhere to a healthier lifestyle and have better access to health care. Future studies should consider investigating further the association between health outcomes and determinants of health and how they are distributed in the Nordic societies.

Psychological Determinants of Consumer Acceptance of Personalised Nutrition in 9 European Countries

PubMed Central

Poínhos, Rui; van der Lans, Ivo A.; Rankin, Audrey; Fischer, Arnout R. H.; Bunting, Brendan; Kuznesof, Sharron; Stewart-Knox, Barbara; Frewer, Lynn J.

2014-01-01

Objective To develop a model of the psychological factors which predict people’s intention to adopt personalised nutrition. Potential determinants of adoption included perceived risk and benefit, perceived self-efficacy, internal locus of control and health commitment. Methods A questionnaire, developed from exploratory study data and the existing theoretical literature, and including validated psychological scales was administered to N = 9381 participants from 9 European countries (Germany, Greece, Ireland, Poland, Portugal, Spain, the Netherlands, the UK, and Norway). Results Structural equation modelling indicated that the greater participants’ perceived benefits to be associated with personalised nutrition, the more positive their attitudes were towards personalised nutrition, and the greater their intention to adopt it. Higher levels of nutrition self-efficacy were related to more positive attitudes towards, and a greater expressed intention to adopt, personalised nutrition. Other constructs positively impacting attitudes towards personalised nutrition included more positive perceptions of the efficacy of regulatory control to protect consumers (e.g. in relation to personal data protection), higher self-reported internal health locus of control, and health commitment. Although higher perceived risk had a negative relationship with attitude and an inverse relationship with perceived benefit, its effects on attitude and intention to adopt personalised nutrition was less influential than perceived benefit. The model was stable across the different European countries, suggesting that psychological factors determining adoption of personalised nutrition have generic applicability across different European countries. Conclusion The results suggest that transparent provision of information about potential benefits, and protection of consumers’ personal data is important for adoption, delivery of public health benefits, and commercialisation of personalised

Patterns and determinants of antenatal care utilization: analysis of national survey data in seven countdown countries

PubMed Central

Saad–Haddad, Ghada; DeJong, Jocelyn; Terreri, Nancy; Restrepo–Méndez, María Clara; Perin, Jamie; Vaz, Lara; Newby, Holly; Amouzou, Agbessi; Barros, Aluísio JD; Bryce, Jennifer

2016-01-01

Background Antenatal care (ANC) is critical for improving maternal and newborn health. WHO recommends that pregnant women complete at least four ANC visits. Countdown and other global monitoring efforts track the proportions of women who receive one or more visits by a skilled provider (ANC1+) and four or more visits by any provider (ANC4+). This study investigates patterns of drop–off in use between ANC1+ and ANC4+, and explores inequalities in women’s use of ANC services. It also identifies determinants of utilization and describes countries’ ANC–related policies, and programs. Methods We performed secondary analyses using Demographic Health Survey (DHS) data from seven Countdown countries: Bangladesh, Cambodia, Cameroon, Nepal, Peru, Senegal and Uganda. The descriptive analysis illustrates country variations in the frequency of visits by provider type, content, and by household wealth, women’s education and type of residence. We conducted a multivariable analysis using a conceptual framework to identify determinants of ANC utilization. We collected contextual information from countries through a standard questionnaire completed by country–based informants. Results Each country had a unique pattern of ANC utilization in terms of coverage, inequality and the extent to which predictors affected the frequency of visits. Nevertheless, common patterns arise. Women having four or more visits usually saw a skilled provider at least once, and received more evidence–based content interventions than women reporting fewer than four visits. A considerable proportion of women reporting four or more visits did not report receiving the essential interventions. Large disparities exist in ANC use by household wealth, women’s education and residence area; and are wider for a larger number of visits. The multivariable analyses of two models in each country showed that determinants had different effects on the dependent variable in each model. Overall, strong

Accommodating Indigenous Nurse-Initiated and Managed Antiretroviral Therapy (NIMART) Reporting in a Developing Country Context.

PubMed

Brown, Alistair M

Financial reporting represents a critical tool in eliminating HIV across Papua New Guinea (PNG). Using the tenets of the theory of indigenous alternative reporting, this paper considers how the PNG Nursing Council may accommodate nurse-initiated and managed antiretroviral therapy (NIMART) reporting. Textual analysis of indigenous reporting expectations placed on the PNG Nursing Council are examined in a NIMART context to examine levels of reporting compliance exercised by council administrators from year-end reports (1980 to 2016) to accommodate NIMART reporting. The study revealed that the 2014 annual report of the PNG Nursing Council generated a 40% NIMART compliance rate, offering encouraging signs of financial reporting that could make room for NIMART reporting. The study suggested that local mechanisms could be used to meet local indigenous reporting expectations in order to adopt NIMART reporting. The study also has far-reaching implications for other developing country nursing councils wanting to develop NIMART reporting. Copyright © 2017 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

How does context influence performance of community health workers in low- and middle-income countries? Evidence from the literature.

PubMed

Kok, Maryse C; Kane, Sumit S; Tulloch, Olivia; Ormel, Hermen; Theobald, Sally; Dieleman, Marjolein; Taegtmeyer, Miriam; Broerse, Jacqueline E W; de Koning, Korrie A M

2015-03-07

Community health workers (CHWs) are increasingly recognized as an integral component of the health workforce needed to achieve public health goals in low- and middle-income countries (LMICs). Many factors intersect to influence CHW performance. A systematic review with a narrative analysis was conducted to identify contextual factors influencing performance of CHWs. We searched six databases for quantitative, qualitative, and mixed-methods studies that included CHWs working in promotional, preventive or curative primary health care services in LMICs. We differentiated CHW performance outcome measures at two levels: CHW level and end-user level. Ninety-four studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programmes. Thematic coding was conducted and evidence on five main categories of contextual factors influencing CHW performance was synthesized. Few studies had the influence of contextual factors on CHW performance as their primary research focus. Contextual factors related to community (most prominently), economy, environment, and health system policy and practice were found to influence CHW performance. Socio-cultural factors (including gender norms and values and disease related stigma), safety and security and education and knowledge level of the target group were community factors that influenced CHW performance. Existence of a CHW policy, human resource policy legislation related to CHWs and political commitment were found to be influencing factors within the health system policy context. Health system practice factors included health service functionality, human resources provisions, level of decision-making, costs of health services, and the governance and coordination structure. All contextual factors can interact to shape CHW performance and affect the performance of CHW interventions or programmes. Research on CHW programmes often does not capture or explicitly discuss the context in which CHW

Cooperative context is a determinant of the social influence on outcome evaluation: An electrophysiological study.

PubMed

Kimura, Kenta; Katayama, Jun'ichi

2016-02-01

The present study examined whether or not a cooperative context is a determinant of the social influence on the evaluation of two action outcomes: a monetary outcome and a conflict of opinion with other group members. In the present study, three-person groups were randomly assigned to be either a cooperative or individual group and asked to perform a gambling task. The monetary outcomes in the cooperative group were interrelated among group members, whereas those in the individual group did not influence each other. The present results showed that monetary outcomes elicited feedback-related negativity (FRN) and a conflict of opinion with other group members elicited FRN-like negativity, which reflect an evaluation of the motivational significance of action outcomes. The FRN elicited by monetary outcomes was reduced when participants shared decisions with other group members only in the cooperative group, indicating that the cooperative context reduced the motivational significance of monetary outcomes through the diffusion of responsibility. The FRN-like negativity elicited by a conflict of opinion showed a different pattern between the cooperative and individual groups, indicating that the cooperative context can influence the evaluation of a conflict of opinion, possibly via the modulation of group cohesiveness or conflict processing. The present results suggest that a cooperative context, rather than the social setting, is a determinant of the social influence on outcome evaluation. Copyright © 2015 Elsevier B.V. All rights reserved.

The feasibility of measuring and monitoring social determinants of health and the relevance for policy and programme – a qualitative assessment of four countries

PubMed Central

Blas, Erik; Ataguba, John E.; Huda, Tanvir M.; Bao, Giang Kim; Rasella, Davide; Gerecke, Megan R.

2016-01-01

Background Since the publication of the reports by the Commission on Social Determinants of Health (CSDH), many research papers have documented inequities, explaining causal pathways in order to inform policy and programmatic decision-making. At the international level, the sustainable development goals (SDGs) reflect an attempt to bring together these themes and the complexities involved in defining a comprehensive development framework. However, to date, much less has been done to address the monitoring challenges, that is, how data generation, analysis and use are to become routine tasks. Objective To test proposed indicators of social determinants of health (SDH), gender, equity, and human rights with respect to their relevance in tracking progress in universal health coverage and population health (level and distribution). Design In an attempt to explore these monitoring challenges, indicators covering a wide range of social determinants were tested in four country case studies (Bangladesh, Brazil, South Africa, and Vietnam) for their technical feasibility, reliability, and validity, and their communicability and usefulness to policy-makers. Twelve thematic domains with 20 core indicators covering different aspects of equity, human rights, gender, and SDH were tested through a review of data sources, descriptive analyses, key informant interviews, and focus group discussions. To test the communicability and usefulness of the domains, domain narratives that explained the causal pathways were presented to policy-makers, managers, the media, and civil society leaders. Results For most countries, monitoring is possible, as some data were available for most of the core indicators. However, a qualitative assessment showed that technical feasibility, reliability, and validity varied across indicators and countries. Producing understandable and useful information proved challenging, and particularly so in translating indicator definitions and data into meaningful lay

Origins of food crops connect countries worldwide

PubMed Central

Achicanoy, Harold A.; Bjorkman, Anne D.; Navarro-Racines, Carlos; Guarino, Luigi; Flores-Palacios, Ximena; Engels, Johannes M. M.; Wiersema, John H.; Dempewolf, Hannes; Sotelo, Steven; Ramírez-Villegas, Julian; Castañeda-Álvarez, Nora P.; Fowler, Cary; Jarvis, Andy; Rieseberg, Loren H.; Struik, Paul C.

2016-01-01

Research into the origins of food plants has led to the recognition that specific geographical regions around the world have been of particular importance to the development of agricultural crops. Yet the relative contributions of these different regions in the context of current food systems have not been quantified. Here we determine the origins (‘primary regions of diversity’) of the crops comprising the food supplies and agricultural production of countries worldwide. We estimate the degree to which countries use crops from regions of diversity other than their own (‘foreign crops’), and quantify changes in this usage over the past 50 years. Countries are highly interconnected with regard to primary regions of diversity of the crops they cultivate and/or consume. Foreign crops are extensively used in food supplies (68.7% of national food supplies as a global mean are derived from foreign crops) and production systems (69.3% of crops grown are foreign). Foreign crop usage has increased significantly over the past 50 years, including in countries with high indigenous crop diversity. The results provide a novel perspective on the ongoing globalization of food systems worldwide, and bolster evidence for the importance of international collaboration on genetic resource conservation and exchange.

And young child feeding practices in different country settings.

PubMed

Sanghvi, Tina; Jimerson, Ann; Hajeebhoy, Nemat; Zewale, Medhanit; Nguyen, Giang Huong

2013-09-01

Alive & Thrive aims to increase exclusive breastfeeding and complementary feeding practices in Bangladesh, Ethiopia, and Vietnam. To develop and execute comprehensive communication strategies adapted to each context. We documented how three countries followed an established iterative planning process, with research steps followed by key decisions, to develop a communication strategy in each country. Secondary analysis and formative research identified the priority practices to focus on, and locally specific constraints to proper infant and young child feeding (IYCF). Communication strategies were then developed based on the social, cultural, economic, epidemiological, media use, and programmatic contexts of each country. There were widespread gaps between recommended and actual feeding practices, and these varied by country. Gaps were identified in household, community, and institutional levels of awareness and skills. Strategies were designed that would enable mothers in each specific setting to adopt practices. To improve priority behaviors, messaging and media strategies addressed the most salient behavioral determinants through face-to-face communication, social mobilization, and mass media. Trials of improved practices (TIPs), concept testing, and pretesting of materials proved useful to verify the relevance and likely effectiveness of communication messages and materials tailored for different audiences in each setting. Coordination and collaboration with multiple stakeholders from the start was important to harmonize messages and approaches, expand geographic coverage to national scale, and sustain the interventions. Our experience with designing large-scale communication strategies for behavior change confirms that systematic analysis and local planning cannot be omitted from the critical process of strategic design tailored to each context. Multiple communication channels matched to media habits in each setting can reach a substantial proportion of mothers

Mass Customization and Personalization Prospects in Developing Country: Indonesian Context

NASA Astrophysics Data System (ADS)

Risdiyono; Djati Widodo, Imam; Mahtarami, Affan

2016-01-01

The advancement of information technology (IT) has changed many modes and ways for people in doing their businesses. Mass Customization and Personalization (MCP) is one example of business modes that has been dramatically evolve, mainly due to the currently very fast IT development. MCP has enabled people to involve in adjusting some design parameters of a product to meet their personal requirements before purchased. The advancement of IT has made MCP more successful as it makes the process faster, easier, simpler and more joyful. The success stories of MCP are easily found in many developed countries, where the IT infrastructure has firmly been established. For developing countries, there are very few industries have implemented the MCP concept, including Indonesia. This paper discusses a descriptive study to depict what people think about MCP implementation in Indonesia especially in Small and Medium Enterprises (SMEs). Kano model was used to see the perception of both producers and consumers in relation with MCP implementation. Five dummy MCP prototypes were developed for five creative products including plaques, hats, invitation card, t-shirts and leather bags. Based on the KANO questionnaire analyses, it is clear that there are big opportunities to implement MCP in Indonesia especially for creative products produced by SMEs. Identifying the correct product features is an important key for successful MCP implementation in developing countries.

Did Equity of Reproductive and Maternal Health Service Coverage Increase during the MDG Era? An Analysis of Trends and Determinants across 74 Low- and Middle-Income Countries

PubMed Central

Sharma, Suneeta

2015-01-01

Introduction Despite widespread gains toward the 5th Millennium Development Goal (MDG), pro-rich inequalities in reproductive health (RH) and maternal health (MH) are pervasive throughout the world. As countries enter the post-MDG era and strive toward UHC, it will be important to monitor the extent to which countries are achieving equity of RH and MH service coverage. This study explores how equity of service coverage differs across countries, and explores what policy factors are associated with a country’s progress, or lack thereof, toward more equitable RH and MH service coverage. Methods We used RH and MH service coverage data from Demographic and Health Surveys (DHS) for 74 countries to examine trends in equity between countries and over time from 1990 to 2014. We examined trends in both relative and absolute equity, and measured relative equity using a concentration index of coverage data grouped by wealth quintile. Through multivariate analysis we examined the relative importance of policy factors, such as political commitment to health, governance, and the level of prepayment, in determining countries’ progress toward greater equity in RH and MH service coverage. Results Relative equity for the coverage of RH and MH services has continually increased across all countries over the past quarter century; however, inequities in coverage persist, in some countries more than others. Multivariate analysis shows that higher education and greater political commitment (measured as the share of government spending allocated to health) were significantly associated with higher equity of service coverage. Neither country income, i.e., GDP per capita, nor better governance were significantly associated with equity. Conclusion Equity in RH and MH service coverage has improved but varies considerably across countries and over time. Even among the subset of countries that are close to achieving the MDGs, progress made on equity varies considerably across countries

Comparing end-of-life practices in different policy contexts: a scoping review.

PubMed

Boivin, Antoine; Marcoux, Isabelle; Garnon, Geneviève; Lehoux, Pascale; Mays, Nicholas; Prémont, Marie-Claude; Chao, Yi-Sheng; van Leeuwen, Evert; Pineault, Raynald

2015-04-01

End-of-life policy reforms are being debated in many countries. Research evidence is used to support different assumptions about the effects of public policies on end-of-life practices. It is however unclear whether reliable international practice comparisons can be conducted between different policy contexts. Our aim was to assess the feasibility of comparing similar end-of-life practices in different policy contexts. This is a scoping review of empirical studies on medical end-of-life practices. We developed a descriptive classification of end-of-life practices that distinguishes practices according to their legal status. We focused on the intentional use of lethal drugs by physicians because of international variations in the legal status of this practice. Bibliographic database searches were supplemented by expert consultation and hand searching of reference lists. The sensitivity of the search strategy was tested using a set of 77 articles meeting our inclusion criteria. Two researchers extracted end-of-life practice definitions, study methods and available comparisons across policy contexts. Canadian decision-makers were involved to increase the policy relevance of the review. In sum, 329 empirical studies on the intentional use of lethal drugs by doctors were identified, including studies from 19 countries. The bibliographic search captured 98.7% of studies initially identified as meeting the inclusion criteria. Studies on the intentional use of lethal drugs were conducted in jurisdictions with permissive (62%) and restrictive policies (43%). The most common study objectives related to the frequency of end-of-life practices, determinants of practices, and doctors' adherence to regulatory standards. Large variations in definitions and research methods were noted across studies. The use of a descriptive classification was useful to translate end-of-life practice definitions across countries. A few studies compared end-of-life practice in countries with

19 CFR 356.7 - Request to determine when the Government of a FTA country received notice of a scope determination.

Code of Federal Regulations, 2010 CFR

2010-04-01

... writing from the Department the date on which the Government of a FTA country received notice of a scope determination made by the Department. (b) A request shall be made by filing a written request and the correct... letter of transmittal must be bound to the original and each copy as the first page of the request. (c...

Human rights conflicts experienced by nurses migrating between developed countries.

PubMed

Palese, Alvisa; Dobrowolska, Beata; Squin, Anna; Lupieri, Giulia; Bulfone, Giampiera; Vecchiato, Sara

2017-11-01

Some developed countries have recently changed their role in the context of international recruitment, becoming donors due to socio-economical and political factors such as recessions. This is also the case in Italy, where there has been a flow of immigrant nurses out of the country that has been documented over the past several years. In a short time, it has become a donor country to other developed European countries, such as the United Kingdom. To advance knowledge in the context of human rights conflicts and ethical implications of the decision-making process of nurses who migrate between developed countries, such as from Italy to the United Kingdom, during times of recession. A case study based on the descriptive phenomenological approach was undertaken in 2014. Participants and research context: A total of 26 Italian newly graduated nurses finding a job in the United Kingdom were interviewed via Skype and telephone. Ethical considerations: The Internal Review Board of the University approved the project. In accordance with the descriptive phenomenological approach undertaken, three main themes emerged: (1) escaping from the feeling of being refused/rejected in order to be desired, (2) perceiving themselves respected, as a person and as a nurse, in a growth project and (3) returning if the country changes its strategy regarding nurses. Ethical implications in the context of human rights, such as autonomy of the decision, social justice and reciprocal obligation, non-maleficence and double effect, have been discussed. The call for investing in nurses and nurses' care in developed countries facing recession is urgent. Investing in nurses means respecting individuals and citizens who are at risk of developing health problems during the recession.

Religion and health in Europe: cultures, countries, context.

PubMed

VanderWeele, Tyler J

2017-10-01

Much of the research on the relationships between religious participation and health comes from the United States. Studies in other geographic regions or cultural contexts is more sparse. Evidence presented by Ahrenfelt et al., and that from other research studies, is reviewed concerning the associations between religion and health within Europe and world-wide. The evidence within Europe suggests protective associations between various forms of religious participation and lower depression, lower mortality, and better self-rated health. Methodological challenges in such research are reviewed, and discussion is given as to whether a person-culture-fit explanation suffices to account for the existing data and to what other mechanisms might be operative.

A Comparison of Physical Activity Levels in Childcare Contexts among Finnish and Dutch Three-Year-Olds

ERIC Educational Resources Information Center

Soini, Anne; Gubbels, Jessica; Sääkslahti, Arja; Villberg, Jari; Kremers, Stef; Van Kann, Dave; Mehtälä, Anette; De Vries, Nanne; Poskiparta, Marita

2016-01-01

The aim of the current study was to determine Finnish and Dutch three-year-old preschool children's physical activity (PA) levels and how levels vary across gender, location, time of day and social contexts in both countries. A modified version of the Observational System for Recording Physical Activity in Children-Preschool (OSRAC-P) was used to…

Addressing research capacity for health equity and the social determinants of health in three African countries: the INTREC programme.

PubMed

Hofman, Karen; Blomstedt, Yulia; Addei, Sheila; Kalage, Rose; Maredza, Mandy; Sankoh, Osman; Bangha, Martin; Kahn, Kathleen; Becher, Heiko; Haafkens, Joke; Kinsman, John

2013-04-03

The importance of tackling economic, social and health-related inequities is increasingly accepted as a core concern for the post-Millennium Development Goal framework. However, there is a global dearth of high-quality, policy-relevant and actionable data on inequities within populations, which means that development solutions seldom focus on the people who need them most. INTREC (INDEPTH Training and Research Centres of Excellence) was established with this concern in mind. It aims to provide training for researchers from the INDEPTH network on associations between health inequities, the social determinants of health (SDH), and health outcomes, and on presenting their findings in a usable form to policy makers. As part of a baseline situation analysis for INTREC, this paper assesses the current status of SDH training in three of the African INTREC countries - Ghana, Tanzania, and South Africa - as well as the gaps, barriers, and opportunities for training. SDH-related courses from the three countries were identified through personal knowledge of the researchers, supplemented by snowballing and online searches. Interviews were also conducted with, among others, academics engaged in SDH and public health training in order to provide context and complementary material. Information regarding access to the Internet, as a possible INTREC teaching medium, was gathered in each country through online searches. SDH-relevant training is available, but 1) the number of places available for students is limited; 2) the training tends to be public-health-oriented rather than inclusive of the broader, multi-sectoral issues associated with SDH; and 3) insufficient funding places limitations on both students and on the training institutions themselves, thereby affecting participation and quality. We also identified rapidly expanding Internet connectivity in all three countries, which opens up opportunities for e-learning on SDH, though the current quality of the Internet services

Teachers' Conceptions about the Genetic Determinism of Human Behaviour: A Survey in 23 Countries

ERIC Educational Resources Information Center

Castéra, Jérémy; Clément, Pierre

2014-01-01

This work analyses the answers to a questionnaire from 8,285 in-service and pre-service teachers from 23 countries, elaborated by the Biohead-Citizen research project, to investigate teachers' conceptions related to the genetic determinism of human behaviour. A principal components analysis is used to assess the main trends in all the interviewed…

Diabetes mellitus and tuberculosis in countries with high tuberculosis burdens: individual risks and social determinants.

PubMed

Goldhaber-Fiebert, Jeremy D; Jeon, Christie Y; Cohen, Ted; Murray, Megan B

2011-04-01

A growing body of evidence supports the role of type 2 diabetes as an individual-level risk factor for tuberculosis (TB), though evidence from developing countries with the highest TB burdens is lacking. In developing countries, TB is most common among the poor, in whom diabetes may be less common. We assessed the relationship between individual-level risk, social determinants and population health in these settings. We performed individual-level analyses using the World Health Survey (n = 124,607; 46 countries). We estimated the relationship between TB and diabetes, adjusting for gender, age, body mass index, education, housing quality, crowding and health insurance. We also performed a longitudinal country-level analysis using data on per-capita gross domestic product and TB prevalence and incidence and diabetes prevalence for 1990-95 and 2003-04 (163 countries) to estimate the relationship between increasing diabetes prevalence and TB, identifying countries at risk for disease interactions. In lower income countries, individuals with diabetes are more likely than non-diabetics to have TB [univariable odds ratio (OR): 2.39; 95% confidence interval (CI): 1.84-3.10; multivariable OR: 1.81; 95% CI: 1.37-2.39]. Increases in TB prevalence and incidence over time were more likely to occur when diabetes prevalence also increased (OR: 4.7; 95% CI: 1.0-22.5; OR: 8.6; 95% CI: 1.9-40.4). Large populations, prevalent TB and projected increases in diabetes make countries like India, Peru and the Russia Federation areas of particular concern. Given the association between diabetes and TB and projected increases in diabetes worldwide, multi-disease health policies should be considered.

Determinants of between-country differences in ambulatory antibiotic use and antibiotic resistance in Europe: a longitudinal observational study.

PubMed

Blommaert, A; Marais, C; Hens, N; Coenen, S; Muller, A; Goossens, H; Beutels, P

2014-02-01

To identify key determinants explaining country-year variations in antibiotic use and resistance. Ambulatory antibiotic use data [in defined daily doses per 1000 inhabitants per day (DIDs)] for 19 European countries from 1999 to 2007 were collected, along with 181 variables describing countries in terms of their agriculture, culture, demography, disease burden, education, healthcare organization and socioeconomics. After assessing data availability, overlap and relevance, multiple imputation generalized estimating equations were applied with a stepwise selection procedure to select significant determinants of global antibiotic use (expressed in DIDs), relative use of subgroups (amoxicillin and co-amoxiclav) and resistance of Escherichia coli and Streptococcus pneumoniae. Relative humidity, healthcare expenditure proportional to gross domestic product, feelings of distrust, proportion of population aged >65 years and availability of treatment guidelines were associated with higher total antibiotic use expressed in DIDs. Restrictions on marketing activities towards prescribers, population density, number of antibiotics, educational attainment and degree of atheism were associated with a lower number of total DIDs used. Relative prescribing of amoxicillin and co-amoxiclav was mainly determined by healthcare system choices [e.g. general practitioner (GP) registration and restricted marketing]. Specific antibiotic use was found to be a significant determinant of resistance for some but not all drug/organism combinations. Incentives to stimulate GP gatekeeping were associated with lower levels of resistance, and life expectancy at age 65+ and atheism were associated with more resistance. Myriad factors influence antibiotic use and resistance at the country level and an important part of these can be modified by policy choices.

Comparing primary energy attributed to renewable energy with primary energy equivalent to determine carbon abatement in a national context.

PubMed

Gallachóir, Brian P O; O'Leary, Fergal; Bazilian, Morgan; Howley, Martin; McKeogh, Eamon J

2006-01-01

The current conventional approach to determining the primary energy associated with non-combustible renewable energy (RE) sources such as wind energy and hydro power is to equate the electricity generated from these sources with the primary energy supply. This paper compares this with an approach that was formerly used by the IEA, in which the primary energy equivalent attributed to renewable energy was equated with the fossil fuel energy it displaces. Difficulties with implementing this approach in a meaningful way for international comparisons lead to most international organisations abandoning the primary energy equivalent methodology. It has recently re-emerged in prominence however, as efforts grow to develop baseline procedures for quantifying the greenhouse gas (GHG) emissions avoided by renewable energy within the context of the Kyoto Protocol credit trading mechanisms. This paper discusses the primary energy equivalent approach and in particular the distinctions between displacing fossil fuel energy in existing plant or in new plant. The approach is then extended provide insight into future primary energy displacement by renewable energy and to quantify the amount of CO2 emissions avoided by renewable energy. The usefulness of this approach in quantifying the benefits of renewable energy is also discussed in an energy policy context, with regard to increasing security of energy supply as well as reducing energy-related GHG (and other) emissions. The approach is applied in a national context and Ireland is case study country selected for this research. The choice of Ireland is interesting in two respects. The first relates to the high proportion of electricity only fossil fuel plants in Ireland resulting in a significant variation between primary energy and primary energy equivalent. The second concerns Ireland's poor performance to date in limiting GHG emissions in line with its Kyoto target and points to the need for techniques to quantify the potential

Determinants of Literacy Proficiency: A Lifelong-Lifewide Learning Perspective

ERIC Educational Resources Information Center

Desjardins, Richard

2003-01-01

The aim of this article is to investigate the predictive capacity of major determinants of literacy proficiency that are associated with a variety of contexts including school, home, work, community and leisure. An identical structural model based on previous research is fitted to data for 18 countries. The results show that even after accounting…

The Functioning of Context-Based Physics Instruction in Higher Education

ERIC Educational Resources Information Center

Tural, Guner

2014-01-01

The effects of the context-based approach have been discussed in educational settings as one of the innovative instructional approaches. Many countries throughout the world have implemented context-based physics projects or programs to make physics more relevant to students' lives. This paper examined the effects of context-based physics…

Development and validation of a multilateral index to determine economic status in developing countries: the Patient Financial Eligibility Tool (PFET).

PubMed

Saba, Joseph; Audureau, Etienne; Bizé, Marion; Koloshuk, Barbara; Ladner, Joël

2013-04-01

The objective was to develop and validate a multilateral index to determine patient ability to pay for medication in low- and middle-income countries. Primary data were collected in 2009 from 117 cancer patients in China, India, Thailand, and Malaysia. The initial tool included income, expenditures, and assets-based items using ad hoc determined brackets. Principal components analysis was performed to determine final weights. Agreement (Kappa) was measured between results from the final tool and from an Impact Survey (IS) conducted after beginning drug therapy to quantify a patient's actual ability to pay in terms of number of drug cycles per year. The authors present the step-by-step methodology employed to develop the tool on a country-by-country basis. Overall Cronbach value was 0.84. Agreement between the Patient Financial Eligibility Tool (PFET) and IS was perfect (equal number of drug cycles) for 58.1% of patients, fair (1 cycle difference) for 29.1%, and poor (>1 cycle) for 12.8%. Overall Kappa was 0.76 (P<0.0001). The PFET is an effective tool for determining an individual's ability to pay for medication. Combined with tiered models for patient participation in the cost of medication, it could help to increase access to high-priced products in developing countries.

Influence of Sociocultural Context on Language Learning in Foreign Countries

ERIC Educational Resources Information Center

Pazyura, Natalia

2016-01-01

Professional foreign language training is offered to cultivate the ability to master cross-cultural communication in the sphere of future professional activity. By means of intercultural competence of foreign language we are raising professional competence, too. In countries where English is the native language, it is taught to speakers of other…

Political economy of tobacco control in low-income and middle-income countries: lessons from Thailand and Zimbabwe. Global Analysis Project Team.

PubMed Central

Chantornvong, S.; Collin, J.; Dodgson, R.; Lee, K.; McCargo, D.; Seddon, D.; Vaughan, P.; Woelk, G.

2000-01-01

Crucial to the success of the proposed Framework Convention on Tobacco Control will be an understanding of the political and economic context for tobacco control policies, particularly in low-income and middle-income countries. Policy studies in Thailand and Zimbabwe employed the analytical perspective of political economy and a research strategy that used political mapping, a technique for characterizing and evaluating the political environment surrounding a policy issue, and stakeholder analysis, which seeks to identify key actors and to determine their capacity to shape policy outcomes. These policy studies clearly revealed how tobacco control in low-income and middle-income countries is also being shaped by developments in the global and regional political economy. Hence efforts to strengthen national control policies need to be set within the context of globalization and the international context. Besides the transnational tobacco companies, international tobacco groups and foreign governments, international agencies and nongovernmental organizations are also playing influential roles. It cannot be assumed, therefore, that the tobacco control strategies being implemented in industrialized countries will be just as effective and appropriate when implemented in developing countries. There is an urgent need to expand the number of such tobacco policy studies, particularly in low-income and middle-income countries. Comprehensive guidelines for tobacco policy analysis and research are required to support this process, as is a broader international strategy to coordinate further tobacco policy research studies at country, regional and global levels. PMID:10994265

"Bridgers" in the Third Space: An In-Country Investigation of the Leadership Practices of US-Educated Chinese Nationals

ERIC Educational Resources Information Center

Martinez, Maria L.

2016-01-01

This in-country grounded theory study examined the lived experiences of 24 Chinese returnees who completed advanced degrees in the United States. The study found that the four types of organizations in mainland China determine the social context of the application of Western education of the Chinese returnees. Returnees working in multinational…

Modelling the Sociocultural Contexts of Science Education: The Teachers' Perspective

ERIC Educational Resources Information Center

Mansour, Nasser

2013-01-01

A growing body of research argues that teachers' beliefs and practices should be studied within the sociocultural contexts of their work because the relationship between their beliefs and practices is both complex and context-dependent. There is a need for further research in this area in understudied contexts such as developing countries, in…

Urban health in Johannesburg: the importance of place in understanding intra-urban inequalities in a context of migration and HIV.

PubMed

Vearey, Joanna; Palmary, Ingrid; Thomas, Liz; Nunez, Lorena; Drimie, Scott

2010-07-01

Developing country urban contexts present multiple challenges to those responsible for ensuring the good health of urban populations. These include urban growth, migration, informal settlements, intra-urban inequalities and - in some cases - high HIV prevalence. Using Johannesburg as a case study, this paper explores the complexities of the urban context by comparing the social determinants of urban health between migrant groups residing in the inner-city and a peripheral urban informal settlement. It is argued that any attempt to improve the health of urban populations in the context of migration and HIV requires understanding that 'place matters'. 2010 Elsevier Ltd. All rights reserved.

Compulsory Schooling Laws and Migration Across European Countries.

PubMed

Aparicio Fenoll, Ainhoa; Kuehn, Zoë

2017-12-01

Educational attainment is a key factor for understanding why some individuals migrate and others do not. Compulsory schooling laws, which determine an individual's minimum level of education, can potentially affect migration. We test whether and how increasing the length of compulsory schooling influences migration of affected cohorts across European countries, a context where labor mobility is essentially free. We construct a novel database that includes information for 31 European countries on compulsory education reforms passed between 1950 and 1990. Combining this data with information on recent migration flows by cohorts, we find that an additional year of compulsory education reduces the number of individuals from affected cohorts who migrate in a given year by 9 %. Our results rely on the exogeneity of compulsory schooling laws. A variety of empirical tests indicate that European legislators did not pass compulsory education reforms as a reaction to changes in emigration rates or educational attainment.

Lessons learned from health sector reform: a four-country comparison.

PubMed

Talukder, Md Noorunnabi; Rob, Ubaidur; Mahabub-Ul-Anwar, Md

Various reforms have been undertaken to improve the functioning of health systems in developing countries, but there is limited comparative analysis of reform initiatives. This article discusses health sector reform experiences of four developing countries and identifies the lessons learned. The article is based on the review of background papers on Bangladesh, Pakistan, Indonesia, and Tanzania prepared as part of a multi-country study on health sector reform. Findings suggest that decentralization works effectively while implementing primary and secondary health programs. Decentralization of power and authority to local authorities requires strengthening and supporting these units. Along with the public sector, the private sector plays an effective role in institutional and human resources development as well as in improving service delivery. Community participation facilitates recruitment and development of field workers, facility improvement, and service delivery. For providing financial protection to the poor, there is a need to review user fees and develop affordable health insurance with an exemption mechanism. There is no uniform health sector reform approach; therefore, the experiences of other countries will help countries undertake appropriate reforms. Here, it is important to examine the context and determine the reform measures that constitute the best means in terms of equity, efficiency, and sustainability.

The application of Intervention Mapping in developing and implementing school-based sexuality and HIV/AIDS education in a developing country context: the case of Tanzania.

PubMed

Mkumbo, Kitila; Schaalma, Herman; Kaaya, Sylvia; Leerlooijer, Joanne; Mbwambo, Jessie; Kilonzo, Gad

2009-06-01

Effective sexuality and HIV/AIDS education programmes are needed to protect young people against HIV/AIDS and teenage pregnancy in Tanzania and other Sub-Saharan African countries. Using a theory- and evidence-based approach and adapting the programmes to local contexts, increases the effectiveness of these programmes. This paper describes and discusses the challenges and opportunities concerning the application of Intervention Mapping (IM) in the development and implementation of a sexuality and HIV/AIDS education programme targeting young people aged 12-14 in Tanzania. The sexuality and HIV/AIDS programme was designed in a participatory manner, involving researchers, curriculum developers and teachers' and students' panels. The programme comprised five lessons, organized around 23 sessions with the aim of delaying the onset of sexual intercourse and increase correct and consistent condom use among young people. The programme was delivered by trained teachers as an extracurricular lesson. The IM protocol facilitated the development of a comprehensive sexuality and HIV/AIDS education programme relevant and appropriate to the social cultural context and the needs of learners in Tanzania. The paper has demonstrated that, although the IM was developed in the Western context, it can be used in a flexible manner to adapt to local contexts such as those in Sub-Saharan Africa.

49 CFR 583.8 - Procedure for determining country of origin for engines and transmissions (for purposes of...

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Procedure for determining country of origin for engines and transmissions (for purposes of determining the information specified by §§ 583.5(a)(4) and 583.5(a)(5) only). 583.8 Section 583.8 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY...

Determinants of maternal immunization in developing countries.

PubMed

Pathirana, Jayani; Nkambule, Jerome; Black, Steven

2015-06-12

Maternal immunization is an effective intervention to protect newborns and young infants from infections when their immune response is immature. Tetanus toxoid vaccination of pregnant women is the most widely implemented maternal vaccine in developing countries where neonatal mortality is the highest. We identified barriers to maternal tetanus vaccination in developing African and Asian countries to identify means of improving maternal immunization platforms in these countries. We categorized barriers into health system, health care provider and patient barriers to maternal tetanus immunization and conducted a literature review on each category. Due to limited literature from Africa, we conducted a pilot survey of health care providers in Malawi on barriers they experience in immunizing pregnant women. The major barriers of the health system are due to inadequate financial and human resources which translate to inadequate vaccination services delivery and logistics management. Health care providers are limited by poor attendance of Antenatal Care and inadequate knowledge on vaccinating pregnant women. Patient barriers are due to lack of education and knowledge on pregnancy immunization and socioeconomic factors such as low income and high parity. There are several factors that affect maternal tetanus immunization. Increasing knowledge in health care providers and patients, increasing antenatal care attendance and outreach activities will aid the uptake of maternal immunization. Health system barriers are more difficult to address requiring an improvement of overall immunization services. Further analyses of maternal immunization specific barriers and the means of addressing them are required to strengthen the existing program and provide a more efficient delivery system for additional maternal vaccines. Copyright © 2015 Elsevier Ltd. All rights reserved.

Unmet reproductive health needs among women in some West African countries: a systematic review of outcome measures and determinants.

PubMed

Ayanore, Martin Amogre; Pavlova, Milena; Groot, Wim

2016-01-16

Identifying relevant measures of women's reproductive health needs is critical to improve women's chances of service utilization. The study aims to systematically review and analyze the adequacy of outcome measures and determinants applied in previous studies for assessing women reproductive health needs across West Africa. Evidence on outcomes and determinants of unmet reproductive health needs among women of childbearing age in diverse multicultural, religious, and ethnic settings in West African countries was systematically reviewed. The review included recent English language publications (from January 2009 - March 2014). Clinical studies particularly on obstetric care services and reproductive services in relation to HIV/AIDS were excluded. We acknowledge the possibility to have excluded non-English publications and yet-to-be-published articles related to the study aim and objectives. Outcomes and determinants were assessed and defined at three main levels; contraceptive use, obstetric care, and antenatal care utilization. Results show increasing unmet need for women's reproductive health needs. Socio-cultural norms and practices resulting in discontinuation of service use, economic constraints, travel distance to access services and low education levels of women were found to be key predictors of service utilization for contraception, antenatal and obstetric care services. Outcome measures were mainly assessed based on service utilization, satisfaction, cost, and quality of services available as core measures across the three levels assessed in this review. Evidence from this review indicates that currently applied measures of women's reproductive health needs might be inadequate in attaining best maternal outcomes since they appear rather broad. More support and research for developing and advancing context-related measures may help to improve women's maternal health.

Practitioner consensus on the determinants of capacity building practice in high-income countries.

PubMed

Swanepoel, Elizabeth; Fox, Ann; Hughes, Roger

2015-07-01

To assess and develop consensus among experienced public health nutrition practitioners from high-income countries regarding conceptualisation of capacity building in practice, and to test the content validity of a previously published conceptual framework for capacity building in public health nutrition practice. A Delphi study involving three iterations of email-delivered questionnaires testing a range of capacity determinants derived from the literature. Consensus was set at >50% of panellists ranking items as 'very important' on a five-point Likert scale across three survey rounds. Public health nutrition practice in Australia, the UK, Canada and the USA. Public health nutrition practitioners and academics. Result A total of thirty expert panellists (68% of an initial panel of forty-four participants) completed all three rounds of Delphi questionnaires. Consensus identified determinants of capacity building in practice including partnerships, resourcing, community development, leadership, workforce development, intelligence and quality of project management. The findings from the study suggest there is broad agreement among public health nutritionists from high-income countries about how they conceptualise capacity building in public health nutrition practice. This agreement suggests considerable content validity for a capacity building conceptual framework proposed by Baillie et al. (Public Health Nutr 12, 1031-1038). More research is needed to apply the conceptual framework to the implementation and evaluation of strategies that enhance the practice of capacity building approaches by public health nutrition professionals.

Community Participation in Schools in Developing Countries: Characteristics, Methods and Outcomes

ERIC Educational Resources Information Center

Russell, Kenneth A.

2009-01-01

This study examines how communities participate in schools across diverse contexts in developing countries and the results attributed to community participation. It reviews evaluations of participatory approaches to education in developing countries to answer two basic questions: 1) How do communities participate in school in developing countries?…

Determinants of Healthcare Expenditure in Economic Cooperation Organization (ECO) Countries: Evidence from Panel Cointegration Tests.

PubMed

Samadi, Alihussein; Homaie Rad, Enayatollah

2013-06-01

Over the last decade there has been an increase in healthcare expenditures while at the same time the inequity in distribution of resources has grown. These two issues have urged the researchers to review the determinants of healthcare expenditures. In this study, we surveyed the determinants of health expenditures in Economic Cooperation Organization (ECO) countries. We used Panel data econometrics methods for the purpose of this research. For long term analysis, we used Pesaran cross sectional dependency test followed by panel unit root tests to show first whether the variables were stationary or not. Upon confirmation of no stationary variables, we used Westerlund panel cointegration test in order to show whether long term relationships exist between the variables. At the end, we estimated the model with Continuous-Updated Fully Modified (CUP-FM) estimator. For short term analysis also, we used Fixed Effects (FE) estimator to estimate the model. A long term relationship was found between the health expenditures per capita and GDP per capita, the proportion of population below 15 and above 65 years old, number of physicians, and urbanisation. Besides, all the variables had short term relationships with health expenditures, except for the proportion of population above 65 years old. The coefficient of GDP was below 1 in the model. Therefore, health is counted as a necessary good in ECO countries and governments must pay due attention to the equal distribution of health services in all regions of the country.

Determinants of Healthcare Expenditure in Economic Cooperation Organization (ECO) Countries: Evidence from Panel Cointegration Tests

PubMed Central

Samadi, Alihussein; Homaie Rad, Enayatollah

2013-01-01

Background: Over the last decade there has been an increase in healthcare expenditures while at the same time the inequity in distribution of resources has grown. These two issues have urged the researchers to review the determinants of healthcare expenditures. In this study, we surveyed the determinants of health expenditures in Economic Cooperation Organization (ECO) countries. Methods: We used Panel data econometrics methods for the purpose of this research. For long term analysis, we used Pesaran cross sectional dependency test followed by panel unit root tests to show first whether the variables were stationary or not. Upon confirmation of no stationary variables, we used Westerlund panel cointegration test in order to show whether long term relationships exist between the variables. At the end, we estimated the model with Continuous-Updated Fully Modified (CUP-FM) estimator. For short term analysis also, we used Fixed Effects (FE) estimator to estimate the model. Results: A long term relationship was found between the health expenditures per capita and GDP per capita, the proportion of population below 15 and above 65 years old, number of physicians, and urbanisation. Besides, all the variables had short term relationships with health expenditures, except for the proportion of population above 65 years old. Conclusion: The coefficient of GDP was below 1 in the model. Therefore, health is counted as a necessary good in ECO countries and governments must pay due attention to the equal distribution of health services in all regions of the country. PMID:24596838

Toward a multi-country monitoring system of reproductive health in the context of endocrine disrupting chemical exposure.

PubMed

Le Moal, Joëlle; Sharpe, Richard M; Jϕrgensen, Niels; Levine, Hagai; Jurewicz, Joanna; Mendiola, Jaime; Swan, Shanna H; Virtanen, Helena; Christin-Maître, Sophie; Cordier, Sylvaine; Toppari, Jorma; Hanke, Wojciech

2016-02-01

Worrying trends regarding human reproductive endpoints (e.g. semen quality, reproductive cancers) have been reported and there is growing circumstantial evidence for a possible causal link between these trends and exposure to endocrine disrupting chemicals (EDCs). However, there is a striking lack of human data to fill the current knowledge gaps. To answer the crucial questions raised on human reproductive health, there is an urgent need for a reproductive surveillance system to be shared across countries. A multidisciplinary network named HUman Reproductive health and Global ENvironment Network (HURGENT) was created aiming at designing a European monitoring system for reproductive health indicators. Collaborative work allowed setting up the available knowledge to design such a system. Furthermore we conducted an overview of 23 potential indicators, based upon a weight of evidence (WoE) approach according to their potential relation with EDC exposure. The framework and purposes of the surveillance system are settled as well as the approach to select suitable reproductive indicators. The indicators found with the highest scores according to the WoE approach are prostate and breast cancer incidence, sex ratio, endometriosis and uterine fibroid incidence, indicators related to the testicular dysgenesis syndrome, precocious puberty incidence and reproductive hormone levels. Not only sentinel health endpoints, but also diseases with high burdens in public health are highlighted as prior indicators in the context of EDC exposure. Our work can serve as a basis to construct, as soon as possible, the first multi-country reproductive monitoring system. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

75 FR 28058 - Certain Oil Country Tubular Goods From China; Determination

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-19

... INTERNATIONAL TRADE COMMISSION [Investigation No. 731-TA-1159 (Final)] Certain Oil Country Tubular... threatened with material injury by reason of imports from China of certain oil country tubular goods (``OCTG... are contained in USITC Publication 4152 (May 2010), entitled Certain Oil Country Tubular Goods From...

The Impact of Institutional Context, Education and Labour Market Policies on Early School Leaving: A Comparative Analysis of EU Countries

ERIC Educational Resources Information Center

De Witte, Kristof; Nicaise, Ides; Lavrijsen, Jeroen; Van Landeghem, Georges; Lamote, Carl; Van Damme, Jan

2013-01-01

This article presents a comparative analysis of the determinants of early school leaving (ESL) at the country level. We decompose ESL rates into two components: a "primary" rate reflecting unqualified school leaving from initial education, and a second component accounting for early school leavers who participate in training programmes.…

Scaling up prevention of mother-to-child HIV transmission programs in sub-Saharan African countries: a multilevel assessment of site-, program- and country-level determinants of performance.

PubMed

Audureau, Etienne; Kahn, James G; Besson, Marie-Hélène; Saba, Joseph; Ladner, Joël

2013-04-01

Uptake of prevention of mother-to-child HIV transmission (PMTCT) programs remains challenging in sub-Saharan Africa because of multiple barriers operating at the individual or health facility levels. Less is known regarding the influence of program-level and contextual determinants. In this study, we explored the multilevel factors associated with coverage in single-dose nevirapine PMTCT programs. We analyzed aggregate routine data collected within the framework of the Viramune(®) Donation Programme (VDP) from 269 sites in 20 PMTCT programs and 15 sub-Saharan countries from 2002 to 2005. Site performance was measured using a nevirapine coverage ratio (NCR), defined as the reported number of women receiving nevirapine divided by the number of women who should have received nevirapine (observed HIV prevalence x number of women in antenatal care [ANC]). Data on program-level determinants were drawn from the initial application forms, and country-level determinants from the Demographic and Health Surveys (DHS) and the World Bank (World Development Indicators). Multilevel linear mixed models were used to identify independent factors associated with NCR at the site-, program- and country-level. Of 283,410 pregnant women attending ANC in the included sites, 174,312 women (61.5%) underwent HIV testing after receiving pre-test counselling, of whom 26,700 tested HIV positive (15.3%), and 22,591 were dispensed NVP (84.6%). Site performance was highly heterogeneous between and within programs. Mean NCR by site was 43.8% (interquartile range: 19.1-63.9). Multilevel analysis identified higher HIV prevalence (Beta coefficient: 25.1, 95% confidence interval [CI] 18.7 to 31.6), higher proportion of persons with knowledge of PMTCT (8.3; CI 0.5 to 16.0), higher health expenditure as a proportion of Gross Domestic Product (3.9 per %; CI 2.0 to 5.8) and lower percentage of rural population (-0.7 per %; CI -1.0 to -0.5) as significant country-level predictors of higher NCR at the p<0

Balance across contexts: importance of balanced need satisfaction across various life domains.

PubMed

Milyavskaya, Marina; Gingras, Isabelle; Mageau, Geneviève A; Koestner, Richard; Gagnon, Hugo; Fang, Jianqun; Boiché, Julie

2009-08-01

Self-determination theory posits that satisfaction of three basic psychological needs-autonomy, competence, and relatedness-are required for psychological well-being, and a recent study showed that the balance in the satisfaction of these three needs independently affects well-being. The present investigation builds on these findings by examining the balance of adolescents' need satisfaction across distinct life contexts. The results of three studies show that adolescents who experience a balance of need satisfaction across important life contexts, including at school, at home, with friends, and in part-time jobs, reported higher well-being and better school adjustment. This finding emerged consistently across four countries and across multiple measures of school adjustment, including teacher reports. Together, these results support previous research that highlights the importance of consistency for psychological functioning.

The School Improvement Policy Context in Trinidad and Tobago

ERIC Educational Resources Information Center

James, Freddy

2014-01-01

There have been appeals within the educational change (EC) and school improvement (SI) literature for research to explore more non-westernized and developing country contexts (Dimmock, 2000; Harris, 2009; Harris & Chrispeels, 2006; McMahon, 2006). This article is a response to those appeals. The study maps the SI educational policy contexts of…

Self-Determination Theory Applied to Health Contexts: A Meta-Analysis.

PubMed

Ng, Johan Y Y; Ntoumanis, Nikos; Thøgersen-Ntoumani, Cecilie; Deci, Edward L; Ryan, Richard M; Duda, Joan L; Williams, Geoffrey C

2012-07-01

Behavior change is more effective and lasting when patients are autonomously motivated. To examine this idea, we identified 184 independent data sets from studies that utilized self-determination theory (SDT; Deci & Ryan, 2000) in health care and health promotion contexts. A meta-analysis evaluated relations between the SDT-based constructs of practitioner support for patient autonomy and patients' experience of psychological need satisfaction, as well as relations between these SDT constructs and indices of mental and physical health. Results showed the expected relations among the SDT variables, as well as positive relations of psychological need satisfaction and autonomous motivation to beneficial health outcomes. Several variables (e.g., participants' age, study design) were tested as potential moderators when effect sizes were heterogeneous. Finally, we used path analyses of the meta-analyzed correlations to test the interrelations among the SDT variables. Results suggested that SDT is a viable conceptual framework to study antecedents and outcomes of motivation for health-related behaviors. © The Author(s) 2012.

Trends and determinants of the Flynn effect in cognitive functioning among older individuals in 10 European countries.

PubMed

Hessel, Philipp; Kinge, Jonas M; Skirbekk, Vegard; Staudinger, Ursula M

2018-05-01

Although cognitive performance levels in old age have increased in most countries, recent evidence documents a slowing down or even decline in cohort gains in highly developed countries. The aim of this study was to assess trends and determinants in secular cohort gains in cognitive functioning among older individuals and whether cohort gains are levelling off in most advanced countries. Data for individuals aged between 50 and 84 years from the Survey of Health, Ageing and Retirement in Europe in 10 European countries between 2004 and 2013 (n=92 739) were used to assess country and age-specific changes in immediate word recall. Multivariate random intercept models were used to assess associations between secular cohort changes in immediate word recall, initial performance levels and changes in country-level socio-demographic characteristics. Performance in immediate word recall improved in all countries between 2004 and 2013 (from 4.40 to 5.08 words, P<0.05). However, secular cohort gains were significantly smaller in countries with initially higher performance levels (coeff.=-0.554, 95% CI -0.682 to -0.426). Changes in socio-demographic and health conditions, including decreases in cardiovascular disease, physical activity and educational achievement, were associated with larger secular cohort gains. Results may either reflect that some countries are approaching the limits of cognitive plasticity, are slowing in their progress or that societal structures have not yet been optimised to improve cognitive abilities in midlife and beyond, or a combination of these interpretations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Explaining the Role of Proximate Determinants on Fertility Decline among Poor and Non-Poor in Asian Countries

PubMed Central

Majumder, Nabanita; Ram, Faujdar

2015-01-01

Objectives We examined the overall contributions of the poor and non-poor in fertility decline across the Asian countries. Further, we analyzed the direct and indirect factors that determine the reproductive behaviour of two distinct population sub-groups. Design Data from several new rounds of DHS surveys are available over the past few years. The DHS provides cross-nationally comparable and useful data on fertility, family planning, maternal and child health along with the other information. Six selected Asian countries namely: Bangladesh, India, Indonesia, Nepal, Philippines, and Vietnam are considered for the purpose of the study. Three rounds of DHS surveys for each country (except Vietnam) are considered in the present study. Methods Economic status is measured by computing a “wealth index”, i.e. a composite indicator constructed by aggregating data on asset ownership and housing characteristics using principal components analysis (PCA). Computed household wealth index has been broken into three equal parts (33.3 percent each) and the lowest and the highest 33.3 percent is considered as poor and non-poor respectively. The Bongaarts model was employed to quantify the contribution of each of the proximate determinants of fertility among poor and non-poor women. Results Fertility reduction across all population subgroups is now an established fact despite the diversity in the level of socio-economic development in Asian countries. It is clear from the analysis that fertility has declined irrespective of economic status at varying degrees within and across the countries which can be attributed to the increasing level of contraceptive use especially among poor women. Over the period of time changing marriage pattern and induced abortion are playing an important role in reducing fertility among poor women. Conclusions Fertility decline among majority of the poor women across the Asian countries is accompanied by high prevalence of contraceptive use followed by

Determining the psychometric properties of the Enhancing Decision-making Assessment in Midwifery (EDAM) measure in a cross cultural context.

PubMed

Jefford, Elaine; Jomeen, Julie; Martin, Colin R

2016-04-28

The ability to act on and justify clinical decisions as autonomous accountable midwifery practitioners, is encompassed within many international regulatory frameworks, yet decision-making within midwifery is poorly defined. Decision-making theories from medicine and nursing may have something to offer, but fail to take into consideration midwifery context and philosophy and the decisional autonomy of women. Using an underpinning qualitative methodology, a decision-making framework was developed, which identified Good Clinical Reasoning and Good Midwifery Practice as two conditions necessary to facilitate optimal midwifery decision-making during 2nd stage labour. This study aims to confirm the robustness of the framework and describe the development of Enhancing Decision-making Assessment in Midwifery (EDAM) as a measurement tool through testing of its factor structure, validity and reliability. A cross-sectional design for instrument development and a 2 (country; Australia/UK) x 2 (Decision-making; optimal/sub-optimal) between-subjects design for instrument evaluation using exploratory and confirmatory factor analysis, internal consistency and known-groups validity. Two 'expert' maternity panels, based in Australia and the UK, comprising of 42 participants assessed 16 midwifery real care episode vignettes using the empirically derived 26 item framework. Each item was answered on a 5 point likert scale based on the level of agreement to which the participant felt each item was present in each of the vignettes. Participants were then asked to rate the overall decision-making (optimal/sub-optimal). Post factor analysis the framework was reduced to a 19 item EDAM measure, and confirmed as two distinct scales of 'Clinical Reasoning' (CR) and 'Midwifery Practice' (MP). The CR scale comprised of two subscales; 'the clinical reasoning process' and 'integration and intervention'. The MP scale also comprised two subscales; women's relationship with the midwife' and 'general

Islamic Schools in Three Western Countries: Policy and Procedure

ERIC Educational Resources Information Center

Merry, Michael S.; Driessen, Geert

2005-01-01

In this article, the authors compare Islamic schools in three countries: the United States, the Netherlands, and Belgium. In each country, the authors take care to situate Islamic schools within the broader context of educational policy and practice. In particular, the authors examine the mechanisms for funding, choice and control, noting that for…

Geriatric dentistry education and context in a selection of countries in 5 continents.

PubMed

Marchini, Leonardo; Ettinger, Ronald; Chen, Xi; Kossioni, Anastassia; Tan, Haiping; Tada, Sayaka; Ikebe, Kazunori; Dosumu, Elizabeth Bosede; Oginni, Fadekemi O; Akeredolu, Patricia Adetokunbo; Butali, Azeez; Donnelly, Leeann; Brondani, Mario; Fritzsch, Bernd; Adeola, Henry A

2018-05-01

To summarize and discuss how geriatric dentistry has been addressed in dental schools of different countries regarding to (1) teaching students at the predoctoral level; (2) advanced training, and (3) research. A convenience sample of faculty members from a selection of high, upper-middle and lower-middle income countries were recruited to complete the survey. The survey had 5 open-ended main topics, and asked about (1) the size of their elderly population, (2) general information about dental education; (3) the number of dental schools teaching geriatric dentistry, and their teaching methods; (4) advanced training in geriatric dentistry; (5) scholarship/research in geriatric dentistry. (1) There is great variation in the size of elderly population; (2) duration of training and content of dental education curriculum varies; (3) geriatric dentistry has not been established as a standalone course in dental schools in the majority of the countries, (4) most countries, with the exception of Japan, lack adequate number of dentists trained in geriatric dentistry as well as training programs, and (5) geriatric dentistry-related research has increased in recent years in scope and content, although the majority of these papers are not in English. © 2018 Special Care Dentistry Association and Wiley Periodicals, Inc.

Country logistics performance and disaster impact.

PubMed

Vaillancourt, Alain; Haavisto, Ira

2016-04-01

The aim of this paper is to deepen the understanding of the relationship between country logistics performance and disaster impact. The relationship is analysed through correlation analysis and regression models for 117 countries for the years 2007 to 2012 with disaster impact variables from the International Disaster Database (EM-DAT) and logistics performance indicators from the World Bank. The results show a significant relationship between country logistics performance and disaster impact overall and for five out of six specific logistic performance indicators. These specific indicators were further used to explore the relationship between country logistic performance and disaster impact for three specific disaster types (epidemic, flood and storm). The findings enhance the understanding of the role of logistics in a humanitarian context with empirical evidence of the importance of country logistics performance in disaster response operations. © 2016 The Author(s). Disasters © Overseas Development Institute, 2016.

Social determinants of health and tobacco use in thirteen low and middle income countries: evidence from Global Adult Tobacco Survey.

PubMed

Palipudi, Krishna M; Gupta, Prakash C; Sinha, Dhirendra N; Andes, Linda J; Asma, Samira; McAfee, Tim

2012-01-01

Tobacco use has been identified as the single biggest cause of inequality in morbidity. The objective of this study is to examine the role of social determinants on current tobacco use in thirteen low-and-middle income countries. We used nationally representative data from the Global Adult Tobacco Survey (GATS) conducted during 2008-2010 in 13 low-and-middle income countries: Bangladesh, China, Egypt, India, Mexico, Philippines, Poland, Russian Federation, Thailand, Turkey, Ukraine, Uruguay, and Viet Nam. These surveys provided information on 209,027 respondent's aged 15 years and above and the country datasets were analyzed individually for estimating current tobacco use across various socio-demographic factors (gender, age, place of residence, education, wealth index, and knowledge on harmful effects of smoking). Multiple logistic regression analysis was used to predict the impact of these determinants on current tobacco use status. Current tobacco use was defined as current smoking or use of smokeless tobacco, either daily or occasionally. Former smokers were excluded from the analysis. Adjusted odds ratios for current tobacco use after controlling other cofactors, was significantly higher for males across all countries and for urban areas in eight of the 13 countries. For educational level, the trend was significant in Bangladesh, Egypt, India, Philippines and Thailand demonstrating decreasing prevalence of tobacco use with increasing levels of education. For wealth index, the trend of decreasing prevalence of tobacco use with increasing wealth was significant for Bangladesh, India, Philippines, Thailand, Turkey, Ukraine, Uruguay and Viet Nam. The trend of decreasing prevalence with increasing levels of knowledge on harmful effects of smoking was significant in China, India, Philippines, Poland, Russian Federation, Thailand, Ukraine and Viet Nam. These findings demonstrate a significant but varied role of social determinants on current tobacco use within and

The economic determinants of land degradation in developing countries

PubMed Central

Barbier, E. B.

1997-01-01

The following paper investigates the economic determinants of land degradation in developing countries. The main trends examined are rural households' decisions to degrade as opposed to conserve land resources, and the expansion of frontier agricultural activity that contributes to forest and marginal land conversion. These two phenomena appear often to be linked. In many developing areas, a poor rural household's decision whether to undertake long-term investment in improving existing agricultural land must be weighed against the decision to abandon this land and migrate to environmentally fragile areas. Economic factors play a critical role in determining these relationships. Poverty, imperfect capital markets and insecure land tenure may reinforce the tendency towards short-term time horizons in production decisions, and may bias land use decisions against long-term land management strategies. In periods of commodity booms and land speculation, wealthier households generally take advantage of their superior political and market power to ensure initial access to better quality resources, in order to capture a larger share of the resource rents. Poorer households are confined either to marginal environmental areas where resource rents are limited, or only have access to resources once they are degraded and rents dissipated.
Overall trends in land degradation and deforestation are examined, followed by an overview of rural households' resource management decisions with respect to land management, frontier agricultural expansion, and migration from existing agricultural land to frontiers. Finally, the discussion focuses on the scope for policy improvements to reduce economic constraints to effective land management.

Oral health workforce planning part 2: figures, determinants and trends in a sample of World Dental Federation member countries.

PubMed

Yamalik, Nermin; Ensaldo-Carrasco, Eduardo; Cavalle, Edoardo; Kell, Kathyrn

2014-06-01

A range of factors needs to be taken into account for an ideal oral health workforce plan. The figures related to dentists, specialists, auxiliaries, practice patterns, undergraduate and continuing dental education, laws/regulations, the attitudes of oral health-care providers and the general trends affecting the practice patterns, work conditions and preferences of oral health-care providers are among such determinants. Thus, the aim of the present study was to gather such information from a sample of World Dental Federation (FDI) member countries with different characteristics. A cross-sectional survey study was carried out among a sample of FDI member countries between March 2, 2012 and March 27, 2012. A questionnaire was developed addressing some main determinants of oral health workforce, such as its structure, involvement of the public/private sector to provide oral health-care services, specialty services, dental schools, trends in workforce and compliance with oral health needs, and a descriptive analysis was performed. The countries were classified as developed and developing countries and Mann-Whitney U-tests and chi-square tests were used to identify potential significant differences (P > 0.05) between developed and developing countries. All data were processed in SPSS v.19. In the18 questionnaires processed, the median number of dentists (P = 0.005), dental practices (P = 0.002), hygienists (P = 0.005), technicians (P = 0.013) and graduates per year (P = 0.037) was higher in developed countries. Only 12.5% of developed and 22.2% of developing countries reported having optimal number of graduates per year. It was noted that 66.7% of developing countries had more regions lacking enough dentists to meet the demand (P = 0.050) and 77.8% lacked the necessary specialist care (P = 0.015). Although developing countries reported mostly an oversupply of dentists, regardless of the level of development most countries did not report an oversupply of specialists

Localization of determinants of fertility through measurement adaptations in developing-country settings: The case of Iran: Comment on "Analysis of economic determinants of fertility in Iran: a multilevel approach".

PubMed

Erfani, Amir

2014-12-01

Studies investigating fertility decline in developing countries often adopt measures of determinants of fertility behavior developed based on observations from developed countries, without adapting them to the realities of the study setting. As a result, their findings are usually invalid, anomalous or statistically non-significant. This commentary draws on the research article by Moeeni and colleagues, as an exemplary work which has not adapted measures of two key economic determinants of fertility behavior, namely gender inequality and opportunity costs of childbearing, to the realities of Iran's economy. Measurement adaptations that can improve the study are discussed.

Changes in the social context and conduct of eating in four Nordic countries between 1997 and 2012.

PubMed

Holm, Lotte; Lauridsen, Drude; Lund, Thomas Bøker; Gronow, Jukka; Niva, Mari; Mäkelä, Johanna

2016-08-01

How have eating patterns changed in modern life? In public and academic debate concern has been expressed that the social function of eating may be challenged by de-structuration and the dissolution of traditions. We analyzed changes in the social context and conduct of eating in four Nordic countries over the period 1997-2012. We focused on three interlinked processes often claimed to be distinctive of modern eating: delocalization of eating from private households to commercial settings, individualization in the form of more eating alone, and informalization, implying more casual codes of conduct. We based the analysis on data from two surveys conducted in Denmark, Finland, Norway and Sweden in 1997 and 2012. The surveys reported in detail one day of eating in representative samples of adult populations in the four countries (N = 4823 and N = 8242). We compared data regarding where, with whom, and for how long people ate, and whether parallel activities took place while eating. While Nordic people's primary location for eating remained the home and the workplace, the practices of eating in haste, and while watching television increased and using tablets, computers and smartphones while eating was frequent in 2012. Propensity to eat alone increased slightly in Denmark and Norway, and decreased slightly in Sweden. While such practices vary with socio-economic background, regression analysis showed several changes were common across the Nordic populations. However, the new practice of using tablets, computers, and smartphones while eating was strongly associated with young age. Further, each of the practices appeared to be related to different types of meal. We conclude that while the changes in the social organization of eating were not dramatic, signs of individualization and informalization could be detected. Copyright © 2016 Elsevier Ltd. All rights reserved.

Testing the relationship between personality characteristics, contextual factors and entrepreneurial intentions in a developing country.

PubMed

Karimi, Saeid; Biemans, Harm J A; Naderi Mahdei, Karim; Lans, Thomas; Chizari, Mohammad; Mulder, Martin

2017-06-01

Drawing upon the theory of planned behaviour (TPB), we developed and tested a conceptual model which integrates both internal personality factors and external contextual factors to determine their associations with motivational factors and entrepreneurial intentions (EIs). We then investigated if the model of EI applies in a developing country, namely Iran. We also set out to identify the most relevant factors for EI within this developing country context. Do distal predictors of EI including personality factors (i.e. need for achievement, risk taking and locus of control) and contextual factors (i.e. perceived barriers and support) significantly relate to EI via proximal predictors including motivational factors (i.e. attitudes towards entrepreneurship and perceived behavioural control [PBC])? Data were collected on 331 students from 7 public universities. The findings support the TPB for EI in Iran. All three motivational factors related to EI, but PBC showed the strongest association, which is different than in developed country contexts. Possible explanations for these differences are discussed. All three personality characteristics indirectly related to EI via the proximal attitudes towards entrepreneurship and PBC. Perceived contextual support and barriers indirectly related to EI via proximal PBC while perceived barriers also directly related to EI. © 2015 International Union of Psychological Science.

Determinants of Women's Education in the Middle East and North Africa: Illustrations from Seven Countries. PHREE Background Paper Series.

ERIC Educational Resources Information Center

El-Sanabary, Nagat

Despite considerable progress by Middle Eastern and North African countries in improving opportunities for women to access and attain education at all levels, much remains to be done. This report focuses on three sets of highly inter-related determinants of access, achievement, and outcome--macro-level societal determinants, school…

Does Context Matter? Literacy Disparities in Self-rated Health Using Evidence from 17 Developed Countries.

PubMed

Lee, Yeonjin

2017-05-01

The study examines whether adult literacy skills predict self-rated health status beyond educational credentials in 17 developed countries using a cross-national survey, the Programme for the International Assessment of Adult Competencies (PIAAC). The study uses linear regression models with country-level fixed effects to predict self-rated health to account the unobserved country-level heterogeneity. A total of 73,806 respondents aged 25 to 65 were included in the analysis. Although adult literacy is positively associated with better self-rated health in general, the strength of the relationship varies across nations. The literacy-related health inequalities are less severe in countries with the higher public share of health expenditures that may better address the needs of individuals with limited cognitive abilities. Curriculum standardization also contributes to reducing the literacy gradients in health by decreasing variations in skills obtained in school across individuals with different social origins. Overall, this study reveals that promoting equity in adult literacy skills is an important way to improve a population's health. Country-level differences in the strength of the relationship between literacy and self-rated health are systematically related to between-country differences in health financing and educational systems.

Exploring the Global/Local Boundary in Education in Developing Countries: The Case of the Caribbean

ERIC Educational Resources Information Center

George, June; Lewis, Theodore

2011-01-01

This article focuses on education in developing countries in the context of globalization and with specific reference to the Caribbean. It examines the concept of globalization and related concepts and positions developing countries within this context. It explores the possibility of the creation of a third space where the local and the global can…

Using theories of behaviour to understand transfusion prescribing in three clinical contexts in two countries: development work for an implementation trial.

PubMed

Francis, Jill J; Tinmouth, Alan; Stanworth, Simon J; Grimshaw, Jeremy M; Johnston, Marie; Hyde, Chris; Stockton, Charlotte; Brehaut, Jamie C; Fergusson, Dean; Eccles, Martin P

2009-10-24

Blood transfusion is an essential part of healthcare and can improve patient outcomes. However, like most therapies, it is also associated with significant clinical risks. In addition, there is some evidence of overuse. Understanding the potential barriers and enablers to reduced prescribing of blood products will facilitate the selection of intervention components likely to be effective, thereby reducing the number of costly trials evaluating different implementation strategies. Using a theoretical basis to understand behaviours targeted for change will contribute to a 'basic science' relating to determinants of professional behaviour and how these inform the selection of techniques for changing behaviour. However, it is not clear which theories of behaviour are relevant to clinicians' transfusing behaviour. The aim of this study is to use a theoretical domains framework to identify relevant theories, and to use these theories to identify factors that predict the decision to transfuse. The study involves two steps: interview study and questionnaire study. Using a previously identified framework, we will conduct semi-structured interviews with clinicians to elicit their views about which factors are associated with waiting and further monitoring the patient rather than transfusing red blood cells. Interviews will cover the following theoretical domains: knowledge; skills; social/professional role and identity; beliefs about capabilities; beliefs about consequences; motivation and goals; memory, attention, and decision processes; environmental context and resources; social influences; emotion; behavioural regulation; nature of the behaviour. The interviews will take place independently in Canada and the UK and involve two groups of physicians in each country (UK: adult and neonatal intensive care physicians; Canada: intensive care physicians and orthopaedic surgeons). We will: analyse interview transcript content to select relevant theoretical domains; use consensus

Linking national contexts with intellectual capital: a comparison between Spain and Morocco.

PubMed

Cegarra-Navarro, Juan-Gabriel; Sánchez-Polo, Maria Teresa

2010-05-01

The 'national environment', which includes belief and value systems, shapes the way individuals, groups and organisations perceive the world around them and determines how they react to ongoing changes. This paper analyses the role of different context's effects on intellectual capital by means of an empirical investigation of 112 Small to Medium sized Enterprises (SMEs) in the Spanish and Moroccan telecommunication industries. Within the investigation, repeated ANOVA were used, which were validated by factor analysis. Results support that Spanish SMEs are more positively associated with higher levels of human, structural and relational capital. The meaningful differences are clearly found in the 'structural capital'. Our findings open avenues for further research to explore how governments can facilitate learning and unlearning environments in SME communities. These findings have important implications for general intellectual capital theories, as they suggest that there is no guarantee that intellectual capital theories developed within the cultural context of one particular country can be applied in another with good effect. National contexts provide the environment for learning, which in turn may have the effect of adequately improving intellectual capital.

Migration as a form of workforce attrition: a nine-country study of pharmacists

PubMed Central

Wuliji, Tana; Carter, Sarah; Bates, Ian

2009-01-01

Background There is a lack of evidence to inform policy development on the reasons why health professionals migrate. Few studies have sought to empirically determine factors influencing the intention to migrate and none have explored the relationship between factors. This paper reports on the first international attempt to investigate the migration intentions of pharmacy students and identify migration factors and their relationships. Methods Responses were gathered from 791 final-year pharmacy students from nine countries: Australia, Bangladesh, Croatia, Egypt, Portugal, Nepal, Singapore, Slovenia and Zimbabwe. Data were analysed by means of Principal Components Analysis (PCA) and two-step cluster analysis to determine the relationships between factors influencing migration and the characteristics of subpopulations most likely and least likely to migrate. Results Results showed a significant difference in attitudes towards the professional and sociopolitical environment of the home country and perceptions of opportunities abroad between those who have no intention of migrating and those who intend to migrate on a long-term basis. Attitudes of students planning short-term migration were not significantly different from those of students who did not intend to migrate. These attitudes, together with gender, knowledge of other migrant pharmacists and past experiences abroad, are associated with an increased propensity for migration. Conclusion Given the influence of the country context and environment on migration intentions, research and policy should frame the issue of migration in the context of the wider human resource agenda, thus viewing migration as one form of attrition and a symptom of other root causes. Remuneration is not an independent stand-alone factor influencing migration intentions and cannot be decoupled from professional development factors. Comprehensive human resource policy development that takes into account the issues of both remuneration and

The eHealth agenda for developing countries.

PubMed

Drury, Peter

2005-01-01

Delivering eHealth in developing countries faces different health and socio-economic challenges to the developed one. But, if a global health infrastructure is to evolve, then developing countries need to play their part. So, whilst the context may differ, the localization-globalization of content issues needs to be jointly addressed. In providing robust and affordable connectivity, particularly to rural areas, developing countries can fully exploit the potential of handheld computers and wireless connectivity. Over such an infrastructure new ways of building capacity, both locally and globally, can be supported. Finally, an eHealth infrastructure can support the delivery of healthcare in communities, thereby supporting individuals and community development.

Gender differences in public and private drinking contexts: a multi-level GENACIS analysis.

PubMed

Bond, Jason C; Roberts, Sarah C M; Greenfield, Thomas K; Korcha, Rachael; Ye, Yu; Nayak, Madhabika B

2010-05-01

This multi-national study hypothesized that higher levels of country-level gender equality would predict smaller differences in the frequency of women's compared to men's drinking in public (like bars and restaurants) settings and possibly private (home or party) settings. GENACIS project survey data with drinking contexts included 22 countries in Europe (8); the Americas (7); Asia (3); Australasia (2), and Africa (2), analyzed using hierarchical linear models (individuals nested within country). Age, gender and marital status were individual predictors; country-level gender equality as well as equality in economic participation, education, and political participation, and reproductive autonomy and context of violence against women measures were country-level variables. In separate models, more reproductive autonomy, economic participation, and educational attainment and less violence against women predicted smaller differences in drinking in public settings. Once controlling for country-level economic status, only equality in economic participation predicted the size of the gender difference. Most country-level variables did not explain the gender difference in frequency of drinking in private settings. Where gender equality predicted this difference, the direction of the findings was opposite from the direction in public settings, with more equality predicting a larger gender difference, although this relationship was no longer significant after controlling for country-level economic status. Findings suggest that country-level gender equality may influence gender differences in drinking. However, the effects of gender equality on drinking may depend on the specific alcohol measure, in this case drinking context, as well as on the aspect of gender equality considered. Similar studies that use only global measures of gender equality may miss key relationships. We consider potential implications for alcohol related consequences, policy and public health.

Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings.

PubMed

Bergström, Anna; Skeen, Sarah; Duc, Duong M; Blandon, Elmer Zelaya; Estabrooks, Carole; Gustavsson, Petter; Hoa, Dinh Thi Phuong; Källestål, Carina; Målqvist, Mats; Nga, Nguyen Thu; Persson, Lars-Åke; Pervin, Jesmin; Peterson, Stefan; Rahman, Anisur; Selling, Katarina; Squires, Janet E; Tomlinson, Mark; Waiswa, Peter; Wallin, Lars

2015-08-15

The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow

The extinction context enables extinction performance after a change in context

PubMed Central

Nelson, James Byron; Gregory, Pamela; Sanjuan, Maria del Carmen

2012-01-01

One experiment with human participants determined the extent to which recovery of extinguished responding with a context switch was due to a failure to retrieve contextually-controlled learning, or some other process such as participants learning that context changes signal reversals in the meaning of stimulus – outcome relationships. In a video game, participants learned to suppress mouse clicking in the presence of a stimulus that predicted an attack. Then, that stimulus underwent extinction in a different context (environment within the game). Following extinction, suppression was recovered and then extinguished again during testing in the conditioning context. In a final test, participants that were tested in the context where extinction first took place showed less of a recovery than those tested in a neutral context, but they showed a recovery of suppression nevertheless. A change in context tended to cause a change in the meaning of the stimulus, leading to recovery in both the neutral and extinction contexts. The extinction context attenuated that recovery, perhaps by enabling retrieval of the learning that took place in extinction. Recovery outside an extinction context is due to a failure of the context to enable the learning acquired during extinction, but only in part. PMID:22521549

Outcome of schizophrenia: some transcultural observations with particular reference to developing countries.

PubMed

Kulhara, P

1994-01-01

The present paper provides a description of data based and methodologically sound studies of outcome of schizophrenia from developing and non-Western countries and compares the results. Major studies reviewed include the 2- and 5-year follow-up of the cohort of the International Pilot Study of Schizophrenia, the patients of the World Health Organization Collaborative Study on the Determinants of Outcome of Severe Mental Disorders, a few Indian studies including the study sponsored by the Indian Council of Medical Research and some studies from Colombia and South-East Asia. The studies are compared in terms of the quality of methodology and the rate of attrition. Although the outcome criteria of these studies are not similar, it is obvious that the outcome of schizophrenia in developing countries is generally more favourable. The reasons for this are far from clear. Research concerning the issues pertaining to better outcome of schizophrenia in developing countries in the context of socio-cultural differences in woefully lacking. This is an area that deserves research attention.

Implementation of mobile satellite services in developing countries: The Mexican experience

NASA Technical Reports Server (NTRS)

Reimers, Alexis; Weitzner, Jorge

1990-01-01

An analysis of the differences between Developing Countries (DCs) and Industrialized Countries (ICs), in the context of Mobile Satellite Services (MSSs) providers and regulators, is presented. Additionally, a series of recommendations that may improve the odds for a successful implementation of MSSs in DCs are provided.

Association between Integration Policies and Immigrants’ Mortality: An Explorative Study across Three European Countries

PubMed Central

Ikram, Umar Z.; Malmusi, Davide; Juel, Knud; Rey, Grégoire; Kunst, Anton E.

2015-01-01

Background To integrate immigrants into their societies, European countries have adopted different types of policies, which may influence health through both material and psychosocial determinants. Recent studies have suggested poorer health outcomes for immigrants living in countries with poorly rated integration policies. Objective To analyse mortality differences of immigrants from the same country of origin living in countries with distinct integration policy contexts. Methods From the mortality dataset collected in the Migrant Ethnic Health Observatory (MEHO) project, we chose the Netherlands (linked data from 1996-2006), France (unlinked; 2005-2007) and Denmark (linked; 1992-2001) as representatives of the inclusive, assimilationist and exclusionist policy models, respectively, based on the Migrant Integration Policy Index. We calculated for each country sex- and age-standardized mortality rates for Turkish-, Moroccan- and local-born populations aged 20-69 years. Poisson regression was used to estimate the mortality rate ratios (MRRs) for cross-country and within-country comparisons. The analyses were further stratified by age group and cause of death. Results Compared with their peers in the Netherlands, Turkish-born immigrants had higher all-cause mortality in Denmark (MRR men 1.92; 95% CI 1.74-2.13 and women 2.11; 1.80-2.47) but lower in France (men 0.64; 0.59-0.69 and women 0.58; 0.51-0.67). A similar pattern emerged for Moroccan-born immigrants. The relative differences between immigrants and the local-born population were also largest in Denmark and lowest in France (e.g., Turkish-born men MRR 1.52; 95% CI 1.38-1.67 and 0.62; 0.58-0.66, respectively). These patterns were consistent across all age groups, and more marked for cardiovascular diseases. Conclusions Although confounders and data comparability issues (e.g., French cross-sectional data) may affect the findings, this study suggests that different macro-level policy contexts may influence

Finding the "Right-Size" Physical Therapy Workforce: International Perspective Across 4 Countries.

PubMed

Jesus, Tiago S; Koh, Gerald; Landry, Michel; Ong, Peck-Hoon; Lopes, António M F; Green, Peter L; Hoenig, Helen

2016-10-01

Finding the "right-size" physical therapy workforce is an increasingly important issue, but it has had limited study, particularly across nations. This perspective article provides a comprehensive examination of physical therapy workforce issues across 4 countries (United States, Singapore, Portugal, and Bangladesh), which were deliberately selected to allow consideration of key contextual factors. This investigation provides a theoretical model uniquely adapted to focus on variables most likely to affect physical therapy workforce needs. This theoretical model was used to guide acquisition of public domain data across the respective countries. The data then were used to provide a contextualized interpretation about the physical therapy workforce supply (ie, physical therapists per capita) across the 4 countries in light of the following factors: indicators of physical therapy need, financial and administrative barriers affecting physical therapy access and demand, the proportion of physical therapy graduates (with varying trends over time across the countries), and the role of emigration/immigration in supply inequalities among countries of lower and higher income. In addition, both the physical therapy workforce supply and scope of practice were analyzed in the context of other related professions across the 4 countries. This international comparison indicated that there may not be a "one-size-fits-all" recommendation for physical therapy workforce supply across countries or an ideal formula for its determination. The optimal, country-specific physical therapy workforce supply appears to be affected by discipline-specific health care and contextual factors that may vary across countries, and even within the same country. This article provides a conceptual framework and basis for such contextualized evaluations of the physical therapy workforce. © 2016 American Physical Therapy Association.

School Inspections in Low- and Middle-Income Countries: Explaining Impact and Mechanisms of Impact

ERIC Educational Resources Information Center

Ehren, Melanie C. M.; Eddy-Spicer, David; Bangpan, Mukdarut; Reid, Andy

2017-01-01

Many efforts to implement and improve school inspections have been modelled on examples from high-income countries, and many studies on the effectiveness of such systems have also only been carried out in these countries. However, local contexts in low- and middle-income countries are very different from those in developed countries, and findings…

Test selection, adaptation, and evaluation: a systematic approach to assess nutritional influences on child development in developing countries.

PubMed

Prado, Elizabeth L; Hartini, Sri; Rahmawati, Atik; Ismayani, Elfa; Hidayati, Astri; Hikmah, Nurul; Muadz, Husni; Apriatni, Mandri S; Ullman, Michael T; Shankar, Anuraj H; Alcock, Katherine J

2010-03-01

Evaluating the impact of nutrition interventions on developmental outcomes in developing countries can be challenging since most assessment tests have been produced in and for developed country settings. Such tests may not be valid measures of children's abilities when used in a new context. We present several principles for the selection, adaptation, and evaluation of tests assessing the developmental outcomes of nutrition interventions in developing countries where standard assessment tests do not exist. We then report the application of these principles for a nutrition trial on the Indonesian island of Lombok. Three hundred children age 22-55 months in Lombok participated in a series of pilot tests for the purpose of test adaptation and evaluation. Four hundred and eighty-seven 42-month-old children in Lombok were tested on the finalized test battery. The developmental assessment tests were adapted to the local context and evaluated for a number of psychometric properties, including convergent and discriminant validity, which were measured based on multiple regression models with maternal education, depression, and age predicting each test score. The adapted tests demonstrated satisfactory psychometric properties and the expected pattern of relationships with the three maternal variables. Maternal education significantly predicted all scores but one, maternal depression predicted socio-emotional competence, socio-emotional problems, and vocabulary, while maternal age predicted socio-emotional competence only. Following the methodological principles we present resulted in tests that were appropriate for children in Lombok and informative for evaluating the developmental outcomes of nutritional supplementation in the research context. Following this approach in future studies will help to determine which interventions most effectively improve child development in developing countries.

A Latent Class Growth Analysis of School Bullying and Its Social Context: The Self-Determination Theory Perspective

ERIC Educational Resources Information Center

Lam, Shui-fong; Law, Wilbert; Chan, Chi-Keung; Wong, Bernard P. H.; Zhang, Xiao

2015-01-01

The contribution of social context to school bullying was examined from the self-determination theory perspective in this longitudinal study of 536 adolescents from 3 secondary schools in Hong Kong. Latent class growth analysis of the student-reported data at 5 time points from grade 7 to grade 9 identified 4 groups of students: bullies (9.8%),…

Trends in health complaints from 2002 to 2010 in 34 countries and their association with health behaviours and social context factors at individual and macro-level.

PubMed

Ottová-Jordan, Veronika; Smith, Otto R F; Augustine, Lilly; Gobina, Inese; Rathmann, Katharina; Torsheim, Torbjørn; Mazur, Joanna; Välimaa, Raili; Cavallo, Franco; Jericek Klanscek, Helena; Vollebergh, Wilma; Meilstrup, Charlotte; Richter, Matthias; Moor, Irene; Ravens-Sieberer, Ulrike

2015-04-01

This article describes trends and stability over time in health complaints in adolescents from 2002 to 2010 and investigates associations between health complaints, behavioural and social contextual factors at individual level and economic factors at macro-level. Comprising N = 510 876 11-, 13- and 15-year-old children and adolescents in Europe, North America and Israel, data came from three survey cycles of the international Health Behaviour in School-aged Children (HBSC) study. Age- and gender-adjusted trends in health complaints were examined in each country by means of linear regression. By using the country as the random effects variable, we tested to what extent individual and contextual variables were associated with health complaints. Significant associations are stronger for individual level determinants (e.g. being bullied, smoking) than for determinants at macro-level (e.g. GDP, Gini), as can be seen by the small effect sizes (less than 5% for different trends). Health complaints are fairly stable over time in most countries, and no clear international trend in health complaints can be observed between 2002 and 2010. The most prominent stable determinants were being female, being bullied, school pressure and smoking. Factors associated with health complaints are more related to the proximal environment than to distal macro-level factors. This points towards intensifying targeted interventions, (e.g. for bullying) and also targeting specific risk groups. The comparably small effect size at country-level indicates that country-level factors have an impact on health and should not be ignored. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries.

PubMed

2016-01-01

Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally. Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression. This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed. Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas. NCT02179112; Pre-results.

Three countries' experience with Norplant introduction.

PubMed

Hardee, K; Balogh, S; Villinski, M T

1997-09-01

Despite international efforts to plan for Norplant introduction, the method has drawn the attention of critics of family planning programmes, and has raised several issues for debate since it was introduced into family planning programmes. The experiences of three countries with the introduction of Norplant highlight some of the unique features of the method that have affected its introduction. Indonesia, Bangladesh and the United States represent diverse cultural settings and systems of family planning provision. Experience in each country has highlighted the need to focus on quality of care for clients, most notably the need for good counselling and attention to removal as well as insertion. The cost of Norplant also has influenced its introduction in each country. Another issue includes the need to work with women's health advocacy groups, which is illustrated particularly in Bangladesh. Finally, the role of litigation in the United States, and its potential role in influencing Norplant introduction in other countries, is discussed. These three countries' experience illustrate the importance of understanding the programmatic context of contraceptive introduction.

Professional practice models for nurses in low-income countries: an integrative review.

PubMed

Ng'ang'a, Njoki; Byrne, Mary Woods

2015-01-01

Attention is turning to nurses, who form the greatest proportion of health personnel worldwide, to play a greater role in delivering health services amidst a severe human resources for health crisis and overwhelming disease burden in low-income countries. Nurse leaders in low-income countries must consider essential context for nurses to fulfill their professional obligation to deliver safe and reliable health services. Professional practice models (PPMs) have been proposed as a framework for strategically positioning nurses to impact health outcomes. PPMs comprise 5 elements: professional values, patient care delivery systems, professional relationships, management approach and remuneration. In this paper, we synthesize the existing literature on PPMs for nurses in low-income countries. An integrative review of CINAHL-EBSCO, PubMed and Scopus databases for English language journal articles published after 1990. Search terms included nurses, professionalism, professional practice models, low-income countries, developing countries and relevant Medical Subject Heading Terms (MeSH). Sixty nine articles published between 1993 and 2014 were included in the review. Twenty seven articles examined patient care delivery models, 17 professional relationships, 12 professional values, 11 remuneration and 1 management approach. One article looked at comprehensive PPMs. Adopting comprehensive PPMs or their components can be a strategy to exploit the capacity of nurses and provide a framework for determining the full expression of the nursing role.

Children's Weekend Activities in Four Countries: Context for Personal and Social Development

ERIC Educational Resources Information Center

Ozdogru, Asil Ali

2010-01-01

Out-of-school time constitutes a major context of social and emotional development for children across cultures. Because it is not constrained by school attendance, weekend time allows cultural and gender differences in time usage to emerge. In this study, children's weekend activities, choice, and some of the related emotional outcomes were…

Estimates of performance in the rate of decline of under-five mortality for 113 low- and middle-income countries, 1970-2010.

PubMed

Verguet, Stéphane; Jamison, Dean T

2014-03-01

BACKGROUND; Measuring country performance in health has focused on assessing predicted vs observed levels of outcomes, an indicator that varies slowly over time. An alternative is to measure performance in terms of the rate of change in how a selected outcome compares to what would be expected given contextual determinants. Rates of change in health indicators can prove more sensitive than levels to changes in social, intersectoral or health policy context. It is thus similar to the growth rate of gross domestic product in the economic context. We assess performance in the rate of change (decline) of under-five mortality for 113 low- and middle-income countries. For 1970-2010, we study the evolution in rates of decline of under-five mortality. For each decade, we define performance as the average of the difference between the observed rate of decline and a rate of decline predicted by a model controlling for the contextual factors of income, female education levels, decade and geographical location. In the 1970s, the top performer in the rate of decline of under-five mortality was Costa Rica. In the 2000s, the top performer was Turkey. Overall, performance in rates of decline correlated little with performance in levels of under-five mortality. A major transition in performance between decades suggests a change in underlying determinants and we report the magnitude of these transitions. For example, heavily AIDS impacted countries, such as Botswana, experienced major drops in performance between the 1980s and the 1990s and some, including Botswana, experienced major compensatory improvements between the 1990s and the 2000s. Rate-based measures of country performance in health provide a starting point for assessments of the importance of health system, social and intersectoral determinants of performance.

Socio-Economic and Health Access Determinants of Breast and Cervical Cancer Screening in Low-Income Countries: Analysis of the World Health Survey

PubMed Central

Akinyemiju, Tomi F.

2012-01-01

Background Breast and Cervical cancer are the two most common cancers among women in developing countries. Regular screening is the most effective way of ensuring that these cancers are detected at early stages; however few studies have assessed factors that predict cancer screening in developing countries. Purpose To assess the influence of household socio-economic status (SES), healthcare access and country level characteristics on breast and cervical cancer screening among women in developing countries. Methods Women ages 18–69 years (cervical cancer screening) and 40–69 years (breast cancer screening) from 15 developing countries who participated in the 2003 World Health Survey provided data for this study. Household SES and healthcare access was assessed based on self-reported survey responses. SAS survey procedures (SAS, Version 9.2) were used to assess determinants of breast and cervical cancer screening in separate models. Results 4.1% of women ages 18–69 years had received cervical cancer screening in the past three years, while only 2.2% of women ages 40–69 years had received breast cancer screening in the past 5 years in developing countries. Cancer screening rates varied by country; cervical cancer screening ranged from 1.1% in Bangladesh to 57.6% in Congo and breast cancer screening ranged from 0% in Mali to 26% in Congo. Significant determinants of cancer screening were household SES, rural residence, country health expenditure (as a percent of GDP) as well as healthcare access. Discussion A lot more needs to be done to improve screening rates for breast and cervical cancer in developing countries, such as increasing health expenditure (especially in rural areas), applying the increased funds towards the provision of more, better educated health providers as well as improved infrastructure. PMID:23155413

Satisfaction of Basic Psychological Needs, Self-Determined Exercise Motivation, and Psychological Well-Being in Mothers Exercising in Group-Based Versus Individual-Based Contexts.

PubMed

Lovell, Geoff P; Gordon, James A R; Mueller, Marcus B; Mulgrew, Kate; Sharman, Rachael

2016-01-01

We compared mothers who exercised predominantly in group settings, those who exercised predominantly in individual settings, and those who exercised equally in group and individual contexts among the following: (a) satisfaction of basic psychological needs (autonomy, competence, and relatedness); (b) self-determined exercise motivation; and (c) psychological well-being. With clear implications for mothers' exercise interventions we found that exercising either predominantly in group contexts or in mixed group and individual settings was associated with mothers having significantly higher satisfaction of basic psychological needs and self-determined exercise motivation than those exercising predominantly alone.

Quantitative evaluation of Iranian radiology papers and its comparison with selected countries.

PubMed

Ghafoori, Mahyar; Emami, Hasan; Sedaghat, Abdolrasoul; Ghiasi, Mohammad; Shakiba, Madjid; Alavi, Manijeh

2014-01-01

Recent technological developments in medicine, including modern radiology have promoted the impact of scientific researches on social life. The scientific outputs such as article and patents are products that show the scientists' attempt to access these achievements. In the current study, we evaluate the current situation of Iranian scientists in the field of radiology and compare it with the selected countries in terms of scientific papers. For this purpose, we used scientometric tools to quantitatively assess the scientific papers in the field of radiology. Radiology papers were evaluated in the context of medical field audit using retrospective model. We used the related databases of biomedical sciences for extraction of articles related to radiology. In the next step, the situation of radiology scientific products of the country were determined with respect to the under study regional countries. Results of the current study showed a ratio of 0.19% for Iranian papers in PubMed database published in 2009. In addition, in 2009, Iranian papers constituted 0.29% of the Scopus scientific database. The proportion of Iranian papers in the understudy region was 7.6%. To diminish the gap between Iranian scientific radiology papers and other competitor countries in the region and achievement of document 2025 goals, multifold effort of the society of radiology is necessary.

Determinants of cognitive function in childhood: A cohort study in a middle income context

PubMed Central

Santos, Darci N; Assis, Ana Marlúcia O; Bastos, Ana Cecília S; Santos, Letícia M; Santos, Carlos Antonio ST; Strina, Agostino; Prado, Matildes S; Almeida-Filho, Naomar M; Rodrigues, Laura C; Barreto, Mauricio L

2008-01-01

Background There is evidence that poverty, health and nutrition affect children's cognitive development. This study aimed to examine the relative contributions of both proximal and distal risk factors on child cognitive development, by breaking down the possible causal pathways through which poverty affects cognition. Methods This cohort study collected data on family socioeconomic status, household and neighbourhood environmental conditions, child health and nutritional status, psychosocial stimulation and nursery school attendance. The effect of these on Wechsler Pre-School and Primary Scale of Intelligence scores at five years of age was investigated using a multivariable hierarchical analysis, guided by the proposed conceptual framework. Results Unfavourable socioeconomic conditions, poorly educated mother, absent father, poor sanitary conditions at home and in the neighbourhood and low birth weight were negatively associated with cognitive performance at five years of age, while strong positive associations were found with high levels of domestic stimulation and nursery school attendance. Conclusion Children's cognitive development in urban contexts in developing countries could be substantially increased by interventions promoting early psychosocial stimulation and preschool experience, together with efforts to prevent low birth weight and promote adequate nutritional status. PMID:18534035

Context effects: the role of collectivism as a moderator.

PubMed

Puente-Díaz, Rogelio

2011-02-01

Social cognition experts have shown that participants' answers to research questions can be influenced by previous questions, something known as context effects. It has been suggested that participants from collectivist cultures pay more attention to the context, resulting in larger context effects. The present investigation examined context effects in an experiment that involved manipulating the order in which two questions, one about satisfaction with life as a whole and one about satisfaction with romantic life, were answered by a representative sample of participants from Mexico City. The results were consistent with other investigations that used samples from collectivistic cultures. Participants' responses to questions about satisfaction are influenced by a previous question, and country of origin affects the amount of attention given to the context. The implications of these results are discussed.

Levels and determinants of switching following intrauterine device discontinuation in 14 developing countries.

PubMed

Ali, Mohamed M; Park, Min Hae; Ngo, Thoai D

2014-07-01

To examine the levels and determinants of switching to any reversible modern contraceptive method following intrauterine device (IUD) discontinuation due to method-related reasons among women in developing countries. We analysed 5-year contraceptive calendar data from 14 Demographic and Health Surveys, conducted in 1993-2008 (n=218,092 women; 17,151 women contributed a total of 18,485 IUD episodes). Life-table methods were used to determine overall and cause-specific probabilities of IUD discontinuation at 12 months of use. For IUD episodes discontinued due to method-related reasons, the probability of switching to another reversible modern method within 3 months was estimated, overall and by place of residence, education level, motivation for use, age category and wealth tertiles. Country-specific rate ratios (RR) were estimated using generalized linear models, and pooled RRs using meta-analyses. The median duration of uninterrupted IUD use was 37 months. At 12 months, median probability of discontinuation was 13.2% and median probability of discontinuation due to method-related reasons was 8.9%. Within 3 months of discontinuation due to method-related reasons, half of the women had switched to another reversible modern method, 12% switched to traditional methods, 12% became pregnant, and 25% remained at risk for pregnancy. More educated women were more likely to switch to another reversible modern method than women with primary education or less (pooled RR 1.47; 95% CI 1.10-1.96), as were women in the highest wealth tertile (pooled RR 1.38; 95% CI 1.04-1.83) and women who were limiting births (pooled RR 1.35; 95% CI 1.08-1.68). Delays to switching and switching to less reliable methods following IUD discontinuation remain a problem, exposing women to the risk of unwanted pregnancy. Family planning programmes should aim to improve quality of services through strengthening of counselling and follow-up services to support women's continuation of effective methods

Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries

PubMed Central

Ademuyiwa, Adesoji O

2016-01-01

Background Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally. Methods Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression. Results This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed. Conclusions Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas. Trial registration number NCT02179112; Pre-results. PMID:28588977

The Challenge of Assessing Microcephaly in the Context of the Zika Virus Epidemic.

PubMed

Quintó, Llorenç; García-Basteiro, Alberto L; Bardají, Azucena; González, Raquel; Padilla, Norma; Martinez-Espinosa, Flor E; Arévalo-Herrera, Myriam; Macete, Eusébio; Menéndez, Clara

2017-03-10

The present article examines the impact of the current limitations of the microcephaly definition in the context of the Zika virus outbreak. It highlights its dependence on the method used for determining gestational age and other anthropometric parameters, and includes original results of prevalence of microcephaly in four countries from two different continents (Mozambique, Brazil, Guatemala and Colombia). Alternative definitions of microcephaly are proposed to allow the identification of true cases of microcephaly in a more accurate manner. © The Author [2017]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

International hospital productivity comparison: experiences from the Nordic countries.

PubMed

Medin, Emma; Häkkinen, Unto; Linna, Miika; Anthun, Kjartan S; Kittelsen, Sverre A C; Rehnberg, Clas

2013-09-01

This article focuses on describing the methodological challenges intrinsic in international comparative studies of hospital productivity and how these challenges have been addressed within the context of hospital comparisons in the Nordic countries. The hospital sectors in the Nordic countries are suitable for international comparison as they exhibit similar structures in the organisation for hospital care, hold administrative data of good quality at the hospital level, apply a similar secondary patient classification system, and use similar definitions of operating costs. The results of a number of studies have suggested marked differences in hospital cost efficiency and hospital productivity across the Nordic countries and the Finnish hospitals have the highest estimates in all the analyses. Explanatory factors that were tested and seemed to be of limited importance included institutional, structural and technical. A factor that is yet to be included in the Nordic hospital productivity comparison is the quality of care. Patient-level data available from linkable national registers in each country enable the development of quality indicators and will be included in the forthcoming hospital productivity studies within the context of the EuroHOPE (European health care outcomes, performance and efficiency) project. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Board task performance: An exploration of micro- and macro-level determinants of board effectiveness

PubMed Central

Minichilli, Alessandro; Zattoni, Alessandro; Nielsen, Sabina; Huse, Morten

2012-01-01

This paper addresses recent calls to narrow the micro–macro gap in management research (Bamberger, 2008), by incorporating a macro-level context variable (country) in exploring micro-level determinants of board effectiveness. Following the integrated model proposed by Forbes and Milliken (1999), we identify three board processes as micro-level determinants of board effectiveness. Specifically, we focus on effort norms, cognitive conflicts and the use of knowledge and skills as determinants of board control and advisory task performance. Further, we consider how two different institutional settings influence board tasks, and how the context moderates the relationship between processes and tasks. Our hypotheses are tested on a survey-based dataset of 535 medium-sized and large industrial firms in Italy and Norway, which are considered to substantially differ along legal and cultural dimensions. The findings show that: (i) Board processes have a larger potential than demographic variables to explain board task performance; (ii) board task performance differs significantly between boards operating in different contexts; and (iii) national context moderates the relationships between board processes and board task performance. Copyright © 2010 John Wiley & Sons, Ltd. PMID:23365485

Access to Strong Opioid Analgesics in the Context of Legal and Regulatory Barriers in Eleven Central and Eastern European Countries.

PubMed

Vranken, Marjolein J M; Mantel-Teeuwisse, Aukje K; Schutjens, Marie-Hélène D B; Scholten, Willem K; Jünger, Saskia; Medic, Dr Rer; Leufkens, Hubert G M

2018-04-06

In 2011-2013, >95% of the global opioid analgesics consumption occurred in three regions, accounting for 15% of the world population. Despite abundant literature on barriers to access, little is known on the correlation between actual access to opioid analgesics and barriers to access, including legal and regulatory barriers. This study aimed to evaluate the correlation between access to strong opioid analgesics and barriers to access in national legislation and regulations in 11 central and eastern European countries that participated in the Access to Opioid Medication in Europe (ATOME) project. Two variables were contrasted to assess their correlation: the country level of access to strong opioid analgesics indicated by the Adequacy of Consumption Measure (ACM) and the number of potential legal and regulatory barriers identified by an external review of legislation and regulations. A linear correlation was evaluated using a squared linear correlation coefficient. Evaluation of the correlation between the ACM and the number of potential barriers produces an R 2 value of 0.023 and a correlation plot trend line gradient of -0.075, indicating no correlation between access to strong opioid analgesics and the number of potential barriers in national legislation and regulations in the countries studied. No correlation was found, which indicates that other factors besides potential legal and regulatory barriers play a critical role in withholding prescribers and patients essential pain medication in the studied countries. More research is needed toward better understanding of the complex interplay of factors that determine access to strong opioid analgesics.

Multilevel models of fertility determination in four Southeast Asian countries: 1970 and 1980.

PubMed

Hirschman, C; Guest, P

1990-08-01

Using microdata from the 1970 and 1980 censuses, we specify and test multilevel models of fertility determination for four Southeast Asian societies--Indonesia, Peninsular Malaysia, the Philippines, and Thailand. Social context is indexed by provincial characteristics representing women's status, the roles of children, and infant mortality. These contextual variables are hypothesized to have direct and indirect (through individual socioeconomic characteristics) effects on current fertility. The contextual variables account for a modest but significant share of individual variation in fertility and about one-half of the total between area variation in fertility. The women's status contextual variables, particularly modern sector employment, have the largest and most consistent effect on lowered fertility. The results based on the other contextual variables provide mixed support for the initial hypotheses.

Are the religious suspicious of science? Investigating religiosity, religious context, and orientations towards science.

PubMed

Chan, Esther

2018-06-01

Are the religious suspicious of science? Drawing on data from 52 nations in the World Values Survey (wave 6) ( N = 58,474), I utilize multilevel models to examine the relationship between religiosity, religious context, and five different orientations towards science: confidence in science, trust in scientific authority under conditions of conflict with religion, faith in science, views on the moral effects of science, and interest in scientific knowledge. Results show that while religiosity is on average negatively associated with the five outcomes, the relationship between religiosity and orientations towards science varies by country such that religiosity is sometimes positively associated with the different outcomes. Religiosity is only consistently negatively associated with trust in scientific authority in all countries and with all orientations towards science in western countries. Finally, differences in orientations towards science also exist across country religious contexts, with countries dominated by the unaffiliated having more positive orientations towards science.

Intercultural Education in the European Context: Key Remarks from a Comparative Study

ERIC Educational Resources Information Center

Catarci, Marco

2014-01-01

The article focuses on some findings of a comparative study carried out by a network of scholars and researchers who are active in the field of intercultural education in the European context in the main "old immigration countries" (United Kingdom, France and Germany), "new immigration countries" (Italy, Spain and Greece) and…

Social Determinants of Infectious Diseases in South Asia

PubMed Central

Bishwajit, Ghose; Ide, Seydou; Ghosh, Sharmistha

2014-01-01

South Asian countries have developed infectious disease control programs such as routine immunization, vaccination, and the provision of essential drugs which are operating nationwide in cooperation with many local and foreign NGOs. Most South Asian countries have a relatively low prevalence of HIV/AIDS until now, but issues like poverty, food insecurity, illiteracy, poor sanitation, and social stigma around AIDS are widespread and are creating formidable challenges to prevention of further spread of this epidemic. Besides that, resurgence of tuberculosis along with the emergence of the drug resistant (MDR-TB and XDRTB) strains and the coepidemic of TB and HIV are posing ever-growing threats to the underdeveloped healthcare infrastructure. The countries are undergoing an epidemiological transition where the disease burden is gradually shifting to noncommunicable diseases, but the infectious diseases still account for almost half of the total disease burden. Despite this huge burden of infectious diseases in South Asia, which is second only to Africa, there is yet any study on the social determinants of infectious diseases in a local context. This paper examines various issues surrounding the social determinants of infectious diseases in South Asian countries with a special reference to HIV and tuberculosis. And, by doing so, it attempts to provide a framework for formulating more efficient prevention and intervention strategies for the future. PMID:27350969

Biologic and social determinants of sequelae and long-term survival of pediatric HIV in Romania.

PubMed

Kozinetz, Claudia A; Matusa, Rodica; Hacker, Carl S

2006-08-01

The aim of the study is to investigate the effect of social context and clinical factors on survival in a cohort of 333 children to identify issues useful in the treatment and care of human immunodeficiency virus (HIV)-infected youth in developing countries. A prospective cohort study design was used, and data were gathered at baseline and 1-year follow-up. The study cohort consisted of children given a diagnosis of HIV between 1995 and 1999 and receiving medical care in Constanta, Romania. Data were examined by means of multivariate Cox regression analysis models. The majority of the cohort were in the moderate (41%) or severe (40%) stages of HIV at baseline. Multivariate analysis indicated that social-context factors were the most significant determinants of HIV survival. The hazard for death for those with mothers or fathers with a higher level of education was approximately one quarter (relative hazard, 0.3-0.4; confidence interval, 0.1-1.0) that for a parent with a lower level of education. Subjects with employed mothers were four times more likely to survive than subjects with unemployed mothers. Results suggest that recognition of social-context risk factors for HIV disease progression and survival is important in developing countries, as it is in developed countries.

The adoption of sustainable remediation behaviour in the US and UK: a cross country comparison and determinant analysis.

PubMed

Hou, Deyi; Al-Tabbaa, Abir; Guthrie, Peter

2014-08-15

The sustainable remediation concept, aimed at maximizing the net environmental, social, and economic benefits in contaminated site remediation, is being increasingly recognized by industry, governments, and academia. However, there is limited understanding of actual sustainable behaviour being adopted and the determinants of such sustainable behaviour. The present study identified 27 sustainable practices in remediation. An online questionnaire survey was used to rank and compare them in the US (n=112) and the UK (n=54). The study also rated ten promoting factors, nine barriers, and 17 types of stakeholders' influences. Subsequently, factor analysis and general linear models were used to determine the effects of internal characteristics (i.e. country, organizational characteristics, professional role, personal experience and belief) and external forces (i.e. promoting factors, barriers, and stakeholder influences). It was found that US and UK practitioners adopted many sustainable practices to similar extents. Both US and UK practitioners perceived the most effectively adopted sustainable practices to be reducing the risk to site workers, protecting groundwater and surface water, and reducing the risk to the local community. Comparing the two countries, we found that the US adopted innovative in-situ remediation more effectively; while the UK adopted reuse, recycling, and minimizing material usage more effectively. As for the overall determinants of sustainable remediation, the country of origin was found not to be a significant determinant. Instead, organizational policy was found to be the most important internal characteristic. It had a significant positive effect on reducing distant environmental impact, sustainable resource usage, and reducing remediation cost and time (p<0.01). Customer competitive pressure was found to be the most extensively significant external force. In comparison, perceived stakeholder influence, especially that of primary stakeholders

Determining the utility and durability of medical equipment donated to a rural clinic in a low-income country

PubMed Central

Bauserman, Melissa; Hailey, Claire; Gado, Justin; Lokangaka, Adrien; Williams, Jessica; Richards-Kortum, Rebecca; Tshefu, Antoinette; Bose, Carl

2015-01-01

Background Health centers in low-income countries often depend on donations to provide appropriate diagnostic equipment. However, donations are sometimes made without an understanding of the recipient's needs, practical constraints or sustainability of supplies. Methods We donated a set of physical diagnostic equipment, non-invasive instrument tests and laboratory supplies to a rural health center in the Democratic Republic of Congo. We collected information on the usage and durability of equipment and supplies for each patient encounter over a 1-year period. Results We recorded 913 patient encounters. The most commonly used physical diagnostic equipment were the stethoscope (98.9%; 903/913), thermometer (81.7%; 746/913), adult scale (81.4%; 744/913), stop watch (62.6%; 572/913), adult sphygmomanometer (55.8%; 510/913), infant scale (24.9%; 228/913), measuring tape (24.3%; 222/913) and fetoscope (23.8%; 218/913). The most commonly used laboratory tests were the blood smear for malaria (53.7%; 491/913), hematocrit (23.5%; 215/913), urinalysis (20.1%; 184/913) and sputum stain for TB (13.3%; 122/913). With the exception of a penlight and solar lantern, all equipment remained functional. Conclusions This study adds valuable information about the utility and durability of equipment supplied to a health center in the Democratic Republic of Congo. Our results might aid in determining the appropriateness of donated medical equipment in similar settings. The selection of donated goods should be made with knowledge of the context in which it will be used, and utilization should be monitored. PMID:25525132

Family policies in OECD countries: a comparative analysis.

PubMed

Thévenon, Olivier

2011-01-01

This article discusses the diversity of family policy models in 28 OECD countries in terms of the balance between their different objectives and the mix of instruments adopted to implement the policies. Cross-country policy differences are investigated by applying a principal component analysis to comprehensive country-level data from the OECD Family database covering variables such as parental leave conditions, childcare service provision, and financial support to families. The results find persistent differences in the family policy patterns embedded in different contexts of work-family "outcomes." Country classifications of family policy packages only partially corroborate categorizations in earlier studies, owing to considerable within-group heterogeneity and the presence of group outliers. The Nordic countries outdistance the others with comprehensive support to working parents with very young children. Anglo-Saxon countries provide much less support for working parents with very young children, and financial support is targeted on low-income and large families and focuses on preschool and early elementary education. Continental and Eastern European countries form a more heterogeneous group, while the support received by families in Southern Europe and in Asian countries is much lower in all its dimensions.

Multilingualism in Post-Soviet Countries: Language Revival, Language Removal, and Sociolinguistic Theory

ERIC Educational Resources Information Center

Pavlenko, Aneta

2008-01-01

Since the post-Soviet context is not particularly well known to the majority of readers, the author uses this introduction to provide a general background against which developments in particular post-Soviet countries can be better understood. The author begins by placing these developments in the sociohistoric context of language policies of the…

Climate Change Adaptation Practices in Various Countries

NASA Astrophysics Data System (ADS)

Tanik, A.; Tekten, D.

2017-08-01

The paper will be a review work on the recent strategies of EU in general, and will underline the inspected sectoral based adaptation practices and action plans of 7 countries; namely Germany, France, Spain, Italy, Denmark, USA and Kenya from Africa continent. Although every countries’ action plan have some similarities on sectoral analysis, each country in accordance with the specific nature of the problem seems to create its own sectoral analysis. Within this context, green and white documents of EU adaptation to climate change, EU strategy on climate change, EU targets of 2020 on climate change and EU adaptation support tools are investigated.

Task shifting from physicians to nurses in primary care in 39 countries: a cross-country comparative study.

PubMed

Maier, Claudia B; Aiken, Linda H

2016-12-01

Primary care is in short supply in many countries. Task shifting from physicians to nurses is one strategy to improve access, but international research is scarce. We analysed the extent of task shifting in primary care and policy reforms in 39 countries. Cross-country comparative research, based on an international expert survey, plus literature scoping review. A total of 93 country experts participated, covering Europe, USA, Canada, Australia and New Zealand (response rate: 85.3%). Experts were selected according to pre-defined criteria. Survey responses were triangulated with the literature and analysed using policy, thematic and descriptive methods to assess developments in country-specific contexts. Task shifting, where nurses take up advanced roles from physicians, was implemented in two-thirds of countries (N = 27, 69%), yet its extent varied. Three clusters emerged: 11 countries with extensive (Australia, Canada, England, Northern Ireland, Scotland, Wales, Finland, Ireland, Netherlands, New Zealand and USA), 16 countries with limited and 12 countries with no task shifting. The high number of policy, regulatory and educational reforms, such as on nurse prescribing, demonstrate an evolving trend internationally toward expanding nurses' scope-of-practice in primary care. Many countries have implemented task-shifting reforms to maximise workforce capacity. Reforms have focused on removing regulatory and to a lower extent, financial barriers, yet were often lengthy and controversial. Countries early on in the process are primarily reforming their education. From an international and particularly European Union perspective, developing standardised definitions, minimum educational and practice requirements would facilitate recognition procedures in increasingly connected labour markets. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Determinants of Urban Expansion and Agricultural Land Conversion in 25 EU Countries.

PubMed

Ustaoglu, Eda; Williams, Brendan

2017-10-01

Agricultural land conversion is resulting from ongoing complex interaction between the physical environment, policy settings and socio-economic factors. Case studies of the determinants of agricultural land conversion potentially contribute to the analysis of the main causes of land-use change. This can assist authorities and policy makers in understanding the relative importance of a wide range of factors on urban expansion and associated agricultural land-use change. This paper explores the determinants of agricultural land conversion to urban uses in the studied 25 European Union countries between 2000 and 2006. European-level as well as region-specific land-use changes are studied. The research is using the spatial data adapted from European Corine Land Cover maps of 2000 and 2006 and utilised other European sources regarding socio-economic, natural, geological, climate, and policy-related data. The differences in urbanisation processes observed in different regions in Europe emphasise the regional variations of urban conversion process of agricultural land use. This study identifies a combination of socio-economic drivers, policy-related factors, nature and location-based factors as key influences on agricultural land conversion processes in Europe. Specifically we found that the Common Agricultural Policy (CAP) subsidies were influential in curbing urbanisation and reducing agricultural land consumption.

Biomechanical and energetic determinants of technique selection in classical cross-country skiing.

PubMed

Pellegrini, Barbara; Zoppirolli, Chiara; Bortolan, Lorenzo; Holmberg, Hans-Christer; Zamparo, Paola; Schena, Federico

2013-12-01

Classical cross-country skiing can be performed using three main techniques: diagonal stride (DS), double poling (DP), and double poling with kick (DK). Similar to other forms of human and animal gait, it is currently unclear whether technique selection occurs to minimize metabolic cost or to keep some mechanical factors below a given threshold. The aim of this study was to find the determinants of technique selection. Ten male athletes roller skied on a treadmill at different slopes (from 0° to 7° at 10km/h) and speeds (from 6 to 18km/h at 2°). The technique preferred by skiers was gathered for every proposed condition. Biomechanical parameters and metabolic cost were then measured for each condition and technique. Skiers preferred DP for skiing on the flat and they transitioned to DK and then to DS with increasing slope steepness, when increasing speed all skiers preferred DP. Data suggested that selections mainly occur to remain below a threshold of poling force. Second, critically low values of leg thrust time may limit the use of leg-based techniques at high speeds. A small role has been identified for the metabolic cost of locomotion, which determined the selection of DP for flat skiing. Copyright © 2013 Elsevier B.V. All rights reserved.

Determinants of Urban Expansion and Agricultural Land Conversion in 25 EU Countries

NASA Astrophysics Data System (ADS)

Ustaoglu, Eda; Williams, Brendan

2017-10-01

Agricultural land conversion is resulting from ongoing complex interaction between the physical environment, policy settings and socio-economic factors. Case studies of the determinants of agricultural land conversion potentially contribute to the analysis of the main causes of land-use change. This can assist authorities and policy makers in understanding the relative importance of a wide range of factors on urban expansion and associated agricultural land-use change. This paper explores the determinants of agricultural land conversion to urban uses in the studied 25 European Union countries between 2000 and 2006. European-level as well as region-specific land-use changes are studied. The research is using the spatial data adapted from European Corine Land Cover maps of 2000 and 2006 and utilised other European sources regarding socio-economic, natural, geological, climate, and policy-related data. The differences in urbanisation processes observed in different regions in Europe emphasise the regional variations of urban conversion process of agricultural land use. This study identifies a combination of socio-economic drivers, policy-related factors, nature and location-based factors as key influences on agricultural land conversion processes in Europe. Specifically we found that the Common Agricultural Policy (CAP) subsidies were influential in curbing urbanisation and reducing agricultural land consumption.

Social determinants of health--a comparative study of Bosnian adolescents in different cultural contexts.

PubMed

Sujoldzić, Anita; Peternel, Lana; Kulenović, Tarik; Terzić, Rifet

2006-12-01

This study investigated the effects of sociocultural contexts on health and the psychological well-being of immigrant adolescents, aged 15 to 18 years, originally from Bosnia and Herzegovina and now living as displaced persons either in Bosnia, or immigrants in Croatia and Austria. The study addresses the social determinants of health with a specific focus on five factors in the social environment that might have an influence on health status: gender, socio-economic status (SES), perceived discrimination and exposure to violence, social support and religious commitment. Dependent variables included self-rated health, a count of self-reported objective health problems and a range of indices of psychological well-being (somatic stress, anxiety, depression and self-esteem). The purpose of the study was to examine whether social risk factors have an effect on health, which factors mediate these effects on self-rated health and to assess whether these effects differ by gender Results indicate that perceived discrimination and violence are related to poor health through psychological stress as a major mechanism with stronger effects for girls in the study. Differences across the three socio-cultural contexts reveal the complexity and specificity of the relationships between analyzed factors as the association between discrimination and health was attenuated for some groups due to the protective resources of immigrants.

Cross-Cultural Adaptation of the Intelligibility in Context Scale for South Africa

ERIC Educational Resources Information Center

Pascoe, Michelle; McLeod, Sharynne

2016-01-01

The Intelligibility in Context Scale (ICS) is a screening questionnaire that focuses on parents' perceptions of children's speech in different contexts. Originally developed in English, it has been translated into 60 languages and the validity and clinical utility of the scale has been documented in a range of countries. In South Africa, there are…

Taking the Concept of Citizenship in Mental Health across Countries. Reflections on Transferring Principles and Practice to Different Sociocultural Contexts

PubMed Central

Eiroa-Orosa, Francisco José; Rowe, Michael

2017-01-01

Transferring principles and practices to different sociocultural and professional contexts in the field of mental health can be very complex. Previous research on public health policy points to difficulties in different areas such as the understanding the new concepts, their applicability in different health systems, and suitable approaches to its effective implementation. The purpose of this article is to describe and analyze the process of transferring the concept of Citizenship, from its United States origins in mental health outreach work with persons who are homeless to Catalonia, Spain. We define Citizenship as promoting the rights, responsibilities, roles, resources and relationships of persons with mental illnesses, along with a sense of belonging that is validated by other citizens. The process of this transition involves embedding Citizenship in the mental health “first-person” (internationally known as Consumer/Survivor/Peer) movement in Catalonia. The paper includes a discussion of the concept of transference, including a case example of the adoption of the concept of mental health recovery in different countries. Following this, we describe the United States Citizenship model and key elements of its development. We then turn to Spain and the evolution of its mental health system, and then to Catalonia for a brief case history of transference of the principles and practices of Citizenship to that region. The “take home message” of this work is that concepts being brought from one sociocultural and national context to another, must focus on contextualization in the ‘adoptee’s’ practices, including the balance between personal involvement and professional rigor, the involvement of key actors, and ongoing evaluation of actions taken. PMID:28680412

Beyond conception: legal determinations of filiation in the context of assisted reproductive technologies.

PubMed

Mykitiuk, R

2001-01-01

This article argues that legal determinations of filiation are normative ideological constructions about how societal relations between parents and children should be ordered. They are based upon regular understandings of the relationship between biological and social facts and, as this article demonstrates, operate to create an asymmetrical relationship between the categories between paternity and maternity. I suggest that fairly recent developments in reproductive and genetic filiation have been made and offer the potential for an expanded understanding of relatedness or kinship which does not take the two-parent--one of each sex--model of the family as its normative form. While the examples I draw on arise in the context of reproductive technologies, I suggest that the analysis has broader implications for the recognition of broader family forms and relationship.

District-level hospital trauma care audit filters: Delphi technique for defining context-appropriate indicators for quality improvement initiative evaluation in developing countries.

PubMed

Stewart, Barclay T; Gyedu, Adam; Quansah, Robert; Addo, Wilfred Larbi; Afoko, Akis; Agbenorku, Pius; Amponsah-Manu, Forster; Ankomah, James; Appiah-Denkyira, Ebenezer; Baffoe, Peter; Debrah, Sam; Donkor, Peter; Dorvlo, Theodor; Japiong, Kennedy; Kushner, Adam L; Morna, Martin; Ofosu, Anthony; Oppong-Nketia, Victor; Tabiri, Stephen; Mock, Charles

2016-01-01

Prospective clinical audit of trauma care improves outcomes for the injured in high-income countries (HICs). However, equivalent, context-appropriate audit filters for use in low- and middle-income country (LMIC) district-level hospitals have not been well established. We aimed to develop context-appropriate trauma care audit filters for district-level hospitals in Ghana, was well as other LMICs more broadly. Consensus on trauma care audit filters was built between twenty panellists using a Delphi technique with four anonymous, iterative surveys designed to elicit: (i) trauma care processes to be measured; (ii) important features of audit filters for the district-level hospital setting; and (iii) potentially useful filters. Filters were ranked on a scale from 0 to 10 (10 being very useful). Consensus was measured with average percent majority opinion (APMO) cut-off rate. Target consensus was defined a priori as: a median rank of ≥9 for each filter and an APMO cut-off rate of ≥0.8. Panellists agreed on trauma care processes to target (e.g. triage, phases of trauma assessment, early referral if needed) and specific features of filters for district-level hospital use (e.g. simplicity, unassuming of resource capacity). APMO cut-off rate increased successively: Round 1--0.58; Round 2--0.66; Round 3--0.76; and Round 4--0.82. After Round 4, target consensus on 22 trauma care and referral-specific filters was reached. Example filters include: triage--vital signs are recorded within 15 min of arrival (must include breathing assessment, heart rate, blood pressure, oxygen saturation if available); circulation--a large bore IV was placed within 15 min of patient arrival; referral--if referral is activated, the referring clinician and receiving facility communicate by phone or radio prior to transfer. This study proposes trauma care audit filters appropriate for LMIC district-level hospitals. Given the successes of similar filters in HICs and obstetric care filters in LMICs

District-level hospital trauma care audit filters: Delphi technique for defining context-appropriate indicators for quality improvement initiative evaluation in developing countries

PubMed Central

Stewart, Barclay T; Gyedu, Adam; Quansah, Robert; Addo, Wilfred Larbi; Afoko, Akis; Agbenorku, Pius; Amponsah-Manu, Forster; Ankomah, James; Appiah-Denkyira, Ebenezer; Baffoe, Peter; Debrah, Sam; Donkor, Peter; Dorvlo, Theodor; Japiong, Kennedy; Kushner, Adam L; Morna, Martin; Ofosu, Anthony; Oppong-Nketia, Victor; Tabiri, Stephen; Mock, Charles

2015-01-01

Introduction Prospective clinical audit of trauma care improves outcomes for the injured in high-income countries (HICs). However, equivalent, context-appropriate audit filters for use in low- and middle-income country (LMIC) district-level hospitals have not been well established. We aimed to develop context-appropriate trauma care audit filters for district-level hospitals in Ghana, was well as other LMICs more broadly. Methods Consensus on trauma care audit filters was built between twenty panelists using a Delphi technique with four anonymous, iterative surveys designed to elicit: i) trauma care processes to be measured; ii) important features of audit filters for the district-level hospital setting; and iii) potentially useful filters. Filters were ranked on a scale from 0 – 10 (10 being very useful). Consensus was measured with average percent majority opinion (APMO) cut-off rate. Target consensus was defined a priori as: a median rank of ≥9 for each filter and an APMO cut-off rate of ≥0.8. Results Panelists agreed on trauma care processes to target (e.g. triage, phases of trauma assessment, early referral if needed) and specific features of filters for district-level hospital use (e.g. simplicity, unassuming of resource capacity). APMO cut-off rate increased successively: Round 1 - 0.58; Round 2 - 0.66; Round 3 - 0.76; and Round 4 - 0.82. After Round 4, target consensus on 22 trauma care and referral-specific filters was reached. Example filters include: triage - vital signs are recorded within 15 minutes of arrival (must include breathing assessment, heart rate, blood pressure, oxygen saturation if available); circulation - a large bore IV was placed within 15 minutes of patient arrival; referral - if referral is activated, the referring clinician and receiving facility communicate by phone or radio prior to transfer. Conclusion This study proposes trauma care audit filters appropriate for LMIC district-level hospitals. Given the successes of similar

Education and Training of Adults in the Context of Scientific and Technological Development. A Summary.

ERIC Educational Resources Information Center

Ohayon-Kaczmarek, Marit

This paper summarizes 14 case studies from 13 countries commissioned by Unesco to describe the educational provisions for adults in the special context of scientific and technological development and to study a selected number of programs at greater depth. The countries chosen by Unesco are all countries with developed or developing industries,…

Breastfeeding Trends and Determinants: Implications and recommendations for Gulf Cooperation Council countries.

PubMed

Al-Nuaimi, Nisreen; Katende, Godfrey; Arulappan, Judie

2017-05-01

Optimal breastfeeding practices entail the early initiation of breastfeeding soon after delivery of the baby, exclusive breastfeeding for the first six months of life and the continuation of breastfeeding complemented by solid food up until two years of age. Breastfeeding has wide-ranging health benefits for both the mother and her child; however, many factors contribute to low rates of exclusive breastfeeding. This article highlights the benefits of optimal breastfeeding as well as trends and determinants associated with breastfeeding both worldwide and in Gulf Cooperation Council (GCC) countries. Strategies to optimise breastfeeding and overcome breastfeeding barriers in the GCC region are recommended, including community health and education programmes and 'baby-friendly' hospital initiatives. Advocates of breastfeeding are needed at the national, community and family levels. In addition, more systematic research should be conducted to examine breastfeeding practices and the best strategies to promote breastfeeding in this region.

Establishing Quality Assurance in the South African Context

ERIC Educational Resources Information Center

Strydom, A. H.; Strydom, J. F.

2004-01-01

This paper provides perspectives on the unique challenges and opportunities facing the national auditing and accreditation system in South African higher education. In doing so, the quality assurance contexts of developed countries, Africa and South Africa are considered and the issues of uncertainty and conformity are highlighted. This is…

New Markets for Meeting Old Needs: U.S. Distance Education and Developing Countries.

ERIC Educational Resources Information Center

Carty, Winthrop

This paper analyzes the broad context and covers practical applications for delivering distance education in countries of the developing world. It begins by examining market trends in global higher education and continues by reviewing existing distance education activity in developing countries. This is followed by a discussion of the…

Pandemic influenza preparedness and health systems challenges in Asia: results from rapid analyses in 6 Asian countries.

PubMed

Hanvoravongchai, Piya; Adisasmito, Wiku; Chau, Pham Ngoc; Conseil, Alexandra; de Sa, Joia; Krumkamp, Ralf; Mounier-Jack, Sandra; Phommasack, Bounlay; Putthasri, Weerasak; Shih, Chin-Shui; Touch, Sok; Coker, Richard

2010-06-08

Since 2003, Asia-Pacific, particularly Southeast Asia, has received substantial attention because of the anticipation that it could be the epicentre of the next pandemic. There has been active investment but earlier review of pandemic preparedness plans in the region reveals that the translation of these strategic plans into operational plans is still lacking in some countries particularly those with low resources. The objective of this study is to understand the pandemic preparedness programmes, the health systems context, and challenges and constraints specific to the six Asian countries namely Cambodia, Indonesia, Lao PDR, Taiwan, Thailand, and Viet Nam in the prepandemic phase before the start of H1N1/2009. The study relied on the Systemic Rapid Assessment (SYSRA) toolkit, which evaluates priority disease programmes by taking into account the programmes, the general health system, and the wider socio-cultural and political context. The components under review were: external context; stewardship and organisational arrangements; financing, resource generation and allocation; healthcare provision; and information systems. Qualitative and quantitative data were collected in the second half of 2008 based on a review of published data and interviews with key informants, exploring past and current patterns of health programme and pandemic response. The study shows that health systems in the six countries varied in regard to the epidemiological context, health care financing, and health service provision patterns. For pandemic preparation, all six countries have developed national governance on pandemic preparedness as well as national pandemic influenza preparedness plans and Avian and Human Influenza (AHI) response plans. However, the governance arrangements and the nature of the plans differed. In the five developing countries, the focus was on surveillance and rapid containment of poultry related transmission while preparation for later pandemic stages was limited

Pandemic influenza preparedness and health systems challenges in Asia: results from rapid analyses in 6 Asian countries

PubMed Central

2010-01-01

Background Since 2003, Asia-Pacific, particularly Southeast Asia, has received substantial attention because of the anticipation that it could be the epicentre of the next pandemic. There has been active investment but earlier review of pandemic preparedness plans in the region reveals that the translation of these strategic plans into operational plans is still lacking in some countries particularly those with low resources. The objective of this study is to understand the pandemic preparedness programmes, the health systems context, and challenges and constraints specific to the six Asian countries namely Cambodia, Indonesia, Lao PDR, Taiwan, Thailand, and Viet Nam in the prepandemic phase before the start of H1N1/2009. Methods The study relied on the Systemic Rapid Assessment (SYSRA) toolkit, which evaluates priority disease programmes by taking into account the programmes, the general health system, and the wider socio-cultural and political context. The components under review were: external context; stewardship and organisational arrangements; financing, resource generation and allocation; healthcare provision; and information systems. Qualitative and quantitative data were collected in the second half of 2008 based on a review of published data and interviews with key informants, exploring past and current patterns of health programme and pandemic response. Results The study shows that health systems in the six countries varied in regard to the epidemiological context, health care financing, and health service provision patterns. For pandemic preparation, all six countries have developed national governance on pandemic preparedness as well as national pandemic influenza preparedness plans and Avian and Human Influenza (AHI) response plans. However, the governance arrangements and the nature of the plans differed. In the five developing countries, the focus was on surveillance and rapid containment of poultry related transmission while preparation for later

When Do States Respond to Low Fertility? Contexts of State Concern in Wealthier Countries, 1976-2011.

PubMed

Marshall, Emily A

2015-06-01

Since the 1970s, expressions of state concern over low fertility have greatly increased among wealthier countries. This study asks to what extent this increase is explained by demographic factors, national-level economic and political factors, and processes of international diffusion and changing international norms. Analyses integrate the world polity literature on global policy diffusion with a social problems approach to examine international diffusion of state concern among more powerful members of the world polity, a process that can produce changes in international policy consensus. Comparisons of the characteristics of states that do and do not express concern over low fertility find that among wealthier "first-world" countries, state concern has become more responsive to fertility rates: fertility rates are not significantly associated with concern early in the study period, but are strongly associated with concern later in the study period. There is no evidence that integration into the world polity is associated with concern in these countries, and some evidence that less integrated countries are more likely to express concern, suggesting that processes shaping the diffusion of state concern may differ from those identified as shaping policy diffusion in the existing literature. Among "second-world" former Eastern bloc countries, different patterns of associations reflect different political histories: concern is associated only with demographic factors, with no significant change in this association over time.

Authentic e-Learning in a Multicultural Context: Virtual Benchmarking Cases from Five Countries

ERIC Educational Resources Information Center

Leppisaari, Irja; Herrington, Jan; Vainio, Leena; Im, Yeonwook

2013-01-01

The implementation of authentic learning elements at education institutions in five countries, eight online courses in total, is examined in this paper. The International Virtual Benchmarking Project (2009-2010) applied the elements of authentic learning developed by Herrington and Oliver (2000) as criteria to evaluate authenticity. Twelve…

Modelling the Sociocultural Contexts of Science Education: The Teachers' Perspective

NASA Astrophysics Data System (ADS)

Mansour, Nasser

2013-02-01

A growing body of research argues that teachers' beliefs and practices should be studied within the sociocultural contexts of their work because the relationship between their beliefs and practices is both complex and context-dependent. There is a need for further research in this area in understudied contexts such as developing countries, in order to promote effective education in schools and the professional development of teachers. This paper argues that if this `black box' of sociocultural contexts in which science teachers are embedded is better understood, it may be possible to identify specific aspects of these contexts related to educational organizations that act as either supports or barriers to pedagogical reform or to implementing innovations in science education. Consequently, the main purpose of this study is to explore the sociocultural contexts of ten Egyptian science teachers and to what extent these sociocultural contexts help in understanding teachers' pedagogical beliefs and practices. This paper, by utilizing a multi-grounded theory approach and qualitative methods, reveals a variety of sociocultural contexts that are related to teachers' pedagogical beliefs and practices.

Reinterpreting Responsiveness for Health Systems Research in Low and Middle-Income Countries.

PubMed

Pratt, Bridget; Hyder, Adnan A

2015-07-01

The ethical concept of responsiveness has largely been interpreted in the context of international clinical research. In light of the increasing conduct of externally funded health systems research (HSR) in low- and middle-income countries (LMICs), this article examines how responsiveness might be understood for such research and how it can be applied. It contends that four features (amongst others) set HSR in LMICs apart from international clinical research: a focus on systems; being context-driven; being policy-driven; and being closely linked to development objectives. These features support reinterpreting responsiveness for HSR in LMICs as responsiveness to systems needs, where health system performance assessments can be relied upon to identify systems needs, and/or responsiveness to systems priorities, which entails aligning research with HSR priorities set through country-owned processes involving national and sub-national policymakers from host countries. Both concepts may be difficult to achieve in practice. Country ownership is not an established fact for many countries and alignment to their priorities may be meaningless without it. It is argued that more work is, therefore, needed to identify strategies for how the responsiveness requirement can be ethically fulfilled for HSR in LMICs under non-ideal conditions such as where host countries have not set HSR priorities via country-owned processes. Embeddedness is proposed as one approach that could be the focus of further development. © 2014 John Wiley & Sons Ltd.

Male Sex Workers: Practices, Contexts, and Vulnerabilities for HIV acquisition and transmission

PubMed Central

Baral, Stefan David; Friedman, M. Reuel; Geibel, Scott; Rebe, Kevin; Bozhinov, Borche; Diouf, Daouda; Sabin, Keith; Holland, Claire E.; Chan, Roy; Caceres, Carlos

2015-01-01

Summary Male sex workers (MSW) who sell/exchange sex for money or goods comprise an extremely diverse population across and within countries worldwide. Information characterizing their practices, contexts where they live, and their needs is very limited, as these men are generally included as subsets of larger studies focused on gay men and other men who have sex with men (MSM) or even female sex workers. MSW, regardless of their sexual orientation, mostly offer sex to men, and rarely identify as sex workers, using local or international terms instead. There is growing evidence of a sustained or increasing burden of HIV among some MSW in the context of the slowing global HIV pandemic. There are several synergistic facilitator spotentiating HIV acquisition and transmission among MSW, including biological, behavioural, and structural determinants. The criminalization and intersectional stigmas of same-sex practices, commercial sex, and HIV all increase HIV and STI risk for MSW and decrease their likelihood of accessing essential services. These contexts, taken together with complex sexual networks among MSW, define them as a key population underserved by current HIV prevention, treatment, and care services. Dedicated efforts are needed to make those services available for the sake of both public health and human rights. PMID:25059939

A Holistic Framework for Environmental Flows Determination in Hydropower Contexts

DOE Office of Scientific and Technical Information (OSTI.GOV)

McManamay, Ryan A; Bevelhimer, Mark S

2013-05-01

Among the ecological science community, the consensus view is that the natural flow regime sustains the ecological integrity of river systems. This prevailing viewpoint by many environmental stakeholders has progressively led to increased pressure on hydropower dam owners to change plant operations to affect downstream river flows with the intention of providing better conditions for aquatic biological communities. Identifying the neccessary magnitude, frequency, duration, timing, or rate of change of stream flows to meet ecological needs in a hydropower context is challenging because the ecological responses to changes in flows may not be fully known, there are usually a multitudemore » of competing users of flow, and implementing environmental flows usually comes at a price to energy production. Realistically, hydropower managers must develop a reduced set of goals that provide the most benefit to the identified ecological needs. As a part of the Department of Energy (DOE) Water Power Program, the Instream Flow Project (IFP) was carried out by Oak Ridge National Laboratory (ORNL), Pacific Northwest National Laboratory (PNNL), and Argon National Laboratory (ANL) as an attempt to develop tools aimed at defining environmental flow needs for hydropower operations. The application of these tools ranges from national to site-specific scales; thus, the utility of each tool will depend on various phases of the environmental flow process. Given the complexity and sheer volume of applications used to determine environmentally acceptable flows for hydropower, a framework is needed to organize efforts into a staged process dependent upon spatial, temporal, and functional attributes. By far, the predominant domain for determining environmental flows related to hydropower is within the Federal Energy Regulatory Commission (FERC) relicensing process. This process can take multiple years and can be very expensive depending on the scale of each hydropower project. The utility

Interventions for Children with Pervasive Developmental Disorders in Low and Middle Income Countries

ERIC Educational Resources Information Center

Hastings, Richard P.; Robertson, Janet; Yasamy, M. T.

2012-01-01

Background: Although interventions for children with pervasive developmental disorders (PDD) have been the focus of research effort and evidence reviews in many Western countries, this evidence has not been assessed in the context of low- and middle-income (LAMI) countries especially in terms of the fit with different cultures and resources.…

Country's Competitiveness and Sustainability in the Context of the Higher Education System Reforms

ERIC Educational Resources Information Center

Jermolajeva, Elita; Aleksejeva, Ludmila

2013-01-01

The accumulation of knowledge and its use have become important factors that promote economic development as they contribute to a country's competitiveness in the global economy. The basic significance of research is obtained by defining new approaches in the organisation, function and efficiency of the higher education system (HES) by emphasising…

Why do some countries spend more for health? An assessment of sociopolitical determinants and international aid for government health expenditures.

PubMed

Liang, Li-Lin; Mirelman, Andrew J

2014-08-01

A consensus exists that rising income levels and technological development are among key drivers of total health spending. Determinants of public sector health expenditure, by contrast, are less well understood. This study examines a complex relationship across government health expenditure (GHE), sociopolitical risks, and international aid, while taking into account the impacts of national income, debt and tax financing and aging populations on health spending. We apply a fixed-effects two-stage least squares regression method to a panel dataset comprising 120 countries for the years 1995 through 2010. Our results show that democratic accountability has a diminishing positive correlation with GHE, and that levels of GHE are higher when government is more stable. Corruption is associated with less GHE in developing countries, but with higher GHE in developed countries. We also find that development assistance for health (DAH) is fungible with domestically financed government health expenditure (DGHE). For an average country, a 1% increase in DAH to government is associated with a 0.03-0.04% decrease in DGHE. Furthermore, the degree of fungibility of DAH to government is higher in countries where corruption or ethnic tensions are widespread. However, DAH to non-governmental organizations is not fungible with DGHE. Copyright © 2014 Elsevier Ltd. All rights reserved.

A realist synthesis of cross-border patient movement from low and middle income countries to similar or higher income countries.

PubMed

Durham, Jo; Blondell, Sarah J

2017-08-29

Patient travel across borders to access healthcare is becoming increasingly common and widespread. Patients moving from high income to middle income countries for healthcare is well documented, with patients seeking treatments that are cheaper or more readily available than at home. Less well understood is when patients move from one low income country to another or from a low income country to a higher income country. In this paper, a realist review was undertaken to explore why, in what contexts and how patients from lower income countries travel to countries with the same, or more advanced, economies for planned healthcare. Based on an initial scoping of the literature and discussions with key informants, we generated an initial theory and set of propositions about why, how, who and in what contexts people cross international borders for planned healthcare. We then systematically located and synthesized (1) peer-reviewed studies from the Scopus, Embase, Web of Science and Econlit databases; (2) non-indexed reports using key informants and Google; and (3) papers from the reference lists of included documents, to glean supportive or contradictory evidence for our initial propositions. As we reviewed the literature and extracted our data, we drew on the work of Pierre Bourdieu to understand the interplay between material and non-material capital and cognitive processes in decisions to cross borders for healthcare. Patient travel was largely undertaken due to a lack of services in the home country and/or unacceptability of local services, with decisions on when, and where, to travel, usually made within the patient's social networks. They were able to travel via use of multiple resources, including social networks, economic and cultural capital, and habitus. Those patients with greater volumes of the aforementioned factors had greater healthcare options; however, even those with limited resources engaged in patient travel. Patient movement challenges traditional

Moral imperialism and multi-centric clinical trials in peripheral countries.

PubMed

Garrafa, Volnei; Lorenzo, Claudio

2008-10-01

Moral imperialism is expressed in attempts to impose moral standards from one particular culture, geopolitical region or culture onto other cultures, regions or countries. Examples of Direct Moral Imperialism can be seen in various recurrent events involving multi-centric clinical trials promoted by developed (central) countries in poor and developing (peripheral) countries, particularly projects related to the theory of double standards in research. After the WMA General Assembly refused to change the Helsinki Declaration - which would have given moral recognition to the above mentioned theory - the USA abandoned the declaration and began to promote regional seminars in peripheral countries with the aim of "training" researchers on ethical perspectives that reflect America's best interests. Individuals who received such training became transmitters of these central countries' ideas across the peripheral countries, representing a form of Indirect Moral Imperialism. The paper proposes the establishment of regulatory and social control systems for clinical trials implemented in peripheral countries, through the formulation of ethical norms that reflect the specific contexts of these countries, along with the drawing up and validation of their own national norms.

Poverty and child (0-14 years) mortality in the USA and other Western countries as an indicator of "how well a country meets the needs of its children" (UNICEF).

PubMed

Pritchard, Colin; Williams, Richard

2011-01-01

Children's (0-14 years) mortality rates in the USA and 19 Western countries (WCs) were examined in the context of a nation-specific measure of relative poverty and the Gross Domestic Product Health Expenditure (GDPHE) of countries to compare the effectiveness and efficiency of health care systems "to meet the needs of its children" (UNICEF). World Health Organisation child mortality rates per million were analysed for 1979-1981 and 2003-2005 to determine any significant differences between the USA and the other WCs over these periods. Child mortality rates are correlated with all countries GDPHE and 'relative poverty', defined by 'Income Inequalities', i.e., the gap between top and bottom 20% of incomes. Outputs: The mortality rate of every country fell substantially ranging from falls of 46% in the USA to 78% in Portugal. The highest current mortality rates are: USA, 2436 per million (pm), New Zealand 2105 pm, Portugal 1929 pm, Canada 1877 pm and the UK 1834 pm; the lowest are: Japan 1073 pm and Sweden 1075 pm, Finland 1193 pm and Norway 1200 pm. A total of 16 countries rates fell significantly more than the USA over these periods. Inputs: The USA had the greatest GDPHE and widest Income Inequality gap. There was no significant correlation between GDPHE and mortality but highly significant correlations with children's deaths and income inequalities. The five widest income inequality countries had the six worst rates, the narrowest four had the lowest. Despite major improvements in every WC, based upon financial inputs and child mortality outputs, the USA health care system appears the least efficient and effective in "meeting the needs of its children".

Evaluation of regional project to strengthen national health research systems in four countries in West Africa: lessons learned.

PubMed

Sombié, Issiaka; Aidam, Jude; Montorzi, Gabriela

2017-07-12

Since the Commission on Health Research for Development (COHRED) published its flagship report, more attention has been focused on strengthening national health research systems (NHRS). This paper evaluates the contribution of a regional project that used a participatory approach to strengthen NHRS in four post-conflict West African countries - Guinea-Bissau, Liberia, Sierra Leone and Mali. The data from the situation analysis conducted at the start of the project was compared to data from the project's final evaluation, using a hybrid conceptual framework built around four key areas identified through the analysis of existing frameworks. The four areas are governance and management, capacities, funding, and dissemination/use of research findings. The project helped improve the countries' governance and management mechanisms without strengthening the entire NHRS. In the four countries, at least one policy, plan or research agenda was developed. One country put in place a national health research ethics committee, while all four countries could adopt a research information management system. The participatory approach and support from the West African Health Organisation and COHRED were all determining factors. The lessons learned from this project show that the fragile context of these countries requires long-term engagement and that support from a regional institution is needed to address existing challenges and successfully strengthen the entire NHRS.

Determinants of the number of mammography units in 31 countries with significant mammography screening

PubMed Central

Autier, P; Ouakrim, D A

2008-01-01

In the 2000s, most of the female population of industrialised countries had access to mammography breast cancer screening, but with variable modalities among the countries. We assessed the number of mammography units (MUs) in 31 European, North American and Asian countries where significant mammography activity has existed for over 10 years, collecting data on the number of such units and of radiologists by contacting institutions in each country likely to provide the relevant information. Around 2004, there were 32 324 MU in 31 countries, the number per million women ranging from less than 25 in Turkey, Denmark, the Netherlands, the United Kingdom, Norway, Poland and Hungary to more than 80 in Cyprus, Italy, France, the United States and Austria. In a multivariate analysis, the number of MUs was positively associated with the number of radiologists (P=0.0081), the number of women (P=0.0023) and somewhat with the country surface area (P=0.077). There is considerable variation in the density of MU across countries and the number of MUs in service are often well above what would be necessary according to local screening recommendations. High number of MUs in some countries may have undesirable consequences, such as unnecessarily high screening frequency and decreased age at which screening is started. PMID:18781176

[Determinants of tuberculosis diagnosis delay in limited resources countries].

PubMed

Ndeikoundam Ngangro, N; Chauvin, P; Halley des Fontaines, V

2012-02-01

Delayed diagnoses of pulmonary tuberculosis contribute to the spread of the epidemic. This study aims to identify risk factors associated with patient delay (from symptoms onset to the first visit), health system delay (from the first visit to the tuberculosis treatment initiation) and total delay (sum of the patient and the health system delay) in low income and high tuberculosis burden countries. A systematic literature review has been performed using the keywords: "tuberculosis"; "delay", care seeking"; "health care seeking behavior"; "diagnosis" and "treatment". Only quantitative studies showing delays for pulmonary tuberculosis adult cases were included in this review. Low income, gender, rural life, unemployment, ageing and misunderstanding the microbial cause of tuberculosis are associated with delayed diagnoses. Systemic factors including low health care coverage, patient expenditures and entry into the health system by consulting a traditional healer or a non-skilled professional delay the beginning of tuberculosis treatment. Delays can be used as indicators to evaluate tuberculosis control programs. Active case finding in the households of contagious patients can help to diminish diagnostic delays in low-income countries with high endemicity. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Socio-Economic Resilience to Floods in 90 Countries

NASA Astrophysics Data System (ADS)

Hallegatte, S.; Bangalore, M.; Vogt-Schilb, A.

2015-12-01

Global losses from floods are increasing, with renewed calls for action to reduce their impact. In each country, region or city, many actions can protect the population and help rebuild and recover: building dikes and restoring mangroves; land-use planning; early warning and evacuation; insurance and social safety nets. What should be the priorities? How to build a comprehensive strategy? Is progress being made? We propose a tool - a national-level scorecard based on welfare economics - to assess a country's socio-economic resilience to river floods and identify the most promising policy options in different contexts to reduce the impact of floods on well-being. The tool is applied to 90 countries using open databases, and can serve as a starting point for designing policies and more in-depth local studies.

Social Entrepreneurship in South Africa: Context, Relevance and Extent

ERIC Educational Resources Information Center

Visser, Kobus

2011-01-01

In its broadest context, "social entrepreneurship" refers to individuals and organizations that engage in entrepreneurial activities with social objectives. Whereas this concept and its constituent elements are well-researched and acknowledged in industrialized countries (such as the USA and UK) (Thompson, Alvy and Lees, 2000, p 328) and…

Determining the optimal vaccine vial size in developing countries: a Monte Carlo simulation approach.

PubMed

Dhamodharan, Aswin; Proano, Ruben A

2012-09-01

Outreach immunization services, in which health workers immunize children in their own communities, are indispensable to improve vaccine coverage in rural areas of developing countries. One of the challenges faced by these services is how to reduce high levels of vaccine wastage. In particular, the open vial wastage (OVW) that result from the vaccine doses remaining in a vial after a time for safe use -since opening the vial- has elapsed. This wastage is highly dependent on the choice of vial size and the expected number of participants for which the outreach session is planned (i.e., session size). The use single-dose vials results in zero OVW, but it increases the vaccine purchase, transportation, and holding costs per dose as compared to those resulting from using larger vial sizes. The OVW also decreases when more people are immunized in a session. However, controlling the actual number of people that show to an outreach session in rural areas of developing countries highly depends on factors that are out of control of the immunization planners. This paper integrates a binary integer-programming model to a Monte Carlo simulation method to determine the choice of vial size and the optimal reordering point level to implement an (nQ, r, T) lot-sizing policy that provides the best tradeoff between procurement costs and wastage.

New Strategies for Financial Management in Universities: The Experience of OECD Member Countries and Latin American Countries. IIEP Contribution No. 27.

ERIC Educational Resources Information Center

Sanyal, Bikas C.; Martin, Michaela

In many countries there have been major changes in the financial operations of the university. Change has occurred in the context of diminishing public resources, and this has translated, in most cases, into financial constraint within the university. This situation has led to pressure from the government, and from within the university itself in…

Passive Suicide Ideation Among Older Adults in Europe: A Multilevel Regression Analysis of Individual and Societal Determinants in 12 Countries (SHARE).

PubMed

Stolz, Erwin; Fux, Beat; Mayerl, Hannes; Rásky, Éva; Freidl, Wolfgang

2016-09-01

Passive suicide ideation (PSI) is common among older adults, but prevalences have been reported to vary considerably across European countries. The goal of this study was to assess the role of individual-level risk factors and societal contextual factors associated with PSI in old age. We analyzed longitudinal data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) on 6,791 community-dwelling respondents (75+) from 12 countries. Bayesian logistic multilevel regression models were used to assess variance components, individual-level and country-level risk factors. About 4% of the total variance of PSI was located at the country level, a third of which was attributable to compositional effects of individual-level predictors. Predictors for the development of PSI at the individual level were female gender, depression, older age, poor health, smaller social network size, loneliness, nonreligiosity, and low perceived control (R (2) = 25.8%). At the country level, cultural acceptance of suicide, religiosity, and intergenerational cohabitation were associated with the rates of PSI. Cross-national variation in old-age PSI is mostly attributable to individual-level determinants and compositional differences, but there is also evidence for contextual effects of country-level characteristics. Suicide prevention programs should be intensified in high-risk countries and attitudes toward suicide should be addressed in information campaigns. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Strength of primary care service delivery: a comparative study of European countries, Australia, New Zealand, and Canada.

PubMed

Pavlič, Danica R; Sever, Maja; Klemenc-Ketiš, Zalika; Švab, Igor; Vainieri, Milena; Seghieri, Chiara; Maksuti, Alem

2018-05-01

AimWe sought to examine strength of primary care service delivery as measured by selected process indicators by general practitioners from 31 European countries plus Australia, Canada, and New Zealand. We explored the relation between strength of service delivery and healthcare expenditures. The strength of a country's primary care is determined by the degree of development of a combination of core primary care dimensions in the context of its healthcare system. This study analyses the strength of service delivery in primary care as measured through process indicators in 31 European countries plus Australia, New Zealand, and Canada. A comparative cross-sectional study design was applied using the QUALICOPC GP database. Data on the strength of primary healthcare were collected using a standardized GP questionnaire, which included 60 questions divided into 10 dimensions related to process, structure, and outcomes. A total of 6734 general practitioners participated. Data on healthcare expenditure were obtained from World Bank statistics. We conducted a correlation analysis to analyse the relationship between strength and healthcare expenditures.FindingsOur findings show that the strength of service delivery parameters is less than optimal in some countries, and there are substantial variations among countries. Continuity and comprehensiveness of care are significantly positively related to national healthcare expenditures; however, coordination of care is not.

Identifying determinants of effective complementary feeding behaviour change interventions in developing countries

PubMed Central

Fabrizio, Cecilia S; van Liere, Marti; Pelto, Gretel

2014-01-01

As stunting moves to the forefront of the global agenda, there is substantial evidence that behaviour change interventions (BCI) can improve infant feeding practices and growth. However, this evidence has not been translated into improved outcomes on a national level because we do not know enough about what makes these interventions work, for whom, when, why, at what cost and for how long. Our objective was to examine the design and implementation of complementary feeding BCI, from the peer-reviewed literature, to identify generalisable key determinants. We identified 29 studies that evaluated BCI efficacy or effectiveness, were conducted in developing countries, and reported outcomes on infant and young children aged 6–24 months. Two potential determinants emerged: (1) effective studies used formative research to identify cultural barriers and enablers to optimal feeding practices, to shape the intervention strategy, and to formulate appropriate messages and mediums for delivery; (2) effective studies delineated the programme impact pathway to the target behaviour change and assessed intermediary behaviour changes to learn what worked. We found that BCI that used these developmental and implementation processes could be effective despite heterogeneous approaches and design components. Our analysis was constrained, however, by the limited published data on how design and implementation were carried out, perhaps because of publishing space limits. Information on cost-effectiveness, sustainability and scalability was also very limited. We suggest a more comprehensive reporting process and a more strategic research agenda to enable generalisable evidence to accumulate. PMID:24798264

Child development in developing countries: child rights and policy implications.

PubMed

Britto, Pia Rebello; Ulkuer, Nurper

2012-01-01

The Multiple Indicator Cluster Survey was used to provide information on feeding practices, caregiving, discipline and violence, and the home environment for young children across 28 countries. The findings from the series of studies in this Special Section are the first of their kind because they provide information on the most proximal context for development of the youngest children in the majority world using one of the only data sets to study these contexts across countries. Using the framework of the Convention on the Rights of the Child, in particular the Rights to Survival, Development and Protection, findings are explained with implications for international and national-level social policies. Implications are also discussed, with respect to policy makers and the larger international community, who have the obligation to uphold these rights. © 2012 The Authors. Child Development © 2012 Society for Research in Child Development, Inc.

Shaping Education Policy Research in an Asia-Pacific Context

ERIC Educational Resources Information Center

Jeong, Dong Wook; Lee, Ho Jun; Lee, Seung Ho; Wi, Eunjoo

2014-01-01

Globalization increasingly calls for comparing educational policies across countries. In this study, we assemble and analyze academic journal publications of the past decade in order to shape education policy research within an Asia-Pacific context. After examining Asia-Pacific research publication data from the Web of Science, we find a few…

The importance of socio-economic context for social marketing models for improving reproductive health: evidence from 555 years of program experience.

PubMed

Meekers, Dominique; Rahaim, Stephen

2005-01-27

Over the past two decades, social marketing programs have become an important element of the national family planning and HIV prevention strategy in several developing countries. As yet, there has not been any comprehensive empirical assessment to determine which of several social marketing models is most effective for a given socio-economic context. Such an assessment is urgently needed to inform the design of future social marketing programs, and to avoid that programs are designed using an ineffective model. This study addresses this issue using a database of annual statistics about reproductive health oriented social marketing programs in over 70 countries. In total, the database covers 555 years of program experience with social marketing programs that distribute and promote the use of oral contraceptives and condoms. Specifically, our analysis assesses to what extent the model used by different reproductive health social marketing programs has varied across different socio-economic contexts. We then use random effects regression to test in which socio-economic context each of the models is most successful at increasing use of socially marketed oral contraceptives and condoms. The results show that there has been a tendency to design reproductive health social marketing program with a management structure that matches the local context. However, the evidence also shows that this has not always been the case. While socio-economic context clearly influences the effectiveness of some of the social marketing models, program maturity and the size of the target population appear equally important. To maximize the effectiveness of future social marketing programs, it is essential that more effort is devoted to ensuring that such programs are designed using the model or approach that is most suitable for the local context.

The importance of socio-economic context for social marketing models for improving reproductive health: Evidence from 555 years of program experience

PubMed Central

Meekers, Dominique; Rahaim, Stephen

2005-01-01

Background Over the past two decades, social marketing programs have become an important element of the national family planning and HIV prevention strategy in several developing countries. As yet, there has not been any comprehensive empirical assessment to determine which of several social marketing models is most effective for a given socio-economic context. Such an assessment is urgently needed to inform the design of future social marketing programs, and to avoid that programs are designed using an ineffective model. Methods This study addresses this issue using a database of annual statistics about reproductive health oriented social marketing programs in over 70 countries. In total, the database covers 555 years of program experience with social marketing programs that distribute and promote the use of oral contraceptives and condoms. Specifically, our analysis assesses to what extent the model used by different reproductive health social marketing programs has varied across different socio-economic contexts. We then use random effects regression to test in which socio-economic context each of the models is most successful at increasing use of socially marketed oral contraceptives and condoms. Results The results show that there has been a tendency to design reproductive health social marketing program with a management structure that matches the local context. However, the evidence also shows that this has not always been the case. While socio-economic context clearly influences the effectiveness of some of the social marketing models, program maturity and the size of the target population appear equally important. Conclusions To maximize the effectiveness of future social marketing programs, it is essential that more effort is devoted to ensuring that such programs are designed using the model or approach that is most suitable for the local context. PMID:15676068

Determinants of Underemployment of Young Adults: A Multi-Country Study.

ERIC Educational Resources Information Center

Ruiz-Quintanilla, S. Antonio; Claes, Rita

1996-01-01

Data from the international Work Socialization of Youth project (1988-90) were analyzed for office technology workers and machine operators in six European countries. Organizational and societal factors had greater influence on part-time/temporary employment than did job search strategies, gender, or age. (SK)

Analysis of Classical Time-Trial Performance and Technique-Specific Physiological Determinants in Elite Female Cross-Country Skiers.

PubMed

Sandbakk, Øyvind; Losnegard, Thomas; Skattebo, Øyvind; Hegge, Ann M; Tønnessen, Espen; Kocbach, Jan

2016-01-01

The present study investigated the contribution of performance on uphill, flat, and downhill sections to overall performance in an international 10-km classical time-trial in elite female cross-country skiers, as well as the relationships between performance on snow and laboratory-measured physiological variables in the double poling (DP) and diagonal (DIA) techniques. Ten elite female cross-country skiers were continuously measured by a global positioning system device during an international 10-km cross-country skiing time-trial in the classical technique. One month prior to the race, all skiers performed a 5-min submaximal and 3-min self-paced performance test while roller skiing on a treadmill, both in the DP and DIA techniques. The time spent on uphill (r = 0.98) and flat (r = 0.91) sections of the race correlated most strongly with the overall 10-km performance (both p < 0.05). Approximately 56% of the racing time was spent uphill, and stepwise multiple regression revealed that uphill time explained 95.5% of the variance in overall performance (p < 0.001). Distance covered during the 3-min roller-skiing test and body-mass normalized peak oxygen uptake (VO2peak) in both techniques showed the strongest correlations with overall time-trial performance (r = 0.66-0.78), with DP capacity tending to have greatest impact on the flat and DIA capacity on uphill terrain (all p < 0.05). Our present findings reveal that the time spent uphill most strongly determine classical time-trial performance, and that the major portion of the performance differences among elite female cross-country skiers can be explained by variations in technique-specific aerobic power.

Analysis of Classical Time-Trial Performance and Technique-Specific Physiological Determinants in Elite Female Cross-Country Skiers

PubMed Central

Sandbakk, Øyvind; Losnegard, Thomas; Skattebo, Øyvind; Hegge, Ann M.; Tønnessen, Espen; Kocbach, Jan

2016-01-01

The present study investigated the contribution of performance on uphill, flat, and downhill sections to overall performance in an international 10-km classical time-trial in elite female cross-country skiers, as well as the relationships between performance on snow and laboratory-measured physiological variables in the double poling (DP) and diagonal (DIA) techniques. Ten elite female cross-country skiers were continuously measured by a global positioning system device during an international 10-km cross-country skiing time-trial in the classical technique. One month prior to the race, all skiers performed a 5-min submaximal and 3-min self-paced performance test while roller skiing on a treadmill, both in the DP and DIA techniques. The time spent on uphill (r = 0.98) and flat (r = 0.91) sections of the race correlated most strongly with the overall 10-km performance (both p < 0.05). Approximately 56% of the racing time was spent uphill, and stepwise multiple regression revealed that uphill time explained 95.5% of the variance in overall performance (p < 0.001). Distance covered during the 3-min roller-skiing test and body-mass normalized peak oxygen uptake (VO2peak) in both techniques showed the strongest correlations with overall time-trial performance (r = 0.66–0.78), with DP capacity tending to have greatest impact on the flat and DIA capacity on uphill terrain (all p < 0.05). Our present findings reveal that the time spent uphill most strongly determine classical time-trial performance, and that the major portion of the performance differences among elite female cross-country skiers can be explained by variations in technique-specific aerobic power. PMID:27536245

Dietary Determinants of and Possible Solutions to Iron Deficiency for Young Women Living in Industrialized Countries: A Review

PubMed Central

Beck, Kathryn L.; Conlon, Cathryn A.; Kruger, Rozanne; Coad, Jane

2014-01-01

Iron deficiency is a concern in both developing and developed (industrialized) countries; and young women are particularly vulnerable. This review investigates dietary determinants of and possible solutions to iron deficiency in young women living in industrialized countries. Dietary factors including ascorbic acid and an elusive factor in animal protein foods (meat; fish and poultry) enhance iron absorption; while phytic acid; soy protein; calcium and polyphenols inhibit iron absorption. However; the effects of these dietary factors on iron absorption do not necessarily translate into an association with iron status and iron stores (serum ferritin concentration). In cross-sectional studies; only meat intake has consistently (positively) been associated with higher serum ferritin concentrations. The enhancing effects of ascorbic acid and meat on iron absorption may be negated by the simultaneous consumption of foods and nutrients which are inhibitory. Recent cross-sectional studies have considered the combination and timing of foods consumed; with mixed results. Dietary interventions using a range of focused dietary measures to improve iron status appear to be more effective than dietary approaches that focus on single nutrients or foods. Further research is needed to determine optimal dietary recommendations for both the prevention and treatment of iron deficiency. PMID:25244367

A strategy to improve priority setting in developing countries.

PubMed

Kapiriri, Lydia; Martin, Douglas K

2007-09-01

Because the demand for health services outstrips the available resources, priority setting is one of the most difficult issues faced by health policy makers, particularly those in developing countries. Priority setting in developing countries is fraught with uncertainty due to lack of credible information, weak priority setting institutions, and unclear priority setting processes. Efforts to improve priority setting in these contexts have focused on providing information and tools. In this paper we argue that priority setting is a value laden and political process, and although important, the available information and tools are not sufficient to address the priority setting challenges in developing countries. Additional complementary efforts are required. Hence, a strategy to improve priority setting in developing countries should also include: (i) capturing current priority setting practices, (ii) improving the legitimacy and capacity of institutions that set priorities, and (iii) developing fair priority setting processes.

Information and communication technology (ICT) and eHealth policy in Latin America and the Caribbean: a review of national policies and assessment of socioeconomic context.

PubMed

Jimenez-Marroquin, Maria Carolina; Deber, Raisa; Jadad, Alejandro R

2014-01-01

To examine the availability of national information and communication technology (ICT) or eHealth policies produced by countries in Latin America and the Caribbean (LAC), and to determine the influence of a country's socioeconomic context on the existence of these policies. Documents describing a national ICT or eHealth policy in any of the 33 countries belonging to the LAC region as listed by the United Nations were identified from three data sources: academic databases; the Google search engine; and government agencies and representatives. The relationship between the existence of a policy and national socioeconomic indicators was also investigated. There has been some progress in the establishment of ICT and eHealth policies in the LAC region. The most useful methods for identifying the policies were 1) use of the Google search engine and 2) contact with Pan American Health Organization (PAHO) country representatives. The countries that have developed a national ICT policy seem to be more likely to have a national eHealth policy in place. There was no statistical significant association between the existence of a policy and a country's socioeconomic context. Governments need to make stronger efforts to raise awareness about existing and planned ICT and eHealth policies, not only to facilitate ease of use and communication with their stakeholders, but also to promote collaborative international efforts. In addition, a better understanding of the effect of economic variables on the role that ICTs play in health sector reform efforts will help shape the vision of what can be achieved.

Determining the utility and durability of medical equipment donated to a rural clinic in a low-income country.

PubMed

Bauserman, Melissa; Hailey, Claire; Gado, Justin; Lokangaka, Adrien; Williams, Jessica; Richards-Kortum, Rebecca; Tshefu, Antoinette; Bose, Carl

2015-07-01

Health centers in low-income countries often depend on donations to provide appropriate diagnostic equipment. However, donations are sometimes made without an understanding of the recipient's needs, practical constraints or sustainability of supplies. We donated a set of physical diagnostic equipment, non-invasive instrument tests and laboratory supplies to a rural health center in the Democratic Republic of Congo. We collected information on the usage and durability of equipment and supplies for each patient encounter over a 1-year period. We recorded 913 patient encounters. The most commonly used physical diagnostic equipment were the stethoscope (98.9%; 903/913), thermometer (81.7%; 746/913), adult scale (81.4%; 744/913), stop watch (62.6%; 572/913), adult sphygmomanometer (55.8%; 510/913), infant scale (24.9%; 228/913), measuring tape (24.3%; 222/913) and fetoscope (23.8%; 218/913). The most commonly used laboratory tests were the blood smear for malaria (53.7%; 491/913), hematocrit (23.5%; 215/913), urinalysis (20.1%; 184/913) and sputum stain for TB (13.3%; 122/913). With the exception of a penlight and solar lantern, all equipment remained functional. This study adds valuable information about the utility and durability of equipment supplied to a health center in the Democratic Republic of Congo. Our results might aid in determining the appropriateness of donated medical equipment in similar settings. The selection of donated goods should be made with knowledge of the context in which it will be used, and utilization should be monitored. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Paths towards Family‐friendly Working Time Arrangements: Comparing Workplaces in Different Countries and Industries

PubMed Central

2016-01-01

Abstract Although studies have examined the distribution and conditions of employer‐provided work–family arrangements, we still lack a systematic investigation of how these vary for different countries and industries. Based on the European Working Conditions Survey 2010, this study examines the conditions under which firms provide family‐friendly working time arrangements and what the differences are across four countries (Austria, Denmark, Italy and the UK) and four industries. The impact of employee representatives, employee involvement, manager support and female managers varies across countries and industries because of the institutional environment (prevailing family model, industrial relations) and workforce composition (gender). The impact of employee representatives depends on their co‐determination rights, and the direction of their effect on the prevailing family model (e.g. negative in conservative countries such as Austria) and the gender composition of the workforce (negative in male‐dominated production, but positive in services). Employee involvement in the work organization is significantly positive in Austria and Denmark (both with co‐operative industrial relations), while manager support has the strongest effect in the UK (liberal regime). At the industry level, female supervisors are positively associated with family‐friendly working time arrangements only in the male‐dominated production industry. These findings suggest that the effects of agency variables and their direction vary depending on the institutional context. PMID:29242672

Paths towards Family-friendly Working Time Arrangements: Comparing Workplaces in Different Countries and Industries.

PubMed

Wiß, Tobias

2017-12-01

Although studies have examined the distribution and conditions of employer-provided work-family arrangements, we still lack a systematic investigation of how these vary for different countries and industries. Based on the European Working Conditions Survey 2010, this study examines the conditions under which firms provide family-friendly working time arrangements and what the differences are across four countries (Austria, Denmark, Italy and the UK) and four industries. The impact of employee representatives, employee involvement, manager support and female managers varies across countries and industries because of the institutional environment (prevailing family model, industrial relations) and workforce composition (gender). The impact of employee representatives depends on their co-determination rights, and the direction of their effect on the prevailing family model (e.g. negative in conservative countries such as Austria) and the gender composition of the workforce (negative in male-dominated production, but positive in services). Employee involvement in the work organization is significantly positive in Austria and Denmark (both with co-operative industrial relations), while manager support has the strongest effect in the UK (liberal regime). At the industry level, female supervisors are positively associated with family-friendly working time arrangements only in the male-dominated production industry. These findings suggest that the effects of agency variables and their direction vary depending on the institutional context.

When Do States Respond to Low Fertility? Contexts of State Concern in Wealthier Countries, 1976–2011

PubMed Central

Marshall, Emily A.

2015-01-01

Since the 1970s, expressions of state concern over low fertility have greatly increased among wealthier countries. This study asks to what extent this increase is explained by demographic factors, national-level economic and political factors, and processes of international diffusion and changing international norms. Analyses integrate the world polity literature on global policy diffusion with a social problems approach to examine international diffusion of state concern among more powerful members of the world polity, a process that can produce changes in international policy consensus. Comparisons of the characteristics of states that do and do not express concern over low fertility find that among wealthier “first-world” countries, state concern has become more responsive to fertility rates: fertility rates are not significantly associated with concern early in the study period, but are strongly associated with concern later in the study period. There is no evidence that integration into the world polity is associated with concern in these countries, and some evidence that less integrated countries are more likely to express concern, suggesting that processes shaping the diffusion of state concern may differ from those identified as shaping policy diffusion in the existing literature. Among “second-world” former Eastern bloc countries, different patterns of associations reflect different political histories: concern is associated only with demographic factors, with no significant change in this association over time. PMID:26213421

Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review.

PubMed

Fisher, Jane; Cabral de Mello, Meena; Patel, Vikram; Rahman, Atif; Tran, Thach; Holton, Sara; Holmes, Wendy

2012-02-01

To review the evidence about the prevalence and determinants of non-psychotic common perinatal mental disorders (CPMDs) in World Bank categorized low- and lower-middle-income countries. Major databases were searched systematically for English-language publications on the prevalence of non-psychotic CPMDs and on their risk factors and determinants. All study designs were included. Thirteen papers covering 17 low- and lower-middle-income countries provided findings for pregnant women, and 34, for women who had just given birth. Data on disorders in the antenatal period were available for 9 (8%) countries, and on disorders in the postnatal period, for 17 (15%). Weighted mean prevalence was 15.6% (95% confidence interval, CI: 15.4-15.9) antenatally and 19.8% (19.5-20.0) postnatally. Risk factors were: socioeconomic disadvantage (odds ratio [OR] range: 2.1-13.2); unintended pregnancy (1.6-8.8); being younger (2.1-5.4); being unmarried (3.4-5.8); lacking intimate partner empathy and support (2.0-9.4); having hostile in-laws (2.1-4.4); experiencing intimate partner violence (2.11-6.75); having insufficient emotional and practical support (2.8-6.1); in some settings, giving birth to a female (1.8-2.6), and having a history of mental health problems (5.1-5.6). Protective factors were: having more education (relative risk: 0.5; P = 0.03); having a permanent job (OR: 0.64; 95% CI: 0.4-1.0); being of the ethnic majority (OR: 0.2; 95% CI: 0.1-0.8) and having a kind, trustworthy intimate partner (OR: 0.52; 95% CI: 0.3-0.9). CPMDs are more prevalent in low- and lower-middle-income countries, particularly among poorer women with gender-based risks or a psychiatric history.

Architectures of small satellite programs in developing countries

NASA Astrophysics Data System (ADS)

Wood, Danielle; Weigel, Annalisa

2014-04-01

Global participation in space activity is growing as satellite technology matures and spreads. Countries in Africa, Asia and Latin America are creating or reinvigorating national satellite programs. These countries are building local capability in space through technological learning. This paper analyzes implementation approaches in small satellite programs within developing countries. The study addresses diverse examples of approaches used to master, adapt, diffuse and apply satellite technology in emerging countries. The work focuses on government programs that represent the nation and deliver services that provide public goods such as environmental monitoring. An original framework developed by the authors examines implementation approaches and contextual factors using the concept of Systems Architecture. The Systems Architecture analysis defines the satellite programs as systems within a context which execute functions via forms in order to achieve stakeholder objectives. These Systems Architecture definitions are applied to case studies of six satellite projects executed by countries in Africa and Asia. The architectural models used by these countries in various projects reveal patterns in the areas of training, technical specifications and partnership style. Based on these patterns, three Archetypal Project Architectures are defined which link the contextual factors to the implementation approaches. The three Archetypal Project Architectures lead to distinct opportunities for training, capability building and end user services.

Selecting Teaching Practice Schools across Social Contexts: Conceptual and Policy Challenges from South Africa

ERIC Educational Resources Information Center

Robinson, Maureen

2014-01-01

In a country like South Africa, as in many other countries around the world, there is an imperative to prepare student teachers for a wide variety of social contexts, as part of breaking the cycle of disadvantage for poor learners. This article explores the challenge of placing student teachers for their field experience in schools that differ…

Cultural Context and the New Communication Principles for Intercultural Communication.

ERIC Educational Resources Information Center

Waner, Karen K.; Winter, Janet K.

This paper discusses the problems surrounding intercultural business communication as well as approaches to teaching college level business students appropriate communication skills for intercultural settings. Considered are the classification of countries by cultural context, i.e. how large a role culture, social values, and traditional social…

Learning Organizations: Diagnosis and Measurement in a Developing Country Context--The Case of Lebanon

ERIC Educational Resources Information Center

Jamali, Dima; Sidani, Yusuf

2008-01-01

Purpose: The purpose of this paper is to assess the performance of a sample of Lebanese organizations vis-a-vis some of the core learning organization dimensions identified in the literature, focusing specifically on those dimensions that are considered most salient and relevant in the Lebanese context. Design/methodology/approach: The paper…

[A global view of population health in Colombia: role of social macro-determinants].

PubMed

Idrovo, Alvaro J; Ruiz-Rodríguez, Myriam

2007-09-01

The social environment is an important determinant of population and individual health. However, its impact is often not considered in national health policies and generally its attributes are considered as constants. For this reason, contemporary health policies place greater emphasis on individual risk factors. Colombias position in the world ranking is described with respect to several social macro-determinants of health, previously characterized as components of class/welfare regime model. The exploratory study included all countries with comparable data including the following: (1) economic development [gross domestic product per capita adjusted for purchasing power parity], (2) income inequality [Gini coefficient], (3) social capital corruption perceptions index and generalized trust, and (4) political regime index of freedom. First, correlations between these macro-determinants were estimated, and second, the relationship between them and life expectancy at birth was explored. Finally, the position of Colombia in global context was determined. Important correlations occurred among the macro-determinants. Colombia tended to have intermediate to low positions in the global context in all macro-determinants, with the exception of gross domestic product per capita adjusted for purchasing power parity. The macro-determinant of population health with the highest potential of effecting improvement in health conditions is to modify income inequality.

Moving towards universal health coverage: lessons from 11 country studies.

PubMed

Reich, Michael R; Harris, Joseph; Ikegami, Naoki; Maeda, Akiko; Cashin, Cheryl; Araujo, Edson C; Takemi, Keizo; Evans, Timothy G

2016-02-20

In recent years, many countries have adopted universal health coverage (UHC) as a national aspiration. In response to increasing demand for a systematic assessment of global experiences with UHC, the Government of Japan and the World Bank collaborated on a 2-year multicountry research programme to analyse the processes of moving towards UHC. The programme included 11 countries (Bangladesh, Brazil, Ethiopia, France, Ghana, Indonesia, Japan, Peru, Thailand, Turkey, and Vietnam), representing diverse geographical, economic, and historical contexts. The study identified common challenges and opportunities and useful insights for how to move towards UHC. The study showed that UHC is a complex process, fraught with challenges, many possible pathways, and various pitfalls--but is also feasible and achievable. Movement towards UHC is a long-term policy engagement that needs both technical knowledge and political know-how. Technical solutions need to be accompanied by pragmatic and innovative strategies that address the national political economy context. Copyright © 2016 Elsevier Ltd. All rights reserved.

Analysis of healthcare financing, supply and utilisation trends in the new EU countries.

PubMed

Ruseski, Jane E

2006-01-01

The EU expanded in 2004 to include eight transition countries, i.e. Central and Eastern European (CEE) and newly independent states of the former Soviet Union, and two other CEE countries are scheduled to join the EU in 2007. Each of these countries has undertaken substantial healthcare reform efforts over the past 15 years. The paths of healthcare reform are diverse for a number of reasons including differences in initial economic, political and structural conditions. The objective of this article is to evaluate the process and preliminary outcomes of healthcare reform in the new EU and candidate countries by analysing trends in aggregate financing, supply and utilisation indicators using data drawn from the WHO Health for All database. The analysis is done in the context of an analytical framework built around common healthcare reform themes. The key reform measures examined include implementing social insurance systems, implementing payment systems that promote efficiency, and removal of excess capacity. The trend analysis highlights the importance of the economic, political and social context in driving the direction and pace of healthcare reform. For example, the transition to social insurance systems was smoother in countries with stronger economies and political commitment to reform. Policies aimed at improving the efficiency of the healthcare system, reducing utilisation and reducing excess capacity were met with some success in all of the countries. However, the reform effort continues as the countries are still addressing the initial challenges of insufficient funding, informal payments, excess capacity and inefficiencies in the provision of healthcare.

Nutritional determinants of worldwide diabetes: an econometric study of food markets and diabetes prevalence in 173 countries.

PubMed

Basu, Sanjay; Stuckler, David; McKee, Martin; Galea, Gauden

2013-01-01

Ageing and urbanization leading to sedentary lifestyles have been the major explanations proposed for a dramatic rise in diabetes worldwide and have been the variables used to predict future diabetes rates. However, a transition to Western diets has been suggested as an alternative driver. We sought to determine what socio-economic and dietary factors are the most significant population-level contributors to diabetes prevalence rates internationally. Multivariate regression models were used to study how market sizes of major food products (sugars, cereals, vegetable oils, meats, total joules) corresponded to diabetes prevalence, incorporating lagged and cumulative effects. The underlying social determinants of food market sizes and diabetes prevalence rates were also studied, including ageing, income, urbanization, overweight prevalence and imports of foodstuffs. Data were obtained from 173 countries. Population-based survey recipients were the basis for diabetes prevalence and food market data. We found that increased income tends to increase overall food market size among low- and middle-income countries, but the level of food importation significantly shifts the content of markets such that a greater proportion of available joules is composed of sugar and related sweeteners. Sugar exposure statistically explained why urbanization and income have been correlated with diabetes rates. Current diabetes projection methods may estimate future diabetes rates poorly if they fail to incorporate the impact of nutritional factors. Imported sugars deserve further investigation as a potential population-level driver of global diabetes.

Intervention bioethics: a proposal for peripheral countries in a context of power and injustice.

PubMed

Garrafa, Volnei; Porto, Dora

2003-10-01

The bioethics of the so-called 'peripheral countries' must preferably be concerned with persistent situations, that is, with those problems that are still happening, but should not happen anymore in the 21st century. Resulting conflicts cannot be exclusively analysed based on ethical (or bioethical) theories derived from 'central countries.' The authors warn of the growing lack of political analysis of moral conflicts and of human indignation. The indiscriminate utilisation of the bioethics justification as a neutral methodological tool softens and even cancels out the seriousness of several problems, even those that might result in the most profound social distortions. The current study takes as a theoretical reference the fact that natural resources (which affect us all) are relevant. Based on these premises, and on the concept that equity means 'treating unevenly the unequal', a proposal of a hard bioethics (or intervention bioethics) is introduced, in defence of the historical insights and rights of economically and socially excluded populations that are separated from the international developmental process.

Mediated, moderated and direct effects of country of residence, age, and gender on the cognitive and social determinants of adolescent smoking in Spain and the UK: a cross-sectional study.

PubMed

Markham, Wolfgang A; Lopez, Maria Luisa; Aveyard, Paul; Herrero, Pablo; Bridle, Christopher; Comas, Angel; Charlton, Anne; Thomas, Hywel

2009-06-04

European trans-national adolescent smoking prevention interventions based on social influences approaches have had limited success. The attitudes-social influences-efficacy (ASE) model is a social cognition model that states smoking behaviour is determined by smoking intention which, in turn, is predicted by seven ASE determinants; disadvantages, advantages, social acceptance, social norms, modelling, perceived pressure, self-efficacy. Distal factors such as country of residence, age and gender are external to the model. The ASE model is, thus, closely related to the Theory of Planned Behaviour. This study assessed the utility of the ASE model using cross-sectional data from Spanish and UK adolescents. In 1997, questionnaires were simultaneously administered to Spanish (n = 3716) and UK adolescents (n = 3715) who were considered at high risk of smoking. Participants' age, gender, smoking intentions and ASE determinant scores were identified and linear regression analysis was used to examine the mediated, moderated and direct effects of country of residence, age and gender on participants' smoking intentions. All UK participants were aged 12 or 13 and most Spanish participants were aged between 12 and 14 (range 12-16 years). Amongst 12 and 13 year olds, regular smoking was more common in Spain. Almost half the participants were female (47.2% in Spain; 49.9% in the UK). Gender did not vary significantly according to age. The distribution of ASE determinant scores varied by country and predicted intention. The influence of each ASE determinant on intention was moderated by country. Country had a large direct influence on intention (1.72 points on a 7 point scale) but the effects of age and gender were mediated by the ASE determinants. The findings suggest resisting peer pressure interventions could potentially influence smoking amongst UK adolescents but not Spanish adolescents. Interventions that promote self-efficacy, on the other hand, would possibly have a greater

Hybrid context aware recommender systems

NASA Astrophysics Data System (ADS)

Jain, Rajshree; Tyagi, Jaya; Singh, Sandeep Kumar; Alam, Taj

2017-10-01

Recommender systems and context awareness is currently a vital field of research. Most hybrid recommendation systems implement content based and collaborative filtering techniques whereas this work combines context and collaborative filtering. The paper presents a hybrid context aware recommender system for books and movies that gives recommendations based on the user context as well as user or item similarity. It also addresses the issue of dimensionality reduction using weighted pre filtering based on dynamically entered user context and preference of context. This unique step helps to reduce the size of dataset for collaborative filtering. Bias subtracted collaborative filtering is used so as to consider the relative rating of a particular user and not the absolute values. Cosine similarity is used as a metric to determine the similarity between users or items. The unknown ratings are calculated and evaluated using MSE (Mean Squared Error) in test and train datasets. The overall process of recommendation has helped to personalize recommendations and give more accurate results with reduced complexity in collaborative filtering.

Prospective Trends in the Socio-Economic Context of Education in European Market Economy Countries.

ERIC Educational Resources Information Center

Weiss, M.; And Others

The purpose of this study was to project and analyze the prospective long-term trends in the socioeconomic context of the educational systems of European market economies and to outline in global terms the probable implication for education and training in the future. Composed of three chapters, the chapter 1 focuses on projected long-term…

Rebound Effects in the Context of Developing Country Efficiency

DOE Office of Scientific and Technical Information (OSTI.GOV)

de la Rue du Can, Stephane; McNeil, Michael A.; Leventis, Greg

Energy efficiency-related “rebound effects” usually refer to the tendency of most consumers to increase their use of energy services in response to efficiency measures that have reduced their energy costs. This phenomenon is one reason why energy efficiency policies often result in lower energy savings than engineering-based estimates predict. Rebound effects have been the subject of intense debate in the field of energy efficiency policy for many years.1 In the past, the focus of this debate has been on the perceived loss of the expected energy savings and related benefits resulting from the rebound effects. However, more recently, there hasmore » been a growing recognition that policymakers need to consider the health, economic and other non-energy benefits that often result from the increase in energy services represented by user “rebound effects”. This is especially true in developing countries where basic energy service demands—such as lighting, heating, cooling, and refrigeration of food—are often not being met. As economic conditions improve and household incomes increase, demand for increased energy services (such as space conditioning and appliances) tends to rise rapidly. Improving energy efficiency reduces the amount of energy needed to produce one unit of energy service output (for example an hour of cooling at 21°C delivered for X vs Y kWh). Greater efficiency therefore often enables more rapid increased in energy services (and sometimes access), expanding the amount of services that can be provided by a fixed amount (or cost) of energy.« less

[Relevance of the socioeconomic and health context in patient satisfaction].

PubMed

Pérez-Romero, Shirley; Gascón-Cánovas, Juan J; Salmerón-Martínez, Diego; Parra-Hidalgo, Pedro; Monteagudo-Piqueras, Olga

To determine which factors of the socioeconomic and health contexts influence the perception of the satisfaction of the population with the health services. The data come from the European Health Survey of 2009. In the 22,188 subjects surveyed, the relationship between the perception of satisfaction with the health services received and the individual and contextual variables was studied, applying a multilevel analysis. The factors of the socioeconomic and health contexts that influence satisfaction are: higher rates of low level of studies where the perception of excellence is less likely (odds ratio [OR]: 0.48-0.82) and dissatisfaction is more prevalent (OR: 1.46-1.63). Likewise, the proportion of unsatisfied citizens is lower when per capita expenditure on health services is very high (>1400 €) (OR: 0.49-0.87) and the ratio "primary health care physicians/inhabitants" is high (>60) (OR: 0.500.85). In addition, the prevalence of dissatisfaction describes a positive linear trend with the unemployment rate (OR: 1.12; p=0.0001) and the relative magnitude of the services sector (OR: 1.03; p=0.001). By contrast, this linear trend is negative as the Health Care Coverage Ratio increases (OR: 0.88; p=0.04). The individual factors that determine patient satisfaction are: sex, age, mental health and country of birth. In addition, there are differences in patient satisfaction among the autonomous communities according to socio-economic determinants such as GDP per capita, low-level study rates, unemployment rates or number of inhabitants/doctor's ratio. User satisfaction studies as well as being adjusted for individual variables such as sex, age or health level should also take into account characteristics of the socioeconomic environment of the geographic area where they reside. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Constraining Assertion: An Account of Context-Sensitivity

ERIC Educational Resources Information Center

Villanueva Chigne, Eduardo

2012-01-01

Many philosophers believe that if "S" is an unambiguous, context-sensitive, declarative sentence and "p" is a proposition asserted (without conversational implicatures) by a literal utterance of "S" in a context "c," then "p" is fully determined by the linguistic meaning of "S" in…

Towards an ethically sensitive implementation of non invasive prenatal screening in the global context

PubMed Central

Mozersky, Jessica; Ravitsky, Vardit; Rapp, Rayna; Michie, Marsha; Chandrasekharan, Subhashini; Allyse, Megan

2017-01-01

Cell-free DNA (cfDNA) screening is an emerging prenatal technology available in 90 countries. Despite its rapid global diffusion, there is a gap in knowledge about its implementation outside of North America and Europe including low to middle income countries. To address this, we organized an international comparative workshop to explore the ethical and social implications of the global expansion of cfDNA screening. We describe 8 key insights that arose from discussions to illustrate how bioethical discussions and normative frameworks that originate and reflect North American and European ethical priorities can be enriched by attending to the importance of local context. The utility and ethical implications of cfDNA screening are highly variable and dependent upon local healthcare systems, cultural, economic, and socio-political contexts and needs. We call for a more subtle, dynamic and contextual understanding of the international spread of cfDNA screening, which will evoke diverse challenges across different contexts. PMID:28301696

E-health: determinants, opportunities, challenges and the way forward for countries in the WHO African Region.

PubMed

Kirigia, Joses M; Seddoh, Anthony; Gatwiri, Doris; Muthuri, Lenity H K; Seddoh, Janet

2005-12-20

The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income countries in the Region. By

E-health: Determinants, opportunities, challenges and the way forward for countries in the WHO African Region

PubMed Central

Kirigia, Joses M; Seddoh, Anthony; Gatwiri, Doris; Muthuri, Lenity HK; Seddoh, Janet

2005-01-01

Background The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO) African Region due to lack of information and communications technology (ICT) and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i) explore the key determinants of personal computers (PCs), telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii) to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. Methods The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP), the World Bank and the International Telecommunications Union (ITU) sources. Results There were a number of main findings: (i) the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test) positive effect on the number of PCs in a country; (ii) the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii) the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv) similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v) there were major inequalities in ICT connectivity between upper-middle, lower-middle and low income

Participation Motivation and Student's Physical Activity among Sport Students in Three Countries.

PubMed

Kondric, Miran; Sindik, Joško; Furjan-Mandic, Gordana; Schiefler, Bernd

2013-01-01

The main aim of this study was to examine the differences in motivation to participate in sport activities among sports students from three different countries. On a sample of 390 sports students from Slovenia, Croatia and Germany we studied what motivates an interest in being sports active. The sample was stratified across the choice to attend table tennis lessons at all three institutions and all students have completed the Participation Motivation Questionnaire (PMQ). The results revealed that the latent structure of the types of sports students' motives consisted of six factors (sport action with friend, popularity, fitness & health, social status, sports events, relaxation through sports). We also found significant sex differences in motivation to participate in sport activities for all sports students from the three different countries. We did not find relevant age-based differences among the students, and this is the only initial hypothesis that we can reject. Key pointsThe potential implications of the result can be in better understanding the relationship between different motivational orientations - in particular, extrinsic motivation - and sport motivation among school-aged individuals.In the context of Self Determination Theory, students can be encouraged in developing more autonomous orientations for sport activity, rather than controlled and impersonal, especially in certain countries.Significant factors of differences have been found in motivation to participate in sport activities among sports students from three different countries and also some significant sex differences have been found in motivation to participate in sport activities for all sports students.

Which Love of Country? Tensions, Questions and Contexts for Patriotism and Cosmopolitanism in Education

ERIC Educational Resources Information Center

Schumann, Claudia

2016-01-01

The paper considers Martha Nussbaum's motivation for departing from her earlier cosmopolitan position in favour of now promoting a globally sensitive patriotism. Her reasons for endorsing patriotism will be shown as exemplary for related argumentations by other authors, especially insofar as love of country as a motivating force for civic duty is…

Comparison of Literacy Campaigns in Socialistic and Democratic Countries.

ERIC Educational Resources Information Center

Sauder, Ruth

The literature on mass literacy campaigns conducted in various countries over the past several decades was surveyed to determine if efforts in socialist countries were more successful than those in democratic countries. Five socialist and five democratic countries were matched on the basis of population, geographic proximity, or size. The pairs…

Professional Training in Organic Food Production: A Cross-Country Experience

ERIC Educational Resources Information Center

Guiné, Raquel; Costa, Daniela; Correia, Paula; Costa, Cristina; Correia, Helena; Castro, Moises; Guerra, Luis; Seeds, Catherine; Coll, Collette; Radics, Laszlo; Arslan, Meahmet; Soylu, Soner; Tothova, Monika; Toth, Peter; Basile, Salvatore

2017-01-01

Purpose: The purpose of this paper is to characterize the agricultural activities and past experiences in professional training in the context of mobile learning in different countries (Portugal, Spain, Slovakia, Hungary, UK, Italy and Turkey). Design/methodology/approach: For the survey, a questionnaire was prepared in English and Portuguese and…

Diverse Contexts of Zoonotic Transmission of Simian Foamy Viruses in Asia

PubMed Central

May, Cynthia C.; Engel, Gregory A.; Steinkraus, Katherine A.; Schillaci, Michael A.; Fuentes, Agustin; Rompis, Aida; Chalise, Mukesh K.; Aggimarangsee, Nantiya; Feeroz, Mohammed M.; Grant, Richard; Allan, Jonathan S.; Putra, Arta; Wandia, I. Nengah; Watanabe, Robin; Kuller, LaRene; Thongsawat, Satawat; Chaiwarith, Romanee; Kyes, Randall C.; Linial, Maxine L.

2008-01-01

In Asia, contact between persons and nonhuman primates is widespread in multiple occupational and nonoccupational contexts. Simian foamy viruses (SFVs) are retroviruses that are prevalent in all species of nonhuman primates. To determine SFV prevalence in humans, we tested 305 persons who lived or worked around nonhuman primates in several South and Southeast Asian countries; 8 (2.6%) were confirmed SFV positive by Western blot and, for some, by PCR. The interspecies interactions that likely resulted in virus transmission were diverse; 5 macaque taxa were implicated as a potential source of infection. Phylogenetic analysis showed that SFV from 3 infected persons was similar to that from the nonhuman primate populations with which the infected persons reported contact. Thus, SFV infections are likely to be prevalent among persons who live or work near nonhuman primates in Asia. PMID:18680642

National Degree of Computerization: A Context for Evaluating Computer Education Policies in Developing Countries.

ERIC Educational Resources Information Center

Boehm, Barry W.

Developing countries should take immediate steps to avoid some of the serious problems that are now facing the United States in regard to the pool of trained computer professionals. Problem areas which should be reconciled involve a diverse range of topics from general national policy to salary structures and conversions efforts. By using the…

Smoking and smokeless tobacco use in nine South and Southeast Asian countries: prevalence estimates and social determinants from Demographic and Health Surveys.

PubMed

Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Man Singh; Mir, Imtiyaz Ali; Sin, Shwe

2014-01-01

In South and Southeast Asian countries, tobacco is consumed in diverse forms, and smoking among women is very low. We aimed to provide national estimates of prevalence and social determinants of smoking and smokeless tobacco use among men and women separately. Data from Demographic and Health Surveys completed in nine countries (India, Pakistan, Nepal, Bangladesh, Maldives, Philippines, Cambodia, Indonesia, and Timor Leste) were analyzed. Current smoking or smokeless tobacco use was assessed as response "yes" to one or more of three questions, such as "Do you currently smoke cigarettes?" Weighted country-level prevalence rates for socio-economic subgroups were calculated for smoking and smokeless tobacco use. Binary logistic regression analyses were done on STATA/IC (version 10) by 'svy' command. Prevalence and type of tobacco use among men and women varied across the countries and among socio-economic sub groups. Smoking prevalence was much lower in women than men in all countries. Smoking among men was very high in Indonesia, Maldives, and Bangladesh. Smokeless tobacco (mainly chewable) was used in diverse forms, particularly in India, among both men and women. Chewing tobacco was common in Nepal, Bangladesh, Maldives, and Cambodia. Both smoking and smokeless tobacco use were associated with higher age, lower education, and poverty, but their association with place of residence and marital status was not uniform between men and women across the countries. Policymakers should consider type of tobacco consumption and their differentials among various population subgroups to implement country-specific tobacco control policies and target the vulnerable groups. Smokeless tobacco use should also be prioritized in tobacco control efforts.

Identifying Vulnerable Populations Using a Social Determinants of Health Framework: Analysis of National Survey Data across Six Asia-Pacific Countries

PubMed Central

Ward, Paul R.; Mamerow, Loreen; Meyer, Samantha B.

2013-01-01

Background In order to improve the health of the most vulnerable groups in society, the WHO called for research on the multiple and inter-linking factors shaping the social determinants of health (SDH). This paper analyses four key SDH (social cohesion, social inclusion, social empowerment and socioeconomic security) across six Asia-Pacific countries: Australia, Hong Kong, Japan, South Korea, Taiwan, and Thailand. Methods Population surveys were undertaken using a validated instrument in 2009-10, with sample sizes around 1000 in each country. The four SDH were analysed using multivariate binomial logistic regression to identify socio-demographic predictors in each country. Results Low socio-economic security was associated with low income in all six study countries and with poor subjective health in Japan, South Korea and Thailand and with being married or cohabiting in Australia and Hong Kong. Low social cohesion was associated with low income in all countries and with undertaking household duties in South Korea, Thailand and Taiwan. Low social inclusion was associated with low income in Australia, South Korea and Taiwan and with poor subjective health in Australia, Japan and South Korea. Older people had lower social inclusion in Taiwan (50-59 years) and Hong Kong (retired), younger people in Japan and South Korea (20-29 years in both countries) and younger and middle-aged people in Australia. Low social empowerment was associated with low income in Australia, Thailand and Taiwan, with being aged 60 years or over in Australia, Hong Kong and South Korea, and over 50 years in Thailand. Conclusions This paper provides baseline measures for identifying where and how policy should be altered to improve the SDH. Furthermore, these data can be used for future policy evaluation to identify whether changes in policy have indeed improved the SDH, particularly for marginalised and vulnerable populations. PMID:24349417

Robust analysis of the determinants of healthcare expenditure growth: evidence from panel data for low-, middle- and high-income countries.

PubMed

Younsi, Moheddine; Chakroun, Mohamed; Nafla, Amine

2016-10-01

This paper examines the determinants of healthcare expenditure for low-, middle- and high-income countries, and it quantifies their influences in order to assess policies for achieving universal health coverage. We elaborate two models, a fixed-effect model and the dynamic panel model, to estimate the factors associated with the total health expenditure growth as well as its major components for 167 countries over the period of 1993-2013. The panel data on total health expenditure per capita and its components were taken from the World Development Indicators. Overall, our results showed that total health expenditure per capita is rising in all countries over time as a result of rising incomes. However, our estimates showed that the income elasticity of health expenditure ranged from 0.75 to 0.96 in the fixed-effect static panel model, while in the dynamic panel model, it was smaller and ranged from 0.16 to 0.47. Our empirical findings indicate that development assistance for health reduced government domestic spending on health but increased total government health spending. Our results also indicate that the trend in health expenditure growth is significantly depending with the country's economic development. In addition, out-of-pocket expenditure is powerfully influenced by a country's capacity to increase general government revenues and social insurance contributions. Knowledge of factors associated to health expenditure might help policy makers to make wise judgments, plan health reforms and allocate resources efficiently. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The influence of educational context on science learning: a cross-national analysis of PISA

NASA Astrophysics Data System (ADS)

Coll, Richard K.; Dahsah, Chanyah; Faikhamta, Chatree

2010-04-01

The literature is replete with studies about the importance of context in relation to teaching and learning. Major international studies such as PISA, among others, attempt to develop an understanding of achievement in science learning in a variety of educational contexts. Here we explore the influence of educational context itself on science learning as measured by PISA. Comparison is made between two countries: one developed or 'western' nation, New Zealand, and one non-western developing nation from southeast Asia, Thailand. In this work the authors seek to establish links between the nature of the educational context (based on Lave's notion of situated cognition) and achievement in the PISA science evaluation exercise.

How Can Information and Communication Technology Improve Healthcare Inequalities and Healthcare Inequity? The Concept of Context Driven Care.

PubMed

Yee, Kwang Chien; Bettiol, Silvana; Nash, Rosie; Macintyrne, Kate; Wong, Ming Chao; Nøhr, Christian

2018-01-01

Advances in medicine have improved health and healthcare for many around the world. The challenge is achieving the best outcomes of health via healthcare delivery to every individual. Healthcare inequalities exist within a country and between countries. Health information technology (HIT) has provided a mean to deliver equal access to healthcare services regardless of social context and physical location. In order to achieve better health outcomes for every individual, socio-cultural factors, such as literacy and social context need to consider. This paper argues that HIT while improves healthcare inequalities by providing access, might worsen healthcare inequity. In order to improve healthcare inequity using HIT, this paper argues that we need to consider patients and context, and hence the concept of context driven care. To improve healthcare inequity, we need to conceptually consider the patient's view and methodologically consider design methods that achieve participatory outcomes.

Complex implications around a simple trait: ecological context determines the fecundity effects of corolla marcescence.

PubMed

Herrera, Carlos M

2011-05-01

Post-anthesis functionality of persistent perianth parts has rarely been investigated, but available evidence suggests that perianth persistence may not always have an adaptive value. Given the high occurrence of the trait, that it may sometimes be maladaptive is an intriguing possibility and deserves exploration. This paper tests the hypothesis that the fitness value of corolla persistence after anthesis depends on ecological context, specifically the abundance of fruit predators and pollinators. The study was conducted on Narcissus longispathus, a species in which corolla marcescence is apparently maladaptive because withered corollas provide a shelter for fruit-predatory lepidopteran larvae. By experimentally manipulating corolla persistence, presence of fruit predators, and pollination, I tested whether variation in ecological scenario led to concomitant variation in the sign and magnitude of the effects of corolla marcescence on fecundity. Persistent corollas were detrimental to fecundity when plants were exposed to larvae, but not when larvae were excluded. Pollination and herbivory had nonadditive effects on the fecundity consequences of corolla marcescence, the strongest detrimental effects of corolla persistence occurring for the "exposed to larvae + supplementary pollination" treatment combination. The hypothesis that ecological context is a major determinant of the fitness value of corolla marcescence was supported. In N. longispathus, corolla marcescence will be a maladaptive trait in situations in which pollinators and fruit predators are simultaneously abundant, but will be a neutral character in the absence of fruit predators, irrespective of pollinator service.

Preparing Daughters: The Context of Rurality on Mothers' Role in Contraception

ERIC Educational Resources Information Center

Noone, Joanne; Young, Heather M.

2009-01-01

Context: The United States continues to have the highest rate of adolescent childbearing among developed countries. Lack of access and disadvantage contribute to this problem, which disproportionately impacts rural women. Given the increased difficulty rural young women face regarding contraceptive access, parental communication and support play…

The 'dark side' of social capital: trust and self-rated health in European countries.

PubMed

Campos-Matos, Inês; Subramanian, S V; Kawachi, Ichiro

2016-02-01

Generalized interpersonal trust (as an indicator of social capital) has been linked to health status at both the individual and ecological level. We sought to examine how changes in contextual and individual trust are associated with changes in self-rated health in the European Social Surveys 2002-12. A multilevel analysis using a variance components model was performed on 203 452 individuals nested within 145 country cohorts covering 35 countries. Conditional on sociodemographic covariates, we sought to examine the association between self-rated health and individual trust, country average trust and a cross-level interaction between the two. Although individual trust perceptions were significantly correlated with self-rated health [OR = 0.95, 95% confidence interval (0.94-0.96)], country-level trust was not associated [OR = 1.12, 95% confidence interval (0.95-1.32)]. There was, however, a strong crosslevel interaction between contextual and individual trust (P < 0.001), such that individuals with high interpersonal trust reported better health in contexts in which other individuals expressed high average interpersonal trust. Conversely, low trust individuals reported worse health in high trust contexts. Our findings suggest that contexts with increasing average trust can be harmful for low trust individuals, which might reflect the negative impact that social capital can have in certain groups. These findings suggest that contextual trust has a complex role in explaining health inequalities and individual self-rated health. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

An analysis framework for characterizing and explaining development of EIA legislation in developing countries-Illustrated for Georgia, Ghana and Yemen

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kolhoff, Arend J., E-mail: akolhoff@eia.nl; Driessen, Peter P.J., E-mail: p.driessen@uu.nl; Runhaar, Hens A.C., E-mail: h.a.c.runhaar@uu.nl

2013-01-15

analysis framework may also assist actors involved in the development of EIA legislation in setting ambitions for EIA legislation that are feasible within the context in which it will be developed and implemented. Application of a country-specific EIA model would seem to be the preferred model to develop EIA legislation because by taking capacities of actors and context factors as a starting point, it offers more potential to well-performing EIA systems. - Highlights: Black-Right-Pointing-Pointer EIA systems develop from less to high ambitious and sometimes vice versa. Black-Right-Pointing-Pointer Ambitions in EIA legislation are determined by the capacity of environment- and sector authority. Black-Right-Pointing-Pointer The political system is the most important context factor explaining the ambitions of an EIA system. Black-Right-Pointing-Pointer An analysis framework developed to measure EIA system ambitions might help to setambitions.« less

Health system factors influencing management of multidrug-resistant tuberculosis in four European Union countries - learning from country experiences.

PubMed

de Vries, Gerard; Tsolova, Svetla; Anderson, Laura F; Gebhard, Agnes C; Heldal, Einar; Hollo, Vahur; Cejudo, Laura Sánchez-Cambronero; Schmid, Daniela; Schreuder, Bert; Varleva, Tonka; van der Werf, Marieke J

2017-04-19

In the European Union and European Economic Area only 38% of multidrug-resistant tuberculosis patients notified in 2011 completed treatment successfully at 24 months' evaluation. Socio-economic factors and patient factors such as demographic characteristics, behaviour and attitudes are associated with treatment outcomes. Characteristics of healthcare systems also affect health outcomes. This study was conducted to identify and better understand the contribution of health system components to successful treatment of multidrug-resistant tuberculosis. We selected four European Union countries to provide for a broad range of geographical locations and levels of treatment success rates of the multidrug-resistant tuberculosis cohort in 2009. We conducted semi-structured interviews following a conceptual framework with representatives from policy and planning authorities, healthcare providers and civil society organisations. Responses were organised according to the six building blocks of the World Health Organization health systems framework. In the four included countries, Austria, Bulgaria, Spain, and the United Kingdom, the following healthcare system factors were perceived as key to achieving good treatment results for patients with multidrug-resistant tuberculosis: timely diagnosis of drug-resistant tuberculosis; financial systems that ensure access to a full course of treatment and support for multidrug-resistant tuberculosis patients; patient-centred approaches with strong intersectoral collaboration that address patients' emotional and social needs; motivated and dedicated healthcare workers with sufficient mandate and means to support patients; and cross-border management of multidrug-resistant tuberculosis to secure continuum of care between countries. We suggest that the following actions may improve the success of treatment for multidrug-resistant tuberculosis patients: deployment of rapid molecular diagnostic tests; development of context-specific treatment

Associations of government health expenditures, the supply of health care professionals, and country literacy with prenatal care use in ten West African countries.

PubMed

Taylor, Yhenneko J; Laditka, Sarah B; Laditka, James N; Brunner Huber, Larissa R; Racine, Elizabeth F

2017-03-01

Social and health care context may influence prenatal care use. We studied associations of government health expenditures, supply of health care professionals, and country literacy rates with prenatal care use in ten West African countries, controlling for individual factors. We used data from Demographic and Health Surveys (n = 58,512) and random effect logistic regression models to estimate the likelihood of having any prenatal care and adequate prenatal care. Each percentage increase in the literacy rate was associated with 4% higher odds of having adequate prenatal care (p = .029). Higher literacy rates among women may help to promote adequate prenatal care.

Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review

PubMed Central

Cabral de Mello, Meena; Patel, Vikram; Rahman, Atif; Tran, Thach; Holton, Sara; Holmes, Wendy

2012-01-01

Abstract Objective To review the evidence about the prevalence and determinants of non-psychotic common perinatal mental disorders (CPMDs) in World Bank categorized low- and lower-middle-income countries. Methods Major databases were searched systematically for English-language publications on the prevalence of non-psychotic CPMDs and on their risk factors and determinants. All study designs were included. Findings Thirteen papers covering 17 low- and lower-middle-income countries provided findings for pregnant women, and 34, for women who had just given birth. Data on disorders in the antenatal period were available for 9 (8%) countries, and on disorders in the postnatal period, for 17 (15%). Weighted mean prevalence was 15.6% (95% confidence interval, CI: 15.4–15.9) antenatally and 19.8% (19.5–20.0) postnatally. Risk factors were: socioeconomic disadvantage (odds ratio [OR] range: 2.1–13.2); unintended pregnancy (1.6–8.8); being younger (2.1–5.4); being unmarried (3.4–5.8); lacking intimate partner empathy and support (2.0–9.4); having hostile in-laws (2.1–4.4); experiencing intimate partner violence (2.11–6.75); having insufficient emotional and practical support (2.8–6.1); in some settings, giving birth to a female (1.8–2.6), and having a history of mental health problems (5.1–5.6). Protective factors were: having more education (relative risk: 0.5; P = 0.03); having a permanent job (OR: 0.64; 95% CI: 0.4–1.0); being of the ethnic majority (OR: 0.2; 95% CI: 0.1–0.8) and having a kind, trustworthy intimate partner (OR: 0.52; 95% CI: 0.3–0.9). Conclusion CPMDs are more prevalent in low- and lower-middle-income countries, particularly among poorer women with gender-based risks or a psychiatric history. PMID:22423165

Iron Deficiency Anemia: Focus on Infectious Diseases in Lesser Developed Countries

PubMed Central

Shaw, Julia G.; Friedman, Jennifer F.

2011-01-01

Iron deficiency anemia is thought to affect the health of more than one billion people worldwide, with the greatest burden of disease experienced in lesser developed countries, particularly women of reproductive age and children. This greater disease burden is due to both nutritional and infectious etiologies. Individuals in lesser developed countries have diets that are much lower in iron, less access to multivitamins for young children and pregnant women, and increased rates of fertility which increase demands for iron through the life course. Infectious diseases, particularly parasitic diseases, also lead to both extracorporeal iron loss and anemia of inflammation, which decreases bioavailability of iron to host tissues. This paper will address the unique etiologies and consequences of both iron deficiency anemia and the alterations in iron absorption and distribution seen in the context of anemia of inflammation. Implications for diagnosis and treatment in this unique context will also be discussed. PMID:21738863

Intellectual Disability in the Context of a South African Population

ERIC Educational Resources Information Center

Kromberg, Jennifer; Zwane, Esther; Manga, Prashiela; Venter, Andre; Rosen, Eric; Christianson, Arnold

2008-01-01

Childhood disabilities, including intellectual disabilities (ID), are thought to occur in 5-17% of children in developing countries around the world. In order to identify and describe the childhood disabilities occurring in a rural South African population, as well as the context in which they occur, a study was carried out in the Bushbuckridge…

Work-Family Context and the Longevity Disadvantage of US Women

PubMed Central

Montez, Jennifer Karas; Martikainen, Pekka; Remes, Hanna; Avendano, Mauricio

2015-01-01

Female life expectancy is currently shorter in the United States than in most high-income countries. This study examines work-family context as a potential explanation. While work-family context changed similarly across high-income countries during the past half century, the United States has not implemented institutional supports, such as universally available childcare and family leave, to help Americans contend with these changes. We compare the United States to Finland—a country with similar trends in work-family life but generous institutional supports—and test two hypotheses to explain US women's longevity disadvantage: (1) US women may be less likely than Finnish women to combine employment with childrearing; and (2) US women's longevity may benefit less than Finnish women's longevity from combining employment with childrearing. We used data from women aged 30–60 years during 1988–2006 in the US National Health Interview Survey Linked Mortality File and harmonized it with data from Finnish national registers. We found stronger support for hypothesis 1, especially among low-educated women. Contrary to hypothesis 2, combining employment and childrearing was not less beneficial for US women's longevity. In a simulation exercise, more than 75 percent of US women's longevity disadvantage was eliminated by raising their employment levels to Finnish levels and reducing mortality rates of non-married/non-employed US women to Finnish rates. PMID:27773947

Prevalence and Social Determinants of Smoking in 15 Countries from North Africa, Central and Western Asia, Latin America and Caribbean: Secondary Data Analyses of Demographic and Health Surveys

PubMed Central

Sreeramareddy, Chandrashekhar T.; Pradhan, Pranil Man Singh

2015-01-01

Background Article 20 of the World Health Organisation Framework Convention on Tobacco Control calls for a cross-country surveillance of tobacco use through population-based surveys. We aimed to provide country-level prevalence estimates for current smoking and current smokeless tobacco use and to assess social determinants of smoking. Methods Data from Demographic and Health Surveys done between 2005 and 2012, among men and women from nine North African, Central and West Asian countries and six Latin American and Caribbean countries were analyzed. Weighted country-level prevalence rates were estimated for ‘current smoking’ and ‘current use of smokeless tobacco (SLT) products’ among men and women. In each country, social determinants of smoking among men and women were assessed by binary logistic regression analyses by including men's and women's sampling weights to account for the complex survey design. Findings Prevalence of smoking among men was higher than 40% in Armenia (63.1%), Moldova (51.1%), Ukraine (52%), Azerbaijan (49.8 %), Kyrgyz Republic (44.3 %) and Albania (42.52%) but the prevalence of smoking among women was less than 10% in most countries except Ukraine (14.81%) and Jordan (17.96%). The prevalence of smokeless tobacco use among men and women was less than 5% in all countries except among men in the Kyrgyz Republic (10.6 %). Smoking was associated with older age, lower education and poverty among men and higher education and higher wealth among women. Smoking among both men and women was associated with unskilled work, living in urban areas and being single. Conclusion Smoking among men was very high in Central and West Asian countries. Social pattern of smoking among women that was different from men in education and wealth should be considered while formulating tobacco control policies in some Central and West Asian countries. PMID:26131888

Prevalence and Social Determinants of Smoking in 15 Countries from North Africa, Central and Western Asia, Latin America and Caribbean: Secondary Data Analyses of Demographic and Health Surveys.

PubMed

Sreeramareddy, Chandrashekhar T; Pradhan, Pranil Man Singh

2015-01-01

Article 20 of the World Health Organisation Framework Convention on Tobacco Control calls for a cross-country surveillance of tobacco use through population-based surveys. We aimed to provide country-level prevalence estimates for current smoking and current smokeless tobacco use and to assess social determinants of smoking. Data from Demographic and Health Surveys done between 2005 and 2012, among men and women from nine North African, Central and West Asian countries and six Latin American and Caribbean countries were analyzed. Weighted country-level prevalence rates were estimated for 'current smoking' and 'current use of smokeless tobacco (SLT) products' among men and women. In each country, social determinants of smoking among men and women were assessed by binary logistic regression analyses by including men's and women's sampling weights to account for the complex survey design. Prevalence of smoking among men was higher than 40% in Armenia (63.1%), Moldova (51.1%), Ukraine (52%), Azerbaijan (49.8 %), Kyrgyz Republic (44.3 %) and Albania (42.52%) but the prevalence of smoking among women was less than 10% in most countries except Ukraine (14.81%) and Jordan (17.96%). The prevalence of smokeless tobacco use among men and women was less than 5% in all countries except among men in the Kyrgyz Republic (10.6 %). Smoking was associated with older age, lower education and poverty among men and higher education and higher wealth among women. Smoking among both men and women was associated with unskilled work, living in urban areas and being single. Smoking among men was very high in Central and West Asian countries. Social pattern of smoking among women that was different from men in education and wealth should be considered while formulating tobacco control policies in some Central and West Asian countries.

A Pattern-Based Definition of Urban Context Using Remote Sensing and GIS

PubMed Central

Benza, Magdalena; Weeks, John R.; Stow, Douglas A.; López-Carr, David; Clarke, Keith C.

2016-01-01

In Sub-Saharan Africa rapid urban growth combined with rising poverty is creating diverse urban environments, the nature of which are not adequately captured by a simple urban-rural dichotomy. This paper proposes an alternative classification scheme for urban mapping based on a gradient approach for the southern portion of the West African country of Ghana. Landsat Enhanced Thematic Mapper Plus (ETM+) and European Remote Sensing Satellite-2 (ERS-2) synthetic aperture radar (SAR) imagery are used to generate a pattern based definition of the urban context. Spectral mixture analysis (SMA) is used to classify a Landsat scene into Built, Vegetation and Other land covers. Landscape metrics are estimated for Built and Vegetation land covers for a 450 meter uniform grid covering the study area. A measure of texture is extracted from the SAR imagery and classified as Built/Non-built. SMA based measures of Built and Vegetation fragmentation are combined with SAR texture based Built/Non-built maps through a decision tree classifier to generate a nine class urban context map capturing the transition from unsettled land at one end of the gradient to the compact urban core at the other end. Training and testing of the decision tree classifier was done using very high spatial resolution reference imagery from Google Earth. An overall classification agreement of 77% was determined for the nine-class urban context map, with user’s accuracy (commission errors) being lower than producer’s accuracy (omission errors). Nine urban contexts were classified and then compared with data from the 2000 Census of Ghana. Results suggest that the urban classes appropriately differentiate areas along the urban gradient. PMID:27867227

A Pattern-Based Definition of Urban Context Using Remote Sensing and GIS.

PubMed

Benza, Magdalena; Weeks, John R; Stow, Douglas A; López-Carr, David; Clarke, Keith C

2016-09-15

In Sub-Saharan Africa rapid urban growth combined with rising poverty is creating diverse urban environments, the nature of which are not adequately captured by a simple urban-rural dichotomy. This paper proposes an alternative classification scheme for urban mapping based on a gradient approach for the southern portion of the West African country of Ghana. Landsat Enhanced Thematic Mapper Plus (ETM+) and European Remote Sensing Satellite-2 (ERS-2) synthetic aperture radar (SAR) imagery are used to generate a pattern based definition of the urban context. Spectral mixture analysis (SMA) is used to classify a Landsat scene into Built, Vegetation and Other land covers. Landscape metrics are estimated for Built and Vegetation land covers for a 450 meter uniform grid covering the study area. A measure of texture is extracted from the SAR imagery and classified as Built/Non-built. SMA based measures of Built and Vegetation fragmentation are combined with SAR texture based Built/Non-built maps through a decision tree classifier to generate a nine class urban context map capturing the transition from unsettled land at one end of the gradient to the compact urban core at the other end. Training and testing of the decision tree classifier was done using very high spatial resolution reference imagery from Google Earth. An overall classification agreement of 77% was determined for the nine-class urban context map, with user's accuracy (commission errors) being lower than producer's accuracy (omission errors). Nine urban contexts were classified and then compared with data from the 2000 Census of Ghana. Results suggest that the urban classes appropriately differentiate areas along the urban gradient.

Obstacles to integrated pest management adoption in developing countries

PubMed Central

Parsa, Soroush; Morse, Stephen; Bonifacio, Alejandro; Chancellor, Timothy C. B.; Condori, Bruno; Crespo-Pérez, Verónica; Hobbs, Shaun L. A.; Kroschel, Jürgen; Ba, Malick N.; Rebaudo, François; Sherwood, Stephen G.; Vanek, Steven J.; Faye, Emile; Herrera, Mario A.; Dangles, Olivier

2014-01-01

Despite its theoretical prominence and sound principles, integrated pest management (IPM) continues to suffer from anemic adoption rates in developing countries. To shed light on the reasons, we surveyed the opinions of a large and diverse pool of IPM professionals and practitioners from 96 countries by using structured concept mapping. The first phase of this method elicited 413 open-ended responses on perceived obstacles to IPM. Analysis of responses revealed 51 unique statements on obstacles, the most frequent of which was “insufficient training and technical support to farmers.” Cluster analyses, based on participant opinions, grouped these unique statements into six themes: research weaknesses, outreach weaknesses, IPM weaknesses, farmer weaknesses, pesticide industry interference, and weak adoption incentives. Subsequently, 163 participants rated the obstacles expressed in the 51 unique statements according to importance and remediation difficulty. Respondents from developing countries and high-income countries rated the obstacles differently. As a group, developing-country respondents rated “IPM requires collective action within a farming community” as their top obstacle to IPM adoption. Respondents from high-income countries prioritized instead the “shortage of well-qualified IPM experts and extensionists.” Differential prioritization was also evident among developing-country regions, and when obstacle statements were grouped into themes. Results highlighted the need to improve the participation of stakeholders from developing countries in the IPM adoption debate, and also to situate the debate within specific regional contexts. PMID:24567400

Essential Medicines in a High Income Country: Essential to Whom?

PubMed Central

2015-01-01

Objective To explore the perspectives of a diverse group of stakeholders engaged in medicines decision making around what constitutes an “essential” medicine, and how the Essential Medicines List (EML) concept functions in a high income country context. Methods In-depth qualitative semi-structured interviews were conducted with 32 Australian stakeholders, recognised as decision makers, leaders or advisors in the area of medicines reimbursement or supply chain management. Participants were recruited from government, pharmaceutical industry, pharmaceutical wholesale/distribution companies, medicines non-profit organisations, academic health disciplines, hospitals, and consumer groups. Perspectives on the definition and application of the EML concept in a high income country context were thematically analysed using grounded theory approach. Findings Stakeholders found it challenging to describe the EML concept in the Australian context because many perceived it was generally used in resource scarce settings. Stakeholders were unable to distinguish whether nationally reimbursed medicines were essential medicines in Australia. Despite frequent generic drug shortages and high prices paid by consumers, many struggled to describe how the EML concept applied to Australia. Instead, broad inclusion of consumer needs, such as rare and high cost medicines, and consumer involvement in the decision making process, has led to expansive lists of nationally subsidised medicines. Therefore, improved communication and coordination is needed around shared interests between stakeholders regarding how medicines are prioritised and guaranteed in the supply chain. Conclusions This study showed that decision-making in Australia around reimbursement of medicines has strayed from the fundamental utilitarian concept of essential medicines. Many stakeholders involved in medicine reimbursement decisions and management of the supply chain did not consider the EML concept in their approach

Essential Medicines in a High Income Country: Essential to Whom?

PubMed

Duong, Mai; Moles, Rebekah J; Chaar, Betty; Chen, Timothy F

2015-01-01

To explore the perspectives of a diverse group of stakeholders engaged in medicines decision making around what constitutes an "essential" medicine, and how the Essential Medicines List (EML) concept functions in a high income country context. In-depth qualitative semi-structured interviews were conducted with 32 Australian stakeholders, recognised as decision makers, leaders or advisors in the area of medicines reimbursement or supply chain management. Participants were recruited from government, pharmaceutical industry, pharmaceutical wholesale/distribution companies, medicines non-profit organisations, academic health disciplines, hospitals, and consumer groups. Perspectives on the definition and application of the EML concept in a high income country context were thematically analysed using grounded theory approach. Stakeholders found it challenging to describe the EML concept in the Australian context because many perceived it was generally used in resource scarce settings. Stakeholders were unable to distinguish whether nationally reimbursed medicines were essential medicines in Australia. Despite frequent generic drug shortages and high prices paid by consumers, many struggled to describe how the EML concept applied to Australia. Instead, broad inclusion of consumer needs, such as rare and high cost medicines, and consumer involvement in the decision making process, has led to expansive lists of nationally subsidised medicines. Therefore, improved communication and coordination is needed around shared interests between stakeholders regarding how medicines are prioritised and guaranteed in the supply chain. This study showed that decision-making in Australia around reimbursement of medicines has strayed from the fundamental utilitarian concept of essential medicines. Many stakeholders involved in medicine reimbursement decisions and management of the supply chain did not consider the EML concept in their approach. The wide range of views of what stakeholders

Organization of ambulatory care provision: a critical determinant of health system performance in developing countries.

PubMed Central

Berman, P.

2000-01-01

Success in the provision of ambulatory personal health services, i.e. providing individuals with treatment for acute illness and preventive health care on an ambulatory basis, is the most significant contributor to the health care system's performance in most developing countries. Ambulatory personal health care has the potential to contribute the largest immediate gains in health status in populations, especially for the poor. At present, such health care accounts for the largest share of the total health expenditure in most lower income countries. It frequently comprises the largest share of the financial burden on households associated with health care consumption, which is typically regressively distributed. The "organization" of ambulatory personal health services is a critical determinant of the health system's performance which, at present, is poorly understood and insufficiently considered in policies and programmes for reforming health care systems. This article begins with a brief analysis of the importance of ambulatory care in the overall health system performance and this is followed by a summary of the inadequate global data on ambulatory care organization. It then defines the concept of "macro organization of health care" at a system level. Outlined also is a framework for analysing the organization of health care services and the major pathways through which the organization of ambulatory personal health care services can affect system performance. Examples of recent policy interventions to influence primary care organization--both government and nongovernmental providers and market structure--are reviewed. It is argued that the characteristics of health care markets in developing countries and of most primary care goods result in relatively diverse and competitive environments for ambulatory care services, compared with other types of health care. Therefore, governments will be required to use a variety of approaches beyond direct public provision

Improving the organization of palliative care: identification of barriers and facilitators in five European countries.

PubMed

van Riet Paap, Jasper; Vernooij-Dassen, Myrra; Brouwer, Frederike; Meiland, Franka; Iliffe, Steve; Davies, Nathan; Leppert, Wojciech; Jaspers, Birgit; Mariani, Elena; Sommerbakk, Ragni; Vissers, Kris; Engels, Yvonne

2014-10-16

Interventions to improve palliative care encounter challenges beyond the usual implementation problems because of palliative care's complex and changing character. In this study, we explored barriers and facilitators faced by health-care professionals in five European countries (England, Germany, Italy, Norway and the Netherlands) with regard to improving the organization of their palliative care service. Semi-structured individual and focus group interviews were conducted with purposefully selected health-care professionals. The constant comparative method was used to analyse the data. Professionals working in hospitals, hospices, nursing homes and primary care facilities who provide palliative care to adult patients were interviewed (n =40) or participated in ten focus group interviews (n =59). Barriers and facilitators were inductively grouped into 16 categories and arranged into five themes: innovation, individual professional level, group dynamics, organizational context and local political-economic context. Although the barriers and facilitators identified differed in scope, context, strength and provenance, they were shared by professionals from different European countries. This study identified barriers and facilitators to organizational change in palliative care. Some of these barriers and facilitators were experienced by professionals in almost all countries and are therefore prerequisites to change. Understanding the barriers to and facilitators of change will help tailor organizational improvements to the needs of individuals and organizations.

Transition in Education: Policy Making and the Key Educational Policy Areas in the Central-European and Baltic Countries.

ERIC Educational Resources Information Center

Rado, Peter

This report examines transition in educational systems and identifies key policy areas in Central-Eastern European countries. It summarizes policy implications of the transition process within the educational context of these countries. Chapter 1, "Transition and Education," outlines key characteristics of the transition process and…

Family and Reading in 41 Countries: Differences across Cultures and Students

ERIC Educational Resources Information Center

Chiu, Ming Ming; McBride-Chang, Catherine

2010-01-01

Family characteristics' links to literacy learning and their differences across macrosystems (economic and cultural contexts) were explored in multilevel analyses of the reading tests and questionnaire responses of 193,841 fifteen-year-olds across 41 countries. Students who had two parents, had higher family socioeconomic status (SES), were native…

Participation Motivation and Student’s Physical Activity among Sport Students in Three Countries

PubMed Central

Kondric, Miran; Sindik, Joško; Furjan-Mandic, Gordana; Schiefler, Bernd

2013-01-01

The main aim of this study was to examine the differences in motivation to participate in sport activities among sports students from three different countries. On a sample of 390 sports students from Slovenia, Croatia and Germany we studied what motivates an interest in being sports active. The sample was stratified across the choice to attend table tennis lessons at all three institutions and all students have completed the Participation Motivation Questionnaire (PMQ). The results revealed that the latent structure of the types of sports students’ motives consisted of six factors (sport action with friend, popularity, fitness & health, social status, sports events, relaxation through sports). We also found significant sex differences in motivation to participate in sport activities for all sports students from the three different countries. We did not find relevant age-based differences among the students, and this is the only initial hypothesis that we can reject. Key points The potential implications of the result can be in better understanding the relationship between different motivational orientations - in particular, extrinsic motivation - and sport motivation among school-aged individuals. In the context of Self Determination Theory, students can be encouraged in developing more autonomous orientations for sport activity, rather than controlled and impersonal, especially in certain countries. Significant factors of differences have been found in motivation to participate in sport activities among sports students from three different countries and also some significant sex differences have been found in motivation to participate in sport activities for all sports students. PMID:24149720

Policy-Relevant Context of Waterpipe Tobacco Smoking among University Students in Six Countries Across the Eastern Mediterranean Region: A Qualitative Study

PubMed Central

Salloum, Ramzi G; Abu-Rmeileh, Niveen; Hamadeh, Randah; Thomas, Justin; Mostafa, Aya; Yusufali, Afzalhussein; Kheirallah, Khalid A; Macauda, Mark M; Theis, Ryan P; Kadi, Lama El; Johnson, Evan J; Darawad, Muhammad W; Nakkash, Rima

2017-01-01

Background: Waterpipe tobacco smoking rates in the Eastern Mediterranean region are some of the highest worldwide, especially among young people. This study aimed to improve our knowledge of the policy-relevant context of waterpipe smoking among six countries in the Eastern Mediterranean region. Methods: In-depth interviews were conducted in Bahrain, Egypt, Jordan, Lebanon, Palestine, and the United Arab Emirates. Participants were young adult university students (18-29 years) from both genders who had ever smoked the waterpipe, recruited from universities participating in this study. Directed content analysis was used to analyze the transcripts. Results: A total of 53 in-depth interviews were conducted in Arabic in 2016. Findings were organized around 5 themes: waterpipe product characteristics; patterns of waterpipe smoking; the waterpipe café setting; perceived health consequences; and health warning labels. Waterpipe smoking was commonly perceived as a safe alternative to cigarettes. Waterpipe tobacco was reported to be widely accessible and affordable to young participants. There is a lack of knowledge among waterpipe smokers about the associated health effects. Warning labels are effective at communicating health risks associated with waterpipe smoking. Conclusions: Regulatory frameworks for waterpipe tobacco smoking should be developed and enforced, including waterpipe-specific health warning labels that elucidate the harmful effects of waterpipe smoking. PMID:28952296

The national forest inventory in China: History, results, international context

Treesearch

WeiSheng Zeng; Erkki Tomppo; Sean P. Healey; Klaus V. Gadow

2015-01-01

Main results and important changes in China’s NFI are documented, both to support continued trend analysis and to provide data users with historical perspective. New technologies and data needs ensure that the Chinese NFI, like the national inventories in other countries, will continue to evolve. Within the context of historical change and current conditions, likely...

[Clinical trials in developing countries: who should define ethics?].

PubMed

Béréterbide, F; Hirsch, F

2008-04-01

Many clinical trials have proved much more difficult to implement in developing countries than in the Northern countries if not totally impossible. Should we therefore just observe this situation and approve a "double ethical standard"? Clinical trials in developing countries are also a means for volunteers to have access to medical care, therefore how could the process of informed consent keep its significance? In this context, should the participation in clinical trials be restricted or even stopped? If so, we would thus justify the superiority of an international duty of charity compared with the right of autonomy of these populations. This theoretical analysis cannot be precisely justified. On the contrary, it reveals that while informed consent, international organisations and guidelines have the tendency to play a major role in this debate, local ethics committee are too absent although they represent the more relevant and legitimate discussion partners in this dilemma.

Immigrant Arab adolescents in ethnic enclaves: physical and phenomenological contexts of identity negotiation.

PubMed

Kumar, Revathy; Seay, Nancy; Karabenick, Stuart A

2015-04-01

Ecologically embedded social identity theories were used to examine the risk and protective factors associated with the identity negotiation and adjustment of recent immigrant Arab (IA) adolescents to the United States residing in ethnic enclaves. Yemeni, Lebanese, and Iraqi 8th-graders (n = 45) from 4 ethnic enclave schools participated in focus-group interviews. In-depth analyses of interviews revealed that living in an ethnic enclave enhanced IA adolescents' feelings of belonging to the community. However, the new immigrant status coupled with country of origin determined the permeability of intergroup boundaries with well-established Arab and Arab American peers. Their identity negotiations and social identity salience (national, religious, and pan-Arab) were informed by transitional experiences from home to host country and the prevailing political and cultural tensions between the two, recognition of national hierarchy within the Arab community, perceptions of discrimination by the larger society, changed educational aspirations consequent to immigration, and current physical (school and community) and phenomenological contexts. Findings suggest that current theoretical perspectives should be extended to incorporate phenomenological representations of past spaces and places not currently occupied to understand adolescents' multifaceted identity. (c) 2015 APA, all rights reserved).

Vocational Education and Training in Tanzania and Zimbabwe in the Context of Economic Reform. Education Research Paper.

ERIC Educational Resources Information Center

Bennell, Paul; Bendera, Shane; Kanyenze, Godfrey; Kimambo, Emrode; Kiwia, Sixtus; Mbiriyakura, Tichafa; Mukyanuzi, Faustin; Munetsi, N.; Muzulu, Jo; Parsalaw, Willy; Temu, John

Developments in vocational education and training (VET) in Tanzania and Zimbabwe since the 1980s were examined in the context of economic reform. Formal VET provision in each country's public and private sectors was reviewed, and case studies of one firm in each country's manufacturing and tourism industries were conducted. The research identified…

Environmental Profile of a Community's Health (EPOCH): An Instrument to Measure Environmental Determinants of Cardiovascular Health in Five Countries

PubMed Central

Chow, Clara K.; Lock, Karen; Madhavan, Manisha; Corsi, Daniel J.; Gilmore, Anna B.; Subramanian, S. V.; Li, Wei; Swaminathan, Sumathi; Lopez-Jaramillo, Patricio; Avezum, Alvaro; Lear, Scott A.; Dagenais, Gilles; Teo, Koon; McKee, Martin; Yusuf, Salim

2010-01-01

Background The environment in which people live is known to be important in influencing diet, physical activity, smoking, psychosocial and other risk factors for cardiovascular (CV) disease. However no instrument exists that evaluates communities for these multiple environmental factors and is suitable for use across different communities, regions and countries. This report describes the design and reliability of an instrument to measure environmental determinants of CV risk factors. Method/Principal Findings The Environmental Profile of Community Health (EPOCH) instrument comprises two parts: (I) an assessment of the physical environment, and (II) an interviewer-administered questionnaire to collect residents' perceptions of their community. We examined the inter-rater reliability amongst 3 observers from each region of the direct observation component of the instrument (EPOCH I) in 93 rural and urban communities in 5 countries (Canada, Colombia, Brazil, China and India). Data collection using the EPOCH instrument was feasible in all communities. Reliability of the instrument was excellent (Intraclass Correlation Coefficient - ICC>0.75) for 24 of 38 items and fair to good (ICC 0.4–0.75) for 14 of 38 items. Conclusion This report shows data collection with the EPOCH instrument is feasible and direct observation of community measures reliable. The EPOCH instrument will enable further research on environmental determinants of health for population studies from a broad range of settings. PMID:21170320

Questioning Discrimination through Critical Media Literacy. Findings from Seven European Countries

ERIC Educational Resources Information Center

Ranieri, Maria; Fabbro, Francesco

2016-01-01

This paper presents the main findings of an action-research study that took place in seven European countries in order to develop effective educational responses to prevent and combat discrimination. The study entailed the design of media and citizenship education activities, their implementation in the different educational contexts and the…

Marriage, Cohabitation, and Happiness: A Cross-National Analysis of 27 Countries

ERIC Educational Resources Information Center

Lee, Kristen Schultz; Ono, Hiroshi

2012-01-01

The authors investigated how the reported happiness of married and cohabiting individuals varies cross-nationally with societal gender beliefs and religious context. They used the 2002 International Social Survey Programme data from 27 countries (N = 36,889) and specified hierarchical linear models with macro-micro level interactions in order to…

The Social Determinants of Refugee Mental Health in the Post-Migration Context: A Critical Review.

PubMed

Hynie, Michaela

2018-05-01

With the global increase in the number of refugees and asylum seekers, mental health professionals have become more aware of the need to understand and respond to the mental health needs of forced migrants. This critical review summarizes the findings of recent systematic reviews and primary research on the impact of post-migration conditions on mental disorders and PTSD among refugees and asylum seekers. Historically, the focus of mental health research and interventions with these populations has been on the impact of pre-migration trauma. Pre-migration trauma does predict mental disorders and PTSD, but the post-migration context can be an equally powerful determinant of mental health. Moreover, post-migration factors may moderate the ability of refugees to recover from pre-migration trauma. The importance of post-migration stressors to refugee mental health suggests the need for therapeutic interventions with psychosocial elements that address the broader conditions of refugee and asylum seekers' lives. However, there are few studies of multimodal interventions with refugees, and even fewer with control conditions that allow for conclusions about their effectiveness. These findings are interpreted using a social determinants of health framework that connects the risk and protective factors in the material and social conditions of refugees' post-migration lives to broader social, economic and political factors.

Temporal context processing within hippocampal subfields.

PubMed

Wang, Fang; Diana, Rachel A

2016-07-01

The episodic memory system can differentiate similar events based on the temporal information associated with the events. Temporal context, which is at least partially determined by the events that precede or follow the critical event, may be a cue to differentiate events. The purpose of the present study is to investigate whether the hippocampal dentate gyrus (DG)/CA3 and CA1 subfields are sensitive to changes in temporal context and, if so, whether the subregions show a linear or threshold-like response to similar temporal contexts. Participants incidentally encoded a series of object picture triplets and 20 of them were included in final analyses. The third picture in each triplet was operationally defined as the target and the first two pictures served as temporal context for the target picture. Each target picture was presented twice with temporal context manipulated to be either repeated, high similarity, low similarity, or new on the second presentation. We extracted beta parameters for the repeated target as a function of the type of temporal context. We expected to see repetition suppression, a reduction in the beta values, in response to repetition of the target. If temporal context information is included in the representation of the target within a given region, this repetition suppression should be greater for target images that were preceded by their original context than for target images preceded by a new context. Neuroimaging results showed that CA1, but not DG/CA3, modifies the target's representation based on its temporal context. Right CA1 did not distinguish high similarity temporal context from repeated context but did distinguish low similarity temporal context from repeated context. These results indicate that CA1 is sensitive to temporal context and suggest that it does not differentiate between a substantially similar temporal context and an identical temporal context. In contrast, DG/CA3 does not appear to process temporal context as

Abortion in Islamic Ethics, and How it is Perceived in Turkey: A Secular, Muslim Country.

PubMed

Ekmekci, Perihan Elif

2017-06-01

Abortion is among the most widely discussed concepts of medical ethics. Since the well-known ethical theories have emerged from Western world, the position of Islamic ethics regarding main issues of medical ethics has been overlooked. Muslims constitute a considerable amount of world population. Turkish Republic is the only Muslim country ruled with secular democracy and one of the three Muslim countries where abortion is legalized. The first aim of this paper is to present discussions on abortion in Islamic ethics in the context of major ethical concepts; the legal status of the fetus, respect for life and the right not to be born. The second aim is to put forth Turkey's present legislation about abortion in the context of Islamic ethical and religious aspects.

Public attitudes toward stuttering in Europe: Within-country and between-country comparisons.

PubMed

St Louis, Kenneth O; Sønsterud, Hilda; Junuzović-Žunić, Lejla; Tomaiuoli, Donatella; Del Gado, Francesca; Caparelli, Emilia; Theiling, Mareen; Flobakk, Cecilie; Helmen, Lise Nesbakken; Heitmann, Ragnhild R; Kvenseth, Helene; Nilsson, Sofia; Wetterling, Tobias; Lundström, Cecilia; Daly, Ciara; Leahy, Margaret; Tyrrell, Laila; Ward, David; Węsierska, Marta

2016-01-01

Epidemiological research methods have been shown to be useful in determining factors that might predict commonly reported negative public attitudes toward stuttering. Previous research has suggested that stuttering attitudes of respondents from North America and Europe (i.e., "The West"), though characterized by stereotypes and potential stigma, are more positive than those from several other regions of the world. This inference assumes that public attitudes within various regions characterized by "The West" are similar. This study aimed to determine the extent to which public stuttering attitudes are similar or different both within regions of three different European countries and between or among five different European countries or similar geographic areas. It also aimed to compare these European attitudes to attitudes from 135 samples around the world using a standard measure. Using convenience sampling, 1111 adult respondents from eight different investigations completed the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) in the dominant language of each country or area. In Study I, the authors compared attitudes within three different regions of Bosnia & Herzegovina, Italy, and Norway. In Study II, the authors compared attitudes between combined samples from Bosnia & Herzegovina, Italy, and Norway (with additional respondents from Sweden), and two other samples, one from Germany and the other from Ireland and England. Attitudes of adults from the three samples within Bosnia & Herzegovina, Italy, and Norway were remarkably similar. By contrast, attitudes between the five different countries or area were quite dramatically different. Demographic variables on the POSHA-S did not predict the rank order of these between-country/area differences. Compared to the POSHA-S worldwide database, European attitudes ranged from less positive than average (i.e., Italians) to more positive than average (i.e., Norwegians and Swedes). Factors related to

Academic Development and Educational Developers: Perspectives from Different European Higher Education Contexts

ERIC Educational Resources Information Center

Di Napoli, Roberto; Fry, Heather; Frenay, Mariane; Verhesschen, Piet; Verburgh, An

2010-01-01

This paper reports research in five European universities, in four countries between 2004 and 2008. The research explored and compared institutional contexts for academic development and the interpretations and reflections of a number of academic developers on the organizational position and role of academic development, and of…

Correlational selection on personality and social plasticity: morphology and social context determine behavioural effects on mating success.

PubMed

Montiglio, Pierre-Olivier; Wey, Tina W; Chang, Ann T; Fogarty, Sean; Sih, Andrew

2017-03-01

Despite a central line of research aimed at quantifying relationships between mating success and sexually dimorphic traits (e.g., ornaments), individual variation in sexually selected traits often explains only a modest portion of the variation in mating success. Another line of research suggests that a significant portion of the variation in mating success observed in animal populations could be explained by correlational selection, where the fitness advantage of a given trait depends on other components of an individual's phenotype and/or its environment. We tested the hypothesis that interactions between multiple traits within an individual (phenotype dependence) or between an individual's phenotype and its social environment (context dependence) can select for individual differences in behaviour (i.e., personality) and social plasticity. To quantify the importance of phenotype- and context-dependent selection on mating success, we repeatedly measured the behaviour, social environment and mating success of about 300 male stream water striders, Aquarius remigis. Rather than explaining individual differences in long-term mating success, we instead quantified how the combination of a male's phenotype interacted with the immediate social context to explain variation in hour-by-hour mating decisions. We suggest that this analysis captures more of the mechanisms leading to differences in mating success. Males differed consistently in activity, aggressiveness and social plasticity. The mating advantage of these behavioural traits depended on male morphology and varied with the number of rival males in the pool, suggesting mechanisms selecting for consistent differences in behaviour and social plasticity. Accounting for phenotype and context dependence improved the amount of variation in male mating success we explained statistically by 30-274%. Our analysis of the determinants of male mating success provides important insights into the evolutionary forces that shape

Perceptions of perioperative nursing competence: a cross-country comparison.

PubMed

Gillespie, Brigid M; Harbeck, Emma B; Falk-Brynhildsen, Karin; Nilsson, Ulrica; Jaensson, Maria

2018-01-01

Throughout many countries, professional bodies rely on yearly self-assessment of competence for ongoing registration; therefore, nursing competence is pivotal to safe clinical practice. Our aim was to describe and compare perioperative nurses' perceptions of competence in four countries, while examining the effect of specialist education and years of experience in the operating room. We conducted a secondary analysis of cross-sectional surveys from four countries including; Australia, Canada, Scotland, and Sweden. The 40-item Perceived Perioperative Competence Scale-Revised (PPCS-R), was used with a total sample of 768 respondents. We used a factorial design to examine the influence of country, years of experience in the operating room and specialist education on nurses' reported perceived perioperative competence. Regardless of country origin, nurses with specialist qualifications reported higher perceived perioperative competence when compared to nurses without specialist education. However, cross-country differences were dependent on nurses' number of years of experience in the operating room. Nurses from Sweden with 6-10 years of experience in the operating room reported lower perceived perioperative competence when compared to Australian nurses. In comparing nurses with > 10 years of experience, Swedish nurses reported significantly lower perceived perioperative competence when compared to nurses from Australia, Canada and Scotland. Researchers need to consider educational level and years of experience in the perioperative context when examining constructs such as competence.

Access to HIV/AIDS care: a systematic review of socio-cultural determinants in low and high income countries.

PubMed

Gari, Sara; Doig-Acuña, Camilo; Smail, Tino; Malungo, Jacob R S; Martin-Hilber, Adriane; Merten, Sonja

2013-05-28

The role of socio-cultural factors in influencing access to HIV/AIDS treatment, care and support is increasingly recognized by researchers, international donors and policy makers. Although many of them have been identified through qualitative studies, the evidence gathered by quantitative studies has not been systematically analysed. To fill this knowledge gap, we did a systematic review of quantitative studies comparing surveys done in high and low income countries to assess the extent to which socio-cultural determinants of access, identified through qualitative studies, have been addressed in epidemiological survey studies. Ten electronic databases were searched (Cinahl, EMBASE, ISI Web of Science, IBSS, JSTOR, MedLine, Psyinfo, Psyindex and Cochrane). Two independent reviewers selected eligible publications based on the inclusion/exclusion criteria. Meta-analysis was used to synthesize data comparing studies between low and high income countries. Thirty-four studies were included in the final review, 21 (62%) done in high income countries and 13 (38%) in low income countries. In low income settings, epidemiological research on access to HIV/AIDS services focused on socio-economic and health system factors while in high income countries the focus was on medical and psychosocial factors. These differences depict the perceived different barriers in the two regions. Common factors between the two regions were also found to affect HIV testing, including stigma, high risk sexual behaviours such as multiple sexual partners and not using condoms, and alcohol abuse. On the other hand, having experienced previous illness or other health conditions and good family communication was associated with adherence to ART uptake. Due to insufficient consistent data, a meta-analysis was only possible on adherence to treatment. This review offers evidence of the current challenges for interdisciplinary work in epidemiology and public health. Quantitative studies did not

Drug design and discovery: translational biomedical science varies among countries.

PubMed

Weaver, Ian N; Weaver, Donald F

2013-10-01

Drug design and discovery is an innovation process that translates the outcomes of fundamental biomedical research into therapeutics that are ultimately made available to people with medical disorders in many countries throughout the world. To identify which nations succeed, exceed, or fail at the drug design/discovery endeavor--more specifically, which countries, within the context of their national size and wealth, are "pulling their weight" when it comes to developing medications targeting the myriad of diseases that afflict humankind--we compiled and analyzed a comprehensive survey of all new drugs (small molecular entities and biologics) approved annually throughout the world over the 20-year period from 1991 to 2010. Based upon this analysis, we have devised prediction algorithms to ascertain which countries are successful (or not) in contributing to the worldwide need for effective new therapeutics. © 2013 Wiley Periodicals, Inc.

Worker health is good for the economy: union density and psychosocial safety climate as determinants of country differences in worker health and productivity in 31 European countries.

PubMed

Dollard, Maureen F; Neser, Daniel Y

2013-09-01

Work stress is recognized globally as a social determinant of worker health. Therefore we explored whether work stress related factors explained national differences in health and productivity (gross domestic product (GDP)). We proposed a national worker health productivity model whereby macro market power factors (i.e. union density), influence national worker health and GDP via work psychosocial factors and income inequality. We combined five different data sets canvasing 31 wealthy European countries. Aggregated worker self-reported health accounted for 13 per cent of the variance in national life expectancy and in national gross domestic product (GDP). The most important factors explaining worker self-reported health and GDP between nations were two levels of labor protection, macro-level (union density), and organizational-level (psychosocial safety climate, PSC, i.e. the extent of management concern for worker psychological health). The majority of countries with the highest levels of union density and PSC (i.e., workplace protections) were Social Democratic in nature (i.e., Sweden, Finland, Denmark, Norway). Results support a type of society explanation that social and economic factors (e.g., welfare regimes, work related policies) in concert with political power agents at a national level explain in part national differences in workplace protection (PSC) that are important for worker health and productivity. Attention should be given across all countries, to national policies to improve worker health, by bolstering national and local democratic processes and representation to address and implement policies for psychosocial risk factors for work stress, bullying and violence. Results suggest worker health is good for the economy, and should be considered in national health and productivity accounting. Eroding unionism may not be good for worker health or the economy either. Copyright © 2013 Elsevier Ltd. All rights reserved.

Boys’ and Girls’ Relational and Physical Aggression in Nine Countries

PubMed Central

Lansford, Jennifer E.; Skinner, Ann T.; Sorbring, Emma; Di Giunta, Laura; Deater-Deckard, Kirby; Dodge, Kenneth A.; Malone, Patrick S.; Oburu, Paul; Pastorelli, Concetta; Tapanya, Sombat; Tirado, Liliana Maria Uribe; Zelli, Arnaldo; Al-Hassan, Suha M.; Alampay, Liane Peña; Bacchini, Dario; Bombi, Anna Silvia; Bornstein, Marc H.; Chang, Lei

2012-01-01

Distinguishing between relational and physical aggression has become a key feature of many developmental studies in North America and Western Europe, but very little information is available on relational aggression in more diverse cultural contexts. This study examined the factor structure of, gender differences in, and associations between relational and physical aggression in China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States. Children ages 7 to 10 years (N = 1410) reported on their relationally and physically aggressive behavior. Relational and physical aggression shared a common factor structure across countries. Unsurprisingly, boys reported being more physically aggressive than girls across all nine countries; surprisingly, there were no significant gender differences in relational aggression. In all nine countries, relational and physical aggression were significantly correlated (average r = .49). The countries differed significantly in the mean levels of both relational and physical aggression that children reported using and with respect to whether children reported using more physical than relational aggression or more relational than physical aggression. Despite mean level differences in relational and physical aggression across countries, the findings provided support for cross-country similarities in associations between relational and physical aggression, as well as links between gender and aggression. PMID:23935227

Multidrug-resistant tuberculosis (MDR-TB) in India: an attempt to link biosocial determinants.

PubMed

Atre, Sachin R; Mistry, Nerges F

2005-04-01

Multidrug-resistant tuberculosis (MDR-TB) has emerged as a possible threat to global tuberculosis control efforts in recent years. It is a challenge not only from a public health point of view but also in the context of global economy, especially in the absence of treatment for MDR-TB at national-level programs in developing countries. Biological accounts are insufficient to understand the emergence and dynamics of drug resistance. This article focuses essentially on the need for a holistic perspective, linking biosocial determinants that would probably lead to better insights into MDR-TB control strategies.

Understanding context in knowledge translation: a concept analysis study protocol.

PubMed

Squires, Janet E; Graham, Ian D; Hutchinson, Alison M; Linklater, Stefanie; Brehaut, Jamie C; Curran, Janet; Ivers, Noah; Lavis, John N; Michie, Susan; Sales, Anne E; Fiander, Michelle; Fenton, Shannon; Noseworthy, Thomas; Vine, Jocelyn; Grimshaw, Jeremy M

2015-05-01

To conduct a concept analysis of clinical practice contexts (work environments) that facilitate or militate against the uptake of research evidence by healthcare professionals in clinical practice. This will involve developing a clear definition of context by describing its features, domains and defining characteristics. The context where clinical care is delivered influences that care. While research shows that context is important to knowledge translation (implementation), we lack conceptual clarity on what is context, which contextual factors probably modify the effect of knowledge translation interventions (and hence should be considered when designing interventions) and which contextual factors themselves could be targeted as part of a knowledge translation intervention (context modification). Concept analysis. The Walker and Avant concept analysis method, comprised of eight systematic steps, will be used: (1) concept selection; (2) determination of aims; (3) identification of uses of context; (4) determination of defining attributes of context; (5) identification/construction of a model case of context; (6) identification/construction of additional cases of context; (7) identification/construction of antecedents and consequences of context; and (8) definition of empirical referents of context. This study is funded by the Canadian Institutes of Health Research (January 2014). This study will result in a much needed framework of context for knowledge translation, which identifies specific elements that, if assessed and used to tailor knowledge translation activities, will result in increased research use by nurses and other healthcare professionals in clinical practice, ultimately leading to better patient care. © 2014 John Wiley & Sons Ltd.

Providing ethical guidance for collaborative research in developing countries

PubMed Central

Morris, Nina

2015-01-01

Experience has shown that the application of ethical guidelines developed for research in developed countries to research in developing countries can be, and often is, impractical and raises a number of contentious issues. Various attempts have been made to provide guidelines more appropriate to the developing world context; however, to date these efforts have been dominated by the fields of bioscience, medical research and nutrition. There is very little advice available for those seeking to undertake collaborative social science or natural science research in developing countries and what is there tends to be held within disparate sources. Charting the development of a set of ethics documentation for future use by the Ecosystem Services for Poverty Alleviation (ESPA) programme research community, this paper outlines past and present attitudes towards ethics procedures amongst this community and suggests ways in which ethics procedures might be made more relevant and user-friendly to researchers working in this area. PMID:26640509

Zuckerman's revised alternative five-factor model: validation of the Zuckerman-Kuhlman-Aluja Personality Questionnaire in four French-speaking countries.

PubMed

Rossier, Jérôme; Hansenne, Michel; Baudin, Nicolas; Morizot, Julien

2012-01-01

The aim of this study was to analyze the replicability of Zuckerman's revised Alternative Five-factor model in a French-speaking context by validating the Zuckerman-Kuhlman-Aluja Personality Questionnaire (ZKA-PQ) simultaneously in 4 French-speaking countries. The total sample was made up of 1,497 subjects from Belgium, Canada, France, and Switzerland. The internal consistencies for all countries were generally similar to those found for the normative U.S. and Spanish samples. A factor analysis confirmed that the normative structure replicated well and was stable within this French-speaking context. Moreover, multigroup confirmatory factor analyses have shown that the ZKA-PQ reaches scalar invariance across these 4 countries. Mean scores were slightly different for women and men, with women scoring higher on Neuroticism but lower on Sensation Seeking. Globally, mean score differences across countries were small. Overall, the ZKA-PQ seems an interesting alternative to assess both lower and higher order personality traits for applied or research purposes.

Measuring health inequities in low and middle income countries for the development of observatories on inequities and social determinants of health.

PubMed

Guerra, German; Borde, Elis; Salgado de Snyder, V Nelly

2016-01-19

Almost seven years after the publication of the final report of the World Health Organization's Commission on Social Determinants of Health (CSDH), its third recommendation has not been attended to properly. Measuring health inequities (HI) within countries and globally, in order to develop and evaluate evidence-based policies and actions aimed at the social determinants of health (SDH), is still a pending task in most low and middle income countries (LMIC) in the Latin American region. In this paper we discuss methodological and conceptual issues to measure HI in LMIC and suggest a three-stage methodology for the creation of observatories on health inequities (OHI) and social determinants of health, based on the experience of the Brazilian Observatory on Health Inequities (BOHI) that has been successfully operating since 2010 at the Fundação Oswaldo Cruz (FIOCRUZ). A three-stage methodology for the creation of an OHI was developed based on a literature review on the following topics: SDH, HI measurement, and the process of setting-up of health observatories; followed by semi-structured interviews with key informants from the BOHI. We describe the three stages and discuss the replicability of this methodology in other Latin American countries. We also carried out a search of suitable national information systems to feed an OHI in Mexico, along with an outline of the institutional infrastructure to sustain it. When implementing the methodology for an OHI in LMIC such as Mexico, we found that having strong infrastructure of information systems for measuring HI is required, but not sufficient to build an OHI. Adequate funding and intersectoral network collaborations lead by a group of experts is a requirement for the consolidation and sustainability of an OHI in LMIC. According to the described methodology, and the available information systems on health, the creation of an OHI in LMIC, particularly in Mexico, is plausible in the near future. However, institutional

Epilepsy surgery in developing countries.

PubMed

Williamson, P D; Jobst, B C

2000-01-01

Epilepsy surgery (ES) is a well-accepted treatment for medically intractable epilepsy patients in developed countries, but it is highly technology dependent. Such technology is not usually available in developing countries. For presurgical evaluation, magnetic resonance imaging (MRI) and electroencephalogram recording while videotaping the patient have been important. High technology equipment will, in conjunction with MRI, identify approximately 70% of ES candidates. Introducing ES into developing countries will require determining the candidates that are appropriate for the existing medical infrastructure. This article reviews ES and its possible introduction into conditions existing in developing countries. The authors address (a) the types of patients to be considered for resective ES (some patients require a fairly standard series of noninvasive studies: others will require extensive invasive studies), (b) ways to determine which patients might be appropriate for the existing situation (unilateral mesial temporal lobe epilepsy detected with MRI, epilepsy with a circumscribed MRI lesion, hemispheric lesions, circumscribed MRI detected neuronal migration, and development disorders), (c) surgical procedures (local resection, functional hemispherectomy, multiple subpial transections, corpus callosotomy, and implantation of a vagal nerve stimulator), (d) special considerations for introducing ES into developing countries (medical infrastructure, technology, seizure monitoring systems, selective intracarotid/carotid Amytal testing, and surgical equipment), and (e) the limitations, realistic expectations, personnel requirements, and educational function for selected professionals. Delivery of the technology and expertise to perform ES in developing regions of the world is a realizable project, but it would be limited by available technology and existing medical infrastructure. It should be possible in most areas to train local personnel and thereby leave a lasting

The effect of normative context variability on recognition memory.

PubMed

Steyvers, Mark; Malmberg, Kenneth J

2003-09-01

According to some theories of recognition memory (e.g., S. Dennis & M. S. Humphreys, 2001), the number of different contexts in which words appear determines how memorable individual occurrences of words will be: A word that occurs in a small number of different contexts should be better recognized than a word that appears in a larger number of different contexts. To empirically test this prediction, a normative measure is developed, referred to here as context variability, that estimates the number of different contexts in which words appear in everyday life. These findings confirm the prediction that words low in context variability are better recognized (on average) than words that are high in context variability. (c) 2003 APA, all rights reserved

Health in China and India: a cross-country comparison in a context of rapid globalisation.

PubMed

Dummer, Trevor J B; Cook, Ian G

2008-08-01

China and India are similarly huge nations currently experiencing rapid economic growth, urbanisation and widening inequalities between rich and poor. They are dissimilar in terms of their political regimes, policies for population growth and ethnic composition and heterogeneity. This review compares health and health care in China and India within the framework of the epidemiological transition model and against the backdrop of globalisation. We identify similarities and differences in health situation. In general, for both countries, infectious diseases of the past sit alongside emerging infectious diseases and chronic illnesses associated with ageing societies, although the burden of infectious diseases is much higher in India. Whilst globalisation contributes to widening inequalities in health and health care in both countries--particularly with respect to increasing disparities between urban and rural areas and between rich and poor--there is evidence that local circumstances are important, especially with respect to the structure and financing of health care and the implementation of health policy. For example, India has huge problems providing even rudimentary health care to its large population of urban slum dwellers whilst China is struggling to re-establish universal rural health insurance. In terms of funding access to health care, the Chinese state has traditionally supported most costs, whereas private insurance has always played a major role in India, although recent changes in China have seen the burgeoning of private health care payments. China has, arguably, had more success than India in improving population health, although recent reforms have severely impacted upon the ability of the Chinese health care system to operate effectively. Both countries are experiencing a decline in the amount of government funding for health care and this is a major issue that must be addressed.

Valenced cues and contexts have different effects on event-based prospective memory.

PubMed

Graf, Peter; Yu, Martin

2015-01-01

This study examined the separate influence and joint influences on event-based prospective memory task performance due to the valence of cues and the valence of contexts. We manipulated the valence of cues and contexts with pictures from the International Affective Picture System. The participants, undergraduate students, showed higher performance when neutral compared to valenced pictures were used for cueing prospective memory. In addition, neutral pictures were more effective as cues when they occurred in a valenced context than in the context of neutral pictures, but the effectiveness of valenced cues did not vary across contexts that differed in valence. The finding of an interaction between cue and context valence indicates that their respective influence on event-based prospective memory task performance cannot be understood in isolation from each other. Our findings are not consistent with by the prevailing view which holds that the scope of attention is broadened and narrowed, respectively, by positively and negatively valenced stimuli. Instead, our findings are more supportive of the recent proposal that the scope of attention is determined by the motivational intensity associated with valenced stimuli. Consistent with this proposal, we speculate that the motivational intensity associated with different retrieval cues determines the scope of attention, that contexts with different valence values determine participants' task engagement, and that prospective memory task performance is determined jointly by attention scope and task engagement.

Valenced Cues and Contexts Have Different Effects on Event-Based Prospective Memory

PubMed Central

Graf, Peter; Yu, Martin

2015-01-01

This study examined the separate influence and joint influences on event-based prospective memory task performance due to the valence of cues and the valence of contexts. We manipulated the valence of cues and contexts with pictures from the International Affective Picture System. The participants, undergraduate students, showed higher performance when neutral compared to valenced pictures were used for cueing prospective memory. In addition, neutral pictures were more effective as cues when they occurred in a valenced context than in the context of neutral pictures, but the effectiveness of valenced cues did not vary across contexts that differed in valence. The finding of an interaction between cue and context valence indicates that their respective influence on event-based prospective memory task performance cannot be understood in isolation from each other. Our findings are not consistent with by the prevailing view which holds that the scope of attention is broadened and narrowed, respectively, by positively and negatively valenced stimuli. Instead, our findings are more supportive of the recent proposal that the scope of attention is determined by the motivational intensity associated with valenced stimuli. Consistent with this proposal, we speculate that the motivational intensity associated with different retrieval cues determines the scope of attention, that contexts with different valence values determine participants’ task engagement, and that prospective memory task performance is determined jointly by attention scope and task engagement. PMID:25647484

Technology-enhanced teacher development in rural Bangladesh: A critical realist evaluation of the context.

PubMed

Jamil, Md Golam

2018-08-01

This study arose in response to the complexity of implementing technology-enhanced learning for teacher development in a developing country. Bangladesh is a country with growing technological capacity including mobile phone network coverage, yet it faces vast challenges of utilising these facilities in the education sector. As educational change and technological innovation do not happen in a vacuum, the researcher used a critical realist approach to understand the layers of the rural Bangladesh context where technology-enhanced learning will take place. Findings have been drawn from survey data (n = 207) and a series of six focus group sessions with the same six stakeholders, informing future technology-enhanced teacher development programmes. The implications of the study are to suggest principles for pedagogical change and a methodological approach which attends to context. Copyright © 2018 Elsevier Ltd. All rights reserved.

How is intensive care reimbursed? A review of eight European countries

PubMed Central

2013-01-01

Reimbursement schemes in intensive care are more complex than in other areas of healthcare, due to special procedures and high care needs. Knowledge regarding the principles of functioning in other countries can lead to increased understanding and awareness of potential for improvement. This can be achieved through mutual exchange of solutions found in other countries. In this review, experts from eight European countries explain their respective intensive care unit reimbursement schemes. Important conclusions include the apparent differences in the countries’ reimbursement schemes-despite all of them originating from a DRG system-, the high degree of complexity found, and the difficulties faced in several countries when collecting the data for this collaborative work. This review has been designed to assist the intensivist clinician and researcher in understanding neighbouring countries’ approaches and in putting research into the context of a European perspective. In addition, steering committees and decision makers might find this a valuable source to compare different reimbursement schemes. PMID:24216146

Test Selection, Adaptation, and Evaluation: A Systematic Approach to Assess Nutritional Influences on Child Development in Developing Countries

ERIC Educational Resources Information Center

Prado, Elizabeth L.; Hartini, Sri; Rahmawati, Atik; Ismayani, Elfa; Hidayati, Astri; Hikmah, Nurul; Muadz, Husni; Apriatni, Mandri S.; Ullman, Michael T.; Shankar, Anuraj H.; Alcock, Katherine J.

2010-01-01

Background: Evaluating the impact of nutrition interventions on developmental outcomes in developing countries can be challenging since most assessment tests have been produced in and for developed country settings. Such tests may not be valid measures of children's abilities when used in a new context. Aims: We present several principles for the…

Eating practices and diet quality: a population study of four Nordic countries.

PubMed

Holm, L; Lund, T B; Niva, M

2015-07-01

Daily practices related to eating are embedded in the social and cultural contexts of everyday life. How are such factors associated with diet quality relative to motivational factors? And, are associations universal or context-specific? We analyze the relationship between diet quality and the following practices: social company while eating, the regularity and duration of eating and the activity of watching TV while eating. A cross-sectional, questionnaire-based internet survey was conducted in April 2012 with stratified random samples of the populations (aged 15-80 years) in Denmark, Finland, Norway and Sweden (N=7531, completion rate 9-13%). The questionnaire elicited detailed accounts of one day of eating focusing on social and practical aspects of eating events. The validated Dietary Quality Score was the dependent variable. This measure is based on eight food frequency questions focusing on fats, vegetables, fruits and fish in the diet. Eating activities were associated with diet quality even when motivation to eat healthily and sociodemographic factors were controlled for. The number of daily eating events and eating main meals was positively correlated with diet quality in all countries. Beyond that, activities that were significantly associated with diet quality varied with country. When measured separately, the association between each activity and diet quality was weaker than motivation to eat healthily, but in combinations that are found in parts of the populations, the association was substantial. Daily practices related to eating are correlated with diet quality. Practices that are important are in part universal but also country-specific. Efforts to promote healthy eating should address not only cognitive factors but also everyday contexts of eating that facilitate or hamper healthy practices.

Socioeconomic differential in self-assessment of health and happiness in 5 African countries: Finding from World Value Survey.

PubMed

Adesanya A, Oluwafunmilade; Rojas, Bomar Mendez; Darboe, Amadou; Beogo, Idrissa

2017-01-01

Factors that contribute to wealth related inequalities in self-rated health (SRH) and happiness remains unclear most especially in sub-Saharan countries (SSA). This study aims to explore and compare socioeconomic differentials in SRH and happiness in five SSA countries. Using the 2010/2014 World Values Survey (WVS), we obtained a sample of 9,869 participants of age 16 and above from five SSA countries (Nigeria, Ghana, South Africa, Rwanda and Zimbabwe). Socioeconomic inequalities were quantified using the concentration index. The contribution of each predictor to concentration index's magnitude was obtained by means of regression based decomposition analysis. Poor SRH ranges from approximately 9% in Nigeria to 20% in Zimbabwe, whereas unhappiness was lower in Rwanda (9.5%) and higher in South Africa (23.3%). Concentration index was negative for both outcomes in all countries, which implies that poor SRH and unhappiness are excessively concentrated among the poorest socioeconomic strata. Although magnitudes differ across countries, however, the major contributor to wealth-related inequality in poor SRH is satisfaction with financial situation whereas for unhappiness the major contributors are level of income and satisfaction with financial situation. This study underscores an association between wealth related inequalities and poor SRH and unhappiness in the context of SSA. Improving equity in health, as suggested by the commission of social determinants of health may be useful in fighting against the unfair distribution of resources. Thus, knowledge about the self-rating of health and happiness can serve as proxy estimates for understanding the distribution of health care access and economic resources needed for well-being in resident countries.

Validation of public health competencies and impact variables for low- and middle-income countries.

PubMed

Zwanikken, Prisca Ac; Alexander, Lucy; Huong, Nguyen Thanh; Qian, Xu; Valladares, Laura Magana; Mohamed, Nazar A; Ying, Xiao Hua; Gonzalez-Robledo, Maria Cecilia; Linh, Le Cu; Wadidi, Marwa Se Abuzaid; Tahir, Hanan; Neupane, Sunisha; Scherpbier, Albert

2014-01-20

The number of Master of Public Health (MPH) programmes in low- and middle-income countries (LMICs) is increasing, but questions have been raised regarding the relevance of their outcomes and impacts on context. Although processes for validating public health competencies have taken place in recent years in many high-income countries, validation in LMICs is needed. Furthermore, impact variables of MPH programmes in the workplace and in society have not been developed. A set of public health competencies and impact variables in the workplace and in society was designed using the competencies and learning objectives of six participating institutions offering MPH programmes in or for LMICs, and the set of competencies of the Council on Linkages Between Academia and Public Health Practice as a reference. The resulting competencies and impact variables differ from those of the Council on Linkages in scope and emphasis on social determinants of health, context specificity and intersectoral competencies. A modified Delphi method was used in this study to validate the public health competencies and impact variables; experts and MPH alumni from China, Vietnam, South Africa, Sudan, Mexico and the Netherlands reviewed them and made recommendations. The competencies and variables were validated across two Delphi rounds, first with public health experts (N = 31) from the six countries, then with MPH alumni (N = 30). After the first expert round, competencies and impact variables were refined based on the quantitative results and qualitative comments. Both rounds showed high consensus, more so for the competencies than the impact variables. The response rate was 100%. This is the first time that public health competencies have been validated in LMICs across continents. It is also the first time that impact variables of MPH programmes have been proposed and validated in LMICs across continents. The high degree of consensus between experts and alumni suggests that these

Validation of public health competencies and impact variables for low- and middle-income countries

PubMed Central

2014-01-01

Background The number of Master of Public Health (MPH) programmes in low- and middle-income countries (LMICs) is increasing, but questions have been raised regarding the relevance of their outcomes and impacts on context. Although processes for validating public health competencies have taken place in recent years in many high-income countries, validation in LMICs is needed. Furthermore, impact variables of MPH programmes in the workplace and in society have not been developed. Method A set of public health competencies and impact variables in the workplace and in society was designed using the competencies and learning objectives of six participating institutions offering MPH programmes in or for LMICs, and the set of competencies of the Council on Linkages Between Academia and Public Health Practice as a reference. The resulting competencies and impact variables differ from those of the Council on Linkages in scope and emphasis on social determinants of health, context specificity and intersectoral competencies. A modified Delphi method was used in this study to validate the public health competencies and impact variables; experts and MPH alumni from China, Vietnam, South Africa, Sudan, Mexico and the Netherlands reviewed them and made recommendations. Results The competencies and variables were validated across two Delphi rounds, first with public health experts (N = 31) from the six countries, then with MPH alumni (N = 30). After the first expert round, competencies and impact variables were refined based on the quantitative results and qualitative comments. Both rounds showed high consensus, more so for the competencies than the impact variables. The response rate was 100%. Conclusion This is the first time that public health competencies have been validated in LMICs across continents. It is also the first time that impact variables of MPH programmes have been proposed and validated in LMICs across continents. The high degree of consensus between

Social capital and health in the least developed countries: A critical review of the literature and implications for a future research agenda

PubMed Central

Story, William T.

2015-01-01

Research on the linkage between social capital and health has grown in recent years; however, there is a dearth of evidence from resource-poor countries. This review examines the association between social capital and physical health (including health behaviours) in the least developed countries (LDCs). Citations were searched using three databases from 1990 to 2011 using the keyword ‘social capital’ combined with the name of each of the 48 LDCs. Of the 14 studies reviewed, 12 took place in Africa and two in South Asia. All used cross-sectional study designs, including five qualitative and nine quantitative studies. The literature reviewed suggests that social capital is an important factor for improving health in resource-poor settings; however, more research is needed in order to determine the best measures for social capital and elucidate the mechanisms through which social capital affects health in the developing world. Future research on social capital and health in the developing world should focus on applying appropriate theoretical conceptualizations of social capital to the developing country context, adapting and validating instruments for measuring social capital, and examining multilevel models of social capital and health in developing countries. PMID:24172027

Male sex workers: practices, contexts, and vulnerabilities for HIV acquisition and transmission.

PubMed

Baral, Stefan David; Friedman, M Reuel; Geibel, Scott; Rebe, Kevin; Bozhinov, Borche; Diouf, Daouda; Sabin, Keith; Holland, Claire E; Chan, Roy; Cáceres, Carlos F

2015-01-17

Male sex workers who sell or exchange sex for money or goods encompass a very diverse population across and within countries worldwide. Information characterising their practices, contexts where they live, and their needs is limited, because these individuals are generally included as a subset of larger studies focused on gay men and other men who have sex with men (MSM) or even female sex workers. Male sex workers, irrespective of their sexual orientation, mostly offer sex to men and rarely identify as sex workers, using local or international terms instead. Growing evidence indicates a sustained or increasing burden of HIV among some male sex workers within the context of the slowing global HIV pandemic. Several synergistic facilitators could be potentiating HIV acquisition and transmission among male sex workers, including biological, behavioural, and structural determinants. Criminalisation and intersectional stigmas of same-sex practices, commercial sex, and HIV all augment risk for HIV and sexually transmitted infections among male sex workers and reduce the likelihood of these people accessing essential services. These contexts, taken together with complex sexual networks among male sex workers, define this group as a key population underserved by current HIV prevention, treatment, and care services. Dedicated efforts are needed to make those services available for the sake of both public health and human rights. Evidence-based and human rights-affirming services dedicated specifically to male sex workers are needed to improve health outcomes for these men and the people within their sexual networks. Copyright © 2015 Elsevier Ltd. All rights reserved.

Health in All Policies (HiAP) framework for country action.

PubMed

2014-06-01

This document serves as a 'starter's kit' for applying Health in All Policies (HiAP) in decision-making and implementation at national and subnational levels. It can be easily adapted for use in different country contexts and at the regional and global levels. WHAT IS HIAP?: HiAP is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies and avoids harmful health impacts in order to improve population health and health equity. As a concept, it reflects the principles of: legitimacy, accountability, transparency and access to information, participation, sustainability and collaboration across sectors and levels of government. Health and health equity are values in their own right and are also important prerequisites for achieving many other societal goals. Many of the determinants of health and health inequities in populations have social, environmental and economic origins that extend beyond the direct influence of the health sector and health policies. Thus, public policies in all sectors and at different levels of governance can have a significant impact on population health and health equity. The Framework sets out six key components that should be addressed in order to put the HiAP approach into action: (1) establish the need and priorities for HiAP, (2) frame planned action, (3) identify supportive structures and processes, (4) facilitate assessment and engagement, (5) ensure monitoring, evaluation and reporting, (6) build capacity. These components are not fixed in order or priority. Rather, individual countries will adopt and adjust the components in ways that are most relevant for their specific governance, economic and social contexts. Although governments as a whole bear the ultimate responsibility for the health of their citizens, health authorities at all levels are key actors in promoting HiAP. They should therefore actively seek opportunities to collaborate with and

Life cycle development of obesity and its determinants in six European countries.

PubMed

Cavaco, Sandra; Eriksson, Tor; Skalli, Ali

2014-07-01

This paper empirically examines the effect of parents' and individuals' own socioeconomic status on overweight and obesity, and investigates how this effect changes over the life cycle. The impact of individuals' health behaviours on their obesity status later in life is also studied. We use data from Denmark, Finland, France, Greece, the Netherlands and the U.K. in which 4595 individuals aged 50-65 are surveyed and where individuals' height and weight at different ages (25, 35, 45 and current age) are available. We perform "repeated cross-sections" analyses as well as dynamic probit analyses of the individuals' obesity histories. We contribute to the literature by examining the role of a variety of obesity determinants over the whole life cycle, not only over a certain portion of individuals' lives. Key findings are: (i) parents' socioeconomic status predicts obesity in early adulthood whereas the individual's own socioeconomic status as adult is more important in explaining obesity at later stages of the life cycle, (ii) changes in obesity status are associated with changes in health behaviours, (iii) obesity in late adulthood is strongly and positively correlated with overweight and obesity in younger ages, and (iv) cross-country differences in obesity and overweight largely remain after controlling for parental and childhood factors and individuals' health behaviours. Copyright © 2014 Elsevier B.V. All rights reserved.

Institutional Autonomy and Academic Freedom in the Nordic Context--Similarities and Differences

ERIC Educational Resources Information Center

Nokkala, Terhi; Bladh, Agneta

2014-01-01

Owing to their common history, similarities in language and culture, long traditions in political collaboration and the shared Nordic societal model, an assumption is often made that the operational and regulatory context of universities is similar in the five Nordic countries: Denmark, Finland, Iceland, Norway and Sweden. In this article, we…

Context Factors and Student Achievement in the IEA Studies: Evidence from TIMSS

ERIC Educational Resources Information Center

Caponera, Elisa; Losito, Bruno

2016-01-01

Background: The present study investigates what factors related to the school context influence student achievement on TIMSS mathematics tests across countries. A systematic review of the literature on PIRLS, TIMSS, and ICCS was conducted upstream to identify those school, teacher, and classroom factors shown to be useful predictors of student…

Prevention of Asbestos-Related Disease in Countries Currently Using Asbestos.

PubMed

Marsili, Daniela; Terracini, Benedetto; Santana, Vilma S; Ramos-Bonilla, Juan Pablo; Pasetto, Roberto; Mazzeo, Agata; Loomis, Dana; Comba, Pietro; Algranti, Eduardo

2016-05-12

More than 40 years of evaluation have consistently confirmed the carcinogenicity of asbestos in all of its forms. This notwithstanding, according to recent figures, the annual world production of asbestos is approximatively 2,000,000 tons. Currently, about 90% of world asbestos comes from four countries: Russia, China, Brazil and Kazakhstan; and the wide use of asbestos worldwide represents a global threat. The purpose of this paper is to present a review of the asbestos health impact and to discuss the role of epidemiological investigations in countries where asbestos is still used. In these contexts, new, "local" studies can stimulate awareness of the size of the problem by public opinion and other stakeholders and provide important information on the circumstances of exposure, as well as local asbestos-related health impacts. This paper suggests an agenda for an international cooperation framework dedicated to foster a public health response to asbestos, including: new epidemiological studies for assessing the health impact of asbestos in specific contexts; socio-cultural and economic analyses for contributing to identifying stakeholders and to address both the local and global implications of asbestos diffusion; public awareness on the health and socio-economic impact of asbestos use and banning.

Improving Education in Confucian Countries through Analysis of Organizational Challenges, Leadership, and Responsibilities

ERIC Educational Resources Information Center

Schenck, Andrew D.

2015-01-01

While common philosophical foundations influence instruction and leadership in East Asian nations, variable historical factors also significantly impact education within these countries. The current study was designed to holistically examine educational systems in different Confucian contexts, so that contemporary issues and necessary reforms may…

Trust-Based and Context-Aware Authentication in a Software Architecture for Context and Proximity-Aware Services

NASA Astrophysics Data System (ADS)

Lenzini, Gabriele

We describe an existing software architecture for context and proximity aware services that enables trust-based and context-aware authentication. A service is proximity aware when it automatically detects the presence of entities in its proximity. Authentication is context-aware when it uses contextual information to discern among different identities and to evaluate to which extent they are authentic. The software architecture that we describe here is functioning in our Institute: It manages a sensor network to detect the presence and location of users and their devices. A context manager is responsible to merge the different sources of contextual information, to solve potential contradictions, and to determine the level of authentication of the identity of the person approaching one of the services offered in the coffee-break corners of our Institute. In our solution for context-aware authentication, sensors are managed as if they were recommenders having subjective belief, disbelief, and uncertainty (i.e., trust) on the position and identity of users. A sensor’s subjective trust depends on what it has been sensing in the environment. We discuss the results of an array of simulations that we conducted to validate our concept of trust-based and context-aware authentication. We use Subjective Logic to manage trust.

Abortion in Islamic Ethics, and How it is Perceived in Turkey: A Secular, Muslim Country

PubMed Central

Ekmekci, Perihan Elif

2016-01-01

Abortion is among the most widely discussed concepts of medical ethics. Since the well-known ethical theories have emerged from Western world, the position of Islamic ethics regarding main issues of medical ethics has been overlooked. Muslims constitute a considerable amount of world population. Turkish Republic is the only Muslim country ruled with secular democracy and one of the three Muslim countries where abortion is legalized. The first aim of this paper is to present discussions on abortion in Islamic ethics in the context of major ethical concepts; the legal status of the fetus, respect for life and the right not to be born. The second aim is to put forth Turkey’s present legislation about abortion in the context of Islamic ethical and religious aspects. PMID:27364347

Changes in the provision of institutionalized mental health care in post-communist countries.

PubMed

Mundt, Adrian P; Frančišković, Tanja; Gurovich, Isaac; Heinz, Andreas; Ignatyev, Yuriy; Ismayilov, Fouad; Kalapos, Miklós Péter; Krasnov, Valery; Mihai, Adriana; Mir, Jan; Padruchny, Dzianis; Potočan, Matej; Raboch, Jiří; Taube, Māris; Welbel, Marta; Priebe, Stefan

2012-01-01

General psychiatric and forensic psychiatric beds, supported housing and the prison population have been suggested as indicators of institutionalized mental health care. According to the Penrose hypothesis, decreasing psychiatric bed numbers may lead to increasing prison populations. The study aimed to assess indicators of institutionalized mental health care in post-communist countries during the two decades following the political change, and to explore whether the data are consistent with the Penrose hypothesis in that historical context. General psychiatric and forensic psychiatric bed numbers, supported housing capacities and the prison population rates were collected in Azerbaijan, Belarus, Croatia, Czech Republic, East Germany, Hungary, Kazakhstan, Latvia, Poland, Romania, Russia and Slovenia. Percentage change of indicators over the decades 1989-1999, 1999-2009 and the whole period of 1989-2009 and correlations between changes of different indicators were calculated. Between 1989 and 2009, the number of general psychiatric beds was reduced in all countries. The decrease ranged from -11% in Croatia to -51% in East Germany. In 2009, the bed numbers per 100,000 population ranged from 44.7 in Azerbaijan to 134.4 in Latvia. Forensic psychiatric bed numbers and supported housing capacities increased in most countries. From 1989-2009, trends in the prison population ranged from a decrease of -58% in East Germany to an increase of 43% in Belarus and Poland. Trends in different indicators of institutionalised care did not show statistically significant associations. After the political changes in 1989, post-communist countries experienced a substantial reduction in general psychiatric hospital beds, which in some countries may have partly been compensated by an increase in supported housing capacities and more forensic psychiatric beds. Changes in the prison population are inconsistent. The findings do not support the Penrose hypothesis in that historical context as

Women's autonomy in health care decision-making in developing countries: a synthesis of the literature.

PubMed

Osamor, Pauline E; Grady, Christine

2016-01-01

Autonomy is considered essential for decision-making in a range of health care situations, from health care seeking and utilization to choosing among treatment options. Evidence suggests that women in developing or low-income countries often have limited autonomy and control over their health decisions. A review of the published empirical literature to identify definitions and methods used to measure women's autonomy in developing countries describe the relationship between women's autonomy and their health care decision-making, and identify sociodemographic factors that influence women's autonomy and decision-making regarding health care was carried out. An integrated literature review using two databases (PubMed and Scopus) was performed. Inclusion criteria were 1) publication in English; 2) original articles; 3) investigations on women's decision-making autonomy for health and health care utilization; and 4) developing country context. Seventeen articles met inclusion criteria, including eleven from South Asia, five from Africa, and one from Central Asia. Most studies used a definition of autonomy that included independence for women to make their own choices and decisions. Study methods differed in that many used study-specific measures, while others used a set of standardized questions from their countries' national health surveys. Most studies examined women's autonomy in the context of reproductive health, while neglecting other types of health care utilized by women. Several studies found that factors, including age, education, and income, affect women's health care decision-making autonomy. Gaps in existing literature regarding women's autonomy and health care utilization include gaps in the areas of health care that have been measured, the influence of sex roles and social support, and the use of qualitative studies to provide context and nuance.

Health disparities monitoring in the U.S.: lessons for monitoring efforts in Israel and other countries.

PubMed

Abu-Saad, Kathleen; Avni, Shlomit; Kalter-Leibovici, Ofra

2018-02-28

Health disparities are a persistent problem in many high-income countries. Health policymakers recognize the need to develop systematic methods for documenting and tracking these disparities in order to reduce them. The experience of the U.S., which has a well-established health disparities monitoring infrastructure, provides useful insights for other countries. This article provides an in-depth review of health disparities monitoring in the U.S. Lessons of potential relevance for other countries include: 1) the integration of health disparities monitoring in population health surveillance, 2) the role of political commitment, 3) use of monitoring as a feedback loop to inform future directions, 4) use of monitoring to identify data gaps, 5) development of extensive cross-departmental cooperation, and 6) exploitation of digital tools for monitoring and reporting. Using Israel as a case in point, we provide a brief overview of the healthcare and health disparities landscape in Israel, and examine how the lessons from the U.S. experience might be applied in the Israeli context. The U.S. model of health disparities monitoring provides useful lessons for other countries with respect to documentation of health disparities and tracking of progress made towards their elimination. Given the persistence of health disparities both in the U.S. and Israel, there is a need for monitoring systems to expand beyond individual- and healthcare system-level factors, to incorporate social and environmental determinants of health as health indicators/outcomes.

The determinants and outcomes of good provider communication: a cross-sectional study in seven African countries.

PubMed

Larson, Elysia; Leslie, Hannah H; Kruk, Margaret E

2017-07-02

To determine the extent of provider communication, predictors of good communication and the association between provider communication and patient outcomes, such as patient satisfaction, in seven sub-Saharan African countries. Cross-sectional, multicountry study. Data from recent Service Provision Assessment (SPA) surveys from seven countries in sub-Saharan Africa. SPA surveys include assessment of facility inputs and processes as well as interviews with caretakers of sick children. These data included 3898 facilities and 4627 providers. 16 352 caregivers visiting the facility for their sick children. We developed an index of four recommended provider communication items for a sick child assessment based on WHO guidelines. We assessed potential predictors of provider communication and considered whether better provider communication was associated with intent to return to the facility for care. The average score of the composite indicator of provider communication was low, at 35% (SD 26.9). Fifty-four per cent of caregivers reported that they were told the child's diagnosis, and only 10% reported that they were counselled on feeding for the child. Caregivers' educational attainment and provider preservice education and training in integrated management of childhood illness were associated with better communication. Private facilities and facilities with better infrastructure received higher communication scores. Caretakers reporting better communication were significantly more likely to state intent to return to the facility (relative risk: 1.19, 95% CI 1.16 to 1.22). There are major deficiencies in communication during sick child visits. These are associated with lower provider education as well as less well-equipped facilities. Poor communication, in turn, is linked to lower satisfaction and intention to return to facility among caregivers of sick children. Countries should test strategies for enhancing quality of communication in their efforts to improve

Attitudes of Primary School Teachers in Three Western Countries toward Learning Disabilities

ERIC Educational Resources Information Center

Cornoldi, Cesare; Capodieci, Agnese; Colomer Diago, Carla; Miranda, Ana; Shepherd, Katharine G.

2018-01-01

In recent years, teachers in Western countries have developed beliefs and attitudes related to working with students with specific learning disabilities (LD) that may be critical in shaping their educational practices with them; however, their beliefs and attitudes differ across political and geographical contexts and may be influenced by specific…

Teaching Mathematics in Seven Countries: Results from the TIMSS 1999 Video Study.

ERIC Educational Resources Information Center

Hiebert, James; Gallimore, Ronald; Garnier, Helen; Givvin, Karen Bogard; Hollingsworth, Hilary; Jacobs, Jennifer; Chui, Angel Miu-Ying; Wearne, Diana; Smith, Margaret; Kersting, Nicole; Manaster, Alfred; Tseng, Ellen; Etterbeek, Wallace; Manaster, Carl; Gonzales, Patrick; Stigler, James

This book reports teaching practices in mathematics in seven countries from the Third International Mathematics and Science Study (TIMSS) 1999 video study. A detailed description of the methods in the mathematics portion of the study is presented in an accompanying technical report from an international perspective. Contexts of the lessons, the…

The Health Impact of Child Labor in Developing Countries: Evidence From Cross-Country Data

PubMed Central

Roggero, Paola; Mangiaterra, Viviana; Bustreo, Flavia; Rosati, Furio

2007-01-01

Objectives. Research on child labor and its effect on health has been limited. We sought to determine the impact of child labor on children’s health by correlating existing health indicators with the prevalence of child labor in selected developing countries. Methods. We analyzed the relationship between child labor (defined as the percentage of children aged 10 to14 years who were workers) and selected health indicators in 83 countries using multiple regression to determine the nature and strength of the relation. The regression included control variables such as the percentage of the population below the poverty line and the adult mortality rate. Results. Child labor was significantly and positively related to adolescent mortality, to a population’s nutrition level, and to the presence of infectious disease. Conclusions. Longitudinal studies are required to understand the short- and long-term health effects of child labor on the individual child. PMID:17194870

Spending on medicines in Israel in an international context.

PubMed

Sax, Philip

2005-05-01

Like most developed countries, in the last decade Israel's healthcare system has been subject to cost-containing measures in the drug sector. To provide comparative information in an international context on the level of outpatient drug expenditures in Israel, both total and those publicly financed, and to analyze how these have changed with time during the last decade. Using definitions of the OECD (Organization of Economic Cooperation and Development), internationally comparable data on total expenditure and public expenditure on medicines in Israel are provided. The Israeli estimates are based on data from the Ministry of Health audited reports of financial activities of the health management organizations and from the family expenditure surveys carried out by the Central Bureau of Statistics. Per capita total and public expenditures in Israel are analyzed over time, as are their share of national expenditure on health and of gross domestic product. Israel expenditures are then compared with those for individual member countries of the OECD, as well as a 21 country average, from 1992 to 2002. Analysis of the Israeli expenditure data shows a considerable reduction in growth of per capita total and public expenditures on medicines since 1997. Growth in the share of total drug expenditure of NEH and of GDP has also been constrained since 1997. In an international context, per capita expenditure on medicines in Israel, particularly what is publicly financed, is one of the lowest. Furthermore, its share of NEH and GDP is also very low compared to other countries. This substantive gap in spending on medicines between Israel and other countries has increased since 1997. Israel, a medium-income country with a lower than average level of expenditure on health compared to OECD countries, has a particularly low level of expenditure on medicines. Whereas the share of health expenditure of GDP in Israel is similar to the international average, the share of drug expenditure

‘Contexts of Exit in the Migration of Russian Speakers from the Baltic Countries to Ireland’

PubMed Central

Aptekar, Sofya

2013-01-01

Recently, Ireland has become a major destination for migrants from Estonia, Latvia, and Lithuania. Many of these migrants are members of Russian-speaking minorities leaving a context of restrictive citizenship and language laws and varying degrees of ethnic tension. This paper draws on interviews collected in Ireland to examine the role played by the contexts of exit in decisions to migrate among Russian-speaking minorities from the Baltics. The results suggest that Russian speakers from Estonia migrate because of their experiences as minorities, while those from Latvia and Lithuania migrate to escape low wages and irregular employment. This is so despite equally restrictive language and citizenship laws in Estonia and Latvia. I argue that the effect of state policy as a push factor for minority emigration is mediated by other contextual aspects, such as levels of contact, timbre of ethnic relations, and the degree of intersection between economic stratification and ethnicity. PMID:24363609

Psycho-Socio-Cultural Determinants of Food Choice: A Qualitative Study on Adults in Social and Cultural Context of Iran

PubMed Central

Haghighian Roudsari, Arezoo; Vedadhir, Abouali; Amiri, Parisa; Kalantari, Naser; Omidvar, Nasrin; Eini-Zinab, Hassan; Hani Sadati, Seyed Mohammad

2017-01-01

Objective: Food choice is a process through which people think, feel, and eat food. It does not only influence individuals' health and well-being, families and communities, but also it has an effect on regional, national, and global levels. This qualitative study was conducted to explore perceptions and lived experiences of Tehran adult residents on psychological, social and cultural determinants of food choice. Method: In this qualitative design, we recruited 33 adults aged 30 to 64 years from various districts of Tehran, capital of Iran, and we explored how people make decisions about food choice in practice and shape their perception, attitude, and eating practices. An individual in-depth semi-structured interview guide included major questions with follow-up probes was used to explore participants’ current and past eating habits from childhood to adulthood, dietary change at different life courses, and effective psychological state on food selection in different seasons. Results: This study revealed that food choice in the studied adults (30-64 years old) was widely influenced by psychological, social, and cultural determinants, which can be categorized into 5 main themes: cultural context and patterns; social Structure and norms; information resources and media; household and family structure; and nutrition transition. Conclusion: The findings clarified the importance of social and cultural contexts, which influence the food choice of adults in a metropolis like Tehran. Many of these concepts are contextualized from childhood. These findings could serve as guideline to design socio-culturally appropriate strategies and improve dietary behaviors of Iranians. PMID:29472950

Psycho-Socio-Cultural Determinants of Food Choice: A Qualitative Study on Adults in Social and Cultural Context of Iran.

PubMed

Haghighian Roudsari, Arezoo; Vedadhir, Abouali; Amiri, Parisa; Kalantari, Naser; Omidvar, Nasrin; Eini-Zinab, Hassan; Hani Sadati, Seyed Mohammad

2017-10-01

Objective: Food choice is a process through which people think, feel, and eat food. It does not only influence individuals' health and well-being, families and communities, but also it has an effect on regional, national, and global levels. This qualitative study was conducted to explore perceptions and lived experiences of Tehran adult residents on psychological, social and cultural determinants of food choice. Method: In this qualitative design, we recruited 33 adults aged 30 to 64 years from various districts of Tehran, capital of Iran, and we explored how people make decisions about food choice in practice and shape their perception, attitude, and eating practices. An individual in-depth semi-structured interview guide included major questions with follow-up probes was used to explore participants' current and past eating habits from childhood to adulthood, dietary change at different life courses, and effective psychological state on food selection in different seasons. Results: This study revealed that food choice in the studied adults (30-64 years old) was widely influenced by psychological, social, and cultural determinants, which can be categorized into 5 main themes: cultural context and patterns; social Structure and norms; information resources and media; household and family structure; and nutrition transition. Conclusion: The findings clarified the importance of social and cultural contexts, which influence the food choice of adults in a metropolis like Tehran. Many of these concepts are contextualized from childhood. These findings could serve as guideline to design socio-culturally appropriate strategies and improve dietary behaviors of Iranians.

The feasibility and appropriateness of introducing nursing curricula from developed countries into developing countries: a comprehensive systematic review.

PubMed

Jayasekara, Rasika; Schultz, Tim

of the review is presented in narrative form. In this review, a descriptive study and a textual opinion paper examined the cultural relevancy of borrowed curriculum models, and the global influence of American nursing. Another two opinion papers evaluated the adaptability of another country curriculum models in their countries. The evidence regarding the feasibility and appropriateness of introducing developed countries' nursing curricula into developing countries is weak because of the paucity of high-quality studies. However, some lower-level evidence suggesting that direct transfer of the curriculum model from one country to another is not appropriate without first assessing the cultural context of both countries. Second, the approach of considering international, regional and local experiences more feasible and presumably a more effective strategy for adapting of a country's curriculum into a culturally or economically different country.

The feasibility and appropriateness of introducing nursing curricula from developed countries into developing countries: a comprehensive systematic review.

PubMed

Jayasekara, Rasika; Schultz, Tim

2006-09-01

these papers, meta-synthesis of the results was not possible. For this reason, this section of the review is presented in narrative form. In this review, a descriptive study and a textual opinion paper examined the cultural relevancy of borrowed curriculum models, and the global influence of American nursing. Another two opinion papers evaluated the adaptability of another country curriculum models in their countries. Conclusion  The evidence regarding the feasibility and appropriateness of introducing developed countries' nursing curricula into developing countries is weak because of the paucity of high-quality studies. However, some lower-level evidence suggesting that direct transfer of the curriculum model from one country to another is not appropriate without first assessing the cultural context of both countries. Second, the approach of considering international, regional and local experiences more feasible and presumably a more effective strategy for adapting of a country's curriculum into a culturally or economically different country.

The form and context of federalism: meanings for health care financing.

PubMed

France, George

2008-08-01

This article examines the meaning of federalism for health care financing (HCF) and is based on two considerations. First, federal institutions are embedded in their national context and interact with them. The design and performance of HCF policy will be influenced by contexts, the workings of the federal institutions, and the interactions of these institutions with different elements of the context. This article unravels these influences. Second, there is no unique model of federalism, and so we have to specify the particular form to which we refer. The examination of the influence of federalism and its context on HCF policy is facilitated by using a transnational comparative approach, and this article examines four mature federations: the United States, Australia, Canada, and Germany. The relatively poor performance of the U.S. HCF system seems associated with the fact that it operates in a context markedly less benign than those of the other national HCF systems. Heterogeneity of context appears also to have contributed to important differences between the United States and the other countries in the design of HCF policies. An analysis of how federalism works in practice suggests that, while U.S. federalism may be overall less favorable to the development of well-functioning HCF policies, the inferior performance of these policies is to be principally attributed to context.

Global Health Equity: Cancer Care Outcome Disparities in High-, Middle-, and Low-Income Countries

PubMed Central

de Souza, Jonas A.; Hunt, Bijou; Asirwa, Fredrick Chite; Adebamowo, Clement

2016-01-01

Breakthroughs in our global fight against cancer have been achieved. However, this progress has been unequal. In low- and middle-income countries and for specific populations in high-income settings, many of these advancements are but an aspiration and hope for the future. This review will focus on health disparities in cancer within and across countries, drawing from examples in Kenya, Brazil, and the United States. Placed in context with these examples, the authors also draw basic recommendations from several initiatives and groups that are working on the issue of global cancer disparities, including the US Institute of Medicine, the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries, and the Union for International Cancer Control. From increasing initiatives in basic resources in low-income countries to rapid learning systems in high-income countries, the authors argue that beyond ethics and equity issues, it makes economic sense to invest in global cancer control, especially in low- and middle-income countries. PMID:26578608

Determining the feasibility and preliminary efficacy of a stroke instructional and educational DVD in a multinational context: a randomized controlled pilot study.

PubMed

Jones, Kelly M; Bhattacharjee, Rohit; Krishnamurthi, Rita; Blanton, Sarah; Barker-Collo, Suzanne; Theadom, Alice; Thrift, Amanda G; Wolf, Steven L; Venketasubramanian, Narayanaswamy; Parmar, Priya; Maujean, Annick; Ranta, Annemarei; Cadilhac, Dominique; Sanya, Emmanuel O; MacKay-Lyons, Marilyn; Pandian, Jeyaraj D; Arora, Deepti; Obiako, Reginald O; Saposnik, Gustavo; Balalla, Shivanthi; Bornstein, Natan M; Langhorne, Peter; Norrving, Bo; Brown, Nita; Brainin, Michael; Taylor, Denise; Feigin, Valery L

2018-05-01

To assess the feasibility of conducting a randomized controlled trial of an instructional and educational stroke DVD and determine the feasibility and preliminary efficacy of this intervention in a multinational context. Non-funded, pilot randomized controlled trial of intervention versus usual care. International, multicentre, community-based. Community-living adults up to three years post stroke with moderate to severe disability and their nominated informal caregivers. Intervention patients viewed and practised rehabilitation techniques demonstrated in the DVD over six weeks. Trial feasibility by number of active recruitment sites, recruitment efficiency, randomization and follow-up. Intervention feasibility by patient and caregiver impressions. Preliminary efficacy by the quality of life - 5-level EuroQol-5D (EQ-5D) health status measure, General Health Questionnaire and Centre for Epidemiological Studies-Depression at two months. In total, 14 recruitment sites were established across eight countries. Recruitment was achieved at nine (64%) sites. Over 16 months, 66 participants were recruited (mean (SD) age = 63.5 (12.47) years) and randomized to intervention ( n = 34) and control ( n = 32) groups. In total, 54 (82%) completed a follow-up assessment. Patient and/or caregiver comments about the benefits and barriers to accessing the intervention were mixed. There were no significant between-group differences in outcomes at two months ( P > 0.05). Conducting a multinational trial of a stroke DVD requires full funding. The intervention was acceptable to some patients and their caregivers, yet a generalized education approach did not fully meet their needs and/or expectations. A more individualized method may be required to meet peoples' changing needs during stroke recovery.

Determinants of mortality transition in developing countries before and after the Second World War: Some evidence from Cuba.

PubMed

Díaz-Briquets, S

1981-11-01

Few studies provide an insight into what factors contributed to declines in the mortality rates of developing countries before the Second World War. In this paper, statistics on causes of death from Cuba, particularly Havana, are used to investigate what may have been some of the principal determinants of mortality decline in the developing world before the arrival of modern drugs and insecticides. Trends in cause-specific mortality are examined in the light of Cuba's social, economic, medical and public health history. The Cuban experience strongly suggests that in this country public health and sanitary reforms and nutritional improvements were largely responsible for initial declines in mortality throughout the first half of the twentieth century. One important finding is that the impact of these reforms and improved nutrition was greatly influenced by prevailing economic conditions. Periods of economic prosperity facilitated declines in mortality; but in times of adversity, the reverse occurred. It appears that during prosperous periods the maintenance and expansion of public health and sanitary facilities were made possible by increased public and private revenues, and that individuals had access to a more abundant diet. The severe economic crisis of the Great Depression had the opposite effect. With the appearance of sulphonamides in the late 1930s, antibiotics, and residual insecticides and other specific measures at the end of the Second World War, the relevance of economic conditions as a determinant of mortality decline diminished. Although this analysis points to the aforementioned trends, the Cuban experience also suggests that other factors enter into the process of declining mortality and that this phenomenon can only be explained as the result of the complex interplay of many forces.

"If the land is healthy ... it makes the people healthy": the relationship between caring for Country and health for the Yorta Yorta Nation, Boonwurrung and Bangerang Tribes.

PubMed

'yotti' Kingsley, Jonathan; Townsend, Mardie; Phillips, Rebecca; Aldous, David

2009-03-01

This article reports on research undertaken with members of three Indigenous groups in Victoria, Australia, to explore the health and wellbeing implications of caring for Country (defined as having knowledge, sense of responsibility and inherent right to be involved in the management of traditional lands). The research findings provide a better understanding of this key determinant of the health and wellbeing of Indigenous people in the context of public health where there are few existing published studies assessing this relationship. Thirteen traditional custodians(1) and local Indigenous environmental workers were interviewed. This qualitative study involving semi-structured interviews identified that caring for Country offers great benefits, including building self-esteem, fostering self-identity, maintaining cultural connection and enabling relaxation and enjoyment through contact with the natural environment. Results generated indicate that caring for Country may offer a means of improving the current poor health status of Indigenous Australian peoples.

Alcohol Consumption in Movies and Adolescent Binge Drinking in 6 European Countries

PubMed Central

Sargent, James D.; Poelen, Evelien A. P.; Scholte, Ron; Florek, Ewa; Sweeting, Helen; Hunt, Kate; Karlsdottir, Solveig; Jonsson, Stefan Hrafn; Mathis, Federica; Faggiano, Fabrizio; Morgenstern, Matthis

2012-01-01

OBJECTIVE: The goal of this study was to investigate whether the association between exposure to images of alcohol use in movies and binge drinking among adolescents is independent of cultural context. METHODS: A cross-sectional survey study in 6 European countries (Germany, Iceland, Italy, Netherlands, Poland, and Scotland) was conducted. A total of 16 551 pupils from 114 public schools with a mean (± SD) age of 13.4 (± 1.18) years participated. By using previously validated methods, exposure to alcohol use in movies was estimated from the 250 top-grossing movies of each country (years 2004−2009). Lifetime binge drinking was the main outcome measure. RESULTS: Overall, 27% of the sample had consumed >5 drinks on at least 1 occasion in their life. After controlling for age, gender, family affluence, school performance, television screen time, sensation seeking and rebelliousness, and frequency of drinking of peers, parents, and siblings, the adjusted β-coefficient for lifetime binge drinking in the entire sample was 0.12 (95% confidence interval: 0.10−0.14; P < .001). The crude relationship between movie alcohol use exposure and lifetime binge drinking was significant in all countries; after covariate adjustment, the relationship was still significant in 5 of 6 countries. A sensitivity analysis revealed that the association is content specific, as there was no significant association between lifetime binge drinking and exposure to smoking in movies. CONCLUSIONS: The link between alcohol use in movies and adolescent binge drinking was robust and seems relatively unaffected by cultural contexts. PMID:22392174

Alcohol consumption in movies and adolescent binge drinking in 6 European countries.

PubMed

Hanewinkel, Reiner; Sargent, James D; Poelen, Evelien A P; Scholte, Ron; Florek, Ewa; Sweeting, Helen; Hunt, Kate; Karlsdottir, Solveig; Jonsson, Stefan Hrafn; Mathis, Federica; Faggiano, Fabrizio; Morgenstern, Matthis

2012-04-01

The goal of this study was to investigate whether the association between exposure to images of alcohol use in movies and binge drinking among adolescents is independent of cultural context. A cross-sectional survey study in 6 European countries (Germany, Iceland, Italy, Netherlands, Poland, and Scotland) was conducted. A total of 16 551 pupils from 114 public schools with a mean (± SD) age of 13.4 (± 1.18) years participated. By using previously validated methods, exposure to alcohol use in movies was estimated from the 250 top-grossing movies of each country (years 2004-2009). Lifetime binge drinking was the main outcome measure. Overall, 27% of the sample had consumed >5 drinks on at least 1 occasion in their life. After controlling for age, gender, family affluence, school performance, television screen time, sensation seeking and rebelliousness, and frequency of drinking of peers, parents, and siblings, the adjusted β-coefficient for lifetime binge drinking in the entire sample was 0.12 (95% confidence interval: 0.10-0.14; P < .001). The crude relationship between movie alcohol use exposure and lifetime binge drinking was significant in all countries; after covariate adjustment, the relationship was still significant in 5 of 6 countries. A sensitivity analysis revealed that the association is content specific, as there was no significant association between lifetime binge drinking and exposure to smoking in movies. The link between alcohol use in movies and adolescent binge drinking was robust and seems relatively unaffected by cultural contexts.

Political Impetus: Towards a Successful Agenda-Setting for Inclusive Health Policies in Low- and Middle-Income Countries Comment on "Shaping the Health Policy Agenda: The Case of Safe Motherhood Policy in Vietnam".

PubMed

Yang, Xiaoguang; Qian, Xu

2016-02-04

Agenda-setting is a crucial step for inclusive health policies in the low- and middle-income countries (LMICs). Enlightened by Ha et al manuscript, this commentary paper argues that 'political impetus' is the key to the successful agenda-setting of health policies in LMICs, though other determinants may also play the role during the process. This Vietnamese case study presents a good example for policy-makers of other LMICs; it offers insights for contexts where there are limited health resources and poor health performance. Further research which compares various stages of the health policy process across countries, is much needed. © 2016 by Kerman University of Medical Sciences.

One for all: workplace social context and drinking among railway workers in Ukraine.

PubMed

Murphy, Adrianna; Roberts, Bayard; McGowan, Catherine; Kizilova, Kseniya; Kizilov, Alexiy; Rhodes, Tim; McKee, Martin

2015-01-01

Alcohol consumption is a leading cause of mortality and morbidity in countries of the former Soviet Union, but little is known about its social determinants. Recent research has suggested that workplace contexts may play a role. Using qualitative methods, we investigate the relationship between workplace social contexts and drinking in Ukraine. We conducted 24 individual semi-structured interviews and two focus group discussions in Lviv and Kharkiv, Ukraine, with male railway employees aged 18+ years. Data were analysed using a thematic analysis approach. Men in our sample expressed strong feelings of interdependence and trust towards their co-workers which we defined as 'social solidarity'. Drinking with co-workers was often seen as obligatory and an integral part of co-worker social occasions. Engagement in sport or family obligations seemed to act as a deterrent to drinking among some workers. A strong sense of solidarity exists between railway co-workers in Ukraine, perhaps a remnant of the Soviet era when individuals relied on informal networks for support. Alcohol may be used as a means of expressing this solidarity. Our findings point to factors, namely engagement in sports and family, which may offer opportunities for interventions to reduce alcohol consumption among workers in Ukraine.

Sustainable solid waste management: an integrated approach for Asian countries.

PubMed

Shekdar, Ashok V

2009-04-01

Solid waste management (SWM) has been an integral part of every human society. The approaches for SWM should be compatible with the nature of a given society, and, in this regard, Asian countries are no exception. In keeping with global trends, the systems are being oriented to concentrate on sustainability issues; mainly through the incorporation of 3R (reduce, reuse and recycle) technologies. However, degree and nature of improvements toward sustainability are varying and depend on the economic status of a country. High-income countries like Japan and South Korea can afford to spend more to incorporate 3R technologies. Most of the latest efforts focus on "Zero Waste" and/or "Zero Landfilling" which is certainly expensive for weaker economies such as those of India or Indonesia. There is a need to pragmatically assess the expectations of SWM systems in Asian countries. Hence, in this paper, we analyze the situation in different Asian countries, and explore future trends. We conceptually evaluate issues surrounding the sustainability of SWM. We propose a multi-pronged integrated approach for improvement that achieves sustainable SWM in the context of national policy and legal frameworks, institutional arrangement, appropriate technology, operational and financial management, and public awareness and participation. In keeping with this approach, a generic action plan has been proposed that could be tailored to suit a situation in a particular country. Our proposed concept and action plan framework would be useful across a variety of country-specific scenarios.

User Situational Context: An Essential Challenge to Context Awareness

ERIC Educational Resources Information Center

Mowafi, Yaser Abdallah

2009-01-01

Existing research on context and context awareness has broadly focused on the technical aspects of context acquisition and interpretation of users' surroundings, also called physical or sensor-based context. Such an approach has lacked from reconciling the perception of real-world context exhibited by humans, also known as user context, and…

Vector-borne disease surveillance in livestock populations: A critical review of literature recommendations and implemented surveillance (BTV-8) in five European countries.

PubMed

Dórea, Fernanda C; Elbers, Armin R W; Hendrikx, Pascal; Enoe, Claes; Kirkeby, Carsten; Hoinville, Linda; Lindberg, Ann

2016-03-01

Preparedness against vector-borne threats depends on the existence of a long-term, sustainable surveillance of vector-borne disease and their relevant vectors. This work reviewed the availability of such surveillance systems in five European countries (Denmark, France, The Netherlands, Sweden and United Kingdom, part of the CoVetLab network). A qualitative assessment was then performed focusing on surveillance directed particularly to BTV-8. Information regarding surveillance activities were reviewed for the years 2008 and 2012. The results were then complemented with a critical scoping review of the literature aimed at identifying disease surveillance strategies and methods that are currently suggested as best suited to target vector-borne diseases in order to guide future development of surveillance in the countries in question. Passive surveillance was found to be efficient for early detection of diseases during the early phase of introduction into a free country. However, its value diminished once the disease has been established in a territory. Detection of emerging diseases was found to be very context and area specific, and thus active surveillance designs need to take the available epidemiological, ecological and entomological information into account. This was demonstrated by the effectiveness of the bulk milk surveillance in detecting the first case in Sweden, highlighting the need for output based standards to allow the most effective, context dependent, surveillance strategies to be used. Preparedness was of fundamental importance in determining the timeliness of detection and control in each country and that this in turn was heavily influenced by knowledge of emerging diseases in neighboring countries. Therefore it is crucial to share information on outbreaks between researchers and decision-makers and across borders continuously in order to react timely in case of an outbreak. Furthermore, timely reaction to an outbreak was heavily influenced by

Infant and Young Child Feeding in Developing Countries

ERIC Educational Resources Information Center

Arabi, Mandana; Frongillo, Edward A.; Avula, Rasmi; Mangasaryan, Nune

2012-01-01

Feeding practices are important determinants of growth and development of children. Using infant and young child feeding indicators and complementary feeding guidelines, 7 practices in 28 countries are described, showing substantial variation across countries. Only 25% of 0- to 5-month-olds were exclusively breastfed, and only half of 6- to…

Long-term disability programs in selected countries.

PubMed

Zeitzer, I R; Beedon, L E

1987-09-01

In 1985, the Social Security Administration commissioned an 18-month research project to study disability in eight industrialized countries: Austria, Canada, Finland, the Federal Republic of Germany, Israel, the Netherlands, Sweden, and the United Kingdom. The study focused on three key areas: (1) the initial determination of disability, (2) the methods of monitoring disability, and (3) the incentives to return to work. Although the study revealed great variations among the countries in the definition of long-term disability, the approach followed in providing benefits, and the organization and features of the programs, some basic similarities were also found. Among the similarities are: (1) most countries have several income-maintenance programs to protect workers in the event that they are disabled, and (2) the disability test to determine whether a person is eligible for a disability benefit is ambiguous in that the various programs each have different eligibility criteria, different definitions of disability, different considerations given to labor-market conditions, and so forth. This article examines the diversity among the countries and attempts to highlight unique approaches to adjudicating disability, providing linkages to rehabilitation, and creating incentives for returning to work.

The cost determinants of routine infant immunization services: a meta-regression analysis of six country studies.

PubMed

Menzies, Nicolas A; Suharlim, Christian; Geng, Fangli; Ward, Zachary J; Brenzel, Logan; Resch, Stephen C

2017-10-06

Evidence on immunization costs is a critical input for cost-effectiveness analysis and budgeting, and can describe variation in site-level efficiency. The Expanded Program on Immunization Costing and Financing (EPIC) Project represents the largest investigation of immunization delivery costs, collecting empirical data on routine infant immunization in Benin, Ghana, Honduras, Moldova, Uganda, and Zambia. We developed a pooled dataset from individual EPIC country studies (316 sites). We regressed log total costs against explanatory variables describing service volume, quality, access, other site characteristics, and income level. We used Bayesian hierarchical regression models to combine data from different countries and account for the multi-stage sample design. We calculated output elasticity as the percentage increase in outputs (service volume) for a 1% increase in inputs (total costs), averaged across the sample in each country, and reported first differences to describe the impact of other predictors. We estimated average and total cost curves for each country as a function of service volume. Across countries, average costs per dose ranged from $2.75 to $13.63. Average costs per child receiving diphtheria, tetanus, and pertussis ranged from $27 to $139. Within countries costs per dose varied widely-on average, sites in the highest quintile were 440% more expensive than those in the lowest quintile. In each country, higher service volume was strongly associated with lower average costs. A doubling of service volume was associated with a 19% (95% interval, 4.0-32) reduction in costs per dose delivered, (range 13% to 32% across countries), and the largest 20% of sites in each country realized costs per dose that were on average 61% lower than those for the smallest 20% of sites, controlling for other factors. Other factors associated with higher costs included hospital status, provision of outreach services, share of effort to management, level of staff training

Factors determining the viability of radiation processing in developing countries

NASA Astrophysics Data System (ADS)

van der Linde, HJ; Basson, RA

In the fifteen years since the introduction of radiation processing to South Africa, four commercial irradiation facilities have been established. These are involved in the processing of a large variety of products, from syringes and prostheses to strawberries and sugar yeast. Three of the facilities are devoted mainly to food irradiation and several thousand tonnes are now processed annually. During this period it was repeatedly experienced that the successful introduction of radiation processing in general, and food radurization in particular, on a commercial scale was critically dependent on the following factors: acceptance by the producer, industry and consumer; initial capital expenditure; running costs and overheads in general; and continous throughput. All of these factors contribute to the processing cost which is the ultimate factor in determing the value/price ratio for the potential entrepreneur and customer of this new technology. After a market survey had identified the need for a new food irradiation facility to cope with the growing interest in commercial food radurization in the Western Cape, the above-mentioned factors were of cardinal importance in the design and manufacture of a new irradiator. The resulting batch-pallet facility which was commisioned in August 1986, is rather inefficient as far as energy utilization is concerned but this shortcoming is compensated for by its low cost, versatility and low hold-up. Although the facility has limitations as far as the processing of really large volumes of produce is concerned, it is particularly suitable not only for developing countries, but for developed countries in the introductory phase of commercial food radurization.

Renewal, Resurgence, and Alternative Reinforcement Context

PubMed Central

Sweeney, Mary M.; Shahan, Timothy A.

2015-01-01

Resurgence, relapse induced by the removal of alternative reinforcement, and renewal, relapse induced by a change in contextual stimuli, are typically studied separately in operant conditioning paradigms. In analogous treatments of operant problem behavior, aspects of both relapse phenomena can operate simultaneously. Therefore, the purpose of this study was to examine a novel method for studying resurgence and renewal in the same experimental preparation. An alternative source of reinforcement was available during extinction for one group of rats (a typical resurgence preparation). Another group experienced an operant renewal preparation in which the extinction context was distinguished via olfactory and visual stimuli. A third group experienced alternative reinforcement delivery in the new context, a novel combination of typical resurgence and renewal preparations. Removal of alternative reinforcement and/or a change in context induced relapse, relative to an extinction-only control group. When alternative reinforcement was delivered in a novel context, the alternative response was less persistent relative to when extinction of the alternative response took place in the context in which it was trained. This methodology might be used to illustrate shared (or distinct) mechanisms of resurgence and renewal, and to determine how delivering alternative reinforcement in another context may affect persistence and relapse. PMID:25936876

Successful Secondary School Principalship in Disadvantaged Contexts from a Leadership for Learning Perspective

ERIC Educational Resources Information Center

Moral, Cristina; Martín-Romera, Ana; Martínez-Valdivia, Estefanía; Olmo-Extremera, Marta

2018-01-01

The paper we present here is part of the International Successful School Principalship Project (ISSPP), which is designed to analyse the characteristic traits of successful leadership in different contexts and countries [Day, C., and K. Leithwood. 2007. "Successful School Leadership in Times of Change." Dordrecht: Springer-Kluwer; Day,…

Standard Setting Lessons Learned in the South African Context: Implications for International Implementation

ERIC Educational Resources Information Center

Pitoniak, Mary J.; Yeld, Nan

2013-01-01

Criterion-referenced assessments have become more common around the world, with performance standards being set to differentiate different levels of student performance. However, use of standard setting methods developed in the United States may be complicated by factors related to the political and educational contexts within another country. In…

Using ICTs (Educationally) for Development in an African Context: Possibilities and Limitations

ERIC Educational Resources Information Center

Carrim, Nazir; Taruvinga, Mandi

2015-01-01

This article examines the possibilities and limitations of using ICTs for development in an African context from an education perspective. Although we provide an account of the Pan-African Agenda on integrating ICTs, which covers many countries on the African continent, our focus is specifically on using ICTs for development in a South African…

Development of voluntary private health insurance in Nordic countries - An exploratory study on country-specific contextual factors.

PubMed

Tynkkynen, Liina-Kaisa; Alexandersen, Nina; Kaarbøe, Oddvar; Anell, Anders; Lehto, Juhani; Vrangbӕk, Karsten

2018-03-16

The Nordic countries are healthcare systems with tax-based financing and ambitions for universal access to comprehensive services. This implies that distribution of healthcare resources should be based on individual needs, not on the ability to pay. Despite this ideological orientation, significant expansion in voluntary private health insurance (VPHI) contracts has occurred in recent decades. The development and role of VPHIs are different across the Nordic countries. Complementary VPHI plays a significant role in Denmark and in Finland. Supplementary VPHI is prominent in Norway and Sweden. The aim of this paper is to explore drivers behind the developments of the VPHI markets in the Nordic countries. We analyze the developments in terms of the following aspects: the performance of the statutory system (real or perceived), lack of coverage in certain areas of healthcare, governmental interventions or inability to reform the system, policy trends and the general socio-cultural environment, and policy responses to voting behavior or lobbying by certain interest groups. It seems that the early developments in VPHI markets have been an answer to the gaps in the national health systems created by institutional contexts, political decisions, and cultural interpretations on the functioning of the system. However, once the market is created it introduces new dynamics that have less to do with gaps and inflexibilities and more with cultural factors. Copyright © 2018. Published by Elsevier B.V.

Placing Families in Context: Challenges for Cross-National Family Research

PubMed Central

Yu, Wei-hsin

2015-01-01

Cross-national comparisons constitute a valuable strategy to assess how broader cultural, political, and institutional contexts shape family outcomes. One typical approach of cross-national family research is to use comparable data from a limited number of countries, fit similar regression models for each country, and compare results across country-specific models. Increasingly, researchers are adopting a second approach, which requires merging data from many more societies and testing multilevel models using the pooled sample. Although the second approach has the advantage of allowing direct estimates of the effects of nation-level characteristics, it is more likely to suffer from the problems of omitted-variable bias, influential cases, and measurement and construct nonequivalence. I discuss ways to improve the first approach's ability to infer macrolevel influences, as well as how to deal with challenges associated with the second one. I also suggest choosing analytical strategies according to whether the data meet multilevel models’ assumptions. PMID:25999603

Cognitive determinants of healthcare evaluations - A comparison of Eastern and Western European countries.

PubMed

Schneider, Simone M; Popic, Tamara

2018-03-01

Knowing the public opinion of healthcare is essential when assessing healthcare system performance; but little research has focussed on the links between the public's general attitude to the healthcare system and its perceptions and expectations of specific healthcare-related aspects. Using data from the fourth round of the European Social Survey 2008/09, we explore the cognitive determinants of global evaluations of the healthcare system in 12 Eastern and 16 Western European countries. We find that healthcare evaluations follow a coherent cognitive reasoning. They are associated with (i) perceptions of the performance of healthcare systems (i.e. efficiency, equality of treatment, health outcomes), (ii) expectations of the government's role in providing healthcare, and (iii) reflections on demographic pressures (i.e. aging populations). Contrary to the general assumption that normative expectations are responsible for differences in healthcare evaluations between Eastern and Western Europe, our results suggest that regional differences are largely due to a more negative perception of the performance of healthcare systems within Eastern Europe. To enhance the public opinion of healthcare, policy makers should improve the efficiency of healthcare systems and take measures to assure equality in health treatment. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

The Determinants of Reported Personal and Household Hygiene Behaviour: A Multi-Country Study

PubMed Central

Aunger, Robert; Greenland, Katie; Ploubidis, George; Schmidt, Wolf; Oxford, John; Curtis, Valerie

2016-01-01

A substantial proportion of the total infectious disease burden world-wide is due to person-to-person spread of pathogens within households. A questionnaire-based survey on the determinants of hand-washing with soap and cleaning of household surfaces was conducted in at least 1000 households in each of twelve countries across the world (N = 12,239). A structural equation model of hygiene behaviour and its consequences derived from theory was then estimated on this dataset for both behaviours, using a maximum likelihood procedure. The analysis showed that the frequency of handwashing with soap is significantly related to how automatically it is performed, and whether or not someone is busy, or tired. Surface cleaning was strongly linked to possessing a cleaning routine, the perception that one is living in a dirty environment and that others are doing the behaviour, whether one has a strong sense of contamination, as well as a felt need to keep one’s surroundings tidy. Being concerned with good manners is also linked to the performance of both behaviours. This study is the first to identify the role of manners, orderliness and routine on hygiene behaviours globally. Such findings should prove helpful in designing programs to improve domestic hygiene practices. PMID:27541259

The Determinants of Reported Personal and Household Hygiene Behaviour: A Multi-Country Study.

PubMed

Aunger, Robert; Greenland, Katie; Ploubidis, George; Schmidt, Wolf; Oxford, John; Curtis, Valerie

2016-01-01

A substantial proportion of the total infectious disease burden world-wide is due to person-to-person spread of pathogens within households. A questionnaire-based survey on the determinants of hand-washing with soap and cleaning of household surfaces was conducted in at least 1000 households in each of twelve countries across the world (N = 12,239). A structural equation model of hygiene behaviour and its consequences derived from theory was then estimated on this dataset for both behaviours, using a maximum likelihood procedure. The analysis showed that the frequency of handwashing with soap is significantly related to how automatically it is performed, and whether or not someone is busy, or tired. Surface cleaning was strongly linked to possessing a cleaning routine, the perception that one is living in a dirty environment and that others are doing the behaviour, whether one has a strong sense of contamination, as well as a felt need to keep one's surroundings tidy. Being concerned with good manners is also linked to the performance of both behaviours. This study is the first to identify the role of manners, orderliness and routine on hygiene behaviours globally. Such findings should prove helpful in designing programs to improve domestic hygiene practices.

Do We Expect Too Much of Bilingual Teachers? Bilingual Teaching in Developing Countries

ERIC Educational Resources Information Center

Benson, Carol

2004-01-01

Given the unique character of bilingual students and the programmes that support them, primary bilingual teaching is a challenging job in any country. However, bilingual teachers in developing contexts are especially challenged; they are often undertrained and underpaid, and must function in under-resourced schools with undernourished students.…

The validity and clinical utility of the Disabilities of the Arm Shoulder and Hand questionnaire for hand injuries in developing country contexts: A systematic review.

PubMed

de Klerk, Susan; Buchanan, Helen; Jerosch-Herold, Christina

Systematic review. The Disabilities of the Arm Shoulder and Hand Questionnaire has multiple language versions from many countries around the world. In addition there is extensive research evidence of its psychometric properties. The purpose of this study was to systematically review the evidence available on the validity and clinical utility of the Disabilities of the Arm Shoulder and Hand as a measure of activity and participation in patients with musculoskeletal hand injuries in developing country contexts. We registered the review with international prospective register of systematic reviews prior to conducting a comprehensive literature search and extracting descriptive data. Two reviewers independently assessed methodological quality with the Consensus-Based Standards for the Selection of Health Measurement Instruments critical appraisal tool, the checklist to operationalize measurement characteristics of patient-rated outcome measures and the multidimensional model of clinical utility. Fourteen studies reporting 12 language versions met the eligibility criteria. Two language versions (Persian and Turkish) had an overall rating of good, and one (Thai) had an overall rating of excellent for cross-cultural validity. The remaining 9 language versions had an overall poor rating for cross-cultural validity. Content and construct validity and clinical utility yielded similar results. Poor quality ratings for validity and clinical utility were due to insufficient documentation of results and inadequate psychometric testing. With the increase in migration and globalization, hand therapists are likely to require a range of culturally adapted and translated versions of the Disabilities of the Arm Shoulder and Hand. Recommendations include rigorous application and reporting of cross-cultural adaptation, appropriate psychometric testing, and testing of clinical utility in routine clinical practice. Copyright © 2017 Hanley & Belfus. Published by Elsevier Inc. All rights

The educational gradient in marriage: a comparison of 25 European countries.

PubMed

Kalmijn, Matthijs

2013-08-01

Previous research has suggested that a new marriage gradient has emerged in the United States, with marriage becoming increasingly the privilege of the better-educated. This article examines whether this is true for Europe and explores differences in the marriage gradient among 25 European countries, using multilevel models. The focus is on the chances of living in a marital (or cohabiting) union during midlife (ages 40-49). Multilevel analyses show that the direction and strength of the gradient depend on the societal context. In countries where gender roles are traditional, better-educated women are less likely to be married than less-educated women; in gender-egalitarian countries, better-educated women are more likely to be married. For men, the educational effect on marriage is absent in traditional countries but becomes positive as gender roles become more equal. Inequality in a society also modifies the gradient: if the degree of economic inequality between educational groups in a society is strong, better-educated men are more likely to be married than less-educated men. In general, the results suggest that there may be an accumulation of social and economic disadvantages for the less well educated in more-developed countries.

Country profile: Hungary

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1991-09-01

Country Profile: Hungary has been prepared as a background document for use by US Government agencies and US businesses interested in becoming involved with the new democracies of Eastern Europe as they pursue sustainable economic development. The focus of the Profile is on energy and highlights information on Hungary`s energy supply, demand, and utilization. It identifies patterns of energy usage in the important economic sectors, especially industry, and provides a preliminary assessment for opportunities to improve efficiencies in energy production, distribution and use by introducing more efficient technologies. The use of more efficient technologies would have the added benefit ofmore » reducing the environmental impact which, although is not the focus of the report, is an issue that effects energy choices. The Profile also presents considerable economic information, primarily in the context of how economic restructuring may affect energy supply, demand, and the introduction of more efficient technologies.« less

Country profile: Hungary

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1991-09-01

Country Profile: Hungary has been prepared as a background document for use by US Government agencies and US businesses interested in becoming involved with the new democracies of Eastern Europe as they pursue sustainable economic development. The focus of the Profile is on energy and highlights information on Hungary's energy supply, demand, and utilization. It identifies patterns of energy usage in the important economic sectors, especially industry, and provides a preliminary assessment for opportunities to improve efficiencies in energy production, distribution and use by introducing more efficient technologies. The use of more efficient technologies would have the added benefit ofmore » reducing the environmental impact which, although is not the focus of the report, is an issue that effects energy choices. The Profile also presents considerable economic information, primarily in the context of how economic restructuring may affect energy supply, demand, and the introduction of more efficient technologies.« less

Hierarchical cluster analysis of labour market regulations and population health: a taxonomy of low- and middle-income countries

PubMed Central

2012-01-01

Background An important contribution of the social determinants of health perspective has been to inquire about non-medical determinants of population health. Among these, labour market regulations are of vital significance. In this study, we investigate the labour market regulations among low- and middle-income countries (LMICs) and propose a labour market taxonomy to further understand population health in a global context. Methods Using Gross National Product per capita, we classify 113 countries into either low-income (n = 71) or middle-income (n = 42) strata. Principal component analysis of three standardized indicators of labour market inequality and poverty is used to construct 2 factor scores. Factor score reliability is evaluated with Cronbach's alpha. Using these scores, we conduct a hierarchical cluster analysis to produce a labour market taxonomy, conduct zero-order correlations, and create box plots to test their associations with adult mortality, healthy life expectancy, infant mortality, maternal mortality, neonatal mortality, under-5 mortality, and years of life lost to communicable and non-communicable diseases. Labour market and health data are retrieved from the International Labour Organization's Key Indicators of Labour Markets and World Health Organization's Statistical Information System. Results Six labour market clusters emerged: Residual (n = 16), Emerging (n = 16), Informal (n = 10), Post-Communist (n = 18), Less Successful Informal (n = 22), and Insecure (n = 31). Primary findings indicate: (i) labour market poverty and population health is correlated in both LMICs; (ii) association between labour market inequality and health indicators is significant only in low-income countries; (iii) Emerging (e.g., East Asian and Eastern European countries) and Insecure (e.g., sub-Saharan African nations) clusters are the most advantaged and disadvantaged, respectively, with the remaining clusters experiencing levels of population health consistent

Hierarchical cluster analysis of labour market regulations and population health: a taxonomy of low- and middle-income countries.

PubMed

Muntaner, Carles; Chung, Haejoo; Benach, Joan; Ng, Edwin

2012-04-18

An important contribution of the social determinants of health perspective has been to inquire about non-medical determinants of population health. Among these, labour market regulations are of vital significance. In this study, we investigate the labour market regulations among low- and middle-income countries (LMICs) and propose a labour market taxonomy to further understand population health in a global context. Using Gross National Product per capita, we classify 113 countries into either low-income (n = 71) or middle-income (n = 42) strata. Principal component analysis of three standardized indicators of labour market inequality and poverty is used to construct 2 factor scores. Factor score reliability is evaluated with Cronbach's alpha. Using these scores, we conduct a hierarchical cluster analysis to produce a labour market taxonomy, conduct zero-order correlations, and create box plots to test their associations with adult mortality, healthy life expectancy, infant mortality, maternal mortality, neonatal mortality, under-5 mortality, and years of life lost to communicable and non-communicable diseases. Labour market and health data are retrieved from the International Labour Organization's Key Indicators of Labour Markets and World Health Organization's Statistical Information System. Six labour market clusters emerged: Residual (n = 16), Emerging (n = 16), Informal (n = 10), Post-Communist (n = 18), Less Successful Informal (n = 22), and Insecure (n = 31). Primary findings indicate: (i) labour market poverty and population health is correlated in both LMICs; (ii) association between labour market inequality and health indicators is significant only in low-income countries; (iii) Emerging (e.g., East Asian and Eastern European countries) and Insecure (e.g., sub-Saharan African nations) clusters are the most advantaged and disadvantaged, respectively, with the remaining clusters experiencing levels of population health consistent with their labour market

Common threads? Palliative care service developments in seven European countries.

PubMed

Clark, D; ten Have, H; Janssens, R

2000-11-01

Since the late 1960s hospice and palliative care services have been developing in many European countries. Although attention has been given to patterns of development in specific national contexts, so far we lack a comparative understanding of how these services are organized and delivered. Such a comparison poses certain practical and methodological difficulties. It does, however, allow a wider view of the current provision of palliative care in Europe, together with a consideration of implications for the future. We report on an analysis of palliative care developments in seven European countries which gave attention to early origins, patterns of provision, and structural and policy integration. We conclude that, despite different processes of development, the emergent discipline of palliative care now finds its most congenial home within the structures of the formal health care system. Accordingly, inequities between the seven countries can be more clearly identified, posing continuing challenges to policy makers and planners who operate with a European perspective.

Developing the evidentiary basis for family medicine in the global context

PubMed Central

Ponka, David; Rouleau, Katherine; Arya, Neil; Redwood-Campbell, Lynda; Woollard, Robert; Siedlecki, Basia; Dunikowski, Lynn

2015-01-01

Abstract Objective To provide an overview of the main methodologic challenges to finding definitive evidence of the positive effects of family medicine and family medicine training on a global scale. Composition of the committee In 2012, 2013, and 2014, the College of Family Physicians of Canada hosted the Besrour Conferences to reflect on its role in advancing the discipline of family medicine globally. The Besrour Papers Working Group, which was struck at the 2013 conference, was tasked with developing a series of papers to highlight the key issues, lessons learned, and outcomes emerging from the various activities of the Besrour collaboration. The working group comprised members of various academic departments of family medicine in Canada and abroad who attended the conferences. Methods We performed a scoping review to determine the methodologic obstacles to understanding the positive effects of family medicine globally. Report The main obstacle to evaluating family medicine globally is that one of its core dimensions and assets is its local adaptability. Family medicine takes on very different roles in different health systems, making aggregation of data difficult. In many countries family medicine competes with other disciplines rather than performing a gatekeeping role. Further, most research that has been conducted thus far comes from industrialized contexts, and patient continuity and its benefits might not be achievable in the short term in developing countries when clinical demands are great. We must find frameworks to permit strengthening the evidentiary basis of the discipline across different contexts without sacrificing its beneficial adaptability. Conclusion We believe that developing family medicine and its attributes is one of the keys to achieving global health. These attributes—including its comprehensiveness, adaptability, and attention to both local and patient needs—are key to advancing global health priorities, but make common evaluative

Emotional support, education and self-rated health in 22 European countries.

PubMed

von dem Knesebeck, Olaf; Geyer, Siegfried

2007-10-01

The analyses focus on three aims: (1) to explore the associations between education and emotional support in 22 European countries, (2) to explore the associations between emotional support and self-rated health in the European countries, and (3) to analyse whether the association between education and self-rated health can be partly explained by emotional support. The study uses data from the European Social Survey 2003. Probability sampling from all private residents aged 15 years and older was applied in all countries. The European Social Survey includes 42,359 cases. Persons under age 25 were excluded to minimise the number of respondents whose education was not complete. Education was coded according to the International Standard Classification of Education. Perceived emotional support was assessed by the availability of a confidant with whom one can discuss intimate and personal matters with. Self-rated health was used as health indicator. Results of multiple logistic regression analyses show that emotional support is positively associated with education among women and men in most European countries. However, the magnitude of the association varies according to country and gender. Emotional support is positively associated with self-rated health. Again, gender and country differences in the association were observed. Emotional support explains little of the educational differences in self-rated health among women and men in most European countries. Results indicate that it is important to consider socio-economic factors like education and country-specific contexts in studies on health effects of emotional support.

[Female employment and fertility in developing countries: what does the World Fertility Survey tell us?].

PubMed

Poirier, J; Piche, V; Neill, G

1989-01-01

This work reviews the general objectives of the World Fertility Survey (WFS), the theoretical basis and objectives of the questions on female employment and fertility, and their results and interpretations in an effort to assess the usefulness of the WFS in understanding the links between female employment and fertility in developing countries. 42 developing countries participated in the WFS from 1974-82. The 14 questions on female employment were the only ones in the basic questionnaire that had an explicit theoretical foundation. The questions reflected 2 interrelated approaches to differential fertility behavior prevalent in social demography, those of role incompatibility and of sex role orientation. The WFS definition of work as including all productive activity except household occupations was accepted by only 26 of the 42 developing countries. The results of major studies comparing WFS results from at least 10 countries using multivariate analytical techniques have been confusing and contradictory in the area of female employment and fertility. The studies have used varying dependent and independent variables and have defined work status in different ways in attempts to distinguish between paid and unpaid work, work at home or outside the home, and work at different stages of the life cycle. Some analysts have concluded on the basis of WFS data that there is no systematic relationship between female employment and fertility in developing countries and that a detailed focus on questions about employment represents a misuse of resources. It appears more likely that the concepts chosen and their application were responsible for the lack of clear results. The exclusion of "house occupations" in the definition of work may have serious consequences in the context of developing countries, where such work may be essential to the survival of most households. Interviewers had responsibility for determining the principal occupation of women with more than 1 and juding

Gender differences in hazardous drinking among middle-aged in Europe: the role of social context and women's empowerment.

PubMed

Bosque-Prous, Marina; Espelt, Albert; Borrell, Carme; Bartroli, Montse; Guitart, Anna M; Villalbí, Joan R; Brugal, M Teresa

2015-08-01

The aim of this study was to estimate the magnitude of gender differences in hazardous drinking among middle-aged people and to analyse whether these differences are associated with contextual factors, such as public policies or socioeconomic factors. Cross-sectional design. The study population included 50- to 64-year-old residents of 16 European countries who participated in the Survey of Health, Ageing and Retirement in Europe project conducted in 2010-12 (n = 26 017). We estimated gender differences in hazardous drinking in each country. To determine whether different social context or women's empowerment variables were associated with gender differences in hazardous drinking, we fitted multilevel Poisson regression models adjusted for various individual and country-level variables, which yielded prevalence ratios and their 95% confidence intervals (95% CI). Prevalence of hazardous drinking was significantly higher in men than women [30.2% (95% CI: 29.1-31.4%) and 18.6% (95% CI: 17.7-19.4%), respectively] in most countries, although the extent of these differences varied between countries. Among individuals aged 50-64 years in Europe, risk of becoming a hazardous drinker was 1.69 times higher (95% CI: 1.45-1.97) in men, after controlling for individual and country-level variables. We also found that lower values of the gender empowerment measure and higher unemployment rates were associated with higher gender differences in hazardous drinking. Countries with the greatest gender differences in hazardous drinking were those with the most restrictions on women's behaviour, and the greatest gender inequalities in daily life. Lower gender differences in hazardous drinking seem to be related to higher consumption among women. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

The future of reforestation programs in the tropical developing countries: insights from the Philippines

NASA Astrophysics Data System (ADS)

Mukul, S. A.; Herbohn, J. L.

2013-12-01

Reforestation against the rapid rate of deforestation and forest degradation is common in most tropical developing countries. The main objective of reforestation programs is to restore and/or enhance the degraded landscapes depreciated in environmental value. However due to changing socio-political contexts and increasing awareness on sustainable development and environmental issues such programs are becoming more challenging, particularly in the developing tropics. Like most tropical developing countries substantial deforestation has occurred in the Philippines followed by massive logging and slash-and-burn agriculture, resulting in severe social and environmental problems. The country is also one of the pioneer countries that introduces reforestation program to restore its degraded forests. Most recently the government of the Philippines has launched the National Greening Program (NGP), one of the largest reforestation projects so far, with an aim to reforest 1.5 million hectares of degraded forest in critical watersheds over a five year time period. This paper highlights the key challenges that might hinder the success of the reforestation program through National Greening Program. We found that it is unlikely to achieve the desired project goals if rural communities dependent on upland landscapes are excluded from the reforestation program through plantation establishment. Bringing larger amount of areas and greater number of people under community based forest management (CBFM) initiatives for reforestation programs, with clearly defined rights and responsibilities, as well as securing timely access to timber harvesting permits to the communities involved in maintaining the plantations could enhance the long term reforestation success in the country. The paper also tries to provide a critical review of the past reforestation efforts in the Philippines, and direction of possible research and development in order to achieve a win-win situation that will benefits

Determinants of pregnancy and induced and spontaneous abortion in a jointly determined framework: evidence from a country-wide, district-level household survey in India.

PubMed

Ahmed, Salma; Ray, Ranjan

2014-07-01

This study provides evidence on the principal determinants of pregnancy and abortion in India using a large country-wide district-level data set (DLHS 2007). The paper provides an economic framework for the analysis of pregnancy and abortion. The study distinguishes between induced and spontaneous abortion and compares the effects of their determinants. The results show that there are wide differences between induced and spontaneous abortions in terms of the sign and magnitude of the estimated effects of several of their determinants, most notably wealth, the woman's age and her desire for children. The study makes a methodological contribution by proposing a trivariate probit estimation framework that recognizes the joint dependence of pregnancy and induced and spontaneous abortion, and provides evidence in support of this joint dependence. The study reports an inverted U-shaped effect of a woman's age on her pregnancy and both forms of abortion. The turning point in each case is quite robust to the estimation framework. A significant effect of contextual variables, at the village level, constructed from the individual responses, on a woman's pregnancy is found. The effects are weaker in the case of induced abortion, and insignificant in the case of spontaneous abortion. The results are shown to be fairly robust. This paper extends the literature on the relation between son preference and fertility by examining the link between mother's son preference and desire for more children with abortion rates.

Socio-economic effects on meeting PA guidelines: comparisons among 32 countries

PubMed Central

Borraccino, A; Lemma, P; Iannotti, R; Zambon, A; Dalmasso, P; Lazzeri, G; Giacchi, M; Cavallo, F

2008-01-01

Purpose This study examined the relationship between age and gender with physical activity (PA) and how meeting of PA guidelines (PAGL) is related to socio-economic-status. Methods Data were collected from 11-, 13-, and 15-y.o. students in 32 countries participating in the Health Behaviour in School-aged Children (HBSC) survey 2001/2002. A self-completed questionnaire assessed moderate-to-vigorous physical activity (MVPA) for the past seven days and MVPA for a typical week. Socio-economic status (SES) was assessed using the Family Affluence Scale (FAS). Results None of the countries averaged enough MVPA to meet PAGL. The pattern of MVPA across gender and age was consistent among all countries. In all countries girls were significantly less active than boys (mean hours/week of MVPA 3.52 ±1.88 vs 4.13 ±1.95) and were more likely to not meet the PAGL; older children were less active when compared to the youngest. SES was significantly associated with the amount of reported MVPA. SES and PAGL were significantly related in seven countries and a significant decrease in the influence of age was observed in these countries compared to other countries. Conclusions Levels of MVPA during adolescence showed consistent patterns across countries in relation to age, gender and social-class. The limited effect of age on PA in countries where the influence of social class was less strong, suggesting the possibility of a moderating effect of context in the development of habits acquired in childhood PMID:19276860

Countries population determination to test rice crisis indicator at national level using k-means cluster analysis

NASA Astrophysics Data System (ADS)

Hidayat, Y.; Purwandari, T.; Sukono; Ariska, Y. D.

2017-01-01

This study aimed to obtain information on the population of the countries which is have similarities with Indonesia based on three characteristics, that is the democratic atmosphere, rice consumption and purchasing power of rice. It is useful as a reference material for research which tested the strength and predictability of the rice crisis indicators Unprecedented Restlessness (UR). The similarities countries with Indonesia were conducted using multivariate analysis that is non-hierarchical cluster analysis k-Means with 38 countries as the data population. This analysis is done repeatedly until the obtainment number of clusters which is capable to show the differentiator power of the three characteristics and describe the high similarity within clusters. Based on the results, it turns out with 6 clusters can describe the differentiator power of characteristics of formed clusters. However, to answer the purpose of the study, only one cluster which will be taken accordance with the criteria of success for the population of countries that have similarities with Indonesia that cluster contain Indonesia therein, there are countries which is sustain crisis and non-crisis of rice in 2008, and cluster which is have the largest member among them. This criterion is met by cluster 2, which consists of 22 countries, namely Indonesia, Brazil, Costa Rica, Djibouti, Dominican Republic, Ecuador, Fiji, Guinea-Bissau, Haiti, India, Jamaica, Japan, Korea South, Madagascar, Malaysia, Mali, Nicaragua, Panama, Peru, Senegal, Sierra Leone and Suriname.

Implementation of Large-Scale Science Curricula: A Study in Seven European Countries

ERIC Educational Resources Information Center

Pilling, G. M.; Waddington, D. J.

2005-01-01

The Salters Chemistry courses, context-led curricula for 13-16 and 17-18 year old students, first developed by the Science Education Group at the University of York in the UK, have now been translated and/or adapted in seven other European countries. This paper describes and discusses the different reasons for taking up the courses, the ways in…

Programming maternal and child overweight and obesity in the context of undernutrition: current evidence and key considerations for low- and middle-income countries.

PubMed

Jaacks, Lindsay M; Kavle, Justine; Perry, Abigail; Nyaku, Albertha

2017-05-01

The goals of the present targeted review on maternal and child overweight and obesity were to: (i) understand the current situation in low- and middle-income countries (LMIC) with regard to recent trends and context-specific risk factors; and (ii) building off this, identify entry points for leveraging existing undernutrition programmes to address overweight and obesity in LMIC. Trends reveal that overweight and obesity are a growing problem among women and children in LMIC; as in Ghana, Kenya, Niger, Sierra Leone, Tanzania and Zimbabwe, where the prevalence among urban women is approaching 50 %. Four promising entry points were identified: (i) the integration of overweight and obesity into national nutrition plans; (ii) food systems (integration of food and beverage marketing regulations into existing polices on the marketing of breast-milk substitutes and adoption of policies to promote healthy diets); (iii) education systems (integration of nutrition into school curricula with provision of high-quality foods through school feeding programmes); and (iv) health systems (counselling and social and behaviour change communication to improve maternal diet, appropriate gestational weight gain, and optimal infant and young child feeding practices). We conclude by presenting a step-by-step guide for programme officers and policy makers in LMIC with actionable objectives to address overweight and obesity.

Identification of cultural determinants of antibiotic use cited in primary care in Europe: a mixed research synthesis study of integrated design "Culture is all around us".

PubMed

Touboul-Lundgren, Pia; Jensen, Siri; Drai, Johann; Lindbæk, Morten

2015-09-17

Inappropriate antibiotic prescribing, particularly for respiratory tract infections (RTI) in ambulatory care, has become a worldwide public health threat due to resulting antibiotic resistance. In spite of various interventions and campaigns, wide variations in antibiotic use persist between European countries. Cultural determinants are often referred to as a potential cause, but are rarely defined. To our knowledge, so far no systematic literature review has focused on cultural determinants of antibiotic use. The aim of this study was to identify cultural determinants, on a country-specific level in ambulatory care in Europe, and to describe the influence of culture on antibiotic use, using a framework of cultural dimensions. A computer-based systematic literature review was conducted by two research teams, in France and in Norway. Eligible publications included studies exploring antibiotic use in primary care in at least two European countries based on primary study results, featuring a description of cultural determinants, and published between 1997 and 2015. Quality assessment was conducted independently by two researchers, one in each team, using appropriate checklists according to study design. Each included paper was characterized according to method, countries involved, sampling and main results, and cultural determinants mentioned in each selected paper were extracted, described and categorized. Finally, the influence of Hofstede's cultural dimensions associated with antibiotic consumption within a primary care setting was described. Among 24 eligible papers, 11 were rejected according to exclusion criteria. Overall, 13 papers meeting the quality assessment criteria were included, of which 11 used quantitative methods and two qualitative or mixed methods. The study participants were patients (nine studies) and general practitioners (two studies). This literature review identified various cultural determinants either patient-related (illness perception

[Building and teaching bioethics in French-speaking countries: at the crossroads of disciplines and practices].

PubMed

Godard, Béatrice; Moubé, Zéphirin

2013-01-01

It is inmportant to emphasize three aspects concerning the construction and teaching of 'French bioethics: the maintenance and promotion ofa multidisciplinary approach; a greater autonomy in the management and development of training programs; positioning a power of attraction and development in French-speaking countries. Bioethics is defined as a field of interdisciplinary studies at the junction of the health sciences and the humanities and, more importantly, directly connected to the reality of the health community, research and public Policy. A greater autonomy in the management and development of training programs is also capital. The danger of being dominated by one discipline involved whether medicine, law, philosophy, theology is real and prevents from promoting methodological approaches that are both theoretical and empirical. Finally, compliance with local and national, but also disciplinary diversity is essential to the construction and teaching of French bioethics. As such, the University of Montreal has positioned itself as a leader in the French-speaking countries: at the junction of North America and European countries, Quebec has developed its own specificity in bioethics, which is a force of attraction for many countries of the French-speaking world. In this context, the Bioethics Programs at the University of Montreal rely heavily on knowledge transfer to other cultures. Moreover, the internationalization of training programs in French bioethics is a major issue in the current context of globalization and transmission of knowledge.

Geneva-Seattle collaboration in support of developing country vaccine manufacturing.

PubMed

Stevenson, Michael A

2018-04-01

Vaccines were once produced almost exclusively by state-supported entities. While they remain essential tools for public health protection, the majority of the world's governments have allowed industry to assume responsibility for this function. This is significant because while the international harmonisation of quality assurance standards have effectively increased vaccine safety, they have also reduced the number of developing country vaccine producers, and Northern multinational pharmaceutical companies have shown little interest in offering the range of low-priced products needed in low and middle-income-country contexts. This article examines how public-private collaboration is relevant to contemporary efforts aimed at strengthening developing country manufacturers' capacity to produce high-quality, low-priced vaccines. Specifically, it casts light on the important and largely complimentary roles of the World Health Organization, The Bill and Melinda Gates Foundation, and the Seattle-based non-profit PATH, in this process. The take away message is that external support remains critical to ensuring that developing country vaccine manufacturers have the tools needed to produce for both domestic and global markets, and the United Nations supply chain, and collaboration at the public-private interface is driving organisational innovation focused on meeting these goals.

Prevention of Asbestos-Related Disease in Countries Currently Using Asbestos

PubMed Central

Marsili, Daniela; Terracini, Benedetto; Santana, Vilma S.; Ramos-Bonilla, Juan Pablo; Pasetto, Roberto; Mazzeo, Agata; Loomis, Dana; Comba, Pietro; Algranti, Eduardo

2016-01-01

More than 40 years of evaluation have consistently confirmed the carcinogenicity of asbestos in all of its forms. This notwithstanding, according to recent figures, the annual world production of asbestos is approximatively 2,000,000 tons. Currently, about 90% of world asbestos comes from four countries: Russia, China, Brazil and Kazakhstan; and the wide use of asbestos worldwide represents a global threat. The purpose of this paper is to present a review of the asbestos health impact and to discuss the role of epidemiological investigations in countries where asbestos is still used. In these contexts, new, “local” studies can stimulate awareness of the size of the problem by public opinion and other stakeholders and provide important information on the circumstances of exposure, as well as local asbestos-related health impacts. This paper suggests an agenda for an international cooperation framework dedicated to foster a public health response to asbestos, including: new epidemiological studies for assessing the health impact of asbestos in specific contexts; socio-cultural and economic analyses for contributing to identifying stakeholders and to address both the local and global implications of asbestos diffusion; public awareness on the health and socio-economic impact of asbestos use and banning. PMID:27187433

ContextProvider: Context awareness for medical monitoring applications.

PubMed

Mitchell, Michael; Meyers, Christopher; Wang, An-I Andy; Tyson, Gary

2011-01-01

Smartphones are sensor-rich and Internet-enabled. With their on-board sensors, web services, social media, and external biosensors, smartphones can provide contextual information about the device, user, and environment, thereby enabling the creation of rich, biologically driven applications. We introduce ContextProvider, a framework that offers a unified, query-able interface to contextual data on the device. Unlike other context-based frameworks, ContextProvider offers interactive user feedback, self-adaptive sensor polling, and minimal reliance on third-party infrastructure. ContextProvider also allows for rapid development of new context and bio-aware applications. Evaluation of ContextProvider shows the incorporation of an additional monitoring sensor into the framework with fewer than 100 lines of Java code. With adaptive sensor monitoring, power consumption per sensor can be reduced down to 1% overhead. Finally, through the use of context, accuracy of data interpretation can be improved by up to 80%.

The silencing of political context in health research in Ethiopia: why it should be a concern.

PubMed

Østebø, Marit Tolo; Cogburn, Megan D; Mandani, Anjum Shams

2018-03-01

In 2004, the Ethiopian government launched what has been called an innovative and groundbreaking solution to the country's public health challenges; the Health Extension Programme (HEP). The positive public health outcomes that have been reported following the implementation of the HEP have led researchers and global health actors to propose it as a model for other countries to emulate. In this systematic review, we point to a potential weakness and methodological bias in the existing research. Despite being implemented within a context of an increasingly authoritarian regime, research conducted following the implementation of HEP reflects a limited discussion of the political context. Following a discussion of why political context is marginalized we provide arguments for why a focus on political context is important: first, political context has an impact on health systems and actualizes questions related to good governance and ethics. While some of the studies we reviewed acknowledge the importance of political factors we contend that the one-sided focus on the positive relationship between political will, political commitment and political leadership on the one hand, and key public health outcomes on the other, reflects a narrow engagement with health system governance frameworks. This leads to a silencing of issues actualized by the authoritarian nature of the Ethiopian regime. Secondly, the political context has methodological implications. More specifically, we contend that the current political situation increases the probability of social desirability bias. In order to balance the overarching positive literature on Ethiopia's health system, research that takes the political context into account is much needed. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Information systems for mental health in six low and middle income countries: cross country situation analysis.

PubMed

Upadhaya, Nawaraj; Jordans, Mark J D; Abdulmalik, Jibril; Ahuja, Shalini; Alem, Atalay; Hanlon, Charlotte; Kigozi, Fred; Kizza, Dorothy; Lund, Crick; Semrau, Maya; Shidhaye, Rahul; Thornicroft, Graham; Komproe, Ivan H; Gureje, Oye

2016-01-01

Research on information systems for mental health in low and middle income countries (LMICs) is scarce. As a result, there is a lack of reliable information on mental health service needs, treatment coverage and the quality of services provided. With the aim of informing the development and implementation of a mental health information sub-system that includes reliable and measurable indicators on mental health within the Health Management Information Systems (HMIS), a cross-country situation analysis of HMIS was conducted in six LMICs (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda), participating in the 'Emerging mental health systems in low and middle income countries' (Emerald) research programme. A situation analysis tool was developed to obtain and chart information from documents in the public domain. In circumstances when information was inadequate, key government officials were contacted to verify the data collected. In this paper we compare the baseline policy context, human resources situation as well as the processes and mechanisms of collecting, verifying, reporting and disseminating mental health related HMIS data. The findings suggest that countries face substantial policy, human resource and health governance challenges for mental health HMIS, many of which are common across sites. In particular, the specific policies and plans for the governance and implementation of mental health data collection, reporting and dissemination are absent. Across sites there is inadequate infrastructure, few HMIS experts, and inadequate technical support and supervision to junior staff, particularly in the area of mental health. Nonetheless there are also strengths in existing HMIS where a few mental health morbidity, mortality, and system level indicators are collected and reported. Our study indicates the need for greater technical and resources input to strengthen routine HMIS and develop standardized HMIS indicators for mental health, focusing in

How Institutional Contexts Influence the Civic Development of Students at Three Mexican Universities

ERIC Educational Resources Information Center

Canton Guzman, Alicia

2011-01-01

The purpose of every university is to contribute to the public good by educating socially responsible, civically minded, engaged citizens. In the context of a developing country such as Mexico, with multiple challenges of social, political and economic order, the role of universities in preparing future leaders and civically engaged citizens is…

Strengthening of causality assessment of adverse events following immunization in the WHO South East Asia and Western Pacific regions: Lessons from the 2014 SEAR inter-country workshop.

PubMed

MacDonald, Noni E; Guichard, Stephane; Amarasinghe, Ananda; Balakrishnan, Madhava Ram

2015-11-27

Poorly managed AEFI undermine immunization programs. Improved surveillance in SEAR countries means more AEFIs but management varies. SEAR brought countries together to share AEFI experiences, and learn more about causality assessment. Three day 10 country workshop (9 SEAR; 1 WPR). Participants outlined county AEFI experiences, undertook causality assessment for 8 AEFIs using WHO methodology, critiqued the process by questionnaire and had a discussion. All 10 valued AEFI monitoring and causality assessment, and praised the opportunity to share experiences. Participants determined a range of AEFI and causality assessment needs in SEAR such as adapting WHO Algorithm, CIOMS/Brighton definitions, WHO verbal autopsy to fit context, requesting a practical guide--AEFI definition, time interval, rates of AEFI for different vaccines and evidence for vaccine related causes of death under 24h. LMIC need WHO AEFI tools adapted to better fit LMIC. Learning from each other builds capacity. Sharing AEFI experiences, case reviews help LMIC improve practices. Copyright © 2015. Published by Elsevier Ltd.

Sustainable solid waste management: An integrated approach for Asian countries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shekdar, Ashok V.

2009-04-15

Solid waste management (SWM) has been an integral part of every human society. The approaches for SWM should be compatible with the nature of a given society, and, in this regard, Asian countries are no exception. In keeping with global trends, the systems are being oriented to concentrate on sustainability issues; mainly through the incorporation of 3R (reduce, reuse and recycle) technologies. However, degree and nature of improvements toward sustainability are varying and depend on the economic status of a country. High-income countries like Japan and South Korea can afford to spend more to incorporate 3R technologies. Most of themore » latest efforts focus on 'Zero Waste' and/or 'Zero Landfilling' which is certainly expensive for weaker economies such as those of India or Indonesia. There is a need to pragmatically assess the expectations of SWM systems in Asian countries. Hence, in this paper, we analyze the situation in different Asian countries, and explore future trends. We conceptually evaluate issues surrounding the sustainability of SWM. We propose a multi-pronged integrated approach for improvement that achieves sustainable SWM in the context of national policy and legal frameworks, institutional arrangement, appropriate technology, operational and financial management, and public awareness and participation. In keeping with this approach, a generic action plan has been proposed that could be tailored to suit a situation in a particular country. Our proposed concept and action plan framework would be useful across a variety of country-specific scenarios.« less

Can we determine whether physical limitations are more prevalent in the US than in countries with comparable life expectancy?

PubMed

Glei, Dana A; Goldman, Noreen; Ryff, Carol D; Weinstein, Maxine

2017-12-01

We evaluate the variability in estimates of self-reported physical limitations by age across four nationally representative surveys in the US. We consider its implications for determining whether, as previous literature suggests, the US estimates reveal limitations at an earlier age than in three countries with similar life expectancy: England, Taiwan, and Costa Rica. Based on cross-sectional data from seven population-based surveys, we use local mean smoothing to plot self-reported limitations by age for each of four physical tasks for each survey, stratified by sex. We find substantial variation in the estimates in the US across four nationally-representative surveys. For example, one US survey suggests that American women experience a walking limitation 15 years earlier than their Costa Rican counterparts, while another US survey implies that Americans have a 4-year advantage. Differences in mode of survey may account for higher prevalence of limitations in the one survey that used a self-administered mail-in questionnaire than in the other surveys that used in-person or telephone interviews. Yet, even among US surveys that used the same mode, there is still so much variability in estimates that we cannot conclude whether Americans have better or worse function than their counterparts in the other countries. Seemingly minor differences in question wording and response categories may account for the remaining inconsistency. If minor differences in question wording can result in such extensive variation in the estimates within a given population, then lack of comparability is likely to be an even greater problem when examining results across countries that do not share the same language or culture. Despite the potential utility of self-reported physical function within a survey sample, our findings imply that absolute estimates of population-level prevalence of self-reported physical limitations are unlikely to be strictly comparable across countries-or even

Context Inference for Mobile Applications in the UPCASE Project

NASA Astrophysics Data System (ADS)

Santos, André C.; Tarrataca, Luís; Cardoso, João M. P.; Ferreira, Diogo R.; Diniz, Pedro C.; Chainho, Paulo

The growing processing capabilities of mobile devices coupled with portable and wearable sensors have enabled the development of context-aware services tailored to the user environment and its daily activities. The problem of determining the user context at each particular point in time is one of the main challenges in this area. In this paper, we describe the approach pursued in the UPCASE project, which makes use of sensors available in the mobile device as well as sensors externally connected via Bluetooth. We describe the system architecture from raw data acquisition to feature extraction and context inference. As a proof of concept, the inference of contexts is based on a decision tree to learn and identify contexts automatically and dynamically at runtime. Preliminary results suggest that this is a promising approach for context inference in several application scenarios.

Is a global rural and remote health research agenda desirable or is context supreme?

PubMed

Farmer, Jane; Clark, Ann; Munoz, Sarah-Anne

2010-06-01

This paper proposes that there is value in international comparison of rural and remote health-care service delivery models because of practical reasons - to find ideas, models and lessons to address 'local' delivery challenges; and for theoretical reasons - to derive a conceptual framework for international comparison. Literature review and commentary. There are significant challenges to international comparative research that have been highlighted generically; for example, equivalence of terminology, datasets and indicators. Context supremacy has been raised as a reason why models and research findings might not be transferable. This paper proposes that there is insufficient knowledge about how rural contexts in relation to health service delivery are similar or different internationally. Investigating contexts in different countries and identifying the dimensions on which service delivery might differ is an important stimulus for study. The paper suggests, for discussion, dimensions on which rural service delivery might differ between countries and regions, including physical geographical factors, social interaction with rurality, policies of service provision and the politics and operation of health care. The paper asks whether, given the need to develop models suitable for rural areas and for theory on rural health to extend, international comparative research is an imperative or an indulgence.

Ahead with Cairo. Monitoring country activities.

PubMed

Danguilan, M; Wainer, J; Widyantoro, N; Capoor, I; Huq, N; Ashino, Y; Sadasivam, B; Le Thi Nham Tuyet

1995-04-01

In the aftermath of the 1994 UN Conference on Population and Development (ICPD) in Cairo, countries are proceeding with their implementation of the plan of action adopted at the conference. A brief description is given of some actions taken by specific countries toward plan implementation. In the Philippines meetings were held immediately after the conference in October on the implications for the Management, Family Planning, and Nongovernmental Organizations programs. The issues of concern were identified as the need for regular consultative meetings among relevant agencies, consultations with women's groups, and a responsive adolescents program. In Australia the program thrust was to focus on the implications for immigration. Monitoring of the plans of action will be undertaken by nongovernmental organizations (NGOs). In Malaysia committees are preparing a program of action suitable for implementation in Malaysia. A regional women's NGO organized a forum on the implications of ICPD for women's reproductive health, women's rights, and empowerment in Malaysia. In Vietnam, press conferences are used to communicate conference results. An NGO translated relevant ICPD materials into Vietnamese. In Indonesia, several ministries convened meetings among donors, NGOs, women's groups, and experts. In India, the government held a national conference. One view was that population issues should be discussed in the context of gender equality and empowerment of women. Another issue was the importance of placing reproductive health in the larger context of health and primary health services. Health personnel at all levels were considered in need of sensitization on gender issues. Problems such as anemia have not been successfully addressed in existing programs. The government agreed to remove in phases target driven programs and the sterilization emphasis. In Bangladesh, a national committee was formed, and NGOs are actively distributing information. In Japan, the Family Planning

An Activity-Driven Model for an Interactional Notion of Context

DTIC Science & Technology

2009-06-01

environmental states and settings that either determines an application’s behaviour or in which an application event occurs and is interesting to the...user.” They further differentiate between active context that influences the behaviours of an application, and passive context that is relevant but...environment and treated as implicit input to positively affect the behaviour of an application.” [6]. An abstract representation of this notion of context is

Determinants of prenatal care use: evidence from 32 low-income countries across Asia, Sub-Saharan Africa and Latin America.

PubMed

Guliani, Harminder; Sepehri, Ardeshir; Serieux, John

2014-08-01

While much has been written on the determinants of prenatal care attendance in low-income countries, comparatively little is known about the determinants of the frequency of prenatal visits in general and whether there are separate processes generating the decisions to use prenatal care and the frequency of use. Using the Demographic and Health Surveys data for 32 low-income countries (across Asia, Sub-Saharan Africa and Latin America) and appropriate two-part and multilevel models, this article empirically assesses the influence of a wide array of observed individual-, household- and community-level characteristics on a woman's decision to use prenatal care and the frequency of that use, while controlling for unobserved community level factors. The results suggest that, though both the decision to use care and the number of prenatal visits are influenced by a range of observed individual-, household- and community-level characteristics, the influence of these determinants vary in magnitude for prenatal care attendance and the frequency of prenatal visits. Despite remarkable consistency among regions in the association of individual, household and community indicators with prenatal care utilization, the estimated coefficients of the risk factors vary greatly across the three world regions. The strong influence of household wealth, education and regional poverty on the use of prenatal care suggests that safe motherhood programmes should be linked with the objectives of social development programmes such as poverty reduction, enhancing the status of women and increasing primary and secondary school enrolment rate among girls. Finally, the finding that teenage mothers and unmarried women and those with unintended pregnancies are less likely to use prenatal care and have fewer visits suggests that safe mother programmes need to pay particular attention to the disadvantaged and vulnerable subgroups of population whose reproductive health issues are often fraught with

Modernisation of Vocational Education and Training in Bulgaria. National Observatory Country Report, 1999.

ERIC Educational Resources Information Center

Bulgarian National Observatory on Vocational Education and Training and the Labour Market, Sofia.

This report provides an overview of the state of vocational education and training systems in Bulgaria, in the context of the history and the present economic development of the country. The report is organized in nine sections that cover the following topics: (1) political and socioeconomic background information, including economic development,…

A multi-country perspective on nurses' tasks below their skill level: reports from domestically trained nurses and foreign trained nurses from developing countries.

PubMed

Bruyneel, Luk; Li, Baoyue; Aiken, Linda; Lesaffre, Emmanuel; Van den Heede, Koen; Sermeus, Walter

2013-02-01

standards, skill levels of foreign trained nurses from developing countries and values attached to these tasks resulting from previous work experiences in their home countries. This will allow us to better understand the conditions under which foreign trained nurses from developing countries can optimally contribute to professional nursing practice in developed country contexts. Copyright © 2012 Elsevier Ltd. All rights reserved.

Global health and local poverty: rich countries' responses to vulnerable populations.

PubMed

Simms, Chris D; Persaud, D David

2009-01-01

Poverty is an important determinant of ill health, mortality and suffering across the globe. This commentary asks what we can learn about poverty by looking at the way rich countries respond to the needs of vulnerable populations both within their own societies and those of low-income countries. Taking advantage of recent efforts to redefine child poverty in a way that is consistent with the World Health Organization's Commission on Social Determinants of Health, three sets of data are reviewed: levels of child well-being within 23 Organization of Economic Community Development countries; the amount of official development assistance these countries disburse to poor countries; and, government social transfers targeted at families as a percentage of GDP. Analysis shows that countries in Northern Europe tend to have lower levels of child poverty, and are the most generous with social transfers and providing development assistance to poor countries; in contrast, the non-European countries like Australia, Canada, Japan, and the United States, and generally, the G7 countries, are the least generous towards the vulnerable at home and abroad and tend to have the highest levels of child poverty. The findings suggest that nations' responses tend to be ideologically based rather than evidence or needs based and that poverty is neither inevitable nor intractable.

Global determinants of mortality in under 5s: 10 year worldwide longitudinal study.

PubMed

Hanf, Matthieu; Nacher, Mathieu; Guihenneuc, Chantal; Tubert-Bitter, Pascale; Chavance, Michel

2013-11-08

To assess at country level the association of mortality in under 5s with a large set of determinants. Longitudinal study. 193 United Nations member countries, 2000-09. Yearly data between 2000 and 2009 based on 12 world development indicators were used in a multivariable general additive mixed model allowing for non-linear relations and lag effects. National rate of deaths in under 5s per 1000 live births The model retained the variables: gross domestic product per capita; percentage of the population having access to improved water sources, having access to improved sanitation facilities, and living in urban areas; adolescent fertility rate; public health expenditure per capita; prevalence of HIV; perceived level of corruption and of violence; and mean number of years in school for women of reproductive age. Most of these variables exhibited non-linear behaviours and lag effects. By providing a unified framework for mortality in under 5s, encompassing both high and low income countries this study showed non-linear behaviours and lag effects of known or suspected determinants of mortality in this age group. Although some of the determinants presented a linear action on log mortality indicating that whatever the context, acting on them would be a pertinent strategy to effectively reduce mortality, others had a threshold based relation potentially mediated by lag effects. These findings could help designing efficient strategies to achieve maximum progress towards millennium development goal 4, which aims to reduce mortality in under 5s by two thirds between 1990 and 2015.

Tuberculosis stigma as a social determinant of health: a systematic mapping review of research in low incidence countries.

PubMed

Craig, G M; Daftary, A; Engel, N; O'Driscoll, S; Ioannaki, A

2017-03-01

Tuberculosis (TB)-related stigma is an important social determinant of health. Research generally highlights how stigma can have a considerable impact on individuals and communities, including delays in seeking health care and adherence to treatment. There is scant research into the assessment of TB-related stigma in low incidence countries. This study aimed to systematically map out the research into stigma. A particular emphasis was placed on the methods employed to measure stigma, the conceptual frameworks used to understand stigma, and whether structural factors were theorized. Twenty-two studies were identified; the majority adopted a qualitative approach and aimed to assess knowledge, attitudes, and beliefs about TB. Few studies included stigma as a substantive topic. Only one study aimed to reduce stigma. A number of studies suggested that TB control measures and representations of migrants in the media reporting of TB were implicated in the production of stigma. The paucity of conceptual models and theories about how the social and structural determinants intersect with stigma was apparent. Future interventions to reduce stigma, and measurements of effectiveness, would benefit from a stronger theoretical underpinning in relation to TB stigma and the intersection between the social and structural determinants of health. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

A Phenomenographic Study of Lecturers' Conceptions of Using Learning Technology in a Pakistani Context

ERIC Educational Resources Information Center

Hodgson, Vivien; Shah, Uzair

2017-01-01

While there are many studies exploring the phenomenon of lecturers' use of learning technology within teaching practices in western higher education contexts, currently we know little about this phenomenon within less developed countries. In the paper, we discuss the findings from a phenomenographic study of lecturers' conceptions of using…

Critical Pedagogy in an EFL Teaching Context: An Ignis Fatuus or an Alternative Approach?

ERIC Educational Resources Information Center

Sadeghi, Sima

2008-01-01

Language teaching has, for much of its history, been subject to the heavy "evangelical zeal" of the centers who have exported their theories, methods derived from these, approaches, materials, and books to the developing countries "often with doubtful relevance to the sociological, educational and economic context of the Outer…

The Relationship between Ethnic Diversity and Classroom Disruption in the Context of Migration Policies

ERIC Educational Resources Information Center

Veerman, Gert-Jan M.

2015-01-01

This paper studies the relationship between ethnic school composition and classroom disruption in secondary education in the context of migration policies. We measured classroom disruption using students' reports from 3533 schools in 20 countries provided by cross-national PISA (Programme for International Student Assessment) 2009 data. We employ…

Arsenic removal methods for drinking water in the developing countries: technological developments and research needs.

PubMed

Kabir, Fayzul; Chowdhury, Shakhawat

2017-11-01

Arsenic pollution of drinking water is a concern, particularly in the developing countries. Removal of arsenic from drinking water is strongly recommended. Despite the availability of efficient technologies for arsenic removal, the small and rural communities in the developing countries are not capable of employing most of these technologies due to their high cost and technical complexity. There is a need for the "low-cost" and "easy to use" technologies to protect the humans in the arsenic affected developing countries. In this study, arsenic removal technologies were summarized and the low-cost technologies were reviewed. The advantages and disadvantages of these technologies were identified and their scopes of applications and improvements were investigated. The costs were compared in context to the capacity of the low-income populations in the developing countries. Finally, future research directions were proposed to protect the low-income populations in the developing countries.

Predictors of patients' satisfaction with health care services in three balkan countries (macedonia, bulgaria and serbia): a cross country survey.

PubMed

Lazarevik, Vladimir; Kasapinov, Blasko

2015-02-01

Patients' satisfaction with provided healthcare services is one of the factors to measure the overall quality of the delivered health care. Main objective of our study was to determine the common predictors associated with patients 'satisfaction in three Balkan countries. We conducted web based survey among population in Macedonia, Serbia and Bulgaria using paid campaign over the social network Facebook. A questionnaire consisted of 31 questions was developed following studies on patients' satisfaction conducted elsewhere. Descriptive analysis was performed to assess the predictors associated with patients' satisfaction. In addition we performed content analysis to all open-ended responses. In total 4118 respondents participated in the survey. Main predictors associated with low users satisfaction with the health care services in three surveyed countries are waiting time to appointments, huge administrative procedures, and attitudes of the medical personnel towards the patients. The analysis showed that there are many similarities in user experiences in three countries, but also there are some differences. The health care systems in these three counties are organized around centralized and monopolistic position of one health insurance fund that serves as main purchaser of health care services. Top three indicators of patients' satisfaction across three countries are trust and overall satisfaction with the attention of the doctors, as well as satisfaction with the outcome of the treatment. Long waiting time and huge administrative procedures are determined as common predictor for lower patients' satisfaction across these Balkan countries. Patients' privacy protection is issue for concern in all three countries.

Gender differences in hazardous drinking among middle-aged in Europe: the role of social context and women’s empowerment

PubMed Central

Bosque-Prous, Marina; Borrell, Carme; Bartroli, Montse; Guitart, Anna M.; Villalbí, Joan R.; Brugal, M. Teresa

2015-01-01

Background: The aim of this study was to estimate the magnitude of gender differences in hazardous drinking among middle-aged people and to analyse whether these differences are associated with contextual factors, such as public policies or socioeconomic factors. Methods: Cross-sectional design. The study population included 50- to 64-year-old residents of 16 European countries who participated in the Survey of Health, Ageing and Retirement in Europe project conducted in 2010–12 (n = 26 017). We estimated gender differences in hazardous drinking in each country. To determine whether different social context or women’s empowerment variables were associated with gender differences in hazardous drinking, we fitted multilevel Poisson regression models adjusted for various individual and country-level variables, which yielded prevalence ratios and their 95% confidence intervals (95% CI). Results: Prevalence of hazardous drinking was significantly higher in men than women [30.2% (95% CI: 29.1–31.4%) and 18.6% (95% CI: 17.7–19.4%), respectively] in most countries, although the extent of these differences varied between countries. Among individuals aged 50–64 years in Europe, risk of becoming a hazardous drinker was 1.69 times higher (95% CI: 1.45–1.97) in men, after controlling for individual and country-level variables. We also found that lower values of the gender empowerment measure and higher unemployment rates were associated with higher gender differences in hazardous drinking. Conclusion: Countries with the greatest gender differences in hazardous drinking were those with the most restrictions on women’s behaviour, and the greatest gender inequalities in daily life. Lower gender differences in hazardous drinking seem to be related to higher consumption among women. PMID:25616593

Determinants of efficiency in reducing child mortality in developing countries. The role of inequality and government effectiveness.

PubMed

Ortega, Bienvenido; Sanjuán, Jesús; Casquero, Antonio

2017-12-01

The main aim of this article was to analyze the relationship of income inequality and government effectiveness with differences in efficiency in the use of health inputs to improve the under-five survival rate (U5SR) in developing countries. Robust Data Envelopment Analysis (DEA) and regression analysis were conducted using data for 47 developing countries for the periods 2000-2004, 2005-2009, and 2010-2012. The estimations show that countries with a more equal income distribution and better government effectiveness (i.e. a more competent bureaucracy and good quality public service delivery) may need fewer health inputs to achieve a specific level of the U5SR than other countries with higher inequality and worse government effectiveness.

Encoding context and false recognition memories.

PubMed

Bruce, Darryl; Phillips-Grant, Kimberly; Conrad, Nicole; Bona, Susan

2004-09-01

False recognition of an extralist word that is thematically related to all words of a study list may reflect internal activation of the theme word during encoding followed by impaired source monitoring at retrieval, that is, difficulty in determining whether the word had actually been experienced or merely thought of. To assist source monitoring, distinctive visual or verbal contexts were added to study words at input. Both types of context produced similar effects: False alarms to theme-word (critical) lures were reduced; remember judgements of critical lures called old were lower; and if contextual information had been added to lists, subjects indicated as much for list items and associated critical foils identified as old. The visual and verbal contexts used in the present studies were held to disrupt semantic categorisation of list words at input and to facilitate source monitoring at output.

Sensory determinants of stated liking for vegetable names and actual liking for canned vegetables: A cross-country study among European adolescents.

PubMed

Dinnella, Caterina; Morizet, David; Masi, Camilla; Cliceri, Danny; Depezay, Laurence; Appleton, Katherine M; Giboreau, Agnés; Perez-Cueto, Federico J A; Hartwell, Heather; Monteleone, Erminio

2016-12-01

Sensory properties are reported as one of the main factors hindering an appropriate vegetable intake by the young. In the present work the sensory determinants of likings for vegetables were explored in adolescents of four European countries (Denmark, n = 88; France, n = 206; Italy, n = 110 and United Kingdom, n = 93). A questionnaire was designed to study cross country differences in stated liking for and familiarity with a list of vegetables popular among European markets (between-vegetable approach). A within-vegetable comparison approach with actual tasting was used to analyze differences and similarities in liking for canned pea and sweet corn samples across the countries. A close positive relationship between stated liking and familiarity was found. Irrespective of the country, one group of highly liked vegetables (carrots, tomatoes, green salad) was identified, characterized by innately liked tastes (sweet, umami), delicate flavour and bright appealing colour. A second group of highly disliked vegetables consists of cauliflowers and broccoli, characterized by disliked sensations such as bitter taste and objectionable flavour. Internal Preference Maps from actual liking scores indicate that the generally disliked tastes (bitter, sour), are clearly correlated with a negative hedonic response for both peas and sweet corn. The hedonic valence of a generally well accepted taste such as salty and texture descriptors depends on the type of vegetable. Internal preference maps from actual liking data indicate that flavour and appearance descriptors of the distinct sensory properties of each type of vegetable positively affect liking, while the intensity of unusual flavours is related to sample disliking. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Effect of Union Type on Work-Life Conflict in Five European Countries

ERIC Educational Resources Information Center

Kasearu, Kairi

2009-01-01

This paper explores the strategies for reconciling family and work in different union types. The focus here is on investigating how cohabiting and married individuals perceive the work-life conflict in different European countries. To test the union type impact on work-life balance in the context of different societal conditions, this paper draws…

Cultural context, obsessive-compulsive disorder symptoms, and cognitions: a preliminary study of three Turkish samples living in different countries.

PubMed

Yorulmaz, Orçun; Işık, Bilgen

2011-04-01

Previous research findings have suggested that recent cognitive accounts of obsessive-compulsive disorder (OCD) are valid across different cultural contexts for both clinical and nonclinical samples; however, there is evidence that cultural differences may have an impact on a number of cognitive variables. For this reason, immigration provides an exceptional opportunity for an examination of the role of cultural context in cognitions and possible changes in cultural characteristics. To this end, the present study examined the interrelationships between thought-action fusion, thought control strategies and OCD symptoms in three nonclinical samples, taking the immigration factor into consideration. Thus, the current study included three Turkish sample groups: those who remigrated to Turkey from Bulgaria, those still living in Bulgaria, and those that have always resided in Turkey. The findings of the study supported the role of thought and action fusion and control strategies in OCD symptoms in a cross-cultural context. To illustrate, worry, as a thought control strategy for OCD symptoms, was a common factor in all three sample groups. However, differences were also noted between the groups, despite having the same ethnic origin. Although they immigrated back to Turkey and have been living there for a considerable period of time, the Turkish remigrants retained similar characteristics to the respondents in Bulgaria on cognitions in general. Consequently, it may be suggested that cultural context might have a relative impact on certain correlates. A replication of these findings using different immigration groups and examining various cultural factors is strongly encouraged.

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false Solo cross-country flight requirements. 61...

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Solo cross-country flight requirements. 61...

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false Solo cross-country flight requirements. 61...

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false Solo cross-country flight requirements. 61...

14 CFR 61.93 - Solo cross-country flight requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... preflight planning and preparation is correct and that the student is prepared to make the flight safely... instructor has: (1) Determined that the student's cross-country planning is correct for the flight; (2... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false Solo cross-country flight requirements. 61...

Building multi-country collaboration on watershed ...

EPA Pesticide Factsheets

Community-based watershed resilience programs that bridge public health and environmental outcomes often require cross-boundary, multi-country collaboration. The CRESSIDA project, led by the Regional Environmental Center for Central and Eastern Europe (REC) and supported by the US Environmental Protection Agency (EPA), forwards a resilience-focused approach for Western Balkan communities in the Drini and Drina river watersheds with the goal of safeguarding public health and the environment. The initial phases of this project give a contextualized example of how to advance resilience-driven environmental health goals in Western Balkan communities, and experience within the region has garnered several theme areas that require focus in order to promote a holistic watershed management program. In this paper, using CRESSIDA as a case study, we show (1) how watershed projects designed with resilience-driven environmental health goals can work in context, (2) provide data surrounding contextualized problems with resilience and suggest tools and strategies for the implementation of projects to address these problems, and (3) explore how cross-boundary foci are central to the success of these approaches in watersheds that comprise several countries. Published in the journal, Reviews on Environmental Health.

Substantial between-country differences in organising community care for older people in Europe-a review.

PubMed

Van Eenoo, Liza; Declercq, Anja; Onder, Graziano; Finne-Soveri, Harriet; Garms-Homolová, Vjenka; Jónsson, Pálmi V; Dix, Olivia H M; Smit, Johannes H; van Hout, Hein P J; van der Roest, Henriëtte G

2016-04-01

The European population is aging. The main drivers of public spending on health care for people of 65 years and older are hospital admission and admission to long-term care facilities. High quality community care can be a cost-effective and quality solution to respond to the impact of ageing populations on health-care systems. It is unclear how well countries are equipped to provide affordable and quality community care. The aim of this article is to describe and compare community care delivery with care-dependent older people in Europe.  This study is conducted within the European Union-financed IBenC project [Identifying best practices for care-dependent elderly byBenchmarkingCosts and outcomes of community care (FP7)] in which six European countries are involved. To compare the community care delivery with care-dependent older people in these countries, we performed a systematic comparison of macro indicators using metadata complemented with data from multinational surveys.  Data on the following dimensions are described and compared: population of the country, governmental expenditures on health, sources of community health services funding, governmental vision and regulation on community care, community care organisations and care professionals, eligibility criteria for and equity in receiving care and the involvement of informal care.  : Because of the variations in the European community care contexts, the growing demand for community care as a cost-effective and quality solution to the care burden of aging populations will have country-specific impacts. When learning from other countries' best practices, in addition to researchers, policy makers should take full account of local and national care contexts. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Technology Enhanced Instruction: An Example of English Language Learning in the Context of Peace

ERIC Educational Resources Information Center

Sasi, Sabri; Chang, Maiga; Altinay-Aksal, Fahriye; Kayimbasioglu, Dervis; Dervis, Huseyin; Kinshuk; Altinay-Gazi, Zehra

2017-01-01

Early childhood quality education is a cornerstone in educational development. Many countries have started to develop their own preschool educational system in accordance with the European Union Standards, where learning English language and using technology are prerequisites. In this research, the peace context was used as a mediator for learning…

Carbon emissions-income relationships with structural breaks: the case of the Middle Eastern and North African countries.

PubMed

El Montasser, Ghassen; Ajmi, Ahdi Noomen; Nguyen, Duc Khuong

2018-01-01

This article revisits the carbon dioxide (CO 2 ) emissions-GDP causal relationships in the Middle Eastern and North African (MENA) countries by employing the Rossi (Economet Theor 21:962-990, 2005) instability-robust causality test. We show evidence of significant causality relationships for all considered countries within the instability context, whereas the standard Granger causality test fails to detect causal links in any direction, except for Egypt, Iran, and Morocco. An important policy implication resulting from this robust analysis is that the income is not affected by the cuts in the CO 2 emissions for only two MENA countries, the UAE and Syria.

Context-aware workflow management of mobile health applications.

PubMed

Salden, Alfons; Poortinga, Remco

2006-01-01

We propose a medical application management architecture that allows medical (IT) experts readily designing, developing and deploying context-aware mobile health (m-health) applications or services. In particular, we elaborate on how our application workflow management architecture enables chaining, coordinating, composing, and adapting context-sensitive medical application components such that critical Quality of Service (QoS) and Quality of Context (QoC) requirements typical for m-health applications or services can be met. This functional architectural support requires learning modules for distilling application-critical selection of attention and anticipation models. These models will help medical experts constructing and adjusting on-the-fly m-health application workflows and workflow strategies. We illustrate our context-aware workflow management paradigm for a m-health data delivery problem, in which optimal communication network configurations have to be determined.

Evaluation of Students' Understanding of Thermal Concepts in Everyday Contexts

ERIC Educational Resources Information Center

Chu, Hye-Eun; Treagust, David F.; Yeo, Shelley; Zadnik, Marjan

2012-01-01

The aims of this study were to determine the underlying conceptual structure of the thermal concept evaluation (TCE) questionnaire, a pencil-and-paper instrument about everyday contexts of heat, temperature, and heat transfer, to investigate students' conceptual understanding of thermal concepts in everyday contexts across several school years and…

Challenging Ideological Environments: International Teachers' Experiences in an Outside-of-Country Teacher Training Programme

ERIC Educational Resources Information Center

Gutierrez, Amanda

2016-01-01

Teacher training for developing nation contexts is often conducted in short, intensive inside and outside-of-country programmes. Concerns have been raised in relation to the uncritical take-up of the western-centric material provided by these programmes, which are usually funded by national and international government organizations. This paper…

Challenges and gaps for energy planning models in the developing-world context

NASA Astrophysics Data System (ADS)

Debnath, Kumar Biswajit; Mourshed, Monjur

2018-03-01

Energy planning models (EPMs) support multi-criteria assessments of the impact of energy policies on the economy and environment. Most EPMs originated in developed countries and are primarily aimed at reducing greenhouse gas emissions while enhancing energy security. In contrast, most, if not all, developing countries are predominantly concerned with increasing energy access. Here, we review thirty-four widely used EPMs to investigate their applicability to developing countries and find an absence of consideration of the objectives, challenges, and nuances of the developing context. Key deficiencies arise from the lack of deliberation of the low energy demand resulting from lack of access and availability of supply. Other inadequacies include the lack of consideration of socio-economic nuances such as the prevalence of corruption and resulting cost inflation, the methods for adequately addressing the shortcomings in data quality, availability and adequacy, and the effects of climate change. We argue for further research on characterization and modelling of suppressed demand, climate change impacts, and socio-political feedback in developing countries, and the development of contextual EPMs.

Coping in context: sociocultural determinants of responses to sexual harassment.

PubMed

Wasti, S Arzu; Cortina, Lilia M

2002-08-01

The authors investigated coping responses to sexual harassment across 4 samples of working women from 3 cultures and 2 occupational classes. Complete-link cluster analyses provide preliminary support for D. E. Knapp, R. H. Faley, S. E. Ekeberg, and C. L. Z. Dubois's (1997) coping framework, suggesting that avoidance, denial, negotiation, advocacy seeking, and social coping are universal responses to sexual harassment. Further, L. F. Fitzgerald's (1990) internal-external dichotomy appears to capture higher order relationships among coping responses. In addition, regression analyses suggest that Turkish and Hispanic American women engage in more avoidance than Anglo American women, and Hispanic women also use more denial but less advocacy seeking. No differences emerged in social coping. The authors discuss these results in the context of coping theory, individualism-collectivism, power distance, and patriarchal gender norms.

Moral and social reasons to acknowledge the use of cognitive enhancers in competitive-selective contexts.

PubMed

Garasic, Mirko D; Lavazza, Andrea

2016-03-29

Although some of the most radical hypothesis related to the practical implementations of human enhancement have yet to become even close to reality, the use of cognitive enhancers is a very tangible phenomenon occurring with increasing popularity in university campuses as well as in other contexts. It is now well documented that the use of cognitive enhancers is not only increasingly common in Western countries, but also gradually accepted as a normal procedure by the media as well. In fact, its implementation is not unusual in various professional contexts and it has its peak in colleges (where the trend has been characterized as "academic doping"). Even when certain restrictions in the legislation of a country are indeed in place (i.e. through prescriptions requirements), they are without doubts easy to overcome. The legitimacy and appropriateness of such restrictions will not be the focus of our investigation. Our concern is instead related to the moral and social reasons to publicly acknowledge the use of cognitive enhancers in competitive-selective contexts. These reasons are linked to a more neutral analysis of contemporary Western society: it is a fact that an increasing number of competitive-selective contexts have a substantial number of contenders using cognitive enhancers. Through the use of five explicative examples, in this paper we want to analyse the problems related to its use. In particular, it will be our aim to show the tension between one of the main argument used by bio-liberals (the use of cognitive enhancers is an eligible procedure that society does not impose on anyone) and the actual implementation of the drugs in competitive, or semi-competitive contexts.

Computer Assisted Language Learning and the Internationalisation of the Portuguese Language in Higher Education Contexts

ERIC Educational Resources Information Center

Sevilla-Pavón, Ana

2015-01-01

The internationalisation of the Portuguese language has become a priority for academic institutions of different Portuguese-speaking countries which are trying to adapt to the current context of globalisation and ubiquitous communications through digital media. In order to achieve it, several challenges should be faced, namely providing…

Geographical Education in Brazil: Past and Present in "The Country of the Future"

ERIC Educational Resources Information Center

Lastoria, Andrea Coelho; Papadimitriou, Fivos

2012-01-01

This paper examines the past, present and future context of geographical education in Brazil and the issues that, in our view, are relevant to understand its ebb and flow in the complex reality of the country. Various trends have affected the development of geographical education since the 1970s. Two pillars of training and school practice reflect…

Everyday Laptop Use by Children in a Southern Country: A Mixed-Method Approach

ERIC Educational Resources Information Center

Nogry, S.; Varly, P.

2018-01-01

Information and communication technology (ICT) use among children in low-income countries remains understudied. The purpose of this study is to describe laptop usage among children in the context of the One Laptop per Child (OLPC) project 4 years after the laptops were first introduced in a community in Madagascar. The study was conducted using a…

Predictability and context determine differences in conflict monitoring between adolescence and adulthood.

PubMed

Chmielewski, Witold X; Roessner, Veit; Beste, Christian

2015-10-01

The ability to link contextual information to actions is an important aspect of conflict monitoring and response selection. These mechanisms depend on medial prefrontal networks. Although these areas undergo a protracted development from adolescence to adulthood, it has remained elusive how the influence of contextual information on conflict monitoring is modulated between adolescence and adulthood. Using event-related potentials (ERPs) and source localization techniques we show that the ability to link contextual information to actions is altered and that the predictability of upcoming events is an important factor to consider in this context. In adolescents, conflict monitoring functions are not as much modulated by predictability factors as in adults. It seems that adults exhibit a stronger anticipation of upcoming events than adolescents. This results in disadvantages for adults when the upcoming context is not predictable. In adolescents, problems to predict upcoming events therefore turn out to be beneficial. Two cognitive-neurophysiological factors are important for this: The first factor is related to altered conflict monitoring functions associated with modulations of neural activity in the medial frontal cortex. The second factor is related to altered perceptual processing of target stimuli associated with modulations of neural activity in parieto-occipital areas. Copyright © 2015 Elsevier B.V. All rights reserved.

Race and ethnic differences in determinants of preterm birth in the USA: broadening the social context.

PubMed

Reagan, Patricia B; Salsberry, Pamela J

2005-05-01

Preterm births occur in 9.7% of all US singleton births. The rate for blacks is double that of whites and the rate is 25% higher for Hispanics than for whites. While a number of individual correlates with preterm birth have been identified, race and ethnic differences have not been fully explained. Influenced by a growing body of literature documenting a relationship among health, individual income, and neighborhood disadvantage, researchers interested in explaining racial differences in preterm birth are designing studies that extend beyond the individual. No studies of adverse birth outcomes have considered contextual effects beyond the neighborhood level. Only a handful of studies, comparing blacks and whites, have evaluated the influence of neighborhood disadvantage on preterm birth. This study examines how preterm birth among blacks, whites and Hispanics is influenced by social context, broadly defined to include measures of neighborhood disadvantage and cumulative exposure to state-level income inequality, controlling for individual risk factors. Neighborhood disadvantage is determined by Census tract data. Cumulative exposure to income inequality is measured by the fraction of the mother's life since age 14 spent residing in states with a state-level Gini coefficient above the median. The results for neighborhood disadvantage are highly sensitive across race/ethnicities to the measure used. We find evidence that neighborhood poverty rates and housing vacancy rates increased the rate of very preterm birth and decreased the rate of moderately preterm birth for blacks. The rate of very preterm increased with the fraction of female-headed households for Hispanics and decreased with the fraction of people employed in professional occupations for whites. We find direct effects of cumulative exposure to income inequality only for Hispanics. However, we do find indirect effects of context broadly defined on behaviors that increased the risk of preterm birth.

Priorities for action on the social determinants of health: Empirical evidence on the strongest associations with life expectancy in 54 low-income countries, 1990-2012.

PubMed

Hauck, K; Martin, S; Smith, P C

2016-10-01

The WHO Commission on the Social Determinants of Health set out an impressive collection of policy proposals on the social determinants of health. However, a serious weakness for securing implementation is the difficulty for policymakers in identifying priorities for action. The objective of this study is to determine a small set of the most influential determinants using existing data and an empirical approach. 45 Indicators from the World Bank's World Development Indicators are selected to measure attainment for the determinants proposed by the Commission. Panel data models of life expectancy at birth for 54 low-income countries over the years 1990-2012 (1188 country-years) are estimated. Each determinant is subjected to a robustness test using Extreme Bound Analysis, to determine the stability of its estimated impact on life expectancy. For 20 robust and significant determinants the magnitude of association with life expectancy is determined. The largest average increases in life expectancy at 14.5 months per capita is associated with a one standard deviation reduction in HIV prevalence among children, followed by advances in gender equality at 9.4 months. Improvements in life expectancy between 6 and 9 months are associated with agricultural production, political stability, access to clean water and sanitation, good governance, and primary school enrolment. Improvements below 6 months are associated with increases in private health expenditure and overseas development assistance, and control of armed conflict and HIV prevalence among men. There is no evidence that national income, public spending on healthcare and education, secondary schooling, terms of international trade, employment, debt service and relief, out-of-pocket expenditures, agricultural ex- or imports, lifestock production, foreign investment, urbanization or environmental degradation are robustly associated with population health. Results provide support for the relevance of some proposed

Study protocol for a pilot study to explore the determinants of knowledge use in a medical education context.

PubMed

Reeves, Scott; Leslie, Karen; Baker, Lindsay; Egan-Lee, Eileen; Légaré, France; Silver, Ivan; Rosenfield, Jay; Hodges, Brian; Curran, Vernon; Armson, Heather; Kitto, Simon

2013-10-01

While the science of knowledge translation (KT) has been growing steadily for the past decade in relation to understanding processes and actions which are embedded within clinical practice settings, little is known about how empirical knowledge is used within the medical education system. Despite an increase of research in this domain, we know very little about the contribution of this evidence in the development of medical students into effective physicians. This pilot study aims to: provide a synthesis of the evidence for educational strategies within medical education; explore the perceptions and experiences of faculty in undergraduate (UG) medical education in relation to their use of evidence in their educational practices; and illuminate how medical education evidence is formally integrated into a UG medical curriculum. The study will involve three phases. First, a scoping review of the medical education research literature will be undertaken to generate insight into the evidence available for curriculum development, teaching and assessment activities within this domain. Second, a content analysis of undergraduate courses at the University of Toronto will be undertaken to generate an additional insight into the extent that medical education research has been formally integrated into the UG curriculum for medical students at the University. Finally, a purposeful sample of 30-40 medical education leaders from a single large university, selected as it aims to deliver a rigorous research-oriented medical curriculum, will be interviewed to understand how they use the available evidence in their education practices. This study will lay the grounds to generate initial data into the determinants of knowledge use in a medical education context. In doing so, the findings will also inform the development of a larger, pan-Canadian study at medical schools that will generate a comprehensive account of the processes and challenges related to KT within an educational

Context cue focality influences strategic prospective memory monitoring.

PubMed

Hunter Ball, B; Bugg, Julie M

2018-02-12

Monitoring the environment for the occurrence of prospective memory (PM) targets is a resource-demanding process that produces cost (e.g., slower responding) to ongoing activities. However, research suggests that individuals are able to monitor strategically by using contextual cues to reduce monitoring in contexts in which PM targets are not expected to occur. In the current study, we investigated the processes supporting context identification (i.e., determining whether or not the context is appropriate for monitoring) by testing the context cue focality hypothesis. This hypothesis predicts that the ability to monitor strategically depends on whether the ongoing task orients attention to the contextual cues that are available to guide monitoring. In Experiment 1, participants performed an ongoing lexical decision task and were told that PM targets (TOR syllable) would only occur in word trials (focal context cue condition) or in items starting with consonants (nonfocal context cue condition). In Experiment 2, participants performed an ongoing first letter judgment (consonant/vowel) task and were told that PM targets would only occur in items starting with consonants (focal context cue condition) or in word trials (nonfocal context cue condition). Consistent with the context cue focality hypothesis, strategic monitoring was only observed during focal context cue conditions in which the type of ongoing task processing automatically oriented attention to the relevant features of the contextual cue. These findings suggest that strategic monitoring is dependent on limited-capacity processing resources and may be relatively limited when the attentional demands of context identification are sufficiently high.

Gynephilic Men's Self-Reported and Genital Sexual Responses to Relationship Context Cues.

PubMed

Timmers, Amanda D; Chivers, Meredith L

2018-04-01

The current study examined men's sexual responses to relationship context. Chivers and Timmers (2012) previously reported that heterosexual men's genital and self-reported sexual arousal varied by gender but not relationship context, suggesting that gender cues are more salient determinants of sexual response than relationship context cues for men. Those analyses were, however, significantly underpowered to detect relationship context effects (n = 9). The current study utilized the same paradigm as Chivers and Timmers' study, exposing a larger sample of heterosexual men (n = 26) to audio narratives describing sexual interactions that varied by partner gender (man, woman) and relationship context (stranger, friend, long-term relationship), and observing effects on genital and self-reported sexual response. Results indicated that men's genital response to relationship context cues mirrored those previously reported for heterosexual women (Chivers & Timmers, 2012); heterosexual men demonstrated less genital response to the friend than to the stranger or long-term relationship conditions. No significant effect of relationship context was found for men's self-reported sexual arousal. These data suggest that, in addition to gender cues, relationship cues may also be an important determinant of men's genital sexual responses.

Strategy for Improved Nutrition of Children and Women in Developing Countries. A UNICEF Policy Review.

ERIC Educational Resources Information Center

United Nations Children's Fund, New York, NY.

This United Nations Children's Fund (UNICEF) report proposes a strategy for reducing, and ultimately eliminating, malnutrition in developing countries. It proposes a methodology for the identification of appropriate actions in a given context through situation assessment and analysis, rather than through a predetermined set of technical…

The economic impact of a new animal disease: same effects in developed and developing countries?

PubMed

Rich, K M; Niemi, J K

2017-04-01

Animal disease outbreaks generate a range of economic and non-economic impacts. While a significant number of research studies have estimated the effects of various diseases in a variety of contexts, examining the differential impacts and implications associated with the introduction of a novel disease into a developing country, as opposed to a developed one, is a rich area for further research. In this paper, the authors highlight some of the key dimensions and implications associated with the impacts of new diseases, how they differ in different contexts, and their implications for public policy.

The Significance of Context for Curriculum Development in Engineering Education: A Case Study across Three African Countries

ERIC Educational Resources Information Center

Case, Jennifer M.; Fraser, Duncan M.; Kumar, Anil; Itika, Ambrose

2016-01-01

Curriculum reform is a key topic in the engineering education literature, but much of this discussion proceeds with little engagement with the impact of the local context in which the programme resides. This article thus seeks to understand the influence of local contextual dynamics on curriculum reform in engineering education. The empirical…

Developed-developing country partnerships: Benefits to developed countries?

PubMed Central

2012-01-01

Developing countries can generate effective solutions for today’s global health challenges. This paper reviews relevant literature to construct the case for international cooperation, and in particular, developed-developing country partnerships. Standard database and web-based searches were conducted for publications in English between 1990 and 2010. Studies containing full or partial data relating to international cooperation between developed and developing countries were retained for further analysis. Of 227 articles retained through initial screening, 65 were included in the final analysis. The results were two-fold: some articles pointed to intangible benefits accrued by developed country partners, but the majority of information pointed to developing country innovations that can potentially inform health systems in developed countries. This information spanned all six WHO health system components. Ten key health areas where developed countries have the most to learn from the developing world were identified and include, rural health service delivery; skills substitution; decentralisation of management; creative problem-solving; education in communicable disease control; innovation in mobile phone use; low technology simulation training; local product manufacture; health financing; and social entrepreneurship. While there are no guarantees that innovations from developing country experiences can effectively transfer to developed countries, combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is virgin and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardized method for reporting partnership benefits is needed—this is perhaps the single most immediate need in planning for, and realizing, the full potential of international cooperation between developed and

Developed-developing country partnerships: benefits to developed countries?

PubMed

Syed, Shamsuzzoha B; Dadwal, Viva; Rutter, Paul; Storr, Julie; Hightower, Joyce D; Gooden, Rachel; Carlet, Jean; Bagheri Nejad, Sepideh; Kelley, Edward T; Donaldson, Liam; Pittet, Didier

2012-06-18

Developing countries can generate effective solutions for today's global health challenges. This paper reviews relevant literature to construct the case for international cooperation, and in particular, developed-developing country partnerships. Standard database and web-based searches were conducted for publications in English between 1990 and 2010. Studies containing full or partial data relating to international cooperation between developed and developing countries were retained for further analysis. Of 227 articles retained through initial screening, 65 were included in the final analysis. The results were two-fold: some articles pointed to intangible benefits accrued by developed country partners, but the majority of information pointed to developing country innovations that can potentially inform health systems in developed countries. This information spanned all six WHO health system components. Ten key health areas where developed countries have the most to learn from the developing world were identified and include, rural health service delivery; skills substitution; decentralisation of management; creative problem-solving; education in communicable disease control; innovation in mobile phone use; low technology simulation training; local product manufacture; health financing; and social entrepreneurship. While there are no guarantees that innovations from developing country experiences can effectively transfer to developed countries, combined developed-developing country learning processes can potentially generate effective solutions for global health systems. However, the global pool of knowledge in this area is virgin and further work needs to be undertaken to advance understanding of health innovation diffusion. Even more urgently, a standardized method for reporting partnership benefits is needed--this is perhaps the single most immediate need in planning for, and realizing, the full potential of international cooperation between developed and

Social Determinants of Health and Tobacco Use in Five Low and Middle-Income Countries - Results from the Global Adult Tobacco Survey (GATS), 2011 - 2012.

PubMed

Tee, Guat Hiong; Aris, Tahir; Rarick, James; Irimie, Sorina

2016-01-01

Tobacco consumption continues to be the leading cause of preventable deaths globally. The objective of this study was to examine the associaton of selected socio-demographic variables with current tobacco use in five countries that participated in the Phase II Global Adult Tobacco Survey in 2011 - 2012. We analysed internationally comparable representative household survey data from 33,482 respondents aged ≥ 15 years in Indonesia, Malaysia, Romania, Argentina and Nigeria for determinants of tobacco use within each country. Socio-demographic variables analysed included gender, age, residency, education, wealth index and awareness of smoking health consequences. Current tobacco use was defined as smoking or use of smokeless tobacco daily or occasionally. The overall prevalence of tobacco use varied from 5.5% in Nigeria to 35.7% in Indonesia and was significantly higher among males than females in all five countries. Odds ratios for current tobacco use were significantly higher among males for all countries [with the greatest odds among Indonesian men (OR=67.4, 95% CI: 51.2-88.7)] and among urban dwellers in Romania. The odds of current tobacco use decreased as age increased for all countries except Nigeria where. The reverse was true for Argentina and Nigeria. Significant trends for decreasing tobacco use with increasing educational levels and wealth index were seen in Indonesia, Malaysia and Romania. Significant negative associations between current tobacco use and awareness of adverse health consequences of smoking were found in all countries except Argentina. Males and the socially and economically disadvantaged populations are at the greatest risk of tobacco use. Tobacco control interventions maybe tailored to this segment of population and incorporate educational interventions to increase knowledge of adverse health consequences of smoking.

Autonomy and self-determination theory in different contexts: A comparison of middle school science teachers' motivation and instruction in China and the United States

NASA Astrophysics Data System (ADS)

Robertson, Laura Elizabeth

This study examined factors that contribute to Chinese and United States middle school science teachers' perceptions of autonomy support. Autonomy is one component of self-determination theory and has been associated with intrinsic motivation. The study used a mixed methods design including quantitative data collected through an online survey and qualitative data collected through open-ended interview questions. The online survey consisted of four assessments related to teachers' self-determination, perceptions of constraints at work, perceptions of students' self-determination, and level of autonomy support for students and allowed for the testing of the structural model developed by Pelletier, Seguin-Levesque, and Legault (2002). Exploratory factor analysis (EFA) of responses for the combined teacher sample (n=201) was carried out for each of the survey assessments. Significance testing for Chinese (n=107) and U.S. (n=94) teachers, based on the factors resulting from EFA, revealed significant differences in teachers' self-determination and perceptions of constraints at work. No significant differences were found for teachers' perceptions of students' self-determination or level of autonomy support for students. Multiple regression was used to predict teachers' autonomy support for students. For the Chinese teachers, perceptions of constraints at work, teachers' self-determination, and teachers' perceptions of student motivation were found to significantly predict teachers' autonomy support. For the U.S. teachers, teacher motivation was the only significant predictor of teachers' autonomy support. A sub-sample of the Chinese and U.S. science teachers (n=19) were interviewed about their perceived levels of autonomy support, constraints at work, and their students' self determination. The analyses of the interviews showed that teachers in both countries reported that autonomy was important to their motivation and the quality of instruction they provided to students

The Evolution of U.S.-Turkish Relations in a Transatlantic Context

DTIC Science & Technology

2008-04-01

THE EVOLUTION OF U.s.-TURKIsH RELATIONs IN A TRANsATLANTIC CONTEXT Colloquium Report Frances G. Burwell Editor April 2008 This publication is a work ...PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) U.S. Army War College,Strategic Studies...need to continue addressing the issues identified. vi Such work should prove valuable to policymakers of both countries in their efforts to improve

Determinants of CO2 emissions in ASEAN countries using energy and mining indicators

NASA Astrophysics Data System (ADS)

Nordin, Sayed Kushairi Sayed; Samat, Khairul Fadzli; Ismail, Siti Fatimah; Hamzah, Khairum; Halim, Bushra Abdul; Kun, Sek Siok

2015-05-01

Carbon dioxide (CO2) is the main greenhouse gas emitted from human activities. Industrial revolution is one of the triggers to accelerate the quantity of CO2 in the atmosphere which lead to undesirable changes in the cycle of carbon. Like China and United States which are affected by the economic development growth, the atmospheric CO2 level in ASEAN countries is expected to be higher from year to year. This study focuses on energy and mining indicators, namely alternative and nuclear energy, energy production, combustible renewables and waste, fossil fuel energy consumption and the pump price for diesel fuel that contribute to CO2 emissions. Six ASEAN countries were examined from 1970 to 2010 using panel data approach. The result shows that model of cross section-fixed effect is the most appropriate model with the value of R-squared is about 86%. Energy production and fossil fuel energy consumption are found to be significantly influenced to CO2 emissions.

Deep uncertainty and broad heterogeneity in country-level social cost of carbon

NASA Astrophysics Data System (ADS)

Ricke, K.; Drouet, L.; Caldeira, K.; Tavoni, M.

2017-12-01

The social cost of carbon (SCC) is a commonly employed metric of the expected economic damages expected from carbon dioxide (CO2) emissions. Recent estimates of SCC range from approximately 10/tonne of CO2 to as much as 1000/tCO2, but these have been computed at the global level. While useful in an optimal policy context, a world-level approach obscures the heterogeneous geography of climate damages and vast differences in country-level contributions to global SCC, as well as climate and socio-economic uncertainties, which are much larger at the regional level. For the first time, we estimate country-level contributions to SCC using recent climate and carbon-cycle model projections, empirical climate-driven economic damage estimations, and information from the Shared Socio-economic Pathways. Central specifications show high global SCC values (median: 417 /tCO2, 66% confidence intervals: 168 - 793 /tCO2) with country-level contributions ranging from -11 (-8 - -14) /tCO2 to 86 (50 - 158) /tCO2. We quantify climate-, scenario- and economic damage- driven uncertainties associated with the calculated values of SCC. We find that while the magnitude of country-level social cost of carbon is highly uncertain, the relative positioning among countries is consistent. Countries incurring large fractions of the global cost include India, China, and the United States. The share of SCC distributed among countries is robust, indicating climate change winners and losers from a geopolitical perspective.