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Sample records for countries prevalence management

  1. Prevalence and Management of Diabetic Nephropathy in Western Countries

    PubMed Central

    Satirapoj, Bancha; Adler, Sharon G.

    2015-01-01

    Background Diabetic nephropathy (DN) often results in end-stage renal disease, and this is the most common reason for initiation of dialysis in the United States. Complications of diabetes, particularly renal disease, substantially increase the risk of subsequent severe illness and death. The prevalence of DN is still rising dramatically, with concomitant increases in associated mortality and cardiovascular complications. Summary Renal involvement in type 1 and type 2 diabetes reflects a complex pathogenesis. Various genetic and environmental factors determine the susceptibility and progression to advanced stages of the disease. DN should be considered in patients who have had type 1 diabetes for at least 10 years with microalbuminuria and diabetic retinopathy, as well as in patients with type 1 or type 2 diabetes with macroalbuminuria in whom other causes for proteinuria are absent. The glomerular characteristic features include mesangial expansion, thickened glomerular basement membrane, and hyalinosis of arterioles. The optimal therapy of DN continues to evolve. For all diabetic patients, practical management including blood glucose and blood pressure control with renin-angiotensin-aldosterone blockade combined with lipid control, dietary salt restriction, lowering the dietary protein intake, increased physical activity, weight reduction, and smoking cessation can reduce the rate of progression of nephropathy and cardiovascular disease. Key Message DN is a complex disease linking hemodynamic and metabolic pathways with oxidative stress, and systemic inflammation. We summarize the current evidence of epidemiology, clinical diagnosis, and the current management of DN in Western countries. Facts from East and West The prevalence of DN is increasing in Asia and Western countries alike. The deletion (D) allele of the angiotensin-converting enzyme gene is associated with progression to end-stage renal disease in Asian patients with DN, but this association is

  2. Prevalence, pattern, etiology, and management of maxillofacial trauma in a developing country: a retrospective study

    PubMed Central

    Udhayakumar, Rajesh Kumar

    2016-01-01

    Objectives This retrospective study aims to evaluate the prevalence of maxillofacial trauma in a developing country, along with its pattern, etiology and management. Data for the present study were collected from the Department of Dentistry, ESIC Medical College and Post Graduate Institute of Medical Sciences and Research, Chennai in India. Materials and Methods The medical records of patients treated for maxillofacial injuries between May 2014 and November 2015 were retrospectively retrieved and analyzed for prevalence, pattern, etiology, and management of maxillofacial trauma. SPSS software version 16.0 was used for the data analysis. Results Maxillofacial fractures accounts for 93.3% of total injuries. The mean and standard deviation for the age of the patients were 35.0±11.8 years and with a minimum age of 5 years and maximum age of 75 years. Adults from 20 to 40 years age groups were more commonly involved, with a male to female ratio of 3:1. There was a statistically significantly higher proportion of males more commonly involved in accident and injuries (P <0.001). Conclusion The most common etiology of maxillofacial injury was road traffic accidents (RTA) followed by falls and assaults, the sports injuries seem to be very less. In RTA, motorized two-wheelers (MTW) were the most common cause of incidents. The majority of victims of RTA were young adult males between the ages of 20 to 40 years. The malar bone and maxilla were the most common sites of fracture, followed by the mandible. The right side of the zygomatic complex was the predominant side of MTW injury. The majority of the zygomatic complex fractures were treated by conservative management. Open reduction and internal fixation were performed for indicated fracture patients. PMID:27595083

  3. Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors

    PubMed Central

    Kalaria, Raj N; Maestre, Gladys E; Arizaga, Raul; Friedland, Robert P; Galasko, Doug; Hall, Kathleen; Luchsinger, José A; Ogunniyi, Adesola; Perry, Elaine K; Potocnik, Felix; Prince, Martin; Stewart, Robert; Wimo, Anders; Zhang, Zhen-Xin; Antuono, Piero

    2010-01-01

    Despite mortality due to communicable diseases, poverty, and human conflicts, dementia incidence is destined to increase in the developing world in tandem with the ageing population. Current data from developing countries suggest that age-adjusted dementia prevalence estimates in 65 year olds are high (≥5%) in certain Asian and Latin American countries, but consistently low (1–3%) in India and sub-Saharan Africa; Alzheimer's disease accounts for 60% whereas vascular dementia accounts for ∼30% of the prevalence. Early-onset familial forms of dementia with single-gene defects occur in Latin America, Asia, and Africa. Illiteracy remains a risk factor for dementia. The APOE ε4 allele does not influence dementia progression in sub-Saharan Africans. Vascular factors, such as hypertension and type 2 diabetes, are likely to increase the burden of dementia. Use of traditional diets and medicinal plant extracts might aid prevention and treatment. Dementia costs in developing countries are estimated to be US$73 billion yearly, but care demands social protection, which seems scarce in these regions. PMID:18667359

  4. Prevention and management of tuberculosis in HIV positive patients living in countries with a low prevalence of Mycobacterium tuberculosis.

    PubMed Central

    Brook, M G; Miller, R F

    1996-01-01

    We have re-examined the evidence on which current British Thoracic Society recommendations for primary and secondary prophylaxis and therapy of tuberculosis are based. We suggest that in a country such as the UK with a low prevalence of tuberculosis, primary prophylaxis should be offered primarily to tuberculin positive or anergic patients from high-incidence groups, including immigrants from high-prevalence countries, intravenous drug users and those with previous tuberculosis, that secondary prophylaxis be withheld from all but very high-risk patients and that four drug regimens which include ethambutol should be used for patients originating from, or who have lived in areas of the world with more than 2% primary isoniazid resistance. PMID:8698373

  5. Rethinking HIV prevalence determination in developing countries.

    PubMed

    Makinde, Olusesan A; Oyediran, Kolawole A

    2015-01-01

    The process for HIV prevalence determination using antenatal clinic (ANC) sentinel surveillance data has been plagued by criticisms of its biasness. Exploring other means of HIV prevalence determination is necessary to validate that estimates are near actual values or to replace the current system. We propose a data collection model that leverages the increasing adoption and penetration of the Internet and mobile technology to collect and archive routine data from HIV counseling and testing (HCT) client intake forms from all HCT centers and prevention of mother-to-child transmission (PMTCT) sites in a country. These data will then be mined to determine prevalence rates and risk factors at the community level. The need to improve the method for the generation of HIV prevalence rates has been repeatedly echoed by researchers though no one has been able to fashion out a better and more reliable way to the current ANC sentinel surveillance method at a reasonable cost. The chance of using routinely generated data during HCT and PMTCT is appealing and needs to be envisioned as the technology to achieve this is increasingly becoming available and affordable in countries worst hit by the pandemic. Triangulating data generated from routine HCT and PMTCT sites with data from sentinel surveillance and where the confidence of its quality is assured, as the sole source of HIV prevalence rate determination and behavioral risk assessment will improve the acceptance by communities and drive evidence-based interventions at the community level. PMID:25174731

  6. Epidemiology, Diagnosis and Management of Extra-Pulmonary Tuberculosis in a Low-Prevalence Country: A Four Year Retrospective Study in an Australian Tertiary Infectious Diseases Unit

    PubMed Central

    Pollett, Simon; Banner, Pamela; O’Sullivan, Matthew V. N.; Ralph, Anna P.

    2016-01-01

    Objectives Extra-pulmonary tuberculosis (EPTB) is relatively neglected and increasing in incidence, in comparison to pulmonary tuberculosis (PTB) in low-burden settings. It poses particular diagnostic and management challenges. We aimed to determine the characteristics of EPTB in Western Sydney, Australia, and to conduct a quality assurance investigation of adherence to guidelines among Infectious Diseases (ID) practitioners managing EPTB cases. Methods All adult EPTB cases managed by a large ID service during 01/01/2008–31/12/2011 were eligible for inclusion in the retrospective review. Data were extracted from patient medical records on demographic, diagnostic, clinical and management details, and on clinician adherence to local and international TB guidelines. Results 129 cases managed by the ID service were identified, with files available for 117. 98 cases were managed by the Respiratory service and were excluded. 98.2%(112/114) had been born in a country other than Australia. HIV status was tested or previously known in 97 people, and positive in 4 (4%). Microbiological confirmation was obtained in 68/117 (58.1%), an additional 24 had histopathological findings considered confirmatory (92/117, 78.6%), with the remainder diagnosed on clinical and/or radiological grounds. Median time to diagnosis post-migration from a high TB-burden country was 5 years (range 0–41). 95 cases were successfully treated, 11 cases defaulted, refused therapy or transferred, 2 cases relapsed and outcomes unknown or pending in 9 cases. No deaths occurred in the sample analysed. Clinician adherence to guidelines was high, but with scope for improvement in offering testing for co-infections, performing eye checks, monitoring blood glucose in patients receiving adjunctive corticosteroids, and considering drug interactions. Conclusions Despite excellent TB outcomes in this setting, the low proportion of cases with susceptibility data is worrying in this era of increasing drug

  7. Prevalence and management of hypertensive patients in clinical practice: Cross-sectional registry in five countries outside the European Union.

    PubMed

    Ragot, Stéphanie; Beneteau, Mathieu; Guillou-Bonnici, Françoise; Herpin, Daniel

    2016-01-01

    Inadequate blood pressure (BP) control may be linked with poor adherence to guidelines by the treating physician. This study aimed at assessing the rates of controlled hypertension as per the 2009 Reappraisal of the 2007 European Society of Cardiology/European Society of Hypertension (ESC/ESH) guidelines in 2185 hypertensive adults across five countries (Algeria, Pakistan, Ukraine, Egypt and Venezuela). The rates of controlled hypertension according to physician perception, type of therapy and risk factors were evaluated. Overall, 40% of patients had controlled hypertension according to the guidelines. A marked divergence in the rates of controlled hypertension as assessed by physicians and guidelines was observed (72% vs 40%). The presence of high/very high risks was linked to poor BP control. High salt intake [29%; odds ratio (OR) 9.94, 95% confidence interval (CI) 6.72;14.69], treatment non-adherence (27%; OR 7.32, 95% CI 4.82;11.13), lack of understanding of the treatment's importance (25%; OR 4.95, 95% CI 3.16;7.75), comorbidity (13%) and depression (9%; OR 10.50, 95% CI 5.37;20.54) were major reasons for not achieving hypertension control. Addition of another drug was the most frequent medication change prescribed. Poor rates of BP control warrant repeated promotion of guidelines while identifying potential contributing factors and implementing strategies that re-establish BP control. PMID:26873621

  8. Trends in prevalence of diabetes in Asian countries.

    PubMed

    Ramachandran, Ambady; Snehalatha, Chamukuttan; Shetty, Ananth Samith; Nanditha, Arun

    2012-06-15

    Diabetes is a major lifestyle disorder, the prevalence of which is increasing globally. Asian countries contribute to more than 60% of the world's diabetic population as the prevalence of diabetes is increasing in these countries. Socio-economic growth and industrialization are rapidly occurring in many of these countries. The urban-rural divide in prevalence is narrowing as urbanization is spreading widely, adversely affecting the lifestyle of populations. Asians have a strong ethnic and genetic predisposition for diabetes and have lower thresholds for the environmental risk factors. As a result, they develop diabetes at a younger age and at a lower body mass index and waist circumference when compared with the Western population. The adverse effect of physical inactivity and fatty food are manifested as the increasing rate of overweightness and obesity, even among children. The health care budgets for the disease management are meager and the health care outcome is far from the optimum. As a result, complications of diabetes are common and the economic burden is very high, especially among the poor strata of the society. National endeavors are urgently needed for early diagnosis, effective management and for primary prevention of diabetes. This editorial aims to highlight the rising trend in prevalence of diabetes in Asia, its causative factors and the urgent need to implement national strategies for primary prevention of type 2 diabetes. PMID:22737281

  9. The prevalence of toxic hotspots in former Soviet countries.

    PubMed

    Sharov, Petr; Dowling, Russell; Gogishvili, Megi; Jones, Barbara; Caravanos, Jack; McCartor, Andrew; Kashdan, Zachary; Fuller, Richard

    2016-04-01

    Using a global database of contaminated sites, toxic hotspots in eight former Soviet countries were analyzed to identify the prevalence, types and sources of toxic pollution, as well as their associated potential public health impacts. For this analysis, polluted sites in Armenia, Azerbaijan, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Ukraine, and Uzbekistan were compiled and analyzed. The levels of contamination of seven key pollutants were assessed in each country. 424 contaminated sites were identified using data from Blacksmith Institute. Pesticides, lead (Pb), radioactive metals, arsenic (As), mercury (Hg), chromium (Cr), and cadmium (Cd) were the most commonly identified key pollutants. Collectively, these sites pose health risks to an estimated 6.2 million residents. The existing data on toxic hotspots in former Soviet countries likely captures only a small percentage of actual contaminated sites, but suggests potentially severe public health consequences. Additional assessments are needed to understand the risks posed by toxic pollution in the region. PMID:26796744

  10. High prevalence of asthma in cross country skiers.

    PubMed Central

    Larsson, K; Ohlsén, P; Larsson, L; Malmberg, P; Rydström, P O; Ulriksen, H

    1993-01-01

    OBJECTIVES--To study the prevalence of asthma (asthma symptoms and bronchial hyperresponsiveness) in Swedish cross country skiers compared with non-skiers and monitor changes in symptoms and bronchial hyperresponsiveness during the year. DESIGN--Cross sectional study during the winter ski season and in the summer. SETTING--Six ski clubs for élite skiers (total 47) in two different areas of Sweden. SUBJECTS--42 élite cross country skiers and 29 non-skiing referents. MAIN OUTCOME MEASURES--Bronchial responsiveness, asthma symptoms, and lung function. RESULTS--Bronchial responsiveness was significantly greater and asthma symptoms more prevalent in the skiers than in the referents. There was no difference in bronchial responsiveness within either group between winter and summer. 15 of the 42 skiers used antiasthmatic drugs regularly and 23 had a combination of asthma symptoms and hyperresponsive airways or physician diagnosed asthma, or both. Altogether 33 skiers had symptoms of asthma or bronchial hyperresponsiveness. One of the referents had symptoms of asthma and bronchial hyperresponsiveness, and none used antiasthmatic drugs regularly. CONCLUSIONS--Asthma, asthma-like symptoms, and bronchial hyperresponsiveness are much more common in cross country skiers than in the general population and non-skiers. Strenuous exercise at low temperatures entailing breathing large volumes of cold air is the most probable explanation of persistent asthma in skiers. PMID:8257888

  11. Prevalence of diabetes among immigrants in the Nordic countries.

    PubMed

    Wändell, Per E; Carlsson, Axel; Steiner, Kristin H

    2010-03-01

    Some immigrant groups in Europe show an increased prevalence of diabetes, e.g. South Asians in the UK and Moroccans and Turks in the Netherlands. This study aimed at reviewing the literature among immigrants in the Nordic countries. Search was performed primarily of Medline through PubMed, and secondarily of other databases and by using information from reference lists. Terms used were: "Diabetes Mellitus", "Immigrant", and "Nordic countries" or "Scandinavia" or "Denmark", "Finland", "Iceland", "Norway" or "Sweden". Altogether 17 articles on diabetes were found. Excess risk of diabetes was found in non-European immigrant groups, especially from the Middle East and South Asian regions, in some cases 10 times the risk of the indigenous population, with the highest relative risks among women. No excess risk was found among European immigrants, with the possible exception of Finnish women. Conflicting results were found in studies with a low number of diabetic cases, with a failure to show statistically significant excess risks among non-European groups. There were also some other methodological problems, e.g. low participation rate in population based clinical studies, and probable underestimation of known diabetes by self-report. A genetic sensitivity seems likely in the Middle East and South Asian groups, combined with lifestyle factors. PMID:20201798

  12. Management of Membranous Nephropathy in Western Countries

    PubMed Central

    Alfaadhel, Talal; Cattran, Daniel

    2015-01-01

    Background Idiopathic membranous nephropathy (IMN) is a common cause of nephrotic syndrome (NS) in adults in Western countries. In 2012, the KDIGO (Kidney Disease: Improving Global Outcomes) working group published guidelines for the management of glomerulonephritis, thus providing a template for the treatment of this condition. While being aware of the impact of the clinicians' acumen and that patients may choose a different therapeutic option due to the risks of specific drugs and also of the evolving guidelines, this review details our approach to the management of patients with IMN in a Western center (Toronto). Summary Based on studies published in Europe and North America, we included recent advances in the diagnosis and management of patients with membranous nephropathy similar to our practice population. We highlight the importance of establishing the idiopathic nature of this condition before initiating immunosuppressive therapy, which should include the screening for secondary causes, especially malignancy in the elderly population. The expected outcomes with and without treatment for patients with different risks of progression will be discussed to help guide clinicians in choosing the appropriate course of treatment. The role of conservative therapy as well as of established immunosuppressive treatment, such as the combination of cyclophosphamide and prednisone, and calcineurin inhibitors (CNIs), as well as of newer agents such as rituximab will be reviewed. Key Messages Appropriate assessment is required to exclude secondary conditions causing membranous glomerulonephritis. The role of antibodies to phospholipase A2 receptor (anti-PLA2R) in establishing the primary disease is growing, though more data are required. The increase in therapeutic options supports treatment individualization, taking into account the availability, benefits and risks, as well as patient preference. Facts from East and West (1) The prevalence of IMN is increasing worldwide

  13. Retrospective observational study to assess the clinical management and outcomes of hospitalised patients with complicated urinary tract infection in countries with high prevalence of multidrug resistant Gram-negative bacteria (RESCUING)

    PubMed Central

    Shaw, Evelyn; Addy, Ibironke; Stoddart, Margaret; Vank, Christiane; Grier, Sally; Wiegand, Irith; Leibovici, Leonard; Eliakim-Raz, Noa; Vallejo-Torres, Laura; Morris, Stephen; MacGowan, Alasdair; Carratalà, Jordi; Pujol, Miquel

    2016-01-01

    Introduction The emergence of multidrug resistant (MDR) Gram-negative bacteria (GNB), including carbapenemase-producing strains, has become a major therapeutic challenge. These MDR isolates are often involved in complicated urinary tract infection (cUTI), and are associated with poor clinical outcomes. The study has been designed to gain insight into the epidemiology, clinical management, outcome and healthcare cost of patients with cUTI, especially in countries with high prevalence of MDR GNB. Methods and analysis This multinational and multicentre observational, retrospective study will identify cases from 1 January 2013 to 31 December 2014 in order to collect data on patients with cUTI as a cause of hospital admission, and patients who develop cUTI during their hospital stay. The primary end point will be treatment failure defined as the presence of any of the following criteria: (1) signs or symptoms of cUTI present at diagnosis that have not improved by days 5–7 with appropriate antibiotic therapy, (2) new cUTI-related symptoms that have developed within 30 days of diagnosis, (3) urine culture taken within 30 days of diagnosis, either during or after completion of therapy, that grows ≥104 colony-forming unit/mL of the original pathogen and (4) death irrespective of cause within 30 days of the cUTI diagnosis. Sample size 1000 patients afford a power of 0.83 (α=0.05) to detect an absolute difference of 10% in the treatment failure rate between MDR bacteria and other pathogens. This should allow for the introduction of about 20 independent risk factors (or their interaction) in a logistic regression model looking at risk factors for failure. Ethics and dissemination Approval will be sought from all relevant Research Ethics Committees. Publication of this study will be considered as a joint publication by the participating investigator leads, and will follow the recommendations of the International Committee of Medical Journal Editors (ICMJE). Trial

  14. Strong Country Level Correlation between Syphilis and HSV-2 Prevalence

    PubMed Central

    Kenyon, Chris Richard; Tsoumanis, Achilleas

    2016-01-01

    Background. Syphilis is curable but Herpes Simplex Virus-2 (HSV-2) is not. As a result, the prevalence of syphilis but not HSV-2 may be influenced by the efficacy of national STI screening and treatment capacity. If the prevalence of syphilis and HSV-2 is found to be correlated, then this makes it more likely that something other than differential STI treatment is responsible for variations in the prevalence of both HSV-2 and syphilis. Methods. Simple linear regression was used to evaluate the relationship between national antenatal syphilis prevalence and HSV-2 prevalence in women in two time periods: 1990–1999 and 2008. Adjustments were performed for the laboratory syphilis testing algorithm used and the prevalence of circumcision. Results. The prevalence of syphilis was positively correlated with that of HSV-2 for both time periods (adjusted correlations, 20–24-year-olds: 1990–99: R2 = 0.54, P < 0.001; 2008: R2 = 0.41, P < 0.001 and 40–44-year-olds: 1990–99: R2 = 0.42, P < 0.001; 2008: R2 = 0.49, P < 0.001). Conclusion. The prevalence of syphilis and HSV-2 is positively correlated. This could be due to a common set of risk factors underpinning both STIs. PMID:27069710

  15. Managing international migration in developing countries.

    PubMed

    Farrag, M

    1997-01-01

    This article summarizes the findings of 180 participants from 57 governments attending the UN's International Office of Migration's (IOM) Migration Seminar in April 1997 in Geneva. The teams of researchers represented the four developing world regions: sub-Saharan Africa; South Asia; the Arab Region; and Mexico, Central America, and the Caribbean. The seminar was part of IOM's research project on emigration dynamics in developing countries, which was begun in 1993. Researchers shared a common conceptual framework, which recognized the changing socioeconomic, sociopolitical, demographic, and ecological conditions in each country and subregion, the role of networks between people in sending and receiving countries, and the nature of entry restrictions. The research and workshop aimed to help policymakers in developed and developing countries. Conference delegates found the research framework acceptable despite the differences between regions and countries. Conference delegates agreed that the IOM research project was a unique forum for exchange of information and experience between sending and receiving countries. Many participants wanted IOM to provide technical assistance that would help countries manage migration. Delegates strongly desired international commitments to human rights for migrants. Delegates wanted better information exchanges, particularly interchanges of experience on policy measures among Governments, and the stronger inclusion of migrants in management. Returning migrants needed assistance with reintegration. The delegates made 12 recommendations about establishment of an effective system of information exchange, research on emigration dynamics and return migration, development of measures for managing flows that respect existing employment structures, new agreements, and reliable information for migrants on living conditions in host countries. PMID:12348081

  16. Prevalence and antibiotic resistance of commensal Streptococcus pneumoniae in nine European countries.

    PubMed

    Yahiaoui, Rachid Y; den Heijer, Casper Dj; van Bijnen, Evelien Me; Paget, W John; Pringle, Mike; Goossens, Herman; Bruggeman, Cathrien A; Schellevis, François G; Stobberingh, Ellen E

    2016-06-01

    The human microbiota represents an important reservoir of antibiotic resistance. Moreover, the majority of antibiotics are prescribed in primary care. For this reason, we assessed the prevalence and antibiotic resistance of nasal carriage strains of Streptococcus pneumoniae, the most prevalent bacterial causative agent of community-acquired respiratory tract infections, in outpatients in nine European countries. Nasal swabs were collected between October 2010 and May 2011, from 32,770 patients, recruited by general practices in nine European countries. Overall prevalence of S. pneumoniae nasal carriage in the nine countries was 2.9%. The carriage was higher in men (3.7%) than in women (2.7%). Children (4-9 years) had a higher carriage prevalence (27.2%) compared with those older than 10 years (1.9%). The highest resistance observed was to cefaclor. The highest prevalence of multidrug resistance was found in Spain and the lowest prevalence was observed in Sweden. PMID:27191588

  17. Determining Prevalence of Acute Bilirubin Encephalopathy in Developing Countries

    ClinicalTrials.gov

    2015-11-11

    Demonstrate BIND II Score of >=5, is Valid for Detecting Moderate to Severe ABE in Neonates <14 Days Old.; Demonstrate Community-BIND Instrument, a Modified BIND II, is a Valid and Reliable Tool for Detecting ABE.; Demonstrate That Community-BIND Can be Used for Acquiring Population-based Prevalence of ABE in the Community.

  18. Evidence base for children affected by HIV and AIDS in low prevalence and concentrated epidemic countries: applicability to programming guidance from high prevalence countries

    PubMed Central

    Franco, Lynne Miller; Burkhalter, Bart; de Wagt, Arjan; Jennings, Larissa; Kelley, Allison Gamble; Hammink, Marie-Eve

    2009-01-01

    As global commitment grows to protect and support children affected by HIV and AIDS, questions remain about how best to meet the needs of these children in low prevalence settings and whether information from high prevalence countries can appropriately guide programming in these settings. A 2007 search for the evidence in low prevalence settings on situational challenges of HIV and AIDS-affected children and interventions to address these challenges identified 413 documents. They were reviewed and judged for quality of documentation and scientific rigor. Information was compiled across eight types of challenges (health and health care, nutrition and food security, education, protection, placement, psychosocial development, socioeconomic status, and stigma/ discrimination); and also assessed was strength of evidence for situational and intervention findings. Results were compared to three programming principles drawn from research in high prevalence countries: family-centered preventive efforts, treatment, and care; family-focused support to ensure capacity to care for and protect these children; and sustaining economic livelihood of HIV and AIDS-affected households. Findings show that children affected by HIV and AIDS in low prevalence settings face increased vulnerabilities similar to those in high prevalence settings. These findings support seeking and testing programmatic directions for interventions identified in high prevalence settings. However, low prevalence settings/countries are extremely diverse, and the strength of the evidence base among them was mixed (strong, moderate, and weak in study design and documentation), geographically limited, and had insufficient evidence on interventions to draw conclusions about how best to reduce additional vulnerabilities of affected children. Information on family, economic, sociocultural, and political factors within local contexts will be vital in the development of appropriate strategies to mitigate vulnerabilities

  19. Educational Attainment and HIV/AIDS Prevalence: A Cross-Country Study

    ERIC Educational Resources Information Center

    Lakhanpal, Manisha; Ram, Rati

    2008-01-01

    Using data for a large cross-country sample, a reasonable model is estimated to judge the effect of adult educational attainment on prevalence of HIV. Three main points are noted. First, there is an indication of a significantly negative effect of educational attainment on HIV prevalence. Second, magnitude of the impact appears sizable. Third, a…

  20. Prevalence and correlates of adult overweight in the Muslim world: analysis of 46 countries.

    PubMed

    Kahan, D

    2015-04-01

    The primary objectives of the study were to calculate overweight prevalence (body mass index ≥ 25.0) and simple correlations between 10 demographic, social welfare and behavioural variables and overweight prevalence for Muslim countries (populations >50% Muslim; N = 46). Overweight data for a country's total, male and female populations were extracted from the World Health Organization's (WHO) STEPwise country reports and relevant publications. Country-level data for potential correlates were extracted from multiple sources: Central Intelligence Agency (literacy), Gallup Poll (religiosity), United Nations (agricultural employment, food supply, gender inequality, human development), World Bank (automobile ownership, Internet, labour force) and WHO (physical inactivity). The overall, male and female overweight prevalence was 37.4, 33.0 and 42.1%, respectively. Prevalence estimates significantly differed by economic classification, gender and ethnicity. Middle- and upper income countries were 1.54-7.76 (95% confidence interval [CI]: 1.49-8.07) times more likely overweight than low-income countries, females were 1.48 (CI: 1.45-1.50) times more likely overweight than males and Arab countries were 2.92 (CI: 2.86-2.97) times more likely overweight than non-Arab countries. All 10 of the potential correlates were significantly associated with overweight for at least one permutation (total, economic classification, gender, ethnicity). The greater percentage of poorer countries among non-Arab Muslim countries, which compared with Arab countries have not as rapidly been transformed by globalization, nutrition transition and urbanization, may partially explain prevalence differences. Evaluation of correlational data generally followed associations seen in non-Muslim countries but more complex analysis of subnational data is needed. Arab women are a particularly vulnerable subgroup and governments should act within religious and cultural parameters to provide

  1. No association between gender inequality and peak HIV prevalence in developing countries - an ecological study.

    PubMed

    Kenyon, Chris R; Buyze, Jozefien

    2015-01-01

    The prevalence of both gender inequality and HIV prevalence vary considerably both within all developing countries and within those in sub-Saharan Africa. We test the hypothesis that the extent of gender inequality is associated with national peak HIV prevalence. Linear regression was used to test the association between national peak HIV prevalence and three markers of gender equality - the gender-related development index (GDI), the gender empowerment measure (GEM), and the gender inequality index (GII). No evidence was found of a positive relationship between gender inequality and HIV prevalence, either in the analyses of all developing countries or those limited to Africa. In the bivariate analyses limited to Africa, there was a positive association between the two measures of gender "equality" and peak HIV prevalence (GDI: coefficient 28, 95% confidence interval (CI) 9.1-46.8; GEM: coefficient 54.8, 95% CI 20.5-89.1). There was also a negative association between the marker of gender "inequality" and peak HIV prevalence (GII: coefficient -66.9, 95% CI -112.8 to -21.0). These associations all disappeared on multivariate analyses. We could not find any evidence to support the hypothesis that variations in the extent of gender inequality explain variations in HIV prevalence in developing countries. PMID:25279690

  2. Solid waste management for climate change policy in industrial countries, newly industrialized countries, and developing countries

    SciTech Connect

    Horng, J.J.

    1996-12-31

    Although the First FCCC COP did not reach agreement on controlling greenhouse gases, the intention of international society on limiting climate change problems is obvious. Among the important greenhouse gases of CO{sub 2}, CH{sub 4}, and N{sub 2}O, the control of CO{sub 2} emission is more important for industrial countries than for the others due to their large emission. The CO{sub 2} reduction for export-oriented NICs (Newly Industrialized Countries) is a growth-limited or -killing policy that will severely hurt the national economics and will be carefully evaluated before taking any action. On the other hand, the reduction of methane emission by proper managing solid wastes, especially landfills, stands for good short- and long-term investments for NICs and developing countries. A 50 to 90% CH{sub 4} recovery from landfill is feasible and profitable, but the methane recovery technology or capital cost needs to come from industrial countries. Taking the example in Taiwan, more than 60% of methane emission is from landfills. A medium 50% reduction can contribute to more than 5% reduction of CO{sub 2} equivalent basis on global warming potentials (GWPs). However, the landfill gas recovery program is still under demonstration without actual applications.

  3. Prevalence of asthma symptoms in schoolchildren, and climate in west European countries: an ecologic study

    NASA Astrophysics Data System (ADS)

    Arnedo-Pena, Alberto; García-Marcos, Luis; Bercedo-Sanz, Alberto; Aguinaga-Ontoso, Inés; González-Díaz, Carlos; García-Merino, Águeda; Busquets-Monge, Rosa; Suárez-Varela, Maria Morales; Batlles-Garrido, Juan; Blanco-Quirós, Alfredo A.; López-Silvarrey, Angel; García-Hernández, Gloria; Fuertes, Jorge

    2013-09-01

    The aim of the present study was to estimate the associations between the prevalence of asthma symptoms in schoolchildren and meteorological variables in west European countries that participated in the International Study of Asthma and Allergies in Children (ISAAC), Phase III 1997-2003. An ecologic study was carried out. The prevalence of asthma was obtained from this study from 48 centers in 14 countries, and meteorological variables from those stations closest to ISAAC centers, together with other socioeconomic and health care variables. Multilevel mixed-effects linear regression models were used. For schoolchildren aged 6-7 years, the prevalence rate of asthma decreased with an increase in mean annual sunshine hours, showed a positive association with rainy weather, and warm temperature, and a negative one with relative humidity and physician density (PD). Current wheeze prevalence was stronger in autumn/winter seasons and decreased with increasing PD. Severe current wheeze decreased with PD. For schoolchildren aged 13-14 years, the prevalence rates of asthma and current wheeze increased with rainy weather, and these rates decreased with increased PD. Current wheeze, as measured by a video questionnaire, was inversely associated with sunny weather, and nurse density. Severe current wheeze prevalence was stronger during autumn/winter seasons, decreased with PD, and indoor chlorinated public swimming pool density, and increased with rainy weather. Meteorological factors, including sunny and rainy weather, and PD may have some effect on the prevalence rates of asthma symptoms in children from west European countries.

  4. Prevalence of asthma symptoms in schoolchildren, and climate in west European countries: an ecologic study.

    PubMed

    Arnedo-Pena, Alberto; García-Marcos, Luis; Bercedo-Sanz, Alberto; Aguinaga-Ontoso, Inés; González-Díaz, Carlos; García-Merino, Agueda; Busquets-Monge, Rosa; Suárez-Varela, Maria Morales; Batlles-Garrido, Juan; Blanco-Quirós, Alfredo A; López-Silvarrey, Angel; García-Hernández, Gloria; Fuertes, Jorge

    2013-09-01

    The aim of the present study was to estimate the associations between the prevalence of asthma symptoms in schoolchildren and meteorological variables in west European countries that participated in the International Study of Asthma and Allergies in Children (ISAAC), Phase III 1997-2003. An ecologic study was carried out. The prevalence of asthma was obtained from this study from 48 centers in 14 countries, and meteorological variables from those stations closest to ISAAC centers, together with other socioeconomic and health care variables. Multilevel mixed-effects linear regression models were used. For schoolchildren aged 6-7 years, the prevalence rate of asthma decreased with an increase in mean annual sunshine hours, showed a positive association with rainy weather, and warm temperature, and a negative one with relative humidity and physician density (PD). Current wheeze prevalence was stronger in autumn/winter seasons and decreased with increasing PD. Severe current wheeze decreased with PD. For schoolchildren aged 13-14 years, the prevalence rates of asthma and current wheeze increased with rainy weather, and these rates decreased with increased PD. Current wheeze, as measured by a video questionnaire, was inversely associated with sunny weather, and nurse density. Severe current wheeze prevalence was stronger during autumn/winter seasons, decreased with PD, and indoor chlorinated public swimming pool density, and increased with rainy weather. Meteorological factors, including sunny and rainy weather, and PD may have some effect on the prevalence rates of asthma symptoms in children from west European countries. PMID:23152194

  5. Intimate partner violence during pregnancy: analysis of prevalence data from 19 countries.

    PubMed

    Devries, Karen M; Kishor, Sunita; Johnson, Holly; Stöckl, Heidi; Bacchus, Loraine J; Garcia-Moreno, Claudia; Watts, Charlotte

    2010-11-01

    We aimed to describe the prevalence of intimate partner violence (IPV) during pregnancy across 19 countries, and examine trends across age groups and UN regions. We conducted a secondary analysis of data from the Demographic and Health Surveys (20 surveys from 15 countries) and the International Violence Against Women Surveys (4 surveys from 4 countries) carried out between 1998 and 2007. Our data suggest that intimate partner violence during a pregnancy is a common experience. The prevalence of IPV during pregnancy ranged from approximately 2.0% in Australia, Cambodia, Denmark and the Philippines to 13.5% in Uganda among ever-pregnant, ever-partnered women; half of the surveys estimated prevalence to be between 3.9 and 8.7%. Prevalence appeared to be higher in African and Latin American countries relative to the European and Asian countries surveyed. In most settings, prevalence was relatively constant in the younger age groups (age 15-35), and then appeared to decline very slightly after age 35. Intimate partner violence during pregnancy is more common than some maternal health conditions routinely screened for in antenatal care. Global initiatives to reduce maternal mortality and improve maternal health must devote increased attention to violence against women, particularly violence during pregnancy. PMID:21111360

  6. Sustainable sludge management in developing countries.

    PubMed

    Jimenez, B; Barrios, J A; Mendez, J M; Diaz, J

    2004-01-01

    Worldwide, unsanitary conditions are responsible for more than three million deaths annually. One of the reasons is the low level of sanitation in developing countries. Particularly, sludge from these regions has a high parasite concentration and low heavy metal content even though the available information is limited. Different issues needed to achieve a sustainable sludge management in developing nations are analysed. Based on this analysis some conclusions arise: sludge management plays an important role in sanitation programs by helping reduce health problems and associated risks; investments in sanitation should consider sludge management within the overall projects; the main restriction for reusing sludge is the high microbial concentration, which requires a science-based decision on the treatment process, while heavy metals are generally low; adequate sludge management needs the commitment of those sectors involved in the development and enforcement of the regulations as well as those that are directly related to its generation, treatment, reuse or disposal; current regulations have followed different approaches, based mainly on local conditions, but they favour sludge reuse to fight problems like soil degradation, reduced crop production, and the increased use of inorganic fertilizers. This paper summarises an overview of these issues. PMID:15259962

  7. Estimating Contraceptive Prevalence Using Logistics Data for Short-Acting Methods: Analysis Across 30 Countries

    PubMed Central

    Cunningham, Marc; Brown, Niquelle; Sacher, Suzy; Hatch, Benjamin; Inglis, Andrew; Aronovich, Dana

    2015-01-01

    Background: Contraceptive prevalence rate (CPR) is a vital indicator used by country governments, international donors, and other stakeholders for measuring progress in family planning programs against country targets and global initiatives as well as for estimating health outcomes. Because of the need for more frequent CPR estimates than population-based surveys currently provide, alternative approaches for estimating CPRs are being explored, including using contraceptive logistics data. Methods: Using data from the Demographic and Health Surveys (DHS) in 30 countries, population data from the United States Census Bureau International Database, and logistics data from the Procurement Planning and Monitoring Report (PPMR) and the Pipeline Monitoring and Procurement Planning System (PipeLine), we developed and evaluated 3 models to generate country-level, public-sector contraceptive prevalence estimates for injectable contraceptives, oral contraceptives, and male condoms. Models included: direct estimation through existing couple-years of protection (CYP) conversion factors, bivariate linear regression, and multivariate linear regression. Model evaluation consisted of comparing the referent DHS prevalence rates for each short-acting method with the model-generated prevalence rate using multiple metrics, including mean absolute error and proportion of countries where the modeled prevalence rate for each method was within 1, 2, or 5 percentage points of the DHS referent value. Results: For the methods studied, family planning use estimates from public-sector logistics data were correlated with those from the DHS, validating the quality and accuracy of current public-sector logistics data. Logistics data for oral and injectable contraceptives were significantly associated (P<.05) with the referent DHS values for both bivariate and multivariate models. For condoms, however, that association was only significant for the bivariate model. With the exception of the CYP

  8. The Hospital Management of Fatal Self-Poisoning in Industrialized Countries: An Opportunity for Suicide Prevention?

    ERIC Educational Resources Information Center

    Kapur, Navneet; Turnbull, Pauline; Hawton, Keith; Simkin, Sue; Mackway-Jones, Kevin; Gunnell, David

    2006-01-01

    Suicide by self-poisoning is a prevalent cause of death worldwide. A substantial proportion of individuals who poison themselves come into contact with medical services before they die. Our focus in the current study was the medical management of drug self-poisoning in industrialized countries and its possible contribution to suicide prevention.…

  9. Comparing epidemic forecasts for European countries obtained from AIDS incidence and HIV prevalence data

    NASA Astrophysics Data System (ADS)

    Smith, Phillip W.; Thomas, Richard

    2005-12-01

    Previously, the diffusion of HIV/AIDS among the countries of Europe has been reconstructed using a multiregion epidemic modelling system (Thomas 2000; Smith and Thomas 2001). This model was calibrated to WHO AIDS incidence series for each country which, in most instances, were replicated with a high degree of fit. The size of the epidemic implied by this procedure, however, did not conform to point estimates of cumulative HIV prevalence which indicate an eventual size at least three times greater than that attributable to recorded AIDS cases. This paper, therefore, investigates the consequences of this discrepancy for the space time structure that is estimated for the epidemic in Europe. The first part considers how the modelling system is adapted to take account of national HIV statistics. To this end, an optimisation method is described for identifying disease transmission rates that are consistent with current cumulative HIV prevalence in each country. This method generates a range of feasible solutions where the eventual size of the epidemic is inversely related to this infectivity rate. The second part derives multiregion simulations for European countries using parameter sets calibrated according to both AIDS incidence and HIV prevalence. The outputs for each set include the predicted starting pathway of the epidemic together with a graph recording the direction of the principal infection vector for each country at the forecast time of peak HIV prevalence. For AIDS based scenarios, the diffusion of the epidemic generally flows across Europe from west to east. In contrast, for HIV scenarios at peak prevalence the direction of flow is partially reversed from east to west. The discussion considers the implications of these findings for disease control in the light of issues concerning the recording of HIV and AIDS statistics.

  10. Prevalence of Gastrointestinal Pathogens In Developed and Developing Countries: Systematic Review and Meta-Analysis

    PubMed Central

    Fletcher, Stephanie M.; McLaws, Mary-Louise; Ellis, John T.

    2013-01-01

    Diarrhoeal illness is a leading cause of child mortality and morbidity worldwide. There are no precise or current estimates of the types and prevalence of pathogens associated with diarrheal illnesses in developed and developing settings. This systematic review assessed data from 60 studies published in the English language from five developing regions and developed countries worldwide to provide regional estimates of enteric pathogens affecting children. The random-effect method was used to establish the weighted average prevalence of pathogens in adults and children for each region. Significantly more pathogens were reported by studies from developing regions compared with Organisation for Economic Co-operation and Development countries (P<0.016). The identification rates of pathogens from community based and hospital based studies were similar (58.5% and 58.1% respectively, P<0.619). The overall detection of enteric pathogens in developing countries was higher in adults (74.8%; 95% CI 63.1-83.8%) compared with children (56.7%; 95% CI 53.0-60.4%) (P<0.001). Rotavirus was the most frequently detected pathogen in all regions with the highest rate, 24.8% (95% CI 18.0-33.1%), detected in the developed countries. This systematic review is the first to provide an estimate of the prevalence of enteric pathogens associated with diarrhoeal illnesses in adults and children in developed and developing settings. While pathogen detection rate is greater in developing regions the consistently high prevalence of rotavirus in both developed and developing settings underscores the urgent need for access to rotavirus vaccines. Increased travel between developing and developed countries increases disease risk, and hence developed countries have a vested interest in supporting vaccine accessibility in developing settings. PMID:25170480

  11. Radioactive waste management approaches for developed countries

    SciTech Connect

    Patricia Paviet-Hartmann; Anthony Hechanova; Catherine Riddle

    2013-07-01

    Nuclear power has demonstrated over the last 30 years its capacity to produce base-load electricity at a low, predictable and stable cost due to the very low economic dependence on the price of uranium. However the management of used nuclear fuel remains the “Achilles’ Heel” of this energy source since the storage of used nuclear fuel is increasing as evidenced by the following number with 2,000 tons of UNF produced each year by the 104 US nuclear reactor units which equates to a total of 62,000 spent fuel assemblies stored in dry cask and 88,000 stored in pools. Two options adopted by several countries will be presented. The first one adopted by Europe, Japan and Russia consists of recycling the used nuclear fuel after irradiation in a nuclear reactor. Ninety six percent of uranium and plutonium contained in the spent fuel could be reused to produce electricity and are worth recycling. The separation of uranium and plutonium from the wastes is realized through the industrial PUREX process so that they can be recycled for re-use in a nuclear reactor as a mixed oxide (MOX) fuel. The second option undertaken by Finland, Sweden and the United States implies the direct disposal of used nuclear fuel into a geologic formation. One has to remind that only 30% of the worldwide used nuclear fuel are currently recycled, the larger part being stored (70% in pool) waiting for scientific or political decisions. A third option is emerging with a closed fuel cycle which will improve the global sustainability of nuclear energy. This option will not only decrease the volume amount of nuclear waste but also the long-term radiotoxicity of the final waste, as well as improving the long-term safety and the heat-loading of the final repository. At the present time, numerous countries are focusing on the R&D recycling activities of the ultimate waste composed of fission products and minor actinides (americium and curium). Several new chemical extraction processes, such as TRUSPEAK

  12. High Prevalence of Biocide Resistance Determinants in Staphylococcus aureus Isolates from Three African Countries

    PubMed Central

    Conceição, Teresa; Coelho, Céline; de Lencastre, Hermínia

    2015-01-01

    We assessed the prevalence of six biocide resistance genes among 82 methicillin-resistant Staphylococcus aureus (MRSA) and 219 methicillin-susceptible S. aureus (MSSA) isolates from three African countries; the prevalence was very high for sepA (95.3%), mepA (89.4%), and norA (86.4%), intermediate for lmrS (60.8%) and qacAB (40.5%), and low for smr (3.7%). A significant association between biocide resistance genes and antibiotic resistance was observed, and a new cutoff MIC of ≥1 mg/liter for chlorhexidine nonsusceptibility was defined. PMID:26552979

  13. High Prevalence of Biocide Resistance Determinants in Staphylococcus aureus Isolates from Three African Countries.

    PubMed

    Conceição, Teresa; Coelho, Céline; de Lencastre, Hermínia; Aires-de-Sousa, Marta

    2016-01-01

    We assessed the prevalence of six biocide resistance genes among 82 methicillin-resistant Staphylococcus aureus (MRSA) and 219 methicillin-susceptible S. aureus (MSSA) isolates from three African countries; the prevalence was very high for sepA (95.3%), mepA (89.4%), and norA (86.4%), intermediate for lmrS (60.8%) and qacAB (40.5%), and low for smr (3.7%). A significant association between biocide resistance genes and antibiotic resistance was observed, and a new cutoff MIC of ≥1 mg/liter for chlorhexidine nonsusceptibility was defined. PMID:26552979

  14. Strongyloidiasis—An Insight into Its Global Prevalence and Management

    PubMed Central

    Puthiyakunnon, Santhosh; Boddu, Swapna; Li, Yiji; Zhou, Xiaohong; Wang, Chunmei; Li, Juan; Chen, Xiaoguang

    2014-01-01

    Background Strongyloides stercoralis, an intestinal parasitic nematode, infects more than 100 million people worldwide. Strongyloides are unique in their ability to exist as a free-living and autoinfective cycle. Strongyloidiasis can occur without any symptoms or as a potentially fatal hyperinfection or disseminated infection. The most common risk factors for these complications are immunosuppression caused by corticosteroids and infection with human T-lymphotropic virus or human immunodeficiency virus. Even though the diagnosis of strongyloidiasis is improved by advanced instrumentation techniques in isolated and complicated cases of hyperinfection or dissemination, efficient guidelines for screening the population in epidemiological surveys are lacking. Methodology and Results In this review, we have discussed various conventional methods for the diagnosis and management of this disease, with an emphasis on recently developed molecular and serological methods that could be implemented to establish guidelines for precise diagnosis of infection in patients and screening in epidemiological surveys. A comprehensive analysis of various cases reported worldwide from different endemic and nonendemic foci of the disease for the last 40 years was evaluated in an effort to delineate the global prevalence of this disease. We also updated the current knowledge of the various clinical spectrum of this parasitic disease, with an emphasis on newer molecular diagnostic methods, treatment, and management of cases in immunosuppressed patients. Conclusion Strongyloidiasis is considered a neglected tropical disease and is probably an underdiagnosed parasitic disease due to its low parasitic load and uncertain clinical symptoms. Increased infectivity rates in many developed countries and nonendemic regions nearing those in the most prevalent endemic regions of this parasite and the increasing transmission potential to immigrants, travelers, and immunosuppressed populations are

  15. Prevalence and predictors for musculoskeletal discomfort in Malaysian office workers: Investigating explanatory factors for a developing country.

    PubMed

    Maakip, Ismail; Keegel, Tessa; Oakman, Jodi

    2016-03-01

    Musculoskeletal disorders (MSDs) are a major occupational health issue for workers in developed and developing countries, including Malaysia. Most research related to MSDs has been undertaken in developed countries; given the different regulatory and cultural practices it is plausible that contributions of hazard and risk factors may be different. A population of Malaysian public service office workers were surveyed (N = 417, 65.5% response rate) to determine prevalence and associated predictors of MSD discomfort. The 6-month period prevalence of MSD discomfort was 92.8% (95%CI = 90.2-95.2%). Akaike's Information Criterion (AIC) analyses was used to compare a range of models and determine a model of best fit. Contributions associated with MSD discomfort in the final model consisted of physical demands (61%), workload (14%), gender (13%), work-home balance (9%) and psychosocial factors (3%). Factors associated with MSD discomfort were similar in developed and developing countries but the relative contribution of factors was different, providing insight into future development of risk management strategies. PMID:26499952

  16. Prevalence of Child Sexual Abuse in the Nordic Countries: A Literature Review.

    PubMed

    Kloppen, Kathrine; Haugland, Siren; Svedin, Carl Göran; Mæhle, Magne; Breivik, Kyrre

    2016-01-01

    This review examined child sexual abuse in the Nordic countries focusing on prevalence rates and victims' age and relationship to the perpetrator. The results show a prevalence of child sexual abuse (broadly defined) between 3-23% for boys and 11-36% for girls. The prevalence rates for contact abuse were 1-12% for boys and 6-30% for girls, while 0.3-6.8% of the boys and 1.1-13.5% of the girls reported penetrating abuse. The findings suggest an increased risk of abuse from early adolescence. In adolescence, peers may constitute the largest group of perpetrators. The results highlight the need for preventive efforts also targeting peer abuse. Future research should include cross-national and repeated studies using comparable methodology. PMID:26809050

  17. Prevalence of Overweight/Obesity and Its Associated Factors among University Students from 22 Countries

    PubMed Central

    Peltzer, Karl; Pengpid, Supa; Samuels, T. Alafia; Özcan, Neslihan Keser; Mantilla, Carolina; Rahamefy, Onja H.; Wong, Mee Lian; Gasparishvili, Alexander

    2014-01-01

    Obesity among young people increases lifetime cardiovascular risk. This study assesses the prevalence of overweight/obesity and its associated factors among a random sample of university students from 22 universities in 22 low, middle income and emerging economy countries. This cross-sectional survey comprised of a self-administered questionnaire and collected anthropometric measurements. The study population was 6773 (43.2%) males and 8913 (56.8%) females, aged 16 to 30 years (mean 20.8 years, SD = 2.6). Body mass index (BMI) was used for weight status. Among men, the prevalence of underweight was 10.8%, normal weight 64.4%, overweight 18.9% and obesity 5.8%, while among women, the prevalence of underweight was 17.6%, normal weight 62.1%, overweight 14.1% and obesity 5.2%. Overall, 22% were overweight or obese (24.7% men and 19.3% women). In multivariate regression among men, younger age, coming from a higher income country, consciously avoiding fat and cholesterol, physically inactivity, current tobacco use and childhood physical abuse, and among women older age, coming from a higher income country, frequent organized religious activity, avoiding fat and cholesterol, posttraumatic stress symptoms and physical childhood abuse were associated overweight or obesity. Several gender specific risk factors identified can be utilized in health promotion programmes. PMID:25050651

  18. Prevalence of overweight/obesity and its associated factors among university students from 22 countries.

    PubMed

    Peltzer, Karl; Pengpid, Supa; Samuels, T Alafia; Özcan, Neslihan Keser; Mantilla, Carolina; Rahamefy, Onja H; Wong, Mee Lian; Gasparishvili, Alexander

    2014-07-01

    Obesity among young people increases lifetime cardiovascular risk. This study assesses the prevalence of overweight/obesity and its associated factors among a random sample of university students from 22 universities in 22 low, middle income and emerging economy countries. This cross-sectional survey comprised of a self-administered questionnaire and collected anthropometric measurements. The study population was 6773 (43.2%) males and 8913 (56.8%) females, aged 16 to 30 years (mean 20.8 years, SD = 2.6). Body mass index (BMI) was used for weight status. Among men, the prevalence of underweight was 10.8%, normal weight 64.4%, overweight 18.9% and obesity 5.8%, while among women, the prevalence of underweight was 17.6%, normal weight 62.1%, overweight 14.1% and obesity 5.2%. Overall, 22% were overweight or obese (24.7% men and 19.3% women). In multivariate regression among men, younger age, coming from a higher income country, consciously avoiding fat and cholesterol, physically inactivity, current tobacco use and childhood physical abuse, and among women older age, coming from a higher income country, frequent organized religious activity, avoiding fat and cholesterol, posttraumatic stress symptoms and physical childhood abuse were associated overweight or obesity. Several gender specific risk factors identified can be utilized in health promotion programmes. PMID:25050651

  19. The Project Manager Who Saved His Country

    NASA Technical Reports Server (NTRS)

    Baniszewski, John

    2008-01-01

    George Meade defeated Robert E. Lee, one of the greatest military leaders of all time. How did he do it? By using the skills he had learned as a project manager and outperforming Lee in all aspects of project management. Most project managers are familiar with the Project Management Institute's "Guide to the Project Management Body of Knowledge" (PMBOK), which identifies the skills and knowledge crucial to successful project management. Project managers need to make sure that all the elements of a project work together. They must develop and execute plans and coordinate changes to those plans. A project manager must define the scope of the work, break it into manageable pieces, verify and control what work is being done, and make sure that the work being done is essential to the project. Every project manager knows the challenges of schedule and the value of schedule slack. Project managers must get the resources they need and use them effectively. Project managers get the people they need and use their talents to achieve mission success. Projects generate huge amounts of information. A key to project success is getting sufficient and accurate information to the people who need it when they need it. Project managers must identify and quantify the risks that jeopardize project success and make plans for dealing with them. Studying Meade and Lee's performances at Gettysburg can help modern project managers appreciate, develop, and use the skills they need to be good project managers. The circumstances may be different, but the basic principles are the same. This dramatic event in American history shows how the skills of project management can be used in almost any situation. Former project manager George Meade used those skills to change the tide of the Civil War.

  20. Decreasing prevalence of cigarette smoking in the middle income country of Mauritius: questionnaire survey

    PubMed Central

    Cox, Helen S; Williams, Joanne W; de Courten, Maximilian P; Chitson, Pierrot; Tuomilehto, Jaakko; Zimmet, Paul Z

    2000-01-01

    Objectives To describe changes in the prevalence of cigarette smoking in the middle income country of Mauritius from 1987 to 1998, and to relate these changes to legislative and health promotion efforts over the same period. Design Questionnaire survey. Setting Mauritius, an island in the Indian Ocean with a population of about 1.2 million (about 70% south Asian, 2% Chinese, and 28% Creole). Participants Data were obtained from 5072 participants in 1987, 6573 in 1992, and 6281 in 1998. Main outcome measures Prevalence of current smoking in 1987, 1992, and 1998, sales of cigarettes in Mauritius, and information on activities for control of tobacco. Results Self reported cigarette smoking has been decreasing in Mauritius since 1987, with the largest decrease between 1987 and 1992. From 1987 to 1998 smoking prevalence decreased by 23% in men and 61% in women. Smoking decreased across all age and ethnic groups and across different levels of income and education. Sales of cigarettes also decreased in line with smoking prevalence. Conclusions The introduction of cigarette taxes, a limited health promotion programme, and the absence of massive promotional campaigns by the sole tobacco company on Mauritius have led to a striking and continued decrease in smoking prevalence and cigarette consumption on the island. PMID:10926592

  1. Systematic review of the birth prevalence of congenital cytomegalovirus infection in developing countries

    PubMed Central

    Lanzieri, Tatiana M.; Dollard, Sheila C.; Bialek, Stephanie R.; Grosse, Scott D.

    2016-01-01

    Summary Background Congenital cytomegalovirus (CMV) infection is the leading infectious cause of congenital hearing loss and neurodevelopmental disability in developed countries. Information on congenital CMV infection in developing countries appears to be lacking. Methods We conducted a systematic literature review to identify studies from developing countries with population-based samples of at least 300 infants that used laboratory methods established as reliable for the diagnosis of congenital CMV infection. Results Most studies were excluded due to biased samples or inadequate diagnostic methods; consequently the search identified just 11 studies that were from Africa, Asia, and Latin America. The number of newborns tested ranged from 317 to 12 195. Maternal CMV seroprevalence ranged from 84% to 100%. CMV birth prevalence varied from 0.6% to 6.1%. CMV-associated impairments were not documented in most studies. Conclusions Birth prevalence ranges were higher than for Europe and North America, as expected based on the higher maternal CMV seroprevalence. With very limited data available on sequelae, the disease burden of congenital CMV in developing countries remains largely unknown at this time. PMID:24631522

  2. Radioactive Waste Management in Non-Nuclear Countries - 13070

    SciTech Connect

    Kubelka, Dragan; Trifunovic, Dejan

    2013-07-01

    This paper challenges internationally accepted concepts of dissemination of responsibilities between all stakeholders involved in national radioactive waste management infrastructure in the countries without nuclear power program. Mainly it concerns countries classified as class A and potentially B countries according to International Atomic Energy Agency. It will be shown that in such countries long term sustainability of national radioactive waste management infrastructure is very sensitive issue that can be addressed by involving regulatory body in more active way in the infrastructure. In that way countries can mitigate possible consequences on the very sensitive open market of radioactive waste management services, comprised mainly of radioactive waste generators, operators of end-life management facilities and regulatory body. (authors)

  3. Challenges for lupus management in emerging countries.

    PubMed

    Tazi Mezalek, Zoubida; Bono, Wafaa

    2014-06-01

    In emerging countries, systemic lupus erythematosus (SLE) has been associated with several unfavorable outcomes including disease activity, damage accrual, work disability and mortality. Poor socioeconomic status (SES) and lack of access to healthcare, especially in medically underserved communities, may be responsible for many of the observed disparities. Diagnostic delay of SLE or for severe organ damages (renal involvement) have a negative impact on those adverse outcomes in lupus patients who either belong to minority groups or live in emerging countries. Longitudinal and observational prospective studies and registries may help to identify the factors that influence poor SLE outcomes in emerging countries. Infection is an important cause of mortality and morbidity in SLE, particularly in low SES patients and tuberculosis appears to be frequent in SLE patients living in endemic areas (mainly emerging countries). Thus, tuberculosis screening should be systematically performed and prophylaxis discussed for patients from these areas. SLE treatment in the developing world is restricted by the availability and cost of some immunosuppressive drugs. Moreover, poor adherence has been associated to bad outcomes in lupus patients with a higher risk of flares, morbidity, hospitalization, and poor renal prognosis. Low education and the lack of money are identified as the main barrier to improve lupus prognosis. Newer therapeutic agents and new protocols had contributed to improve survival in SLE. The use of corticoid-sparing agents (hydroxychloroquine, methotrexate, azathioprine and mycophenolate mofetif) is one of the most useful strategy; availability of inexpensive generics may help to optimize access to these medications. PMID:24857588

  4. Prevalence of rheumatoid arthritis in low– and middle–income countries: A systematic review and analysis

    PubMed Central

    Rudan, Igor; Sidhu, Simrita; Papana, Angeliki; Meng, Shi–Jiao; Xin–Wei, Yu; Wang, Wei; Campbell–Page, Ruth M.; Demaio, Alessandro Rhyll; Nair, Harish; Sridhar, Devi; Theodoratou, Evropi; Dowman, Ben; Adeloye, Davies; Majeed, Azeem; Car, Josip; Campbell, Harry; Wang, Wei; Chan, Kit Yee

    2015-01-01

    Background Rheumatoid arthritis (RA) is an autoimmune disorder that affects the small joints of the body. It is one of the leading causes of chronic morbidity in high–income countries, but little is known about the burden of this disease in low– and middle–income countries (LMIC). Methods The aim of this study was to estimate the prevalence of RA in six of the World Health Organization's (WHO) regions that harbour LMIC by identifying all relevant studies in those regions. To accomplish this aim various bibliographic databases were searched: PubMed, EMBASE, Global Health, LILACS and the Chinese databases CNKI and WanFang. Studies were selected based on pre–defined inclusion criteria, including a definition of RA based on the 1987 revision of the American College of Rheumatology (ACR) definition. Results Meta–estimates of regional RA prevalence rates for countries of low or middle income were 0.40% (95% CI: 0.23–0.57%) for Southeast Asian, 0.37% (95% CI: 0.23–0.51%) for Eastern Mediterranean, 0.62% (95% CI: 0.47–0.77%) for European, 1.25% (95% CI: 0.64–1.86%) for American and 0.42% (95% CI: 0.30–0.53%) for Western Pacific regions. A formal meta–analysis could not be performed for the sub–Saharan African region due to limited data. Male prevalence of RA in LMIC was 0.16% (95% CI: 0.11–0.20%) while the prevalence in women reached 0.75% (95% CI: 0.60–0.90%). This difference between males and females was statistically significant (P < 0.0001). The prevalence of RA did not differ significantly between urban and rural settings (P = 0.353). These prevalence estimates represent 2.60 (95% CI: 1.85–3.34%) million male sufferers and 12.21 (95% CI: 9.78–14.67%) million female sufferers in LMIC in the year 2000, and 3.16 (95% CI: 2.25–4.05%) million affected males and 14.87 (95% CI: 11.91–17.86%) million affected females in LMIC in the year 2010. Conclusion Given that majority of the world’s population resides in LMIC, the number of

  5. Prevalence of alcohol, illicit drugs and psychoactive medicines in killed drivers in four European countries.

    PubMed

    Legrand, Sara-Ann; Gjerde, Hallvard; Isalberti, Cristina; Van der Linden, Trudy; Lillsunde, Pirjo; Dias, Mario J; Gustafsson, Susanne; Ceder, Gunnel; Verstraete, Alain G

    2014-01-01

    Our objective was to determine the presence of psychoactive substances in blood of drivers killed in road crashes in four European countries. Data from 1118 drivers of car and vans, killed between 2006 and 2009, were collected in Finland, Norway, Portugal and Sweden. The prevalence of any psychoactive substance ranged between 31 and 48%. Alcohol (≥ 0.1 g/L) was the most common finding, 87% had a blood alcohol concentration (BAC) ≥ .5 g/L. Benzodiazepines (1.8-13.3%) and amphetamines (0-7.4%) were the most prevalent psychoactive medicines and illicit drugs, respectively. Alcohol-drug and drug-drug combinations were rather prevalent. Differences in alcohol/drug findings seemed to reflect differences in use in the countries. More research should be done to develop preventive strategies to reduce the number of alcohol- and drug-related traffic accidents targeting at-risk groups, such as drivers with very high BACs and novice drivers. PMID:23297822

  6. Prevalence of sexual violence against children and use of social services - seven countries, 2007-2013.

    PubMed

    Sumner, Steven A; Mercy, Ames A; Saul, Janet; Motsa-Nzuza, Nozipho; Kwesigabo, Gideon; Buluma, Robert; Marcelin, Louis H; Lina, Hang; Shawa, Mary; Moloney-Kitts, Michele; Kilbane, Theresa; Sommarin, Clara; Ligiero, Daniela P; Brookmeyer, Kathryn; Chiang, Laura; Lea, Veronica; Lee, Juliette; Kress, Howard; Hillis, Susan D

    2015-06-01

    Sexual violence against children erodes the strong foundation that children require for leading healthy and productive lives. Globally, studies show that exposure to violence during childhood can increase vulnerability to a broad range of mental and physical health problems, ranging from depression and unwanted pregnancy to cardiovascular disease, diabetes, and sexually transmitted diseases, including human immunodeficiency virus (HIV). Despite this, in many countries, the extent of sexual violence against children is unknown; estimates are needed to stimulate prevention and response efforts and to monitor progress. Consequently, CDC, as a member of the global public-private partnership known as Together for Girls, collaborated with Cambodia, Haiti, Kenya, Malawi, Swaziland, Tanzania, and Zimbabwe to conduct national household surveys of children and youth aged 13-24 years to measure the extent of violence against children. The lifetime prevalence of experiencing any form of sexual violence in childhood ranged from 4.4% among females in Cambodia to 37.6% among females in Swaziland, with prevalence in most countries greater than 25.0%. In most countries surveyed, the proportion of victims that received services, including health and child protective services, was ≤10.0%. Both prevention and response strategies for sexual violence are needed. PMID:26042646

  7. The recent decline in prevalence of dementia in developed countries: implications for prevention in the Republic of Korea.

    PubMed

    Lee, Yunhwan

    2014-07-01

    With the rapid aging of the population in Korea, the number of older people with dementia is projected to increase, forecasting an epidemic of dementia. Recent trends in dementia in several western countries, however, depict a gradual decline in prevalence and incidence. This decrease has been attributed to an improvement in education and living environments, engagement in healthy behaviors, and reduction in the prevalence of vascular risk factors. In Korea, however, trends in modifiable risk factors do not favor an optimistic outlook due to the continuous increase in the prevalence of hypertension, diabetes mellitus, and obesity. Given these observations, there is much to be gained through the promotion of healthy lifestyles. Moreover, public health resources need to be directed toward the provision of health promotion and preventive services, control and management of vascular risk factors, and improvement in the standard of living. Nationwide initiatives to develop and implement policies and strategies to protect cognitive health throughout the lifespan should be considered a public health priority. PMID:25045222

  8. Ethnic identity, region, and attitudes toward male circumcision in a high HIV–prevalence country

    PubMed Central

    Poulin, Michelle

    2013-01-01

    We study how considerations of male circumcision as both a favourable practice and as protective against HIV are linked with ethnicity in sub-Saharan Africa, where many ethnic groups do not traditionally circumcise. We focus on Malawi, a country with a high HIV prevalence but low male circumcision prevalence. Survey data from a population-based random sample in rural Malawi (N=3400) was analysed for ethnoregional patterns in attitudes toward male circumcision. We used logit regression models to measure how reported circumcision status, region of residence, and ethnic identity relate to attitudes toward circumcision. Overall, Malawians reported more negative than positive opinions about male circumcision, but attitudes toward circumcision varied by ethnicity and region. The implications for agencies and governments aggressively scaling up the provision of male circumcision are clear: acceptance of circumcision as a tool for HIV prevention could be low in societies divided by ethnoregional identities that also shape the practice of circumcision. PMID:23731239

  9. Systems approaches to integrated solid waste management in developing countries

    SciTech Connect

    Marshall, Rachael E.; Farahbakhsh, Khosrow

    2013-04-15

    Highlights: ► Five drivers led developed countries to current solid waste management paradigm. ► Many unique factors challenge developing country solid waste management. ► Limited transferability of developed country approaches to developing countries. ► High uncertainties and decision stakes call for post-normal approaches. ► Systems thinking needed for multi-scale, self-organizing eco-social waste systems. - Abstract: Solid waste management (SWM) has become an issue of increasing global concern as urban populations continue to rise and consumption patterns change. The health and environmental implications associated with SWM are mounting in urgency, particularly in the context of developing countries. While systems analyses largely targeting well-defined, engineered systems have been used to help SWM agencies in industrialized countries since the 1960s, collection and removal dominate the SWM sector in developing countries. This review contrasts the history and current paradigms of SWM practices and policies in industrialized countries with the current challenges and complexities faced in developing country SWM. In industrialized countries, public health, environment, resource scarcity, climate change, and public awareness and participation have acted as SWM drivers towards the current paradigm of integrated SWM. However, urbanization, inequality, and economic growth; cultural and socio-economic aspects; policy, governance, and institutional issues; and international influences have complicated SWM in developing countries. This has limited the applicability of approaches that were successful along the SWM development trajectories of industrialized countries. This review demonstrates the importance of founding new SWM approaches for developing country contexts in post-normal science and complex, adaptive systems thinking.

  10. Shared Sanitation and the Prevalence of Diarrhea in Young Children: Evidence from 51 Countries, 2001–2011

    PubMed Central

    Fuller, James A.; Clasen, Thomas; Heijnen, Marieke; Eisenberg, Joseph N. S.

    2014-01-01

    Shared sanitation is defined as unimproved because of concerns that it creates unsanitary conditions; this policy is being reconsidered. We assessed whether sharing a toilet facility was associated with an increased prevalence of diarrhea among children < 5 years of age. We use data from Demographic and Health Surveys conducted in 51 countries. Crude and adjusted prevalence ratios (PRs) for diarrhea, comparing children from households that used a shared facility with children from households that used a non-shared facility, were estimated for each country and pooled across countries. Unadjusted PRs varied across countries, ranging from 2.15 to 0.65. The pooled PR was 1.09; differences in socioeconomic status explained approximately half of this increased prevalence (adjusted PR = 1.05). Shared sanitation appears to be a risk factor for diarrhea although differences in socioeconomic status are important. The heterogeneity across countries, however, suggests that the social and economic context is an important factor. PMID:24865679

  11. Sex Differences in HIV Prevalence Persist over Time: Evidence from 18 Countries in Sub-Saharan Africa

    PubMed Central

    Hegdahl, Hanne K.; Fylkesnes, Knut M.; Sandøy, Ingvild F.

    2016-01-01

    Objective The aim of this study was to examine changes over time in the female: male HIV prevalence ratio in 18 countries in Sub-Saharan Africa, overall and when stratified by area of residence, educational attainment and marital status. Methodology We used data from the Demographic and Health Surveys, which are nationally representative household surveys. By using data from 18 countries with at least two survey rounds with HIV testing, and dividing the countries into three regions (Western/Central, Eastern and Southern) we were able to examine cross-country and regional changes in the female: male HIV prevalence ratio over time. Logistic regression was used to estimate female: male HIV prevalence ratios in urban versus rural areas and for different categories of education and marital status. To assess changes over time, we compared the confidence intervals of the prevalence ratios. Results The female: male HIV prevalence ratio was above one in all countries in at least one survey round for both ages 15–24 years and 25–49 years. In 13 out of 18 countries the prevalence ratio was higher for the younger age group compared to the age group 25–49 years (3 significant) and this difference in prevalence ratios between the age groups did not change over time. Overall, there was a higher frequency of increasing than decreasing prevalence ratios. The gender disparity was greater among those who were married/living together than among the never-married, and over time, the ratio was more stable among the married/living together. The study found no clear differential changes by education. Conclusion Women continue to carry the greater burden of HIV in Sub-Saharan Africa and there is no clear pattern of change in the gap between men and women as the direction and magnitude of change in the prevalence ratios varied greatly. PMID:26841112

  12. Solid waste management in European countries: a review of systems analysis techniques.

    PubMed

    Pires, Ana; Martinho, Graça; Chang, Ni-Bin

    2011-04-01

    In the past few decades, solid waste management systems in Europe have involved complex and multi-faceted trade-offs among a plethora of technological alternatives, economic instruments, and regulatory frameworks. These changes resulted in various environmental, economic, social, and regulatory impacts in waste management practices which not only complicate regional policy analysis, but also reshape the paradigm of global sustainable development. Systems analysis, a discipline that harmonizes these integrated solid waste management strategies, has been uniquely providing interdisciplinary support for decision making in this area. Systems engineering models and system assessment tools, both of which enrich the analytical framework of waste management, were designed specifically to handle particular types of problems. Though how to smooth out the barriers toward achieving appropriate systems synthesis and integration of these models and tools to aid in the solid waste management schemes prevalent in European countries still remains somewhat uncertain. This paper conducts a thorough literature review of models and tools illuminating possible overlapped boundaries in waste management practices in European countries and encompassing the pros and cons of waste management practices in each member state of the European Union. Whereas the Southern European Union (EU) countries need to develop further measures to implement more integrated solid waste management and reach EU directives, the Central EU countries need models and tools with which to rationalize their technological choices and management strategies. Nevertheless, considering systems analysis models and tools in a synergistic way would certainly provide opportunities to develop better solid waste management strategies leading to conformity with current standards and foster future perspectives for both the waste management industry and government agencies in European Union. PMID:21194829

  13. Systems approaches to integrated solid waste management in developing countries.

    PubMed

    Marshall, Rachael E; Farahbakhsh, Khosrow

    2013-04-01

    Solid waste management (SWM) has become an issue of increasing global concern as urban populations continue to rise and consumption patterns change. The health and environmental implications associated with SWM are mounting in urgency, particularly in the context of developing countries. While systems analyses largely targeting well-defined, engineered systems have been used to help SWM agencies in industrialized countries since the 1960s, collection and removal dominate the SWM sector in developing countries. This review contrasts the history and current paradigms of SWM practices and policies in industrialized countries with the current challenges and complexities faced in developing country SWM. In industrialized countries, public health, environment, resource scarcity, climate change, and public awareness and participation have acted as SWM drivers towards the current paradigm of integrated SWM. However, urbanization, inequality, and economic growth; cultural and socio-economic aspects; policy, governance, and institutional issues; and international influences have complicated SWM in developing countries. This has limited the applicability of approaches that were successful along the SWM development trajectories of industrialized countries. This review demonstrates the importance of founding new SWM approaches for developing country contexts in post-normal science and complex, adaptive systems thinking. PMID:23360772

  14. Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control

    PubMed Central

    Lloyd-Sherlock, Peter; Beard, John; Minicuci, Nadia; Ebrahim, Shah; Chatterji, Somnath

    2014-01-01

    Background This study uses data from the World Health Organization’s Study on Global Ageing and Adult Health (SAGE) to examine patterns of hypertension prevalence, awareness, treatment and control for people aged 50 years and over in China, Ghana, India, Mexico, the Russian Federation and South Africa. Methods The SAGE sample comprises of 35 125 people aged 50 years and older, selected randomly. Hypertension was defined as ≥140 mmHg (systolic blood pressure) or ≥90 mmHg (diastolic blood pressure) or by currently taking antihypertensives. Control of hypertension was defined as blood pressure below 140/90 mmHg on treatment. A person was defined as aware if he/she was hypertensive and self-reported the condition. Results Prevalence rates in all countries are broadly comparable to those of developed countries (52.9%; range 32.3% in India to 77.9% in South Africa). Hypertension was associated with overweight/obesity and was more common in women, those in the lowest wealth quintile and in heavy alcohol consumers. Awareness was found to be low for all countries, albeit with substantial national variations (48.3%; range 23.3% in Ghana to 72.1% in the Russian Federation). This was also the case for control (10.2%; range 4.1% in Ghana to 14.1% India) and treatment efficacy (26.3%; range 17.4% in the Russian Federation to 55.2% in India). Awareness was associated with increasing age, being female and being overweight or obese. Effective control of hypertension was more likely in older people, women and in the richest quintile. Obesity was associated with poorer control. Conclusions The high rates of hypertension in low- and middle-income countries are striking. Levels of treatment and control are inadequate despite half those sampled being aware of their condition. Since cardiovascular disease is by far the largest cause of years of life lost in these settings, these findings emphasize the need for new approaches towards control of this major risk factor. PMID:24505082

  15. Managing health care system in small island countries: Palau.

    PubMed

    Kuartei, Stevenson

    2006-09-01

    Managing health systems in small island countries carry with it challenges that are common with other small communities around the world but also articulates for unique challenges that are intrinsically that of small island countries. Sustainability of economies and the small population in small island countries in the Pacific dictates how health care services align and organize to meet the needs of their population. This paper is an attempt to outline possible strategies that could be implemented in view of the ever decreasing meager resources. It will outline a step approach toward realignment and reengineering a viable health care system that is hopefully both cost effective and outcome oriented. PMID:18181405

  16. Sustainable solid waste management: An integrated approach for Asian countries

    SciTech Connect

    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 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.

  17. 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. PMID:19081236

  18. Simplified training for hazardous materials management in developing countries

    SciTech Connect

    Braithwaite, J.

    1994-12-31

    There are thousands of dangerous situations happening daily in developing countries around the world involving untrained workers and hazardous materials. There are very few if any agencies in developing countries that are charged with ensuring safe and healthful working conditions. In addition to the problem of regulation and enforcement, there are potential training problems due to the level of literacy and degree of scientific background of these workers. Many of these workers are refugees from poorly developed countries who are willing to work no matter what the conditions. Training methods (standards) accepted as state of the art in the United States and other developed countries may not work well under the conditions found in developing countries. Because these methods may not be appropriate, new and novel ways to train workers quickly, precisely and economically in hazardous materials management should be developed. One approach is to develop training programs that use easily recognizable graphics with minimal verbal instruction, programs similar to the type used to teach universal international driving regulations and safety. The program as outlined in this paper could be tailored to any sized plant and any hazardous material handling or exposure situation. The situation in many developing countries is critical, development of simplified training methods for workers exposed to hazardous materials hold valuable market potential and are an opportunity for many underdeveloped countries to develop indigenous expertise in hazardous materials management.

  19. Prevalence of erectile dysfunction and its correlates among men attending primary care clinics in three countries: Pakistan, Egypt, and Nigeria.

    PubMed

    Shaeer, K Z M; Osegbe, D N; Siddiqui, S H; Razzaque, A; Glasser, D B; Jaguste, V

    2003-04-01

    The prevalence and correlates of erectile dysfunction (ED) in developing countries are largely unknown. Our objectives were to determine the prevalence and associated factors of ED in three countries (Pakistan, Egypt, Nigeria) that represent very different cultures. Men 35-70y of age seeking primary medical care answered a structured questionnaire adapted to reflect local cultures. Degree of ED was categorized as 'none,' 'mild,' 'moderate,' or 'complete.' The age-adjusted prevalence rates of ED among men attending primary care clinics was 57.4% in Nigeria, 63.6% in Egypt, and 80.8% in Pakistan. Older age, diabetes, peptic ulcers, prostate disease, depression-related symptoms, and caffeine consumption were independently associated with increased prevalence of ED, whereas being moderately active to very active at work (hard physical labor) and during leisure time (strenuous exercise) was associated with half the prevalence of moderate-to-complete ED. Our multicultural study demonstrates that in every country studied, high proportions of men older than age 35 have some degree of ED (57-81%). Both severity and prevalence increase consistently with age. Factors associated with ED are similar, but their distribution differs across countries. PMID:12825103

  20. Solid waste management challenges for cities in developing countries

    SciTech Connect

    Abarca Guerrero, Lilliana; Maas, Ger; Hogland, William

    2013-01-15

    Highlights: Black-Right-Pointing-Pointer Stakeholders. Black-Right-Pointing-Pointer Factors affecting performance waste management systems. Black-Right-Pointing-Pointer Questionnaire as Annex for waste management baseline assessment. - Abstract: Solid waste management is a challenge for the cities' authorities in developing countries mainly due to the increasing generation of waste, the burden posed on the municipal budget as a result of the high costs associated to its management, the lack of understanding over a diversity of factors that affect the different stages of waste management and linkages necessary to enable the entire handling system functioning. An analysis of literature on the work done and reported mainly in publications from 2005 to 2011, related to waste management in developing countries, showed that few articles give quantitative information. The analysis was conducted in two of the major scientific journals, Waste Management Journal and Waste Management and Research. The objective of this research was to determine the stakeholders' action/behavior that have a role in the waste management process and to analyze influential factors on the system, in more than thirty urban areas in 22 developing countries in 4 continents. A combination of methods was used in this study in order to assess the stakeholders and the factors influencing the performance of waste management in the cities. Data was collected from scientific literature, existing data bases, observations made during visits to urban areas, structured interviews with relevant professionals, exercises provided to participants in workshops and a questionnaire applied to stakeholders. Descriptive and inferential statistic methods were used to draw conclusions. The outcomes of the research are a comprehensive list of stakeholders that are relevant in the waste management systems and a set of factors that reveal the most important causes for the systems' failure. The information provided is very

  1. Smoking Prevalence among Migrants in the US Compared to the US-Born and the Population in Countries of Origin

    PubMed Central

    Bosdriesz, Jizzo R.; Lichthart, Nienke; Witvliet, Margot I.; Busschers, Wim B.; Stronks, Karien; Kunst, Anton E.

    2013-01-01

    Objectives Smoking among migrants is known to differ from the host population, but migrants’ smoking is rarely ever compared to the prevalence of smoking in their country of origin. The goal of this study is to compare the smoking prevalence among migrants to that of both the US-born population and the countries of origin. Further analyses assess the influence of sex, age at time of entry to the US and education level. Methods Data of 248,726 US-born and migrants from 14 countries were obtained from the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) from 2006–2007. Data on 108,653 respondents from the corresponding countries of origin were taken from the World Health Survey (WHS) from 2002–2005. Results The prevalence of smoking among migrants (men: 14.2%, women: 4.1%) was lower than both the US-born group (men: 21.4%, women: 18.1%) and countries of origin (men: 39.4%, women: 11.0%). The gender gap among migrants was smaller than in the countries of origin. Age at time of entry to the US was not related to smoking prevalence for migrants. The risk of smoking for high-educated migrants was closer to their US counterparts. Conclusions The smoking prevalence among migrants is consistently lower than both the country of origin levels and the US level. The theory of segmented assimilation is supported by some results of this study, but not all. Other mechanisms that might influence the smoking prevalence among migrants are the ‘healthy migrant effect’ or the stage of the smoking epidemic at the time of migration. PMID:23520525

  2. 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

  3. Obstacles to integrated pest management adoption in developing countries.

    PubMed

    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

    2014-03-11

    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

  4. [Prevalence and differentiating aspects related to gender with regard to the bullying phenomenon in poor countries].

    PubMed

    Romera Félix, Eva M; Del Rey Alamillo, Rosario; Ortega Ruiz, Rosario

    2011-11-01

    There is a large body of scientific knowledge about school violence and bullying in Europe and some other regions of the so-called developed world. However, improvement is scarce in poor and developing regions, as in the case of Latin America and, in particular, Nicaragua. The goal of this work was to determine the prevalence of the bullying phenomenon in Nicaraguan primary schools, to analyze the eventual relationships between the different forms of violence used by the students and to explore, in relation to these aspects, the similarities and differences between boys and girls. For this purpose, we surveyed 3042 pupils of primary school (50.3% girls) using the "Cuestionario sobre Convivencia, Violencia y Experiencias de Riesgo" (COVER, in English, Questionnaire about Living Together, Violence and Risk Experiences). We found that the level of involvement in bullying is significantly higher than in developed countries, that boys are more involved than girls in verbal, physical and psychological bullying, and that there are no differences with regard to social exclusion. The results are discussed, comparing them with studies conducted in different countries but with similar methodologies. PMID:22047849

  5. Prevalence of multimorbidity according to the deprivation level among the elderly in the Basque Country

    PubMed Central

    2013-01-01

    Background Multimorbidity is clearly a major challenge for healthcare systems. However, currently, its magnitude and impact on healthcare expenditures is still not well known. The objective of this paper is to present an overview of the prevalence of multimorbidity by deprivation level in the elderly population of the Basque Country. Methods We conducted a cross-sectional analysis that included all the inhabitants of the Basque Country aged 65 years and over (N = 452,698). This was based on data from primary care electronic medical records, hospital admissions, and outpatient care databases, for a 4-year period. The health problems of the patients were identified from their diagnoses and prescriptions. Multimorbidity was defined as the presence of two or more chronic diseases out of a list of 47 of the most important and common chronic conditions consistent with the literature. In addition, we explored socio-economic and demographic variables such as age, sex, and deprivation level. Results Multimorbidity was found in 66.13% of the population aged 65 and over and increases with age until 80 years. The prevalence of multimorbidity was higher in deprived (69.94%) than better-off (60.22%) areas. This pattern of differences between the most and least disadvantaged areas was observed in all age groups and more marked in female (70.96-59.78%) than in male (68.54-60.86%) populations. In almost all diseases studied (43 out of 47), 90% of patients had been diagnosed with at least one other illness. It was also frequent the coexistence of mental and physical health problems in the same person and the presence of multiple physical diseases is higher in patients with mental disease than in the rest of population (74.97% vs. 58.14%). Conclusion Multimorbidity is very common among people over 65 years old in the Basque Country, particularly in unfavourable socioeconomic environments. Given the ageing population, multimorbidity and its consequences should be taken into

  6. A three-country comparison of psychotropic medication prevalence in youth

    PubMed Central

    Zito, Julie M; Safer, Daniel J; Berg, Lolkje TW de Jong-van den; Janhsen, Katrin; Fegert, Joerg M; Gardner, James F; Glaeske, Gerd; Valluri, Satish C

    2008-01-01

    Background The study aims to compare cross-national prevalence of psychotropic medication use in youth. Methods A population-based analysis of psychotropic medication use based on administrative claims data for the year 2000 was undertaken for insured enrollees from 3 countries in relation to age group (0–4, 5–9, 10–14, and 15–19), gender, drug subclass pattern and concomitant use. The data include insured youth aged 0–19 in the year 2000 from the Netherlands (n = 110,944), Germany (n = 356,520) and the United States (n = 127,157). Results The annual prevalence of any psychotropic medication in youth was significantly greater in the US (6.7%) than in the Netherlands (2.9%) and in Germany (2.0%). Antidepressant and stimulant prevalence were 3 or more times greater in the US than in the Netherlands and Germany, while antipsychotic prevalence was 1.5–2.2 times greater. The atypical antipsychotic subclass represented only 5% of antipsychotic use in Germany, but 48% in the Netherlands and 66% in the US. The less commonly used drugs e.g. alpha agonists, lithium and antiparkinsonian agents generally followed the ranking of US>Dutch>German youth with very rare (less than 0.05%) use in Dutch and German youth. Though rarely used, anxiolytics were twice as common in Dutch as in US and German youth. Prescription hypnotics were half as common as anxiolytics in Dutch and US youth and were very uncommon in German youth. Concomitant drug use applied to 19.2% of US youth which was more than double the Dutch use and three times that of German youth. Conclusion Prominent differences in psychotropic medication treatment patterns exist between youth in the US and Western Europe and within Western Europe. Differences in policies regarding direct to consumer drug advertising, government regulatory restrictions, reimbursement policies, diagnostic classification systems, and cultural beliefs regarding the role of medication for emotional and behavioral treatment are likely to

  7. The 2005 Workbook: an improved tool for estimating HIV prevalence in countries with low level and concentrated epidemics

    PubMed Central

    Lyerla, R; Gouws, E; García‐Calleja, J M; Zaniewski, E

    2006-01-01

    Objective This paper describes improvements and updates to an established approach to making epidemiological estimates of HIV prevalence in countries with low level and concentrated epidemics. Methods The structure of the software used to make estimates is briefly described, with particular attention to changes and improvements. Discussion The approach focuses on identifying populations which, through their behaviour, are at high risk of infection with HIV or who are exposed through the risk behaviour of their sexual partners. Estimates of size and HIV prevalence of these populations allow the total number of HIV infected people in a country or region to be estimated. Major changes in the software focus on the move away from short term projections and towards developing an epidemiological curve that more accurately represents the change in prevalence of HIV over time. The software continues to provide an output file for use in the Spectrum software so as to estimate the demographic impact of HIV infection at country level. PMID:16735292

  8. Solid waste management challenges for cities in developing countries.

    PubMed

    Guerrero, Lilliana Abarca; Maas, Ger; Hogland, William

    2013-01-01

    Solid waste management is a challenge for the cities' authorities in developing countries mainly due to the increasing generation of waste, the burden posed on the municipal budget as a result of the high costs associated to its management, the lack of understanding over a diversity of factors that affect the different stages of waste management and linkages necessary to enable the entire handling system functioning. An analysis of literature on the work done and reported mainly in publications from 2005 to 2011, related to waste management in developing countries, showed that few articles give quantitative information. The analysis was conducted in two of the major scientific journals, Waste Management Journal and Waste Management and Research. The objective of this research was to determine the stakeholders' action/behavior that have a role in the waste management process and to analyze influential factors on the system, in more than thirty urban areas in 22 developing countries in 4 continents. A combination of methods was used in this study in order to assess the stakeholders and the factors influencing the performance of waste management in the cities. Data was collected from scientific literature, existing data bases, observations made during visits to urban areas, structured interviews with relevant professionals, exercises provided to participants in workshops and a questionnaire applied to stakeholders. Descriptive and inferential statistic methods were used to draw conclusions. The outcomes of the research are a comprehensive list of stakeholders that are relevant in the waste management systems and a set of factors that reveal the most important causes for the systems' failure. The information provided is very useful when planning, changing or implementing waste management systems in cities. PMID:23098815

  9. Patients' management of type 2 diabetes in Middle Eastern countries: review of studies.

    PubMed

    Alsairafi, Zahra Khalil; Taylor, Kevin Michael Geoffrey; Smith, Felicity J; Alattar, Abdulnabi T

    2016-01-01

    The increased prevalence of diabetes in Middle Eastern countries is a health policy priority. Important risk factors for diabetes have been identified. Lifestyle interventions and adherence to medications are central to disease prevention and management. This review focuses on the management of type 2 diabetes mellitus in Middle Eastern countries. The aim is to identify the ways in which knowledge, health beliefs, and social and cultural factors influence adherence to medication and lifestyle measures. Thirty-four studies were identified following a systematic search of the literature. The studies describe the influence of knowledge, health beliefs, culture, and lifestyle on the management of type 2 diabetes mellitus in the Middle East. Findings indicate a lack of health knowledge about diabetes among populations, which has implications for health behaviors, medication adherence, and treatment outcomes. Many identified health beliefs and cultural lifestyle factors, such as religious beliefs, beliefs about fasting during Ramadan, and sedentary lifestyles played a role in patients' decisions. For better management of this disease, a collaborative approach between patients, their families, health care professionals, and governments should be adopted. Implementing behavioral strategies and psychological interventions that incorporate all health care professionals in the management process have been shown to be effective methods. Such services help patients change their behavior. However, the utilization of such services and interventions is still limited in Arabian countries. Physicians in the Middle East are the health care professionals most involved in the care process. PMID:27354775

  10. Patients’ management of type 2 diabetes in Middle Eastern countries: review of studies

    PubMed Central

    Alsairafi, Zahra Khalil; Taylor, Kevin Michael Geoffrey; Smith, Felicity J; Alattar, Abdulnabi T

    2016-01-01

    The increased prevalence of diabetes in Middle Eastern countries is a health policy priority. Important risk factors for diabetes have been identified. Lifestyle interventions and adherence to medications are central to disease prevention and management. This review focuses on the management of type 2 diabetes mellitus in Middle Eastern countries. The aim is to identify the ways in which knowledge, health beliefs, and social and cultural factors influence adherence to medication and lifestyle measures. Thirty-four studies were identified following a systematic search of the literature. The studies describe the influence of knowledge, health beliefs, culture, and lifestyle on the management of type 2 diabetes mellitus in the Middle East. Findings indicate a lack of health knowledge about diabetes among populations, which has implications for health behaviors, medication adherence, and treatment outcomes. Many identified health beliefs and cultural lifestyle factors, such as religious beliefs, beliefs about fasting during Ramadan, and sedentary lifestyles played a role in patients’ decisions. For better management of this disease, a collaborative approach between patients, their families, health care professionals, and governments should be adopted. Implementing behavioral strategies and psychological interventions that incorporate all health care professionals in the management process have been shown to be effective methods. Such services help patients change their behavior. However, the utilization of such services and interventions is still limited in Arabian countries. Physicians in the Middle East are the health care professionals most involved in the care process. PMID:27354775

  11. A comparative cross-cultural study of the prevalence of late life depression in low and middle income countries

    PubMed Central

    Guerra, M.; Prina, A.M.; Ferri, C.P.; Acosta, D.; Gallardo, S.; Huang, Y.; Jacob, K.S.; Jimenez-Velazquez, I.Z.; Llibre Rodriguez, J.J.; Liu, Z.; Salas, A.; Sosa, A.L.; Williams, J.D.; Uwakwe, R.; Prince, M.

    2016-01-01

    Background Current estimates of the prevalence of depression in later life mostly arise from studies carried out in Europe, North America and Asia. In this study we aimed to measure the prevalence of depression using a standardised method in a number of low and middle income countries (LMIC). Methods A one-phase cross-sectional survey involving over 17,000 participants aged 65 years and over living in urban and rural catchment areas in 13 sites from 9 countries (Cuba, Dominican Republic, Puerto Rico, Mexico, Venezuela, Peru, China, India and Nigeria). Depression was assessed and compared using ICD-10 and EURO-D criteria. Results Depression prevalence varied across sites according to diagnostic criteria. The lowest prevalence was observed for ICD-10 depressive episode (0.3 to 13.8%). When using the EURO-D depression scale, the prevalence was higher and ranged from 1.0% to 38.6%. The crude prevalence was particularly high in the Dominican Republic and in rural India. ICD-10 depression was also associated with increased age and being female. Limitations Generalisability of findings outside of catchment areas is difficult to assess. Conclusions Late life depression is burdensome, and common in LMIC. However its prevalence varies from culture to culture; its diagnosis poses a significant challenge and requires proper recognition of its expression. PMID:26544620

  12. Training for Planning and Management: Improved Management Systems in Higher Education in Developing Countries.

    ERIC Educational Resources Information Center

    Lillis, Kevin M.

    The management crisis within higher education in developing countries reflects the wider crisis in educational management and public administration. The contemporary management context is further threatened by narrowing management capacity and capability due to the continued dwindling of already scarce resources and the increasing across-the-board…

  13. Genital Chlamydia Prevalence in Europe and Non-European High Income Countries: Systematic Review and Meta-Analysis

    PubMed Central

    Redmond, Shelagh M.; Alexander-Kisslig, Karin; Woodhall, Sarah C.; van den Broek, Ingrid V. F.; van Bergen, Jan; Ward, Helen; Uusküla, Anneli; Herrmann, Björn; Andersen, Berit; Götz, Hannelore M.; Sfetcu, Otilia; Low, Nicola

    2015-01-01

    Background Accurate information about the prevalence of Chlamydia trachomatis is needed to assess national prevention and control measures. Methods We systematically reviewed population-based cross-sectional studies that estimated chlamydia prevalence in European Union/European Economic Area (EU/EEA) Member States and non-European high income countries from January 1990 to August 2012. We examined results in forest plots, explored heterogeneity using the I2 statistic, and conducted random effects meta-analysis if appropriate. Meta-regression was used to examine the relationship between study characteristics and chlamydia prevalence estimates. Results We included 25 population-based studies from 11 EU/EEA countries and 14 studies from five other high income countries. Four EU/EEA Member States reported on nationally representative surveys of sexually experienced adults aged 18–26 years (response rates 52–71%). In women, chlamydia point prevalence estimates ranged from 3.0–5.3%; the pooled average of these estimates was 3.6% (95% CI 2.4, 4.8, I2 0%). In men, estimates ranged from 2.4–7.3% (pooled average 3.5%; 95% CI 1.9, 5.2, I2 27%). Estimates in EU/EEA Member States were statistically consistent with those in other high income countries (I2 0% for women, 6% for men). There was statistical evidence of an association between survey response rate and estimated chlamydia prevalence; estimates were higher in surveys with lower response rates, (p = 0.003 in women, 0.018 in men). Conclusions Population-based surveys that estimate chlamydia prevalence are at risk of participation bias owing to low response rates. Estimates obtained in nationally representative samples of the general population of EU/EEA Member States are similar to estimates from other high income countries. PMID:25615574

  14. Energy Use and Related Risk Management Problems in CEE Countries

    NASA Astrophysics Data System (ADS)

    Ney, R.; Michna, J.; Ekmanis, J.; Zeltins, N.; Zebergs, V.

    2008-03-01

    Nowadays, the efficiency of energy use in the Central and East-European (CEE) countries is insufficient, being much lower than in the "Old Europe". The problem becomes increasingly pressing due to non-stop increasing prices of energy carriers (especially of crude oil). The authors trace the development of research activities in this sphere, classifying the revealed changes in parameters of energy consumption processes in particular time intervals into deterministic, probabilistic, and fuzzy. The paper presents a thorough analysis of decision-making in the energy management at its different levels - normative, strategic, and operative. Particular attention is given to the management under uncertainty conditions - i.e. to the risk management. The most wanted research directions in this area proposed by the energy and environment policy (EEP) Center specially created for CEE countries concern management under risk connected with innovations, international activities, loss of reputation, etc. The authors consider in detail the risk management with insufficient knowledge (non-knowledge) and under chaos. Much consideration is given to the scenario management and the game theory principles as related to the sphere of energy use.

  15. Unwanted sexual experiences among young men in four sub-Saharan African countries: prevalence and context.

    PubMed

    Moore, Ann M; Madise, Nyovani; Awusabo-Asare, Kofi

    2012-10-01

    Unwanted sexual experiences are most frequently examined from the woman's perspective, yet these experiences happen to men as well. Part of the reason for the paucity of studies on coerced sexual experiences among men is the difficulty in gathering information about such experiences. This study examines the prevalence of unwanted sexual experiences at sexual debut as well as ever among young men aged 12-19 years old in Burkina Faso, Ghana, Malawi and Uganda. The data come from nationally-representative surveys and in-depth interviews with approximately 50 young men in each country gathered around 2004. Between 4 and 12% of young men stated that they were 'not willing at all' at sexual debut and between 3 and 6% said that they had ever experienced unwanted sex. Narratives from in-depth interviews give insights into the context surrounding men's unwanted sexual experiences. The sometimes conflicting information provided by the respondents serve to confound rather than illuminate the contexts within which these unwanted sexual experiences occurred, demonstrating that coercion for young men looks extremely different than coercion for young women, spurring us to improve our measures of sexual coercion among men. PMID:22943657

  16. Treated Prevalence of and Mental Health Services Received by Children and Adolescents in 42 Low-and-Middle-Income Countries

    ERIC Educational Resources Information Center

    Morris, Jodi; Belfer, Myron; Daniels, Amy; Flisher, Alan; Ville, Liesbet; Lora, Antonio; Saxena, Shekhar

    2011-01-01

    Background: Little is known about the treated prevalence and services received by children and adolescents in low- and middle-income countries (LAMICs). The purpose of this study is to describe the characteristics and capacity of mental health services for children and adolescents in 42 LAMICs. Methods: The "World Health Organization Assessment…

  17. Prevalence of Hypertension in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

    PubMed

    Sarki, Ahmed M; Nduka, Chidozie U; Stranges, Saverio; Kandala, Ngianga-Bakwin; Uthman, Olalekan A

    2015-12-01

    We aimed to obtain overall and regional estimates of hypertension prevalence, and to examine the pattern of this disease condition across different socio-demographic characteristics in low-and middle-income countries. We searched electronic databases from inception to August 2015. We included population-based studies that reported hypertension prevalence using the current definition of blood pressure ≥140/90 mm Hg or self-reported use of antihypertensive medication. We used random-effects meta-analyses to pool prevalence estimates of hypertension, overall, by World Bank region and country income group. Meta-regression analyses were performed to explore sources of heterogeneity across the included studies. A total of 242 studies, comprising data on 1,494,609 adults from 45 countries, met our inclusion criteria. The overall prevalence of hypertension was 32.3% (95% confidence interval [CI] 29.4-35.3), with the Latin America and Caribbean region reporting the highest estimates (39.1%, 95% CI 33.1-45.2). Pooled prevalence estimate was also highest across upper middle income countries (37.8%, 95% CI 35.0-40.6) and lowest across low-income countries (23.1%, 95% CI 20.1-26.2). Prevalence estimates were significantly higher in the elderly (≥65 years) compared with younger adults (<65 years) overall and across the geographical regions; however, there was no significant sex-difference in hypertension prevalence (31.9% vs 30.8%, P = 0.6). Persons without formal education (49.0% vs 24.9%, P < 0.00001), overweight/obese (46.4% vs 26.3%, P < 0.00001), and urban settlers (32.7% vs 25.2%, P = 0.0005) were also more likely to be hypertensive, compared with those who were educated, normal weight, and rural settlers respectively. This study provides contemporary and up-to-date estimates that reflect the significant burden of hypertension in low- and middle-income countries, as well as evidence that hypertension remains a major public health issue across the

  18. 1996 hazardous waste management survey in selected Asian countries

    SciTech Connect

    Nelson, D.; Christie, K.; Tao, Hong-lei

    1996-12-31

    This report documents the results of a 42-question survey submitted to countries in Asia concerning their hazardous waste management programs and other issues. The same survey questions were distributed in 1992. This report compares the 1992 and 1996 responses. The respondents were Australia, New Zealand, Malaysia, Philippines, Hong Kong, People`s Republic of China, Taiwan, Japan, Korea, Singapore, Thailand, and Indonesia. 7 figs.

  19. Women with Cirrhosis: Prevalence, Natural History, and Management.

    PubMed

    Giard, Jeanne-Marie; Terrault, Norah A

    2016-06-01

    Cirrhosis is less frequent in women than in men, in large part due to the lower prevalence of hepatitis B, hepatitis C, and alcohol use in women. The most common causes of cirrhosis among women are hepatitis C, autoimmune etiologies, nonalcoholic steatohepatitis, and alcoholic liver disease. For most chronic liver diseases, the risk of progression to cirrhosis and rates of liver failure and hepatocellular carcinoma are lower in women than in men. Pregnancy is very infrequent in women with cirrhosis due to reduced fertility, but when it occurs, requires specialized management. PMID:27261903

  20. High Prevalence of Vitamin D Deficiency in Cambodian Women: A Common Deficiency in a Sunny Country.

    PubMed

    Smith, Geoffry; Wimalawansa, Sunil J; Laillou, Arnaud; Sophonneary, Prak; Un, Samoeurn; Hong, Rathavuth; Poirot, Etienne; Kuong, Khov; Chamnan, Chhoun; De Los Reyes, Francisco N; Wieringa, Frank T

    2016-01-01

    Recent studies have shown that in spite of being generally close to the equator; vitamin D deficiency is common in South East Asian countries. In order to quantify micronutrient status for women and children in Cambodia; a nationally-representative survey was conducted in 2014 linked to the Cambodian Demographic Health Survey. The countrywide median of 25(OH)D was, respectively, 64.9 and 91.1 nmol/L for mothers and children. Based on The Endocrine Society cutoffs (>50<75 nmol/L = insufficiency; ≤50 nmol/L = deficiency); 64.6% of mothers and 34.8% of their children had plasma vitamin D concentrations indicating insufficiency or deficiency. For deficiency alone, 29% of the mothers were found to be vitamin D deficient, but only 13.4% of children. Children who live in urban areas had a 43% higher rate of vitamin D insufficiency versus those who live in rural areas (OR; 1.434; 95% CI: 1.007; 2.041). However, such differences were not observed in their mothers. The high prevalence of vitamin D deficiency is likely in part due to lifestyle choices, including sun avoidance, increasingly predominant indoor work, and covered transport. These survey findings support the need for a broader national Cambodian study incorporating testing of adult men, adolescents and the elderly, and encompassing other parameters such as skeletal health. However, the data presented in this study already show significant deficiencies which need to be addressed and we discuss the benefit of establishing nationally-mandated food fortification programs to enhance the intake of vitamin D. PMID:27187456

  1. High Prevalence of Vitamin D Deficiency in Cambodian Women: A Common Deficiency in a Sunny Country

    PubMed Central

    Smith, Geoffry; Wimalawansa, Sunil J.; Laillou, Arnaud; Sophonneary, Prak; Un, Samoeurn; Hong, Rathavuth; Poirot, Etienne; Kuong, Khov; Chamnan, Chhoun; De los Reyes, Francisco N.; Wieringa, Frank T.

    2016-01-01

    Recent studies have shown that in spite of being generally close to the equator; vitamin D deficiency is common in South East Asian countries. In order to quantify micronutrient status for women and children in Cambodia; a nationally-representative survey was conducted in 2014 linked to the Cambodian Demographic Health Survey. The countrywide median of 25(OH)D was, respectively, 64.9 and 91.1 nmol/L for mothers and children. Based on The Endocrine Society cutoffs (>50<75 nmol/L = insufficiency; ≤50 nmol/L = deficiency); 64.6% of mothers and 34.8% of their children had plasma vitamin D concentrations indicating insufficiency or deficiency. For deficiency alone, 29% of the mothers were found to be vitamin D deficient, but only 13.4% of children. Children who live in urban areas had a 43% higher rate of vitamin D insufficiency versus those who live in rural areas (OR; 1.434; 95% CI: 1.007; 2.041). However, such differences were not observed in their mothers. The high prevalence of vitamin D deficiency is likely in part due to lifestyle choices, including sun avoidance, increasingly predominant indoor work, and covered transport. These survey findings support the need for a broader national Cambodian study incorporating testing of adult men, adolescents and the elderly, and encompassing other parameters such as skeletal health. However, the data presented in this study already show significant deficiencies which need to be addressed and we discuss the benefit of establishing nationally-mandated food fortification programs to enhance the intake of vitamin D. PMID:27187456

  2. Management of Haemophilia in Developing Countries: Challenges and Options.

    PubMed

    Ghosh, Kanjaksha; Ghosh, Kinjalka

    2016-09-01

    There are significant challenges in managing haemophilia patients in developing countries. These challenges are (i) Lack of proper health care infrastructure and human resources suitable for haemophilia care (ii) Competing health care priorities of the government. (iii) Lack of penetrance of medical insurance in the population. (iv) Lesser visibility of the haemophilia patients in health care system (v) Low awareness across the medical profession, population and the policy makers about the condition (vi) Non availability of factor concentrates (vii) Inadequate utilization of knowledge for reducing factor concentrate use. (viii) Inadequate pain relief (ix) Challenges due to inhibitor developing (x) Viral hepatitis & (xi) Lack of research publications relevant to the country are some of the challenges faced by PWH for their management in developing country. The solutions are not easy but development of a strong patient organization with linkages with World Federation of Haemophilia is an important initial step. Following that internal and international twinning, use of internal sources, strong advocacy programme targeting government, doctors, opinion makers will solve many of the challenges in the time to come. PMID:27429529

  3. Comparison of adult HIV prevalence from national population-based surveys and antenatal clinic surveillance in countries with generalised epidemics: implications for calibrating surveillance data

    PubMed Central

    Gouws, E; Mishra, V; Fowler, T B

    2008-01-01

    Background: Estimates of the impact of HIV in countries with generalised epidemics are generally based on antenatal clinic surveillance data collected over time. In an attempt to obtain geographically more representative estimates of HIV prevalence, many countries are now also conducting national population-based surveys in which HIV testing is included. We compare adult HIV prevalence estimates from antenatal clinic surveillance to those from national population-based surveys to assess the implications for calibrating surveillance data. Methods: HIV prevalence estimates derived from fitting prevalence curves to antenatal clinic surveillance data are statistically compared to prevalence from national population-based surveys using data from 26 countries with generalised epidemics for the year in which the survey was conducted. Appropriate transformations are applied to inform the correction factors needed to adjust prevalence in countries where population-based surveys have not been conducted. Results: HIV prevalence derived from antenatal clinic surveillance data generally overestimate population-based survey prevalence by about 20% (95% confidence interval: 10% to 30%) in both urban and rural areas. Conclusions: In countries where national population-based HIV surveys have been conducted, survey estimates of HIV prevalence (adjusted for potential survey biases as appropriate) can be used directly to calibrate antenatal clinic surveillance data. In countries where national HIV surveys have not been conducted, HIV prevalence derived from antenatal clinic surveillance data should be multiplied by about 0.8 to adjust for overestimation. PMID:18647861

  4. Socioeconomic inequalities in HIV/AIDS prevalence in sub-Saharan African countries: evidence from the Demographic Health Surveys

    PubMed Central

    2014-01-01

    Introduction Extant studies universally document a positive gradient between socioeconomic status (SES) and health. A notable exception is the apparent concentration of HIV/AIDS among wealthier individuals. This paper uses data from the Demographic Health Surveys and AIDS Indicator Surveys to examine socioeconomic inequalities in HIV/AIDS prevalence in 24 sub-Saharan African (SSA) countries, the region that accounts for two-thirds of the global HIV/AIDS burden. Methods The relative and generalized concentration indices (RC and GC) were used to quantify wealth-based socioeconomic inequalities in HIV/AIDS prevalence for the total adult population (aged 15-49), for men and women, and in urban and rural areas in each country. Further, we decomposed the RC and GC indices to identify the determinants of socioeconomic inequalities in HIV/AIDS prevalence in each country. Results Our findings demonstrated that HIV/AIDS was concentrated among higher SES individuals in the majority of SSA countries. Swaziland and Senegal were the only countries in the region where HIV/AIDS was concentrated among individuals living in poorer households. Stratified analyses by gender showed HIV/AIDS was generally concentrated among wealthier men and women. In some countries, including Kenya, Lesotho Uganda, and Zambia, HIV/AIDS was concentrated among the poor in urban areas but among wealthier adults in rural areas. Decomposition analyses indicated that, besides wealth itself (median = 49%, interquartile range [IQR] = 90%), urban residence (median = 54%, IQR = 81%) was the most important factor contributing to the concentration of HIV/AIDS among wealthier participants in SSA countries. Conclusions Further work is needed to understand the mechanisms explaining the concentration of HIV/AIDS among wealthier individuals and urban residents in SSA. Higher prevalence of HIV/AIDS could be indicative of better care and survival among wealthier individuals and urban adults, or reflect

  5. A workplace tuberculosis case investigation in the presence of immigrant contacts from high prevalence countries.

    PubMed

    Kambali, Shrinivas; Nantsupawat, Nopakoon; Lee, Melanie; Nugent, Kenneth

    2015-06-01

    The highest prevalence of tuberculosis (TB) occurs in foreign born immigrants in the United States. Contact investigations at work sites with mostly immigrant workers present multiple practical problems. Recently 402 contacts were investigated at a meat packing plant in rural Texas by the Texas Department of State Health Services (DSHS). Our objective was to study the approach and effectiveness of this intensive investigation. We reviewed information, including symptoms, BCG status, TB history, X-rays, and treatment, on the sentinel case and 47 contacts managed by the Texas DSHS TB Division in Lubbock, TX. We used a gamma interferon release assay (T-SPOT.TB) to identify contacts with TB infection. The sentinel case was foreign born and had cavitary TB with acid-fast positive smears. Forty-two work site contacts were foreign born, and five were US born. The foreign born contacts were from Sudan, Somalia, Mexico, Burma, and Haiti; 18 contacts had a history of BCG vaccination. T-SPOT.TB tests were positive in 20 contacts, borderline in four, and negative in 23. Contacts with borderline results had negative repeat tests. Twenty-three contacts with negative T-SPOT.TB tests were scheduled for repeat tests in 4 weeks, but only four returned for this testing. Chest X-rays were abnormal in two contacts who were started on treatment. Sputum was collected in three individuals; one was culture positive for pan-sensitive Mycobacterium tuberculosis. Twelve contacts were treated for latent TB. Our investigation established an infection rate of 42.5% in this work site contact cohort, which is similar to the 39% prevalence reported by the Center for Disease Control. The use of T-SPOT.TB assays simplified testing in immigrants with high rates of BCG vaccination. Our investigation was complicated by language barriers, varying and uncertain levels of exposure, and a high rate of drop outs in the negative T-SPOT.TB contacts. This concerted effort provides a model for investigating work

  6. Mapping the Prevalence and Sociodemographic Characteristics of Women Who Deliver Alone: Evidence From Demographic and Health Surveys From 80 Countries.

    PubMed

    Orobaton, Nosakhare; Austin, Anne; Fapohunda, Bolaji; Abegunde, Dele; Omo, Kizzy

    2016-03-01

    Evidence has shown that quality skilled care during labor and delivery is essential to improve maternal and newborn health outcomes. Unfortunately, analyses of Demographic and Health Survey (DHS) data show that there are a substantial number of women around the world that not only do not have access to skilled care but also deliver alone with no one present (NOP). Among the 80 countries with data, we found the practice of delivering with NOP was concentrated in West and Central Africa and parts of East Africa. Across these countries, the prevalence of giving birth with NOP was higher among women who were poor, older, of higher parity, living in rural areas, and uneducated than among their counterparts. As women increased use of antenatal care services, the proportion giving birth with NOP declined. Using census data for each country from the US Census Bureau's International Database and data on prevalence of delivering with NOP from the DHS among countries with surveys from 2005 onwards (n = 59), we estimated the number of women who gave birth alone in each country, as well as each country's contribution to the total burden. Our analysis indicates that between 2005 and 2015, an estimated 2.2 million women, who had given birth in the 3 years preceding each country survey, delivered with NOP. Nigeria, alone, accounted for 44% (nearly 1 million) of these deliveries. As countries work on reducing inequalities in access to health care, wealth, education, and family planning, concurrent efforts to change community norms that condone and facilitate the practice of women giving birth alone must also be implemented. Programmatic experience from Sokoto State in northern Nigeria suggests that the practice can be reduced markedly through grassroots community advocacy and education, even in poor and low-resource areas. It is time for leaders to act now to eradicate the practice of giving birth alone-one of many important steps needed to ensure no mother or newborn dies of a

  7. Adverse-Drug-Reaction-Related Hospitalisations in Developed and Developing Countries: A Review of Prevalence and Contributing Factors.

    PubMed

    Angamo, Mulugeta Tarekegn; Chalmers, Leanne; Curtain, Colin M; Bereznicki, Luke R E

    2016-09-01

    Adverse drug reactions (ADRs) are one of the leading causes of hospital admissions and morbidity in developed countries and represent a substantial burden on healthcare delivery systems. However, there is little data available from low- and middle-income countries. This review compares the prevalence and characteristics of ADR-related hospitalisations in adults in developed and developing countries, including the mortality, severity and preventability associated with these events, commonly implicated drugs and contributing factors. A literature search was conducted via PubMed, Scopus, Web of Science, Embase, ProQuest and Google Scholar to find articles published in English from 2000 to 2015. Relevant observational studies were included. The median (with interquartile range [IQR]) prevalence of ADR-related hospitalisation in developed and developing countries was 6.3 % (3.3-11.0) and 5.5 % (1.1-16.9), respectively. The median proportions of preventable ADRs in developed and developing countries were 71.7 % (62.3-80.0) and 59.6 % (51.5-79.6), respectively. Similarly, the median proportions of ADRs resulting in mortality in developed and developing countries were 1.7 % (0.7-4.8) and 1.8 % (0.8-8.0), respectively. Commonly implicated drugs in both settings were antithrombotic, non-steroidal anti-inflammatory and cardiovascular drugs. Older age, female gender, number of medications, renal impairment and heart failure were reported to be associated with an increased risk for ADR-related hospitalisation in both settings while HIV/AIDS was implicated in developing countries only. The majority of ADRs were preventable in both settings, highlighting the importance of improving medication use, particularly in vulnerable patient groups such as the elderly, patients with multiple comorbidities and, in developing countries, patients with HIV/AIDS. PMID:27449638

  8. Changes in Hypertension Prevalence, Awareness, Treatment, and Control in High-, Middle-, and Low-Income Countries: An Update.

    PubMed

    Cifkova, Renata; Fodor, George; Wohlfahrt, Peter

    2016-08-01

    The aim of this paper was to critically evaluate recent publications on hypertension treatment and control in regions by income. Prevalence of hypertension is increasing worldwide, most prominently in low-income countries. Awareness, treatment, and control are most successful in North America while remaining a challenge in middle- and low-income countries. Easy access to medical care and aggressive use of pharmacotherapy are the key strategies which have proved to be successful in reducing the burden of hypertension on the population level. PMID:27372446

  9. Food category consumption and obesity prevalence across countries: an application of Machine Learning method to big data analysis

    NASA Astrophysics Data System (ADS)

    Dunstan, Jocelyn; Fallah-Fini, Saeideh; Nau, Claudia; Glass, Thomas; Global Obesity Prevention Center Team

    The applications of sophisticated mathematical and numerical tools in public health has been demonstrated to be useful in predicting the outcome of public intervention as well as to study, for example, the main causes of obesity without doing experiments with the population. In this project we aim to understand which kind of food consumed in different countries over time best defines the rate of obesity in those countries. The use of Machine Learning is particularly useful because we do not need to create a hypothesis and test it with the data, but instead we learn from the data to find the groups of food that best describe the prevalence of obesity.

  10. Differences in prevalence rates of PTSD in various European countries explained by war exposure, other trauma and cultural value orientation

    PubMed Central

    2014-01-01

    Background Guided by previous explorations of historical and cultural influences on the occurrence of PTSD, the aim of the present study was to investigate the contributions of war victimisation (in particular, World War II) and other civil trauma on the prevalence of PTSD, as mediated by cultural value orientation. Secondary data analysis was performed for 12 European countries using data, including PTSD prevalence and number of war victims, crime victims, and natural disaster victims, from different sources. Ten single value orientations, as well as value aggregates for traditional and modern factors, were investigated. Results Whilst differences in PTSD prevalence were strongly associated with war victim rates, associations, albeit weaker, were also found between crime victims and PTSD. When cultural value orientations, such as stimulation and conformity as representatives of modern and traditional values, were included in the multivariate predictions of PTSD prevalence, an average of approximately 80% of PTSD variance could be explained by the model, independent of the type of trauma exposure. Conclusion The results suggest that the aftermath of war contributes to current PTSD prevalence, which may be explained by the high proportion of the older population who directly or indirectly experienced traumatic war experiences. Additional findings for other types of civil trauma point towards an interaction between value orientation and country-specific trauma rates. Particularly, being personally oriented towards stimulation appears to interact with differences in trauma prevalence. Thus, cultural value orientation might be viewed not only as an individual intrinsic process but also as a compensatory strategy after trauma exposure. PMID:24972489

  11. Prevalence and geographical distribution of canine hemotropic mycoplasma infections in Mediterranean countries and analysis of risk factors for infection.

    PubMed

    Novacco, Marilisa; Meli, Marina L; Gentilini, Fabio; Marsilio, Fulvio; Ceci, Chiara; Pennisi, Maria Grazia; Lombardo, Gabriella; Lloret, Albert; Santos, Laura; Carrapiço, Tiago; Willi, Barbara; Wolf, Godelind; Lutz, Hans; Hofmann-Lehmann, Regina

    2010-05-19

    Two hemoplasma species are known in dogs: Mycoplasma haemocanis (Mhc) and 'Candidatus Mycoplasma haematoparvum' (CMhp). Although their transmission routes are poorly understood, Rhipicephalus sanguineus has been suggested as a potential tick vector. The aim of the present study was to assess the prevalence, risk factors, and clinical importance of canine hemoplasmas in countries with a Mediterranean climate where R. sanguineus is highly prevalent using TaqMan real-time PCR, and to molecularly characterize the identified isolates. DNA (canine glyceraldehyde-3-phosphate dehydrogenase) was successfully amplified from all samples collected from 850 dogs in Italy, Spain, and Portugal, and 82 (9.6%) were PCR-positive for canine hemoplasmas (43 Mhc, 34 CMhp and 5 co-infected). The hemoplasma sample prevalence was significantly higher in Portugal (40%) than in Italy (9.5%) and Spain (2.5%). Risk factors for infection included living in kennels, young age, crossbreeding, and mange infection. No association was found with anemia. Phylogenetic analyses of the 16S rRNA and RNase P genes revealed >99% identity to other European isolates. In conclusion, canine hemoplasma infections were readily encountered in Mediterranean countries. The climate and living conditions seemed to influence canine hemoplasma prevalence. The clinical importance of canine hemoplasma infections appeared to be low, but the infection stage of the presented dogs was unknown. PMID:19931320

  12. Management of phenylketonuria in Europe: survey results from 19 countries.

    PubMed

    Blau, Nenad; Bélanger-Quintana, Amaya; Demirkol, Mübeccel; Feillet, François; Giovannini, Marcello; MacDonald, Anita; Trefz, Friedrich K; van Spronsen, Francjan

    2010-02-01

    To gain better insight in the most current diagnosis and treatment practices for phenylketonuria (PKU) from a broad group of experts, a European PKU survey was performed. The questionnaire, consisting of 33 questions, was sent to 243 PKU professionals in 165 PKU centers in 23 European countries. The responses were compiled and descriptive analyses were performed. One hundred and one questionnaires were returned by 93/165 centers (56%) from 19/23 European countries (83%). The majority of respondents (77%) managed patients of all age groups and more than 90% of PKU teams included physicians or dieticians/nutritionists. The greatest variability existed especially in the definition of PKU phenotypes, therapeutic blood phenylalanine (Phe) target concentrations, and follow-up practices for PKU patients. The tetrahydrobiopterin (BH4; sapropterin) loading test was performed by 54% of respondents, of which 61% applied a single dose test (20mg/kg over 24h). BH4 was reported as a treatment option by 34%. This survey documents differences in diagnostic and treatment practices for PKU patients in European centers. In particular, recommendations for the treatment decision varied greatly between different European countries. There is an urgent need to pool long-term data in PKU registries in order to generate an evidence-based international guideline. PMID:19800826

  13. Modeling financial disaster risk management in developing countries

    NASA Astrophysics Data System (ADS)

    Mechler, R.; Hochrainer, S.; Pflug, G.; Linnerooth-Bayer, J.

    2005-12-01

    The public sector plays a major role in reducing the long-term economic repercussions of disasters by repairing damaged infrastructure and providing financial assistance to households and businesses. If critical infrastructure is not repaired in a timely manner, there can be serious effects on the economy and the livelihoods of the population. The repair of public infrastructure, however, can be a significant drain on public budgets especially in developing and transition countries. Developing country governments frequently lack the liquidity, even including international aid and loans, to fully repair damaged critical public infrastructure or provide sufficient support to households and businesses for their recovery. The earthquake in Gujarat, and other recent cases of government post-disaster liquidity crises, have sounded an alarm, prompting financial development organizations, such as the World Bank, among others, to call for greater attention to reducing financial vulnerability and increasing the resilience of the public sector. This talk reports on a model designed to illustrate the tradeoffs and choices a developing country must make in financially managing the economic risks due to natural disasters. Budgetary resources allocated to pre-disaster risk management strategies, such as loss mitigation measures, a catastrophe reserve fund, insurance and contingent credit arrangements for public assets, reduce the probability of financing gaps - the inability of governments to meet their full obligations in providing relief to private victims and restoring public infrastructure - or prevent the deterioration of the ability to undertake additional borrowing without incurring a debt crisis. The model -which is equipped with a graphical interface - can be a helpful tool for building capacity of policy makers for developing and assessing public financing strategies for disaster risk by indicating the respective costs and consequences of financing alternatives.

  14. The Prevalence and Management of Diabetic Nephropathy in Asia

    PubMed Central

    Tomino, Yasuhiko; Gohda, Tomohito

    2015-01-01

    treatment of such patients. Facts from East and West The prevalence of DN is increasing in Asia and Western countries alike. The deletion (D) allele of the angiotensin-converting enzyme gene is associated with progression to end-stage renal disease in Asian patients with DN, but this association is uncertain in Europeans. An association between DN and polymorphism of the gene coding for acetyl coenzyme A carboxylase β has been reported in Asian and Western populations. Both in Japan and the US, criteria for diagnosis are a 5-year history of diabetes and persistent albuminuria. Renal biopsy should be done in patients with severe hematuria, cellular casts and - in the US - hepatitis and HIV to rule out other pathologies. Diabetic retinopathy is considered a key criterion in Japan, but the absence of it does not rule out DN in the US. Enlargement of the kidney is observed as a diagnostic criterion in Japan. The differential use of renal biopsy as diagnostic tool might account for a different prevalence between Asian countries. Some Japanese diabetic patients showed typical histological alterations for DN with a normal ACR and GFR. The clinical classification is similar between Japan and the US including five stages based on ACR and GFR. The Japanese guidelines do not include blood pressure values for the classification of DN. Guidelines for DN treatment are evolving quickly both in Asia and Western countries based on the numerous clinical trials performed worldwide. Targeting the angiotensin system for its hemodynamic and nonhemodynamic effects is a common approach. DPP-4 inhibitors are widely used in Japan and might have a higher glucose-lowering effect in Asian patients due to their specific diet. A randomized, double-blind placebo-controlled study has been launched to assess the efficacy of the Chinese herbal tea extract Shenyan Kangfu in DN.

  15. Study of urban community survey in India: growing trend of high prevalence of hypertension in a developing country.

    PubMed

    Das, Shyamal Kumar; Sanyal, Kalyan; Basu, Arindam

    2005-01-01

    The prevalence pattern of hypertension in developing countries is different from that in the developed countries. In India, a very large, populous and typical developing country, community surveys have documented that between three and six decades, prevalence of hypertension has increased by about 30 times among urban dwellers and by about 10 times among the rural inhabitants. Various factors might have contributed to this rising trend and among others, consequences of urbanization such as change in life style pattern, diet and stress, increased population and shrinking employment have been implicated. In this paper, we study the prevalence of hypertension in an urban community of India using the JNC VII criteria, with the aim of identifying the risk factors and suggesting intervention strategies. A total of 1609 respondents out of 1662 individuals participated in our cross-sectional survey of validated and structured questionnaire followed by blood pressure measurement. Results showed pre-hypertensive levels of blood pressures among 35.8% of the participants in systolic group (120-139mm of Hg) and 47.7% in diastolic group (80-89 mm of Hg). Systolic hypertension (140 mm of Hg) was present in 40.9% and diastolic hypertension (90 mm of Hg) in 29.3% of the participants. Age and sex-specific prevalence of hypertension showed progressive rise of systolic and diastolic hypertension in women when compared to men. Men showed progressive rise in systolic hypertension beyond fifth decade of life. Bivariate analysis showed significant relationship of hypertension with age, sedentary occupation, body mass index (BMI), diet, ischemic heart disease, and smoking. Multivariate analysis revealed age and BMI as risk factors, and non-vegetarian diet as protective factor with respect to hypertension. Prevalence of prehypertensives was high among younger subjects - particularly students and laborers who need special attention. Role of non-vegetarian diet as a protective factor might

  16. Sustainable solutions for solid waste management in Southeast Asian countries

    SciTech Connect

    Uyen Nguyen Ngoc Schnitzer, Hans

    2009-06-15

    Human activities generate waste and the amounts tend to increase as the demand for quality of life increases. Today's rate in the Southeast Asian Nations (ASEANs) is alarming, posing a challenge to governments regarding environmental pollution in the recent years. The expectation is that eventually waste treatment and waste prevention approaches will develop towards sustainable waste management solutions. This expectation is for instance reflected in the term 'zero emission systems'. The concept of zero emissions can be applied successfully with today's technical possibilities in the agro-based processing industry. First, the state-of-the-art of waste management in Southeast Asian countries will be outlined in this paper, followed by waste generation rates, sources, and composition, as well as future trends of waste. Further on, solutions for solid waste management will be reviewed in the discussions of sustainable waste management. The paper emphasizes the concept of waste prevention through utilization of all wastes as process inputs, leading to the possibility of creating an ecosystem in a loop of materials. Also, a case study, focusing on the citrus processing industry, is displayed to illustrate the application of the aggregated material input-output model in a widespread processing industry in ASEAN. The model can be shown as a closed cluster, which permits an identification of opportunities for reducing environmental impacts at the process level in the food processing industry. Throughout the discussion in this paper, the utilization of renewable energy and economic aspects are considered to adapt to environmental and economic issues and the aim of eco-efficiency. Additionally, the opportunities and constraints of waste management will be discussed.

  17. Expanded HIV Testing in Low-Prevalence, High-Income Countries: A Cost-Effectiveness Analysis for the United Kingdom

    PubMed Central

    Long, Elisa F.; Mandalia, Roshni; Mandalia, Sundhiya; Alistar, Sabina S.

    2014-01-01

    Objective In many high-income countries with low HIV prevalence, significant numbers of persons living with HIV (PLHIV) remain undiagnosed. Identification of PLHIV via HIV testing offers timely access to lifesaving antiretroviral therapy (ART) and decreases HIV transmission. We estimated the effectiveness and cost-effectiveness of HIV testing in the United Kingdom (UK), where 25% of PLHIV are estimated to be undiagnosed. Design We developed a dynamic compartmental model to analyze strategies to expand HIV testing and treatment in the UK, with particular focus on men who have sex with men (MSM), people who inject drugs (PWID), and individuals from HIV-endemic countries. Methods We estimated HIV prevalence, incidence, quality-adjusted life years (QALYs), and health care costs over 10 years, and cost-effectiveness. Results Annual HIV testing of all adults could avert 5% of new infections, even with no behavior change following HIV diagnosis because of earlier ART initiation, or up to 18% if risky behavior is halved. This strategy costs £67,000–£106,000/QALY gained. Providing annual testing only to MSM, PWID, and people from HIV-endemic countries, and one-time testing for all other adults, prevents 4–15% of infections, requires one-fourth as many tests to diagnose each PLHIV, and costs £17,500/QALY gained. Augmenting this program with increased ART access could add 145,000 QALYs to the population over 10 years, at £26,800/QALY gained. Conclusions Annual HIV testing of key populations in the UK is very cost-effective. Additional one-time testing of all other adults could identify the majority of undiagnosed PLHIV. These findings are potentially relevant to other low-prevalence, high-income countries. PMID:24763373

  18. Trachomatous Trichiasis and its Management in Endemic Countries

    PubMed Central

    Rajak, Saul N.; Collin, J. Richard O.; Burton, Matthew J.

    2012-01-01

    Trichiasis is the sight-threatening consequence of conjunctival scarring in trachoma, the most common infectious cause of blindness worldwide. Trachomatous trichiasis is the result of multiple infections from childhood with Chlamydia trachomatis, which causes recurrent chronic inflammation in the tarsal conjunctiva. This produces conjunctival scarring, entropion, trichiasis, and ultimately blinding corneal opacification. The disease causes painful, usually irreversible sight loss. Over eight million people have trachomatous trichiasis, mostly those living in poor rural communities in 57 endemic countries. The global cost is estimated at US$ 5.3 billion. The WHO recommends surgery as part of the SAFE strategy for controlling the disease.We examine the principles of clinical management, treatment options, and the challenging issues of providing the quantity and quality of surgery that is needed in resource-poor settings. PMID:22285842

  19. Partner violence during pregnancy: prevalence, effects, screening, and management

    PubMed Central

    Bailey, Beth A

    2010-01-01

    The purpose of this review is to provide an overview of the current state of knowledge regarding the experience of intimate partner violence (IPV) during pregnancy. Pregnancy IPV is a significant problem worldwide, with rates varying significantly by country and maternal risk factors. Pregnancy IPV is associated with adverse newborn outcomes, including low birth weight and preterm birth. Many mechanisms for how IPV may impact birth outcomes have been proposed and include direct health, mental health, and behavioral effects, which all may interact. Screening for IPV during pregnancy is essential, yet due to time constraints and few clear recommendations for assessment, many prenatal providers do not routinely inquire about IPV, or even believe they should. More training is needed to assist health care providers in identifying and managing pregnancy IPV, with additional research needed to inform effective interventions to reduce the rates of pregnancy IPV and resultant outcomes. PMID:21072311

  20. Prevalence of tic disorder in two schools in the Basque country: Results and methodological caveats.

    PubMed

    Linazasoro, Gurutz; Van Blercom, Nadège; de Zárate, Carmen Ortiz

    2006-12-01

    Different studies have shown that the prevalence of tic disorder is highly variable, depending on the methodology employed. The aim of this study was to determine the prevalence of tic disorder among children of two schools. The study was conducted in three successive steps: information to parents and teachers by way of speeches and projection of videotapes; anonymous fulfilling of an ad hoc questionnaire by teachers and parents and identification of children as "possible tic disorder" according to the questionnaire; and confirmation of the presence of tics by direct observation of children at school (20 minutes in each classroom). Eight hundred sixty-seven children were included. Age ranged from 4 to 16 years. Ninety percent of parents and 99% of teachers fulfilled the questionnaire. Seventy-one children had tics according to parents' and 50 according to teachers' opinion (both coincided in 23 cases). Fifty-seven cases were identified after direct observation in the classroom (prevalence of 6.5%). The vast majority of tics were mild in severity and duration. Prevalence obtained in this study was comparable with data reported in studies using a similar methodology, which is higher than results shown in early studies addressed with less rigid methodology. Most of identified cases were quite mild, not leading to major functional disability. In spite of the methodology employed, it is possible that some cases were lost. PMID:17013915

  1. Analysis of Trend of Malaria Prevalence in the Ten Asian Countries from 2006 to 2011: A Longitudinal Study

    PubMed Central

    Roy, Shongkour; Khatun, Tanjina

    2015-01-01

    Background. To control the malaria mortality, the global and national communities have worked together and produced impressive results in the world. Some of the Asian counties' malaria mortality rate is more compared to countries with high health facilities around the world. This paper's main aim is to describe trend of malaria cases and mortality in 10 Asian countries using the World Health Organization data. Methods. Malaria mortality data was collected systematically from WHO and UN database for the period 2006–2011. We estimated malaria mortality by age and countries. We also explored the dynamic relationships among malaria death rate, total populations, and geographical region using a map. During 2006–2011, the average malaria death per 10,000 population of all ages was 0.239 (95% CI 0.104 to 0.373), of children aged less than 5 year 1.143 (0.598 to 1.687), and of age greater than 5 years 0.089 (0.043 to 0.137) in Asian countries. Malaria prevalence per 10,000 populations steadily decreased from 486.7 in 2006 to 298.9 in 2011. Conclusion. The findings show that malaria mortality is higher for children aged less than 5 years compared with with adults selected in Asian countries except Sri Lanka. PMID:26693382

  2. An overview of food waste management in developing countries: Current status and future perspective.

    PubMed

    Thi, Ngoc Bao Dung; Kumar, Gopalakrishnan; Lin, Chiu-Yue

    2015-07-01

    Food waste (FW) related issues in developing countries is currently considered to be a major threatening factor for sustainable development and FW management systems. Due to incomplete FW management systems, many developing countries are facing challenges, such as environmental and sanitary problems that are caused by FW. The difference in FW generation trends between developing countries and developed countries was reviewed in this work, which demonstrated that the effects of income level, population growth, and public participation in FW management are very important. Thus, this work aimed to provide an overview of recycling activities, related regulations, and current FW treatment technology in developing countries by following some case studies. Taiwan, has been suggested as being a successful case in terms of FW management, and is therefore a typical model for developing countries to follow. Finally, an integrative management system as a suitable model for FW management has been suggested for developing countries. PMID:25910976

  3. G6PD Deficiency Prevalence and Estimates of Affected Populations in Malaria Endemic Countries: A Geostatistical Model-Based Map

    PubMed Central

    Howes, Rosalind E.; Piel, Frédéric B.; Patil, Anand P.; Nyangiri, Oscar A.; Gething, Peter W.; Dewi, Mewahyu; Hogg, Mariana M.; Battle, Katherine E.; Padilla, Carmencita D.; Baird, J. Kevin; Hay, Simon I.

    2012-01-01

    Background Primaquine is a key drug for malaria elimination. In addition to being the only drug active against the dormant relapsing forms of Plasmodium vivax, primaquine is the sole effective treatment of infectious P. falciparum gametocytes, and may interrupt transmission and help contain the spread of artemisinin resistance. However, primaquine can trigger haemolysis in patients with a deficiency in glucose-6-phosphate dehydrogenase (G6PDd). Poor information is available about the distribution of individuals at risk of primaquine-induced haemolysis. We present a continuous evidence-based prevalence map of G6PDd and estimates of affected populations, together with a national index of relative haemolytic risk. Methods and Findings Representative community surveys of phenotypic G6PDd prevalence were identified for 1,734 spatially unique sites. These surveys formed the evidence-base for a Bayesian geostatistical model adapted to the gene's X-linked inheritance, which predicted a G6PDd allele frequency map across malaria endemic countries (MECs) and generated population-weighted estimates of affected populations. Highest median prevalence (peaking at 32.5%) was predicted across sub-Saharan Africa and the Arabian Peninsula. Although G6PDd prevalence was generally lower across central and southeast Asia, rarely exceeding 20%, the majority of G6PDd individuals (67.5% median estimate) were from Asian countries. We estimated a G6PDd allele frequency of 8.0% (interquartile range: 7.4–8.8) across MECs, and 5.3% (4.4–6.7) within malaria-eliminating countries. The reliability of the map is contingent on the underlying data informing the model; population heterogeneity can only be represented by the available surveys, and important weaknesses exist in the map across data-sparse regions. Uncertainty metrics are used to quantify some aspects of these limitations in the map. Finally, we assembled a database of G6PDd variant occurrences to inform a national-level index of

  4. Mapping the Prevalence and Sociodemographic Characteristics of Women Who Deliver Alone: Evidence From Demographic and Health Surveys From 80 Countries

    PubMed Central

    Orobaton, Nosakhare; Austin, Anne; Fapohunda, Bolaji; Abegunde, Dele; Omo, Kizzy

    2016-01-01

    ABSTRACT Evidence has shown that quality skilled care during labor and delivery is essential to improve maternal and newborn health outcomes. Unfortunately, analyses of Demographic and Health Survey (DHS) data show that there are a substantial number of women around the world that not only do not have access to skilled care but also deliver alone with no one present (NOP). Among the 80 countries with data, we found the practice of delivering with NOP was concentrated in West and Central Africa and parts of East Africa. Across these countries, the prevalence of giving birth with NOP was higher among women who were poor, older, of higher parity, living in rural areas, and uneducated than among their counterparts. As women increased use of antenatal care services, the proportion giving birth with NOP declined. Using census data for each country from the US Census Bureau’s International Database and data on prevalence of delivering with NOP from the DHS among countries with surveys from 2005 onwards (n = 59), we estimated the number of women who gave birth alone in each country, as well as each country’s contribution to the total burden. Our analysis indicates that between 2005 and 2015, an estimated 2.2 million women, who had given birth in the 3 years preceding each country survey, delivered with NOP. Nigeria, alone, accounted for 44% (nearly 1 million) of these deliveries. As countries work on reducing inequalities in access to health care, wealth, education, and family planning, concurrent efforts to change community norms that condone and facilitate the practice of women giving birth alone must also be implemented. Programmatic experience from Sokoto State in northern Nigeria suggests that the practice can be reduced markedly through grassroots community advocacy and education, even in poor and low-resource areas. It is time for leaders to act now to eradicate the practice of giving birth alone—one of many important steps needed to ensure no mother or

  5. Prevalence of HBsAg mutants and impact of hepatitis B infant immunisation in four Pacific Island countries.

    PubMed

    Basuni, Ashraf A; Butterworth, Lesley; Cooksley, G; Locarnini, S; Carman, W F

    2004-07-29

    The prevalence rate of hepatitis B virus (HBV) infection in Pacific Island countries is amongst the highest in the world. Hepatitis B immunisation has been incorporated into national programmes at various times, often with erratic supply and coverage, until a regionally co-ordinated programme, which commenced in 1995 ensured adequate supply. The effectiveness of these programmes was recently evaluated in four countries, Vanuatu and Fiji in Melanesia, Tonga in Polynesia and Kiribati in Micronesia. That evaluation established that the programmes had a substantial beneficial impact in preventing chronic hepatitis B infection [Vaccine 18 (2000) 3059]. Several studies of hepatitis B vaccination programmes in endemic countries have identified the potential significance of surface gene mutants as a cause for failure of immunisation. In the study outlined in this paper, we screened infected children and their mothers for the emergence and prevalence of these variants in specimens collected from the four country evaluation. Although the opportunity for the emergence of HBV vaccine escape mutants in these populations was high due to the presence of a considerable amount of the virus in the population and the selection pressure from vaccine use, there were no "a" determinant vaccine escape mutants found. This suggests that vaccine escape variants are not an important cause for failure to prevent HBV transmission in this setting. Other HBsAg variants were detected, but their functional significance remains to be determined. The failure to provide satisfactory protection during such immunisation programmes reflects the need for achieving and sustaining high vaccine coverage, improving the timeliness of doses as well as improving 'cold-chain' support, rather than the selection of vaccine-escape mutants of HBV. PMID:15246613

  6. Public or private water management: Experience from different European Countries

    NASA Astrophysics Data System (ADS)

    Wackerbauer, Johann

    2008-11-01

    Faced with liberalisation proposals and an increasing internationalisation of water resource management, the question arises as to how a change of the regulatory framework would affect the market structure and the supply conditions in this area. While the term "privatisation" relates to the ownership structure of the providers, the term "liberalisation" implies extensive free market ideas. Privatisation involves the outsourcing of public services from the public authorities to a privately organised organisation. Through this, however, nothing needs to change in terms of the market or the intensity of competition for the commodity in question. Within the framework of privatisation it can also occur that the public monopoly is only transferred to a private monopoly. The term "liberalisation" in addition refers to the basic regulatory constraints: liberalisation signifies the cessation of limitations to competition and supply monopolies, and open competition between several suppliers for the consumers. In the EU-15, the only country where the provision of operational services in the water supply has been totally passed to the private sector is the UK, but this is only true for UK and Wales. Another singular case is France, where there is a mix of mainly private operating companies and municipalities which have divided the regional supply areas among themselves. In six other EU-15 countries where some privatisation took place, either the municipalities or (majority) publicly owned companies are controlling water supply. In the remaining seven countries, the water supply is organised by municipality companies only. In an international comparison, there are three basic models for the regulation of natural monopolies in the public water supply: the Anglo-Saxon, the French and the German model. The delimitation between supervisory bodies and operations in the water supply is strongest in the first model and weakest in the last. This has led to three basic types of

  7. Pricing Policies And Control of Tobacco in Europe (PPACTE) project: cross-national comparison of smoking prevalence in 18 European countries.

    PubMed

    Gallus, Silvano; Lugo, Alessandra; La Vecchia, Carlo; Boffetta, Paolo; Chaloupka, Frank J; Colombo, Paolo; Currie, Laura; Fernandez, Esteve; Fischbacher, Colin; Gilmore, Anna; Godfrey, Fiona; Joossens, Luk; Leon, Maria E; Levy, David T; Nguyen, Lien; Rosenqvist, Gunnar; Ross, Hana; Townsend, Joy; Clancy, Luke

    2014-05-01

    Limited data on smoking prevalence allowing valid between-country comparison are available in Europe. The aim of this study is to provide data on smoking prevalence and its determinants in 18 European countries. In 2010, within the Pricing Policies And Control of Tobacco in Europe (PPACTE) project, we conducted a face-to-face survey on smoking in 18 European countries (Albania, Austria, Bulgaria, Czech Republic, Croatia, England, Finland, France, Greece, Hungary, Ireland, Italy, Latvia, Poland, Portugal, Romania, Spain and Sweden) on a total of 18 056 participants, representative for each country of the population aged 15 years or older. Overall, 27.2% of the participants were current smokers (30.6% of men and 24.1% of women). Smoking prevalence was highest in Bulgaria (40.9%) and Greece (38.9%) and lowest in Italy (22.0%) and Sweden (16.3%). Smoking prevalence ranged between 15.7% (Sweden) and 44.3% (Bulgaria) for men and between 11.6% (Albania) and 38.1% (Ireland) for women. Multivariate analysis showed a significant inverse trend between smoking prevalence and the level of education in both sexes. Male-to-female smoking prevalence ratios ranged from 0.85 in Spain to 3.47 in Albania and current-to-ex prevalence ratios ranged from 0.68 in Sweden to 4.28 in Albania. There are considerable differences across Europe in smoking prevalence, and male-to-female and current-to-ex smoking prevalence ratios. Eastern European countries, lower income countries and those with less advanced tobacco control policies have less favourable smoking patterns and are at an earlier stage of the tobacco epidemic. PMID:24441832

  8. Towards a science of sustainable upland management in developing countries

    NASA Astrophysics Data System (ADS)

    Carpenter, Richard A.; Harper, David E.

    1989-01-01

    Farmers attempting to subsist in tropical uplands often rely upon unsustainable resource use practices that lead to soil erosion, declining crop yields, and a loss of soil productivity capacity. Other uses of tropical uplands, including logging and conversion of forest to rangelands, have similar results. The undesirable effects of these actions are felt on-site, at the watershed level, and even nationally. Ecological cause-effect relationships are poorly understood, and few examples exist of the successful integration of ecological knowledge with upland development. It is hypothesized that recent results of ecological research could be applied to uplands management so that stable sustainable systems of human use may be established. A second hypothesis is that statistically reliable data can be obtained from experiments in upland situations, although natural variations of soils, weather, and vegetation are great. To test these hypotheses, research involving multinational collaboration among American and Southeast Asian scientists has begun. The objective of the work is to provide credible quantitative information to help policy and decision makers and resident farmers to plan and implement improved practices based on ecological principles. Some findings to date include: 1. Ecological principles are difficult to relate to the practical context of upland agroecosystems. Indeed, the null hypothesis is necessary for planning experiments and demonstrations. 2. The “signal-to-noise” ratio in these field experiments is low, and the detection of changes due to human intervention in soil erosion, nutrient movement, and plant productivity is difficult. 3. Obstacles to field research in developing countries include logistic, cultural, political, and institutional factors. It is essential that local land managers participate from the start with scientific researchers in designing experiments. 4. Planned collaboration among academic and government scientists facilitates

  9. Prevalence of Nutrition and Health-Related Claims on Pre-Packaged Foods: A Five-Country Study in Europe.

    PubMed

    Hieke, Sophie; Kuljanic, Nera; Pravst, Igor; Miklavec, Krista; Kaur, Asha; Brown, Kerry A; Egan, Bernadette M; Pfeifer, Katja; Gracia, Azucena; Rayner, Mike

    2016-03-01

    This study is part of the research undertaken in the EU funded project CLYMBOL ("Role of health-related CLaims and sYMBOLs in consumer behaviour"). The first phase of this project consisted of mapping the prevalence of symbolic and non-symbolic nutrition and health-related claims (NHC) on foods and non-alcoholic beverages in five European countries. Pre-packaged foods and drinks were sampled based on a standardized sampling protocol, using store lists or a store floor plan. Data collection took place across five countries, in three types of stores. A total of 2034 foods and drinks were sampled and packaging information was analyzed. At least one claim was identified for 26% (95% CI (24.0%-27.9%)) of all foods and drinks sampled. Six percent of these claims were symbolic. The majority of the claims were nutrition claims (64%), followed by health claims (29%) and health-related ingredient claims (6%). The most common health claims were nutrient and other function claims (47% of all claims), followed by disease risk reduction claims (5%). Eight percent of the health claims were children's development and health claims but these were only observed on less than 1% (0.4%-1.1%) of the foods. The category of foods for specific dietary use had the highest proportion of NHC (70% of foods carried a claim). The prevalence of symbolic and non-symbolic NHC varies across European countries and between different food categories. This study provides baseline data for policy makers and the food industry to monitor and evaluate the use of claims on food packaging. PMID:26950149

  10. Prevalence of Nutrition and Health-Related Claims on Pre-Packaged Foods: A Five-Country Study in Europe

    PubMed Central

    Hieke, Sophie; Kuljanic, Nera; Pravst, Igor; Miklavec, Krista; Kaur, Asha; Brown, Kerry A.; Egan, Bernadette M.; Pfeifer, Katja; Gracia, Azucena; Rayner, Mike

    2016-01-01

    This study is part of the research undertaken in the EU funded project CLYMBOL (“Role of health-related CLaims and sYMBOLs in consumer behaviour”). The first phase of this project consisted of mapping the prevalence of symbolic and non-symbolic nutrition and health-related claims (NHC) on foods and non-alcoholic beverages in five European countries. Pre-packaged foods and drinks were sampled based on a standardized sampling protocol, using store lists or a store floor plan. Data collection took place across five countries, in three types of stores. A total of 2034 foods and drinks were sampled and packaging information was analyzed. At least one claim was identified for 26% (95% CI (24.0%–27.9%)) of all foods and drinks sampled. Six percent of these claims were symbolic. The majority of the claims were nutrition claims (64%), followed by health claims (29%) and health-related ingredient claims (6%). The most common health claims were nutrient and other function claims (47% of all claims), followed by disease risk reduction claims (5%). Eight percent of the health claims were children’s development and health claims but these were only observed on less than 1% (0.4%–1.1%) of the foods. The category of foods for specific dietary use had the highest proportion of NHC (70% of foods carried a claim). The prevalence of symbolic and non-symbolic NHC varies across European countries and between different food categories. This study provides baseline data for policy makers and the food industry to monitor and evaluate the use of claims on food packaging. PMID:26950149

  11. The prevalence and correlates of sitting in European adults - a comparison of 32 Eurobarometer-participating countries

    PubMed Central

    2013-01-01

    Background Prolonged sitting is an emerging health risk. However, multi-country comparative sitting data are sparse. This paper reports the prevalence and correlates of sitting time in 32 European countries. Methods Data from the Eurobarometer 64.3 study were used, which included nationally representative samples (n = 304-1,102) from 32 European countries. Face-to-face interviews were conducted during November and December 2005. Usual weekday sitting time was assessed using the International Physical Activity Questionnaire (short-version). Sitting time was compared by country, age, gender, years of education, general health status, usual activity and physical activity. Multivariable-adjusted analyses assessed the odds of belonging to the highest sitting quartile. Results Data were available for 27,637 adults aged 15–98 years. Overall, mean reported weekday sitting time was 309 min/day (SD 184 min/day). There was a broad geographical pattern and some of the lowest amounts of daily sitting were reported in southern (Malta and Portugal means 194–236 min/day) and eastern (Romania and Hungary means 191–276 min/day) European countries; and some of the highest amounts of daily sitting were reported in northern European countries (Germany, Benelux and Scandinavian countries; means 407–335 min/day). Multivariable-adjusted analyses showed adults with low physical activity levels (OR = 5.10, CI95 = 4.60-5.66), those with high sitting in their main daily activity (OR = 2.99, CI95 = 2.74-3.25), those with a bad/very bad general health state (OR = 1.87, CI95 = 1.63-2.15) and higher education levels (OR = 1.48, CI95 = 1.38-1.59) were more likely to be in the highest quartile of daily sitting time. Adults within Greece (OR = 2.91, CI95 = 2.51-3.36) and Netherlands (OR = 2.56, CI95 = 2.22-2.94) were most likely to be in the highest quartile. High-sit/low-active participants comprised 10.1% of the sample. Adults self

  12. 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

  13. Modeling and Managing Regional Aquifers in Arid Countries

    NASA Astrophysics Data System (ADS)

    Schüth, C.; Rausch, R.

    2009-12-01

    Most of the regional aquifers in arid countries were recharged many thousand years ago when the climate was much wetter than today. Therefore, most of the groundwater stored in the aquifers is fossil water. The aquifers are in a state of constant depletion as recent groundwater recharge is much smaller than the outflow. A prerequisite for the smart management of such groundwater resources is a sound understanding of the aquifer system based on reliable data and robust simulation models. Mathematical groundwater models are one of the tools available that can consider a complex array of aquifer variables and allow these variables to interact with themselves. Exploring these interactions with a model can reveal how an aquifer behaves. Once a model is working properly, it can be used to make predictions for managing groundwater resources, such as predicting how groundwater levels might respond to increased pumping or drought, testing different management scenarios etc. Furthermore, groundwater models describing regional aquifers in arid regions must be considered to be in a transient state and consider the entire extent of the aquifer. The introduction of artificial boundaries is not possible and lead to wrong estimations. Within the modeling process the reduction and estimation of uncertainties is required, which leads to the “inverse problem” in groundwater modeling. Strategies for the reduction and estimation of uncertainties are needed. Problems are (1) the ill-posedness of parameter estimation, (2) that no unique solution may exist, and (3) that measurement errors make the results unreliable. Ways out are the reduction of degrees of freedom by introducing geological ‘a priori’ knowledge as well as the joint use of head, flow and/or concentration measurements, and the estimation of uncertainty. This concept is demonstrated by examples of model development for regional aquifers on the Arabian Peninsula, e.g. ‘a priori’ knowledge is introduced into the

  14. International Models of Care that Address the Growing Diabetes Prevalence in Developing Countries.

    PubMed

    Singh, Kavita; Ranjani, Harish; Rhodes, Elizabeth; Weber, Mary Beth

    2016-08-01

    Diabetes care involves a complex interaction between patients, physicians, the health care system, and society. In low- and middle-income countries (LMICs), where the majority of individuals with diabetes live, there is a shortage of resources and infrastructure for diabetes care. Translation of proven interventions for diabetes prevention and care from experimental settings to the real world is a major challenge, and there is limited evidence from LMICs. To curtail the diabetes burden in LMICs, it is crucial to develop and execute innovative diabetes care models that improve access to care, knowledge, and outcomes. Additionally, adequate training of local health professionals and community engagement can help LMICs become self-sufficient in delivery of diabetes care. In this paper, we reviewed the existing models of diabetes care and prevention in LMICs and provided recommendations to guide the development of a comprehensive and effective future model for diabetes care in LMICs. PMID:27313071

  15. Management of microbial food safety in the Arab countries

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Microbial food safety remains a major economical and public health concern in the Arab countries. Over the several past years, many of these countries have attempted to revise and upgrade food quality control and surveillance programs. However, these systems vary in scope and effectiveness. This rev...

  16. Asthma Prevalence, Management, and Education in New York State Elementary Schools: A Survey of School Nurses

    ERIC Educational Resources Information Center

    Kielb, Christine; Lin, Shao; Hwang, Syni-an

    2007-01-01

    A survey of school nurses was conducted in New York State elementary schools to assess asthma and asthma management in students. The survey contained questions about asthma morbidity, management and education, obstacles to management, and school indoor air quality. The reported prevalence of asthma among students was 8.5%. Of the students with…

  17. Prevalence and Current Approaches of Ebola Virus Disease in ASEAN Countries

    PubMed Central

    San, Kok Pui; Jiun, Ting Wei; May, Tam Ai; Neng, Yap Chan; Seng, Hee Kah; Soon, Lim Jing; Pazooki, Nazanin

    2015-01-01

    As indicated by the World Health Organization as of year 2014, around 10,000 people have been influenced with Ebola infection. The episode of Ebola in African locale is courged with a high death rate. Notwithstanding, in the United States, people influenced by Ebola have been given brilliant wellbeing offices, as the U.S. is one of the highest nations that have taken sterner wellbeing measures and principles against Ebola. Aside from the U.S., individuals in Asia, where billions live in indigence and general wellbeing frameworks are frequently extremely powerless, are under more serious danger of the Ebola infection. Despite the fact that nations like Singapore, Malaysia, South Korea and Japan can take stretched out measures to battle against the infection, nations like Philippines and Indonesia have unfathomable quantities of poor who may be incredibly influenced by a conceivable episode. At this moment, the chances that Asia will take a critical hit from the Ebola infection appear to be genuinely little. Yet, while it is far-fetched that Asia will encounter a real flare-up, genuine concerns stay about the infection coming to urban communities like Hong Kong, Beijing, Shanghai and Singapore through their worldwide airplane terminals. Wellbeing priests from the Association of Southeast Asian Nations (ASEAN) reported key measures not long ago to keep the Ebola plague from coming to the locale and to backing influenced nations. This article accordingly will concentrate on the prevalence and current approaches of Ebola Virus Disease in ASEAN nations which is the need of the hour. PMID:26500929

  18. Energy management in rural sector of developing countries

    SciTech Connect

    Ali, M.; Duragapal, B.C.

    1983-12-01

    The necessity of finding new sources of energy is becoming urgent as the supply of fossil fuels is rapidly approaching depletion in the developing countries, and therefore, these countries are importing petroleum products from other countries. Recent hikes in petroleum prices by the Organization of Petroleum Exporting Countries has given a serious jolt to economic development, and also disturbed the balance of payment position through the rise in the price of imports and essential goods. Therefore, rising prices of petroleum products have forced us to find alternative ways and means of producing energy. Rural areas of developing countries have large supplies of waste materials like animal wastes, crop residues and by-products. These wastes can be converted into useable thermal energy and organic fertilizer. In this paper, an attempt has been made to discuss the efficient and economic utilization of animal wastes, agricultural residues and by-products for the formation of thermal energy in the form of bio-gas and bio-fertilizers. Proper utilization of rural wastes, abundantly available in the rural sector of developing countries, would go a long way in conserving the fast-depleting forest resources, reducing environmental pollution, creating a healthy atmosphere and improving economic conditions of the rural masses in developing countries, where unemployment is rising with the continuous increase in population, aggravating environmental pollution and reducing conventional resources of energy.

  19. Global Health Donor Presence, Variations in HIV/AIDS Prevalence, and External Resources for Health in Developing Countries in Africa and Asia

    PubMed Central

    Azuine, Romuladus Emeka; Singh, Gopal K.; Ekejiuba, Sussan E.; Ashu, Eta; Azuine, Magnus A.

    2014-01-01

    Objective: The presence of multiple global health aid organizations in donor recipient countries at any point in time has led to arguments for and against aid coordination and aid pluralism. Little data, however, exist to empirically demonstrate the relationship between donor presence and longitudinal disease outcomes in donor-recipient countries. We examined the association between global health donor presence and changes in HIV/AIDS prevalence in 14 developing countries: 12 in Africa (Ethiopia, Kenya, Tanzania, Malawi, Zimbabwe, Mozambique, Rwanda, South Africa, Uganda, Zambia, Burkina Faso and Mali) and compared them with two developing countries in Asia (India and Vietnam). Methods: To conduct our analyses, we conceptualized a framework for examining global health donor presence and disease outcomes. Donor presence data were derived from Mapping the Donor Landscape in Global Health: HIV/AIDS, a report published by the Kaiser Family Foundation, Washington, DC, USA. HIV/AIDS prevalence data were obtained and analyzed from the World Health Statistics and the Demographic and Health Surveys. Percent changes in national HIV/AIDS prevalence between 2009 and 2011 in the 14 developing countries were computed and correlation coefficients between donor presence and prevalence changes were calculated. Results: Between 2009 and 2011, HIV/AIDS prevalence decreased in all but one of the 14 developing countries with the presence of 21 or more global health donors. There was about 40% overall reduction in HIV/AIDS prevalence across the 14 countries in our analyses. South Africa recorded the most reduction in HIV/AIDS prevalence (-6.7%) followed by Zambia (-6.3, %), and Mozambique (-5.7%). Ethiopia was the only country without a reduction in HIV/AIDS prevalence (+0.1%). A correlation coefficient of 0.43 implied greater reductions in HIV/AIDS prevalence associated with increased donor presence. Conclusions and Public Health Implications: Our study shows a correlation between

  20. Factor Configurations with Governance as Conditions for Low HIV/AIDS Prevalence in HIV/AIDS Recipient Countries: Fuzzy-set Analysis

    PubMed Central

    Lee, Hwa-Young; Kang, Minah

    2015-01-01

    This paper aims to investigate whether good governance of a recipient country is a necessary condition and what combinations of factors including governance factor are sufficient for low prevalence of HIV/AIDS in HIV/AIDS aid recipient countries during the period of 2002-2010. For this, Fuzzy-set Qualitative Comparative Analysis (QCA) was used. Nine potential attributes for a causal configuration for low HIV/AIDS prevalence were identified through a review of previous studies. For each factor, full membership, full non-membership, and crossover point were specified using both author's knowledge and statistical information of the variables. Calibration and conversion to a fuzzy-set score were conducted using Fs/QCA 2.0 and probabilistic tests for necessary and sufficiency were performed by STATA 11. The result suggested that governance is the necessary condition for low prevalence of HIV/AIDS in a recipient country. From sufficiency test, two pathways were resulted. The low level of governance can lead to low level of HIV/AIDS prevalence when it is combined with other favorable factors, especially, low economic inequality, high economic development and high health expenditure. However, strengthening governance is a more practical measure to keep low prevalence of HIV/AIDS because it is hard to achieve both economic development and economic quality. This study highlights that a comprehensive policy measure is the key for achieving low prevalence of HIV/AIDS in recipient country. PMID:26617451

  1. Factor Configurations with Governance as Conditions for Low HIV/AIDS Prevalence in HIV/AIDS Recipient Countries: Fuzzy-set Analysis.

    PubMed

    Lee, Hwa-Young; Yang, Bong-Min; Kang, Minah

    2015-11-01

    This paper aims to investigate whether good governance of a recipient country is a necessary condition and what combinations of factors including governance factor are sufficient for low prevalence of HIV/AIDS in HIV/AIDS aid recipient countries during the period of 2002-2010. For this, Fuzzy-set Qualitative Comparative Analysis (QCA) was used. Nine potential attributes for a causal configuration for low HIV/AIDS prevalence were identified through a review of previous studies. For each factor, full membership, full non-membership, and crossover point were specified using both author's knowledge and statistical information of the variables. Calibration and conversion to a fuzzy-set score were conducted using Fs/QCA 2.0 and probabilistic tests for necessary and sufficiency were performed by STATA 11. The result suggested that governance is the necessary condition for low prevalence of HIV/AIDS in a recipient country. From sufficiency test, two pathways were resulted. The low level of governance can lead to low level of HIV/AIDS prevalence when it is combined with other favorable factors, especially, low economic inequality, high economic development and high health expenditure. However, strengthening governance is a more practical measure to keep low prevalence of HIV/AIDS because it is hard to achieve both economic development and economic quality. This study highlights that a comprehensive policy measure is the key for achieving low prevalence of HIV/AIDS in recipient country. PMID:26617451

  2. The HBsAg Prevalence Among Blood Donors From Eastern Mediterranean and Middle Eastern Countries: A Systematic Review and Meta-Analysis

    PubMed Central

    Babanejad, Mehran; Izadi, Neda; Najafi, Farid; Alavian, Seyed Moayed

    2016-01-01

    Context The world health organization (WHO) recommends that all blood donations should be screened for evidence of infections, such as hepatitis B. The present study aimed to determine the prevalence of hepatitis B surface antigen (HBsAg) in blood donors at the eastern Mediterranean region office (EMRO) of the WHO and middle eastern countries. Evidence Acquisition A meta-analysis was carried out based on the results of an electronic literature search of PubMed, Ovid, Scopus, and Google Scholar for articles published from January 1, 2000, to August 31, 2015. In accordance with a significant homogeneity test and a large value of I2, the random effects model was used to aggregate data from the studies and produce the pooled estimates using the “Metan” command. Results We included 66 eligible studies. The pooled prevalence of HBsAg in blood donors of both EMRO and middle eastern (E and M) countries was 2.03% (95% confidence interval [CI]: 1.79 – 2.26). In addition, the prevalence rates in the EMRO countries was 1.99% (95% CI: 1.84 – 2.14) and 1.62% in the Middle Eastern countries (95% CI: 1.36 – 1.88). The prevalence among blood donors with more than one study was 1.58% in Egypt, 0.58% in Iran, 0.67% in Iraq, 2.84% in Pakistan, 3.02% in Saudi Arabia, 1.68% in Turkey, and 5.05% in Yemen. Conclusions Based on the WHO classification of hepatitis B virus (HBV) prevalence, the prevalence of HBsAg in blood donors from E and M countries reached an intermediate level. However, there were low prevalence levels in some E and M countries. PMID:27226804

  3. Prevalence and Costs of Multimorbidity by Deprivation Levels in the Basque Country: A Population Based Study Using Health Administrative Databases

    PubMed Central

    Orueta, Juan F.; García-Álvarez, Arturo; García-Goñi, Manuel; Paolucci, Francesco; Nuño-Solinís, Roberto

    2014-01-01

    Background Multimorbidity is a major challenge for healthcare systems. However, currently, its magnitude and impact in healthcare expenditures is still mostly unknown. Objective To present an overview of the prevalence and costs of multimorbidity by socioeconomic levels in the whole Basque population. Methods We develop a cross-sectional analysis that includes all the inhabitants of the Basque Country (N = 2,262,698). We utilize data from primary health care electronic medical records, hospital admissions, and outpatient care databases, corresponding to a 4 year period. Multimorbidity was defined as the presence of two or more chronic diseases out of a list of 52 of the most important and common chronic conditions given in the literature. We also use socioeconomic and demographic variables such as age, sex, individual healthcare cost, and deprivation level. Predicted adjusted costs were obtained by log-gamma regression models. Results Multimorbidity of chronic diseases was found among 23.61% of the total Basque population and among 66.13% of those older than 65 years. Multimorbid patients account for 63.55% of total healthcare expenditures. Prevalence of multimorbidity is higher in the most deprived areas for all age and sex groups. The annual cost of healthcare per patient generated for any chronic disease depends on the number of coexisting comorbidities, and varies from 637 € for the first pathology in average to 1,657 € for the ninth one. Conclusion Multimorbidity is very common for the Basque population and its prevalence rises in age, and unfavourable socioeconomic environment. The costs of care for chronic patients with several conditions cannot be described as the sum of their individual pathologies in average. They usually increase dramatically according to the number of comorbidities. Given the ageing population, multimorbidity and its consequences should be taken into account in healthcare policy, the organization of care and medical research

  4. Seroprevalence of Helicobacter pylori infection and gastric mucosal atrophy in Bhutan, a country with a high prevalence of gastric cancer

    PubMed Central

    Shiota, Seiji; Mahachai, Varocha; Vilaichone, Ratha-korn; Ratanachu-ek, Thawee; Tshering, Lotay; Uchida, Tomohisa; Matsunari, Osamu

    2013-01-01

    Gastric cancer is the second leading cause of cancer-related mortality in the world. Recently, serum Helicobacter pylori antibodies and pepsinogen (PG) have been used for gastric cancer screening. The incidence of gastric cancer in Bhutan is reported to be quite high compared with that in neighbouring countries. In this study, 381 subjects from three areas of Bhutan were assessed for gastric mucosal atrophy and serological parameters. Anti-H. pylori IgG, PG I, PG II and cytotoxin-associated gene A (CagA) antibodies were measured using ELISA. Subjects were classified into four groups according to H. pylori and PG seropositivity: Group A (H. pylori-negative/PG-negative), Group B (H. pylori-positive/PG-negative), Group C (H. pylori-positive/PG-positive) and Group D (H. pylori-negative/PG-positive). The prevalence of H. pylori in the 381 subjects was 71.1 % (271/381), with high infection rates found in rural areas. The PG I/II ratio was significantly inversely correlated with the atrophy score in the antrum and the corpus (P<0.001). Multivariate analysis showed that the PG status was significantly associated with the presence of atrophy in the corpus. The prevalence of the PG-positive status was significantly higher among H. pylori-positive subjects than among H. pylori-negative subjects (P<0.001). Based on the ABC method, Group B was the most dominant, followed by Group A, Group C and Group D. The high incidence of gastric cancer in Bhutan can be attributed to the high prevalence of H. pylori infection and gastric mucosal atrophy. PMID:23831768

  5. Molecular investigations on the prevalence and viral load of enteric viruses in pigs from five European countries.

    PubMed

    Zhou, Weiguang; Ullman, Karin; Chowdry, Vinay; Reining, Márta; Benyeda, Zsófia; Baule, Claudia; Juremalm, Mikael; Wallgren, Per; Schwarz, Lukas; Zhou, Enmin; Pedrero, Sonia Pina; Hennig-Pauka, Isabel; Segales, Joaquim; Liu, Lihong

    2016-01-15

    Enteric viral infections in pigs may cause diarrhea resulting in ill-thrift and substantial economic losses. This study reports the enteric infections with porcine astrovirus type 4 (PAstV4), porcine group A rotavirus (GARV), porcine group C rotavirus (GCRV), porcine circovirus type 2 (PCV2) and porcine kobuvirus (PKoV) in 419 pigs, comprising both healthy and diarrheic animals, from 49 farms in five European countries (Austria, Germany, Hungary, Spain and Sweden). Real-time RT-PCR assays were developed to test fecal samples and to compare the prevalence and viral load in relation to health status, farms of origin and age groups. The results showed that PAstV4 (70.4%) was the dominant virus species, followed by PKoV (56.7%), PCV2 (42.2%), GCRV (3%) and GARV (0.9%). Diarrheic pigs had a higher viral load of PAstV4 in the nursery and growing-finishing groups. Rotaviruses were mainly detected in diarrheic pigs, whereas PCV2 was more often detected in clinically healthy than in diarrheic pigs, suggesting that most PCV2 infections were subclinical. PAstV4, PCV2 and PKoV were considered ubiquitous in the European pig livestock and co-infections among them were frequent, independently of the disease status, in contrast to a low prevalence of classical rotavirus infections. PMID:26711031

  6. Early Childhood Developmental Status in Low- and Middle-Income Countries: National, Regional, and Global Prevalence Estimates Using Predictive Modeling

    PubMed Central

    McCoy, Dana Charles; Danaei, Goodarz; Black, Maureen M.; Sudfeld, Christopher R.; Fawzi, Wafaie; Fink, Günther

    2016-01-01

    Background The development of cognitive and socioemotional skills early in life influences later health and well-being. Existing estimates of unmet developmental potential in low- and middle-income countries (LMICs) are based on either measures of physical growth or proxy measures such as poverty. In this paper we aim to directly estimate the number of children in LMICs who would be reported by their caregivers to show low cognitive and/or socioemotional development. Methods and Findings The present paper uses Early Childhood Development Index (ECDI) data collected between 2005 and 2015 from 99,222 3- and 4-y-old children living in 35 LMICs as part of the Multiple Indicator Cluster Survey (MICS) and Demographic and Health Surveys (DHS) programs. First, we estimate the prevalence of low cognitive and/or socioemotional ECDI scores within our MICS/DHS sample. Next, we test a series of ordinary least squares regression models predicting low ECDI scores across our MICS/DHS sample countries based on country-level data from the Human Development Index (HDI) and the Nutrition Impact Model Study. We use cross-validation to select the model with the best predictive validity. We then apply this model to all LMICs to generate country-level estimates of the prevalence of low ECDI scores globally, as well as confidence intervals around these estimates. In the pooled MICS and DHS sample, 14.6% of children had low ECDI scores in the cognitive domain, 26.2% had low socioemotional scores, and 36.8% performed poorly in either or both domains. Country-level prevalence of low cognitive and/or socioemotional scores on the ECDI was best represented by a model using the HDI as a predictor. Applying this model to all LMICs, we estimate that 80.8 million children ages 3 and 4 y (95% CI 48.1 million, 113.6 million) in LMICs experienced low cognitive and/or socioemotional development in 2010, with the largest number of affected children in sub-Saharan Africa (29.4.1 million; 43.8% of children

  7. The prevalence of ABCB1:c.227_230delATAG mutation in affected dog breeds from European countries.

    PubMed

    Firdova, Zuzana; Turnova, Evelina; Bielikova, Marcela; Turna, Jan; Dudas, Andrej

    2016-06-01

    Deletion of 4-base pairs in the canine ABCB1 (MDR1) gene, responsible for encoding P-glycoprotein, leads to nonsense frame-shift mutation, which causes hypersensitivity to macrocyclic lactones drugs (e.g. ivermectin). To date, at least 12 purebred dog breeds have been found to be affected by this mutation. The aim of this study was to update information about the prevalence of ABCB1 mutation (c.227_230delATAG) in predisposed breeds in multiple European countries. This large scale survey also includes countries which were not involved in previous studies. The samples were collected in the period from 2012 to 2014. The overview is based on genotyping data of 4729 individuals. The observed mutant allele frequencies were 58.5% (Smooth Collie), 48.3% (Rough Collie), 35% (Australian Shepherd), 30.3% (Shetland Sheepdog), 28.1% (Silken Windhound), 26.1% (Miniature Australian Shepherd), 24.3% (Longhaired Whippet), 16.2% (White Swiss Shepherd) and 0% (Border Collie). The possible presence of an ABCB1 mutant allele in Akita-Inu breed has been investigated with negative results. This information could be helpful for breeders in optimization of their breeding strategy and for veterinarians when prescribing drug therapy for dogs of predisposed breeds. PMID:27234542

  8. Community-Onset Escherichia coli Infection Resistant to Expanded-Spectrum Cephalosporins in Low-Prevalence Countries

    PubMed Central

    Ingram, Paul R.; Runnegar, Naomi; Pitman, Matthew C.; Freeman, Joshua T.; Athan, Eugene; Havers, Sally M.; Sidjabat, Hanna E.; Jones, Mark; Gunning, Earleen; De Almeida, Mary; Styles, Kaylene; Paterson, David L.

    2014-01-01

    By global standards, the prevalence of community-onset expanded-spectrum-cephalosporin-resistant (ESC-R) Escherichia coli remains low in Australia and New Zealand. Of concern, our countries are in a unique position, with high extramural resistance pressure from close population and trade links to Asia-Pacific neighbors with high ESC-R E. coli rates. We aimed to characterize the risks and dynamics of community-onset ESC-R E. coli infection in our low-prevalence region. A case-control methodology was used. Patients with ESC-R E. coli or ESC-susceptible E. coli isolated from blood or urine were recruited at six geographically dispersed tertiary care hospitals in Australia and New Zealand. Epidemiological data were prospectively collected, and bacteria were retained for analysis. In total, 182 patients (91 cases and 91 controls) were recruited. Multivariate logistic regression identified risk factors for ESC-R among E. coli strains, including birth on the Indian subcontinent (odds ratio [OR] = 11.13, 95% confidence interval [95% CI] = 2.17 to 56.98, P = 0.003), urinary tract infection in the past year (per-infection OR = 1.430, 95% CI = 1.13 to 1.82, P = 0.003), travel to southeast Asia, China, the Indian subcontinent, Africa, and the Middle East (OR = 3.089, 95% CI = 1.29 to 7.38, P = 0.011), prior exposure to trimethoprim with or without sulfamethoxazole and with or without an expanded-spectrum cephalosporin (OR = 3.665, 95% CI = 1.30 to 10.35, P = 0.014), and health care exposure in the previous 6 months (OR = 3.16, 95% CI = 1.54 to 6.46, P = 0.02). Among our ESC-R E. coli strains, the blaCTX-M ESBLs were dominant (83% of ESC-R E. coli strains), and the worldwide pandemic ST-131 clone was frequent (45% of ESC-R E. coli strains). In our low-prevalence setting, ESC-R among community-onset E. coli strains may be associated with both “export” from health care facilities into the community and direct “import” into the community from high-prevalence regions. PMID

  9. A Systematic Review of Tobacco Smoking Prevalence and Description of Tobacco Control Strategies in Sub-Saharan African Countries; 2007 to 2014

    PubMed Central

    2015-01-01

    Objective To systematically review current smoking prevalence among adults in sub-Saharan Africa from 2007 to May 2014 and to describe the context of tobacco control strategies in these countries. Data Sources Five databases, Medline, Embase, Africa-wide Information, Cinahl Plus, and Global Health were searched using a systematic search strategy. There were no language restrictions. Study Selection 26 included studies measured current smoking prevalence in nationally representative adult populations in sub-Saharan African countries. Data Extraction Study details were independently extracted using a standard datasheet. Data on tobacco control policies, taxation and trends in prices were obtained from the Implementation Database of the WHO FCTC website. Results Studies represented 13 countries. Current smoking prevalence varied widely ranging from 1.8% in Zambia to 25.8% in Sierra Leone. The prevalence of smoking was consistently lower in women compared to men with the widest gender difference observed in Malawi (men 25.9%, women 2.9%). Rwanda had the highest prevalence of women smokers (12.6%) and Ghana had the lowest (0.2%). Rural, urban patterns were inconsistent. Most countries have implemented demand-reduction measures including bans on advertising, and taxation rates but to different extents. Conclusion Smoking prevalence varied widely across sub-Saharan Africa, even between similar country regions, but was always higher in men. High smoking rates were observed among countries in the eastern and southern regions of Africa, mainly among men in Ethiopia, Malawi, Rwanda, and Zambia and women in Rwanda and rural Zambia. Effective action to reduce smoking across sub-Saharan Africa, particularly targeting population groups at increased risk remains a pressing public health priority. PMID:26162085

  10. Obesity: Prevalence, Theories, Medical Consequences, Management, and Research Directions

    PubMed Central

    Wilborn, Colin; Beckham, Jacqueline; Campbell, Bill; Harvey, Travis; Galbreath, Melyn; La Bounty, Paul; Nassar, Erika; Wismann, Jennifer; Kreider, Richard

    2005-01-01

    Obesity and its associated disorders are a growing epidemic across the world. Many genetic, physiological, and behavioral factors play a role in the etiology of obesity. Diet and exercise are known to play a valuable role in the treatment and prevention of obesity and associated disorders such as hypertension, heart disease, and diabetes. Therefore, the purpose of this review is to examine the prevalence, etiology, consequences, and treatment of obesity. PMID:18500955

  11. Added value of molecular assay Xpert MTB/RIF compared to sputum smear microscopy to assess the risk of tuberculosis transmission in a low-prevalence country.

    PubMed

    Opota, O; Senn, L; Prod'hom, G; Mazza-Stalder, J; Tissot, F; Greub, G; Jaton, K

    2016-07-01

    Airborne precautions are required at hospital admission for patients with suspected pulmonary tuberculosis. The isolation is maintained until 3 serially collected sputum smears are acid-fast bacilli negative, a time- and labor-intensive method with limited sensitivity and specificity, which has a great impact on patient flow management. We evaluated the possibility of replacing the result of microscopy by the semiquantitative result of the molecular point-of-care test Xpert MTB/RIF to assess patients' transmission risk to quickly guide airborne isolation decisions in low-endemic countries. The performance of the Xpert MTB/RIF, used as a first-line test, was compared to the results of microscopy for specimens (n=242) collected from May 2010 to December 2014 in Lausanne, Switzerland. The sensitivity and specificity of Xpert MTB/RIF were 91.5% (65/71) and 99.6% (170/171), respectively, vs. 64.8% (46/71) and 94.2% (161/171) for microscopy. Samples with negative Xpert MTB/RIF were all smear negative for Mycobacterium tuberculosis (negative predictive value, 100%). The semiquantitative results of Xpert MTB/RIF-high, medium, low or very low-were found to correlate with acid-fast bacilli detection: positive predictive value of 100% (6/6), 96.5% (27/28), 52.2% (12/23) and 11.1% (1/9) respectively. Finally, when including clinical criteria, we identified 11 smear-negative but Xpert MTB/RIF-positive patients with a significant transmission potential. In conclusion, our data support the introduction of an Xpert MTB/RIF-based strategy as a replacement of smear microscopy for a faster and more accurate management of tuberculosis patients' transmission risk in a low-prevalence country. PMID:27139592

  12. Management of NCD in low- and middle-income countries.

    PubMed

    Checkley, William; Ghannem, Hassen; Irazola, Vilma; Kimaiyo, Sylvester; Levitt, Naomi S; Miranda, J Jaime; Niessen, Louis; Prabhakaran, Dorairaj; Rabadán-Diehl, Cristina; Ramirez-Zea, Manuel; Rubinstein, Adolfo; Sigamani, Alben; Smith, Richard; Tandon, Nikhil; Wu, Yangfeng; Xavier, Denis; Yan, Lijing L

    2014-12-01

    Noncommunicable disease (NCD), comprising cardiovascular disease, stroke, diabetes, and chronic obstructive pulmonary disease, are increasing in incidence rapidly in low- and middle-income countries (LMICs). Some patients have access to the same treatments available in high-income countries, but most do not, and different strategies are needed. Most research on noncommunicable diseases has been conducted in high-income countries, but the need for research in LMICs has been recognized. LMICs can learn from high-income countries, but they need to devise their own systems that emphasize primary care, the use of community health workers, and sometimes the use of mobile technology. The World Health Organization has identified "best buys" it advocates as interventions in LMICs. Non-laboratory-based risk scores can be used to identify those at high risk. Targeting interventions to those at high risk for developing diabetes has been shown to work in LMICs. Indoor cooking with biomass fuels is an important cause of chronic obstructive pulmonary disease in LMICs, and improved cookstoves with chimneys may be effective in the prevention of chronic diseases. PMID:25592798

  13. Overview of hepatitis B prevalence, prevention, and management in the Pacific Islands and Territories.

    PubMed

    Howell, Jessica; Van Gemert, Caroline; Lemoine, Maud; Thursz, Mark; Hellard, Margaret

    2014-11-01

    There are over 500-750 000 deaths per year because of hepatitis B virus (HBV)-related cirrhosis and liver cancer worldwide and the World Health Organization Western Pacific Region has some of the highest endemic levels of HBV in the world, particularly within China, South East Asia and Pacific Island Countries and Territories (PICT). The PICT have unique ethnic diversity and a very high prevalence of smoking and metabolic syndrome, both important risk factors for liver fibrosis and liver cancer. However, in contrast to many Asian countries, there is little published data on HBV prevalence and related liver disease burden in PICT. In this review, the available published literature and World Health Organization data for HBV prevalence and related liver disease and liver cancer burden in PICT is outlined, and unmet needs for improving HBV prevention and control in the region are highlighted. PMID:25131570

  14. Prevalence of heroin markers in urine for pain management patients.

    PubMed

    Knight, Julie; Puet, Brandi L; DePriest, Anne; Heltsley, Rebecca; Hild, Cheryl; Black, David L; Robert, Timothy; Caplan, Yale H; Cone, Edward J

    2014-10-01

    Surveys of current trends indicate heroin abuse is associated with nonmedical use of pain relievers. Consequently, there is an interest in evaluating the presence of heroin-specific markers in chronic pain patients who are prescribed controlled substances. A total of 926,084 urine specimens from chronic pain patients were tested for heroin/diacetylmorphine (DAM), 6-acetylmorphine (6AM), 6-acetylcodeine (6AC), codeine (COD), and morphine (MOR). Heroin and markers were analyzed using liquid chromatography tandem mass spectrometry (LC-MS-MS). Opiates were analyzed following hydrolysis using LC-MS-MS. The prevalence of heroin use was 0.31%, as 2871 were positive for one or more heroin-specific markers including DAM, 6AM, or 6AC (a known contaminant of illicit heroin). Of these, 1884 were additionally tested for the following markers of illicit drug use: 3,4-methylenedioxymethamphetamine (MDMA), 3,4-methylenedioxyamphetamine (MDA), methamphetamine (MAMP), 11-nor-9-carboxy-Δ(9)-tetracannabinol (THCCOOH), and benzoylecgonine (BZE); 654 (34.7%) had positive findings for one or more of these analytes. The overall prevalence of heroin markers were as follows: DAM 1203 (41.9%), 6AM 2570 (89.5%), 6AC 1082 (37.7%). MOR was present in 2194 (76.4%) and absent (Prevalence of combinations for specimens containing MOR were as follows: DAM only 13 (0.59%), 6AM only 1140 (52.0%), 6AC only 24 (1.1%), DAM/6AM/6AC 710 (32.4%), 6AM/6AC 188 (8.6%), DAM/6AM 113 (5.2%), DAM/6AC 6 (0.27%). Importantly, the prevalence of combinations for specimens without MOR were as follows: DAM only 161 (23.8%), 6AM only 217 (32.1%), 6AC only 92 (13.6%), DAM/6AM/6AC 50 (7.4%), 6AM/6AC 7 (1.0%), DAM/6AM 145 (21.4%), DAM/6AC 5 (0.74%). Unexpected patterns of excretion were observed, such as the presence of DAM and 6AC in the absence of 6AM and MOR; therefore, multiple heroin markers may be useful to assess for

  15. The prevalence, impact and management of musculoskeletal disorders in older people living in care homes: a systematic review.

    PubMed

    Smith, Toby O; Purdy, Rachel; Latham, Sarah K; Kingsbury, Sarah R; Mulley, Graham; Conaghan, Philip G

    2016-01-01

    The aim was to systematically review the literature describing the prevalence, impact and current management of musculoskeletal pain in older people living in care homes. Published literature (AMED, CINAHL, EMBASE, psycINFO, MEDLINE, Cochrane Library) and unpublished literature (OpenGrey, the WHO International Clinical Trials Registry Platform, Current Controlled Trials, UK National Research Register Archive) were searched on 1 March 2015. All studies assessing the prevalence, impact and management of musculoskeletal disorders in older people living in care homes were included. Literature was appraised using the CASP cohort and qualitative critical appraisal tools. Data were analysed using descriptive statistical approaches, meta-analysis and meta-ethnography techniques. Twenty-four papers reporting the results of 263,775 care home residents in 12 countries were identified. The evidence base was moderate in quality. Prevalence of musculoskeletal pain for people in care homes was 30.2 % (95 % confidence intervals 29.9-30.5 %; n = 105,463). Care home residents reported that musculoskeletal pain had a significant impact on their perceived independence and overall ability to participate in everyday activities of daily living. Three papers which presented data on interventions demonstrated that whilst multi-component assessment and management packages did not significantly change clinical outcomes, these empowered care home staff to feel more confident in managing these patients. Musculoskeletal pain is a common problem in care homes worldwide, and residents report significant impact on their lives. However, there is uncertainty regarding how to assess and manage such pain. PROSPERO Registration Number: CRD42014009824. PMID:26245357

  16. PREVALENCE, MECHANISMS, AND MANAGEMENT OF CANCER-RELATED COGNITIVE IMPAIRMENT

    PubMed Central

    Janelsins, Michelle C.; Kesler, Shelli R.; Ahles, Tim A.; Morrow, Gary R.

    2014-01-01

    This review summarizes the current literature on cancer-related cognitive impairment (CRCI) with a focus on prevalence, mechanisms, and possible interventions for CRCI in those who receive adjuvant chemotherapy for non-central nervous system tumors and is primarily focused on breast cancer. CRCI is characterized as deficits in areas of cognition including memory, attention, concentration, and executive function. Development of CRCI can impair quality of life and impact treatment decisions. CRCI is highly prevalent; these problems can be detected in up to 30% of patients prior to chemotherapy; up to 75% of patients report some form of CRCI during treatment, and CRCI is still present in up to 35% of patients many years following completion of treatment. While the trajectory of CRCI is becoming better understood, the mechanisms underlying the development of CRCI are still obscure; however, host characteristics, immune dysfunction, neural toxicity, and genetics may play key roles in the development and trajectory of CRCI. Intervention research is limited, though strategies to maintain function are being studied with promising preliminary findings. This review highlights key research being conducted in these areas, both in patient populations and in animals, which will ultimately result in better understanding and effective treatments for CRCI. PMID:24716504

  17. High Prevalence of the BIM Deletion Polymorphism in Young Female Breast Cancer in an East Asian Country

    PubMed Central

    Lin, Ching-Hung; Shen, Chen-Yang; Lee, Jih-Hsiang; Huang, Chiun-Sheng; Yang, Chih-Hsin; Kuo, Wen-Hung; Chang, Dwan-Ying; Hsiung, Chia-Ni; Kuo, Kuan-Ting; Chen, Wei-Wu; Chen, I-Chun; Wu, Pei-Fang; Kuo, Sung-Hsin; Chen, Chien-Jen

    2015-01-01

    Background A rapid surge of female breast cancer has been observed in young women in several East Asian countries. The BIM deletion polymorphism, which confers cell resistance to apoptosis, was recently found exclusively in East Asian people with prevalence rate of 12%. We aimed to evaluate the possible role of this genetic alteration in carcinogenesis of breast cancer in East Asians. Method Female healthy volunteers (n = 307), patients in one consecutive stage I-III breast cancer cohort (n = 692) and one metastatic breast cancer cohort (n = 189) were evaluated. BIM wild-type and deletion alleles were separately genotyped in genomic DNAs. Results Both cancer cohorts consistently showed inverse associations between the BIM deletion polymorphism and patient age (≤35 y vs. 36-50 y vs. >50 y: 29% vs. 22% vs. 15%, P = 0.006 in the consecutive cohort, and 40% vs. 23% vs. 13%, P = 0.023 in the metastatic cohort). In healthy volunteers, the frequencies of the BIM deletion polymorphism were similar (13%-14%) in all age groups. Further analyses indicated that the BIM deletion polymorphism was not associated with specific clinicopathologic features, but it was associated with poor overall survival (adjusted hazard ratio 1.71) in the consecutive cohort. Conclusions BIM deletion polymorphism may be involved in the tumorigenesis of the early-onset breast cancer among East Asians. PMID:25909194

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

    PubMed Central

    2014-01-01

    Background 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. Methods 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. Results 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. Conclusion 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. PMID:25183954

  19. Extensive Genetic Diversity of HIV-1 in Incident and Prevalent Infections among Malaysian Blood Donors: Multiple Introductions of HIV-1 Genotypes from Highly Prevalent Countries

    PubMed Central

    Chow, Wei Zhen; Bon, Abdul Hamid; Keating, Sheila; Anderios, Fread; Halim, Hazwan Abdul; Takebe, Yutaka; Kamarulzaman, Adeeba; Busch, Michael P.; Tee, Kok Keng

    2016-01-01

    were sequenced from recently infected individuals, indicating the possible emergence and on-going spread of foreign clades of CRF candidates among the local population. The findings demonstrate extensive molecular complexity of HIV-1 among the infected blood donors in Malaysia, driven in part by the increased spread of recently described CRFs and multiple introductions of previously unreported genotypes from highly prevalent countries. PMID:27575746

  20. Extensive Genetic Diversity of HIV-1 in Incident and Prevalent Infections among Malaysian Blood Donors: Multiple Introductions of HIV-1 Genotypes from Highly Prevalent Countries.

    PubMed

    Chow, Wei Zhen; Bon, Abdul Hamid; Keating, Sheila; Anderios, Fread; Halim, Hazwan Abdul; Takebe, Yutaka; Kamarulzaman, Adeeba; Busch, Michael P; Tee, Kok Keng

    2016-01-01

    were sequenced from recently infected individuals, indicating the possible emergence and on-going spread of foreign clades of CRF candidates among the local population. The findings demonstrate extensive molecular complexity of HIV-1 among the infected blood donors in Malaysia, driven in part by the increased spread of recently described CRFs and multiple introductions of previously unreported genotypes from highly prevalent countries. PMID:27575746

  1. Emergency management of disasters involving livestock in developing countries.

    PubMed

    Heath, S E; Kenyon, S J; Zepeda Sein, C A

    1999-04-01

    Different disasters have similar consequence on the health and welfare of livestock. Numerous geophysical disasters can exacerbate epizootics, resulting in the deaths of many animals and the reduction of production efficiency. These disasters also present a considerable threat of spoilage of processed foods, endangering public health. Furthermore, large-scale disasters involving animals can modify the long-term stability of national economies, the environment and social structures. The authors discuss the vulnerability of the livestock industry to natural disasters and the impact of floods, droughts and transboundary diseases and pests on national economies. Examples are given on how some losses can be avoided, evaluated and compensated. The role of the veterinarian is presented in relation to work conducted by other relief organisations in cases of emergency. In developing countries, mitigation programmes should focus on strengthening global animal health services. Preparedness needs to be community based, with education provided in a timely manner. Effective recovery from disasters should be based on mitigation programmes, including international trade and mutual aid agreements between neighbouring countries to supply appropriate goods and environmentally and culturally appropriate breeds of livestock. Disaster relief for the care of livestock should be recognised as a form of humanitarian assistance, given the benefits to be derived for public health and the socio-economic implications of successful intervention. PMID:10190219

  2. Lifetime Prevalence and Factors Associated with Head Injury among Older People in Low and Middle Income Countries: A 10/66 Study

    PubMed Central

    Khan, A.; Prince, M.; Brayne, C.; Prina, A. M.

    2015-01-01

    Introduction Traumatic brain injury (TBI) is a growing public health problem around the world, yet there is little information on the prevalence of head injury in low and middle income countries (LMICs). We utilised data collected by the 10/66 research group to investigate the lifetime prevalence of head injury in defined sites in low and middle income countries, its risk factors and its relationship with disability. Methods We analysed data from one-phase cross-sectional surveys of all residents aged 65 years and older (n = 16430) distributed across twelve sites in eight low and middle income countries (China, Cuba, Dominican Republic, India, Venezuela, Mexico, Peru, and Puerto Rico). Self-reported cases of head injury with loss of consciousness were identified during the interview. A sensitivity analysis including data provided by informants of people with dementia was also used to estimate the impact of this information on the estimates. Prevalence ratios (PR) from Poisson regressions were used to identify associated risk factors. Results The standardised lifetime prevalence of TBI ranged from 0.3% in China to 14.6% in rural Mexico and Venezuela. Being male (PR: 1.6, 95% CI: 1.29–1.82), younger (PR: 0.95, 95% CI: 0.92–0.99), with lower education (PR 0.91, 95% CI: 0.86–0.96), and having fewer assets (PR 0.92, 95% CI: 0.88–0.96), was associated with a higher prevalence of TBI when pooling estimates across sites. Discussion Our analysis revealed that the prevalence of TBI in LMICs is similar to that of developed nations. Considering the growing impact of TBI on health resources in these countries, there is an urgent need for further research. PMID:26146992

  3. Challenges of managing nasopharyngeal carcinoma in a developing country.

    PubMed Central

    Fatusi, Olawunmi; Akinpelu, Olubunmi; Amusa, Yemisi

    2006-01-01

    The maxillofacial unit is an uncommon entry point for cases of nasopharyngeal carcinoma (NPC). This report documents involvement of the maxillofacial unit in the management of NPC in Obafemi Awolowo University Teaching Hospitals Complex, Ile-lfe, Nigeria, with the aim of highlighting the challenges associated with recognition and management of the disease. Almost all cases (86.7%) were recorded in the low socioeconomic group, and males constituted 66.7%. The median age of our patients was 38 years, with an earlier cluster in females. Most of our patients (86.7%) presented with late stages of the disease. The challenges posed to surgeons in the management of NPC in the tropics include limited availability of diagnostic and treatment facilities. The inability of patients to afford the cost of relevant healthcare services due to high poverty level and absence of effective social support system also limits their access and utilization of available clinical facilities. These issues need to be addressed to facilitate early diagnosis and improved management that would ensure better prognosis for Nigerian patients with NPC. Education targeted at community members as well as healthcare service providers, including maxillofacial surgeons, would be important to enhance the possibility of detecting the cases at an earlier stage. Images Figure 1 PMID:16749652

  4. General Review of Tinnitus Prevalence, Mechanisms, Effects, and Management

    ERIC Educational Resources Information Center

    Henry, James A.; Dennis, Kyle C.; Schechter, Martin A.

    2005-01-01

    Tinnitus is an increasing health concern across all strata of the general population. Although an abundant amount of literature has addressed the many facets of tinnitus, wide-ranging differences in professional beliefs and attitudes persist concerning its clinical management. These differences are detrimental to tinnitus patients because the…

  5. Perspectives, perceptions and experiences in postoperative pain management in developing countries: A focus group study conducted in Rwanda

    PubMed Central

    Johnson, Ana P; Mahaffey, Ryan; Egan, Rylan; Twagirumugabe, Theogene; Parlow, Joel L

    2015-01-01

    BACKGROUND: Access to postoperative acute pain treatment is an important component of perioperative care and is frequently managed by a multidisciplinary team of anesthesiologists, surgeons, pharmacists, technicians and nurses. In some developing countries, treatment modalities are often not performed due to scarce health care resources, knowledge deficiencies and cultural attitudes. OBJECTIVES: In advance of a comprehensive knowledge translation initiative, the present study aimed to determine the perspectives, perceptions and experiences of anesthesia residents regarding postoperative pain management strategies. METHODS: The present study was conducted using a qualitative assessment strategy in a large teaching hospital in Rwanda. During two sessions separated by seven days, a 10-participant semistructured focus group needs analysis was conducted with anesthesia residents at the Centre Hospitalier Universitaire de Kigali (Kigali, Rwanda). Field notes were analyzed using interpretative and descriptive phenomenological approaches. Participants were questioned regarding their perspectives, perceptions and experiences in pain management. RESULTS: The responses from the focus groups were related to five general areas: general patient and medical practice management; knowledge base regarding postoperative pain management; pain evaluation; institutional/system issues related to protocol implementation; and perceptions about resource allocation. Within these areas, challenges (eg, communication among stakeholders and with patients) and opportunities (eg, on-the-job training, use of protocols, routine pain assessment, participation in resource allocation decisions) were identified. CONCLUSIONS: The present study revealed the prevalent challenges residents perceive in implementing postoperative pain management strategies, and offers practical suggestions to overcoming them, primarily through training and the implementation of practice recommendations. PMID:26448971

  6. Prevalence, diagnosis and management of ectopic thyroid glands.

    PubMed

    Santangelo, Giuseppe; Pellino, Gianluca; De Falco, Nadia; Colella, Giuseppe; D'Amato, Salvatore; Maglione, M Grazia; De Luca, Roberto; Canonico, Silvestro; De Falco, Massimo

    2016-04-01

    Ectopic thyroid tissue (ETT) is an uncommon entity that may be found anywhere along the line of the obliterated thyroglossal duct, usually from the tongue to the diaphragm. We performed a retrospective analysis of patients undergoing surgical treatment for thyroid disease between January 2000 and December 2013, seeking for ETT All patients with prior neck surgery or trauma were excluded. The clinic-pathologic features, prevalence and diagnosis of the lesions were collected and analyzed. Out of 3092 included patients, 28 ETT were identified (0.9%). The anatomical site of ETT was as follows: lateral cervical in 6 (21.4%), along the thyroglossal duct in 6 (21.4%), mediastinal in 5 (17.9%), lingual in 5 (17.9%), sublingual in 3 (10.7%), and submandibular in 3 (10.7%). Histopathology revealed 27 benign lesions and 1 (3.6%) papillary carcinoma. ETT is found in less than 1% of patients receiving thyroid surgery. Diagnosis of ETT requires clinical imaging. Surgery is a prudent choice due to the potential of malignant evolution of ETT. PMID:26708843

  7. Challenges in managing postpartum hemorrhage in resource-poor countries.

    PubMed

    Karoshi, Mahantesh; Keith, Louis

    2009-06-01

    Managing postpartum hemorrhage depends in part on having a prepared mind, a complement of trained coworkers, and full access to modern therapies. The last 2 components are rare in resource-poor areas and their absence may be accentuated by climatic instability and lack of basic transportation. Greater use of the active management of third stage of labor and administration of misoprostol by nontrained birth attendants will provide beneficial reductions in hemorrhage rates in resource-poor areas. Additional improvements depend on increasing public awareness, facilitating existing nongovernmental organizations in their community-related, upgrading training of traditional birth attendants, and providing cell phone communication to workers in remote areas, in addition to providing better access to blood. PMID:19407535

  8. The Prevalence, Correlates, Detection and Control of Diabetes among Older People in Low and Middle Income Countries. A 10/66 Dementia Research Group Population-Based Survey

    PubMed Central

    Salas, Aquiles; Acosta, Daisy; Ferri, Cleusa P.; Guerra, Mariella; Huang, Yueqin; Jacob, K. S.; Jimenez-Velazquez, Ivonne Z.; Llibre Rodriguez, Juan J.; Sosa, Ana L.; Uwakwe, Richard; Williams, Joseph D.; Jotheeswaran, A. T.; Liu, Zhaorui; Lopez Medina, A. M.; Salinas-Contreras, Rosa Maria; Prince, Martin J.

    2016-01-01

    Background Little is known of the epidemiology of diabetes among older people in low and middle income countries. We aimed to study and compare prevalence, social patterning, correlates, detection, treatment and control of diabetes among older people in Latin America, India, China and Nigeria. Methods Cross-sectional surveys in 13 catchment area sites in nine countries. Diagnosed diabetes was assessed in all sites through self-reported diagnosis. Undiagnosed diabetes was assessed in seven Latin American sites through fasting blood samples (glucose > = 7mmol/L). Results Total diabetes prevalence in catchment sites in Cuba (prevalence 24.2%, SMR 116), Puerto Rico (43.4%, 197), and urban (27.0%, 125), and rural Mexico (23.7%, 111) already exceeds that in the USA, while that in Venezuela (20.9%, 100) is similar. Diagnosed diabetes prevalence varied very widely, between low prevalences in sites in rural China (0.9%), rural India (6.6%) and Nigeria (6.0%). and 32.1% in Puerto Rico, explained mainly by access to health services. Treatment coverage varied substantially between sites. Diabetes control (40 to 61% of those diagnosed) was modest in the Latin American sites where this was studied. Diabetes was independently associated with less education, but more assets. Hypertension, central obesity and hypertriglyceridaemia, but not hypercholesterolaemia were consistently associated with total diabetes. Conclusions Diabetes prevalence is already high in most sites. Identifying undiagnosed cases is essential to quantify population burden, particularly in least developed settings where diagnosis is uncommon. Metabolic risk factors and associated lifestyles may play an important part in aetiology, but this requires confirmation with longitudinal data. Given the high prevalence among older people, more population research is indicated to quantify the impact of diabetes, and to monitor the effect of prevention and health system strengthening on prevalence, treatment and control

  9. Factors influencing economic profitability of dampling-based integrated management of wheat in country elevators

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Integrated pest management provides the potential for better insect management in stored wheat, as well as increased worker safety and reduced environmental concerns. Many country elevators, however, continue to use chemical-based approaches. To determine if this choice is economically justified, to...

  10. Preparing the Host Country Workforce for Expatriate Managers: The Neglected Other Side of the Coin.

    ERIC Educational Resources Information Center

    Vance, Charles M.; Ring, Peter Smith

    1994-01-01

    Using an instructional systems development approach, ways to prepare the host country workforce for the assignment of an expatriate manager are discussed. The model is based on a number of perspectives: exchange theory, participatory management, corporate social responsibility, communication theory, and strategic human resource planning. (SK)

  11. Calving management practices on Canadian dairy farms: Prevalence of practices.

    PubMed

    Villettaz Robichaud, M; de Passillé, A M; Pearl, D L; LeBlanc, S J; Godden, S M; Pellerin, D; Vasseur, E; Rushen, J; Haley, D B

    2016-03-01

    Little information is available about current practices around calving in dairy cattle. The aim of this study was to describe calving management practices in the Canadian dairy industry related to housing, calving protocols, monitoring of parturition, and calving assistance. Information was gathered by in-person interviews from 236 dairy farms from 3 Canadian provinces (Alberta, Ontario, and Québec) with freestalls and an automatic milking system (n=24), freestalls with a parlor (n=112), and tiestalls (n=100). The most commonly used types of calving facilities were group calving pens (35%) followed by individual calving pens (30%). Tiestalls were used by 26% of all surveyed producers as their main type of calving area (49% of the tiestall, 7% of the freestall with parlor, and 13% of the automatic milking system farms). Written protocols related to calving were found on only 7% of the farms visited, and only 50% of those protocols were developed with a veterinarian. However, 90% of producers kept written records of calving difficulty. Monitoring of cows around calving occurred 5 times more often during the daytime (between morning and evening milking) compared with nighttime. Cameras were used to monitor cows around and during calvings on 18% of farms. Sixteen percent of producers vaginally palpated all animals during calving. Twenty-seven percent of producers interviewed assisted all calvings on their farms by pulling the calf, and 37% assisted all heifers at calving. According to the producers' reported perception, 93% of them had "a minor problem" or "no problem" with calving difficulties on their farms. This study provides basic data on current calving practices and identifies areas for improvement and potential targets for knowledge transfer efforts or research to clarify best management practices. PMID:26723128

  12. Managing the health care market in developing countries: prospects and problems.

    PubMed

    Broomberg, J

    1994-09-01

    There is increasing interest in the prospects for managed market reforms in developing countries, stimulated by current reforms and policy debates in developed countries, and by perceptions of widespread public sector inefficiency in many countries. This review examines the prospects for such reforms in a developing country context, primarily by drawing on the arguments and evidence emerging from developed countries, with a specific focus on the provision of hospital services. The paper begins with a discussion of the current policy context of these reforms, and their main features. It argues that while current and proposed reforms vary in detail, most have in common the introduction of competition in the provision of health care, with the retention of a public monopoly of financing, and that this structure emerges from the dual goals of addressing current public sector inefficiencies while retaining the known equity and efficiency advantages of public health systems. The paper then explores the theoretical arguments and empirical evidence for and against these reforms, and examines their relevance for developing countries. Managed markets are argued to enhance both efficiency and equity. These arguments are analysed in terms of three distinct claims made by their proponents: that managed markets will promote increased provider competition, and hence, provider efficiency; that contractual relationships are more efficient than direct management; and that the benefits of managed markets will outweigh their costs. The analysis suggests that on all three issues, the theoretical arguments and empirical evidence remain ambiguous, and that this ambiguity is attributable in part to poor understanding of the behaviour of health sector agents within the market, and to the limited experience with these reforms. In the context of developing countries, the paper argues that most of the conditions required for successful implementation of these reforms are absent in all but a

  13. Prevalence, associated factors and management of insomnia in prison populations: An integrative review.

    PubMed

    Dewa, Lindsay H; Kyle, Simon D; Hassan, Lamiece; Shaw, Jenny; Senior, Jane

    2015-12-01

    Prisoners have many potential risk factors for insomnia including mental ill health and substance misuse. However, literature on prevalence, associated factors and management of insomnia in prison has yet to be systematically examined in this group. The paper objective was to synthesise and appraise the research that examines insomnia in a prison environment. An integrative literature review using thematic analysis was conducted to critically reflect on the current evidence base and outline a prospective research agenda. From the original 384 sourced papers, 33 met the inclusion criteria and were subsequently included for review. Definitions of insomnia and assessment tools used in studies varied considerably making the overall validity of findings uncertain. Notably, no studies used a recommended measure to assess insomnia disorder (ID). Thematic analysis yielded five themes: 1) the varied prevalence of insomnia; 2) the comorbidity of insomnia, psychiatric disorder and substance misuse; 3) the negative influence of prison-related situational and environmental factors on insomnia; 4) the role of hypnotic medication, and, 5) preliminary indications that non-pharmacological treatment can improve sleep. The methodological heterogeneity and variable quality across studies in the assessment of insomnia means conclusive data on prevalence, associated factors and management is lacking. Nonetheless, sleep problems are common and impairing in prison, are linked to comorbid conditions and negatively influenced by the prison environment, which routinely provides limited scope for effective management. Future research in prison populations is needed to reliably identify insomnia prevalence and determine how it can be managed effectively. PMID:25644983

  14. The relationship between managed bees and the prevalence of parasites in bumblebees

    PubMed Central

    Goulson, Dave; Hughes, William O.H.

    2014-01-01

    Honey bees and, more recently, bumblebees have been domesticated and are now managed commercially primarily for crop pollination, mixing with wild pollinators during foraging on shared flower resources. There is mounting evidence that managed honey bees or commercially produced bumblebees may affect the health of wild pollinators such as bumblebees by increasing competition for resources and the prevalence of parasites in wild bees. Here we screened 764 bumblebees from around five greenhouses that either used commercially produced bumblebees or did not, as well as bumblebees from 10 colonies placed at two sites either close to or far from a honey bee apiary, for the parasites Apicystis bombi, Crithidia bombi, Nosema bombi, N. ceranae, N. apis and deformed wing virus. We found that A. bombi and C. bombi were more prevalent around greenhouses using commercially produced bumblebees, while C. bombi was 18% more prevalent in bumblebees at the site near to the honey bee apiary than those at the site far from the apiary. Whilst these results are from only a limited number of sites, they support previous reports of parasite spillover from commercially produced bumblebees to wild bumblebees, and suggest that the impact of stress from competing with managed bees or the vectoring of parasites by them on parasite prevalence in wild bees needs further investigation. It appears increasingly likely that the use of managed bees comes at a cost of increased parasites in wild bumblebees, which is not only a concern for bumblebee conservation, but which may impact other pollinators as well. PMID:25165632

  15. Service innovation management practices in the telecommunications industry: what does cross country analysis reveal?

    PubMed

    Rahman, Syed Abidur; Taghizadeh, Seyedeh Khadijeh; Ramayah, T; Ahmad, Noor Hazlina

    2015-01-01

    Service innovation management practice is currently being widely scrutinized mainly in the developed countries, where it has been initiated. The current study attempts to propose a framework and empirically validate and explain the service innovation practices for successful performance in the telecommunications industry of two developing countries, Malaysia and Bangladesh. The research framework proposes relationships among organisational culture, operating core (innovation process, cross-functional organisation, and implementation of tools/technology), competition-informed pricing, and performance. A total of 176 usable data from both countries are analysed for the purpose of the research. The findings show that organisational culture tends to be more influential on innovation process and cross-functional organisation in Malaysian telecommunication industry. In contrast, implementation of tools/technology plays a more instrumental role in competition-informed pricing practices in Bangladesh. This study revealed few differences in the innovation management practices between two developing countries. The findings have strategic implications for the service sectors in both the developing countries regarding implementation of innovative enterprises, especially in Bangladesh where innovation is the basis for survival. Testing the innovation management practices in the developing countries perhaps contains uniqueness in the field of innovation management. PMID:26722630

  16. Relationship between periparturient management, prevalence of MAP and preventable economic losses in UK dairy herds.

    PubMed

    Radia, D; Bond, K; Limon, G; van Winden, S; Guitian, J

    2013-10-12

    Johne's disease (JD) is an infectious, progressive, gastrointestinal disease affecting ruminants. Calves are mostly infected in their first six months of life, or in utero. We investigated the impact of specific periparturient management practices on within-herd JD prevalence and economic losses foregone in UK dairy herds by means of data synthesis (systematic appraisal of published evidence and expert elicitation) and use of a pre-existing simulation model. Our results show the scarcity of accurate estimates of the impact of specific periparturient management practices on within-herd JD prevalence, which could, in part, be explained by challenges associated with the chronic nature of JD. Management practices aiming to limit the faecal-oral transmission route of Mycobacterium avium subspecies paratuberculosis (MAP) were found to be most effective at reducing within-herd prevalence of JD. Practices aiming to limit MAP transmission via colostrum and milk were found to be less effective. Losses foregone for a hypothetical herd of 200 milking cows were considerable; based on the assumptions, it is reasonable to expect between £7000 and £11,000 of losses foregone when management practices are implemented as a package of measures. The findings of this study are envisaged to enable farmers and veterinarians to make more informed decisions on changes to periparturient management to control JD. PMID:23897995

  17. Meta-analysis in assessment of the prevalence and annual incidence of Giardia spp. and Cryptosporidium spp. infections in humans in the Nordic countries.

    PubMed

    Hörman, Ari; Korpela, Heikki; Sutinen, Jussi; Wedel, Hans; Hänninen, Marja-Liisa

    2004-11-01

    We aimed to apply the meta-analysis in the studies of protozoan pathogens in order to obtain a general overview of the prevalence and annual incidence of Giardia spp. and Cryptosporidium spp. infections in asymptomatic and symptomatic human populations in the Nordic countries of Denmark, Finland, Norway and Sweden. In combining the data of 13 clinically and methodologically non-heterogeneous studies published before 2004 using the random effects model with DerSimonian-Laird estimator, we estimated the prevalence (% prevalence: 95% confidence limits) of Giardia cases in the asymptomatic (i.e. no gastroenteric symptoms) general population to be 2.97% (2.64; 3.31) and in the symptomatic population 5.81% (5.34; 6.30). For Cryptosporidium the prevalences were 0.99% (0.81; 1.19) and 2.91% (2.71; 3.12), respectively. In analyzing the data, we estimated that there will be 4670 (4300; 5060) symptomatic cases of Giardia and 3340 (3110; 3580) symptomatic cases of Cryptosporidium annually per 100,000 general population in the Nordic countries. The vast majority of cases will remain unregistered in the national registers of infectious diseases, since for single registered cases there will be 254-867 cases of Giardia undetected/unregistered and 4072 to 15,181 cases of Cryptosporidium, respectively. PMID:15542094

  18. Management of waste electrical and electronic equipment in two EU countries: A comparison

    SciTech Connect

    Torretta, Vincenzo; Ragazzi, Marco; Istrate, Irina Aura; Rada, Elena Cristina

    2013-01-15

    Highlights: Black-Right-Pointing-Pointer Review on data regarding WEEE management in Italy and in Romania. Black-Right-Pointing-Pointer Problems that countries that will enter in the EU will have to solve facing with the WEEE management. Black-Right-Pointing-Pointer Pilot experiences useful for the awareness campaign of the population. - Abstract: The paper presents some data regarding waste electrical and electronic (WEEE) management in one of the founding countries of the EU, Italy, and in a recent entry into the EU, Romania. The aim of this research was to analyze some problems that countries entering the EU will have to solve with respect to WEEE management. The experiences of Italy and Romania could provide an interesting reference point. The strengths and weaknesses that the two EU countries have encountered can be used in order to give a more rational plan for other countries. In Italy the increase of WEEE collection was achieved in parallel with the increase of the efficiency of selective Municipal Solid Waste collection. In Romania, pilot experiences were useful to increase the awareness of the population. The different interests of the two populations towards recyclable waste led to a different scenario: in Romania all types of WEEE have been collected since its entrance into the EU; in Italy the 'interest' in recycling is typically related to large household appliances, with a secondary role of lighting equipment.

  19. Prevalence of Hepatitis C Virus Genotypes Among Patients in Countries of the Eastern Mediterranean Regional Office of WHO (EMRO): A Systematic Review and Meta-Analysis

    PubMed Central

    Sadeghi, Farzin; Salehi-Vaziri, Mostafa; Almasi-Hashiani, Amir; Gholami-Fesharaki, Mohammad; Pakzad, Reza; Alavian, Seyed Moayed

    2016-01-01

    Context Hepatitis C virus (HCV) infection is a major global public health issue. The Eastern Mediterranean regional office (EMRO) of the world health organization (WHO) seems to have one of the highest prevalence rates worldwide, with at least 21.3 million HCV-infected patients. Objectives The aim of the present study was to review systematically all epidemiological data related to the prevalence of HCV genotypes in infected patients in EMRO countries. Data Sources A systematic search was conducted of peer-reviewed journals indexed in electronic databases (PubMed, Scopus, ISI, PakMediNet, and IMEMR, and Persian-specific databases including SID, Iran Medex, and MagIran). Study Selection A systematic search was performed with temporal limits (papers published between January 2000 up to June 2015), regarding the prevalence and distribution of HCV genotypes in EMRO countries. Data Extraction The prevalence rates of HCV genotypes were pooled by metan command in Stata 14. Statistical heterogeneity was explored using the I-square at the 5% significance level. Publication bias was assessed, graphically and statistically, by funnel plot and Begg and Egger tests. Results A total of 563 records were identified through the electronic search. Of these records, 134 studies comprising 67681 HCV-infected individuals were included in the meta-analysis. In Iran, subtype 1a was the predominant subtype with a rate of 42% (95% CI, 39 - 46), followed by subtype 3a, 35% (95% CI, 31 - 38). In Pakistan, Subtype 3a was the most common subtype with a rate of 56% (95% CI, 49 - 62), followed by subtype 3b, 10% (95% CI, 7 - 12). In Saudi Arabia and Egypt, genotype 4 was the most prevalent genotype with a rate of 65% (95% CI, 59 - 72) and 69% (95% CI, 36 - 100) respectively. In Tunisia and Morocco, subtype 1b was the most common subtype with a rate of 69% (95% CI, 50 - 88) and 32% (95% CI, 7 - 56) respectively. Conclusions The genotype distribution of HCV takes diverse patterns in EMRO countries

  20. Achieving Resource Conservation in Electronic Waste Management: A Review of Options Available to Developing Countries

    NASA Astrophysics Data System (ADS)

    Chidi Nnorom, Innocent; Osibanjo, Oladele; Onyedikachi Nnorom, Stanley

    Large quantities of waste electronic devices (e-waste) at their end-of-life, generated internally or imported illegally from developed countries, are currently being managed in the developing countries, through low-end means such as crude backyard recycling and disposal at unlined landfills or open dumps. The extension of the lifespan of electronic devices through reuse options such as repair, reconditioning and remanufacturing should be a priority in the management of electronic waste in developing countries considering the near absence of state-of-the-art recycling facilities in these countries. Life extension through product and component reuse is especially critical to electronic products because in recent years, electronics have increased in technological complexity, with new product innovations and ever shortening product life expectancy. For many products, environmentalists assume that reuse is environmentally beneficial because it replaces the manufacturing and purchase of new goods. However, on the contrary, manufacturers may oppose this type of reuse for the same reason. There is an urgent need to control the trans-boundary movement of electronic scrap especially to countries without established recycling facilities. Importations of secondhand electronics make such devices available to those who cannot afford new products. However, an international method of testing and certification is needed to ensure that exported secondhand devices are functional. Establishment of formal recycling facilities for e-waste in the developing countries will ensure resource reutilization with both economical and ecological gains. This study reviews options available in working towards eco-efficient management of e-waste in developing countries in the light of the present low-end management practices.

  1. The challenge of electronic waste (e-waste) management in developing countries.

    PubMed

    Osibanjo, O; Nnorom, I C

    2007-12-01

    Information and telecommunications technology (ICT) and computer Internet networking has penetrated nearly every aspect of modern life, and is positively affecting human life even in the most remote areas of the developing countries. The rapid growth in ICT has led to an improvement in the capacity of computers but simultaneously to a decrease in the products lifetime as a result of which increasingly large quantities of waste electrical and electronic equipment (e-waste) are generated annually. ICT development in most developing countries, particularly in Africa, depends more on secondhand or refurbished EEEs most of which are imported without confirmatory testing for functionality. As a result large quantities of e-waste are presently being managed in these countries. The challenges facing the developing countries in e-waste management include: an absence of infrastructure for appropriate waste management, an absence of legislation dealing specifically with e-waste, an absence of any framework for end-of-life (EoL) product take-back or implementation of extended producer responsibility (EPR). This study examines these issues as they relate to practices in developing countries with emphasis on the prevailing situation in Nigeria. Effective management of e-waste in the developing countries demands the implementation of EPR, the establishment of product reuse through remanufacturing and the introduction of efficient recycling facilities. The implementation of a global system for the standardization and certification/labelling of secondhand appliances intended for export to developing countries will be required to control the export of electronic recyclables (e-scarp) in the name of secondhand appliances. PMID:18229743

  2. [The Prevalence and Management of Pediculosis Capitis in Turkey: A Systematic Review].

    PubMed

    Özkan, Özlem; Hamzaoğlu, Onur; Yavuz, Melike

    2015-06-01

    This study aimed to examine scientific articles performed in Turkey on the prevalence and management of PK (diagnosis, contagion, prevention, treatment) from a critical perspective. The population of the systematic review consisted of total 63 published and unpublished theses or dissertations and peer-reviewed articles published in Turkish or English in national or foreign scientific journals from studies performed in Turkey between 1982 and 2012 years. It reached 578,938 people in 63 studies. Seventy-eight percent of the studies were related to the prevalence of PK and/or associated factors. The number of the studies was limited regarding diagnosis, prevention, contagion, treatment compliance, difficulties and causes of failure. Of the studies, 90.5% had been performed in public schools, almost exclusively elementary schools. The prevalence of PK was 0.3-34.1%, 0-35.4%, and it was 0.3-34.1% in elementary school children. It increased with years of education. It was double that of the boys in the girls (p<0.05). The prevalence among the subjects with low economic status were 1.9-42.3%, and it increased with worsening economic status (p<0.05). The prevalence reached up to 44.1% among children with illiterate mother. Basic recommendations include increasing the number of studies on the diagnosis, prevention, contagion, treatment compliance and efficacy, treatment failures and difficulties; public health workers also should prioritize investigation of head lice infestation. PMID:26081888

  3. Overview of legislation on sewage sludge management in developed countries worldwide.

    PubMed

    Christodoulou, A; Stamatelatou, K

    2016-01-01

    The need to apply innovative technologies for maximizing the efficiency and minimizing the carbon footprint of sewage treatment plants has upgraded sewage sludge management to a highly sophisticated research and development sector. Sewage sludge cannot be regarded solely as 'waste'; it is a renewable resource for energy and material recovery. From this perspective, legislation on sewage sludge management tends to incorporate issues related to environmental protection, public health, climate change impacts and socio-economic benefits. This paper reviews the existing legislative frameworks and policies on sewage sludge management in various countries, highlighting the common ground as well as the different priorities in all cases studied. More specifically, the key features of legislation regarding sludge management in developed countries such as the USA, Japan, Australia, New Zealand and the European Union (EU27) are discussed. PMID:26877026

  4. Epidemiology of Helicobacter pylori infection among the healthy population in Iran and countries of the Eastern Mediterranean Region: A systematic review of prevalence and risk factors

    PubMed Central

    Eshraghian, Ahad

    2014-01-01

    AIM: To investigate the epidemiology of Helicobacter pylori (H. pylori) infection among the healthy asymptomatic population in Iran and countries of the Eastern Mediterranean Region. METHODS: A computerized English language literature search of PubMed, ISI Web of Science, Scopus, and Google Scholar was performed in September 2013. The terms, “Eastern Mediterranean Regional Office (EMRO)” and “Helicobacter pylori”, “H. pylori” and “prevalence” were used as key words in titles and/or abstracts. A complementary literature search was also performed in the following countries: Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Palestine, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, The United Arab Emirates, and Yemen. RESULTS: In the electronic search, a total of 308 articles were initially identified. Of these articles, 26 relevant articles were identified and included in the study. There were 10 studies from Iran, 5 studies from the Kingdom of Saudi Arabia, 4 studies from Egypt, 2 from the United Arab Emirates, and one study from Libya, Oman, Tunisia, and Lebanon, respectively. The overall prevalence of H. pylori infection in Iran, irrespective of time and age group, ranged from 30.6% to 82%. The overall prevalence of H. pylori infection, irrespective of time and age group, in other EMRO countries ranged from 22% to 87.6%. CONCLUSION: The prevalence of H. pylori in EMRO countries is still high in the healthy asymptomatic population. Strategies to improve sanitary facilities, educational status, and socioeconomic status should be implemented to minimize H. pylori infection. PMID:25516677

  5. Rational development of guidelines for management of neonatal sepsis in developing countries

    PubMed Central

    Seale, Anna C; Obiero, Christina W; Berkley, James A

    2015-01-01

    Purpose of review This review discusses the rational development of guidelines for the management of neonatal sepsis in developing countries. Recent findings Diagnosis of neonatal sepsis with high specificity remains challenging in developing countries. Aetiology data, particularly from rural, community based studies are very limited, but molecular tests to improve diagnostics are being tested in a community-based study in South Asia. Antibiotic susceptibility data are limited, but suggest reducing susceptibility to first and second line antibiotics in both hospital and community acquired neonatal sepsis. Results of clinical trials in South Asia and sub-Saharan Africa assessing feasibility of simplified antibiotic regimens are awaited. Summary Effective management of neonatal sepsis in developing countries is essential to reduce neonatal mortality and morbidity. Simplified antibiotic regimens are currently being examined in clinical trials, but reduced antimicrobial susceptibility threatens current empiric treatment strategies. Improved clinical and microbiological surveillance is essential, to inform current practice, treatment guidelines, and monitor implementation of policy changes. PMID:25887615

  6. School-Based Management Committees in Low-Income Countries: Can They Improve Service Delivery?

    ERIC Educational Resources Information Center

    Abadzi, Helen

    2013-01-01

    With the advent of school-based management, citizen committees in low-income countries or areas are often expected to oversee the functioning of schools, health centres, and other community resources. However, studies of their effectiveness show mixed results. Though members of such committees may be able to repair buildings, they often cannot…

  7. New Resources for Education: Community Management and Financing of Schools in Less Developed Countries.

    ERIC Educational Resources Information Center

    Bray, Mark

    Strategies for community management and financing of educational systems in developing countries are presented in this book, which is the outcome of a Commonwealth Secretariat workshop and associated studies. Part 1 deals with preliminary issues such as different types of communities and schools and reasons for community support. Part 2 provides…

  8. Migration of health-care workers from developing countries: strategic approaches to its management.

    PubMed

    Stilwell, Barbara; Diallo, Khassoum; Zurn, Pascal; Vujicic, Marko; Adams, Orvill; Dal Poz, Mario

    2004-08-01

    Of the 175 million people (2.9% of the world's population) living outside their country of birth in 2000, 65 million were economically active. The rise in the number of people migrating is significant for many developing countries because they are losing their better-educated nationals to richer countries. Medical practitioners and nurses represent a small proportion of the highly skilled workers who migrate, but the loss for developing countries of human resources in the health sector may mean that the capacity of the health system to deliver health care equitably is significantly compromised. It is unlikely that migration will stop given the advances in global communications and the development of global labour markets in some fields, which now include nursing. The aim of this paper is to examine some key issues related to the international migration of health workers and to discuss strategic approaches to managing migration. PMID:15375449

  9. Migration of health-care workers from developing countries: strategic approaches to its management.

    PubMed Central

    Stilwell, Barbara; Diallo, Khassoum; Zurn, Pascal; Vujicic, Marko; Adams, Orvill; Dal Poz, Mario

    2004-01-01

    Of the 175 million people (2.9% of the world's population) living outside their country of birth in 2000, 65 million were economically active. The rise in the number of people migrating is significant for many developing countries because they are losing their better-educated nationals to richer countries. Medical practitioners and nurses represent a small proportion of the highly skilled workers who migrate, but the loss for developing countries of human resources in the health sector may mean that the capacity of the health system to deliver health care equitably is significantly compromised. It is unlikely that migration will stop given the advances in global communications and the development of global labour markets in some fields, which now include nursing. The aim of this paper is to examine some key issues related to the international migration of health workers and to discuss strategic approaches to managing migration. PMID:15375449

  10. Nasal polyps in patients with asthma: prevalence, impact, and management challenges

    PubMed Central

    Langdon, Cristobal; Mullol, Joaquim

    2016-01-01

    Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often have coexisting asthma under the concept of “United Airway Disease”, being the combination of both diseases, which is one of the most challenging phenotypes to treat. Although clinicians have recognized this difficult-to-treat phenotype for many years, it remained poorly characterized. There is increasing epidemiological evidence linking chronic rhinosinusitis and asthma, but a good understanding of the pathophysiology and the combined management is still lacking. Bronchial asthma is more prevalent in patients who suffer chronic rhinosinusitis, while asthmatic patients have a greater prevalence of CRSwNP than patients without asthma. The effect of CRSwNP treatment, whether medical or surgical, in asthma is today less controversial after some studies have shown improvement of asthma after medical and/or surgical treatment of CRSwNP. However, direct comparisons between surgical and medical treatments are limited. Further randomized clinical trials are, however, still needed to better understand the management when both asthma and CRSwNP occur together. This review aims at summarizing the prevalence, impact, and management challenges regarding both asthma and CRSwNP. PMID:27042129

  11. Nasal polyps in patients with asthma: prevalence, impact, and management challenges.

    PubMed

    Langdon, Cristobal; Mullol, Joaquim

    2016-01-01

    Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) often have coexisting asthma under the concept of "United Airway Disease", being the combination of both diseases, which is one of the most challenging phenotypes to treat. Although clinicians have recognized this difficult-to-treat phenotype for many years, it remained poorly characterized. There is increasing epidemiological evidence linking chronic rhinosinusitis and asthma, but a good understanding of the pathophysiology and the combined management is still lacking. Bronchial asthma is more prevalent in patients who suffer chronic rhinosinusitis, while asthmatic patients have a greater prevalence of CRSwNP than patients without asthma. The effect of CRSwNP treatment, whether medical or surgical, in asthma is today less controversial after some studies have shown improvement of asthma after medical and/or surgical treatment of CRSwNP. However, direct comparisons between surgical and medical treatments are limited. Further randomized clinical trials are, however, still needed to better understand the management when both asthma and CRSwNP occur together. This review aims at summarizing the prevalence, impact, and management challenges regarding both asthma and CRSwNP. PMID:27042129

  12. Effect of the Prevalence of HIV/AIDS and the Life Expectancy Rate on Economic Growth in SSA Countries: Difference GMM Approach

    PubMed Central

    Waziri, Salisu Ibrahim; Nor, Norashidah Mohamed; Abdullah, Nik Mustapha Raja; Adamu, Peter

    2016-01-01

    The productivity of countries around the globe is adversely affected by the health-related problems of their labour force. This study examined the effect of the prevalence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and life expectancy on the economic growth of 33 Sub-Saharan African (SSA) countries over a period of 11 years (2002–2012). The study employed a dynamic panel approach as opposed to the static traditional approach utilised in the literature. The dynamic approach became eminent because of the fact that HIV/AIDS is a dynamic variable as its prevalence today depends on the previous years. The result revealed that HIV/AIDS is negatively correlated with economic growth in the region, with a coefficient of 0.014, and significant at the 1% level. That is, a 10% increase in HIV/AIDS prevalence leads to a 0.14% decrease in the GDP of the region. Tackling HIV/AIDS is therefore imperative to the developing Sub-Saharan African region and all hands must be on deck to end the menace globally. PMID:26573032

  13. Effect of the Prevalence of HIV/AIDS and the Life Expectancy Rate on Economic Growth in SSA Countries: Difference GMM Approach.

    PubMed

    Waziri, Salisu Ibrahim; Mohamed Nor, Norashidah; Raja Abdullah, Nik Mustapha; Adamu, Peter

    2016-01-01

    The productivity of countries around the globe is adversely affected by the health-related problems of their labour force. This study examined the effect of the prevalence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and life expectancy on the economic growth of 33 Sub-Saharan African (SSA) countries over a period of 11 years (2002-2012). The study employed a dynamic panel approach as opposed to the static traditional approach utilised in the literature. The dynamic approach became eminent because of the fact that HIV/AIDS is a dynamic variable as its prevalence today depends on the previous years. The result revealed that HIV/AIDS is negatively correlated with economic growth in the region, with a coefficient of 0.014, and significant at the 1% level. That is, a 10% increase in HIV/AIDS prevalence leads to a 0.14% decrease in the GDP of the region. Tackling HIV/AIDS is therefore imperative to the developing Sub-Saharan African region and all hands must be on deck to end the menace globally. PMID:26573032

  14. Management of emerging multidrug-resistant tuberculosis in a low-prevalence setting.

    PubMed

    Catho, G; Couraud, S; Grard, S; Bouaziz, A; Sénéchal, A; Valour, F; Perpoint, T; Braun, E; Biron, F; Ferry, T; Chidiac, C; Freymond, N; Perrot, E; Souquet, P-J; Maury, J-M; Tronc, F; Veziris, N; Lina, G; Dumitrescu, O; Ader, F

    2015-05-01

    Multidrug-resistant (MDR) tuberculosis (TB) is an emerging concern in communities with a low TB prevalence and a high standard of public health. Twenty-three consecutive adult MDR TB patients who were treated at our institution between 2007 and 2013 were reviewed for demographic characteristics and anti-TB treatment management, which included surgical procedures and long-term patient follow-up. This report of our experience emphasizes the need for an individualized approach as MDR TB brings mycobacterial disease management to a higher level of expertise, and for a balance to be found between international current guidelines and patient-tailored treatment strategies. PMID:25708551

  15. Prevalence and correlates of physical disability and functional limitation among community dwelling older people in rural Malaysia, a middle income country

    PubMed Central

    2010-01-01

    Background The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries. Methods A population-based cross sectional study was conducted in Alor Gajah, Malacca. Seven hundred and sixty five older people aged 60 years and above underwent tests of functional limitation (Tinetti Performance Oriented Mobility Assessment Tool). Data were also collected for self reported activities of daily living (ADL) using the Barthel Index (ten items). To compare prevalence with other studies, ADL disability was also defined using six basic ADL's (eating, bathing, dressing, transferring, toileting and walking) and five basic ADL's (eating, bathing, dressing, transferring and toileting). Results Ten, six and five basic ADL disability was reported by 24.7% (95% CI 21.6-27.9), 14.4% (95% CI 11.9-17.2) and 10.6% (95% CI 8.5-13.1), respectively. Functional limitation was found in 19.5% (95% CI 16.8-22.5) of participants. Variables independently associated with 10 item ADL disability physical disability, were advanced age (≥ 75 years: prevalence ratio (PR) 7.9; 95% CI 4.8-12.9), presence of diabetes (PR 1.8; 95% CI 1.4-2.3), stroke (PR 1.5; 95% CI 1.1-2.2), depressive symptomology (PR 1.3; 95% CI 1.1-1.8) and visual impairment (blind: PR 2.0; 95% CI 1.1-3.6). Advancing age (≥ 75 years: PR 3.0; 95% CI 1.7-5.2) being female (PR 2.7; 95% CI 1.2-6.1), presence of arthritis (PR 1.6; 95% CI 1.2-2.1) and depressive symptomology (PR 2.0; 95% CI 1.5-2.7) were significantly associated with functional limitation. Conclusions The prevalence of physical disability and functional limitation among older Malaysians appears to be much higher than in developed countries but is comparable to developing

  16. The behavior of multiple independent managers and ecological traits interact to determine prevalence of weeds.

    PubMed

    Coutts, Shaun R; Yokomizo, Hiroyuki; Buckley, Yvonne M

    2013-04-01

    Management of damaging invasive plants is often undertaken by multiple decision makers, each managing only a small part of the invader's population. As weeds can move between properties and re-infest eradicated sites from unmanaged sources, the dynamics of multiple decision makers plays a significant role in weed prevalence and invasion risk at the landscape scale. We used a spatially explicit agent-based simulation to determine how individual agent behavior, in concert with weed population ecology, determined weed prevalence. We compared two invasive grass species that differ in ecology, control methods, and costs: Nassella trichotoma (serrated tussock) and Eragrostis curvula (African love grass). The way decision makers reacted to the benefit of management had a large effect on the extent of a weed. If benefits of weed control outweighed the costs, and either net benefit was very large or all agents were very sensitive to net benefits, then agents tended to act synchronously, reducing the pool of infested agents available to spread the weed. As N. trichotoma was more damaging than E. curvula and had more effective control methods, agents chose to manage it more often, which resulted in lower prevalence of N. trichotoma. A relatively low number of agents who were intrinsically less motivated to control weeds led to increased prevalence of both species. This was particularly apparent when long-distance dispersal meant each infested agent increased the invasion risk for a large portion of the landscape. In this case, a small proportion of land mangers reluctant to control, regardless of costs and benefits, could lead to the whole landscape being infested, even when local control stopped new infestations. Social pressure was important, but only if it was independent of weed prevalence, suggesting that early access to information, and incentives to act on that information, may be crucial in stopping a weed from infesting large areas. The response of our model to both

  17. Effect of ethnicity on the prevalence, severity, and management of COPD in general practice

    PubMed Central

    Martin, Alice; Badrick, Ellena; Mathur, Rohini; Hull, Sally

    2012-01-01

    Background Chronic obstructive pulmonary disease (COPD) remains a major cause of mortality and hospital use. Little is known in the UK about the variation in COPD prevalence, severity, and management depending on ethnicity. Aim To examine differences by ethnicity in COPD prevalence, severity, and management. Design & setting Cross-sectional study using routinely collected computerised data from general practice in three east-London primary care trusts (Newham, Tower Hamlets, and City and Hackney) with multiethnic populations of people who are socially deprived. Method Routine demographic, clinical, and hospital admission data from 140 practices were collected. Results Crude COPD prevalence was 0.9%; the highest recorded rates were in the white population. Severity of COPD, measured by percentage-predicted forced expiratory volume in 1 second, did not vary by ethnicity. South Asians and black patients were less likely than white patients to have breathlessness, indicated by a Medical Research Council dyspnoea grade of ≥4 (odds ratio [OR] 0.7 [95% confidence interval (CI) = 0.6 to 0.9] and 0.6 [95% CI = 0.4 to 0.8]). Black patients were less likely than white patients to receive inhaled medications. Influenza and pneumococcal vaccine rates were highest among groups of South Asians (OR 3.0 [95% CI = 2.1 to 4.3] and 1.8 [95% CI = 1.4 to 2.3] respectively). Both minority ethnic groups had low referral rates to pulmonary rehabilitation. In Tower Hamlets, black patients were more likely to be admitted to hospital for respiratory causes. Conclusion Differences in COPD prevalence and severity by ethnicity were identified, and significant differences in drug and non-drug management and hospital admissions observed. Systematic ethnicity recording in general practice is needed to be able to explore such differences and monitor inequalities in healthcare by ethnicity. PMID:22520773

  18. Potential use of economic instruments in waste management in the Arab countries.

    PubMed

    Saqqar, Muwaffaq M

    2004-01-01

    Changing public behavior towards the environment is considered an essential component in the environmental strategies of all the Arab countries. An important mechanism is using economic instruments (pricing, charges, taxes, and financial incentives) to achieve the desired changes. This article presents potential applications for the use of economic instruments in waste management in the Arab countries. Applications are suggested for implementation in several fields that include wastewater, solid waste, hazardous waste, and agricultural pollution. Examples are presented based on real data from Jordan. In addition, the requirements needed to implement the economic instruments are explained. PMID:15027827

  19. 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

  20. Schistosomiasis Prevalence and Intensity of Infection in Latin America and the Caribbean Countries, 1942-2014: A Systematic Review in the Context of a Regional Elimination Goal

    PubMed Central

    2016-01-01

    Background In 2012 the World Health Assembly adopted resolution WHA65.21 on elimination of schistosomiasis, calling for increased investment in schistosomiasis control and support for countries to initiate elimination programs. This study aims to analyze prevalence and intensity of Schistosoma mansoni infection in children in Latin America and the Caribbean countries and territories (LAC), at the second administrative level or lower. Methodology A systematic review of schistosomiasis prevalence and intensity of infection was conducted by searching at PubMed, LILACS and EMBASE. Experts on the topic were informally consulted and institutional web pages were reviewed (PAHO/WHO, Ministries of Health). Only SCH infection among children was registered because it can be a ‘proxi-indicator’ of recent transmission by the time the study is conducted. Principal Findings One hundred thirty two full-text articles met the inclusion criteria and provided 1,242 prevalence and 199 intensity of infection data points. Most of them were from Brazil (69.7%). Only Brazil published studies after 2001, showing several 'hot spots' with high prevalence. Brazil, Venezuela, Suriname and Saint Lucia need to update the epidemiological status of schistosomiasis to re-design their national programs and target the elimination of Schistosoma mansoni transmission by 2020. In Antigua and Barbuda, Dominican Republic, Guadeloupe, Martinique, Montserrat and Puerto Rico schistosomiasis transmission may be interrupted. However the compilation of an elimination dossier and follow-up surveys, per WHO recommendations, are needed to verify that status. Hence, the burden of subtle SCH chronic infection may be still present and even high in countries that may have eliminated transmission. Heterogeneity in the methodologies used for monitoring and evaluating the progress of the schistosomiasis programs was found, making cross-national and chronological comparisons difficult. Conclusions There is a need for

  1. Prevalence of Anti-Tuberculosis Drug Resistance in Foreign-Born Tuberculosis Cases in the U.S. and in Their Countries of Origin

    PubMed Central

    Taylor, Allison B.; Kurbatova, Ekaterina V.; Cegielski, J. Peter

    2012-01-01

    Background Foreign-born individuals comprise >50% of tuberculosis (TB) cases in the U.S. Since anti-TB drug resistance is more common in most other countries, when evaluating a foreign-born individual for TB, one must consider the risk of drug resistance. Naturally, clinicians query The Global Project on Anti-tuberculosis Drug Resistance Surveillance (Global DRS) which provides population-based data on the prevalence of anti-TB drug resistance in 127 countries starting in 1994. However, foreign-born persons in the U.S. are a biased sample of the population of their countries of origin, and Global DRS data may not accurately predict their risk of drug resistance. Since implementing drug resistance surveillance in 1993, the U.S. National TB Surveillance System (NTSS) has accumulated systematic data on over 130,000 foreign-born TB cases from more than 200 countries and territories. Our objective was to determine whether the prevalence of drug resistance among foreign-born TB cases correlates better with data from the Global DRS or with data on foreign-born TB cases in the NTSS. Methods and Findings We compared the prevalence of resistance to isoniazid and rifampin among foreign-born TB cases in the U.S., 2007–2009, with US NTSS data from 1993 to 2006 and with Global DRS data from 1994–2007 visually with scatterplots and statistically with correlation and linear regression analyses. Among foreign-born TB cases in the U.S., 2007–2009, the prevalence of isoniazid resistance and multidrug resistance (MDR, i.e. resistance to isoniazid and rifampin), correlated much better with 1993–2006 US surveillance data (isoniazid: r = 0.95, P<.001, MDR: r = 0.75, P<.001) than with Global DRS data, 1994–2007 (isoniazid: r = 0.55, P = .001; MDR: r = 0.50, P<.001). Conclusion Since 1993, the US NTSS has accumulated sufficient data on foreign-born TB cases to estimate the risk of drug resistance among such individuals better than data from the Global DRS

  2. Cardiovascular disease in spinal cord injury: an overview of prevalence, risk, evaluation, and management.

    PubMed

    Myers, Jonathan; Lee, Matthew; Kiratli, Jenny

    2007-02-01

    Cardiovascular disease is a growing concern for the spinal cord-injured (SCI) population. For long-term SCI, morbidity and mortality from cardiovascular causes now exceeds that caused by renal and pulmonary conditions, the primary causes of mortality in previous decades. Although risk estimates commonly used for ambulatory individuals have not been established from follow-up studies in SCI, nearly all risk factors tend to be more prevalent in SCI subjects compared with ambulatory subjects. These risks include a greater prevalence of obesity, lipid disorders, metabolic syndrome, and diabetes. Daily energy expenditure is significantly lower in SCI individuals, not only because of a lack of motor function, but also because of a lack of accessibility and fewer opportunities to engage in physical activity. Autonomic dysfunction caused by SCI is also associated with several conditions that contribute to heightened cardiovascular risk, including abnormalities in blood pressure, heart rate variability, arrhythmias, and a blunted cardiovascular response to exercise that can limit the capacity to perform physical activity. Thus, screening, recognition, and treatment of cardiovascular disease should be an essential component of managing individuals with SCI, and judicious treatment of risk factors can play an important role in minimizing the incidence of cardiovascular disease in these individuals. This article reviews the cardiovascular consequences of chronic SCI, including the prevalence of cardiovascular disease and risk factors unique to these individuals, and provides a synopsis of management of cardiovascular disease in this population. PMID:17251696

  3. Information technology and public health management of disasters--a model for South Asian countries.

    PubMed

    Mathew, Dolly

    2005-01-01

    This paper highlights the use of information technology (IT) in disaster management and public health management of disasters. Effective health response to disasters will depend on three important lines of action: (1) disaster preparedness; (2) emergency relief; and (3) management of disasters. This is facilitated by the presence of modern communication and space technology, especially the Internet and remote sensing satellites. This has made the use of databases, knowledge bases, geographic information systems (GIS), management information systems (MIS), information transfer, and online connectivity possible in the area of disaster management and medicine. This paper suggests a conceptual model called, "The Model for Public Health Management of Disasters for South Asia". This Model visualizes the use of IT in the public health management of disasters by setting up the Health and Disaster Information Network and Internet Community Centers, which will facilitate cooperation among all those in the areas of disaster management and emergency medicine. The suggested infrastructure would benefit the governments, non-government organizations, and institutions working in the areas of disaster and emergency medicine, professionals, the community, and all others associated with disaster management and emergency medicine. The creation of such an infrastructure will enable the rapid transfer of information, data, knowledge, and online connectivity from top officials to the grassroots organizations, and also among these countries regionally. This Model may be debated, modified, and tested further in the field to suit the national and local conditions. It is hoped that this exercise will result in a viable and practical model for use in public health management of disasters by South Asian countries. PMID:15748016

  4. Web-based reporting of the results of the 2006 four country prevalence survey of healthcare associated infections.

    PubMed

    Harris, S; Morgan, M; Davies, E

    2008-07-01

    A web-base reporting system was developed in order to feed back the results of the 2006 prevalence survey of healthcare-associated infections in a timely manner to all participating hospitals in England, Wales and Northern Ireland. The database accommodated approximately 75 000 records from over 250 hospitals. The reporting system was hosted on the National Health Service intranet, accessible via secure login. Users were able to access their individual Trust data via a series of predefined reports and an export facility was included to facilitate additional analysis. The reporting system was made available to participating hospitals within 12 months of completion of the survey. From the results of a user satisfaction survey, end-users responded positively to receiving feedback in this format. It serves as a useful model for the feedback of results for future prevalence surveys. PMID:18511152

  5. Policy initiatives for electric-utility load management in AID-assisted countries

    SciTech Connect

    Not Available

    1990-08-01

    The demand for electricity has been growing at a rate of over 7 percent per year, on average, for developing countries (in contrast, demand has been rising by less than 3% annually in the United States). While developing nations have traditionally relied on building new power plants to satisfy their increasing needs for electricity, the strategy has proven to be expensive, consuming over one-quarter of their development budgets and over a quarter of their foreign borrowings. Load management, whereby an electric utility modifies its customers' demand characteristics, offers developing countries an alternative for reducing the need to construct new generating capacity and for better utilizing their existing supply facilities. To mitigate the problems associated with high energy growth rates, especially in the power sector, the lack of investment capital for the electricity sector, and the growing concern for environmental hazards including global climate change, the Office of Energy promotes energy efficiency, the role of private power and other supply options to ensure sustainable development. In view of these objectives, the report examines the rationale for load management in the electricity sector and summarizes the positive U.S. experience with these techniques. Additionally, it recommends a strategy for achieving energy efficiency via load management. Lastly, it recommends to A.I.D. a method for identifying priority Agency-assisted countries as candidates for load management assistance.

  6. Building Co-Management as a Process: Problem Solving Through Partnerships in Aboriginal Country, Australia

    NASA Astrophysics Data System (ADS)

    Zurba, Melanie; Ross, Helen; Izurieta, Arturo; Rist, Philip; Bock, Ellie; Berkes, Fikret

    2012-06-01

    Collaborative problem solving has increasingly become important in the face of the complexities in the management of resources, including protected areas. The strategy undertaken by Girringun Aboriginal Corporation in north tropical Queensland, Australia, for developing co-management demonstrates the potential for a problem solving approach involving sequential initiatives, as an alternative to the more familiar negotiated agreements for co-management. Our longitudinal case study focuses on the development of indigenous ranger units as a strategic mechanism for the involvement of traditional owners in managing their country in collaboration with government and other interested parties. This was followed by Australia's first traditional use of marine resources agreement, and development of a multi-jurisdictional, land to sea, indigenous protected area. In using a relationship building approach to develop regional scale co-management, Girringun has been strengthening its capabilities as collaborator and regional service provider, thus, bringing customary decision-making structures into play to `care for country'. From this evolving process we have identified the key components of a relationship building strategy, `the pillars of co-management'. This approach includes learning-by-doing, the building of respect and rapport, sorting out responsibilities, practical engagement, and capacity-building.

  7. A Systematic Review of the Effects of Behavioral Counseling on Sexual Risk Behaviors and HIV/STI Prevalence in Low- and Middle-Income Countries.

    PubMed

    Zajac, Kristyn; Kennedy, Caitlin E; Fonner, Virginia A; Armstrong, Kevin S; O'Reilly, Kevin R; Sweat, Michael D

    2015-07-01

    The purpose of this study was to assess the effectiveness of behavioral counseling interventions in reducing sexual risk behaviors and HIV/STI prevalence in low- and middle-income countries. A systematic review of papers published between 1990 and 2011 was conducted, identifying studies that utilized either a multi-arm or pre-post design and presented post-intervention data. Standardized methods of searching and data abstraction were used, and 30 studies met inclusion criteria. Results are summarized by intervention groups: (a) people living with HIV; (b) people who use drugs and alcohol; (c) serodiscordant couples; (d) key populations for HIV prevention; and (e) people at low to moderate HIV risk. Evidence for the effectiveness of behavioral counseling was mixed, with more rigorously designed studies often showing modest or no effects. Recommendations about the use of behavioral counseling in developing countries are made based on study results and in light of the field's movement towards combination prevention programs. PMID:25213302

  8. Diabetes in Algeria and challenges for health policy: a literature review of prevalence, cost, management and outcomes of diabetes and its complications

    PubMed Central

    2014-01-01

    Background Diabetes has become an increasingly prevalent and severe public health issue in Algeria. This article investigates the prevalence, the cost and the management of this disease. Its first objective is to better understand the burden (both from an epidemiological and economic perspective) and management of diabetes. The second objective is to understand the health policy strategy adopted by Algeria in order to respond to the disease. Methods We conducted a literature review of prevalence, costs, management and outcomes of diabetes and its complications. This was complemented by data compilations and results of expert consultations. Results The epidemiology of diabetes is continually evolving and is becoming more problematic. The national evidence suggests that the prevalence of diabetes in Algeria has increased from 6.8% in 1990 to 12.29% in 2005, but is quite higher among certain groups and areas of the country. This disease affects all population groups, especially 35–70 year olds, who constitute a large segment of the working population. There are very few estimates of the cost of diabetes. These include a 1998 study on the total cost of type 1 diabetes (USD 11.6 million, which, inflated to 2013 value, totals to USD 16.6 million), a study on the cost of complications in 2010 (at 2013 value, ranging from USD 141 for first-year treatment of peripheral vascular disease to USD 30,441 for first-year cost of renal transplantation) and the 2013 IDF estimates of total cost of type 1 and type 2 diabetes (USD 513 million). Conclusions As the prevalence of diabetes continues to increase, the financial burden will increasingly weigh heavily on social security resources and the government budget. Future priorities must focus on empowering general practitioners in treating type 2 diabetes, improving screening of diabetes and its complications, tackling the growing obesity epidemic, strengthening health information systems and implementing the national diabetes

  9. Sustainable Agricultural and Watershed Management in Developing Countries - An India Case Study

    NASA Astrophysics Data System (ADS)

    Kiliszek, A.; Vaicunas, R.; Zook, K.; Popkin, J.; Inamdar, S. P.; Duke, J.; Awokuse, T.; Sims, T.; Hansen, D.; Wani, S. P.

    2011-12-01

    The goal of sustainable agricultural and watershed management is to enhance agricultural productivity while protecting and preserving our environment and natural resources. The vast majority of information on sustainable watershed management practices is primarily derived from studies in developed nations with very few inputs from developing nations. Through a USDA-funded project, the University of Delaware (UD) initiated a collaboration with the International Crop Research Institute for the Semi-Arid Tropics (ICRISAT) located in Hyderabad, India to study sustainable agricultural management practices in developing countries and their impacts on the environment, crop productivity, and socioeconomic conditions of the watershed community. As a part of this project, ICRISAT provided us with a vast amount of data on sustainable agricultural practices and their impacts on runoff, soil and water quality, crop yields, nutrient management and socioeconomic conditions. Conservation practices that were implemented included check dams, groundwater recharge wells, intercropping, nutrient management, integrated pest management and a suite of other practices. Using this information, students and faculty at UD developed teaching modules that were used for education and enrichment of existing UD courses and are also being used for the development of a stand-alone online course. The students and faculty visited India in July 2010 to get a first-hand experience of the conditions in the agricultural watersheds and the impacts of sustainable management practices. The project was a tremendous learning experience for US students and faculty and highlighted the challenges people face in developing countries and how that affects every aspect of their lives. Such challenges include environmental, agricultural, technological, economic, and transportation. Although we experience many of the same challenges, developing countries do not have the technology or economic infrastructure in place to

  10. Prevalence and correlates of young people's sexual aggression perpetration and victimisation in 10 European countries: a multi-level analysis.

    PubMed

    Krahé, Barbara; Berger, Anja; Vanwesenbeeck, Ine; Bianchi, Gabriel; Chliaoutakis, Joannes; Fernández-Fuertes, Andrés A; Fuertes, Antonio; de Matos, Margarida Gaspar; Hadjigeorgiou, Eleni; Haller, Birgitt; Hellemans, Sabine; Izdebski, Zbigniew; Kouta, Christiana; Meijnckens, Dwayne; Murauskiene, Liubove; Papadakaki, Maria; Ramiro, Lucia; Reis, Marta; Symons, Katrien; Tomaszewska, Paulina; Vicario-Molina, Isabel; Zygadło, Andrzej

    2015-01-01

    Data are presented on young people's sexual victimisation and perpetration from 10 European countries (Austria, Belgium, Cyprus, Greece, Lithuania, the Netherlands, Poland, Portugal, Slovakia and Spain) using a shared measurement tool (N = 3480 participants, aged between 18 and 27 years). Between 19.7 and 52.2% of female and between 10.1 and 55.8% of male respondents reported having experienced at least one incident of sexual victimisation since the age of consent. In two countries, victimisation rates were significantly higher for men than for women. Between 5.5 and 48.7% of male and 2.6 and 14.8% of female participants reported having engaged in a least one act of sexual aggression perpetration, with higher rates for men than for women in all countries. Victimisation rates correlated negatively with sexual assertiveness and positively with alcohol use in sexual encounters. Perpetration rates correlated positively with attitudes condoning physical dating violence and with alcohol use in men, and negatively with sexual assertiveness in women. At the country level, lower gender equality in economic power and in the work domain was related to higher male perpetration rates. Lower gender equality in political power and higher sexual assertiveness in women relative to men were linked to higher male victimisation rates. PMID:25567318

  11. Spinal alignment, mobility of the hip and thoracic spine and prevalence of low back pain in young elite cross-country skiers

    PubMed Central

    Alricsson, Marie; Björklund, Glenn; Cronholm, Martin; Olsson, Oscar; Viklund, Peter; Svantesson, Ulla

    2016-01-01

    This study investigated the association between spinal alignment, mobility of the hips and the thoracic spine and low back pain in adolescent cross-country skiers. Cohort of 51 elite cross-country skiers from a cross-country skiing high school in Sweden participated in the study. Sagittal spinal alignment, active range of motion in flexion, extension and rotation of the thoracic spine as well as passive and active extension of the hips were measured. The participants also completed a questionnaire regarding training, competition, skiing technique and occurrence of low back pain. A simple linear regression was calculated to predict pain score based on thoraco-lumbar relation, with a significant (P<0.05) regression equation of y=−0.069x+2.280 (standard error of estimate, 0.034). Participants with greater lordosis than kyphosis were more likely to suffer from low back pain than subjects without this offset. Thoracic mobility and passive or active hip extension showed no correlation with low back pain. Sagittal spinal alignment seems to be related with low back pain among young elite cross-country skiers. This study shows that range of motion of the thoracic spine and hips do not have an effect on the prevalence of low back pain in this population. PMID:26933656

  12. [Amputation in low-income countries: particularities in epidmiological features and management practices].

    PubMed

    Bisseriex, H; Rogez, D; Thomas, M; Truffaut, S; Compere, S; Mercier, H; Dochez, F; Lapeyre, E; Thefenne, L

    2011-12-01

    The epidemiological features and management practices associated with amputation in low-income countries, generally synonymous with the tropics, are different from those observed in Western countries. Unlike developed countries, amputation most frequently involves traumatic injury in young active people. However, Westernization of the lifestyle is leading to an increasing number of cases involving diabetes and atherosclerotic disease. In the developing world, leprosy and Buruli ulcer are still significant etiologic factors for amputation. In war-torn countries, use of antipersonnel landmines is another major cause of amputation with characteristic features. Management of amputees in the developing world is hindered by the lack of facilities for rehabilitation and prosthetic fitting. Many international organizations are supporting national programs to develop such facilities. In addition to being affordable, prosthetics and orthotics must be adapted to the living conditions of a mostly rural amputee population, i.e., heat, humidity, and farm work. The rehabilitation process must be part of a global handicap policy aimed at changing attitudes about disability and reintegrating amputees both socially and professionally. PMID:22393622

  13. Management of waste electrical and electronic equipment in two EU countries: a comparison.

    PubMed

    Torretta, Vincenzo; Ragazzi, Marco; Istrate, Irina Aura; Rada, Elena Cristina

    2013-01-01

    The paper presents some data regarding waste electrical and electronic (WEEE) management in one of the founding countries of the EU, Italy, and in a recent entry into the EU, Romania. The aim of this research was to analyze some problems that countries entering the EU will have to solve with respect to WEEE management. The experiences of Italy and Romania could provide an interesting reference point. The strengths and weaknesses that the two EU countries have encountered can be used in order to give a more rational plan for other countries. In Italy the increase of WEEE collection was achieved in parallel with the increase of the efficiency of selective Municipal Solid Waste collection. In Romania, pilot experiences were useful to increase the awareness of the population. The different interests of the two populations towards recyclable waste led to a different scenario: in Romania all types of WEEE have been collected since its entrance into the EU; in Italy the "interest" in recycling is typically related to large household appliances, with a secondary role of lighting equipment. PMID:22921899

  14. Managing menstruation in the workplace: an overlooked issue in low- and middle-income countries.

    PubMed

    Sommer, Marni; Chandraratna, Sahani; Cavill, Sue; Mahon, Therese; Phillips-Howard, Penelope

    2016-01-01

    The potential menstrual hygiene management barriers faced by adolescent girls and women in workplace environments in low- and middle-income countries has been under addressed in research, programming and policy. Despite global efforts to reduce poverty among women in such contexts, there has been insufficient attention to the water and sanitation related barriers, specifically in relation to managing monthly menstruation, that may hinder girls' and women's contributions to the workplace, and their health and wellbeing. There is an urgent need to document the specific social and environmental barriers they may be facing in relation to menstrual management, to conduct a costing of the implications of inadequate supportive workplace environments for menstrual hygiene management, and to understand the implications for girls' and women's health and wellbeing. This will provide essential evidence for guiding national policy makers, the private sector, donors and activists focused on advancing girls' and women's rights. PMID:27268416

  15. Technological Innovation and Developmental Strategies for Sustainable Management of Aquatic Resources in Developing Countries

    NASA Astrophysics Data System (ADS)

    Agboola, Julius Ibukun

    2014-12-01

    Sustainable use and allocation of aquatic resources including water resources require implementation of ecologically appropriate technologies, efficient and relevant to local needs. Despite the numerous international agreements and provisions on transfer of technology, this has not been successfully achieved in developing countries. While reviewing some challenges to technological innovations and developments (TID), this paper analyzes five TID strategic approaches centered on grassroots technology development and provision of localized capacity for sustainable aquatic resources management. Three case studies provide examples of successful implementation of these strategies. Success requires the provision of localized capacity to manage technology through knowledge empowerment in rural communities situated within a framework of clear national priorities for technology development.

  16. Report: transboundary hazardous waste management. part II: performance auditing of treatment facilities in importing countries.

    PubMed

    Chang, Tien-Chin; Ni, Shih-Piao; Fan, Kuo-Shuh; Lee, Ching-Hwa

    2006-06-01

    Before implementing the self-monitoring model programme of the Basel Convention in the Asia, Taiwan has conducted a comprehensive 4-year follow-up project to visit the governmental authorities and waste-disposal facilities in the countries that import waste from Taiwan. A total of nine treatment facilities, six of which are reported in this paper, and the five countries where the plants are located were visited in 2001-2002. France, Belgium and Finland primarily handled polychlorinated biphenyl capacitors, steel mill dust and metal waste. The United States accepted metal sludge, mainly electroplating sludge, from Taiwan. Waste printed circuit boards, waste wires and cables, and a mixture of waste metals and electronics were the major items exported to China. Relatively speaking, most treatment plants for hazardous waste paid close attention to environmental management, such as pollution control and monitoring, site zoning, system management regarding occupational safety and hygiene, data management, permits application, and image promotion. Under the tight restrictions formulated by the central environment agency, waste treatment plants in China managed the environmental issues seriously. For example, one of the treatment plants had ISO 14001 certification. It is believed that with continuous implementation of regulations, more improvement is foreseeable. Meanwhile, Taiwan and China should also continuously enhance their collaboration regarding the transboundary management of hazardous waste. PMID:16784171

  17. Financial implications of compliance with EU waste management goals: Feasibility and consequences in a transition country.

    PubMed

    Mihajlović, Višnja; Vujić, Goran; Stanisavljević, Nemanja; Batinić, Bojan

    2016-09-01

    This paper outlines the approach that can assist decision makers to have first preliminary insights regarding costs of complying with requested European Union municipal waste management goals in transition and developing countries. Serbia, as a joining member of European Union, must confront itself with the challenges resulting from European Union waste management directives. Implementation of waste separation units and the construction of sanitary landfills is already in place in Serbia. However, new waste management practice will need additional transformation and will require implementation of waste treatment technologies for additional management of generated waste. Implementation of analyzed best available technology/techniques for waste treatment can support the country's effort in reaching the policy goals. However, the question here is how much will the implementation of additional waste treatments influence the overall waste management costs? Results of the scenario's financial viability show that composting and sanitary landfill are the most viable solutions regarding the costs, even under increasing discount rates. Although different discount rates influence the overall gate fees and net present values, the level of affordability for different scenarios remains the same. PMID:27357561

  18. Physicians' Attitudes to Clinical Pain Management and Education: Survey from a Middle Eastern Country.

    PubMed

    Nasser, Soumana C; Nassif, Jeanette G; Saad, Aline Hanna

    2016-01-01

    Despite promising initiatives to advance the practice of pain management in Middle Eastern countries, their pain care lags behind developed countries. The objectives of this study are to evaluate physicians' assessment of their own competency in pain management, to assess physicians' practice related to pain management, and to identify physician-related barriers to effective pain control. A cross-sectional survey was conducted in 3 teaching medical centers in Lebanon targeting the above-mentioned outcomes and assessing the impact of physicians' years in practice on the studied end-points. A total of 69 physicians were surveyed. Fifty-seven percent reported "very good to excellent" pain management skills; only 25% of them described the need for continuing professional development. When treating patients with pain, 52% of physicians refer to updated international guidelines, whereas 43% rely on their own judgment. Physicians were more likely to consult with another physician (65%) rather than a pharmacist (12%) when treating patients with pain. Fear of adverse effects of analgesics was the most commonly reported barrier (45%) to pain control among physicians from different career stages. Based on these survey findings, national pain management and practice policies are needed to optimize this area of deficiency in patient care. PMID:27445596

  19. Physicians' Attitudes to Clinical Pain Management and Education: Survey from a Middle Eastern Country

    PubMed Central

    Saad, Aline Hanna

    2016-01-01

    Despite promising initiatives to advance the practice of pain management in Middle Eastern countries, their pain care lags behind developed countries. The objectives of this study are to evaluate physicians' assessment of their own competency in pain management, to assess physicians' practice related to pain management, and to identify physician-related barriers to effective pain control. A cross-sectional survey was conducted in 3 teaching medical centers in Lebanon targeting the above-mentioned outcomes and assessing the impact of physicians' years in practice on the studied end-points. A total of 69 physicians were surveyed. Fifty-seven percent reported “very good to excellent” pain management skills; only 25% of them described the need for continuing professional development. When treating patients with pain, 52% of physicians refer to updated international guidelines, whereas 43% rely on their own judgment. Physicians were more likely to consult with another physician (65%) rather than a pharmacist (12%) when treating patients with pain. Fear of adverse effects of analgesics was the most commonly reported barrier (45%) to pain control among physicians from different career stages. Based on these survey findings, national pain management and practice policies are needed to optimize this area of deficiency in patient care.

  20. [Malaria in Gabon. 2. Evaluation of the qualitative and quantitative prevalence of parasites in the total school and preschool population of the country].

    PubMed

    Richard-Lenoble, D; Kombila, M; Chandenier, J; Gay, F; Billiault, X; Nguiri, C; Martz, M; Boyer, F; Bauzou, M

    1987-01-01

    The distribution of carriers of hematozoa in the pre-school and school age group in Gabon has been established with the help of systematic enquiry. The plasmodial indexes vary between 11 and 32% in the savanna zones of the south-east, they rise to 64.9% in the forest regions of the north of the country, and in the urban zones (Libreville, Franceville, Lambarene) 6 to 18% of the school children are gametocyte carriers. In Libreville, amongst the febrile children seen in pediatric consultation, the prevalence reached 30%. Boys and girls are equally affected. The most important prevalence is observed in the group of children from 5 to 10 years of age. P. falciparum is found in 96.4% of the cases, P. malariae in 5.3% and P. ovale in 2.4%. The study of the parasitic load revealed that 56% of the positive subjects had less than 10,000 asexual forms/mm3, 44% more than 10,000 hematozoa/mm3. These results are similar to those of the neighbouring countries of equatorial Africa. PMID:3690800

  1. Primary Dysmenorrhea and Menstrual Symptoms in Indian Female Students: Prevalence, Impact and Management

    PubMed Central

    Omidvar, Shabnam; Bakouei, Fatemeh; Amiri, Fatemeh Nasiri; Begum, Khyrunnisa

    2016-01-01

    Background: Dysmenorrhea is the most common gynecological problem among females and it is defined as cramping pain in the lower abdomen occurring just before or during menstruation. Menstrual symptoms are a broad collection of affective and somatic concerns that occur around the time of menses. The effect and importance of dysmenorrhea is very wide, therefore managing the problem is important. Objective: To ascertain the prevalence, and impact of primary dysmenorrhea in student girls and their management behaviors. Methods and Materials: A Cross-sectional study was conducted on 1000 healthy females aged 11-28 years. Standardized Self-reporting questionnaires were used to obtain relevant data. Pain intensity was assessed by using the Numerical Pain Scale (NPS). Data was analyzed by SPSS version 16. Results: Prevalence of dysmenorrhea was 70.2%. Majority of the subjects experienced pain for one or 1-2 days during menstruation. 23.2% of the dysmenorrheic girls experienced pain for 2-3 days. The most common symptom in both dysmenorrheic and non dysmenorrheic girls during the menstrual periods was tiredness and second most prevalent symptom was back pain. Females experiencing mild pain on an average absented for one and half day a month while 2.1±1.2 and 2.5±1.3 days for those who experienced moderate and severe forms of dysmenorrhea respectively. A small proportion of girls sought pharmacological management (25.5%) and 83.2% depended on non-pharmacological methods. Only 14.2% had sought medical advice. Conclusion: Sub optimal use of the medical advice and the barriers to seek medical attention by dysmenorrheic females need exploration. It is important that health education on puberty and menstruation is regarded as inadequate for many girls in India.

  2. Prevalence of Diabetes and Intermediate Hyperglycemia Among Adults From the First Multinational Study of Noncommunicable Diseases in Six Central American Countries

    PubMed Central

    Barcelo, Alberto; Gregg, Edward W.; Gerzoff, Robert B.; Wong, Roy; Perez Flores, Enrique; Ramirez-Zea, Manuel; Cafiero, Elizabeth; Altamirano, Lesbia; Ascencio Rivera, Melanie; de Cosio, Gerardo; de Maza, Martha Dinorah; del Aguila, Roberto; Emanuel, Englebert; Gil, Enrique; Gough, Ethan; Jenkins, Valerie; Orellana, Patrícia; Palma, Ruben; Palomo, Ruben; Pastora, Martha; Peña, Rodolfo; Pineda, Elia; Rodriguez, Bismark; Tacsan, Luis; Thompson, Loraine; Villagra, Lucy

    2012-01-01

    OBJECTIVE The increasing burdens of obesity and diabetes are two of the most prominent threats to the health of populations of developed and developing countries alike. The Central America Diabetes Initiative (CAMDI) is the first study to examine the prevalence of diabetes in Central America. RESEARCH DESIGN AND METHODS The CAMDI survey was a cross-sectional survey based on a probabilistic sample of the noninstitutionalized population of five Central American populations conducted between 2003 and 2006. The total sample population was 10,822, of whom 7,234 (67%) underwent anthropometry measurement and a fasting blood glucose or 2-h oral glucose tolerance test. RESULTS The total prevalence of diabetes was 8.5%, but was higher in Belize (12.9%) and lower in Honduras (5.4%). Of the screened population, 18.6% had impaired glucose tolerance/impaired fasting glucose. CONCLUSIONS As this population ages, the prevalence of diabetes is likely to continue to rise in a dramatic and devastating manner. Preventive strategies must be quickly introduced. PMID:22323417

  3. Cardiovascular disease and type 1 diabetes: prevalence, prediction and management in an ageing population.

    PubMed

    Lee, Siang Ing; Patel, Mitesh; Jones, Christopher M; Narendran, Parth

    2015-11-01

    Cardiovascular disease (CVD) is a major cause of mortality in type 1 diabetes mellitus (T1D). However, evidence of its risks and management is often extrapolated from studies in type 2 diabetic (T2D) patients or the general population. This approach is unsatisfactory given that the underlying pathology, demographics and natural history of the disease differ between T1D and T2D. Furthermore, with a rising life expectancy, a greater number of T1D patients are exposed to the cardiovascular (CV) risk factors associated with an ageing population. The aim of this review is to examine the existing literature around CVD in T1D. We pay particular attention to CVD prevalence, how well we manage risk, potential biomarkers, and whether the studies included the older aged patients (defined as aged over 65). We also discuss approaches to the management of CV risk in the older aged. The available data suggest a significant CVD burden in patients with T1D and poor management of CV risk factors. This is underpinned by a poor evidence base for therapeutic management of CV risk specifically for patients with T1D, and in the most relevant population - the older aged patients. We would suggest that important areas remain to be addressed, particularly exploring the risks and benefits of therapeutic approaches to CVD management in the older aged. PMID:26568811

  4. Cardiovascular disease and type 1 diabetes: prevalence, prediction and management in an ageing population

    PubMed Central

    Lee, Siang Ing; Patel, Mitesh; Jones, Christopher M.; Narendran, Parth

    2015-01-01

    Cardiovascular disease (CVD) is a major cause of mortality in type 1 diabetes mellitus (T1D). However, evidence of its risks and management is often extrapolated from studies in type 2 diabetic (T2D) patients or the general population. This approach is unsatisfactory given that the underlying pathology, demographics and natural history of the disease differ between T1D and T2D. Furthermore, with a rising life expectancy, a greater number of T1D patients are exposed to the cardiovascular (CV) risk factors associated with an ageing population. The aim of this review is to examine the existing literature around CVD in T1D. We pay particular attention to CVD prevalence, how well we manage risk, potential biomarkers, and whether the studies included the older aged patients (defined as aged over 65). We also discuss approaches to the management of CV risk in the older aged. The available data suggest a significant CVD burden in patients with T1D and poor management of CV risk factors. This is underpinned by a poor evidence base for therapeutic management of CV risk specifically for patients with T1D, and in the most relevant population – the older aged patients. We would suggest that important areas remain to be addressed, particularly exploring the risks and benefits of therapeutic approaches to CVD management in the older aged. PMID:26568811

  5. The costs of integrated community case management (iCCM) programs: A multi–country analysis

    PubMed Central

    Collins, David; Jarrah, Zina; Gilmartin, Colin; Saya, Uzaib

    2014-01-01

    Background Integrated community case management (iCCM) can be an effective strategy for expanding the provision of diarrhea, pneumonia, and malaria services to children under 5 years old but there are concerns in some countries about the corresponding cost and impact. This paper presents and compares findings from a multi–country analysis of iCCM program costs. Methods Data on coverage, utilization, and costs were collected as part of two sets of studies conducted between 2011 and 2013 for iCCM programs in seven sub–Saharan African countries: Cameroon, the Democratic Republic of the Congo, Malawi, Senegal, Sierra Leone, South Sudan and Zambia. The data were used to compare some elements of program performance as well as costs per capita and costs per service (which are key indicators of resource allocation and efficiency). Results Among the seven countries, iCCM utilization ranged from a total of 0.26 to 3.05 contacts per capita (children 2–59 months) per year for the diseases treated, representing a range of 2.7% to 36.7% of the expected numbers of cases. The total recurrent cost per treatment ranged from US$ 2.44 to US$ 13.71 for diarrhea; from US$ 2.17 to US$ 17.54 for malaria (excluding rapid diagnostic testing); and from US$ 1.70 to US$ 12.94 for pneumonia. In some of the country programs, the utilization of iCCM services was quite low and this, together with significant fixed costs, particularly for management and supervision, resulted in services being quite costly. Given the differences across the countries and programs, however, these results should be treated as indicative and not definitive. Conclusion A comprehensive understanding of iCCM program costs and results can help countries obtain resources and use them efficiently. To be cost–effective and affordable, iCCM programs must be well–utilized while program management and supervision should be organized to minimize costs and ensure quality of care. iCCM programs will not always be low

  6. Prevalence and Treatment Management of Oropharyngeal Candidiasis in Cancer Patients: Results of the French Candidoscope Study

    SciTech Connect

    Gligorov, Joseph; Bastit, Laurent; Gervais, Honorine; Henni, Mehdi; Kahila, Widad; Lepille, Daniel; Luporsi, Elisabeth; Sasso, Giuseppe; Varette, Charles; Azria, David

    2011-06-01

    Purpose: The aim of this pharmaco-epidemiological study was to evaluate the prevalence of oropharyngeal candidiasis (OPC) in cancer patients treated with chemotherapy and/or radiotherapy. Methods and Materials: Signs and symptoms of OPC were noted for all patients. Antifungal therapeutic management was recorded in OPC patients. Patients receiving local antifungal treatments were monitored until the end of treatment. Results: Enrolled in the study were 2,042 patients with solid tumor and/or lymphoma treated with chemotherapy and/or another systemic cancer treatment and/or radiotherapy. The overall prevalence of OPC was 9.6% (95% confidence interval, 8.4%-11.0%]in this population. It was most frequent in patients treated with combined chemoradiotherapy (22.0%) or with more than two cytotoxic agents (16.9%). Local antifungal treatments were prescribed in 75.0% of OPC patients as recommended by guidelines. The compliance to treatment was higher in patients receiving once-daily miconazole mucoadhesive buccal tablet (MBT; 88.2%) than in those treated with several daily mouthwashes of amphotericin B (40%) or nystatin (18.8%). Conclusion: OPC prevalence in treated cancer patients was high. Local treatments were usually prescribed as per guidelines. Compliance to local treatments was better with once-daily drugs.

  7. Mood disorders in the elderly: prevalence, functional impact, and management challenges

    PubMed Central

    Valiengo, Leandro da Costa Lane; Stella, Florindo; Forlenza, Orestes Vicente

    2016-01-01

    Despite the lower prevalence of severe mood disorders in the elderly as compared to younger adults, late-life depression and bipolar disorder (BD) are more strongly associated with negative outcomes related to the presence of medical comorbidities, cognitive deficits, and increased suicide risk and overall mortality. The mechanisms that contribute to these associations are probably multifactorial, involving pathological factors related directly and indirectly to the disease itself, ranging from biological to psychosocial factors. Most of the accumulated knowledge on the nature of these associations derives from naturalistic and observational studies, and controlled data are still scarce. Nonetheless, there has clearly been a recent growth of the scientific interest on late-life BD and geriatric depression. In the present study, we review the most relevant studies on prevalence, clinical presentation, and cognitive/functional impact of mood disorders in elderly. Several clinical–epidemiological studies were dedicated to the study of the prevalence of mood disorders in old age in distinct settings; however, fewer studies investigated the underlying neurobiological findings and treatment specificities in late-life depression and BD. In the present study, we further discuss the implications of these findings on the management of mood disorders in older adults. PMID:27601905

  8. Mood disorders in the elderly: prevalence, functional impact, and management challenges.

    PubMed

    Valiengo, Leandro da Costa Lane; Stella, Florindo; Forlenza, Orestes Vicente

    2016-01-01

    Despite the lower prevalence of severe mood disorders in the elderly as compared to younger adults, late-life depression and bipolar disorder (BD) are more strongly associated with negative outcomes related to the presence of medical comorbidities, cognitive deficits, and increased suicide risk and overall mortality. The mechanisms that contribute to these associations are probably multifactorial, involving pathological factors related directly and indirectly to the disease itself, ranging from biological to psychosocial factors. Most of the accumulated knowledge on the nature of these associations derives from naturalistic and observational studies, and controlled data are still scarce. Nonetheless, there has clearly been a recent growth of the scientific interest on late-life BD and geriatric depression. In the present study, we review the most relevant studies on prevalence, clinical presentation, and cognitive/functional impact of mood disorders in elderly. Several clinical-epidemiological studies were dedicated to the study of the prevalence of mood disorders in old age in distinct settings; however, fewer studies investigated the underlying neurobiological findings and treatment specificities in late-life depression and BD. In the present study, we further discuss the implications of these findings on the management of mood disorders in older adults. PMID:27601905

  9. The prevalence, aetiology and management of wounds in a community care area in Ireland.

    PubMed

    Skerritt, Louise; Moore, Zena

    2014-06-01

    This study aimed to establish the prevalence and aetiology of wounds, allowing an insight into the management of wound care, the use of dressings and the nursing time allocated to the provision of wound care in a community setting in Ireland. A cross-sectional survey was used, with data collected on all clients in the community who received treatment from public health nurses or community registered general nurses for wound care over a 1-week period in April 2013. A 98.9% response rate was realised, and 188 people were identified as having wounds, equating to a crude prevalence of 5% of the active community nursing caseload. A total of 60% (n=112) had leg ulcers, 22% (n=42) had pressure ulcers, 16% (n=30) had an acute wound (surgical or traumatic wounds), 1% (n=2) had a diabetic foot wound and a further 1% (n=2) had wounds of other aetiologies. The mean duration of wounds was 5.41 months. A total of 18% of wounds were identified as infected; however, 60% (n=112) of wounds had antimicrobial products in use as either a primary or secondary dressing. The study established that there is a significant prevalence of wounds in this community care area. There was absence of a clinical diagnosis in many cases, and evidence of inappropriate dressing use, risking an increase in costs and a decrease in good clinical outcomes. It also highlighted the importance of ongoing education and auditing in the provision of wound care. PMID:24912830

  10. Effective Coverage and Systems Effectiveness for Malaria Case Management in Sub-Saharan African Countries

    PubMed Central

    Galactionova, Katya; Tediosi, Fabrizio; de Savigny, Don; Smith, Thomas; Tanner, Marcel

    2015-01-01

    Scale-up of malaria preventive and control interventions over the last decade resulted in substantial declines in mortality and morbidity from the disease in sub-Saharan Africa and many other parts of the world. Sustaining these gains will depend on the health system performance. Treatment provides individual benefits by curing infection and preventing progression to severe disease as well as community-level benefits by reducing the infectious reservoir and averting emergence and spread of drug resistance. However many patients with malaria do not access care, providers do not comply with treatment guidelines, and hence, patients do not necessarily receive the correct regimen. Even when the correct regimen is administered some patients will not adhere and others will be treated with counterfeit or substandard medication leading to treatment failures and spread of drug resistance. We apply systems effectiveness concepts that explicitly consider implications of health system factors such as treatment seeking, provider compliance, adherence, and quality of medication to estimate treatment outcomes for malaria case management. We compile data for these indicators to derive estimates of effective coverage for 43 high-burden Sub-Saharan African countries. Parameters are populated from the Demographic and Health Surveys and other published sources. We assess the relative importance of these factors on the level of effective coverage and consider variation in these health systems indicators across countries. Our findings suggest that effective coverage for malaria case management ranges from 8% to 72% in the region. Different factors account for health system inefficiencies in different countries. Significant losses in effectiveness of treatment are estimated in all countries. The patterns of inter-country variation suggest that these are system failures that are amenable to change. Identifying the reasons for the poor health system performance and intervening to tackle

  11. Multiple Chronic Conditions: Prevalence, Health Consequences, and Implications for Quality, Care Management, and Costs

    PubMed Central

    Shields, Alexandra E.; Lee, Todd A.; Gibson, Teresa B.; Marder, William D.; Weiss, Kevin B.; Blumenthal, David

    2007-01-01

    Persons with multiple chronic conditions are a large and growing segment of the US population. However, little is known about how chronic conditions cluster, and the ramifications of having specific combinations of chronic conditions. Clinical guidelines and disease management programs focus on single conditions, and clinical research often excludes persons with multiple chronic conditions. Understanding how conditions in combination impact the burden of disease and the costs and quality of care received is critical to improving care for the 1 in 5 Americans with multiple chronic conditions. This Medline review of publications examining somatic chronic conditions co-occurring with 1 or more additional specific chronic illness between January 2000 and March 2007 summarizes the state of our understanding of the prevalence and health challenges of multiple chronic conditions and the implications for quality, care management, and costs. PMID:18026807

  12. Teacher-reported prevalence and management of child health problems at primary school.

    PubMed

    Leyland, Anna F; Pickett, Kate E; Barber, Sally; McEachan, Rosemary; Wright, John

    2016-06-01

    We explored primary school teacher-reported experiences, prevalence and management of child health and developmental problems and medication administration from one multi-ethnic urban community in England. A survey was delivered to 90 reception class teachers in 45 primary schools, and semi-structured interviews were conducted with a purposive sample of eight respondents. Fifty-six percent of teachers completed the questionnaire. Findings suggest that teachers and school staff may represent an underused resource for identifying children with developmental and health conditions and that the connections formed between schools and families could be utilized by other services by delivering interventions in schools where possible. Whilst most schools use a policy to inform the management of child health in school, some key areas such as training and documentation of medication administration may not be followed in practice. Interview findings supported and expanded on survey data by identifying barriers to collaboration between services and families. PMID:25713008

  13. Prevalence, Diagnosis and Management of Pancreatic Cystic Neoplasms: Current Status and Future Directions

    PubMed Central

    Farrell, James J.

    2015-01-01

    Cystic neoplasms of the pancreas are found with increasing prevalence, especially in elderly asymptomatic individuals. Although the overall risk of malignancy is very low, the presence of these pancreatic cysts is associated with a large degree of anxiety and further medical investigation due to concerns about malignancy. This review discusses the different cystic neoplasms of the pancreas and reports diagnostic strategies based on clinical features and imaging data. Surgical and nonsurgical management of the most common cystic neoplasms, based on the recently revised Sendai guidelines, is also discussed, with special reference to intraductal papillary mucinous neoplasm (IPMN; particularly the branch duct variant), which is the lesion most frequently identified incidentally. IPMN pathology, its risk for development into pancreatic ductal adenocarcinoma, the pros and cons of current guidelines for management, and the potential role of endoscopic ultrasound in determining cancer risk are discussed. Finally, surgical treatment, strategies for surveillance of pancreatic cysts, and possible future directions are discussed. PMID:26343068

  14. Chronic respiratory diseases in developing countries: the burden and strategies for prevention and management.

    PubMed Central

    Aït-Khaled, N.; Enarson, D.; Bousquet, J.

    2001-01-01

    In developing countries, chronic respiratory diseases represent a challenge to public health because of their frequency, severity, projected trends, and economic impact. Health care planners, for example, are faced with a dramatic increase in tobacco use and must establish priorities for the allocation of limited resources. Nevertheless, smoking prevention and standardized management programmes for asthma and chronic obstructive pulmonary disease should be implemented in developing countries whenever possible. International measures will be required to reverse tobacco smoking trends, and international agencies could define essential drugs and equipment and encourage the use of generic drugs, particularly for corticosteroids inhaled at high dosages. For such programmes to be effective, producers of high-quality generics will need to be identified, and the medications added to national lists of essential drugs and included in procurement procedures. Other recommendations for alleviating the burden of chronic respiratory diseases in developing countries are: adapting guidelines to local contexts and ensuring their distribution; upgrading equipment at district level; purchasing high-quality drugs at low prices; routine training and supervision of health services personnel; and regular monitoring of performance. Social mobilization by professional societies, nongovernmental organizations, and the mass media will also increase government commitment to tobacco control and standardized case management. PMID:11693980

  15. Environment, health & safety management systems for upstream oil & gas projects in developing countries

    SciTech Connect

    Gossen, R.G.; Mann, G.J.

    1996-11-01

    The international oil and gas exploration and production industry faces a vast array of environmental issues that are global in nature but play an increasingly prominent role in individual project decision making. When placed against a backdrop of socio-political and cultural challenges presented in developing countries, project planners require an enlightened approach to ensure the environmental, economic and social components are appropriately balanced to ensure sustainable business success. Although a relatively new player in the international E & P industry, Canadian Occidental Petroleum Ltd. has developed such an approach to EMS management for projects in developing countries. Drawing from recent experience with a major project in Yemen, and others in the planning stages in several other developing countries, this paper presents a number of positive strategies and actions which are being applied in the many countries in which the company is active. Lessons learned and opportunities for improvement are presented for consideration by responsible operators working internationally toward the goal of environmentally sustainable energy development.

  16. Risk Factors for Community-Acquired Urinary Tract Infections Caused by ESBL-Producing Enterobacteriaceae –A Case–Control Study in a Low Prevalence Country

    PubMed Central

    Søraas, Arne; Sundsfjord, Arnfinn; Sandven, Irene; Brunborg, Cathrine; Jenum, Pål A.

    2013-01-01

    Community-acquired urinary tract infection (CA-UTI) is the most common infection caused by extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, but the clinical epidemiology of these infections in low prevalence countries is largely unknown. A population based case-control study was conducted to assess risk factors for CA-UTI caused by ESBL-producing E. coli or K. pneumoniae. The study was carried out in a source population in Eastern Norway, a country with a low prevalence of infections caused by ESBL-producing Enterobacteriaceae. The study population comprised 100 cases and 190 controls with CA-UTI caused by ESBL-producing and non-ESBL-producing E. coli or K. pneumoniae, respectively. The following independent risk factors of ESBL-positive UTIs were identified: Travel to Asia, The Middle East or Africa either during the past six weeks (Odds ratio (OR) = 21; 95% confidence interval (CI): 4.5–97) or during the past 6 weeks to 24 months (OR = 2.3; 95% CI: 1.1–4.4), recent use of fluoroquinolones (OR = 16; 95% CI: 3.2–80) and β-lactams (except mecillinam) (OR = 5.0; 95% CI: 2.1–12), diabetes mellitus (OR = 3.2; 95% CI: 1.0–11) and recreational freshwater swimming the past year (OR = 2.1; 95% CI: 1.0–4.0). Factors associated with decreased risk were increasing number of fish meals per week (OR = 0.68 per fish meal; 95% CI: 0.51–0.90) and age (OR = 0.89 per 5 year increase; 95% CI: 0.82–0.97). In conclusion, we have identified risk factors that elucidate mechanisms and routes for dissemination of ESBL-producing Enterobacteriaceae in a low prevalence country, which can be used to guide appropriate treatment of CA-UTI and targeted infection control measures. PMID:23936052

  17. Hospital managers' need for information in decision-making--An interview study in nine European countries.

    PubMed

    Kidholm, Kristian; Ølholm, Anne Mette; Birk-Olsen, Mette; Cicchetti, Americo; Fure, Brynjar; Halmesmäki, Esa; Kahveci, Rabia; Kiivet, Raul-Allan; Wasserfallen, Jean-Blaise; Wild, Claudia; Sampietro-Colom, Laura

    2015-11-01

    Assessments of new health technologies in Europe are often made at the hospital level. However, the guidelines for health technology assessment (HTA), e.g. the EUnetHTA Core Model, are produced by national HTA organizations and focus on decision-making at the national level. This paper describes the results of an interview study with European hospital managers about their need for information when deciding about investments in new treatments. The study is part of the AdHopHTA project. Face-to-face, structured interviews were conducted with 53 hospital managers from nine European countries. The hospital managers identified the clinical, economic, safety and organizational aspects of new treatments as being the most relevant for decision-making. With regard to economic aspects, the hospital managers typically had a narrower focus on budget impact and reimbursement. In addition to the information included in traditional HTAs, hospital managers sometimes needed information on the political and strategic aspects of new treatments, in particular the relationship between the treatment and the strategic goals of the hospital. If further studies are able to verify our results, guidelines for hospital-based HTA should be altered to reflect the information needs of hospital managers when deciding about investments in new treatments. PMID:26362086

  18. Childhood intussusception: A prospective study of management trend in a developing country

    PubMed Central

    Ogundoyin, Olakayode Olaolu; Olulana, Dare Isaac; Lawal, Taiwo Akeem

    2015-01-01

    Background: The management of intussusception has evolved universally from the use of hydrostatic reduction through operative reduction to the use of pneumatic reduction for the acute and uncomplicated cases and surgical reduction for the complicated cases. However, the process of evolution has been very slow in the developing countries, especially sub-Saharan Africa, due to lack of requisite facilities and expertise to manage these patients nonoperatively. This study examined the trends in the management of childhood intussusception in a developing country, compared operative and nonoperative modalities of treatment, and assessed the impact of delayed presentation on the outcome of management. Patients and Methods: This was a prospective study of the management of children with intussusception at the University College Hospital, Ibadan, Nigeria. Results: Fifty-five consecutive cases of intussusception that presented to the Children Emergency Unit of the University College Hospital between January 2005 and December 2011 were prospectively studied. Details of sex, age of the patients, clinical presentation, duration of symptoms, mode of treatment, and incidence of recurrence were recorded and analyzed. The median age was 7 months. Moreover, the duration of symptoms varied from 1 to 21 days with a mean of 4 days. Twenty-two patients (40%) had attempted hydrostatic reduction; this was successful in 14 patients (63.6%), whereas 8 patients (36.4%) had failed reduction. In all, 41 patients (74.6%) had operative management of intussusceptions; primary operative intervention was carried out in 33 patients (60%) and secondary surgical management in 8 patients (14.5%) with failed hydrostatic reduction. At surgery, manual reduction of intussusception was carried out on 17 patients (30.9%) and resection of devitalized bowel with end to end anastomosis was carried out on the remaining 24 patients (43.6%). The incidence of surgical intervention for intussusception was 74

  19. The status of IT service management in health care - ITIL® in selected European countries

    PubMed Central

    2011-01-01

    Background Due to the strained financial situation in the healthcare sector, hospitals and other healthcare providers are facing an increasing pressure to improve their efficiency and to reduce costs. These trends challenge health care organizations to introduce innovative information technology (IT) based supportive processes. To guarantee that IT supports the clinical processes perfectly, IT must be managed proactively. However, until now, there is only very few research on IT service management especially on ITIL® implementations in the health care context. Methods The current study aims at exploring knowledge about and acceptance of IT service management (especially ITIL®) in hospitals in Austria and its neighboring regions Bavaria (Germany), Slovakia, South Tyrol (Italy) and Switzerland. Therefore highly standardized interviews with the respective head of information technology (CIO, IT manager) were conducted for selected hospitals from the different regions. In total 75 hospitals were interviewed. Data gathered was analyzed using descriptive statistics and where necessary methods of qualitative content analysis. Results In most regions, two-thirds or more of the participating IT managers claim to be familiar with the concepts of IT service management and of ITIL®. IT managers expect from ITIL® mostly better IT services, followed by an increased productivity and a reduction of IT cost. But only five hospitals said to have implemented at least parts of ITIL®, and eight hospitals stated to be planning to do this in the next two years. When it comes to ITIL®, Switzerland and Bavaria seem to be ahead of the other countries. There, the highest levels of knowledge, the highest number of implementations or plans of an implementation as well as the highest number of ITIL® certified staff members were observed. Conclusion The results collected through this study indicate that the idea of IT services and IT service management is still not widely recognized in

  20. Prevalence of Antibodies to Hepatitis E Virus in Veterinarians Working with Swine and in Normal Blood Donors in the United States and Other Countries

    PubMed Central

    Meng, X. J.; Wiseman, B.; Elvinger, F.; Guenette, D. K.; Toth, T. E.; Engle, R. E.; Emerson, S. U.; Purcell, R. H.

    2002-01-01

    Hepatitis E virus (HEV) is endemic in many developing and some industrialized countries. It has been hypothesized that animals may be the source of infection. The recent identification of swine HEV in U.S. pigs and the demonstration of its ability to infect across species have lent credence to this hypothesis. To assess the potential risk of zoonotic HEV infection, we tested a total of 468 veterinarians working with swine (including 389 U.S. swine veterinarians) and 400 normal U.S. blood donors for immunoglobulin G anti-HEV. Recombinant capsid antigens from a U.S. strain of swine HEV and from a human HEV strain (Sar-55) were each used in an enzyme-linked immunosorbent assay. The anti-HEV prevalence assayed with the swine HEV antigen showed 97% concordance with that obtained with the human HEV antigen (κ = 92%). Among the 295 swine veterinarians tested from the eight U.S. states (Minnesota, Indiana, Nebraska, Iowa, Illinois, Missouri, North Carolina, and Alabama) from which normal blood donor samples were available, 26% were positive with Sar-55 antigen and 23% were positive with swine HEV antigen. In contrast, 18% of the blood donors from the same eight U.S. states were positive with Sar-55 antigen and 17% were positive with swine HEV antigen. Swine veterinarians in the eight states were 1.51 times more likely when tested with swine HEV antigen (95% confidence interval, 1.03 to 2.20) and 1.46 times more likely when tested with Sar-55 antigen (95% confidence interval, 0.99 to 2.17) to be anti-HEV positive than normal blood donors. We did not find a difference in anti-HEV prevalence between veterinarians who reported having had a needle stick or cut and those who had not or between those who spent more time (≥80% of the time) and those who spent less time (≤20% of the time) working with pigs. Similarly, we did not find a difference in anti-HEV prevalence according to four job categories (academic, practicing, student, and industry veterinarians). There was a

  1. Scientific practices and social behaviors in managing landslide risks: comparing experiences between developing and developed countries

    NASA Astrophysics Data System (ADS)

    Devoli, G.

    2012-04-01

    A successful landslide risk reduction program requires that the society is aware and understand the landslide problems within the geographic area involved. Central organizations that manage national landslide risks should: a) create and systematically applied natural hazard laws/national landslide strategies, where roles and limits of responsibilities of federal, state, provincial, municipal and private entities are well defined; c) establish fruitful multidisciplinary and interinstitutional collaboration among scientists; d) provide good risk assessments in which landslide experts report transparently what is really known and the limitations of methods and tools used; e) share and systematically communicate their knowledge more effectively with all private and public stakeholders involved, paying attention to providing balanced information about risks and addressing inevitable uncertainties; f) support the mass-media in spreading correct scientific information; g) perform serious risk and cost-benefit analyses before mitigation measures are realized; h) assist local authorities in the application of land-use planning policies and g) built trust and confidence by means of a continuous contact and communication with the public and local authorities. However, this is not yet achieved, not even in developed countries where, in theory, more economical resources are available and people are better educated then in developing countries. Herein I make some observations on how national landslide prevention efforts are being organized in two countries (Nicaragua and Norway), where I have been worked at governmental agencies as landslide expert in the last 10 years. I start describing similarities and differences between the countries and try to compare practices and experiences. The analysis was motivated by the following questions: Why after so many years of landslide mapping and investigations, landslide prevention is not good and effective as it should be? Is this

  2. The implementation of quality management systems in hospitals: a comparison between three countries

    PubMed Central

    Wagner, C; Gulácsi, L; Takacs, E; Outinen, M

    2006-01-01

    Background Is the implementation of Quality Management (QM) in health care proceeding satisfactorily and can national health care policies influence the implementation process? Policymakers and researchers in a country need to know the answer to this question. Cross country comparisons can reveal whether sufficient progress is being made and how this can be stimulated. The objective of the study was to investigate agreement and disparities in the implementation of QMS between The Netherlands, Hungary and Finland with respect to the evaluation model used and the national policy strategy of the three countries. Methods The study has a cross sectional design, based on measurements in 2000. Empirical data about QM-activities in hospitals were gathered by a self-administered questionnaire. The questionnaires were answered by the directors of the hospitals or the quality coordinators. The analyses are based on data from 101 hospitals in the Netherlands, 116 hospitals in Hungary and 59 hospitals in Finland. Outcome measures are the developmental stage of the Quality Management System (QMS), the development within five focal areas, and distinct QM-activities which were listed in the questionnaire. Results A mean of 22 QM-activities per hospital was found in the Netherlands and Finland versus 20 QM-activities in Hungarian hospitals. Only a small number of hospitals has already implemented a QMS (4% in The Netherlands,0% in Hungary and 3% in Finland). More hospitals in the Netherlands are concentrating on quality documents, whereas Finnish hospitals are concentrating on training in QM and guidelines. Cyclic quality improvement activities have been developed in the three countries, but in most hospitals the results were not used for improvements. All three countries pay hardly any attention to patient participation. Conclusion The study demonstrates that the implementation of QM-activities can be measured at national level and that differences between countries can be

  3. International Cooperation for the Training of Water Managers from Developing Countries

    NASA Astrophysics Data System (ADS)

    Aswathanarayana, U.

    2007-12-01

    Water is the key to the well being of a community. On one hand, water security is linked to food security, as food cannot be grown without water. On the other hand, water security is linked to environmental security, as water is needed to maintain the health of a community. International cooperation is proposed for the training in Hyderabad, India, with international faculty, of ~ 300 water managers from the developing countries at an estimated cost of ~USD 3300/- per candidate (including ~ USD 1800/- for international travel), through ten interactive and customized training programmes during the period of five years, to enable them to address two crucial issues affecting the poor in the developing countries, namely, access to affordable water and coping with water scarcity. Ways of Good governance and geographical targeting of poverty alleviation programmes are built into each training programme. Each training programme will be for about three weeks (inclusive of field work). Each course will have a component common to all, plus a component customized to the biophysical and socioeconomic situation in a candidate's country. Ten course manuals will be produced. which can later be published commercially as low-cost volumes, for the benefit of the readership in the Developing countries . Each candidate will be provided his own computer, and software, and individual faculty adviser. On the basis of the training received, a candidate should be able to carry with him at the end of the course a draft outline of techno-socio-economic action plan for his country/area in respect of the theme of the course, prepared by himself/herself. A copy of this outline would be provided to the World Bank, and relevant organizations for follow- up activity

  4. Introduction: The Complexity and Challenge of Preventing, Treating, and Managing Blood Diseases in the Developing Countries.

    PubMed

    Roberts, David J; Weatherall, David J

    2016-04-01

    Managing hematologic disorders in developing countries poses problems not encountered in Western societies. The clinical features of hematologic conditions may be modified by malnutrition, chronic bacterial infection, or parasitic illness. Iron deficiency is the major factor in anemia worldwide. Anemia is more common in the wet season when malaria transmission peaks. After anemia, eosinophilia is the next most common hematologic abnormality in children in the tropics. Infection with the human immunodeficiency virus can cause hematologic abnormalities. The pattern of distribution of primary disorders of the blood varies among populations and some disorders are unique to certain parts of the world. PMID:27040954

  5. Risk management dilemmas in dementia care: an organizational survey in three UK countries.

    PubMed

    Clarke, Charlotte L; Gibb, Catherine E; Keady, John; Luce, Anna; Wilkinson, Heather; Williams, Linda; Cook, Ailsa

    2009-06-01

    Aims and objectives.  The overall project aimed to understand the variability of the construction of risk in dementia care from the perspective of the person with dementia, family carers and practitioners with the intention of developing negotiated partnerships in risk management. This paper focuses on the objective of identifying the understandings of risk by practitioners. Background.  Risk management can result in a 'safety first' approach to care practices, but this may be disempowering for people with dementia. Design.  This paper describes the results of the first stage of the study: a survey to service managers or equivalent in health, social and voluntary sector care organizations in three countries of the UK. Methods.  Data from this stage was collection by postal questionnaire (n = 46). Results.  Risk was portrayed as a multidimensional concept and clustered around three themes: (1) Risk and Independence, (2) Risk and Resource, and (3) Organizational Risk Management. Conclusions.  Very wide understandings of risk are identifiable, ranging from avoidance of physical harm through to managed risk taking to improve quality of life, and to an appreciation of the impact of organizational and professional patterns of behaviour resulting in harm to the person with dementia. Relevance to clinical practice.  Obtaining information about the perspectives of others may help to illuminate some of the dilemmas experienced by staff in this study, and the development of risk assessment frameworks may assist staff to resolve some of these. PMID:20925808

  6. Does marital status matter in an HIV hyperendemic country? Findings from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey.

    PubMed

    Shisana, Olive; Risher, Kathryn; Celentano, David D; Zungu, Nompumelelo; Rehle, Thomas; Ngcaweni, Busani; Evans, Meredith G B

    2016-01-01

    South Africa has experienced declining marriage rates and the increasing practice of cohabitation without marriage. This study aims to improve the understanding of the relationship between marital status and HIV in South Africa, an HIV hyperendemic country, through an analysis of findings from the 2012 South African National HIV Prevalence, Incidence and Behaviour Survey. The nationally representative population-based cross-sectional survey collected data on HIV and socio-demographic and behavioural determinants in South Africa. This analysis considered respondents aged 16 years and older who consented to participate in the survey and provided dried blood spot specimens for HIV testing (N = 17,356). After controlling for age, race, having multiple sexual partners, condom use at last sex, urban/rural dwelling and level of household income, those who were married living with their spouse had significantly reduced odds of being HIV-positive compared to all other marital spouses groups. HIV incidence was 0.27% among respondents who were married living with their spouses; the highest HIV incidence was found in the cohabiting group (2.91%). Later marriage (after age 24) was associated with increased odds of HIV prevalence. Our analysis suggests an association between marital status and HIV prevalence and incidence in contemporary South Africa, where odds of being HIV-positive were found to be lower among married individuals who lived with their spouses compared to all other marital status groups. HIV prevention messages therefore need to be targeted to unmarried populations, especially cohabitating populations. As low socio-economic status, low social cohesion and the resulting destabilization of sexual relationships may explain the increased risk of HIV among unmarried populations, it is necessary to address structural issues including poverty that create an environment unfavourable to stable sexual relationships. PMID:26551532

  7. Socio-economic and behavioural factors affecting the prevalence of Ascaris infection in a low-country tea plantation in Sri Lanka.

    PubMed

    Gunawardena, G S A; Karunaweera, N D; Ismail, M M

    2004-09-01

    The identification of the factors that affect the prevalences of geohelminthiases should help to maximize the effectiveness of programmes for the control of these diseases. In the present study, the relationships between the prevalence and intensity of human infection with Ascaris and the availability of sanitary facilities, socio-economic status and personal health habits have been explored in Sri Lanka. The 176 subjects, who lived on a low-country tea plantation, were aged 2-50 years (median = 13 years) and were investigated between the July and December of 2000. When the prevalence and intensity of Ascaris infection were determined, using Kato-Katz smears, 50.0% of the subjects were found to be secreting the eggs of the parasite. Almost all (96.6%) of the subjects lived in terraces of one-room houses built by the plantation owners, and only 30.7% had access to a latrine. Most (90.3%) obtained their drinking water from common taps, and 48.8% boiled their drinking water. The subjects who only drank water that had been boiled and those who washed their hands before meals were relatively unlikely to be infected (P < 0.05 for each). In congested living conditions with poor sanitary facilities, the level of faecal contamination of the environment is invariably high. Even under these conditions, however, good hygiene and the boiling of all drinking water can reduce the risks of Ascaris infection. In the study setting and in similar environments, regular anthelmintic therapy, improvements in housing conditions and sanitary facilities, and health education, to promote risk-reducing patterns of behaviour, would all be beneficial. PMID:15324467

  8. Human Resource Management in Public Higher Education in the Tempus Partner Countries. A Tempus Study. Issue 10

    ERIC Educational Resources Information Center

    Dubosc, Flora; Kelo, Maria

    2011-01-01

    The aim of this study is to give an overview of the ways in which human resources are managed in public higher education institutions in the Tempus Partner Countries. It is based on a survey addressed to individuals involved in Tempus projects and on information gathered at the level of the national authorities. In all the countries covered by the…

  9. Role of Occupational Stress and Burnout in Prevalence of Musculoskeletal Disorders Among Embassy Personnel of Foreign Countries in Iran

    PubMed Central

    Aghilinejad, Mashaallah; Sadeghi, Zargham; Abdullah, Amer; Sarebanha, Shima; Bahrami-Ahmadi, Amir

    2014-01-01

    Background: Occupation is one of the major parts of our daily lives that might cause a great amount of stress. Stress and job burnout are linked together. The association between musculoskeletal disorders (MSD) and burnout syndrome as a psychosocial factor was investigated previously. Objectives: The aim of this study was to identify the role of occupational stress and burnout in musculoskeletal complaint among diplomatic employees of different embassies in Iran. Materials and Methods: In a cross-sectional study, we assessed 200 employees of the foreign countries embassies in Iran. The participants were selected randomly from all the embassy personnel. Study questionnaires were delivered to the participants and finally 161 questionnaires were returned to the researchers (response rate: 80.5%). An assessment of burnout and MSD were made using the Maslach Burnout Inventory (MBI) and Nordic questionnaires. The work place stress was measured by the work place stress questionnaire. Results: Mean occupational stress was significantly higher among embassy personnel with MSD than among the personnel without this syndrome during the preceding week (17.18 ± 3.42 and 16.06 ± 2.19, respectively; P = 0.02) and the preceding year (17.17 ± 3.11 and 16.74 ± 3.03, respectively; P < 0.01) to the study. Only smoking and occupational stress were identified as independent predictors of MSD among embassy personnel. Conclusions: It seems that association between musculoskeletal complaints and burnout syndrome was more complex than being attributed to only occupation stress. Further studies are recommended to determine other related factors to this association. PMID:25031868

  10. Industrial-waste management in developing countries: the case of Lebanon.

    PubMed

    el-Fadel, M; Zeinati, M; el-Jisr, K; Jamali, D

    2001-04-01

    This paper presents a critical assessment of the existing Lebanese industrial sector, namely the current status and classification of industrial establishments based on a comparative synthesis and analysis of recent nationwide surveys and studies pertaining to industrial-waste management. Characterisation of solid and liquid industrial wastes generated, including hazardous wastes, is presented together with current and projected waste loads, recycling opportunities, and export/import practices. Institutional capacity and needs pertaining to the enforcement of relevant environmental legislation, staffing and resources, monitoring schemes, and public participation are critically evaluated. Finally, realistic options for industrial-waste management in the context of country-specific institutional economic and technical limitations are outlined. The industrial sector in Lebanon consists of small-scale industries (84% employ less than 10 persons), primarily involved in light manufacturing (96%). These industries which are distributed among 41 ill-defined zones and deficient in appropriate physical infrastructure, generate solid, liquid, and hazardous waste estimated at 346,730 tons/year, 20,169,600 m3/year and between 3000 to 15,000 tons/year, respectively. Although the growth of this sector contributes significantly to the socio-economic development of the country (industry accounts for 17% of the gross domestic product), in the absence of a comprehensive environmental management plan, this expansion may not be sustained into the coming millennium. The anticipated expansion will inevitably amplify adverse environmental impacts associated with industrial activities due to rising waste volumes and improper waste handling and disposal practices. These impacts are further aggravated by a deficient institutional framework, a lack of adequate environmental laws, and lax enforcement of regulations governing industrial-waste management. PMID:11383102

  11. Building the Capacity to Manage Orthopaedic Trauma After a Catastrophe in a Low-Income Country.

    PubMed

    Furey, Andrew; Rourke, James; Larsen, Hans

    2015-10-01

    Providing trauma care in an austere environment is very challenging, especially when the country is faced with a natural disaster. Unfortunately the combination of these elements highlights the deficiencies in managing orthopaedic trauma both in a developing country and in the face of a natural disaster, exponentially amplifying the effects of each. When considering the implementation and practice of orthopaedic trauma care in such an environment, one must consider the initial phase of program development and look further to the future in the development of a resilient program, which is sustainable. Through the use of the example of Haiti and a specific Non-Governmental Organization, we discuss the evidence for and thoughts behind developing orthopaedic trauma care program immediately after a natural disaster. This program aims to build capacity and empower a developing nation's health professionals to advance the care of orthopaedic trauma patients. We describe a model of capacity building that serves as a framework to highlight the strengths and weaknesses of low-to middle-income countries in providing orthopaedic trauma care when faced with such a challenge. PMID:26356206

  12. Prevalence, putative mechanisms, and current management of sleep problems during chemotherapy for cancer

    PubMed Central

    Palesh, Oxana; Peppone, Luke; Innominato, Pasquale F; Janelsins, Michelle; Jeong, Monica; Sprod, Lisa; Savard, Josee; Rotatori, Max; Kesler, Shelli; Telli, Melinda; Mustian, Karen

    2012-01-01

    Sleep problems are highly prevalent in cancer patients undergoing chemotherapy. This article reviews existing evidence on etiology, associated symptoms, and management of sleep problems associated with chemotherapy treatment during cancer. It also discusses limitations and methodological issues of current research. The existing literature suggests that subjectively and objectively measured sleep problems are the highest during the chemotherapy phase of cancer treatments. A possibly involved mechanism reviewed here includes the rise in the circulating proinflammatory cytokines and the associated disruption in circadian rhythm in the development and maintenance of sleep dysregulation in cancer patients during chemotherapy. Various approaches to the management of sleep problems during chemotherapy are discussed with behavioral intervention showing promise. Exercise, including yoga, also appear to be effective and safe at least for subclinical levels of sleep problems in cancer patients. Numerous challenges are associated with conducting research on sleep in cancer patients during chemotherapy treatments and they are discussed in this review. Dedicated intervention trials, methodologically sound and sufficiently powered, are needed to test current and novel treatments of sleep problems in cancer patients receiving chemotherapy. Optimal management of sleep problems in patients with cancer receiving treatment may improve not only the well-being of patients, but also their prognosis given the emerging experimental and clinical evidence suggesting that sleep disruption might adversely impact treatment and recovery from cancer. PMID:23486503

  13. A systematic review of the effects of behavioral counseling on sexual risk behaviors and HIV/STI prevalence in low- and middle-income countries

    PubMed Central

    Zajac, Kristyn; Kennedy, Caitlin E.; Fonner, Virginia A.; Armstrong, Kevin S.; O’Reilly, Kevin R.; Sweat, Michael D.

    2014-01-01

    The purpose of this study was to assess the effectiveness of behavioral counseling interventions in reducing sexual risk behaviors and HIV/STI prevalence in low- and middle-income countries. A systematic review of papers published between 1990 and 2011 was conducted, identifying studies that utilized either a multi-arm or pre-post design and presented post-intervention data. Standardized methods of searching and data abstraction were used, and 30 studies met inclusion criteria. Results are summarized by intervention groups: a) people living with HIV; b) people who use drugs and alcohol; c) serodiscordant couples; d) key populations for HIV prevention; and e) people at low to moderate HIV risk. Evidence for the effectiveness of behavioral counseling was mixed, with more rigorously designed studies often showing modest or no effects. Recommendations about the use of behavioral counseling in developing countries are made based on study results and in light of the field’s movement towards combination prevention programs. PMID:25213302

  14. Prevalence of Cryptosporidium and Giardia infections on two Ohio pig farms with different management systems.

    PubMed

    Xiao, L; Herd, R P; Bowman, G L

    1994-04-01

    The prevalence of Cryptosporidium and Giardia infections in pigs was investigated by the use of a direct immunofluorescence assay on two Ohio farms with different management systems. Cryptosporidium and Giardia infections were detected only in weanlings on the farm with slotted and wire floors, but in both weanlings and nursing piglets on the farm with porous concrete floors. Giardia infection was also detected in sows on the latter farm. The farm with porous concrete floors had a significantly higher Cryptosporidium infection rate in nursing piglets and Giardia infection rates in weanlings than the farm with slotted and wire floors. Sows were implicated as the source of both Cryptosporidium and Giardia infections for nursing piglets. PMID:8073616

  15. Comorbidities and Chronic Obstructive Pulmonary Disease: Prevalence, Influence on Outcomes, and Management

    PubMed Central

    Putcha, Nirupama; Drummond, M. Bradley; Wise, Robert A.; Hansel, Nadia N.

    2016-01-01

    Comorbidities impact a large proportion of patients with chronic obstructive pulmonary disease (COPD), with over 80% of patients with COPD estimated to have at least one comorbid chronic condition. Guidelines for the treatment of COPD are just now incorporating comorbidities to their management recommendations of COPD, and it is becoming increasingly clear that multimorbidity as well as specific comorbidities have strong associations with mortality and clinical outcomes in COPD, including dyspnea, exercise capacity, quality of life, healthcare utilization, and exacerbation risk. Appropriately, there has been an increased focus upon describing the burden of comorbidity in the COPD population and incorporating this information into existing efforts to better understand the clinical and phenotypic heterogeneity of this group. In this article, we summarize existing knowledge about comorbidity burden and specific comorbidities in COPD, focusing on prevalence estimates, association with outcomes, and existing knowledge about treatment strategies. PMID:26238643

  16. Challenges of managing patients with inherited metabolic disorders in a developing country.

    PubMed

    Acosta, Phyllis B; Sabo, Robin

    2003-01-01

    The main problems encountered in managing patients with inherited metabolic disorders (IMDs) are inadequate numbers of clinicians and scientists with experience in IMDs, ill-equipped laboratory facilities, lack of funding, and lack of a well-organized plan. Other challenges that must be faced in developing countries include basic health care, birthing centers, and funding. The community environment including a clean water supply and appropriate waste disposal may also be problems. A stable communication system is necessary, as well as the means of paying for these systems. Analyses of local foods, at least for protein and energy, are required to utilize local materials in the diet. The home environment must also be considered. Adequate housing, clothing, and fuel are essential to help prevent frequent infections that may lead to serious illness or death of patients with IMDs. Adequate parental education is necessary along with adequate finances to purchase equipment to measure a prescribed diet and any necessary foods. Specialized medical, public health, community and home environments all contribute challenges of managing patients with IMDs in developing countries. PMID:15906736

  17. Urinary incontinence in women: its prevalence and its management in a health promotion clinic.

    PubMed Central

    Harrison, G L; Memel, D S

    1994-01-01

    BACKGROUND. It has been suggested that regular clinics might improve the management of urinary incontinence in general practice. AIM. A study was undertaken to determine the prevalence of urinary incontinence among women in one general practice and the feasibility of using a health promotion clinic in its management. METHOD. Questionnaires were sent to a 10% sample of women aged 20 years and over on the practice register. Pregnant women were excluded. RESULTS. Of 384 questionnaires sent to eligible women, 314 were completed correctly (82%). The overall reported prevalence of urinary incontinence was 53%; 8% of these women had urge incontinence, 46% had stress incontinence and 43% had mixed incontinence. Incontinence was positively correlated with parity and with gynaecological operation other than hysterectomy and repair of prolapse but not with perineal suturing after childbirth, delivery of a baby weighing 9 lb (4.1 kg) or more or mode of delivery. Twenty seven out of 78 incontinent women (35%) who completed a second questionnaire admitted to worrying about their incontinence but only 10 (13%) had consulted their doctor about the problem. The main reason given for not consulting was that incontinence was a minor inconvenience only. The 167 incontinent women were offered an appointment at a women's clinic but only 13 attended. Of these, 10 were entered into a 12 week treatment trial. Various treatments were offered, such as the women being taught bladder training and pelvic floor exercises. One woman was lost to follow up, and for eight out of nine women their continence had improved, both subjectively and objectively. CONCLUSION. Urinary incontinence in women is a common problem. It can be successfully diagnosed and treated in general practice but low attendance makes the health promotion clinic setting an inefficient means of achieving this. PMID:8185987

  18. Environmental Behavior's Dirty Secret: The Prevalence of Waste Management in Discussions of Environmental Concern and Action.

    PubMed

    Gould, Rachelle K; Ardoin, Nicole M; Biggar, Matt; Cravens, Amanda E; Wojcik, Deb

    2016-08-01

    Humankind and the planet face many thorny environmentally related challenges that require a range of responses, including changing behaviors related to transportation, eating habits, purchasing, and myriad other aspects of life. Using data from a 1201-person survey and 14 Community Listening Sessions (CLSs), we explore people's perceptions of and actions taken to protect the environment. Our data indicate a striking prevalence of waste management-related actions. Survey respondents described actions and concerns related to trash, recycling, and composting as the most common environmental behaviors; similarly, participants in CLSs discussed waste-related topics, for which we did not prompt, as frequently as those topics for which we specifically prompted. Explanations for this prevalence emerging from the data include (1) the nature of waste-related behaviors (concrete, supported by infrastructure, simple, compatible with lifestyle); (2) norms and social dynamics (family interactions, feelings of belonging/participation, government policy); and (3) internal psychological processes (internalized norms and environmental concern). We also found that many waste-related discussions were relatively superficial, focusing on immediate waste-related issues (e.g., litter or recycling) rather than larger issues such as consumption. Our results may provide insight into future efforts to encourage pro-environmental behavior. Given that most pro-environmental behavior involves tasks more complex and lifestyle-changing than those related to simple aspects of waste management, we suggest focusing on the latter two intertwined categories that our data suggest are important: encouraging social dynamics and related development of norms concerning environmental behavior (category 2), and fostering internalized norms and environmental concern (category 3). PMID:27234803

  19. Environmental Behavior's Dirty Secret: The Prevalence of Waste Management in Discussions of Environmental Concern and Action

    NASA Astrophysics Data System (ADS)

    Gould, Rachelle K.; Ardoin, Nicole M.; Biggar, Matt; Cravens, Amanda E.; Wojcik, Deb

    2016-08-01

    Humankind and the planet face many thorny environmentally related challenges that require a range of responses, including changing behaviors related to transportation, eating habits, purchasing, and myriad other aspects of life. Using data from a 1201-person survey and 14 Community Listening Sessions (CLSs), we explore people's perceptions of and actions taken to protect the environment. Our data indicate a striking prevalence of waste management-related actions. Survey respondents described actions and concerns related to trash, recycling, and composting as the most common environmental behaviors; similarly, participants in CLSs discussed waste-related topics, for which we did not prompt, as frequently as those topics for which we specifically prompted. Explanations for this prevalence emerging from the data include (1) the nature of waste-related behaviors (concrete, supported by infrastructure, simple, compatible with lifestyle); (2) norms and social dynamics (family interactions, feelings of belonging/participation, government policy); and (3) internal psychological processes (internalized norms and environmental concern). We also found that many waste-related discussions were relatively superficial, focusing on immediate waste-related issues (e.g., litter or recycling) rather than larger issues such as consumption. Our results may provide insight into future efforts to encourage pro-environmental behavior. Given that most pro-environmental behavior involves tasks more complex and lifestyle-changing than those related to simple aspects of waste management, we suggest focusing on the latter two intertwined categories that our data suggest are important: encouraging social dynamics and related development of norms concerning environmental behavior (category 2), and fostering internalized norms and environmental concern (category 3).

  20. Integrated modelling of management impacts on land-based GHG emissions and removals in EU countries

    NASA Astrophysics Data System (ADS)

    Böttcher, Hannes; Frank, Stefan; Havlik, Petr; Lauri, Pekka; Witzke, Peter; Obersteiner, Michael

    2013-04-01

    Emissions and removals of greenhouse gases (GHGs) from land use activities play a significant role in the total GHG cycling. In the EU, the land use, land use change and forestry (LULUCF) sector removes the equivalent of 9% of GHGs emitted in other parts of the economy. This net sink is the sum of emissions and removals from afforestation, deforestation, and forest, cropland and grassland management The European Commission has recently proposed that emissions and removals from LULUCF be incorporated into EU climate policy. Successful mitigation policy and GHG management strategies as well as accounting rules require anticipation of future developments of land emissions. In particular an estimation of the direct human impact of present management and concrete management options at the landscape level is needed. Such information is essential for disentangling direct and indirect human induced effects, the aim of this session, e.g. by comparing model results with national inventory information and aggregated measured data. We provide model-based estimates for the recent past, current and future emission pathways of land use activities, taking into account important drivers such as demand for food and wood, bioenergy demand, conservation policies etc. but also forest age class structure and past management. By carrying out sensitivity analyses in which these drivers are varied and by producing counterfactual reference scenarios, direct management change effects can be determined at the landscape level in a quantitative manner. The estimates cover the period 2000 to 2050 and include estimates for emissions from afforestation, deforestation, forest management, cropland management, grassland management and harvested wood products. We use a global land use model with detailed resolution at national level for EU28 countries also to assess mitigation potentials in the LULUCF sector and its cost effectiveness in competition with emission reductions by bioenergy use and

  1. Intraoperative neuromonitoring in thyroid surgery: a point prevalence survey on utilization, management, and documentation in Italy.

    PubMed

    Dionigi, Gianlorenzo; Lombardi, Davide; Lombardi, Celestino Pio; Carcoforo, Paolo; Boniardi, Marco; Innaro, Nadia; Chiofalo, Maria Grazia; Cavicchi, Ottavio; Biondi, Antonio; Basile, Francesco; Zaccaroni, Angelo; Mangano, Alberto; Leotta, Andrea; Lavazza, Matteo; Calò, Pietro Giorgio; Nicolosi, Angelo; Castelnuovo, Paolo; Nicolai, Piero; Pezzullo, Luciano; De Toma, Giorgio; Bellantone, Rocco; Sacco, Rosario

    2014-12-01

    The frequency of neuromonitoring during thyroid surgery is underreported in Italy. The present survey depicts and describes the patterns of use, management, documentation for IONM devices of IONM during thyroid surgery by surgeons in Italy. A point prevalence survey was undertaken. Source data were mixed from Italian surgeons attending the 2014 International Neuromonitoring Study Group (INMSG) meeting, four IONM manufacturers available in Italy and surgical units were identified from Company sales data. Qualitative and quantitative data were used to analyze. Questions probed IONM prevalence, surgeon background, hospital geographic practice locations, type of hospital, rationale for IONM use, sources of initial capital investment for IONM acquisition, type of equipment, use of continuous IONM, monitoring management, use of distinctive standards, and IONM documentation. IONM is currently delivered through 48 units in Italy. In 2013, the distribution of IONM by specialties included: general (50 %), ENT (46 %), and thoracic surgery (4 %). Overall, 12.853 IONM procedures were performed in the period from 2006 to 2013: 253 were performed in 2007 and about 5,100 in 2013. Distribution according to the type of hospital is: public 48 %, academic setting 37 %, and private maintenance 15 %. The use category of high volume thyroid hospitals represented 33 %. Initial capital investment for the acquisition of the monitoring equipment was 67 % public and 33 % with charitable/private funding. Audio plus graphic and EMG electrodes surface endotracheal tube-based monitoring systems accounted for the majority. Continuous IONM was introduced in 5 Academic Centers. Overall motivations expressed are legal (30 %), RLN confirmation (20 %), RLN identification (20 %), prognosis (10 %), helpful in difficult cases (10 %), decrease surgical time (5 %), and educational (5 %). The survey revealed that participants had few experience with the standardized approach of IONM technique (28 %). General

  2. Management of patients with Arrhythmogenic Right Ventricular Cardiomyopathy in the Nordic countries

    PubMed Central

    Haugaa, Kristina H.; Bundgaard, Henning; Edvardsen, Thor; Eschen, Ole; Gilljam, Thomas; Hansen, Jim; Jensen, Henrik Kjærulf; Platonov, Pyotr G.; Svensson, Anneli; Svendsen, Jesper H.

    2015-01-01

    Abstract> Objectives. Diagnostics of patients with arrhythmogenic right ventricular cardiomyopathy (ARVC) are complex, and based on the 2010 Task Force document including different diagnostic modalities. However, recommendations for clinical management and follow-up of patients with ARVC and their relatives are sparse. This paper aims to give a practical overview of management strategies, risk stratification, and selection of appropriate therapies for patients with ARVC and their family members. Design. This paper summarizes follow-up and treatment strategies in ARVC patients in the Nordic countries. The author group represents cardiologists who are actively involved in the Nordic ARVC Registry which was established in 2009, and contains prospectively collected clinical data from more than 590 ARVC patients from Denmark, Norway, Sweden, and Finland. Results. Different approaches of management and follow-up are required in patients with definite ARVC and in genetic-mutation-positive family members. Furthermore, ARVC patients with and without implantable cardioverter defibrillators (ICDs) require different follow-up strategies. Conclusion. Careful follow-up is required in patients with ARVC diagnosis to evaluate the need of anti-arrhythmic therapy and ICD implantation. Mutation-positive family members should be followed regularly for detection of early disease and risk stratification of ventricular arrhythmias. PMID:26395672

  3. The Burden of Cardiovascular Disease in Low- and Middle-Income Countries: Epidemiology and Management.

    PubMed

    Bowry, Ashna D K; Lewey, Jennifer; Dugani, Sagar B; Choudhry, Niteesh K

    2015-09-01

    Cardiovascular disease (CVD) is the second leading cause of mortality worldwide, accounting for 17 million deaths in 2013. More than 80% of these cases were in low- and middle-income countries (LMICs). Although the risk factors for the development of CVD are similar throughout the world, the evolving change in lifestyle and health behaviours in LMICs-including tobacco use, decreased physical activity, and obesity-are contributing to the escalating presence of CVD and mortality. Although CVD mortality is falling in high-income settings because of more effective preventive and management programs, access to evidence-based interventions for combating CVD in resource-limited settings is variable. The existing pressures on both human and financial resources impact the efforts of controlling CVD. The implementation of emerging innovative interventions to improve medication adherence, introducing m-health programs, and decentralizing the management of chronic diseases are promising methods to reduce the burden of chronic disease management on such fragile health care systems. PMID:26321437

  4. Prevalence and management of natal/neonatal teeth in cleft lip and palate patients

    PubMed Central

    Yilmaz, R. Burcu Nur; Cakan, Derya Germec; Mesgarzadeh, Nasim

    2016-01-01

    Objective: The aim of this study was to determine the prevalence and distribution of natal/neonatal teeth in infants with cleft lip and palate (CLP) according to gender, involving jaw and side and to show the management of some cases. Materials and Methods: A retrospective study was carried out on medical history and photographic records of 69 infants with CLP, who were treated at the CLP clinic of Yeditepe University between years 2014–2015. The presence of neonatal teeth was determined, and if present the gender, type of cleft, and position were recorded. Statistical analysis was performed. Results: Neonatal teeth were observed in 7% of the study group. No significant differences were found between cleft types and gender (P > 0.05). The prevalence of neonatal teeth in bilateral, unilateral and isolated cleft type was 16.5%, 6.5%, and none, respectively. All neonatal teeth were located in the maxilla and on the cleft-side (100%). Conclusion: The presence of natal/neonatal teeth in infants with CLP was not rare. In all of these cases the teeth were located adjacent to the cleft region. In isolated palatal cleft, where the alveolar region including the teeth buds are away from the cleft, no neonatal teeth were observed. It may be concluded that neonatal teeth in infants with CLP are frequently present and located inside the borders of the presurgical orthopedic treatment (POT) plate. Therefore, if possible, immediate extraction of the neonatal teeth is advised or if not possible because of systemic health reasons, modifications of the plate are required. PMID:27011740

  5. Prevalence and Incidence of Traumatic Experiences Among Orphans in Institutional and Family-Based Settings in 5 Low- and Middle-Income Countries: A Longitudinal Study

    PubMed Central

    Pence, Brian W; Ostermann, Jan; Whetten, Rachel A; O’Donnell, Karen; Thielman, Nathan M; Whetten, Kathryn

    2015-01-01

    Background: Policy makers struggling to protect the 153 million orphaned and separated children (OSC) worldwide need evidence-based research on the burden of potentially traumatic events (PTEs) and the relative risk of PTEs across different types of care settings. Methods: The Positive Outcomes for Orphans study used a 2-stage, cluster-randomized sampling design to identify 1,357 institution-dwelling and 1,480 family-dwelling orphaned and separated children in 5 low- and middle-income countries (LMICs) in sub-Saharan Africa and Asia. We used the Life Events Checklist developed by the National Center for Posttraumatic Stress Disorder to examine self-reported PTEs among 2,235 OSC ages 10–13 at baseline. We estimated prevalence and incidence during 36-months of follow-up and compared the risk of PTEs across care settings. Data collection began between May 2006 and February 2008, depending on the site. Results: Lifetime prevalence by age 13 of any PTE, excluding loss of a parent, was 91.0% (95% confidence interval (CI) = 85.6, 94.5) in institution-dwelling OSC and 92.4% (95% CI = 90.3, 94.0) in family-dwelling OSC; annual incidence of any PTE was lower in institution-dwelling (23.6% [95% CI = 19.4, 28.7]) than family-dwelling OSC (30.0% [95% CI = 28.1, 32.2]). More than half of children in institutions (50.3% [95% CI = 42.5, 58.0]) and in family-based care (54.0% [95% CI = 50.2, 57.7]) had experienced physical or sexual abuse by age 13. Annual incidence of physical or sexual abuse was lower in institution-dwelling (12.9% [95% CI = 9.6, 17.3]) than family-dwelling OSC (19.4% [95% CI = 17.7, 21.3]), indicating statistically lower risk in institution-dwelling OSC (risk difference = 6.5% [95% CI = 1.4, 11.7]). Conclusion: Prevalence and incidence of PTEs were high among OSC, but contrary to common assumptions, OSC living in institutions did not report more PTEs or more abuse than OSC living with families. Current efforts to reduce

  6. Gender (in) differences in prevalence and incidence of traumatic experiences among orphaned and separated children living in five low- and middle-income countries

    PubMed Central

    Gray, C. L.; Pence, B. W.; Ostermann, J.; Whetten, R. A.; O’Donnell, K.; Thielman, N. M.; Whetten, K.

    2015-01-01

    Background Approximately 153 million children worldwide are orphaned and vulnerable to potentially traumatic events (PTEs). Gender differences in PTEs in low- and middle-income countries (LMIC) are not well-understood, although support services and prevention programs often primarily involve girls. Methods The Positive Outcomes for Orphans study used a two-stage, cluster-randomized sampling design to identify 2837 orphaned and separated children (OSC) in five LMIC in sub-Saharan Africa and Asia. We examined self-reported prevalence and incidence of several PTE types, including physical and sexual abuse, among 2235 children who were ≥10 years at baseline or follow-up, with a focus on gender comparisons. Results Lifetime prevalence by age 13 of any PTE other than loss of a parent was similar in both boys [91.7% (95% confidence interval (CI) (85.0–95.5)] and girls [90.3% CI (84.2–94.1)] in institutional-based care, and boys [92.0% (CI 89.0–94.2)] and girls [92.9% CI (89.8–95.1)] in family-based care; annual incidence was similarly comparable between institution dwelling boys [23.6% CI (19.1, –29.3)] and girls [23.6% CI (18.6, –30.0)], as well as between family-dwelling boys [30.7% CI (28.0, –33.6)] and girls [29.3% CI (26.8,-32.0)]. Physical and sexual abuse had the highest overall annual incidence of any trauma type for institution-based OSC [12.9% CI (9.6–17.4)] and family-based OSC [19.4% CI (14.5–26.1)], although estimates in each setting were no different between genders. Conclusion Prevalence and annual incidence of PTEs were high among OSC in general, but gender-specific estimates were comparable. Although support services and prevention programs are essential for female OSC, programs for male OSC are equally important. PMID:26085939

  7. Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries

    PubMed Central

    Matteelli, Alberto; Abubakar, Ibrahim; Aziz, Mohamed Abdel; Baddeley, Annabel; Barreira, Draurio; Den Boon, Saskia; Borroto Gutierrez, Susana Marta; Bruchfeld, Judith; Burhan, Erlina; Cavalcante, Solange; Cedillos, Rolando; Chaisson, Richard; Chee, Cynthia Bin-Eng; Chesire, Lucy; Corbett, Elizabeth; Dara, Masoud; Denholm, Justin; de Vries, Gerard; Falzon, Dennis; Ford, Nathan; Gale-Rowe, Margaret; Gilpin, Chris; Girardi, Enrico; Go, Un-Yeong; Govindasamy, Darshini; D. Grant, Alison; Grzemska, Malgorzata; Harris, Ross; Horsburgh Jr, C. Robert; Ismayilov, Asker; Jaramillo, Ernesto; Kik, Sandra; Kranzer, Katharina; Lienhardt, Christian; LoBue, Philip; Lönnroth, Knut; Marks, Guy; Menzies, Dick; Migliori, Giovanni Battista; Mosca, Davide; Mukadi, Ya Diul; Mwinga, Alwyn; Nelson, Lisa; Nishikiori, Nobuyuki; Oordt-Speets, Anouk; Rangaka, Molebogeng Xheedha; Reis, Andreas; Rotz, Lisa; Sandgren, Andreas; Sañé Schepisi, Monica; Schünemann, Holger J.; Sharma, Surender Kumar; Sotgiu, Giovanni; Stagg, Helen R.; Sterling, Timothy R.; Tayeb, Tamara; Uplekar, Mukund; van der Werf, Marieke J.; Vandevelde, Wim; van Kessel, Femke; van't Hoog, Anna; Varma, Jay K.; Vezhnina, Natalia; Voniatis, Constantia; Vonk Noordegraaf-Schouten, Marije; Weil, Diana; Weyer, Karin; Wilkinson, Robert John; Yoshiyama, Takashi; Zellweger, Jean Pierre; Raviglione, Mario

    2015-01-01

    Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3–4 month isoniazid plus rifampicin; or 3–4 month rifampicin alone. PMID:26405286

  8. Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries.

    PubMed

    Getahun, Haileyesus; Matteelli, Alberto; Abubakar, Ibrahim; Aziz, Mohamed Abdel; Baddeley, Annabel; Barreira, Draurio; Den Boon, Saskia; Borroto Gutierrez, Susana Marta; Bruchfeld, Judith; Burhan, Erlina; Cavalcante, Solange; Cedillos, Rolando; Chaisson, Richard; Chee, Cynthia Bin-Eng; Chesire, Lucy; Corbett, Elizabeth; Dara, Masoud; Denholm, Justin; de Vries, Gerard; Falzon, Dennis; Ford, Nathan; Gale-Rowe, Margaret; Gilpin, Chris; Girardi, Enrico; Go, Un-Yeong; Govindasamy, Darshini; D Grant, Alison; Grzemska, Malgorzata; Harris, Ross; Horsburgh, C Robert; Ismayilov, Asker; Jaramillo, Ernesto; Kik, Sandra; Kranzer, Katharina; Lienhardt, Christian; LoBue, Philip; Lönnroth, Knut; Marks, Guy; Menzies, Dick; Migliori, Giovanni Battista; Mosca, Davide; Mukadi, Ya Diul; Mwinga, Alwyn; Nelson, Lisa; Nishikiori, Nobuyuki; Oordt-Speets, Anouk; Rangaka, Molebogeng Xheedha; Reis, Andreas; Rotz, Lisa; Sandgren, Andreas; Sañé Schepisi, Monica; Schünemann, Holger J; Sharma, Surender Kumar; Sotgiu, Giovanni; Stagg, Helen R; Sterling, Timothy R; Tayeb, Tamara; Uplekar, Mukund; van der Werf, Marieke J; Vandevelde, Wim; van Kessel, Femke; van't Hoog, Anna; Varma, Jay K; Vezhnina, Natalia; Voniatis, Constantia; Vonk Noordegraaf-Schouten, Marije; Weil, Diana; Weyer, Karin; Wilkinson, Robert John; Yoshiyama, Takashi; Zellweger, Jean Pierre; Raviglione, Mario

    2015-12-01

    Latent tuberculosis infection (LTBI) is characterised by the presence of immune responses to previously acquired Mycobacterium tuberculosis infection without clinical evidence of active tuberculosis (TB). Here we report evidence-based guidelines from the World Health Organization for a public health approach to the management of LTBI in high risk individuals in countries with high or middle upper income and TB incidence of <100 per 100 000 per year. The guidelines strongly recommend systematic testing and treatment of LTBI in people living with HIV, adult and child contacts of pulmonary TB cases, patients initiating anti-tumour necrosis factor treatment, patients receiving dialysis, patients preparing for organ or haematological transplantation, and patients with silicosis. In prisoners, healthcare workers, immigrants from high TB burden countries, homeless persons and illicit drug users, systematic testing and treatment of LTBI is conditionally recommended, according to TB epidemiology and resource availability. Either commercial interferon-gamma release assays or Mantoux tuberculin skin testing could be used to test for LTBI. Chest radiography should be performed before LTBI treatment to rule out active TB disease. Recommended treatment regimens for LTBI include: 6 or 9 month isoniazid; 12 week rifapentine plus isoniazid; 3-4 month isoniazid plus rifampicin; or 3-4 month rifampicin alone. PMID:26405286

  9. Occupational safety and health management among five ASEAN countries: Thailand, Indonesia, Malaysia, Philippines, and Singapore.

    PubMed

    Buranatrevedh, Surasak

    2015-03-01

    Occupational safety and health is one of important issues for workforce movement among ASEAN countries. The objective was to study laws, main agencies, and law enforcement regarding occupational safety and health in Thailand, Indonesia, Malaysia, Philippines, and Singapore. This documentary research covered laws, main agencies' duties, and occupational safety and health law enforcement in Thailand, Indonesia, Malaysia, Philippines, and Singapore. Thailand has its Occupational Safety, Health, and Work EnvironmentAct 2011. Its main agency was Department of Labor Protection and Welfare. Indonesia had WorkSafety Act (Law No. 1, 1970). Its main agency was Department of Manpower and Transmigration. Malaysia had Occupational Safety and Health Act (OSHA) 1994. Its main agency is the Department of Occupational Safety and Health. The Philippines has its Occupational Safety and Health Standards. Its main agency was Department ofLabor and Employment. Singapore has its Workplace Safety and Health Act 2006. Its main agency is Occupational Safety and Health Division. Occupational safety and health law enforcement among each county covers work environment surveillance, workers' health surveillance, advice about prevention and control of occupational health hazards, training and education of employers and employees, data systems, and research. Further in-depth surveys of occupational safety and health among each ASEAN county are needed to develop frameworks for occupational safety and health management for all ASEAN countries. PMID:26211106

  10. Strategic management of the health workforce in developing countries: what have we learned?

    PubMed Central

    Fritzen, Scott A

    2007-01-01

    The study of the health workforce has gained in prominence in recent years, as the dynamic interconnections between human resource issues and health system effectiveness have come into sharper focus. This paper reviews lessons relating to strategic management challenges emerging from the growing literature in this area. Workforce issues are strategic: they affect overall system performance as well as the feasibility and sustainability of health reforms. Viewing workforce issues strategically forces health authorities to confront the yawning gaps between policy and implementation in many developing countries. Lessons emerge in four areas. One concerns imbalances in workforce structure, whether from a functional specialization, geographical or facility lens. These imbalances pose a strategic challenge in that authorities must attempt to steer workforce distribution over time using a limited range of policy tools. A second group of lessons concerns the difficulties of central-level steering of the health workforce, often critically weak due to the lack of proper information systems and the complexities of public sector decentralization and service commercialization trends affecting the grassroots. A third cluster examines worker capacity and motivation, often shaped in developing countries as much by the informal norms and incentives as by formal attempts to support workers or to hold them accountable. Finally, a range of reforms centering on service contracting and improvements to human resource management are emerging. Since these have as a necessary (but not sufficient) condition some flexibility in personnel practices, recent trends towards the sharing of such functions with local authorities are promising. The paper identifies a number of current lines of productive research, focusing on the relationship between health policy reforms and the local institutional environments in which the workforce, both public and private, is deployed. PMID:17319973