Science.gov

Sample records for eleven country review

  1. Planned, Motivated and Habitual Hygiene Behaviour: An Eleven Country Review

    ERIC Educational Resources Information Center

    Curtis, Valerie A.; Danquah, Lisa O.; Aunger, Robert V.

    2009-01-01

    Handwashing with soap (HWWS) may be one of the most cost-effective means of preventing infection in developing countries. However, HWWS is rare in these settings. We reviewed the results of formative research studies from 11 countries so as to understand the planned, motivated and habitual factors involved in HWWS. On average, only 17% of child…

  2. Planned, motivated and habitual hygiene behaviour: an eleven country review

    PubMed Central

    Curtis, Valerie A.; Danquah, Lisa O.; Aunger, Robert V.

    2009-01-01

    Handwashing with soap (HWWS) may be one of the most cost-effective means of preventing infection in developing countries. However, HWWS is rare in these settings. We reviewed the results of formative research studies from 11 countries so as to understand the planned, motivated and habitual factors involved in HWWS. On average, only 17% of child caretakers HWWS after the toilet. Handwash ‘habits’ were generally not inculcated at an early age. Key ‘motivations’ for handwashing were disgust, nurture, comfort and affiliation. Fear of disease generally did not motivate handwashing, except transiently in the case of epidemics such as cholera. ‘Plans’ involving handwashing included to improve family health and to teach children good manners. Environmental barriers were few as soap was available in almost every household, as was water. Because much handwashing is habitual, self-report of the factors determining it is unreliable. Candidate strategies for promoting HWWS include creating social norms, highlighting disgust of dirty hands and teaching children HWWS as good manners. Dividing the factors that determine health-related behaviour into planned, motivated and habitual categories provides a simple, but comprehensive conceptual model. The habitual aspects of many health-relevant behaviours require further study. PMID:19286894

  3. Oesophageal tuberculosis: a review of eleven cases.

    PubMed Central

    Mokoena, T.; Shama, D. M.; Ngakane, H.; Bryer, J. V.

    1992-01-01

    Tuberculous infection of the oesophagus is rare. This is confirmed by our present review of cases managed in our teaching hospitals over a period of 18 years which uncovered only 11 patients. The main presentation is that of dysphagia whose algorithm of investigation should seek to differentiate tuberculosis from carcinoma, the more common cause of this symptom. Of the 11 patients, 9 presented with dysphagia while 2 had haemorrhage; 7 had an abnormal plain chest radiograph, of whom 4 had a mediastinal mass lesion (3 were lymphadenopathy and one an abscess). All but one had an abnormal radio-contrast oesophagogram, including a mediastinal sinus in two and a traction diverticulum in another two. The mainstay of investigation was oesophagoscopy through which diagnostic biopsy material was obtained in half of the patients. In the other half diagnosis was by either biopsy of associated mediastinal (3) or cervical (1) lymph node masses or by acid fast bacilli positive sputum (1). The diagnosis was established post-mortem in one patient. Treatment was primarily non-operative with standard anti-tuberculosis drug therapy. Two patients underwent a diagnostic thoracotomy and one a drainage of mediastinal abscess together with resection and repair of oesophago-mediastinal sinus during the early part of the series. Outcome of management was very rewarding in 9 patients and death occurred in 2 patients, one of whom had his anti-tuberculosis drug therapy interrupted by severe hepatitis B virus infection. The other death occurred in a patient whose haemorrhage from an aorta-oesophageal fistula was not established ante-mortem. It is recommended that when biopsy material of the oesophagus is unobtainable or non-diagnostic in patients with dysphagia, especially with an abnormal chest radiograph or human immunodeficiency virus infection, effort should be made to obtain biopsy material from associated lymph nodes, even by thoracotomy if necessary, or culture of biopsy from the

  4. Mother-Infant Contingent Vocalizations in Eleven Countries

    PubMed Central

    Bornstein, Marc H.; Putnick, Diane L.; Cote, Linda R.; Haynes, O. Maurice; Suwalsky, Joan T.D.

    2015-01-01

    Mother-infant vocal interactions serve multiple functions in child development, but the community-common or community-specific nature of key features of their vocal interactions remains unclear. Here we examined rates, interrelations, and contingencies of vocal interactions in 684 mothers and their 5-month-old infants in diverse communities in 11 countries (Argentina, Belgium, Brazil, Cameroon, France, Israel, Italy, Japan, Kenya, South Korea, and United States). Rates of mothers’ and infants’ vocalizations varied widely across communities and were uncorrelated. However, collapsing across communities mothers vocalized to infants contingent on the offset of their infants’ nondistress vocalizing, infants vocalized contingent on the offset of their mothers’ vocalizing, and maternal and infant contingencies were significantly correlated, pointing to the beginnings of dyadic conversational turn taking. Despite broad differences in the overall talkativeness of mothers and infants, maternal and infant contingent vocal responsiveness is common across communities, supporting essential functions of turn-taking in early child socialization. PMID:26133571

  5. Limb pterygium syndromes: a review and report of eleven patients.

    PubMed

    Hall, J G; Reed, S D; Rosenbaum, K N; Gershanik, J; Chen, H; Wilson, K M

    1982-08-01

    Conditions with limb pterygia and congenital contractures were reviewed as part of a study of over 350 infants with arthrogryposis. Emphasis was placed on inheritance and variability of distinct pterygium conditions. Eleven patients with limb pterygia were recognized in our study and are described here. Seven of the 350 patients with congenital contractures had the autosomal recessively inherited multiple pterygium syndrome (Patients 1-7). Three of the seven are sibs, a fourth was born to consanguineous parents, and three were chance isolated cases. These seven had multiple joint webs, unusual finger contractures, syndactyly, rocker bottom feet, ptosis, antimongoloid slant of palpebral fissures, epicanthal folds, highly arched palate, scoliosis, and short stature. There is intrafamilial variability. Three patients from one family had a lethal multiple pterygium syndrome. Two were monozygotic twins. They had webbing and contractures of the elbows, knees, neck, and fingers, calcaneovalgus deformity of the feet, and an unusual facial appearance: hypertelorism, flat nose, antimongoloid slant of palpebral fissures, apparently low-set ears. One had a cleft palate. Internal malformations included: bilateral pulmonary hypoplasia, small heart, absence of the appendix, and attenuation of the ascending and transverse colon. One sporadic case of lethal popliteal pterygium with facial clefts was studied. Multiple anomalies included: ankyloblepharon filiforme adnatum, upslanting palpebral fissures, hypoplasia of nasal cartilages, frenula, clefts into the oropharynx lateral to the mouth, apparently low-set ears with slit-like canals, large popliteal pterygia, syndactyly with fusion of all digits in hands and feet, and hypoplastic labia. PMID:7124793

  6. Anger Management Programs for Children and Teens: A Review of Eleven Anger Management Programs.

    ERIC Educational Resources Information Center

    Jahnke, Kristine

    This document focuses on anger management programs utilized within and outside of school systems. Eleven programs are reviewed and delineated into the following categories: age/grade level, group size, target population, theoretical basis, techniques utilized, and skills acquired. Practical knowledge of the programs is presented in order to…

  7. Consumption of fruits and vegetables among adolescents: a multi-national comparison of eleven countries in the Eastern Mediterranean Region.

    PubMed

    Al Ani, M F; Al Subhi, L K; Bose, S

    2016-03-28

    Regional cross-country profile of fruit and vegetable (F&V) consumption is lacking in the Eastern Mediterranean Region (EMR). This study examines the prevalence and differences of consuming F&V ≥5 times/d among adolescents in eleven EMR countries, and also describes differences in the proportions of taking F&V ≥5 times/d by sex, age and BMI. The study included 26 328 school adolescents (13-15 years) with complete data on consumption of F&V, age, sex, weight and height taken from the Global School-based Student Health Survey conducted in the EMR between 2005 and 2009. Overall, only 19·4 % of adolescents reported consuming F&V ≥5 times/d. The highest prevalence was reported in Djibouti (40·4 %) and the lowest was reported in Pakistan (10·0 %). Statistically significant differences in prevalence were observed across countries (P<0·05). With the exception of Oman, Libya and Djibouti, significantly more males than females ate F&V ≥5 times/d. Proportion of students consuming F&V ≥5 times/d also varied significantly in all counties based on BMI (P<0·0001), with students within normal BMI having the highest frequency. A negative trend was observed between age and the prevalence of taking F&V ≥5 times/d in most of the eleven EMR countries but Jordan, Djibouti and Morocco. The prevalence of adequate intake of F&V was low in the eleven EMR countries. There is a need for interventions to increase the prevalence of adolescents consuming F&V ≥5 times/d. Interventions should take into consideration psychosocial, environmental and socio-environmental factors influencing F&V intake within countries. PMID:26817392

  8. Measurement equivalence of the CES-D 8 depression-scale among the ageing population in eleven European countries.

    PubMed

    Missinne, Sarah; Vandeviver, Christophe; Van de Velde, Sarah; Bracke, Piet

    2014-07-01

    Depression is one of the most prevalent mental disorders in later life. However, despite considerable research attention, great confusion remains regarding the association between ageing and depression. There is doubt as to whether a depression scale performs identically for different age groups and countries. Although measurement equivalence is a crucial prerequisite for valid comparisons across age groups and countries, it has not been established for the eight-item version of the Centre for Epidemiological Studies Depression Scale (CES-D8). Using multi-group confirmatory factor analysis, we assess configural, metric, and scalar measurement equivalence across two age groups (50-64 years of age and 65 or older) in eleven European countries, employing data from the Survey of Health, Ageing, and Retirement (SHARE). Results indicate that the construct of depression is comparable across age and country groups, allowing the substantive interpretation of correlates and mean levels of depressive symptoms. PMID:24767588

  9. Citizens' Access to Their Digital Health Data in Eleven Countries - A Comparative Study.

    PubMed

    Nohr, Christian; Wong, Ming Chao; Turner, Paul; Almond, Helen; Parv, Liisa; Gilstad, Heidi; Koch, Sabine; Harðardóttir, Guðrún Auður; Hyppönen, Hannele; Marcilly, Romaric; Sheik, Aziz; Day, Karen; Kushniruk, Andre

    2016-01-01

    Governments around the world are actively promoting citizens electronic access to their health data as one of a number of ways to respond to the challenges of health care delivery in the 21st century. While numerous approaches have been utilized it is evident from cross-country comparisons that there are different conceptualizations of: both the expected and desired roles for citizens in the management of their own health; the benefits that will be delivered by citizen access and how these benefits should be measured and benchmarked over-time. This paper presents comparative analyses of the methods by which citizens are provided with access to their own health data across 11 countries. The paper aims to stimulate debate on electronic citizen access to health data and the challenges of measuring benefit as well as reflection on capacity of different citizens to engage with e-health. PMID:27577472

  10. Fourteen new species, one new genus, and eleven new country or state records for New World Lamiinae (Coleoptera, Cerambycidae).

    PubMed

    Martins, Ubirajara R; Santos-Silva, Antonio; Galileo, Maria Helena M

    2015-01-01

    Fourteen new species and one new genus are described from the New World in Lamiinae (Coleoptera: Cerambycidae): Bisaltes (Bisaltes) lingafelteri sp. nov., Trestonia skelleyi sp. nov. and Psapharochrus langeri sp. nov. from Bolivia; Eupogonius azteca sp. nov., Aegomorphus mexicanus sp. nov., Lamacoscylus albatus sp. nov., Lamacoscylus obscurus sp. nov. and Piruanycha wappesi sp. nov. from Mexico; Dolichestola egeri sp. nov. and Wappesellus cavus gen. nov., sp. nov. from Brazil (Rondônia); Scleronotus virgatus sp. nov. from Venezuela; Oreodera casariae sp. nov. from Panama; Alampyris bicolor sp. nov. from Costa Rica; and Emphytoeciosoma flava sp. nov. from Peru. Additionally, eleven new country/state records are established in Lamiinae: three for Peru; three for Bolivia; one for Mexico; one for Uruguay; and two for Brazil (Rondônia) (state records). Bisaltes (Bisaltes) lingafelteri, Eupogonius azteca, Aegomorphus mexicanus, Lamacoscylus albatus, Lamacoscylus obscurus, Piruanycha wappesi, Scleronotus virgatus, Alampyris bicolor, Emphytoeciosoma flava and Wappesellus are included in new or known keys. PMID:26249940

  11. Medication Errors in the Southeast Asian Countries: A Systematic Review

    PubMed Central

    Salmasi, Shahrzad; Khan, Tahir Mehmood; Hong, Yet Hoi; Ming, Long Chiau; Wong, Tin Wui

    2015-01-01

    Background Medication error (ME) is a worldwide issue, but most studies on ME have been undertaken in developed countries and very little is known about ME in Southeast Asian countries. This study aimed systematically to identify and review research done on ME in Southeast Asian countries in order to identify common types of ME and estimate its prevalence in this region. Methods The literature relating to MEs in Southeast Asian countries was systematically reviewed in December 2014 by using; Embase, Medline, Pubmed, ProQuest Central and the CINAHL. Inclusion criteria were studies (in any languages) that investigated the incidence and the contributing factors of ME in patients of all ages. Results The 17 included studies reported data from six of the eleven Southeast Asian countries: five studies in Singapore, four in Malaysia, three in Thailand, three in Vietnam, one in the Philippines and one in Indonesia. There was no data on MEs in Brunei, Laos, Cambodia, Myanmar and Timor. Of the seventeen included studies, eleven measured administration errors, four focused on prescribing errors, three were done on preparation errors, three on dispensing errors and two on transcribing errors. There was only one study of reconciliation error. Three studies were interventional. Discussion The most frequently reported types of administration error were incorrect time, omission error and incorrect dose. Staff shortages, and hence heavy workload for nurses, doctor/nurse distraction, and misinterpretation of the prescription/medication chart, were identified as contributing factors of ME. There is a serious lack of studies on this topic in this region which needs to be addressed if the issue of ME is to be fully understood and addressed. PMID:26340679

  12. Occurrence of perchlorate in indoor dust from the United States and eleven other countries: implications for human exposure.

    PubMed

    Wan, Yanjian; Wu, Qian; Abualnaja, Khalid O; Asimakopoulos, Alexandros G; Covaci, Adrian; Gevao, Bondi; Johnson-Restrepo, Boris; Kumosani, Taha A; Malarvannan, Govindan; Moon, Hyo-Bang; Nakata, Haruhiko; Sinha, Ravindra K; Minh, Tu Binh; Kannan, Kurunthachalam

    2015-02-01

    Perchlorate is a widespread environmental contaminant and potent thyroid hormone disrupting compound. Despite this, very little is known with regard to the occurrence of this compound in indoor dust and the exposure of humans to perchlorate through dust ingestion. In this study, 366 indoor dust samples were collected from 12 countries, the USA, Colombia, Greece, Romania, Japan, Korea, Pakistan, Kuwait, Saudi Arabia, India, Vietnam, and China, during 2010-2014. Dust samples were extracted by 1% (v/v) methylamine in water. Analyte separation was achieved by an ion exchange (AS-21) column and analysis was performed by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The overall concentrations of perchlorate in dust were in the range of 0.02-104μg/g (geometric mean: 0.41μg/g). The indoor dust samples from China contained the highest concentrations (geometric mean: 5.38μg/g). No remarkable differences in perchlorate concentrations in dust were found among various microenvironments (i.e., car, home, office, and laboratory). The estimated median daily intake (EDI) of perchlorate for toddlers through dust ingestion in the USA, Colombia, Greece, Romania, Japan, Korea, Pakistan, Kuwait, Saudi Arabia, India, Vietnam, and China was 1.89, 0.37, 1.71, 0.74, 4.90, 7.20, 0.60, 0.80, 1.55, 0.70, 2.15, and 21.3ng/kgbodyweight (bw)/day, respectively. Although high concentrations of perchlorate were measured in some dust samples, the contribution of dust to total perchlorate intake was <5% of the total perchlorate intake in humans. This is the first multinational survey on the occurrence of perchlorate in indoor dust. PMID:25461426

  13. Spinning-induced Rhabdomyolysis: Eleven Case Reports and Review of the Literature

    PubMed Central

    Kim, Daejin; Ko, Eun-Jung; Cho, HyeJeong; Park, Su Hyung; Lee, Sang Hwan; Cho, Nam-gil; Lee, So-Young; Jeong, Hye Yun

    2015-01-01

    Non-traumatic exertional rhabdomyolysis (exRML) occurs in individuals with normal muscles when the energy supplied to the muscle is insufficient. Here, we report 11 cases of spinning-induced rhabdomyolysis and review related literature. Spinning is a kind of indoor bicycle sport. The 11 patients who were diagnosed with exRML and admitted to CHA Bundang Medical Center were female and their ages ranged from 15 to 46 years. Two to three days prior to the presentation, the patients had attended a spinning class for the first time. All the patients had been otherwise healthy without any known medical illnesses. They were successfully treated without any complications, except mild non-symptomatic hypocalcemia. However, in the literature, severe complications such as compartment syndrome or acute kidney injury had been reported in relation to exRML including spinning-induced rhabdomyolysis. This spinning exercise needs prior guidelines and specific warnings to prevent exertional rhabdomyolysis. PMID:26848305

  14. Eating out is different from eating at home among individuals who occasionally eat out. A cross-sectional study among middle-aged adults from eleven European countries.

    PubMed

    Naska, Androniki; Katsoulis, Michail; Orfanos, Philippos; Lachat, Carl; Gedrich, Kurt; Rodrigues, Sara S P; Freisling, Heinz; Kolsteren, Patrick; Engeset, Dagrun; Lopes, Carla; Elmadfa, Ibrahim; Wendt, Andrea; Knüppel, Sven; Turrini, Aida; Tumino, Rosario; Ocké, Marga C; Sekula, Wlodzimierz; Nilsson, Lena Maria; Key, Tim; Trichopoulou, Antonia

    2015-06-28

    Eating out has been linked to the current obesity epidemic, but the evaluation of the extent to which out of home (OH) dietary intakes are different from those at home (AH) is limited. Data collected among 8849 men and 14,277 women aged 35-64 years from the general population of eleven European countries through 24-h dietary recalls or food diaries were analysed to: (1) compare food consumption OH to those AH; (2) describe the characteristics of substantial OH eaters, defined as those who consumed 25 % or more of their total daily energy intake at OH locations. Logistic regression models were fit to identify personal characteristics associated with eating out. In both sexes, beverages, sugar, desserts, sweet and savoury bakery products were consumed more OH than AH. In some countries, men reported higher intakes of fish OH than AH. Overall, substantial OH eating was more common among men, the younger and the more educated participants, but was weakly associated with total energy intake. The substantial OH eaters reported similar dietary intakes OH and AH. Individuals who were not identified as substantial OH eaters reported consuming proportionally higher quantities of sweet and savoury bakery products, soft drinks, juices and other non-alcoholic beverages OH than AH. The OH intakes were different from the AH ones, only among individuals who reported a relatively small contribution of OH eating to their daily intakes and this may partly explain the inconsistent findings relating eating out to the current obesity epidemic. PMID:25907775

  15. Taxonomic review on the subgenus Tripodura Townes (Diptera: Chironomidae: Polypedilum) from China with eleven new species and a supplementary world checklist.

    PubMed

    Zhang, Ruilei; Song, Chao; Qi, Xin; Wang, Xinhua

    2016-01-01

    The subgenus Tripodura Townes of Polypedilum Kieffer from China including 26 species is reviewed. Eleven new species, named P. (T.) absensilobum Zhang & Wang sp. n., P. (T.) apiculusetosum Zhang & Wang sp. n., P. (T.) arcuatum Zhang & Wang sp. n., P. (T.) bilamella Zhang & Wang sp. n., P. (T.) conghuaense Zhang & Wang sp. n., P. (T.) dengae Zhang & Wang sp. n., P. (T.) mengmanense Zhang & Wang sp. n., P. (T.) napahaiense Zhang & Wang sp. n., P. (T.) parallelum Zhang & Wang sp. n., P. (T.) pollicium Zhang & Wang sp. n. and P. (T.) trapezium Zhang & Wang sp. n. are described and illustrated based on male imagines. Three species, P. (T.) quadriguttatum Kieffer, P. (T.) unifascia (Tokunaga) and P. (T.) udominutum Niitsuma are firstly recorded in China. A key to known male imagines of Chinese species and an updated world checklist of subgenus Tripodura are presented. PMID:27395703

  16. Eleven Primary Melanomas, Colon Cancer, and Atypical Nevi in the Same Patient: A Case Report and Literature Review

    PubMed Central

    Juul Nielsen, Lea; Rosenkrantz Hölmich, Lisbet

    2016-01-01

    Background. As the incidence of cutaneous malignant melanoma increases in the Caucasian population, an increasing population of melanoma survivors is at risk of developing multiple primary melanomas (MPM) as well as secondary primary cancers. Objective. To present a case of a patient with atypical nevi, 11 primary melanomas over 33 years, and colon cancer and to review the literature on multiple primary melanomas, atypical nevi, and correlation of nonmelanoma cancers. Conclusion. The literature indicates that patients with MPM are not uncommon, although 11 primary melanomas are rarely described, that patients with MPM may have a better survival than patients with single primary melanoma, that atypical nevi are a risk marker of not only melanoma in general but also MPM, and that melanoma patients have a significantly increased risk of developing nonmelanoma skin and other cancers, which may be even higher for patients with MPM. PMID:27022491

  17. Factors Influencing Technology Planning in Developing Countries: A Literature Review

    ERIC Educational Resources Information Center

    Keengwe, Jared; Malapile, Sandy

    2014-01-01

    This article is a literature review concerning the factors that play an important role in the development of educational technology plans in the educational system of developing countries (DCs). Largely, the technology plans are influenced by factors that emanates from within the country (internal) and those outside of their borders (external).…

  18. Obesity and socioeconomic status in developing countries: a systematic review

    PubMed Central

    Dinsa, GD; Goryakin, Y; Fumagalli, E; Suhrcke, M

    2012-01-01

    Summary We undertook a systematic review of studies assessing the association between socioeconomic status (SES) and measured obesity in low- and middle-income countries (defined by the World Bank as countries with per capita income up to US$12,275) among children, men and women. The evidence on the subject has grown significantly since an earlier influential review was published in 2004. We find that in low-income countries or in countries with low human development index (HDI), the association between SES and obesity appears to be positive for both men and women: the more affluent and/or those with higher educational attainment tend to be more likely to be obese. However, in middle-income countries or in countries with medium HDI, the association becomes largely mixed for men and mainly negative for women. This particular shift appears to occur at an even lower level of per capita income than suggested by an influential earlier review. By contrast, obesity in children appears to be predominantly a problem of the rich in low- and middle-income countries. PMID:22764734

  19. Faunistic review of the cuckoo wasps of Fennoscandia, Denmark and the Baltic countries (Hymenoptera: Chrysididae).

    PubMed

    Paukkunen, Juho; Rosa, Paolo; Soon, Villu; Johansson, Niklas; Ødegaard, Frode

    2014-01-01

    A critical and annotated review of published records of the Chrysididae of the Nordic and Baltic countries and the Russian part of Fennoscandia is presented with some taxonomic and faunistic notes. A total of 73 species are listed from the region. Additionally, 17 species are deleted. Three species are recorded for the first time from Denmark, six species from Estonia, one from Finland, eleven from Latvia, four from Norway, one from Sweden and 15 from Russian Fennoscandia. Elampus foveatus and Chrysis pulcherrima are reported for the first time from the Nordic and Baltic countries. Lectotypes are designated for Hedychrum cupreum Dahlbom, 1845, Chrysis zetterstedti Dahlbom, 1845, Chrysis succincta var. chrysoprasina Trautmann, 1927, Chrysis succincta var. virideocincta Trautmann, 1927 and Chrysis succincta var. nordstromi Trautmann, 1927. Information and images of the holotypes of Hedychrum metallicum Dahlbom, 1854, Chrysis var. westerlundi Trautmann, 1927 are given. Chrysis integra Dahlbom, 1829 is found to be a new synonym of Hedychridium ardens (Coquebert, 1801) and Chrysis scintillans Valkeila, 1971 a new synonym of Chrysis solida Haupt, 1957. Chrysis terminata Dahlbom, 1854 is reported for the first time as the valid name for C. ignita Form A sensu Linsenmaier, 1959. PMID:25283536

  20. Delivery of health services in Arab countries: a review.

    PubMed

    Kronfol, N M

    2012-12-01

    This paper reviews the essential components of health care delivery systems in Arab countries and their development over the past 3 decades. The changes and challenges which evolved during the last half of the 20th century have had a significant impact on health systems and on health outcomes. An adequate network of hospitals and primary health care facilities has been established in most Arab countries of the Region. The increased participation of civil society has impacted positively on health systems. However, the main challenge is represented by the move towards market economies. In many developing economies, macroeconomic reforms have often necessitated cuts in public spending on social sectors. Cost-sharing policies have been implemented in order to compensate for diminishing government budgets allocated to health. However, this is not to minimize the enormous strides that have been made in all countries nor the important challenges that need to be addressed. PMID:23301398

  1. Eleven Wonderful Learning Center Ideas!

    ERIC Educational Resources Information Center

    Instructor, 1978

    1978-01-01

    Describes eleven ideas for classroom learning centers including: dinosaurs, pets, role playing, music, your own zoo, a bright circuit board, typing, a talking bull, weather, dictionary, and pen pals. (JMB)

  2. Lightcurve Results for Eleven Asteroids

    NASA Astrophysics Data System (ADS)

    Gartrelle, Gordon M.

    2012-04-01

    Differential photometry techniques were used to develop lightcurves, rotation periods and amplitudes for eleven main-belt asteroids: 833 Monica, 962 Aslog, 1020 Arcadia, 1082 Pirola, 1097 Vicia, 1122 Lugduna, 1145 Robelmonte, 1253 Frisia, 1256 Normannia, 1525 Savolinna, and 2324 Janice. Ground-based observations from Badlands Observatory (BLO) in Quinn, SD, as well as the University of North Dakota Observatory (UND) in Grand Forks, ND, provided the data for the project. A search of the asteroid lightcurve database (LCDB) did not reveal any previously reported results for seven of the eleven targets in this study.

  3. Cost of dengue outbreaks: literature review and country case studies

    PubMed Central

    2013-01-01

    Background Dengue disease surveillance and vector surveillance are presumed to detect dengue outbreaks at an early stage and to save – through early response activities – resources, and reduce the social and economic impact of outbreaks on individuals, health systems and economies. The aim of this study is to unveil evidence on the cost of dengue outbreaks. Methods Economic evidence on dengue outbreaks was gathered by conducting a literature review and collecting information on the costs of recent dengue outbreaks in 4 countries: Peru, Dominican Republic, Vietnam, and Indonesia. The literature review distinguished between costs of dengue illness including cost of dengue outbreaks, cost of interventions and cost-effectiveness of interventions. Results Seventeen publications on cost of dengue showed a large range of costs from 0.2 Million US$ in Venezuela to 135.2 Million US$ in Brazil. However, these figures were not standardized to make them comparable. Furthermore, dengue outbreak costs are calculated differently across the publications, and cost of dengue illness is used interchangeably with cost of dengue outbreaks. Only one paper from Australia analysed the resources saved through active dengue surveillance. Costs of vector control interventions have been reported in 4 studies, indicating that the costs of such interventions are lower than those of actual outbreaks. Nine papers focussed on the cost-effectiveness of dengue vaccines or dengue vector control; they do not provide any direct information on cost of dengue outbreaks, but their modelling methodologies could guide future research on cost-effectiveness of national surveillance systems. The country case studies – conducted in very different geographic and health system settings - unveiled rough estimates for 2011 outbreak costs of: 12 million US$ in Vietnam, 6.75 million US$ in Indonesia, 4.5 million US$ in Peru and 2.8 million US$ in Dominican Republic (all in 2012 US$). The proportions of the

  4. Breastfeeding promotion, support and protection: review of six country programmes.

    PubMed

    Mangasaryan, Nune; Martin, Luann; Brownlee, Ann; Ogunlade, Adebayo; Rudert, Christiane; Cai, Xiaodong

    2012-08-01

    Reviews of programmes in Bangladesh, Benin, the Philippines, Sri Lanka, Uganda, and Uzbekistan sought to identify health policy and programmatic factors that influenced breastfeeding practices during a 10 to 15 year period. Exclusive breastfeeding rates and trends were analysed in six countries in general and from an equity perspective in two of them. Success factors and challenges were identified in countries with improved and stagnated rates respectively. The disaggregated data analysis showed that progress may be unequal in population subgroups, but if appropriately designed and implemented, a programme can become a "health equalizer" and eliminate discrepancies among different subgroups. Success requires commitment, supportive policies, and comprehensiveness of programmes for breastfeeding promotion, protection and support. Community-based promotion and support was identified as a particularly important component. Although health workers' training on infant feeding support and counselling was prioritized, further improvement of interpersonal counselling and problem solving skills is needed. More attention is advised for pre-service education, including a stronger focus on clinical practice, to ensure knowledge and skills among all health workers. Large-scale communication activities played a significant role, but essential steps were often underemphasized, including identifying social norms and influencing factors, ensuring community participation, and testing of approaches and messages. PMID:23016128

  5. Diabetes Prevention Interventions in Latin American Countries: a Scoping Review.

    PubMed

    Heisler, Michele; Kaselitz, Elizabeth; Rana, Gurpreet K; Piette, John D

    2016-09-01

    Public policies, population health initiatives, and targeted behavioral change interventions for individuals at risk for developing diabetes are all essential for diabetes prevention in Latin American countries (LACs). This scoping review examines (1) the current evidence on diabetes prevention policies and interventions in LACs to identify components of effective diabetes prevention models in those countries and (2) effective diabetes prevention interventions targeting Latino populations in the USA to explore possible lessons from these interventions for LACs. Diabetes prevention programs in LACs evaluated to date consist of short-term health professional-led face-to-face behavioral counseling sessions. Intervention components of US-based programs for Latinos that might benefit diabetes prevention programs in Latin America include (1) deployment of community health workers ("promotoras") for diabetes screening and delivery of lifestyle modification programs, (2) multiple modes of program delivery beyond face-to-face sessions, (3) information technology to automate and enhance program delivery, (4) leveraging of pre-existing familial relationships to engage in and sustain lifestyle modifications, and (5) innovative environmental change strategies such as collaborations with local food stores and markets to promote healthy behaviors. PMID:27424069

  6. Breastfeeding Promotion, Support and Protection: Review of Six Country Programmes

    PubMed Central

    Mangasaryan, Nune; Martin, Luann; Brownlee, Ann; Ogunlade, Adebayo; Rudert, Christiane; Cai, Xiaodong

    2012-01-01

    Reviews of programmes in Bangladesh, Benin, the Philippines, Sri Lanka, Uganda, and Uzbekistan sought to identify health policy and programmatic factors that influenced breastfeeding practices during a 10 to 15 year period. Exclusive breastfeeding rates and trends were analysed in six countries in general and from an equity perspective in two of them. Success factors and challenges were identified in countries with improved and stagnated rates respectively. The disaggregated data analysis showed that progress may be unequal in population subgroups, but if appropriately designed and implemented, a programme can become a “health equalizer” and eliminate discrepancies among different subgroups. Success requires commitment, supportive policies, and comprehensiveness of programmes for breastfeeding promotion, protection and support. Community-based promotion and support was identified as a particularly important component. Although health workers’ training on infant feeding support and counselling was prioritized, further improvement of interpersonal counselling and problem solving skills is needed. More attention is advised for pre-service education, including a stronger focus on clinical practice, to ensure knowledge and skills among all health workers. Large-scale communication activities played a significant role, but essential steps were often underemphasized, including identifying social norms and influencing factors, ensuring community participation, and testing of approaches and messages. PMID:23016128

  7. Book Review: "Women Educators--Employees of Schools in Western Countries," edited by Patricia A. Schmuck.

    ERIC Educational Resources Information Center

    Lakomski, Gabriele

    1988-01-01

    Reviews "Women Educators--Employees of Schools in Western Countries" edited by Patricia A. Schmuck, a collection of 12 chapters by separate authors from various western countries that discuss women's employment in schools. (TE)

  8. Bulk charges in eleven dimensions

    NASA Astrophysics Data System (ADS)

    Hawking, S. W.; Taylor-Robinson, M. M.

    1998-07-01

    Eleven dimensional supergravity has electric type currents arising from the Chern-Simon and anomaly terms in the action. However the bulk charge integrates to zero for asymptotically flat solutions with topological trivial spatial sections. We show that by relaxing the boundary conditions to generalisations of the ALE and ALF boundary conditions in four dimensions one can obtain static solutions with a bulk charge. Solutions involving anomaly terms preserve between 1/16 and 1/4 of the supersymmetries but Chern-Simons fluxes generally break all of the remaining supersymmetry. One can introduce membranes with the same sign of charge into these backgrounds. This raises the possibility that these generalized membranes might decay quantum mechanically to leave just a bulk distribution of charge. Alternatively and more probably, a bulk distribution of charge can decay into a collection of singly charged membranes. Dimensional reductions of these solutions lead to novel representations of extreme black holes in four dimensions with up to four charges. We discuss how the eleven-dimensional Kaluza-Klein monopole wrapped around a space with non-zero first Pontryagin class picks up an electric charge proportional to the Pontryagin number.

  9. Factors affecting the use of prenatal care by non-western women in industrialized western countries: a systematic review

    PubMed Central

    2013-01-01

    Background Despite the potential of prenatal care for addressing many pregnancy complications and concurrent health problems, non-western women in industrialized western countries more often make inadequate use of prenatal care than women from the majority population do. This study aimed to give a systematic review of factors affecting non-western women’s use of prenatal care (both medical care and prenatal classes) in industrialized western countries. Methods Eleven databases (PubMed, Embase, PsycINFO, Cochrane, Sociological Abstracts, Web of Science, Women’s Studies International, MIDIRS, CINAHL, Scopus and the NIVEL catalogue) were searched for relevant peer-reviewed articles from between 1995 and July 2012. Qualitative as well as quantitative studies were included. Quality was assessed using the Mixed Methods Appraisal Tool. Factors identified were classified as impeding or facilitating, and categorized according to a conceptual framework, an elaborated version of Andersen’s healthcare utilization model. Results Sixteen articles provided relevant factors that were all categorized. A number of factors (migration, culture, position in host country, social network, expertise of the care provider and personal treatment and communication) were found to include both facilitating and impeding factors for non-western women’s utilization of prenatal care. The category demographic, genetic and pregnancy characteristics and the category accessibility of care only included impeding factors. Lack of knowledge of the western healthcare system and poor language proficiency were the most frequently reported impeding factors. Provision of information and care in women’s native languages was the most frequently reported facilitating factor. Conclusion The factors found in this review provide specific indications for identifying non-western women who are at risk of not using prenatal care adequately and for developing interventions and appropriate policy aimed at

  10. Ethical review of health research: a perspective from developing country researchers

    PubMed Central

    Hyder, A; Wali, S; Khan, A; Teoh, N; Kass, N; Dawson, L

    2004-01-01

    Background: Increasing collaboration between industrialised and developing countries in human research studies has led to concerns regarding the potential exploitation of resource deprived countries. This study, commissioned by the former National Bioethics Advisory Commission of the United States, surveyed developing country researchers about their concerns and opinions regarding ethical review processes and the performance of developing country and US international review boards (IRBs). Methods: Contact lists from four international organisations were used to identify and survey 670 health researchers in developing countries. A questionnaire with 169 questions explored issues of IRB review, informed consent, and recommendations. Results: The majority of the developing country researchers were middle aged males who were physicians and were employed by educational institutions, carrying out research on part time basis. Forty four percent of the respondents reported that their studies were not reviewed by a developing country IRB or Ministry of Health and one third of these studies were funded by the US. During the review process issues such as the need for local language consent forms and letters for approval, and confidentiality protection of participants were raised by US IRBs in significantly higher proportions than by host country IRBs. Conclusion: This survey indicates the need for the ethical review of collaborative research in both US and host countries. It also reflects a desire for focused capacity development in supporting ethical review of research. PMID:14872079

  11. Barriers to the Uptake of Eye Care Services in Developing Countries: A Systematic Review of Interventions

    ERIC Educational Resources Information Center

    Abdullah, Khadija Nowaira; Al-Sharqi, Omar Zayan; Abdullah, Muhammad Tanweer

    2013-01-01

    Objective: This research identifies effective and ineffective interventions for reducing barriers to the uptake of eye care services in developing countries. Design: Systematic literature review. Setting: Only research studies done in developing countries were included. Method: The review is restricted to English-language articles published…

  12. Thematic Review on Adult Learning: Finland. Country Note. Revised.

    ERIC Educational Resources Information Center

    Organisation for Economic Cooperation and Development, Paris (France).

    This country note analyzes main issues concerning adult learning and policy responses in Finland. Section 2 describes the political, economic, and social context in which adult learning fits. Sections 3-6 follow these four themes impinging on adult participation in learning: inadequate incentives and motivations; complex pathways between learning…

  13. Hantavirus in Indian Country: The First Decade in Review

    ERIC Educational Resources Information Center

    Pottinger, Richard

    2005-01-01

    Hantavirus, caused due to close contact with mice in a dwelling, first emerged in the spring of 1993 on the Navajo Reservation and although it is by no means an Indian disease, there are four times as many cases of hantavirus pulmonary syndrome (HPS) among non-Indians. Inadequate rural housing, especially common in western Indian Country,…

  14. Access to Elementary Education in India. Country Analytical Review

    ERIC Educational Resources Information Center

    Govinda, R.; Bandyopadhyay, Madhumita

    2008-01-01

    This analytical review aims at exploring trends in educational access and delineating different groups, which are vulnerable to exclusion from educational opportunities at the elementary stage. This review has drawn references from series of analytical papers developed on different themes i.e. regional disparity in education, social equity and…

  15. 75 FR 71068 - Eleven Point Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-22

    ...The Eleven Point Resource Advisory Committee will meet in Winona, Missouri. The committee is meeting as authorized under the Secure Rural Schools and Community Self-Determination Act (Pub. L. 110- 343) and in compliance with the Federal Advisory Committee Act. The purpose of the meeting is to review proposed forest management projects so that recommendations may be made to the Forest Service......

  16. 75 FR 28234 - Eleven Point Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-20

    ...The Eleven Point Resource Advisory Committee will meet in Winona, Missouri. The committee is meeting as authorized under the Secure Rural Schools and Community Self-Determination Act (Pub. L. 110- 343) and in compliance with the Federal Advisory Committee Act. The purpose of the meeting is to initiate review of proposed forest management projects so that recommendations may be made to the......

  17. A review of strategic environmental assessment in 12 selected countries

    SciTech Connect

    Chaker, A. . E-mail: sea@moe.gov.lb; El-Fadl, K.; Chamas, L.; Hatjian, B.

    2006-01-15

    Strategic Environmental Assessment (SEA) is acknowledged to be an important decision support tool. The increased application of its principles in countries worldwide, the introduction of SEA procedures in planning and decision-making processes of international aid and cooperation organisations, as well as the recent endorsement of two relevant legal documents in the international arena only serve to emphasise the acclaimed significance of the process. In light of the scarcity of literature exploring the practical implementation of SEA, this paper attempts to provide a comparative overview of SEA systems in 12 selected countries from their legal, institutional and procedural perspectives in order to unveil potential implementation pitfalls, obstacles and lessons learnt as well as uncertainties and lack of data for future research, replication and customisation elsewhere or refining of existing systems.

  18. Improving mental health among people living with HIV: a review of intervention trials in low- and middle-income countries

    PubMed Central

    Sikkema, Kathleen J.; Dennis, Alexis C.; Watt, Melissa. H.; Choi, Karmel W.; Yemeke, Tatenda T.; Joska, John A.

    2015-01-01

    People living with HIV (PLWH) experience greater psychological distress than the general population. Evidence from high-incomes countries suggests that psychological interventions for PLWH can improve mental health symptoms, quality of life, and HIV care engagement. However, little is known about the effectiveness of mental health interventions for PLWH in low and middle-income countries (LMICs), where the large majority of PLWH reside. This systematized review aims to synthesize findings from mental health intervention trials with PLWH in LMICs to inform the delivery of mental health services in these settings. A systematic search strategy was undertaken to identify peer-reviewed published papers of intervention trials addressing negative psychological states or disorders (e.g., depression, anxiety) among PLWH in LMIC settings. Search results were assessed against pre-established inclusion and exclusion criteria. Data from papers meeting criteria were extracted for synthesis. Twenty-six papers, published between 2000 and 2014, describing 22 unique interventions were identified. Trials were implemented in sub-Saharan Africa (n=13), Asia (n=7), and the Middle East (n=2), and addressed mental health using a variety of approaches, including cognitive-behavioral (n=18), family-level (n=2), and pharmacological (n=2) treatments. Four randomized controlled trials reported significant intervention effects in mental health outcomes, and eleven preliminary studies demonstrated promising findings. Among the limited mental health intervention trials with PLWH in LMICs, few demonstrated efficacy. Mental health interventions for PLWH in LMICs must be further developed and adapted for resource-limited settings to improve effectiveness. PMID:26435843

  19. Microgrid Policy Review of Selected Major Countries, Regions, and Organizations

    SciTech Connect

    Qu, Min; Marnay, Chris; Zhou, Nan

    2011-11-30

    This report collects and reviews policies and regulations related to microgrid development, and is intended as a reference. The material is divided into three parts under five dimensions: interconnection, RD&D, tariff policy, other policies, and recommendations.

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

    PubMed

    Bittner, Martin-Immanuel; Donnelly, Maria; van Zanten, Arthur Rh; Andersen, Jakob Steen; Guidet, Bertrand; Trujillano Cabello, Jose Javier; Gardiner, Shane; Fitzpatrick, Gerard; Winter, Bob; Joannidis, Michael; Schmutz, Axel

    2013-01-01

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

  1. Minerals Yearbook, 1988. The mineral industries of the Arabian Peninsula and Persian Gulf countries. International review

    SciTech Connect

    Michalski, B.; Antonides, L.E.; Morgan, G.A.

    1988-01-01

    The document contains commodity reviews (metals, mineral fuels, industrial minerals where applicable) for the following countries: Bahrain, Iran, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, United Arab Emirates, People's Democratic Republic of Yeman, and Yeman Arab Republic.

  2. Thematic Review on Adult Learning: Canada. Country Note. Revised.

    ERIC Educational Resources Information Center

    Organisation for Economic Cooperation and Development, Paris (France).

    This document analyzes main issues concerning adult learning and policy responses in Canada. Section 1 introduces a background report (available separately), discussions with stakeholders, and site visits. Section 2 addresses the general context of adult education (AE). Sections 3-6 cover four themes that structure the Thematic Review of Adult…

  3. OECD Review of Career Guidance Policies. Netherlands: Country Note.

    ERIC Educational Resources Information Center

    Organisation for Economic Cooperation and Development, Paris (France).

    The Netherlands' career guidance system and policies were evaluated. Data were collected through meetings with policymakers and guidance practitioners in the public and private sectors, analysis of data from a national questionnaire, and a review of pertinent documentation. The evaluation focused on the following areas: markets and the role of…

  4. A systematic review of responsive feeding and child obesity in high-income countries

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Child overweight/obesity continues to be a serious public health problem in high-income countries. The current review had 3 goals: 1) to summarize the associations between responsive feeding and child weight status in high-income countries; 2) to describe existing responsive feeding measures; and 3)...

  5. A Hidden Twelve-Dimensional SuperPoincare Symmetry In Eleven Dimensions

    SciTech Connect

    Bars, Itzhak; Deliduman, Cemsinan; Pasqua, Andrea; Zumino, Bruno

    2003-12-13

    First, we review a result in our previous paper, of how a ten-dimensional superparticle, taken off-shell, has a hidden eleven-dimensional superPoincare symmetry. Then, we show that the physical sector is defined by three first-class constraints which preserve the full eleven-dimensional symmetry. Applying the same concepts to the eleven dimensional superparticle, taken off-shell, we discover a hidden twelve dimensional superPoincare symmetry that governs the theory.

  6. Peer Support and Exclusive Breastfeeding Duration in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis

    PubMed Central

    Sudfeld, Christopher R.; Fawzi, Wafaie W.; Lahariya, Chandrakant

    2012-01-01

    Objective To examine the effect of peer support on duration of exclusive breastfeeding (EBF) in low and middle-income countries (LMICs). Data Sources Medline, EMBASE, and Cochrane Central Register for Controlled Trials were searched from inception to April 2012. Methods Two authors independently searched, reviewed, and assessed the quality of randomized controlled trials utilizing peer support in LMICs. Meta-analysis and metaregression techniques were used to produce pooled relative risks and investigate sources of heterogeneity in the estimates. Results Eleven randomized controlled trials conducted at 13 study sites met the inclusion criteria for systematic review. We noted significant differences in study populations, peer counselor training methods, peer visit schedule, and outcome ascertainment methods. Peer support significantly decreased the risk of discontinuing EBF as compared to control (RR: 0.71; 95% CI: 0.61–0.82; I2 = 92%). The effect of peer support was significantly reduced in settings with >10% community prevalence of formula feeding as compared to settings with <10% prevalence (p = 0.048). There was no evidence of effect modification by inclusion of low birth weight infants (p = 0.367) and no difference in the effect of peer support on EBF at 4 versus 6 months postpartum (p = 0.398). Conclusions Peer support increases the duration of EBF in LMICs; however, the effect appears to be reduced in formula feeding cultures. Future studies are needed to determine the optimal timing of peer visits, how to best integrate peer support into packaged intervention strategies, and the effectiveness of supplemental interventions to peer support in formula feeding cultures. PMID:23028810

  7. Barriers and Facilitators to HIV Testing in Migrants in High-Income Countries: A Systematic Review.

    PubMed

    Blondell, Sarah J; Kitter, Bryony; Griffin, Mark P; Durham, Jo

    2015-11-01

    Migrants, particularly from low- and middle-income countries, are at a heightened risk of adverse HIV outcomes. HIV testing may improve these outcomes. We reviewed and synthesised studies into migrants and HIV testing (outcome variable), published between January 1997 and April 2014. Papers using quantitative, qualitative and mixed methods designs, and samples with adult (≥18 years) migrants from low- and middle-income countries in high-income countries were included in the paper. Of 3155 papers retrieved, 31 met the inclusion criteria and are included in the review. A large number of barriers and facilitators to HIV testing were identified across the individual, social and structural levels. A number of study design and methodological issues, however, inhibited a comprehensive synthesis. There is no doubt that addressing HIV testing in migrants in high-income countries is complex; however, it has important implications for individual, community and population health, and a strong, empirically based response is warranted. PMID:26025193

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

    PubMed Central

    2013-01-01

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

  9. Review of the current use and evaluation of cell substrates for producing biologicals in selected countries.

    PubMed

    Kang, Hye-Na; Xu, Miao; Rodríguez, Violeta Pérez; Mefed, Kirill; Hanada, Kentaro; Ahn, Kwang-Soo; Gangakhedkar, Shri Jayant; Pakzad, Saeed Reza; Prawahju, Elizabeth Ika; Lee, Naery; Phumiamorn, Supaporn; Nemec, Martin; Meng, Shufang; Knezevic, Ivana

    2015-05-01

    In 2010, the WHO guidance document for the evaluation of cell substrates for producing biologicals was replaced with updated recommendations and in May 2013 an implementation workshop on the new recommendations was held in Beijing, China. As part of this workshop, a survey of the use and evaluation of cell substrates for producing biologicals was undertaken and the information obtained was updated in June 2014. The purpose of survey was to capture the status of national requirements related to cell substrates in various countries with particular emphasis on whether or not the updated WHO recommendations had been, or were to be, incorporated into national requirements. This paper reports the outcome of the survey and is based on information provided by regulators in eleven countries. Since the publication of the updated WHO recommendations, several activities such as the implementation workshop and publications have been undertaken by the WHO. The aim of these activities, including the publication of this article, is to contribute to the implementation of WHO recommendations so as to reduce regulatory gaps between national requirements and globally agreed expectations. PMID:25707711

  10. Access to Orphan Drugs: A Comprehensive Review of Legislations, Regulations and Policies in 35 Countries

    PubMed Central

    Gammie, Todd

    2015-01-01

    Objective To review existing regulations and policies utilised by countries to enable patient access to orphan drugs. Methods A review of the literature (1998 to 2014) was performed to identify relevant, peer-reviewed articles. Using content analysis, we synthesised regulations and policies for access to orphan drugs by type and by country. Results Fifty seven articles and 35 countries were included in this review. Six broad categories of regulation and policy instruments were identified: national orphan drug policies, orphan drug designation, marketing authorization, incentives, marketing exclusivity, and pricing and reimbursement. The availability of orphan drugs depends on individual country’s legislation and regulations including national orphan drug policies, orphan drug designation, marketing authorization, marketing exclusivity and incentives such as tax credits to ensure research, development and marketing. The majority of countries (27/35) had in place orphan drug legislation. Access to orphan drugs depends on individual country’s pricing and reimbursement policies, which varied widely between countries. High prices and insufficient evidence often limit orphan drugs from meeting the traditional health technology assessment criteria, especially cost-effectiveness, which may influence access. Conclusions Overall many countries have implemented a combination of legislations, regulations and policies for orphan drugs in the last two decades. While these may enable the availability and access to orphan drugs, there are critical differences between countries in terms of range and types of legislations, regulations and policies implemented. Importantly, China and India, two of the largest countries by population size, both lack national legislation for orphan medicines and rare diseases, which could have substantial negative impacts on their patient populations with rare diseases. PMID:26451948

  11. 75 FR 38457 - Eleven Point Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-02

    ... Forest Service Eleven Point Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eleven Point Resource Advisory Committee will meet in Winona, Missouri. The... the building. FOR FURTHER INFORMATION CONTACT: Richard Hall, Eleven Point Resource Advisory...

  12. 76 FR 16726 - Eleven Point Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ... Forest Service Eleven Point Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eleven Point Resource Advisory Committee will meet in Winona, Missouri. The... the building. FOR FURTHER INFORMATION CONTACT: Richard Hall, Eleven Point Resource Advisory...

  13. The impact of migration on tuberculosis epidemiology and control in high-income countries: a review.

    PubMed

    Pareek, Manish; Greenaway, Christina; Noori, Teymur; Munoz, Jose; Zenner, Dominik

    2016-01-01

    Tuberculosis (TB) causes significant morbidity and mortality in high-income countries with foreign-born individuals bearing a disproportionate burden of the overall TB case burden in these countries. In this review of tuberculosis and migration we discuss the impact of migration on the epidemiology of TB in low burden countries, describe the various screening strategies to address this issue, review the yield and cost-effectiveness of these programs and describe the gaps in knowledge as well as possible future solutions.The reasons for the TB burden in the migrant population are likely to be the reactivation of remotely-acquired latent tuberculosis infection (LTBI) following migration from low/intermediate-income high TB burden settings to high-income, low TB burden countries.TB control in high-income countries has historically focused on the early identification and treatment of active TB with accompanying contact-tracing. In the face of the TB case-load in migrant populations, however, there is ongoing discussion about how best to identify TB in migrant populations. In general, countries have generally focused on two methods: identification of active TB (either at/post-arrival or increasingly pre-arrival in countries of origin) and secondly, conditionally supported by WHO guidance, through identifying LTBI in migrants from high TB burden countries. Although health-economic analyses have shown that TB control in high income settings would benefit from providing targeted LTBI screening and treatment to certain migrants from high TB burden countries, implementation issues and barriers such as sub-optimal treatment completion will need to be addressed to ensure program efficacy. PMID:27004556

  14. Inflation, singular instantons, and eleven dimensional cosmology

    NASA Astrophysics Data System (ADS)

    Hawking, S. W.; Reall, Harvey S.

    1999-01-01

    We investigate cosmological solutions of eleven dimensional supergravity compactified on a squashed seven manifold. The effective action for the four dimensional theory contains scalar fields describing the size and squashing of the compactifying space. The potential for these fields consists of a sum of exponential terms. At early times only one such term is expected to dominate. The condition for an exponential potential to admit inflationary solutions is derived and it is shown that inflation is not possible in our model. The criterion for an exponential potential to admit a Hawking-Turok instanton is also derived. It is shown that the instanton remains singular in eleven dimensions.

  15. A comprehensive review of the epidemiology and disease burden of Influenza B in 9 European countries.

    PubMed

    Tafalla, Monica; Buijssen, Marleen; Geets, Régine; Vonk Noordegraaf-Schouten, Marije

    2016-04-01

    This review was undertaken to consolidate information on the epidemiology and burden of influenza B, as well as the circulation patterns of influenza B lineage in 9 European countries. Following a comprehensive search of peer-reviewed and gray literature sources, we found that published data on influenza B epidemiology and burden are scarce. Surveillance data show frequent co-circulation of both influenza B lineages during influenza seasons, but little is known about its impact, especially in adults and the clinical burden of influenza B remains unknown. Mismatch between the circulating influenza B lineage and vaccine recommendations has been seen in at least one influenza season in every country. Such observations could impact the effectiveness of seasonal influenza vaccination programs using trivalent vaccines, which contain only one influenza B lineage (B/Yamagata or B/Victoria) and highlight the need for local studies to better understand the epidemiology and burden of influenza B in these countries. PMID:26890005

  16. Maternal mortality surveillance and maternal death reviews in countries of the Eastern Mediterranean Region.

    PubMed

    Chichakli, L O; Atrash, H K; Musani, A S; Mahaini, R; Arnaoute, S

    2000-07-01

    This paper presents the findings of a 1999 survey of 19 countries of the World Health Organization Eastern Mediterranean Region on maternal mortality surveillance systems and death review activities in the Region. Data were collected by questionnaire completed by ministry of health personnel. The findings show that 13 countries require official reporting of deaths of women of reproductive age. Most of the countries conduct maternal death reviews although only 8 have surveillance systems. Other areas investigated were the sources of information on maternal deaths, types of data collected, how the data are analysed and how such data are used. There is a need to strengthen information systems on maternal mortality in the Region in order to guide decision-makers in the planning and evaluation of maternal health programmes. PMID:11794068

  17. A comprehensive review of the epidemiology and disease burden of Influenza B in 9 European countries

    PubMed Central

    Tafalla, Monica; Buijssen, Marleen; Geets, Régine; Vonk Noordegraaf-Schouten, Marije

    2016-01-01

    abstract This review was undertaken to consolidate information on the epidemiology and burden of influenza B, as well as the circulation patterns of influenza B lineage in 9 European countries. Following a comprehensive search of peer-reviewed and gray literature sources, we found that published data on influenza B epidemiology and burden are scarce. Surveillance data show frequent co-circulation of both influenza B lineages during influenza seasons, but little is known about its impact, especially in adults and the clinical burden of influenza B remains unknown. Mismatch between the circulating influenza B lineage and vaccine recommendations has been seen in at least one influenza season in every country. Such observations could impact the effectiveness of seasonal influenza vaccination programs using trivalent vaccines, which contain only one influenza B lineage (B/Yamagata or B/Victoria) and highlight the need for local studies to better understand the epidemiology and burden of influenza B in these countries. PMID:26890005

  18. Quality Review in Distance Learning: Policy and Practice in Five Countries

    ERIC Educational Resources Information Center

    Middlehurst, Robin; Woodfield, Steve

    2006-01-01

    This paper is a contribution to knowledge sharing in the field of distance learning. It presents and discusses the findings of a study on the quality review of distance learning in a sample of five countries. The study was commissioned by the Council for Higher Education Accreditation's (CHEA) International Commission in order to understand better…

  19. Access to Education in Bangladesh: Country Analytic Review of Primary and Secondary School

    ERIC Educational Resources Information Center

    Ahmed, Manzoor; Ahmed, Kazi Saleh; Khan, Nurul Islam; Ahmed, Romij

    2007-01-01

    This country analytical review examines the key issues in access to and participation in primary and secondary education in Bangladesh, with a special focus on areas and dimensions of exclusion. Against a background of overall progress, particularly in closing the gender gap in primary and secondary enrollment, the research applies a conceptual…

  20. International Quality Review and Distance Learning: Lessons from Five Countries. CHEA Occasional Paper

    ERIC Educational Resources Information Center

    Middlehurst, Robin; Woodfield, Steve

    2004-01-01

    This is a report on the quality review of distance learning in a sample of five countries. The report was commissioned by the Council for Higher Education Accreditation's (CHEA's) International Commission in order to understand better the nature of existing regulatory arrangements in the context of growth in electronically supported learning and…

  1. The Somalia Country Case Study. Mid-Decade Review of Progress towards Education for All.

    ERIC Educational Resources Information Center

    Bennaars, Gerard A.; Seif, Huda A.; Mwangi, Doris

    In 1995, the International Consultative Forum on Education for All commissioned case studies in developing countries as part of a mid-decade review of progress in expanding access to basic education. This paper examines the situation in Somalia, where civil war has completely destroyed the infrastructure of education. Part 1 summarizes Somalia's…

  2. The Determinants of School Achievement in Developing Countries: A Review of the Research.

    ERIC Educational Resources Information Center

    Simmons, John; Alexander, Leigh

    The goal of the review is to identify the factors which promote student cognitive achievement as measured by several studies conducted in developing countries. The major tool of analysis which measures the relationship between the school inputs, like teacher quality and school facilities, and cognitive achievement is the educational production…

  3. The Real World of Performance Indicators. A Review of Their Use in Selected Commonwealth Countries.

    ERIC Educational Resources Information Center

    David, Dorothy

    This document reviews how performance indicators are currently being used in several Commonwealth countries the United Kingdom, Australia, and Canada, and identifies some of the issues associated with performance indicator development and application. It also examines whether there are any agreed upon "key", or common, indicators that can be…

  4. Wellbeing Research in Developing Countries: Reviewing the Role of Qualitative Methods

    ERIC Educational Resources Information Center

    Camfield, Laura; Crivello, Gina; Woodhead, Martin

    2009-01-01

    The authors review the contribution of qualitative methods to exploring concepts and experiences of wellbeing among children and adults living in developing countries. They provide examples illustrating the potential of these methods for gaining a holistic and contextual understanding of people's perceptions and experiences. Some of these come…

  5. Fuel properties of eleven vegetable oils

    SciTech Connect

    Goering, C.E.; Schwab, A.W.; Daugherty, M.J.; Pryde, E.H.; Keakin, A.J.

    1981-01-01

    Eleven vegetable oils that can be grown as domestic field crops were identified for inclusion in a comparative study. Sample lots of each oil were subjected to ASTM tests appropriate for diesel fuels. The tests identified some problem areas with vegetable oil fuels. The oil samples were also characterized chemically and certain fuel properties were correlated to chemical composition. 10 refs.

  6. CEP's Eleven Principles of Effective Character Education

    ERIC Educational Resources Information Center

    Lickona, Tom; Schaps, Eric; Lewis, Catherine

    2007-01-01

    There is no single script for effective character education, but there are some important basic principles. This document presents eleven principles that schools and other groups can use to plan a character education effort and to evaluate available character education programs: (1) Promotes core ethical values and supportive performance values as…

  7. A review of the infection-associated cancers in North African countries.

    PubMed

    Hussein, Wafaa Mohamed; Anwar, Wagida A; Attaleb, Mohammed; Mazini, Loubna; Försti, Asta; Trimbitas, Roxana-Delia; Khyatti, Meriem

    2016-01-01

    Cancer is typically classified as a leading non-communicable disease; however, infectious agents, such as Helicobacter pylori (H. pylori), hepatitis B virus (HBV), hepatitis C virus (HCV) and human papilloma virus (HPV), contribute significantly to the pathogenesis of various cancers. Less developed countries, including countries of the North African (NA) region, endure the highest burden of infection-related cancers. The five most common infection-associated cancers in NA in order of incidence are bladder cancer, cervical cancer, liver cancer, stomach cancer, and nasopharyngeal carcinoma. This review aims to outline the epidemiologic pattern of infection-associated cancers in five NA countries (namely: Morocco, Algeria, Tunisia, Libya and Egypt) highlighting the similarities and differences across the region. The present study employed an initial literature review of peer-reviewed articles selected from PubMed, ScienceDirect and World Health Organization (WHO) databases based on key word searches without restriction on publication dates. Original research articles and reports written in French, as well as data from institutional reports and regional meeting abstracts were also included in this extensive review. Egypt, Libya, Tunisia, Algeria and Morocco were selected to be the focus of this review. PMID:27512409

  8. Dengue viral infections in Pakistan and other Asian countries: a comprehensive review.

    PubMed

    Zubair, Muhammad; Ashraf, Muhammad; Ahsan, Aitezaz; Nazir, Noor-Ul-Ain; Hanif, Hina; Khan, Haider Ali

    2016-07-01

    Infections due to Dengue virus are widespread throughout the world. Disease starts with mild flu like sickness to a severe intricate condition which results in the death of the patient. Dengue illness has high morbidity and mortality in Pakistan as well as in other Asian countries. The Review article is a discourse analysis that explores the facts about the history, emergence and impact of dengue in Pakistan and other Asian countries. Data was collected from internet sources, mainly using Science Direct and PubMed. The final literature was reviewed and summarised. About 150 articles were identified and 47 articles were shortlisted for final review. Aedesaegypti was found to be a major vector for the transmission and spread of dengue illness. Treatment comprises supportive therapy as no specific treatment was available. During the last couple of years, the incidence of dengue fever was extraordinary in metropolitan cities of Pakistan. PMID:27427141

  9. Interventions to Prevent Child Marriage Among Young People in Low- and Middle-Income Countries: A Systematic Review of the Published and Gray Literature.

    PubMed

    Kalamar, Amanda M; Lee-Rife, Susan; Hindin, Michelle J

    2016-09-01

    Child marriage, defined as marriage before the age of 18 years, is a human rights violation that can have lasting adverse educational and economic impacts. The objective of this review was to identify high-quality interventions and evaluations to decease child marriage in low- and middle-income countries. PubMed, Embase, PsycInfo, CINAHL Plus, Popline, and the Cochrane Databases were searched without language limitations for articles published through November 2015. Gray literature was searched by hand. Reference tracing was used, as well as the unpacking of systematic reviews. Retained articles were those that were evaluated as having high-quality interventions and evaluations using standardized scoring. Eleven high-quality interventions and evaluations were abstracted. Six found positive results in decreasing the proportion married or increasing age at marriage, one had both positive and negative findings, and four had no statistical impact on the proportion married or age at marriage. There is wide range of high-quality, impactful interventions included in this review which can inform researchers, donors, and policy makers about where to make strategic investments to eradicate marriage, a current target of the Sustainable Development Goals. Despite the cultural factors that promote child marriage, the diversity of interventions can allow decision makers to tailor interventions to the cultural context of the target population. PMID:27562449

  10. mHealth Interventions in Low and Middle-Income Countries: A Systematic Review.

    PubMed

    Hurt, Kathryn; Walker, Rebekah J; Campbell, Jennifer A; Egede, Leonard E

    2016-01-01

    The purpose of this review was to determine whether mHealth interventions were effective in low- and middle-income countries in order to create a baseline for the evidence to support mHealth in developing countries. Studies were identified by searching Medline on 02 October 2014 for articles published in the English language between January 2000 and September 2014. Inclusion criteria were: 1) written in English, 2) completion of an mHealth intervention in a low or middle-income country, 3) measurement of patient outcomes, and 4) participants 18 years of age or older. 7,920 titles were reviewed and 7 were determined eligible based on inclusion criteria. Interventions included a cluster randomized trial, mixed methods study, retrospective comparison of an opt-in text message program, a two-arm proof of concept, single arm trial, a randomized trial, and a single subject design. Five out of seven of the studies showed significant difference between the control and intervention. Currently there is little evidence on mHealth interventions in developing countries, and existing studies are very diverse; however initial studies show changes in clinical outcomes, adherence, and health communication, including improved communication with providers, decrease in travel time, ability to receive expert advice, changes in clinical outcomes, and new forms of cost-effective education. While this initial review is promising, more evidence is needed to support and direct system-level resource investment. PMID:27157176

  11. Socioeconomic status and obesity in adult populations of developing countries: a review.

    PubMed Central

    Monteiro, Carlos A.; Moura, Erly C.; Conde, Wolney L.; Popkin, Barry M.

    2004-01-01

    A landmark review of studies published prior to 1989 on socioeconomic status (SES) and obesity supported the view that obesity in the developing world would be essentially a disease of the socioeconomic elite. The present review, on studies conducted in adult populations from developing countries, published between 1989 and 2003, shows a different scenario for the relationship between SES and obesity. Although more studies are necessary to clarify the exact nature of this relationship, particularly among men, three main conclusions emerge from the studies reviewed: 1. Obesity in the developing world can no longer be considered solely a disease of groups with higher SES. 2. The burden of obesity in each developing country tends to shift towards the groups with lower SES as the country's gross national product (GNP) increases. 3. The shift of obesity towards women with low SES apparently occurs at an earlier stage of economic development than it does for men. The crossover to higher rates of obesity among women of low SES is found at a GNP per capita of about US$ 2500, the mid-point value for lower-middle-income economies. The results of this review reinforce the urgent need to: include obesity prevention as a relevant topic on the public health agenda in developing countries; improve the access of all social classes in these countries to reliable information on the determinants and consequences of obesity; and design and implement consistent public actions on the physical, economic, and sociocultural environment that make healthier choices concerning diet and physical activity feasible for all. A significant step in this direction was taken with the approval of the Global Strategy on Diet, Physical Activity and Health by the World Health Assembly in May 2004. PMID:15654409

  12. Fuel properties of eleven vegetable oils

    SciTech Connect

    Goering, C.E.; Schwab, A.W.; Daugherty, M.J.; Pryde, E.H.; Heakin, A.J.

    1982-01-01

    Eleven vegetable oils that can be grown as domestic field crops were identified for inclusion in a comparative study of chemical and fuel properties. Sample lots of each oil were subjected to ASTM tests appropriate for diesel fuels. The tests identified some problem areas with vegetable oil fuels. The oil samples were also characterized chemically and certain fuel properties were correlated to chemical compositions. (Refs. 11).

  13. Brain Gains: a literature review of medical missions to low and middle-income countries

    PubMed Central

    2012-01-01

    Background Healthcare professionals’ participation in short-term medical missions to low and middle income countries (LMIC) to provide healthcare has become common over the past 50 years yet little is known about the quantity and quality of these missions. The aim of this study was to review medical mission publications over 25 years to better understand missions and their potential impact on health systems in LMICs. Methods A literature review was conducted by searching Medline for articles published from 1985–2009 about medical missions to LMICs, revealing 2512 publications. Exclusion criteria such as receiving country and mission length were applied, leaving 230 relevant articles. A data extraction sheet was used to collect information, including sending/receiving countries and funding source. Results The majority of articles were descriptive and lacked contextual or theoretical analysis. Most missions were short-term (1 day – 1 month). The most common sending countries were the U.S. and Canada. The top destination country was Honduras, while regionally Africa received the highest number of missions. Health care professionals typically responded to presenting health needs, ranging from primary care to surgical relief. Cleft lip/palate surgeries were the next most common type of care provided. Conclusions Based on the articles reviewed, there is significant scope for improvement in mission planning, monitoring and evaluation as well as global and/or national policies regarding foreign medical missions. To promote optimum performance by mission staff, training in such areas as cross-cultural communication and contextual realities of mission sites should be provided. With the large number of missions conducted worldwide, efforts to ensure efficacy, harmonisation with existing government programming and transparency are needed. PMID:22643123

  14. The Impact of Mobile Health Interventions on Chronic Disease Outcomes in Developing Countries: A Systematic Review

    PubMed Central

    Lee, Allison G.; Willner, Jonathan M.; Jahangir, Eiman; Ciapponi, Agustín; Rubinstein, Adolfo

    2014-01-01

    Abstract Introduction: Rates of chronic diseases will continue to rise in developing countries unless effective and cost-effective interventions are implemented. This review aims to discuss the impact of mobile health (m-health) on chronic disease outcomes in low- and middle-income countries (LMIC). Materials and Methods: Systematic literature searches were performed using CENTRAL, MEDLINE, EMBASE, and LILACS databases and gray literature. Scientific literature was searched to identify controlled studies evaluating cell phone voice and text message interventions to address chronic diseases in adults in low- or middle-income countries. Outcomes measured included morbidity, mortality, hospitalization rates, behavioral or lifestyle changes, process of care improvements, clinical outcomes, costs, patient–provider satisfaction, compliance, and health-related quality of life (HRQoL). Results: From the 1,709 abstracts retrieved, 163 articles were selected for full text review, including 9 randomized controlled trials with 4,604 participants. Most of the studies addressed more than one outcome. Of the articles selected, six studied clinical outcomes, six studied processes of care, three examined healthcare costs, and two examined HRQoL. M-health positively impacted on chronic disease outcomes, improving attendance rates, clinical outcomes, and HRQoL, and was cost-effective. Conclusions: M-health is emerging as a promising tool to address access, coverage, and equity gaps in developing countries and low-resource settings. The results for m-health interventions showed a positive impact on chronic diseases in LMIC. However, a limiting factor of this review was the relatively small number of studies and patients enrolled, highlighting the need for more rigorous research in this area in developing countries. PMID:24205809

  15. 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

  16. HIV testing and counselling for migrant populations living in high-income countries: a systematic review

    PubMed Central

    Monge, Susana; Azcoaga, Amaya; Rio, Isabel; Hernando, Victoria; Gonzalez, Cristina; Alejos, Belen; Caro, Ana Maria; Perez-Cachafeiro, Santiago; Ramirez-Rubio, Oriana; Bolumar, Francisco; Noori, Teymur; Del Amo, Julia

    2013-01-01

    Background: The barriers to HIV testing and counselling that migrants encounter can jeopardize proactive HIV testing that relies on the fact that HIV testing must be linked to care. We analyse available evidence on HIV testing and counselling strategies targeting migrants and ethnic minorities in high-income countries. Methods: Systematic literature review of the five main databases of articles in English from Europe, North America and Australia between 2005 and 2009. Results: Of 1034 abstracts, 37 articles were selected. Migrants, mainly from HIV-endemic countries, are at risk of HIV infection and its consequences. The HIV prevalence among migrants is higher than the general population’s, and migrants have higher frequency of delayed HIV diagnosis. For migrants from countries with low HIV prevalence and for ethnic minorities, socio-economic vulnerability puts them at risk of acquiring HIV. Migrants have specific legal and administrative impediments to accessing HIV testing—in some countries, undocumented migrants are not entitled to health care—as well as cultural and linguistic barriers, racism and xenophobia. Migrants and ethnic minorities fear stigma from their communities, yet community acceptance is key for well-being. Conclusions: Migrants and ethnic minorities should be offered HIV testing, but the barriers highlighted in this review may deter programs from achieving the final goal, which is linking migrants and ethnic minorities to HIV clinical care under the public health perspective. PMID:23002238

  17. Suicide and poverty in low-income and middle-income countries: a systematic review.

    PubMed

    Iemmi, Valentina; Bantjes, Jason; Coast, Ernestina; Channer, Kerrie; Leone, Tiziana; McDaid, David; Palfreyman, Alexis; Stephens, Bevan; Lund, Crick

    2016-08-01

    Suicide is the 15th leading cause of death worldwide, with over 75% of suicides occurring in low-income and middle-income countries. Nonetheless, evidence on the association between suicide and poverty in low-income and middle-income countries is scarce. We did a systematic review to understand the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries. We included studies testing the association between suicidal ideations and behaviours and economic poverty in low-income and middle-income countries using bivariate or multivariate analysis and published in English between January, 2004, and April, 2014. We identified 37 studies meeting these inclusion criteria. In 18 studies reporting the association between completed suicide and poverty, 31 associations were explored. The majority reported a positive association. Of the 20 studies reporting on the relationship between non-fatal suicidal ideations and behaviours and poverty, 36 associations were explored. Again, almost all studies reported a positive association. However, when considering each poverty dimension separately, we found substantial variations. These findings show a consistent trend at the individual level indicating that poverty, particularly in the form of worse economic status, diminished wealth, and unemployment is associated with suicidal ideations and behaviours. At the country level, there are insufficient data to draw clear conclusions. Available data show a potential benefit in addressing economic poverty within suicide prevention strategies, with particular attention to both chronic poverty and acute economic events. PMID:27475770

  18. 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.

  19. Status of India's population education programme--the subject of tripartite projects review and annual country review.

    PubMed

    1981-12-01

    A 3-step monitoring of India's population education program was undertaken in 1981 in order to determine the level of implementation and progress of the program. This monitoring program, conducted by the Unesco Mobile Team in collaboration with other institutions, followed 3 procedures: Project Progress Report (PPR); Tripartite Project Review (TPR); and Annual Country Review (ACR). The review meetings of the 10 state population education projects were organized at Chandigarh and Madras during August. The states covered in the review were Bihar, Haryana, Madhaya Pradesh, Punjab, Rajasthan, Chandigarh, Gujarat, Karnataka, Maharashtra, and Tamil Nadu. The Tripartite Review identified the following as problems which were hindering the smooth implementation of the population education program: 1) difficulty in spending funds unless certain formalities were completed by the governments of the states; 2) administrative problems such as getting printing paper for instructional materials, waiving the sales tax for equipment to be purchased under the project, and uncertainty regarding the admissible rates of per diem to be paid to the participants in various training programs; 3) the lack of experience of project staff; 4) problems created by having more than 1 cell in a state such as Rajasthan; and 5) an inadequate time frame within which the project should complete all its activities and make population education an integral part of the school system. The following were among the recommendations made: 1) the Project should be made coterminous with the 6th Five-Year Plan up to March 31, 1985; and 2) there should be only 1 Population Education Cell in every state. Among the points discussed at the annual country review, held during October, were the following: rephasing of the program from a 3 to 5 year project to synchronize it with the 6th plan; and the need for additional funds in view of inflation. PMID:12264113

  20. Provider payment in community-based health insurance schemes in developing countries: a systematic review

    PubMed Central

    Robyn, Paul Jacob; Sauerborn, Rainer; Bärnighausen, Till

    2013-01-01

    Objectives Community-based health insurance (CBI) is a common mechanism to generate financial resources for health care in developing countries. We review for the first time provider payment methods used in CBI in developing countries and their impact on CBI performance. Methods We conducted a systematic review of the literature on provider payment methods used by CBI in developing countries published up to January 2010. Results Information on provider payment was available for a total of 32 CBI schemes in 34 reviewed publications: 17 schemes in South Asia, 10 in sub-Saharan Africa, 4 in East Asia and 1 in Latin America. Various types of provider payment were applied by the CBI schemes: 17 used fee-for-service, 12 used salaries, 9 applied a coverage ceiling, 7 used capitation and 6 applied a co-insurance. The evidence suggests that provider payment impacts CBI performance through provider participation and support for CBI, population enrolment and patient satisfaction with CBI, quantity and quality of services provided and provider and patient retention. Lack of provider participation in designing and choosing a CBI payment method can lead to reduced provider support for the scheme. Conclusion CBI schemes in developing countries have used a wide range of provider payment methods. The existing evidence suggests that payment methods are a key determinant of CBI performance and sustainability, but the strength of this evidence is limited since it is largely based on observational studies rather than on trials or on quasi-experimental research. According to the evidence, provider payment can affect provider participation, satisfaction and retention in CBI; the quantity and quality of services provided to CBI patients; patient demand of CBI services; and population enrollment, risk pooling and financial sustainability of CBI. CBI schemes should carefully consider how their current payment methods influence their performance, how changes in the methods could improve

  1. Chronic Pain Without Clear Etiology in Low- and Middle-Income Countries: A Narrative Review.

    PubMed

    Jackson, Tracy; Thomas, Sarah; Stabile, Victoria; Han, Xue; Shotwell, Matthew; McQueen, K A Kelly

    2016-06-01

    Globally, 8 of the top 12 disabling conditions are related either to chronic pain or to the psychological conditions strongly associated with persistent pain. In this narrative review, we explore the demographic and psychosocial associations with chronic pain exclusively from low- and middle-income countries (LMICs) and compare them with current global data. One hundred nineteen publications in 28 LMICs were identified for review; associations with depression, anxiety, posttraumatic stress, insomnia, disability, gender, age, rural/urban location, education level, income, and additional sites of pain were analyzed for each type of chronic pain without clear etiology. Of the 119 publications reviewed, pain was described in association with disability in 50 publications, female gender in 40 publications, older age in 34 publications, depression in 36 publications, anxiety in 19 publications, and multiple somatic complaints in 13 publications. Women, elderly patients, and workers, especially in low-income and low-education subgroups, were more likely to have pain in multiple sites, mood disorders, and disabilities. In high-income countries, multisite pain without etiology, female gender, and association with mood disturbance and disability may be suggestive of a central sensitization syndrome (CSS). Because each type of prevalent chronic pain without known etiology reviewed had similar associations in LMICs, strategies for assessment and treatment of chronic pain worldwide should consider the possibility of prevalent CSS. Recognition is especially critical in resource-poor areas, because treatment of CSS is vastly different than localized chronic pain. PMID:27195643

  2. Eleven theses of general systems theory (GST)

    SciTech Connect

    Waelchli, F.

    1992-12-31

    This paper chronicles an effort to distill and order (for purposes of discussion and elaboration) frequently mentioned and significant ideas encountered in the literature of General Systems theory (GST). The product is a set of eleven theses, representing the author`s selection and collation of seminal and recurrent GST themes. The author argues that attention to theory could aid the effort to develop practical applications of systems thinking. (Remember that a thesis is a statement or assertion, offered originally without proof, as the basis for an argument, discussion, or empirical test). 10 refs.

  3. Rotational Spectroscopy Unveils Eleven Conformers of Adrenaline

    NASA Astrophysics Data System (ADS)

    Cabezas, C.; Cortijo, V.; Mata, S.; Lopez, J. C.; Alonso, J. L.

    2013-06-01

    Recent improvements in our LA-MB-FTMW instrumentation have allowed the characterization of eleven and eight conformers for the neurotransmitters adrenaline and noradrenaline respectively. The observation of this rich conformational behavior is in accordance with the recent observation of seven conformers for dopamine and in sharp contrast with the conformational reduction proposed for catecholamines. C. Cabezas, I. Peña, J. C. López, J. L. Alonso J. Phys. Chem. Lett. 2013, 4, 486. H. Mitsuda, M. Miyazaki, I. B. Nielsen, P. Carcabal,C. Dedonder, C. Jouvet, S. Ishiuchi, M. Fujii J. Phys. Chem. Lett. 2010, 1, 1130.

  4. Interprofessional Education for Whom? — Challenges and Lessons Learned from Its Implementation in Developed Countries and Their Application to Developing Countries: A Systematic Review

    PubMed Central

    Sunguya, Bruno F.; Hinthong, Woranich; Jimba, Masamine; Yasuoka, Junko

    2014-01-01

    Background Evidence is available on the potential efficacy of interprofessional education (IPE) to foster interprofessional cooperation, improve professional satisfaction, and improve patient care. While the intention of the World Health Organization (WHO) is to implement IPE in all countries, evidence comes from developed countries about its efficiency, challenges, and barriers to planning and implementing IPE. We therefore conducted this review to examine challenges of implementing IPE to suggest possible pathways to overcome the anticipated challenges in developing countries. Methods We searched for literatures on IPE in PubMed/MEDLINE, CINAHL, PsycINFO, and ERIC databases. We examined challenges or barriers and initiatives to overcome them so as to suggest methods to solve the anticipated challenges in developing countries. We could not conduct a meta-analysis because of the qualitative nature of the research question and the data; instead we conducted a meta-narrative of evidence. Results A total of 40 out of 2,146 articles were eligible for analyses in the current review. Only two articles were available from developing countries. Despite the known benefits of IPE, a total of ten challenges or barriers were common based on the retrieved evidence. They included curriculum, leadership, resources, stereotypes and attitudes, variety of students, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Out of ten, three had already been reported in developing countries: IPE curriculum, resource limitations, and stereotypes. Conclusion This study found ten important challenges on implementing IPE. They are curriculum, leadership, resources, stereotypes, students' diversity, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Although only three of them are already experienced in developing countries, the remaining seven are potentially important for developing countries, too. By knowing these challenges and barriers in

  5. Mapping ergonomics application to improve SMEs working condition in industrially developing countries: a critical review.

    PubMed

    Hermawati, Setia; Lawson, Glyn; Sutarto, Auditya Purwandini

    2014-01-01

    In industrially developing countries (IDC), small and medium enterprises (SMEs) account for the highest proprotion of employment. Unfortunately, the working conditions in SMEs are often very poor and expose employees to a potentially wide range of health and safety risks. This paper presents a comprehensive review of 161 articles related to ergonomics application in SMEs, using Indonesia as a case study. The aim of this paper is to investigate the extent of ergonomics application and identify areas that can be improved to promote effective ergonomics for SMEs in IDC. The most urgent issue found is the need for adopting participatory approach in contrast to the commonly implemented top-down approach. Some good practices in ergonomics application were also revealed from the review, e.g. a multidisciplinary approach, unsophisticated and low-cost solutions, and recognising the importance of productivity. The review also found that more work is still required to achieve appropriate cross-cultural adaptation of ergonomics application. PMID:25216158

  6. Diarrhea incidence in low- and middle-income countries in 1990 and 2010: a systematic review

    PubMed Central

    2012-01-01

    Background Diarrhea is recognized as a leading cause of morbidity and mortality among children under 5 years of age in low- and middle-income countries yet updated estimates of diarrhea incidence by age for these countries are greatly needed. We conducted a systematic literature review to identify cohort studies that sought to quantify diarrhea incidence among any age group of children 0-59 mo of age. Methods We used the Expectation-Maximization algorithm as a part of a two-stage regression model to handle diverse age data and overall incidence rate variation by study to generate country specific incidence rates for low- and middle-income countries for 1990 and 2010. We then calculated regional incidence rates and uncertainty ranges using the bootstrap method, and estimated the total number of episodes for children 0-59 mo of age in 1990 and 2010. Results We estimate that incidence has declined from 3.4 episodes/child year in 1990 to 2.9 episodes/child year in 2010. As was the case previously, incidence rates are highest among infants 6-11 mo of age; 4.5 episodes/child year in 2010. Among these 139 countries there were nearly 1.9 billion episodes of childhood diarrhea in 1990 and nearly 1.7 billion episodes in 2010. Conclusions Although our results indicate that diarrhea incidence rates may be declining slightly, the total burden on the health of each child due to multiple episodes per year is tremendous and additional funds are needed to improve both prevention and treatment practices in low- and middle-income countries. PMID:22436130

  7. A Systematic Review of Radiotherapy Capacity in Low- and Middle-Income Countries

    PubMed Central

    Grover, Surbhi; Xu, Melody J.; Yeager, Alyssa; Rosman, Lori; Groen, Reinou S.; Chackungal, Smita; Rodin, Danielle; Mangaali, Margaret; Nurkic, Sommer; Fernandes, Annemarie; Lin, Lilie L.; Thomas, Gillian; Tergas, Ana I.

    2015-01-01

    Objectives: The cancer burden in low- and middle-income countries (LMIC) is substantial. The purpose of this study was to identify and describe country and region-specific patterns of radiotherapy (RT) facilities in LMIC. Methods: A systematic review of the literature was undertaken. A search strategy was developed to include articles on radiation capacity in LMIC from the following databases: PubMed, Embase, CINAHL Plus, Global Health, and the Latin American and Caribbean System on Health Sciences Information. Searches included all literature up to April 2013. Results: A total of 49 articles were included in the review. Studies reviewed were divided into one of four regions: Africa, Asia, Eastern Europe, and South America. The African continent has the least amount of resources for RT. Furthermore, a wide disparity exists, as 60% of all machines on the continent are concentrated in Egypt and South Africa while 29 countries in Africa are still lacking any RT resource. A significant heterogeneity also exists across Southeast Asia despite a threefold increase in megavoltage teletherapy machines from 1976 to 1999, which corresponds with a rise in economic status. In LMIC of the Americas, only Uruguay met the International Atomic Energy Agency recommendations of 4 MV/million population, whereas Bolivia and Venezuela had the most radiation oncologists (>1 per 1000 new cancer cases). The main concern with the review of RT resources in Eastern Europe was the lack of data. Conclusion: There is a dearth of publications on RT therapy infrastructure in LMIC. However, based on limited published data, availability of RT resources reflects the countries’ economic status. The challenges to delivering radiation in the discussed regions are multidimensional and include lack of physical resources, lack of human personnel, and lack of data. Furthermore, access to existing RT and affordability of care remains a large problem. PMID:25657930

  8. Country Review of Energy-Efficiency Financial Incentives in the Residential Sector

    SciTech Connect

    Can, Stephane de la Rue du; Shah, Nihar; Phadke, Amol

    2011-07-13

    A large variety of energy-efficiency policy measures exist. Some are mandatory, some are informative, and some use financial incentives to promote diffusion of efficient equipment. From country to country, financial incentives vary considerably in scope and form, the type of framework used to implement them, and the actors that administer them. They range from rebate programs administered by utilities under an Energy-Efficiency Resource Standards (EERS) regulatory framework (California, USA) to the distribution of Eco-points rewarding customers for buying highly efficient appliances (Japan). All have the primary objective of transforming the current market to accelerate the diffusion of efficient technologies by addressing up-front cost barriers faced by consumers; in most instances, efficient technologies require a greater initial investment than conventional technologies. In this paper, we review the different market transformation measures involving the use of financial incentives in the countries belonging to the Major Economies Forum. We characterize the main types of measures, discuss their mechanisms, and provide information on program impacts to the extent that ex-ante or ex-post evaluations have been conducted. Finally, we identify best practices in financial incentive programs and opportunities for coordination between Major Economies Forum countries as envisioned under the Super Efficient Appliance Deployment (SEAD) initiative.

  9. 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

  10. Addressing risk factors, screening, and preventative treatment for diabetic retinopathy in developing countries: a review.

    PubMed

    Lin, Stephanie; Ramulu, Pradeep; Lamoureux, Ecosse L; Sabanayagam, Charumathi

    2016-05-01

    The number of people with diabetic retinopathy (DR) has increased with the increasing prevalence of diabetes mellitus worldwide, especially in developing countries. In recent years, the successful implementation of public health programs in developed countries has been thought to contribute to decreases in blindness from DR. Developing countries, however, have not seen the same improvements, and their public health interventions still face significant challenges. In this review we describe the current state of public health approaches including risk factor control, screening and treatment techniques for DR in developing countries, and suggest recommendations. While the awareness of DR is variable, specific knowledge about DR is low, such that many patients have already experienced vision loss by the time they are screened. Attempts to improve rates of screening, in particular through non-mydriatic cameras and tele-screening, are ongoing and promising, although challenges include collaboration with healthcare systems and technology failures. Laser treatment is the most readily available, with anti-VEGF therapy and vitreo-retinal surgery increasingly sought after and provided. Recommendations include the use of 'targeted mydriasis' for fundus imaging to address high rates of ungradable images, increased communication with diabetes management services to improve patient retention and mobilization of access to DR treatments. PMID:26991970

  11. Review: Sustainability of crossbreeding in developing countries; definitely not like crossing a meadow….

    PubMed

    Leroy, G; Baumung, R; Boettcher, P; Scherf, B; Hoffmann, I

    2016-02-01

    Crossbreeding, considering either terminal or rotational crossing, synthetic breed creation or breed replacement, is often promoted as an efficient strategy to increase farmers' income through the improvement of productivity of local livestock in developing countries. Sustainability of crossbreeding is however frequently challenged by constraints such as poor adaptation to the local environment or lack of logistic support. In this review, we investigate factors that may influence the long-term success or the failure of crossbreeding programs, based on the scientific literature and country reports submitted for The Second Report on the State of the World's Animal Genetic Resources for Food and Agriculture. Crossbreeding activities vary widely across species and countries. Its sustainability is dependent on different prerequisites such as continual access to adequate breeding stock (especially after the end of externally funded crossbreeding projects), the opportunity of improved livestock to express their genetic potential (e.g. through providing proper inputs) and integration within a reliable market chain. As formal crossbreeding programs are often associated with adoption of other technologies, they can be a catalyst for innovation and development for smallholders. Given the increasing global demand for animal products, as well as the potential environmental consequences of climate change, there is a need for practical research to improve the implementation of long-term crossbreeding programs in developing countries. PMID:26503101

  12. Immunisation coverage in rural–urban migrant children in low and middle-income countries (LMICs): a systematic review and meta-analysis

    PubMed Central

    Awoh, Abiyemi Benita; Plugge, Emma

    2016-01-01

    Background The majority of children who die from vaccine-preventable diseases (VPDs) live in low-income and-middle-income countries (LMICs). With the rapid urbanisation and rural–urban migration ongoing in LMICs, available research suggests that migration status might be a determinant of immunisation coverage in LMICs, with rural–urban migrant (RUM) children being less likely to be immunised. Objectives To examine and synthesise the data on immunisation coverage in RUM children in LMICs and to compare coverage in these children with non-migrant children. Methods A multiple database search of published and unpublished literature on immunisation coverage for the routine Expanded Programme on Immunisation (EPI) vaccines in RUM children aged 5 years and below was conducted. Following a staged exclusion process, studies that met the inclusion criteria were assessed for quality and data extracted for meta-analysis. Results Eleven studies from three countries (China, India and Nigeria) were included in the review. There was substantial statistical heterogeneity between the studies, thus no summary estimate was reported for the meta-analysis. Data synthesis from the studies showed that the proportion of fully immunised RUM children was lower than the WHO bench-mark of 90% at the national level. RUMs were also less likely to be fully immunised than the urban-non-migrants and general population. For the individual EPI vaccines, all but two studies showed lower immunisation coverage in RUMs compared with the general population using national coverage estimates. Conclusions This review indicates that there is an association between rural–urban migration and immunisation coverage in LMICs with RUMs being less likely to be fully immunised than the urban non-migrants and the general population. Specific efforts to improve immunisation coverage in this subpopulation of urban residents will not only reduce morbidity and mortality from VPDs in migrants but will also reduce

  13. Review and analysis of quality healthcare system enhancement in developing countries.

    PubMed

    Kurji, Zohra; Premani, Zahra Shaheen; Mithani, Yasmin

    2015-07-01

    Quality has multidimensional perspectives. It is a continuous and dynamic process. A systematic search of national and international literature was conducted from peer-reviewed databases MEDLINE, CINAHL and PubMed during January to July 2012. There are many frameworks to assess and measure quality. All frameworks give some levels in which quality could be assessed. Therefore, multiple frameworks should be used for measuring quality based on the situation and environment. Measuring quality is very important for primary healthcare programme, especially for developing countries because if we will not do quality assessment, our resources will not be utilised effectively and people may divert to curative services. Thus, in developing countries where healthcare system needs to optimise resources for increased population coverage and scale up the care, quality approaches can suggest workable solutions to using resources appropriately. PMID:26160090

  14. 75 FR 59680 - Eleven Point Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-28

    ... Forest Service Eleven Point Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eleven Point Resource Advisory Committee will meet in Winona, Missouri. The... facilitate entry into the building. FOR FURTHER INFORMATION CONTACT: Richard Hall, Eleven Point...

  15. 75 FR 47535 - Eleven Point Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-06

    ... Forest Service Eleven Point Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eleven Point Resource Advisory Committee will meet in Winona, Missouri. The... facilitate entry into the building. FOR FURTHER INFORMATION CONTACT: Richard Hall, Eleven Point...

  16. 76 FR 54732 - Eleven Point Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-02

    ... Forest Service Eleven Point Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eleven Point Resource Advisory Committee will meet in Winona Missouri. The committee... building to view comments. FOR FURTHER INFORMATION CONTACT: Richard Hall, Eleven Point Resource...

  17. 76 FR 1402 - Eleven Point Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-01-10

    ... Forest Service Eleven Point Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eleven Point Resource Advisory Committee will meet in Winona, Missouri. The... facilitate entry into the building. FOR FURTHER INFORMATION CONTACT: Richard Hall, Eleven Point...

  18. 77 FR 50081 - Eleven Point Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-20

    ... Forest Service Eleven Point Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eleven Point Resource Advisory Committee will meet in Winona, Missouri. The... into the building to view comments. FOR FURTHER INFORMATION CONTACT: Richard Hall, Eleven...

  19. 77 FR 55799 - Eleven Point Resource Advisory Committee

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-11

    ... Forest Service Eleven Point Resource Advisory Committee AGENCY: Forest Service, USDA. ACTION: Notice of meeting. SUMMARY: The Eleven Point Resource Advisory Committee will meet in Winona, Missouri. The... building to view comments. FOR FURTHER INFORMATION CONTACT: Richard Hall, Eleven Point Resource...

  20. The impact of socioeconomic status on foodborne illness in high-income countries: a systematic review.

    PubMed

    Newman, K L; Leon, J S; Rebolledo, P A; Scallan, E

    2015-09-01

    Foodborne illness is a major cause of morbidity and loss of productivity in developed nations. Although low socioeconomic status (SES) is generally associated with negative health outcomes, its impact on foodborne illness is poorly understood. We conducted a systematic review to examine the association between SES and laboratory-confirmed illness caused by eight important foodborne pathogens. We completed this systematic review using PubMed for all papers published between 1 January 1980 and 1 January 2013 that measured the association between foodborne illness and SES in highly developed countries and identified 16 studies covering four pathogens. The effect of SES varied across pathogens: the majority of identified studies for Campylobacter, salmonellosis, and E. coli infection showed an association between high SES and illness. The single study of listeriosis showed illness was associated with low SES. A reporting bias by SES could not be excluded. SES should be considered when targeting consumer-level public health interventions for foodborne pathogens. PMID:25600652

  1. Asylum seekers, violence and health: a systematic review of research in high-income host countries.

    PubMed

    Kalt, Anne; Hossain, Mazeda; Kiss, Ligia; Zimmerman, Cathy

    2013-03-01

    We performed a systematic review of literature on violence and related health concerns among asylum seekers in high-income host countries. We extracted data from 23 peer-reviewed studies. Prevalence of torture, variably defined, was above 30% across all studies. Torture history in clinic populations correlated with hunger and posttraumatic stress disorder, although in small, nonrepresentative samples. One study observed that previous exposure to interpersonal violence interacted with longer immigration detention periods, resulting in higher depression scores. Limited evidence suggests that asylum seekers frequently experience violence and health problems, but large-scale studies are needed to inform policies and services for this vulnerable group often at the center of political debate. PMID:23327250

  2. Asylum Seekers, Violence and Health: A Systematic Review of Research in High-Income Host Countries

    PubMed Central

    Hossain, Mazeda; Kiss, Ligia; Zimmerman, Cathy

    2013-01-01

    We performed a systematic review of literature on violence and related health concerns among asylum seekers in high-income host countries. We extracted data from 23 peer-reviewed studies. Prevalence of torture, variably defined, was above 30% across all studies. Torture history in clinic populations correlated with hunger and posttraumatic stress disorder, although in small, nonrepresentative samples. One study observed that previous exposure to interpersonal violence interacted with longer immigration detention periods, resulting in higher depression scores. Limited evidence suggests that asylum seekers frequently experience violence and health problems, but large-scale studies are needed to inform policies and services for this vulnerable group often at the center of political debate. PMID:23327250

  3. The impact of socioeconomic status on foodborne illness in high income countries: A systematic review

    PubMed Central

    Newman, K. L.; Leon, J. S.; Rebolledo, P. A.; Scallan, E.

    2015-01-01

    SUMMARY Foodborne illness is a major cause of morbidity and loss of productivity in developed nations. Though low socioeconomic status (SES) is generally associated with negative health outcomes, its impact on foodborne illness is poorly understood. We conducted a systematic review to examine the association between SES and laboratory-confirmed illness caused by eight important foodborne pathogens. We completed this systematic review using PubMed for all papers published between 1 January 1980 and 1 January 2013 that measured the association between foodborne illness and SES in highly developed countries and identified 16 studies covering 4 pathogens. The effect of SES varied across pathogens: the majority of identified studies for Campylobacter, salmonellosis, and E. coli infection showed an association between high SES and illness. The single study of listeriosis showed illness was associated with low SES. A reporting bias by SES could not be excluded. SES should be considered when targeting consumer level public health interventions for foodborne pathogens. PMID:25600652

  4. GAS eleven node thermal model (GEM)

    NASA Technical Reports Server (NTRS)

    Butler, Dan

    1988-01-01

    The Eleven Node Thermal Model (GEM) of the Get Away Special (GAS) container was originally developed based on the results of thermal tests of the GAS container. The model was then used in the thermal analysis and design of several NASA/GSFC GAS experiments, including the Flight Verification Payload, the Ultraviolet Experiment, and the Capillary Pumped Loop. The model description details the five cu ft container both with and without an insulated end cap. Mass specific heat values are also given so that transient analyses can be performed. A sample problem for each configuration is included as well so that GEM users can verify their computations. The model can be run on most personal computers with a thermal analyzer solution routine.

  5. "Profits before people"? A systematic review of the health and safety impacts of privatising public utilities and industries in developed countries.

    PubMed

    Egan, Matt; Petticrew, Mark; Ogilvie, David; Hamilton, Val; Drever, Frances

    2007-10-01

    Debates on government privatisation policies have often focused on the alleged effects of privatisation on health and safety. A systematic review (through Quality of Reporting of Meta-analysis) of the effects of privatising industries and utilities on the health (including injuries) of employees and the public was conducted. The data sources were electronic databases (medical, social science and economic), bibliographies and expert contacts. Experimental and quasi-experimental studies were sought, dating from 1945, from any Organisation for Economic Cooperation and Development member country (in any language) that evaluated the health outcomes of such interventions. Eleven highly heterogeneous studies that evaluated the health impacts of privatisation of building, water, paper, cement, bus, rail, mining, electric and gas companies were identified. The most robust study found increases in the measures of stress-related ill health among employees after a privatisation intervention involving company downsizing. No robust evidence was found to link privatisation with increased injury rates for employees or customers. In conclusion, public debates on the health and safety implications of privatisation have a poor empirical base, which policy makers and researchers need to address. Some evidence suggests that adverse health outcomes could result from redundancies associated with privatisation. PMID:17873221

  6. “Profits before people”? A systematic review of the health and safety impacts of privatising public utilities and industries in developed countries

    PubMed Central

    Egan, Matt; Petticrew, Mark; Ogilvie, David; Hamilton, Val; Drever, Frances

    2007-01-01

    Debates on government privatisation policies have often focused on the alleged effects of privatisation on health and safety. A systematic review (through Quality of Reporting of Meta‐analysis) of the effects of privatising industries and utilities on the health (including injuries) of employees and the public was conducted. The data sources were electronic databases (medical, social science and economic), bibliographies and expert contacts. Experimental and quasi‐experimental studies were sought, dating from 1945, from any Organisation for Economic Cooperation and Development member country (in any language) that evaluated the health outcomes of such interventions. Eleven highly heterogeneous studies that evaluated the health impacts of privatisation of building, water, paper, cement, bus, rail, mining, electric and gas companies were identified. The most robust study found increases in the measures of stress‐related ill health among employees after a privatisation intervention involving company downsizing. No robust evidence was found to link privatisation with increased injury rates for employees or customers. In conclusion, public debates on the health and safety implications of privatisation have a poor empirical base, which policy makers and researchers need to address. Some evidence suggests that adverse health outcomes could result from redundancies associated with privatisation. PMID:17873221

  7. Effectiveness of Peer Education Interventions for HIV Prevention in Developing Countries: A Systematic Review and Meta-Analysis

    ERIC Educational Resources Information Center

    Medley, Amy; Kennedy, Caitlin; O'Reilly, Kevin; Sweat, Michael

    2009-01-01

    Peer education for HIV prevention has been widely implemented in developing countries, yet the effectiveness of this intervention has not been systematically evaluated. We conducted a systematic review and meta-analysis of peer education interventions in developing countries published between January 1990 and November 2006. Standardized methods of…

  8. [Selected Reports from the Technical Seminar on Educational Wastage and School Drop-Outs, with Summary Review of Country Reports.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Bangkok (Thailand).

    As a part of a study of educational wastage in Asian countries by the United Nations Educational, Scientific , and Cultural Organization, this summary review reports the incidence of dropout and retardation in public elementary schools in the countries included in the study (mainly Afghanistan, Malaysia, Nepal, and the Philippines). It is noted…

  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. A Systematic Review of Responsive Feeding and Child Obesity in High-Income Countries123

    PubMed Central

    Hurley, Kristen M.; Cross, Matthew B.; Hughes, Sheryl O.

    2011-01-01

    Child overweight/obesity continues to be a serious public health problem in high-income countries. The current review had 3 goals: 1) to summarize the associations between responsive feeding and child weight status in high-income countries; 2) to describe existing responsive feeding measures; and 3) to generate suggestions for future research. Articles were obtained from PubMed and PsycInfo using specified search criteria. The majority (24/31) of articles reported significant associations between nonresponsive feeding and child weight-for-height Z-score, BMI Z-score, overweight/obesity, or adiposity. Most studies identified were conducted exclusively in the United States (n = 22), were cross-sectional (n = 25), and used self-report feeding questionnaires (n = 28). A recent trend exists toward conducting research among younger children (i.e. infants and toddlers) and low-income and/or minority populations. Although current evidence suggests that nonresponsive feeding is associated with child BMI or overweight/obesity, more research is needed to understand causality, the reliability and validity between and within existing feeding measures, and to test the efficacy of responsive feeding interventions in the prevention and treatment of child overweight/obesity in high-income countries. PMID:21270360

  11. 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

  12. [National health research systems in Latin America: a 14-country review].

    PubMed

    Alger, Jackeline; Becerra-Posada, Francisco; Kennedy, Andrew; Martinelli, Elena; Cuervo, Luis Gabriel

    2009-11-01

    This article discusses the main features of the national health research systems (NHRS) of Argentina, Bolivia, Brazil, Chile, Costa Rica, Cuba, Ecuador, El Salvador, Honduras, Panama, Paraguay, Peru, Uruguay, and Venezuela, based on documents prepared by their country experts who participated in the First Latin American Conference on Research and Innovation for Health held in April 2008, in Rio de Janeiro, Brazil. The review also includes sources cited in the reports, published scientific papers, and expert opinion, as well as regional secondary sources. Six countries reported having formal entities for health research governance and management: Brazil and Costa Rica's entities are led by their ministries of health; while Argentina, Cuba, Ecuador, and Venezuela have entities shared by their ministries of health and ministries of science and technology. Brazil and Ecuador each reported having a comprehensive national policy devoted specifically to health science, technology, and innovation. Argentina, Brazil, Costa Rica, Cuba, Ecuador, Panama, Paraguay, Peru, and Venezuela reported having established health research priorities. In conclusion, encouraging progress has been made, despite the structural and functional heterogeneity of the study countries' NHRS and their disparate levels of development. Instituting good NHRS governance/management is of utmost importance to how efficiently ministries of health, other government players, and society-at-large can tackle health research. PMID:20107697

  13. Epidemiology and clinical record of multiple sclerosis in selected countries: a systematic review.

    PubMed

    Niedziela, Natalia; Adamczyk-Sowa, Monika; Pierzchała, Krystyna

    2014-05-01

    Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system mainly affecting young adults. The aim of this paper is to review the literature concentrating the main national MS registries in selected countries of the world. We performed a systematic review to determine the MS epidemiology reported on prevalence, incidence, environmental factors, treatment, social consequences of MS and neurological disability or progression among MS-affected people. We got the information on the high-MS prevalence in Sardinia, Sweden or Sicily and on the effects of MS treatment in United States of America, Italy or Germany. We emphasized environmental factors taking into account as MS risk factors. We concluded that there were many descriptions of MS status in particular countries, but they were often insufficiently detailed and not uniform enough to compare it. The paper indicated an importance of the MS epidemiology in the light of the healthcare or quality of life of the MS patients, but further research is needed to optimize this issue. PMID:23998938

  14. Behaviour change techniques and contraceptive use in low and middle income countries: a review.

    PubMed

    Phiri, Mwelwa; King, R; Newell, J N

    2015-01-01

    We aimed to identify effective behaviour change techniques to increase modern contraceptive use in low and middle income countries (LMICs). Literature was identified in Global Health, Web of Science, MEDLINE, PsycINFO and Popline, as well as peer reviewed journals. Articles were included if they were written in English, had an outcome evaluation of contraceptive use, modern contraceptive use, contraceptive initiation/uptake, contraceptive adherence or continuation of contraception, were a systematic review or randomised controlled trial, and were conducted in a low or middle income country. We assessed the behaviour change techniques used in each intervention and included a new category of male partner involvement. We identified six studies meeting the inclusion criteria. The most effective interventions were those that involve male partner involvement in the decision to initiate contraceptive use. The findings also suggest that providing access to contraceptives in the community promotes their use. The interventions that had positive effects on contraceptive use used a combination of behaviour change techniques. Performance techniques were not used in any of the interventions. The use of social support techniques, which are meant to improve wider social acceptability, did not appear except in two of the interventions. Our findings suggest that when information and contraceptives are provided, contraceptive use improves. Recommendations include reporting of behaviour change studies to include more details of the intervention and techniques employed. There is also a need for further research to understand which techniques are especially effective. PMID:26519159

  15. Economic efficiency of countries' clinical review processes and competitiveness on the market of human experimentation.

    PubMed

    Ippoliti, Roberto

    2013-01-01

    Clinical research is a specific phase of pharmaceutical industry's production process in which companies test candidate drugs on patients to collect clinical evidence about safety and effectiveness. Information is essential to obtain manufacturing authorization from the national drug agency and, in this way, make profits on the market. Considering this activity, however, the public stakeholder has to face a conflict of interests. On the one side, there is society's necessity to make advances in medicine and, of course, to promote pharmaceutical companies' investments in this specific phase (new generation). On the other side, there is the duty to protect patients involved in these experimental treatments (old generation). To abide by this moral duty, a protection system was developed through the years, based on two legal institutions: informed consent and institutional review board. How should an efficient protection system that would take human experimentation into account be shaped? Would it be possible for the national protection system of patients' rights to affect the choice of whether to develop a clinical trial in a given country or not? Looking at Europe and considering a protection system that is shaped around institutional review boards, this article is an empirical work that tries to give answers to these open questions. It shows how a protection system that can minimize the time necessary to start a trial can positively affect pharmaceutical clinical research, that is, the choice of pharmaceutical companies to start innovative medical treatments in a given country. PMID:23337226

  16. Wastewater treatment performance efficiency of constructed wetlands in African countries: a review.

    PubMed

    Mekonnen, Andualem; Leta, Seyoum; Njau, Karoli Nicholas

    2015-01-01

    In Africa, different studies have been conducted at different scales to evaluate wastewater treatment efficiency of constructed wetland. This paper aims to review the treatment performance efficiency of constructed wetland used in African countries. In the reviewed papers, the operational parameters, size and type of wetland used and the treatment efficiency are assessed. The results are organized and presented in six tables based on the type of wetland and wastewater used in the study. The results of the review papers indicated that most of the studies were conducted in Tanzania, Egypt and Kenya. In Kenya and Tanzania, different full-scale wetlands are widely used in treating wastewater. Among wetland type, horizontal subsurface flow wetlands were widely studied followed by surface flow and hybrid wetlands. Most of the reported hybrid wetlands were in Kenya. The results of the review papers indicated that wetlands are efficient in removing organic matter (biochemical oxygen demand and chemical oxygen demand) and suspended solids. On the other hand, nutrient removal efficiency appeared to be low. PMID:25607662

  17. What Is the Role of Informal Healthcare Providers in Developing Countries? A Systematic Review

    PubMed Central

    Sudhinaraset, May; Ingram, Matthew; Lofthouse, Heather Kinlaw; Montagu, Dominic

    2013-01-01

    Informal health care providers (IPs) comprise a significant component of health systems in developing nations. Yet little is known about the most basic characteristics of performance, cost, quality, utilization, and size of this sector. To address this gap we conducted a comprehensive literature review on the informal health care sector in developing countries. We searched for studies published since 2000 through electronic databases PubMed, Google Scholar, and relevant grey literature from The New York Academy of Medicine, The World Bank, The Center for Global Development, USAID, SHOPS (formerly PSP-One), The World Health Organization, DFID, Human Resources for Health Global Resource Center. In total, 334 articles were retrieved, and 122 met inclusion criteria and chosen for data abstraction. Results indicate that IPs make up a significant portion of the healthcare sector globally, with almost half of studies (48%) from Sub-Saharan Africa. Utilization estimates from 24 studies in the literature of IP for healthcare services ranged from 9% to 90% of all healthcare interactions, depending on the country, the disease in question, and methods of measurement. IPs operate in a variety of health areas, although baseline information on quality is notably incomplete and poor quality of care is generally assumed. There was a wide variation in how quality of care is measured. The review found that IPs reported inadequate drug provision, poor adherence to clinical national guidelines, and that there were gaps in knowledge and provider practice; however, studies also found that the formal sector also reported poor provider practices. Reasons for using IPs included convenience, affordability, and social and cultural effects. Recommendations from the literature amount to a call for more engagement with the IP sector. IPs are a large component of nearly all developing country health systems. Research and policies of engagement are needed. PMID:23405101

  18. The Diet of Preschool Children in the Mediterranean Countries of the European Union: A Systematic Review.

    PubMed

    Pereira-da-Silva, Luís; Rêgo, Carla; Pietrobelli, Angelo

    2016-01-01

    This systematic review discusses data on the dietary intake of preschool children living in the Mediterranean countries of the European Union, including the comparison with a Mediterranean-like diet and the association with nutritional status. Specifically, data from the multinational European Identification and Prevention on Dietary and life style induced health effects in children and infants (IDEFICS) study and national studies, such as the Estudo do Padrão Alimentar e de Crescimento Infantil (EPACI) study and Geração XXI cohort in Portugal, ALimentando la SAlud del MAñana (ALSALMA) study in Spain, Étude des Déterminants pré-et postnatals précoces du développement et de la santé de l'ENfant (EDEN) cohort in France, Nutrintake 636 study in Italy, and Growth, Exercise and Nutrition Epidemiological Study in preSchoolers (GENESIS) cohort in Greece, were analyzed. In the majority of countries, young children consumed fruit and vegetables quite frequently, but also consumed sugared beverages and snacks. High energy and high protein intakes mainly from dairy products were found in the majority of countries. The majority of children also consumed excessive sodium intake. Early high prevalence of overweight and obesity was found, and both early consumption of energy-dense foods and overweight seemed to track across toddler and preschool ages. Most children living in the analyzed countries showed low adherence to a Mediterranean-like diet, which in turn was associated with being overweight/obese. Unhealthier diets were associated with lower maternal educational level and parental unemployment. Programs promoting adherence of young children to the traditional Mediterranean diet should be part of a multi-intervention strategy for the prevention and treatment of pediatric overweight and obesity. PMID:27338427

  19. KEROSENE: A REVIEW OF HOUSEHOLD USES AND THEIR HAZARDS IN LOW- AND MIDDLE-INCOME COUNTRIES

    PubMed Central

    Lam, Nicholas L.; Smith, Kirk R.; Gauthier, Alison; Bates, Michael N.

    2013-01-01

    Kerosene has been an important household fuel since the mid-19th century. In developed countries its use has greatly declined because of electrification. However, in developing countries, kerosene use for cooking and lighting remains widespread. This review focuses on household kerosene uses, mainly in developing countries, their associated emissions, and their hazards. Kerosene is often advocated as a cleaner alternative to solid fuels, biomass and coal, for cooking, and kerosene lamps are frequently used when electricity is unavailable. Globally, an estimated 500 million households still use fuels, particularly kerosene, for lighting. However, there are few studies, study designs and quality are varied, and results are inconsistent. Well-documented kerosene hazards are poisonings, fires, and explosions. Less investigated are exposures to and risks from kerosene’s combustion products. Some kerosene-using devices emit substantial amounts of fine particulates, carbon monoxide (CO), nitric oxides (NOx), and sulfur dioxide (SO2). Studies of kerosene used for cooking or lighting provide some evidence that emissions may impair lung function and increase infectious illness (including tuberculosis), asthma, and cancer risks. However, there are few study designs, quality is varied, and results are inconsistent. Considering the widespread use in the developing world of kerosene, the scarcity of adequate epidemiologic investigations, the potential for harm, and the implications for national energy policies, researchers are strongly encouraged to consider collecting data on household kerosene uses in studies of health in developing countries. Given the potential risks of kerosene, policymakers may consider alternatives to kerosene subsidies, such as shifting support to cleaner technologies for lighting and cooking. PMID:22934567

  20. The Diet of Preschool Children in the Mediterranean Countries of the European Union: A Systematic Review

    PubMed Central

    Pereira-da-Silva, Luís; Rêgo, Carla; Pietrobelli, Angelo

    2016-01-01

    This systematic review discusses data on the dietary intake of preschool children living in the Mediterranean countries of the European Union, including the comparison with a Mediterranean-like diet and the association with nutritional status. Specifically, data from the multinational European Identification and Prevention on Dietary and life style induced health effects in children and infants (IDEFICS) study and national studies, such as the Estudo do Padrão Alimentar e de Crescimento Infantil (EPACI) study and Geração XXI cohort in Portugal, ALimentando la SAlud del MAñana (ALSALMA) study in Spain, Étude des Déterminants pré-et postnatals précoces du développement et de la santé de l’ENfant (EDEN) cohort in France, Nutrintake 636 study in Italy, and Growth, Exercise and Nutrition Epidemiological Study in preSchoolers (GENESIS) cohort in Greece, were analyzed. In the majority of countries, young children consumed fruit and vegetables quite frequently, but also consumed sugared beverages and snacks. High energy and high protein intakes mainly from dairy products were found in the majority of countries. The majority of children also consumed excessive sodium intake. Early high prevalence of overweight and obesity was found, and both early consumption of energy-dense foods and overweight seemed to track across toddler and preschool ages. Most children living in the analyzed countries showed low adherence to a Mediterranean-like diet, which in turn was associated with being overweight/obese. Unhealthier diets were associated with lower maternal educational level and parental unemployment. Programs promoting adherence of young children to the traditional Mediterranean diet should be part of a multi-intervention strategy for the prevention and treatment of pediatric overweight and obesity. PMID:27338427

  1. Review of the regulation and safety assessment of food substances in various countries and jurisdictions

    PubMed Central

    Magnuson, Bernadene; Munro, Ian; Abbot, Peter; Baldwin, Nigel; Lopez-Garcia, Rebeca; Ly, Karen; McGirr, Larry; Roberts, Ashley; Socolovsky, Susan

    2013-01-01

    This review compares the regulations, definitions and approval processes for substances intentionally added to or unintentionally present in human food in the following specific countries/jurisdictions: Argentina, Australia, Brazil, Canada, China, the European Union, Japan, Mexico, New Zealand, and the United States. This includes direct food additives, food ingredients, flavouring agents, food enzymes and/or processing aids, food contact materials, novel foods, and nanoscale materials for food applications. The regulatory authority of each target jurisdiction/country uses its own regulatory framework and although the definitions, regulations and approval processes may vary among all target countries, in general there are many similarities. In all cases, the main purpose of each authority is to establish a regulatory framework and maintain/enforce regulations to ensure that food consumed and sold within its respective countries is safe. There is a move towards harmonisation of food regulations, as illustrated by Australia and New Zealand and by Mercosur. The European Union has also established regulations, which are applicable for all member states, to establish a common authorisation procedure for direct food additives, flavourings and enzymes. Although the path for approval of different categories of food additives varies from jurisdiction to jurisdiction, there are many commonalities in terms of the data requirements and considerations for assessment of the safety of use of food additives, including the use of positive lists of approved substances, pre-market approval, and a separation between science and policy decisions. The principles applied are largely reflective of the early work by the Joint FAO/WHO Expert Committee on Food Additives (JECFA) committees and JECFA assessments of the safety of food additives for human and animal foods. PMID:23781843

  2. 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

  3. Prescription drug use during pregnancy in developed countries: a systematic review

    PubMed Central

    Daw, Jamie R; Hanley, Gillian E; Greyson, Devon L; Morgan, Steven G

    2012-01-01

    Purpose To review the literature describing patterns of out-patient prescription drug use during pregnancy by therapeutic category, potential for fetal harm, and overall. Methods We conducted a systematic review of peer-reviewed literature published from 1989 to 2010. We included studies evaluating individual-level exposures to prescription medicines during pregnancy. We selected only studies conducted in developed (OECD) countries and published in English. Results Published drug utilization studies reveal wide variation in estimates of overall prescription drug use in pregnancy (27% to 93% of pregnant women filling at least one prescription excluding vitamins and minerals). Among studies of similar design, estimates were lowest in Northern European countries (44% to 47%) and highest in France (93%) and Germany (85%). Measured rates of use of contraindicated medicines in pregnancy ranged from 0.9% (Denmark; 1991–1996) to 4.6% (USA; 1996–2000). The use of medicines with positive evidence of risk (FDA category D) ranged from 2.0% (Italy; 2004) to 59.3% (France; 1995–2001). Conclusion Avoidable inconsistencies in study design and reporting attenuate conclusions that can be drawn from the literature on antenatal drug utilization. Nevertheless, the body of published research shows that antenatal prescription drug use is common, with many studies finding that a majority of women use one or more prescription medicine during pregnancy. Similarly, studies consistently report the use of drugs recognized as having potential risks in pregnancy. Given this widespread use, it is particularly important to develop standards for calculating and reporting antenatal exposures to improve the value of future research in this area. PMID:21774029

  4. The efficiency of health care production in OECD countries: A systematic review and meta-analysis of cross-country comparisons.

    PubMed

    Varabyova, Yauheniya; Müller, Julia-Maria

    2016-03-01

    There has been an ongoing interest in the analysis and comparison of the efficiency of health care systems using nonparametric and parametric applications. The objective of this study was to review the current state of the literature and to synthesize the findings on health system efficiency in OECD countries. We systematically searched five electronic databases through August 2014 and identified 22 studies that analyzed the efficiency of health care production at the country level. We summarized these studies with view on their sample, methods, and utilized variables. We developed and applied a checklist of 14 items to assess the quality of the reviewed studies along four dimensions: reporting, external validity, bias, and power. Moreover, to examine the internal validity of findings we meta-analyzed the efficiency estimates reported in 35 models from ten studies. The qualitative synthesis of the literature indicated large differences in study designs and methods. The meta-analysis revealed low correlations between country rankings suggesting a lack of internal validity of the efficiency estimates. In conclusion, methodological problems of existing cross-country comparisons of the efficiency of health care systems draw into question the ability of these comparisons to provide meaningful guidance to policy-makers. PMID:26819140

  5. Antiretroviral Therapy and Pregnancy Outcomes in Developing Countries: A Systematic Review

    PubMed Central

    Alemu, Fekadu Mazengia; Yalew, Alemayehu Worku; Fantahun, Mesganaw; Ashu, Eta Ebasi

    2015-01-01

    Background: Despite significant efforts to understand adverse pregnancy outcome in women receiving Antiretroviral Therapy (ART), ART-related adverse birth outcomes are still poorly understood. We systematically review ART-related adverse birth outcomes among HIV-infected pregnant women; we also review the covariates associated with adverse birth outcomes in the aforementioned group. Methods: The main source for our systematic review was electronic bibliographic databases. Databases such as MEDLINE, PubMed, EMBASE and AIDSLINE were searched. Furthermore, search engines such as Google and Google Scholar were specifically searched for gray literature. Methodological quality of available literature was assessed using the Newcastle - Ottawa Quality Assessment Scale & M. Hewitt guideline. We examined a total of 1,124 papers and reviewed the studies using the PICOT criteria which stands for Patient (population), Intervention (or “Exposure”), Comparison, Outcome and Type of study. Finally, 32 methodologically fit studies were retained and included in our review. Results: Frequently observed adverse birth outcomes included low birth weight (LBW), Preterm Birth (PB), Small for Gestational Age (SGA), while still birth and congenital anomalies were infrequent. Type of regimen such as Protease Inhibitor (PI) based regimens and timing of initiation of ART are some of the factors associated with adverse pregnancy outcomes. Covariates principally included malnutrition and other co-morbidities such as malaria and HIV. Conclusions and Public Health Implications: There is growing evidence in published literature suggesting that ART might be causing adverse birth outcomes among pregnant women in developing countries. There is a need to consider regimen types for HIV-infected pregnant women. There is need to design large cohort studies.

  6. A comprehensive review of the literature on epilepsy in selected countries in emerging markets

    PubMed Central

    Angalakuditi, Mallik; Angalakuditi, Nupur

    2011-01-01

    Aims: To perform a systematic literature review of studies in peer reviewed journals on the epidemiology, economics, and treatment patterns of epilepsy in selected countries in emerging markets. Methods: A literature search was performed using relevant search terms to identify articles published from 1999 to 2000 on the epidemiology, economics, and treatment patterns of epilepsy. Studies were identified through electronic Embase®, Cochrane©, MEDLINE®, and PubMed® databases. Manual review of bibliographies allowed for the detection of additional articles. Results: Our search yielded 65 articles. These articles contained information relevant to epidemiology (n = 16), treatment guidelines (n = 4), treatment patterns (n = 33), unmet needs (n = 4), and economics (n = 8). From a patient perspective, patients with less than or equal to two adverse events (AEs) while taking anti-epileptic drugs (AEDs) had significantly lower annual costs than those having greater than or equal to three AEs, as did patients with fewer seizures. The overall mean annual cost for epilepsy per patient ranged from US$773 in China to US$2646 in Mexico. Prevalence data varied widely and were found for countries including Arab League Members, China, India, and Taiwan. In Turkey, active prevalence rates ranged from 0.08/1000 to 8.5/1000, and in Arab countries, active prevalence ranged from 0.9/1000 in Sudan to 6.5/1000 in Saudi Arabia. Seventeen different AEDs were used in the identified studies. The most common AEDs utilized were phenobarbital (21.7%), valproate (17.5%), and tiagabine (16.4%). In all studies, the use of AEDs resulted in an increase of patients who became seizure free and a reduction in seizure frequency and severity. Conclusion: Few studies have examined the prevalence and incidence of epilepsy in emerging markets and study limitations tend to underestimate these rates at all times. More cost-effectiveness, cost-minimization, and cost-benefit analyses must be performed to

  7. Student Standardised Testing: Current Practices in OECD Countries and a Literature Review. OECD Education Working Papers, No. 65

    ERIC Educational Resources Information Center

    Morris, Allison

    2011-01-01

    This report discusses the most relevant issues concerning student standardised testing in which there are no-stakes for students ("standardised testing") through a literature review and a review of the trends in standardised testing in OECD countries. Unlike standardised tests in which there are high-stakes for students, no-stakes implies that…

  8. Discovery of eleven new ZZ Ceti stars

    NASA Astrophysics Data System (ADS)

    Castanheira, B. G.; Kepler, S. O.; Mullally, F.; Winget, D. E.; Koester, D.; Voss, B.; Kleinman, S. J.; Nitta, A.; Eisenstein, D. J.; Napiwotzki, R.; Reimers, D.

    2006-04-01

    We report the discovery of eleven new ZZ Cetis using telescopes at OPD (Observatório do Pico dos Dias/LNA) in Brazil, the 4.1 m SOAR (Southern Astrophysical Research) telescope at Cerro Pachon, Chile, and the 2.1 m Otto Struve telescope at McDonald observatory. The candidates were selected from the SDSS (Sloan Digital Sky Survey) and SPY (ESO SN Ia progenitor survey), based on their Teff obtained from optical spectra fitting. This selection criterion yields the highest success rate of detecting new ZZ Cetis, above 90% in the Teff range from 12 000 to 11 000 K. We also report on a DA not observed to vary, with a Teff placing the star close to the blue edge of the instability strip. Among our new pulsators, one is slightly cooler than this star for which pulsations were not detected. Our observations are an important constraint on the location of the blue edge of the ZZ Ceti instability strip. Partially based on observations at Observatório do Pico dos Dias/LNA, the Southern Astrophysical Research telescope, a collaboration between CNPq-Brazil, NOAO, UNC and MSU, and McDonald Observatory of the University of Texas at Austin.

  9. Cytotoxicity potentials of eleven Bangladeshi medicinal plants.

    PubMed

    Khatun, Amina; Rahman, Mahmudur; Haque, Tania; Rahman, Md Mahfizur; Akter, Mahfuja; Akter, Subarna; Jhumur, Afrin

    2014-01-01

    Various forms of cancer are rising all over the world, requiring newer therapy. The quest of anticancer drugs both from natural and synthetic sources is the demand of time. In this study, fourteen extracts of different parts of eleven Bangladeshi medicinal plants which have been traditionally used for the treatment of different types of carcinoma, tumor, leprosy, and diseases associated with cancer were evaluated for their cytotoxicity for the first time. Extraction was conceded using methanol. Phytochemical groups like reducing sugars, tannins, saponins, steroids, gums, flavonoids, and alkaloids were tested using standard chromogenic reagents. Plants were evaluated for cytotoxicity by brine shrimp lethality bioassay using Artemia salina comparing with standard anticancer drug vincristine sulphate. All the extracts showed potent to moderate cytotoxicity ranging from LC50 2 to 115 µg/mL. The highest toxicity was shown by Hygrophila spinosa seeds (LC50 = 2.93 µg/mL) and the lowest by Litsea glutinosa leaves (LC50 = 114.71 µg/mL) in comparison with standard vincristine sulphate (LC50 = 2.04 µg/mL). Among the plants, the plants traditionally used in different cancer and microbial treatments showed highest cytotoxicity. The results support their ethnomedicinal uses and require advanced investigation to elucidate responsible compounds as well as their mode of action. PMID:25431796

  10. Cytotoxicity Potentials of Eleven Bangladeshi Medicinal Plants

    PubMed Central

    Haque, Tania; Akter, Mahfuja; Akter, Subarna; Jhumur, Afrin

    2014-01-01

    Various forms of cancer are rising all over the world, requiring newer therapy. The quest of anticancer drugs both from natural and synthetic sources is the demand of time. In this study, fourteen extracts of different parts of eleven Bangladeshi medicinal plants which have been traditionally used for the treatment of different types of carcinoma, tumor, leprosy, and diseases associated with cancer were evaluated for their cytotoxicity for the first time. Extraction was conceded using methanol. Phytochemical groups like reducing sugars, tannins, saponins, steroids, gums, flavonoids, and alkaloids were tested using standard chromogenic reagents. Plants were evaluated for cytotoxicity by brine shrimp lethality bioassay using Artemia salina comparing with standard anticancer drug vincristine sulphate. All the extracts showed potent to moderate cytotoxicity ranging from LC50 2 to 115 µg/mL. The highest toxicity was shown by Hygrophila spinosa seeds (LC50 = 2.93 µg/mL) and the lowest by Litsea glutinosa leaves (LC50 = 114.71 µg/mL) in comparison with standard vincristine sulphate (LC50 = 2.04 µg/mL). Among the plants, the plants traditionally used in different cancer and microbial treatments showed highest cytotoxicity. The results support their ethnomedicinal uses and require advanced investigation to elucidate responsible compounds as well as their mode of action. PMID:25431796

  11. Systematic Review of Willingness to Pay for Health Insurance in Low and Middle Income Countries

    PubMed Central

    Nosratnejad, Shirin; Rashidian, Arash; Dror, David Mark

    2016-01-01

    Objective Access to healthcare is mostly contingent on out-of-pocket spending (OOPS) by health seekers, particularly in low- and middle-income countries (LMICs). This would require many LMICs to raise enough funds to achieve universal health insurance coverage. But, are individuals or households willing to pay for health insurance, and how much? What factors positively affect WTP for health insurance? We wanted to examine the evidence for this, through a review of the literature. Methods We systematically searched databases up to February 2016 and included studies of individual or household WTP for health insurance. Two authors appraised the identified studies. We estimated the WTP as a percentage of GDP per capita, and adjusted net national income per capita of each country. We used meta-analysis to calculate WTP means and confidence intervals, and vote-counting to identify the variables that more often affected WTP. Result 16 studies (21 articles) from ten countries met the inclusion criteria. The mean WTP of individuals was 1.18% of GDP per capita and 1.39% of adjusted net national income per capita. The corresponding figures for households were 1.82% and 2.16%, respectively. Increases in family size, education level and income were consistently correlated with higher WTP for insurance, and increases in age were correlated with reduced WTP. Conclusions The WTP for healthcare insurance among rural households in LMICs was just below 2% of the GPD per capita. The findings demonstrate that in moving towards universal health coverage in LMICs, governments should not rely on households' premiums as a major financing source and should increase their fiscal capacity for an equitable health care system using other sources. PMID:27362356

  12. Pathogens associated with persistent diarrhoea in children in low and middle income countries: systematic review

    PubMed Central

    2009-01-01

    Background Persistent diarrhoea in children is a common problem in low and middle income countries. To help target appropriate treatment for specific pathogens in the absence of diagnostic tests, we systematically reviewed pathogens most commonly associated with persistent diarrhoea in children. Methods We sought all descriptive studies of pathogens in the stool of children with diarrhoea of over 14 days duration in low and middle income countries with a comprehensive search of the MEDLINE, EMBASE, LILACS and WEB OF SCIENCE databases. We described the study designs and populations, assessed the quality of the laboratory tests, and extracted and summarised data on pathogens. For Escherichia coli, we calculated high and low prevalence estimates of all enteropathic types combined. Results across studies were compared for geographical patterns. Results Nineteen studies were included. Some used episodes of diarrhoea as the unit of analysis, others used children. The quality of reporting of laboratory procedures varied, and pathogens (particularly E. coli types) were classified in different ways. As there were no apparent regional differences in pathogen prevalence, we aggregated data between studies to give a guide to overall prevalence. Enteropathic E. coli types were commonly found in children with persistent diarrhoea (up to 63%). Various other organisms, including viruses, bacteria and parasites, were detected but across all studies their prevalence was under 10%. However, these pathogens were also found in similar frequencies in children without diarrhoea. Conclusion A number of pathogens are commonly associated with persistent diarrhoea in children, but in children without diarrhoea the pathogens are found with similar frequencies. New research with carefully selected controls and standardised laboratory investigations across countries will help map causes and help explore effective options for presumptive treatment. PMID:19515227

  13. Motivation and retention of health workers in developing countries: a systematic review

    PubMed Central

    Willis-Shattuck, Mischa; Bidwell, Posy; Thomas, Steve; Wyness, Laura; Blaauw, Duane; Ditlopo, Prudence

    2008-01-01

    Background A key constraint to achieving the MDGs is the absence of a properly trained and motivated workforce. Loss of clinical staff from low and middle-income countries is crippling already fragile health care systems. Health worker retention is critical for health system performance and a key problem is how best to motivate and retain health workers. The authors undertook a systematic review to consolidate existing evidence on the impact of financial and non-financial incentives on motivation and retention. Methods Four literature databases were searched together with Google Scholar and 'Human Resources for Health' on-line journal. Grey literature studies and informational papers were also captured. The inclusion criteria were: 1) article stated clear reasons for implementing specific motivations to improve health worker motivation and/or reduce medical migration, 2) the intervention recommended can be linked to motivation and 3) the study was conducted in a developing country and 4) the study used primary data. Results Twenty articles met the inclusion criteria. They consisted of a mixture of qualitative and quantitative studies. Seven major motivational themes were identified: financial rewards, career development, continuing education, hospital infrastructure, resource availability, hospital management and recognition/appreciation. There was some evidence to suggest that the use of initiatives to improve motivation had been effective in helping retention. There is less clear evidence on the differential response of different cadres. Conclusion While motivational factors are undoubtedly country specific, financial incentives, career development and management issues are core factors. Nevertheless, financial incentives alone are not enough to motivate health workers. It is clear that recognition is highly influential in health worker motivation and that adequate resources and appropriate infrastructure can improve morale significantly. PMID:19055827

  14. 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

  15. High acceptance of urine source separation in seven European countries: a review.

    PubMed

    Lienert, Judit; Larsen, Tove A

    2010-01-15

    Urine source separation (NoMix-technology) is a promising innovation aiming at a resource-oriented, decentralized approach in urban water management. However, NoMix-technology has a sensitive end-point: people's bathrooms. NoMix-technology is increasingly applied in European pilot projects, but the success from a user point-of-view has rarely been systematically monitored. We aim at closing this gap. We review surveys on acceptance, including reuse of human urine as fertilizer, from 38 NoMix-projects in 7 Northern and Central European countries with 2700 respondents. Additionally, we identify explanatory variables with logistic regression of a representative Swiss library survey. NoMix-technology is well accepted; around 80% of users liked the idea, 75-85% were satisfied with design, hygiene, smell, and seating comfort of NoMix-toilets, 85% regarded urine-fertilizers as good idea (50% of farmers), and 70% would purchase such food. However, 60% of users encountered problems; NoMix-toilets need further development. We found few differences among countries, but systematic differences between public and private settings, where people seem more critical. Information was positively correlated with acceptance, and, e.g., a good mood or environmentally friendly behavior. For future success of NoMix-projects, we recommend authorities follow an integral strategy. Lay people will then find the NoMix-concept appealing and support this promising bathroom innovation. PMID:20000706

  16. Conflict in Neighboring Countries, a Great Risk for Malaria Elimination in Southwestern Iran: Narrative Review Article.

    PubMed

    Molaee Zadeh, Maryam; Shahandeh, Khandan; Bigdeli, Shahla; Basseri, Hamid Reza

    2014-12-01

    The intensity of the conflict such as war is one of the determinants of the flow of migrants and refuges with consequence of introducing infectious disease to other countries. This paper investigates the relationship between malaria incidence and forced immigration due to war from neighboring countries in Dezful district, southwestern Iran. All available data and accessible archived documentary records on malaria cases in the period 1988-2011 in Dezful Health Centers were reviewed. Retrospective analysis of routine surveillance data from the Health authority of Dezful district was conducted to assess the trend of malaria incidence and prevalence in the last two decades. Malaria transmission dynamics was described using surveillance indicators viz, Annual Parasite Incidence (API), Slide Positivity Rate (SPR), Annual Blood Examination Rate (ABER) and based on personal information of patients. Two peaks of malaria incidence occurred during past two decades. The first one arisen by Iran-Iraq war due to residential instability in Dezful while the API reached to 8 per 1000. The second peak happened after to civil war of Afghanistan began which caused large immigrates moved into the study area. During the second peak, API reached 1.7 per 1000 at maximum and the majority of patients were immigrants. This study describes the linkage between incidence and prevalence of malaria and immigration due to civil conflict. Therefore, malaria screening of immigrants and early warning programme are effective to prevent outbreak of disease in a potential risk area such Dezful. PMID:26171354

  17. Antibiotic resistance of Vibrio parahaemolyticus and Vibrio vulnificus in various countries: A review.

    PubMed

    Elmahdi, Sara; DaSilva, Ligia V; Parveen, Salina

    2016-08-01

    Vibrio parahaemolyticus and Vibrio vulnificus are the leading causes of seafood associated infections and mortality in the United States. The main syndromes caused by these pathogens are gastroenteritis, wound infections, and septicemia. This article reviewed the antibiotic resistance profile of V. parahaemolyticus and V. vulnificus in the United States and other countries including Italy, Brazil, Philippines, Malaysia, Thailand, China, India, Iran, South Africa and Australia. The awareness of antimicrobial resistance of these two pathogens is not as well documented as other foodborne bacterial pathogens. Vibrio spp. are usually susceptible to most antimicrobials of veterinary and human significance. However, many studies reported that V. vulnificus and V. parahaemolyticus showed multiple-antibiotic resistance due to misuse of antibiotics to control infections in aquaculture production. In addition, both environmental and clinical isolates showed similar antibiotic resistance profiles. Most frequently observed antibiotic resistance profiles involved ampicillin, penicillin and tetracycline regardless of the countries. The presence of multiple-antibiotic resistant bacteria in seafood and aquatic environments is a major concern in fish and shellfish farming and human health. PMID:27052711

  18. Mechanisation of large-scale agricultural fields in developing countries - a review.

    PubMed

    Onwude, Daniel I; Abdulstter, Rafia; Gomes, Chandima; Hashim, Norhashila

    2016-09-01

    Mechanisation of large-scale agricultural fields often requires the application of modern technologies such as mechanical power, automation, control and robotics. These technologies are generally associated with relatively well developed economies. The application of these technologies in some developing countries in Africa and Asia is limited by factors such as technology compatibility with the environment, availability of resources to facilitate the technology adoption, cost of technology purchase, government policies, adequacy of technology and appropriateness in addressing the needs of the population. As a result, many of the available resources have been used inadequately by farmers, who continue to rely mostly on conventional means of agricultural production, using traditional tools and equipment in most cases. This has led to low productivity and high cost of production among others. Therefore this paper attempts to evaluate the application of present day technology and its limitations to the advancement of large-scale mechanisation in developing countries of Africa and Asia. Particular emphasis is given to a general understanding of the various levels of mechanisation, present day technology, its management and application to large-scale agricultural fields. This review also focuses on/gives emphasis to future outlook that will enable a gradual, evolutionary and sustainable technological change. The study concludes that large-scale-agricultural farm mechanisation for sustainable food production in Africa and Asia must be anchored on a coherent strategy based on the actual needs and priorities of the large-scale farmers. © 2016 Society of Chemical Industry. PMID:26940194

  19. Coping with a diagnosis of breast cancer-literature review and implications for developing countries.

    PubMed

    Al-Azri, Mohammed; Al-Awisi, Huda; Al-Moundhri, Mansour

    2009-01-01

    Breast cancer is the most common cancer affecting women worldwide. Women are at an increased risk of developing both physical and psychological morbidity after diagnosis; however, many use different strategies to cope with the disease. The aim of this article is to review the available literature on the impact of breast cancer diagnoses and the strategies used by women to cope with this disease. The implications of these emerging findings are extrapolated within the context of health services provided in developing countries. Electronic databases were used to search the relevant literature. The findings showed that women who were diagnosed with breast cancer are at risk of developing several psychological morbidities such as depression, anxiety, fatigue, negative thoughts, suicidal thoughts, fear of dying, sense of aloneness, sexual and body images problems, as well as an overall decrease in the quality of life. Several strategies are used by women with breast cancer to cope with the disease, including positive cognitive restructuring, wishful thinking, emotional expression, disease acceptance, increased religious practice, family and social support, and yoga and exercise. Breast cancer diagnoses have been associated with several devastating psychological consequences; however, many women have used different coping strategies to adjust their lives accordingly. Healthcare professionals in developing countries, who work with women with breast cancer, should be aware of the different coping mechanisms that women use when diagnosed with cancer. Integrating a coping strategy into the treatment regimen would constitute an important milestone in the palliative care of patients with breast cancer. PMID:19686231

  20. Evidence based review of type 2 diabetes prevention and management in low and middle income countries

    PubMed Central

    Afable, Aimee; Karingula, Nidhi Shree

    2016-01-01

    AIM: To identify the newest approaches to type 2 diabetes (T2DM) prevention and control in the developing world context. METHODS: We conducted a systematic review of published studies of diabetes prevention and control programs in low and middle-income countries, as defined by the World Bank. We searched PubMed using Medical Subject Headings terms. Studies needed to satisfy four criteria: (1) Must be experimental; (2) Must include patients with T2DM or focusing on prevention of T2DM; (3) Must have a lifestyle intervention component; (4) Must be written in English; and (5) Must have measurable outcomes related to diabetes. RESULTS: A total of 66 studies from 20 developing countries were gathered with publication dates through September 2014. India contributed the largest number of trials (11/66). Of the total 66 studies reviewed, all but 3 studies reported evidence of favorable outcomes in the prevention and control of type 2 diabetes. The overwhelming majority of studies reported on diabetes management (56/66), and among these more than half were structured lifestyle education programs. The evidence suggests that lifestyle education led by allied health professionals (nurses, pharmacists) were as effective as those led by physicians or a team of clinicians. The remaining diabetes management interventions focused on diet or exercise, but the evidence to recommend one approach over another was weak. CONCLUSION: Large experimental diabetes prevention/control studies of dietary and exercise interventions are lacking particularly those that consider quality rather than quantity of carbohydrates and alternative exercise. PMID:27226816

  1. Multiple Functions of Ten-eleven Translocation 1 during Tumorigenesis

    PubMed Central

    Tian, Yi-Ping; Zhu, Yi-Min; Sun, Xiao-Hui; Lai, Mao-De

    2016-01-01

    Objective: Aberrant expression of ten-eleven translocation 1 (TET1) plays a critical role in tumor development and progression. We systematically summarized the latest research progress on the role and mechanisms of TET1 in cancer biology. Data Sources: Relevant articles published in English from 1980 to April 2016 were selected from the PubMed database. The terms “ten-eleven translocation 1,” “5mC,” “5hmC,” “microRNA,” “hypoxia,” and “embryonic stem cell” were used for the search. Study Selection: Articles focusing on the role and mechanism of TET1 in tumor were reviewed, including clinical and basic research articles. Results: TET proteins, the key enzymes converting 5-methylcytosine to 5-hydroxymethylcytosine, play vital roles in DNA demethylation regulation. Recent studies have shown that loss of TET1 is associated with tumorigenesis and can be used as a potential biomarker for cancer therapy, which indicates that TET1 serves as tumor suppressor gene. Moreover, besides its dioxygenase activity, TET1 could induce epithelial-mesenchymal transition and act as a coactivator to regulate gene transcription, such as developmental regulator in embryonic stem cells (ESCs) and hypoxia-responsive gene in cancer. The regulation of TET1 is also correlated with microRNA in a posttranscriptional modification process. Hence, it is complex but critical to comprehend the mechanisms of TET1 in the biology of ESCs and cancer. Conclusions: TET1 not only serves as a demethylation enzyme but also plays multiple roles during tumorigenesis and progression. More studies should be carried out to elucidate the exact mechanisms of TET1 and its associations with cancer before considering it as a therapeutic tool. PMID:27411465

  2. A surveillance sector review applied to infectious diseases at a country level

    PubMed Central

    2010-01-01

    Background The new International Health Regulations (IHR) require World Health Organization (WHO) member states to assess their core capacity for surveillance. Such reviews also have the potential to identify important surveillance gaps, improve the organisation of disparate surveillance systems and to focus attention on upstream hazards, determinants and interventions. Methods We developed a surveillance sector review method for evaluating all of the surveillance systems and related activities across a sector, in this case those concerned with infectious diseases in New Zealand. The first stage was a systematic description of these surveillance systems using a newly developed framework and classification system. Key informant interviews were conducted to validate the available information on the systems identified. Results We identified 91 surveillance systems and related activities in the 12 coherent categories of infectious diseases examined. The majority (n = 40 or 44%) of these were disease surveillance systems. They covered all categories, particularly for more severe outcomes including those resulting in death or hospitalisations. Except for some notifiable diseases and influenza, surveillance of less severe, but important infectious diseases occurring in the community was largely absent. There were 31 systems (34%) for surveillance of upstream infectious disease hazards, including risk and protective factors. This area tended to have many potential gaps and lack integration, partly because such systems were operated by a range of different agencies, often outside the health sector. There were fewer surveillance systems for determinants, including population size and characteristics (n = 9), and interventions (n = 11). Conclusions It was possible to create and populate a workable framework for describing all the infectious diseases surveillance systems and related activities in a single developed country and to identify potential surveillance sector gaps

  3. Socioeconomic status and response to antiretroviral therapy in high-income countries: a literature review.

    PubMed

    Burch, Lisa S; Smith, Colette J; Phillips, Andrew N; Johnson, Margaret A; Lampe, Fiona C

    2016-05-15

    It has been shown that socioeconomic factors are associated with the prognosis of several chronic diseases; however, there is no recent systematic review of their effect on HIV treatment outcomes. We aimed to review the evidence regarding the existence of an association of socioeconomic status with virological and immunological response to antiretroviral therapy (ART). We systematically searched the current literature using the database PubMed. We identified and summarized original research studies in high-income countries that assessed the association between socioeconomic factors (education, employment, income/financial status, housing, health insurance, and neighbourhood-level socioeconomic factors) and virological response, immunological response, and ART nonadherence among people with HIV-prescribed ART. A total of 48 studies met the inclusion criteria (26 from the United States, six Canadian, 13 European, and one Australian), of which 14, six, and 35 analysed virological, immunological, and ART nonadherence outcomes, respectively. Ten (71%), four (67%), and 23 (66%) of these studies found a significant association between lower socioeconomic status and poorer response, and none found a significant association with improved response. Several studies showed that adjustment for nonadherence attenuated the association between socioeconomic status and ART response. Our review provides strong support that socioeconomic disadvantage is associated with poorer response to ART. However, most studies have been conducted in settings such as the United States without universal free healthcare access. Further study in settings with free access to ART could help assess the impact of socioeconomic status on ART outcomes and the mechanisms by which it operates. PMID:26919732

  4. A Systematic Literature Review of the Information-Seeking Behavior of Dentists in Developed Countries.

    PubMed

    Isham, Amy; Bettiol, Silvana; Hoang, Ha; Crocombe, Leonard

    2016-05-01

    Understanding the information-seeking behavior of dentists may inform ways to increase the dentist uptake of evidence-based research for clinical decision making and the practice of evidence-based dentistry, but no systematic review of dentist information-seeking behavior has been conducted. This review aimed to synthesize the best available evidence on where and how dentists seek information. A literature search of Web of Science, Scopus, PubMed, and reference lists of English language studies from the Organization for Economic Cooperation and Development countries of dentists' information-seeking behavior published between 2002 and 2014 was conducted. Selected articles were assessed using mixed methods analysis, and the data extracted were thematically synthesized. Nine studies met the inclusion criteria, and four main themes were identified: dentists' difficulty translating evidence-based resources into clinical practice; dentists' preference for face-to-face meetings, collegial discussion, and print materials over evidence-based resources; dentists' perceptions of the validity of evidence-based resources and the role of specialist and experienced dentists as information sources for general and less experienced dentists; and differences between early and late adopters of research evidence. Dentists in these studies tended to adopt new materials/techniques after discussion with a colleague, a dental specialist, or a respected dental expert. These dentists also reported lacking time, experience, skills, and confidence to find and use evidence-based resources. Many of the dentists studied were cautious about making decisions based on documentary sources like literature reviews and preferred to seek advice from an experienced or specialist colleague or to participate in face-to-face meetings. PMID:27139208

  5. Etiology of Severe Febrile Illness in Low- and Middle-Income Countries: A Systematic Review

    PubMed Central

    Prasad, Namrata; Murdoch, David R.; Reyburn, Hugh; Crump, John A.

    2015-01-01

    Background With apparent declines in malaria worldwide during the last decade and more widespread use of malaria rapid diagnostic tests, healthcare workers in low-resource areas face a growing proportion of febrile patients without malaria. We sought to describe current knowledge and identify information gaps of the etiology severe febrile illness in low-and middle-income countries. Methods and Findings We conducted a systematic review of studies conducted in low-and-middle income countries 1980–2013 that prospectively assessed consecutive febrile patients admitted to hospital using rigorous laboratory-based case definitions. We found 45 eligible studies describing 54,578 patients; 9,771 (17.9%) had a positive result for ≥1 pathogen meeting diagnostic criteria. There were no eligible studies identified from Southern and Middle Africa, Eastern Asia, Oceania, Latin American and Caribbean regions, and the European region. The median (range) number of diagnostic tests meeting our confirmed laboratory case definitions was 2 (1 to 11) per study. Of diagnostic tests, 5,052 (10.3%) of 49,143 had confirmed bacterial or fungal bloodstream infection; 709 (3.8%) of 18,142 had bacterial zoonosis; 3,488 (28.5%) of 12,245 had malaria; and 1,804 (17.4%) of 10,389 had a viral infection. Conclusions We demonstrate a wide range of pathogens associated with severe febrile illness and highlight the substantial information gaps regarding the geographic distribution and role of common pathogens. High quality severe febrile illness etiology research that is comprehensive with respect to pathogens and geographically representative is needed. PMID:26126200

  6. Emergency care in 59 low- and middle-income countries: a systematic review

    PubMed Central

    Abujaber, Samer; Makar, Maggie; Stoll, Samantha; Kayden, Stephanie R; Wallis, Lee A; Reynolds, Teri A

    2015-01-01

    Abstract Objective To conduct a systematic review of emergency care in low- and middle-income countries (LMICs). Methods We searched PubMed, CINAHL and World Health Organization (WHO) databases for reports describing facility-based emergency care and obtained unpublished data from a network of clinicians and researchers. We screened articles for inclusion based on their titles and abstracts in English or French. We extracted data on patient outcomes and demographics as well as facility and provider characteristics. Analyses were restricted to reports published from 1990 onwards. Findings We identified 195 reports concerning 192 facilities in 59 countries. Most were academically-affiliated hospitals in urban areas. The median mortality within emergency departments was 1.8% (interquartile range, IQR: 0.2–5.1%). Mortality was relatively high in paediatric facilities (median: 4.8%; IQR: 2.3–8.4%) and in sub-Saharan Africa (median: 3.4%; IQR: 0.5–6.3%). The median number of patients was 30 000 per year (IQR: 10 296–60 000), most of whom were young (median age: 35 years; IQR: 6.9–41.0) and male (median: 55.7%; IQR: 50.0–59.2%). Most facilities were staffed either by physicians-in-training or by physicians whose level of training was unspecified. Very few of these providers had specialist training in emergency care. Conclusion Available data on emergency care in LMICs indicate high patient loads and mortality, particularly in sub-Saharan Africa, where a substantial proportion of all deaths may occur in emergency departments. The combination of high volume and the urgency of treatment make emergency care an important area of focus for interventions aimed at reducing mortality in these settings. PMID:26478615

  7. Quality Improvement for Cardiovascular Disease Care in Low- and Middle-Income Countries: A Systematic Review

    PubMed Central

    Lee, Edward S.; Vedanthan, Rajesh; Jeemon, Panniyammakal; Kamano, Jemima H.; Kudesia, Preeti; Rajan, Vikram; Engelgau, Michael; Moran, Andrew E.

    2016-01-01

    Background The majority of global cardiovascular disease (CVD) burden falls on people living in low- and middle-income countries (LMICs). In order to reduce preventable CVD mortality and morbidity, LMIC health systems and health care providers need to improve the delivery and quality of CVD care. Objectives As part of the Disease Control Priorities Three (DCP3) Study efforts addressing quality improvement, we reviewed and summarized currently available evidence on interventions to improve quality of clinic-based CVD prevention and management in LMICs. Methods We conducted a narrative review of published comparative clinical trials that evaluated efficacy or effectiveness of clinic-based CVD prevention and management quality improvement interventions in LMICs. Conditions selected a priori included hypertension, diabetes, hyperlipidemia, coronary artery disease, stroke, rheumatic heart disease, and congestive heart failure. MEDLINE and EMBASE electronic databases were systematically searched. Studies were categorized as occurring at the system or patient/provider level and as treating the acute or chronic phase of CVD. Results From 847 articles identified in the electronic search, 49 met full inclusion criteria and were selected for review. Selected studies were performed in 19 different LMICs. There were 10 studies of system level quality improvement interventions, 38 studies of patient/provider interventions, and one study that fit both criteria. At the patient/provider level, regardless of the specific intervention, intensified, team-based care generally led to improved medication adherence and hypertension control. At the system level, studies provided evidence that introduction of universal health insurance coverage improved hypertension and diabetes control. Studies of system and patient/provider level acute coronary syndrome quality improvement interventions yielded inconclusive results. The duration of most studies was less than 12 months. Conclusions The

  8. Effects of the Global Financial Crisis on Health in High-Income Oecd Countries: A Narrative Review.

    PubMed

    Karanikolos, Marina; Heino, Pia; McKee, Martin; Stuckler, David; Legido-Quigley, Helena

    2016-01-01

    A growing body of evidence documents how economic crises impact aspects of health across countries and over time. We performed a systematic narrative review of the health effects of the latest economic crisis based on studies of high-income countries. Papers published between January 2009 and July 2015 were selected based on review of titles and abstracts, followed by a full text review conducted by two independent reviewers. Ultimately, 122 studies were selected and their findings summarized. The review finds that the 2008 financial crisis had negative effects on mental health, including suicide, and to a varying extent on some non-communicable and communicable diseases and access to care. Although unhealthy behaviors such as hazardous drinking and tobacco use appeared to decline during the crisis, there have been increases in some groups, typically those already at greatest risk. The health impact was greatest in countries that suffered the largest economic impact of the crisis or prolonged austerity. The Great Recessions in high-income countries have had mixed impacts on health. They tend to be worse when economic impacts are more severe, prolonged austerity measures are implemented, and there are pre-existing problems of substance use among vulnerable groups. PMID:27076651

  9. Review: Lead exposure in battery manufacturing and recycling in developing countries and among children in nearby communities.

    PubMed

    Gottesfeld, Perry; Pokhrel, Amod K

    2011-09-01

    The battery industry is the largest consumer of lead, using an estimated 80% of the global lead production. The industry is also rapidly expanding in emerging market countries. A review of published literature on exposures from lead-acid battery manufacturing and recycling plants in developing countries was conducted. The review included studies from 37 countries published from 1993 to 2010 and excluded facilities in developed countries, such as the United States and those in Western Europe, except for providing comparisons to reported findings. The average worker blood lead level (BLL) in developing countries was 47 μg/dL in battery manufacturing plants and 64 μg/dL in recycling facilities. Airborne lead concentrations reported in battery plants in developing countries averaged 367 μg/m3, which is 7-fold greater than the U.S. Occupational Safety and Health Administration's 50 μg/m3 permissible exposure limit. The geometric mean BLL of children residing near battery plants in developing countries was 19 μg/dL, which is about 13-fold greater than the levels observed among children in the United States. The blood lead and airborne lead exposure concentrations for battery workers were substantially higher in developing countries than in the United States. This disparity may worsen due to rapid growth in lead-acid battery manufacturing and recycling operations worldwide. Given the lack of regulatory and enforcement capacity in most developing countries, third-party certification programs may be the only viable option to improve conditions. PMID:21793732

  10. Systematic Review of Abstinence-Plus HIV Prevention Programs in High-Income Countries

    PubMed Central

    Underhill, Kristen; Operario, Don; Montgomery, Paul

    2007-01-01

    Background Abstinence-plus (comprehensive) interventions promote sexual abstinence as the best means of preventing HIV, but also encourage condom use and other safer-sex practices. Some critics of abstinence-plus programs have suggested that promoting safer sex along with abstinence may undermine abstinence messages or confuse program participants; conversely, others have suggested that promoting abstinence might undermine safer-sex messages. We conducted a systematic review to investigate the effectiveness of abstinence-plus interventions for HIV prevention among any participants in high-income countries as defined by the World Bank. Methods and Findings Cochrane Collaboration systematic review methods were used. We included randomized and quasi-randomized controlled trials of abstinence-plus programs for HIV prevention among any participants in any high-income country; trials were included if they reported behavioural or biological outcomes. We searched 30 electronic databases without linguistic or geographical restrictions to February 2007, in addition to contacting experts, hand-searching conference abstracts, and cross-referencing papers. After screening 20,070 abstracts and 325 full published and unpublished papers, we included 39 trials that included approximately 37,724 North American youth. Programs were based in schools (10), community facilities (24), both schools and community facilities (2), health care facilities (2), and family homes (1). Control groups varied. All outcomes were self-reported. Quantitative synthesis was not possible because of heterogeneity across trials in programs and evaluation designs. Results suggested that many abstinence-plus programs can reduce HIV risk as indicated by self-reported sexual behaviours. Of 39 trials, 23 found a protective program effect on at least one sexual behaviour, including abstinence, condom use, and unprotected sex (baseline n = 19,819). No trial found adverse program effects on any behavioural outcome

  11. Community pharmacy and emerging public health initiatives in developing Southeast Asian countries: a systematic review.

    PubMed

    Hermansyah, Andi; Sainsbury, Erica; Krass, Ines

    2016-09-01

    The development of health and healthcare systems in South-East Asia has influenced the practice of community pharmacy. Over the years, community pharmacy in the region has striven to expand services beyond dispensing to encompass more involvement in public health issues. Searches were conducted in Scopus, EMBASE, MEDLINE and PubMed for articles published between January 2000 and December 2014, with 21 studies in five countries meeting the inclusion criteria. The findings showed increasing interest in research into the delivery of pharmacy services and public health initiatives. Overall, the review found that provision of some health services in pharmacies was common; however, most public health initiatives appeared to be poorly implemented, had limited evidence and were not demonstrated to be sustainable across the sector. This indicates that the practice of community pharmacy in the region has not significantly changed over the past 14 years with respect to the scope and quality of pharmacy services provided, and fundamental policy changes are necessary to improve this situation. PMID:26427905

  12. Seasonal variation of fecal contamination in drinking water sources in developing countries: a systematic review.

    PubMed

    Kostyla, Caroline; Bain, Rob; Cronk, Ryan; Bartram, Jamie

    2015-05-01

    Accounting for fecal contamination of drinking water sources is an important step in improving monitoring of global access to safe drinking water. Fecal contamination varies with time while its monitoring is often infrequent. We sought to understand seasonal trends in fecal contamination to guide best practices to capture seasonal variation and ascertain the extent to which the results of a single sample may overestimate compliance with health guidelines. The findings from 22 studies from developing countries written in English and identified through a systematic review were analyzed. Fecal contamination in improved drinking water sources was shown to follow a statistically significant seasonal trend of greater contamination during the wet season (p<0.001). This trend was consistent across fecal indicator bacteria, five source types, twelve Köppen-Geiger climate zones, and across both rural and urban areas. Guidance on seasonally representative water quality monitoring by the World Health Organization and national water quality agencies could lead to improved assessments of access to safe drinking water. PMID:25676921

  13. Health Informatics in Developing Countries: Going beyond Pilot Practices to Sustainable Implementations: A Review of the Current Challenges

    PubMed Central

    Almerares, Alfredo; Mayan, John Charles; González Bernaldo de Quirós, Fernán; Otero, Carlos

    2014-01-01

    Objectives Information technology is an essential tool to improve patient safety and the quality of care, and to reduce healthcare costs. There is a scarcity of large sustainable implementations in developing countries. The objective of this paper is to review the challenges faced by developing countries to achieve sustainable implementations in health informatics and possible ways to address them. Methods In this non-systematic review of the literature, articles were searched using the keywords medical informatics, developing countries, implementation, and challenges in PubMed, LILACS, CINAHL, Scopus, and EMBASE. The authors, after reading the literature, reached a consensus to classify the challenges into six broad categories. Results The authors describe the problems faced by developing countries arising from the lack of adequate infrastructure and the ways these can be bypassed; the fundamental need to develop nationwide e-Health agendas to achieve sustainable implementations; ways to overcome public uncertainty with respect to privacy and security; the difficulties shared with developed countries in achieving interoperability; the need for a trained workforce in health informatics and existing initiatives for its development; and strategies to achieve regional integration. Conclusions Central to the success of any implementation in health informatics is knowledge of the challenges to be faced. This is even more important in developing countries, where uncertainty and instability are common. The authors hope this article will assist policy makers, healthcare managers, and project leaders to successfully plan their implementations and make them sustainable, avoiding unexpected barriers and making better use of their resources. PMID:24627813

  14. Systematic Review of the Effectiveness of Mass Communication Programs to Change HIV/AIDS-Related Behaviors in Developing Countries

    ERIC Educational Resources Information Center

    Bertrand, Jane T.; O'Reilly, Kevin; Denison, Julie; Anhang, Rebecca; Sweat, Michael

    2006-01-01

    This review systematically examined the effectiveness of 24 mass media interventions on changing human immunodeficiency virus (HIV)-related knowledge, attitudes and behaviors. The intervention studies were published from 1990 through 2004, reported data from developing countries and compared outcomes using (i) pre- and post-intervention data, (ii)…

  15. 78 FR 60367 - Request for Public Comments on Annual Review of Country Eligibility for Benefits Under the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-01

    ... Opportunity Act Implementation Subcommittee of the Trade Policy Staff Committee (``Subcommittee'') is... to make a submission at www.regulations.gov , please contact Yvonne Jamison, Trade Policy Staff... TRADE REPRESENTATIVE Request for Public Comments on Annual Review of Country Eligibility for...

  16. 75 FR 54939 - Generalized System of Preferences (GSP): Notice Changing the Date of the Country Practices Review...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ... Policy Staff Committee; Office of the U.S. Trade Representative. BILLING CODE 3190-W0-P ... TRADE REPRESENTATIVE Generalized System of Preferences (GSP): Notice Changing the Date of the Country Practices Review Hearing AGENCY: Office of the United States Trade Representative. ACTION: Notice of...

  17. 77 FR 58205 - Request for Public Comments on Annual Review of Country Eligibility for Benefits Under the...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-09-19

    ... Subcommittee of the Trade Policy Staff Committee (the ``Subcommittee'') is requesting written public comments... make a submission at www.regulations.gov , please contact Don Eiss, Trade Policy Staff Committee, at... TRADE REPRESENTATIVE Request for Public Comments on Annual Review of Country Eligibility for...

  18. Quality of Teaching in Four European Countries: A Review of the Literature and Application of an Assessment Instrument

    ERIC Educational Resources Information Center

    Van de Grift, Wim

    2007-01-01

    Background: From 2002 onwards, initiatives and first steps for the project International Comparative Analysis of Learning and Teaching (ICALT) have been taken by the inspectorates of education in England, Flanders (Belgium), Lower Saxony (Germany) and The Netherlands. The inspectorates of education in these European countries reviewed the results…

  19. The effects of global health initiatives on country health systems: a review of the evidence from HIV/AIDS control

    PubMed Central

    Biesma, Regien G; Brugha, Ruairí; Harmer, Andrew; Walsh, Aisling; Spicer, Neil; Walt, Gill

    2009-01-01

    This paper reviews country-level evidence about the impact of global health initiatives (GHIs), which have had profound effects on recipient country health systems in middle and low income countries. We have selected three initiatives that account for an estimated two-thirds of external funding earmarked for HIV/AIDS control in resource-poor countries: the Global Fund to Fight AIDS, TB and Malaria, the World Bank Multi-country AIDS Program (MAP) and the US President's Emergency Plan for AIDS Relief (PEPFAR). This paper draws on 31 original country-specific and cross-country articles and reports, based on country-level fieldwork conducted between 2002 and 2007. Positive effects have included a rapid scale-up in HIV/AIDS service delivery, greater stakeholder participation, and channelling of funds to non-governmental stakeholders, mainly NGOs and faith-based bodies. Negative effects include distortion of recipient countries’ national policies, notably through distracting governments from coordinated efforts to strengthen health systems and re-verticalization of planning, management and monitoring and evaluation systems. Sub-national and district studies are needed to assess the degree to which GHIs are learning to align with and build the capacities of countries to respond to HIV/AIDS; whether marginalized populations access and benefit from GHI-funded programmes; and about the cost-effectiveness and long-term sustainability of the HIV and AIDS programmes funded by the GHIs. Three multi-country sets of evaluations, which will be reporting in 2009, will answer some of these questions. PMID:19491291

  20. Health workforce skill mix and task shifting in low income countries: a review of recent evidence

    PubMed Central

    2011-01-01

    Background Health workforce needs-based shortages and skill mix imbalances are significant health workforce challenges. Task shifting, defined as delegating tasks to existing or new cadres with either less training or narrowly tailored training, is a potential strategy to address these challenges. This study uses an economics perspective to review the skill mix literature to determine its strength of the evidence, identify gaps in the evidence, and to propose a research agenda. Methods Studies primarily from low-income countries published between 2006 and September 2010 were found using Google Scholar and PubMed. Keywords included terms such as skill mix, task shifting, assistant medical officer, assistant clinical officer, assistant nurse, assistant pharmacist, and community health worker. Thirty-one studies were selected to analyze, based on the strength of evidence. Results First, the studies provide substantial evidence that task shifting is an important policy option to help alleviate workforce shortages and skill mix imbalances. For example, in Mozambique, surgically trained assistant medical officers, who were the key providers in district hospitals, produced similar patient outcomes at a significantly lower cost as compared to physician obstetricians and gynaecologists. Second, although task shifting is promising, it can present its own challenges. For example, a study analyzing task shifting in HIV/AIDS in sub-Saharan Africa noted quality and safety concerns, professional and institutional resistance, and the need to sustain motivation and performance. Third, most task shifting studies compare the results of the new cadre with the traditional cadre. Studies also need to compare the new cadre's results to the results from the care that would have been provided--if any care at all--had task shifting not occurred. Conclusions Task shifting is a promising policy option to increase the productive efficiency of the delivery of health care services, increasing

  1. Solid waste management in Asian countries: a review of solid waste minimisation (3'r) towards low carbon

    NASA Astrophysics Data System (ADS)

    Ali, N. E.; Sion, H. C.

    2014-02-01

    The amount of solid-waste generated in Asian countries has increased tremendously, mainly due to the improvement in living standards, rapid developments in technology, growth in economy and population in the cities. Solid waste management is a global issue and major challenge facing Asian countries and neglecting its management may have negative consequences on the environment. Waste composition data proves the developed countries to have generated more recyclable materials while developing countries produce more organic and less recyclable waste such as paper, plastic and aluminium. In this regard, increase in number of landfills and disposal sites, will have an impact on GHG (greenhouse gas) emissions and pollutants to air and water. Alternative methods should therefore be taken to reduce the volume of waste. Most Asian countries have adopted the 3R (reduce, reuse, recycle) concept in order to reduce solid waste and their governments have implemented laws and regulations in order to support this. Implementation of 3R is the major contributor to the solid waste minimization and it can improve the quality of environmental sustainability and reduction of carbon dioxide emission in to the atmosphere. Based on our review, most of the countries practicing the 3R concept in tandem with laws and regulations perform better than those that just practice the 3R concept without any laws and regulations. The paper suggests that every country must focus on the laws and regulations relating to solid waste minimization so that it could be easily implemented as outlined.

  2. E-waste: a problem or an opportunity? Review of issues, challenges and solutions in Asian countries.

    PubMed

    Herat, Sunil; Agamuthu, P

    2012-11-01

    Safe management of electronic and electrical waste (e-waste/WEEE) is becoming a major problem for many countries around the world. In particular, developing countries face a number of issues with the generation, transboundary movement and management of e-waste. It is estimated that the world generates around 20-50 million tonnes of e-waste annually, most of it from Asian countries. Improper handling of e-waste can cause harm to the environment and human health because of its toxic components. Several countries around the world are now struggling to deal with this emerging threat. Although the current emphasis is on end-of-life management of e-waste activities, such as reuse, servicing, remanufacturing, recycling and disposal, upstream reduction of e-waste generation through green design and cleaner production is gaining much attention. Environmentally sound management (ESM) of e-waste in developing countries is absent or very limited. Transboundary movement of e-waste is a major issue throughout the region. Dealing with the informal recycling sector is a complex social and environmental issue. There are significant numbers of such challenges faced by these countries in achieving ESM of e-waste. This article aims to present a review of challenges and issues faced by Asian countries in managing their e-waste in a sustainable way. PMID:22851536

  3. HIV/AIDS health care challenges for cross-country migrants in low- and middle-income countries: a scoping review

    PubMed Central

    Suphanchaimat, Rapeepong; Sommanustweechai, Angkana; Khitdee, Chiraporn; Thaichinda, Chompoonut; Kantamaturapoj, Kanang; Leelahavarong, Pattara; Jumriangrit, Pensom; Topothai, Thitikorn; Wisaijohn, Thunthita; Putthasri, Weerasak

    2014-01-01

    Introduction HIV/AIDS has been one of the world’s most important health challenges in recent history. The global solidarity in responding to HIV/AIDS through the provision of antiretroviral therapy (ART) and encouraging early screening has been proved successful in saving lives of infected populations in past decades. However, there remain several challenges, one of which is how HIV/AIDS policies keep pace with the growing speed and diversity of migration flows. This study therefore aimed to examine the nature and the extent of HIV/AIDS health services, barriers to care, and epidemic burdens among cross-country migrants in low-and middle-income countries. Methods A scoping review was undertaken by gathering evidence from electronic databases and gray literature from the websites of relevant international initiatives. The articles were reviewed according to the defined themes: epidemic burdens of HIV/AIDS, barriers to health services and HIV/AIDS risks, and the operational management of the current health systems for HIV/AIDS. Results Of the 437 articles selected for an initial screening, 35 were read in full and mapped with the defined research questions. A high HIV/AIDS infection rate was a major concern among cross-country migrants in many regions, in particular sub-Saharan Africa. Despite a large number of studies reported in Africa, fewer studies were found in Asia and Latin America. Barriers of access to HIV/AIDS services comprised inadequate management of guidelines and referral systems, discriminatory attitudes, language differences, unstable legal status, and financial hardship. Though health systems management varied across countries, international partners consistently played a critical role in providing support for HIV/AIDS services to uninsured migrants and refugees. Conclusion It was evident that HIV/AIDS health care problems for migrants were a major concern in many developing nations. However, there was little evidence suggesting if the current

  4. Critical review of the application of SWAT in the upper Nile Basin countries

    NASA Astrophysics Data System (ADS)

    van Griensven, A.; Ndomba, P.; Yalew, S.; Kilonzo, F.

    2012-03-01

    The Soil and Water Assessment Tool (SWAT) is a hydrological simulation tool that is widely applied within the Nile basin. Up to date, more than 20 peer reviewed papers describe the use of SWAT for a variety of problems in the upper Nile basin countries, such as erosion modeling, land use modeling, climate change impact modeling and water resources management. The majority of the studies are clustered in the tropical highlands in Ethiopia and around Lake Victoria. The popularity of SWAT is attributed to the fact that the tool is freely available and that it is readily applicable through the development of Geographic Information System (GIS) based interfaces and its easy linkage to sensitivity, calibration and uncertainty analysis tools. The online and free availability of basic GIS data that are required for SWAT made its applicability more straight forward even in data scarce areas. However, the easy use of SWAT may not always lead to knowledgeable models. In this paper, we aim at critically reviewing the use of SWAT in the context of the modeling purpose and problem descriptions in the tropical highlands of the Nile Basin countries. A number of criteria are used to evaluate the model set-up, model performances, physical representation of the model parameters, and the correctness of the hydrological model balance. On the basis of performance indicators, the majority of the SWAT models were classified as giving satisfactory to very good results. Nevertheless, the hydrological mass balances as reported in several papers contained losses that might not be justified. Several papers also reported unrealistic parameter values. More worrying is that many papers lack this information. For this reason, it is difficult to give an overall positive evaluation to most of the reported SWAT models. An important gap is the lack of attention that is given to the vegetation and crop processes. None of the papers reported any adaptation to the crop parameters, or any crop related

  5. Critical review of SWAT applications in the upper Nile basin countries

    NASA Astrophysics Data System (ADS)

    van Griensven, A.; Ndomba, P.; Yalew, S.; Kilonzo, F.

    2012-09-01

    The Soil and Water Assessment Tool (SWAT) is an integrated river basin model that is widely applied within the Nile basin. Up to date, more than 20 peer-reviewed papers describe the use of SWAT for a variety of problems in the upper Nile basin countries, such as erosion modelling, land use and climate change impact modelling and water resources management. The majority of the studies are focused on locations in the tropical highlands in Ethiopia and around Lake Victoria. The popularity of SWAT is attributed to the fact that the tool is freely available and that it is readily applicable through the development of geographic information system (GIS) based interfaces and its easy linkage to sensitivity, calibration and uncertainty analysis tools. The online and free availability of basic GIS data that are required for SWAT made its applicability more straightforward even in data-scarce areas. However, the easy use of SWAT may not always lead to appropriate models which is also a consequence of the quality of the available free databases in these regions. In this paper, we aim at critically reviewing the use of SWAT in the context of the modelling purpose and problem descriptions in the tropical highlands of the Nile basin countries. To evaluate the models that are described in journal papers, a number of criteria are used to evaluate the model set-up, model performances, physical representation of the model parameters, and the correctness of the hydrological model balance. On the basis of performance indicators, the majority of the SWAT models were classified as giving satisfactory to very good results. Nevertheless, the hydrological mass balances as reported in several papers contained losses that might not be justified. Several papers also reported the use of unrealistic parameter values. More worrying is that many papers lack this information. For this reason, most of the reported SWAT models have to be evaluated critically. An important gap is the lack of

  6. Validated Screening Tools for Common Mental Disorders in Low and Middle Income Countries: A Systematic Review

    PubMed Central

    Ryan, Grace; De Silva, Mary J.

    2016-01-01

    Background A wide range of screening tools are available to detect common mental disorders (CMDs), but few have been specifically developed for populations in low and middle income countries (LMIC). Cross-cultural application of a screening tool requires that its validity be assessed against a gold standard diagnostic interview. Validation studies of brief CMD screening tools have been conducted in several LMIC, but until now there has been no review of screening tools for all CMDs across all LMIC populations. Methods A systematic review with broad inclusion criteria was conducted, producing a comprehensive summary of brief CMD screening tools validated for use in LMIC populations. For each validation, the diagnostic odds ratio (DOR) was calculated as an easily comparable measure of screening tool validity. Average DOR results weighted by sample size were calculated for each screening tool, enabling us to make broad recommendations about best performing screening tools. Results 153 studies fulfilled our inclusion criteria. Because many studies validated two or more screening tools, this corresponded to 273 separate validations against gold standard diagnostic criteria. We found that the validity of every screening tool tested in multiple settings and populations varied between studies, highlighting the importance of local validation. Many of the best performing tools were purposely developed for a specific population; however, as these tools have only been validated in one study, it is not possible to draw broader conclusions about their applicability in other contexts. Conclusions Of the tools that have been validated in multiple settings, the authors broadly recommend using the SRQ-20 to screen for general CMDs, the GHQ-12 for CMDs in populations with physical illness, the HADS-D for depressive disorders, the PHQ-9 for depressive disorders in populations with good literacy levels, the EPDS for perinatal depressive disorders, and the HADS-A for anxiety disorders

  7. The Effectiveness of Emergency Obstetric Referral Interventions in Developing Country Settings: A Systematic Review

    PubMed Central

    Hussein, Julia; Kanguru, Lovney; Astin, Margaret; Munjanja, Stephen

    2012-01-01

    Background Pregnancy complications can be unpredictable and many women in developing countries cannot access health facilities where life-saving care is available. This study assesses the effects of referral interventions that enable pregnant women to reach health facilities during an emergency, after the decision to seek care is made. Methods and findings Selected bibliographic databases were searched with no date or language restrictions. Randomised controlled trials and quasi experimental study designs with a comparison group were included. Outcomes of interest included maternal and neonatal mortality and other intermediate measures such as service utilisation. Two reviewers independently selected, appraised, and extracted articles using predefined fields. Forest plots, tables, and qualitative summaries of study quality, size, and direction of effect were used for analysis. Nineteen studies were included. In South Asian settings, four studies of organisational interventions in communities that generated funds for transport reduced neonatal deaths, with the largest effect seen in India (odds ratio 0·48 95% CI 0·34–0·68). Three quasi experimental studies from sub-Saharan Africa reported reductions in stillbirths with maternity waiting home interventions, with one statistically significant result (OR 0.56 95% CI 0.32–0.96). Effects of interventions on maternal mortality were unclear. Referral interventions usually improved utilisation of health services but the opposite effect was also documented. The effects of multiple interventions in the studies could not be disentangled. Explanatory mechanisms through which the interventions worked could not be ascertained. Conclusions Community mobilisation interventions may reduce neonatal mortality but the contribution of referral components cannot be ascertained. The reduction in stillbirth rates resulting from maternity waiting homes needs further study. Referral interventions can have unexpected adverse effects

  8. Review of policy and status of implementation of collaborative HIV-TB activities in 23 high-burden countries.

    PubMed

    Gupta, S; Granich, R; Date, A; Lepere, P; Hersh, B; Gouws, E; Samb, B

    2014-10-01

    Issuance of national policy guidance is a critical step to ensure quality HIV-TB (human immunodeficiency virus-tuberculosis) coordination and programme implementation. From the database of the Joint United Nations Programme on HIV/AIDS (UNAIDS), we reviewed 62 national HIV and TB guidelines from 23 high-burden countries for recommendations on HIV testing for TB patients, criteria for initiating antiretroviral therapy (ART) and the Three I's for HIV/TB (isoniazid preventive treatment [IPT], intensified TB case finding and TB infection control). We used UNAIDS country-level programme data to determine the status of implementation of existing guidance. Of the 23 countries representing 89% of the global HIV-TB burden, Brazil recommends ART irrespective of CD4 count for all people living with HIV, and four (17%) countries recommend ART at the World Health Organization (WHO) 2013 guidelines level of CD4 count ⩿500 cells/mm(3) for asymptomatic persons. Nineteen (83%) countries are consistent with WHO 2013 guidelines and recommend ART for HIV-positive TB patients irrespective of CD4 count. IPT is recommended by 16 (70%) countries, representing 67% of the HIV-TB burden; 12 recommend symptom-based screening alone for IPT initiation. Guidelines from 15 (65%) countries with 79% of the world's HIV-TB burden include recommendations on HIV testing and counselling for TB patients. Although uptake of ART, HIV testing for TB patients, TB screening for people living with HIV and IPT have increased significantly, progress is still limited in many countries. There is considerable variance in the timing and content of national policies compared with WHO guidelines. Missed opportunities to implement new scientific evidence and delayed adaptation of existing WHO guidance remains a key challenge for many countries. PMID:25216827

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

    PubMed Central

    Kim, Daniel; Saada, Adrianna

    2013-01-01

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

  10. Cell block eleven (left) and cell block fifteen, looking from ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Cell block eleven (left) and cell block fifteen, looking from cell block two into the "Death Row" exercise yard - Eastern State Penitentiary, 2125 Fairmount Avenue, Philadelphia, Philadelphia County, PA

  11. Cell block eleven, looking from the "Death Row" exercise yard, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Cell block eleven, looking from the "Death Row" exercise yard, facing north (note cell block fifteen to the right and cell block fourteen in the distance_ - Eastern State Penitentiary, 2125 Fairmount Avenue, Philadelphia, Philadelphia County, PA

  12. What is known about the effects of medical tourism in destination and departure countries? A scoping review

    PubMed Central

    2010-01-01

    Background Medical tourism involves patients intentionally leaving their home country to access non-emergency health care services abroad. Growth in the popularity of this practice has resulted in a significant amount of attention being given to it from researchers, policy-makers, and the media. Yet, there has been little effort to systematically synthesize what is known about the effects of this phenomenon. This article presents the findings of a scoping review examining what is known about the effects of medical tourism in destination and departure countries. Methods Drawing on academic articles, grey literature, and media sources extracted from18 databases, we follow a widely used scoping review protocol to synthesize what is known about the effects of medical tourism in destination and departure countries. The review design has three main stages: (1) identifying the question and relevant literature; (2) selecting the literature; and (3) charting, collating, and summarizing the data. Results The large majority of the 203 sources accepted into the review offer a perspective of medical tourism from the Global North, focusing on the flow of patients from high income nations to lower and middle income countries. This greatly shapes any discussion of the effects of medical tourism on destination and departure countries. Five interrelated themes that characterize existing discussion of the effects of this practice were extracted from the reviewed sources. These themes frame medical tourism as a: (1) user of public resources; (2) solution to health system problems; (3) revenue generating industry; (4) standard of care; and (5) source of inequity. It is observed that what is currently known about the effects of medical tourism is minimal, unreliable, geographically restricted and mostly based on speculation. Conclusions Given its positive and negative effects on the health care systems of departure and destination countries, medical tourism is a highly significant and

  13. 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

  14. 76 FR 77299 - Generalized System of Preferences (GSP): Notice of Review of Certain Pending Country Practice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-12

    ... Bangladesh, Niger, Philippines, Sri Lanka, and Uzbekistan. In addition, the hearing will include testimony on a country practice petition related to the Republic of Georgia. (See 76 FR 67530.) FOR...

  15. PEPFAR Transitions to Country Ownership: Review of Past Donor Transitions and Application of Lessons Learned to the Eastern Caribbean.

    PubMed

    Vogus, Abigail; Graff, Kylie

    2015-01-01

    The US President's Emergency Plan for AIDS Relief (PEPFAR) has shifted from an emergency response to a sustainable, country-owned response. The process of transition to country ownership is already underway in the Eastern Caribbean; the Office of the US Global AIDS Coordinator (OGAC) has advised the region that PEPFAR funding is being redirected away from the Eastern Caribbean toward Caribbean countries with high disease burden to strengthen services for key populations. This article seeks to highlight and apply lessons learned from other donor transitions to support a successful transition of HIV programs in the Eastern Caribbean. Based on a rapid review of both peer-reviewed and gray literature on donor transitions to country ownership in family planning, HIV, and other areas, we identified 48 resources that addressed key steps in the transition process and determinants of readiness for transition. Analysis of the existing literature revealed 6 steps that could help ensure successful transition, including developing a clear roadmap articulated through high-level diplomacy; investing in extensive stakeholder engagement; and supporting monitoring and evaluation during and after the transition to adjust course as needed. Nine specific areas to assess a country's readiness for transition include: leadership and management capacity, political and economic factors, the policy environment, identification of alternative funding sources, integration of HIV programs into the wider health system, the institutionalization of processes, the strength of procurement and supply chain management, identification of staffing and training needs, and engagement of civil society and the private sector. In the Caribbean, key areas requiring strengthening to ensure countries in the region can maintain the gains made under PEPFAR include further engaging civil society and the private sector, building the capacity of NGOs to take on essential program functions, and maintaining donor

  16. Maternal health interventions in resource limited countries: a systematic review of packages, impacts and factors for change

    PubMed Central

    2011-01-01

    Background The burden of maternal mortality in resource limited countries is still huge despite being at the top of the global public health agenda for over the last 20 years. We systematically reviewed the impacts of interventions on maternal health and factors for change in these countries. Methods A systematic review was carried out using the guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles published in the English language reporting on implementation of interventions, their impacts and underlying factors for maternal health in resource limited countries in the past 23 years were searched from PubMed, Popline, African Index Medicus, internet sources including reproductive health gateway and Google, hand-searching, reference lists and grey literature. Results Out of a total of 5084 articles resulting from the search only 58 qualified for systematic review. Programs integrating multiple interventions were more likely to have significant positive impacts on maternal outcomes. Training in emergency obstetric care (EmOC), placement of care providers, refurbishment of existing health facility infrastructure and improved supply of drugs, consumables and equipment for obstetric care were the most frequent interventions integrated in 52% - 65% of all 54 reviewed programs. Statistically significant reduction of maternal mortality ratio and case fatality rate were reported in 55% and 40% of the programs respectively. Births in EmOC facilities and caesarean section rates increased significantly in 71% - 75% of programs using these indicators. Insufficient implementation of evidence-based interventions in resources limited countries was closely linked to a lack of national resources, leadership skills and end-users factors. Conclusions This article presents a list of evidenced-based packages of interventions for maternal health, their impacts and factors for change in resource limited countries. It indicates that no single

  17. A review of the surveillance systems of influenza in selected countries in the tropical region

    PubMed Central

    Sanicas, Melvin; Forleo, Eduardo; Pozzi, Gianni; Diop, Doudou

    2014-01-01

    Influenza viruses cause annual epidemics of respiratory tract disease that affect all age groups. Many developing countries do not have an influenza surveillance system or adequate laboratory capacity for virus detection. The objective of this study was to describe the influenza surveillance systems in the different countries in the tropics and to identify outstanding research needs. A questionnaire was designed and sent to 52 NICs and MoHs in the different countries in tropical Asia and Africa to gather information on the surveillance systems, sentinel sites, specimen and data collection, and laboratory testing. Replies were received from 32 NICs and MoHs (61.5% response) – 17 were located in tropical Asia and 15 in Africa. There are 20 WHO recognized NICs in tropical Asia and 14 in tropical Africa, all with virus isolation and polymerase chain reaction (PCR) testing capacity. Of the Asian countries, only Hong Kong and Singapore reported that the patient population from the sites represents the broader community. In tropical Africa, only Senegal has sentinel sites distributed all over the country contributing to the geographic representativeness of the surveillance system. The rest of the countries in Africa have just established their influenza surveillance system in the past decade and are working toward geographic expansion of the ILI and SARI sites. Limited laboratory capacity or infrastructure to perform influenza surveillance makes difficult to justify the importance of influenza vaccine or other influenza control measures as a strategy for improving population health in the tropical region. PMID:25745529

  18. Factors influencing breastfeeding exclusivity during the first 6 months of life in developing countries: a quantitative and qualitative systematic review.

    PubMed

    Balogun, Olukunmi Omobolanle; Dagvadorj, Amarjagal; Anigo, Kola Mathew; Ota, Erika; Sasaki, Satoshi

    2015-10-01

    Breastfeeding is the most advantageous feeding option for infants, and epidemiological studies provide evidence for its promotion. The objective of this review was to comprehensively delineate the barriers and facilitators of exclusive breastfeeding of infants aged 0-6 months old by mothers in developing countries. A search of CINAHL, MEDLINE and PsycINFO was carried out to retrieve studies from January 2001 to January 2014. Using our inclusion criteria, we selected studies that described barriers and facilitators of exclusive breastfeeding. Qualitative and quantitative studies were considered. Twenty-five studies involving 11 025 participants from 19 countries were included. Barriers and facilitators of exclusive/full breastfeeding were identified, analysed tabulated and summarised in this review. Maternal employment was the most frequently cited barrier to exclusive breastfeeding. Maternal perceptions of insufficient breast milk supply was pervasive among studies while medical barriers related to illness of mothers and/or infants as well as breast problems, rather than health care providers. Socio-cultural factors such as maternal and significant other's beliefs about infant nutrition also often constitute strong barriers to exclusive breastfeeding. Despite these barriers, mothers in developing countries often possess certain personal characteristics and develop strategic plans to enhance their success at breastfeeding. Health care providers should be informed about the determinants of exclusive breastfeeding and provide practical anticipatory guidance targeted at overcoming these barriers. In so doing, health care providers in developing countries can contribute to improving maternal and child health outcomes. PMID:25857205

  19. Barriers to access to opioid medicines: a review of national legislation and regulations of 11 central and eastern European countries.

    PubMed

    Vranken, Marjolein J M; Lisman, John A; Mantel-Teeuwisse, Aukje K; Jünger, Saskia; Scholten, Willem; Radbruch, Lukas; Payne, Sheila; Schutjens, Marie-Hélène D B

    2016-01-01

    Control measures designed to prevent the misuse of opioid medicines can often unintentionally restrict legitimate medical use, leaving patients with cancer in pain. This study aimed to develop and validate an assessment instrument based on WHO policy guidelines to systematically identify legal and regulatory barriers to opioid access in 11 European countries (Bulgaria, Cyprus, Estonia, Greece, Hungary, Latvia, Lithuania, Serbia, Slovakia, Slovenia, and Turkey) as part of the Access to Opioid Medication in Europe project. Relevant legislation and regulations were independently assessed by three reviewers and potential barriers were identified within nine categories including prescribing, penalties, and others. Potential barriers were identified in all countries, ranging from 22 potential barriers (Cyprus) to 128 potential barriers (Lithuania). The total number of barriers in a single category varied from one (Slovenia, usage category) to 49 (Greece, prescribing category). Differences, such as prescription validity, varied within one category, ranging from 5 days (Hungary) to 13 weeks (Cyprus). The results of this Review should give rise to a national review and revision of provisions that impede access to opioids, disproportionate to their (intended) benefit in preventing misuse, in these 11 European countries. PMID:26758755

  20. Systematic Review of Postgraduate Surgical Education in Low- and Middle-Income Countries.

    PubMed

    Rickard, Jennifer

    2016-06-01

    Surgical care is recognized as an important component of public health, however, many low- and middle- income countries (LMICs) are faced with a shortage of trained personnel. In response to this unmet need, many countries have developed local postgraduate training programs in surgery. This study aims to characterize general surgery postgraduate education in LMICs. PubMed, EMBASE, and Global Index Medicus databases were searched for articles related to postgraduate general surgery education in LMICs. Studies in other surgical specialties and those published prior to 1990 were excluded. Data were collected on the characteristics of postgraduate training programs. Sixty-four articles discussed postgraduate surgical education in LMICs. Programs in 34 different countries and 6 different regions were represented. Nine countries were low-income, 12 were low-middle-income, and 13 were upper-middle-income countries. Sixty-four articles described aspects of the local postgraduate training program. Prior to postgraduate training, residents complete an undergraduate medical degree with 19 programs describing a pre-training experience such as internship. Surgical curricula were broad-based to prepare trainees to work in low-resource settings. At the completion of postgraduate training, examination formats varied including oral, written, and clinical exams. Postgraduate general surgery programs ranged from 2.5 to 7 years. Postgraduate surgical education is one mechanism to increase surgical capacity in LMICs. Different strategies have been employed to improve surgical education in LMICs and learning from these programs can optimize surgical education across teaching sites. PMID:26902628

  1. A systematic literature review of pediculosis due to head lice in the Pacific Island Countries and Territories: what country specific research on head lice is needed?

    PubMed Central

    2014-01-01

    Background Lack of guidelines on control of pediculosis in the Solomon Islands led to a search for relevant evidence on head lice in the Pacific Island Countries and Territories (PICTs). The aim of this search was to systematically evaluate evidence in the peer reviewed literature on pediculosis due to head lice (Pediculus humanus var capitis) in the 22 PICTs from the perspective of its value in informing national guidelines and control strategies. Methods PubMed, Web of Science, CINAHL and Scopus were searched using the terms (pediculosis OR head lice) AND each of the 22 PICTs individually. PRISMA methodology was used. Exclusion criteria were: i) not on topic; ii) publications on pediculosis not relevant to the country of the particular search; iii) in grey literature. Results Of 24 publications identified, only 5 were included. Four related to treatment and one to epidemiology. None contained information relevant to informing national guidelines. Conclusions Current local evidence on head lice in the PICTs is minimal and totally inadequate to guide any recommendations for treatment or control. We recommend that local research is required to generate evidence on: i) epidemiology; ii) knowledge, attitudes and practices of health care providers and community members; iii) efficacy of local commercially available pharmaceutical treatments and local customary treatments; iv) acceptability, accessibility and affordability of available treatment strategies; and iv) appropriate control strategies for families, groups and institutions. We also recommend that operational research be done by local researchers based in the PICTs, supported by experienced head lice researchers, using a two way research capacity building model. PMID:24962507

  2. Measurement of social capital in relation to health in low and middle income countries (LMIC): a systematic review.

    PubMed

    Agampodi, Thilini Chanchala; Agampodi, Suneth Buddhika; Glozier, Nicholas; Siribaddana, Sisira

    2015-03-01

    Social capital is a neglected determinant of health in low and middle income countries. To date, majority of evidence syntheses on social capital and health are based upon high income countries. We conducted this systematic review to identify the methods used to measure social capital in low and middle-income countries and to evaluate their relative strengths and weaknesses. An electronic search was conducted using Pubmed, Science citation index expanded, Social science citation index expanded, Web of knowledge, Cochrane, Trip, Google scholar and selected grey literature sources. We aimed to include all studies conducted in low and middle-income countries, published in English that have measured any aspect of social capital in relation to health in the study, from 1980 to January 2013. We extracted data using a data extraction form and performed narrative synthesis as the measures were heterogeneous. Of the 472 articles retrieved, 46 articles were selected for the review. The review included 32 studies from middle income countries and seven studies from low income countries. Seven were cross national studies. Most studies were descriptive cross sectional in design (n = 39). Only two randomized controlled trials were included. Among the studies conducted using primary data (n = 32), we identified18 purposely built tools that measured various dimensions of social capital. Validity (n = 11) and reliability (n = 8) of the tools were assessed only in very few studies. Cognitive constructs of social capital, namely trust, social cohesion and sense of belonging had a positive association towards measured health outcome in majority of the studies. While most studies measured social capital at individual/micro level (n = 32), group level measurements were obtained by aggregation of individual measures. As many tools originate in high income contexts, cultural adaptation, validation and reliability assessment is mandatory in adapting the tool to the study setting. Evidence

  3. Perceptions and impact of plain packaging of tobacco products in low and middle income countries, middle to upper income countries and low-income settings in high-income countries: a systematic review of the literature

    PubMed Central

    Hughes, Nicole; Arora, Monika; Grills, Nathan

    2016-01-01

    Objective To review the current literature around the potential impact, effectiveness and perceptions of plain packaging in low income settings. Method A systematic review of the literature. Data sources 9 databases (PubMed, Global Health, Social Policy and Practice, Applied Social Sciences Index and Abstracts (ASSIA), CINAHL, PsycINFO, British Library for Development Studies (BLDS), Global Health Library and Scopus) were searched. The terms used for searching combined terms for smoking and tobacco use with terms for plain packaging. Study selection Studies investigating the impact of plain packaging on the determinants of tobacco use, such as smoking behaviour, appeal, prominence, effectiveness of health warnings, response to plain packs, attitudes towards quitting or likelihood of smoking in low-income settings, were identified. Studies must have been published in English and be original research of any level of rigour. Data extraction Two independent reviewers assessed studies for inclusion and extracted data. Data synthesis The results were synthesised qualitatively, with themes grouped under four key headings: appeal and attractiveness; salience of health warnings and perceptions of harm; enjoyment and perceived taste ratings; and perceptions of the impact on tobacco usage behaviour. Results This review has identified four articles that met the inclusion criteria. Studies identified that tobacco products in plain packaging had less appeal than in branded packaging in low-income settings. Conclusions This review indicates that plain packaging appears to be successful in reducing appeal of smoking and packets, and supports the call for plain packaging to be widely implemented in conjunction with other tobacco control policies. However, there are considerable gaps in the amount of research conducted outside high-income countries. PMID:27000787

  4. [Medications and financing of health systems in Third World countries. Cost recovery: a concept to review].

    PubMed

    Velasquez, G

    1989-01-01

    During the 1960s most African countries declared that health care would be free in their newly independent countries. Unfortunately, the health care systems inherited from colonial days were hospital based and emphasized curative rather than preventive care, and were too expensive for most countries to maintain. As the quality and availability of health services have deteriorated, the concept of free care has been questioned. At the same time, the number of countries involved in programs of structural adjustment imposed by the International Monetary Fund has grown steadily since the early 1980s, and some countries have drastically restricted public expenditures for health care. IN the search for new sources of financing, the concept of recovery of costs has become prominent. Various attempts have been made to "recover costs" even before the costs have been assessed. Financing of health care by governments, besides being insufficient, has impeded analysis of health care costs in most African countries. The World Bank proposes that the price of each medical product or service should be equal to the cost of providing it. UNICEF proposals stress the need to rationalize expenses and to defend vulnerable population groups during application of adjustment measures. The World Health Organization approach is geared toward attaining the objective of health for all by the year 2000. The basic question is still how to finance quality health care with reasonable participation of users without impeding access of the population to needed health services. An objective of 100% cost recovery will seriously compromise access for the large number of persons without purchasing power to pay the real price of health care. The term "recovery of costs" is inappropriate; the problem is to achieve a balance between participation of the population and government resources for the health system. Health services are not completely self-financing in any developed country and it appears

  5. PEPFAR Transitions to Country Ownership: Review of Past Donor Transitions and Application of Lessons Learned to the Eastern Caribbean

    PubMed Central

    Vogus, Abigail; Graff, Kylie

    2015-01-01

    The US President’s Emergency Plan for AIDS Relief (PEPFAR) has shifted from an emergency response to a sustainable, country-owned response. The process of transition to country ownership is already underway in the Eastern Caribbean; the Office of the US Global AIDS Coordinator (OGAC) has advised the region that PEPFAR funding is being redirected away from the Eastern Caribbean toward Caribbean countries with high disease burden to strengthen services for key populations. This article seeks to highlight and apply lessons learned from other donor transitions to support a successful transition of HIV programs in the Eastern Caribbean. Based on a rapid review of both peer-reviewed and gray literature on donor transitions to country ownership in family planning, HIV, and other areas, we identified 48 resources that addressed key steps in the transition process and determinants of readiness for transition. Analysis of the existing literature revealed 6 steps that could help ensure successful transition, including developing a clear roadmap articulated through high-level diplomacy; investing in extensive stakeholder engagement; and supporting monitoring and evaluation during and after the transition to adjust course as needed. Nine specific areas to assess a country’s readiness for transition include: leadership and management capacity, political and economic factors, the policy environment, identification of alternative funding sources, integration of HIV programs into the wider health system, the institutionalization of processes, the strength of procurement and supply chain management, identification of staffing and training needs, and engagement of civil society and the private sector. In the Caribbean, key areas requiring strengthening to ensure countries in the region can maintain the gains made under PEPFAR include further engaging civil society and the private sector, building the capacity of NGOs to take on essential program functions, and maintaining donor

  6. African Braille Production: A Statistical Review and Evaluation of Countries and Costs.

    ERIC Educational Resources Information Center

    Mayer, Marc; Cylke, Frank Kurt

    A study was conducted in 52 African countries to determine the extent of braille facilities for the blind, with the aim of choosing a location for a central braille producing facility. To make the selection, the factors of ease of communication (i.e., central location), political stability, and extent of already existing organizations for the…

  7. A review of acute and chronic peritoneal dialysis in developing countries

    PubMed Central

    Abraham, Georgi; Varughese, Santosh; Mathew, Milly; Vijayan, Madhusudan

    2015-01-01

    Various modalities of renal replacement therapy (RRT) are available for the management of acute kidney injury (AKI) and end-stage renal disease (ESRD). While developed countries mainly use hemodialysis as a form of RRT, peritoneal dialysis (PD) has been increasingly utilized in developing countries. Chronic PD offers various benefits including lower cost, home-based therapy, single access, less requirement of highly trained personnel and major infrastructure, higher number of patients under a single nephrologist with probably improved quality of life and freedom of activities. PD has been found to be lifesaving in the management of AKI in patients in developing countries where facilities for other forms of RRT are not readily available. The International Society of Peritoneal Dialysis has published guidelines regarding the use of PD in AKI, which has helped in ensuring uniformity. PD has also been successfully used in certain special situations of AKI due to snake bite, malaria, febrile illness, following cardiac surgery and in poisoning. Hemodialysis is the most common form of RRT used in ESRD worldwide, but some countries have begun to adopt a ‘PD first’ policy to reduce healthcare costs of RRT and ensure that it reaches the underserved population. PMID:26034593

  8. Strategy for Improved Nutrition of Children and Women in Developing Countries. A UNICEF Policy Review.

    ERIC Educational Resources Information Center

    United Nations Children's Fund, New York, NY.

    This United Nations Children's Fund (UNICEF) report proposes a strategy for reducing, and ultimately eliminating, malnutrition in developing countries. It proposes a methodology for the identification of appropriate actions in a given context through situation assessment and analysis, rather than through a predetermined set of technical…

  9. Schooling Options for Muslim Children Living in Muslim-Minority Countries--A Thematic Literature Review

    ERIC Educational Resources Information Center

    Musharraf, Muhammad Nabeel; Nabeel, Fatima Bushra

    2015-01-01

    Islamic education of children is a common problem faced by Muslims living in western, European and other developed countries as minority. It can be due to a number of factors such as unavailability of Islamic schools at a particular location, lack of enough number of students to warrant opening a full-fledged Islamic school, curriculum legislated…

  10. Early Childhood, Major Challenges: Review of Early Childhood Education and Care Policies in OECD Countries

    ERIC Educational Resources Information Center

    Bennett, John; Neuman, Michelle J.

    2004-01-01

    This article presents the most recent results of a comparative review of early childhood education and care carried out by the Organization for Economic Co-operation and Development (OECD). Founded in 1961 and based in Paris, OECD is one of the world's most important sources of statistical, economic, and social data. Based on reviews in the…

  11. Epidemiology of end-stage renal disease in the countries of the Gulf Cooperation Council: a systematic review

    PubMed Central

    Hassanien, Amal A.; Al-Shaikh, Fahdah; Vamos, Eszter P.; Yadegarfar, Ghasem; Majeed, Azeem

    2012-01-01

    Objectives To describe the epidemiology of end stage renal disease (ESRD). Design Mixed-methods systematic review. Setting The countries of the Gulf Cooperation Council (GCC) which consist of Saudi Arabia, the United Arab Emirates, Kuwait, Qatar, Bahrain, and Oman. Participants Defined to have ESRD or patients on regular dialysis for a minimum dialysis period of at least three months. Since many outcomes were reviewed, studies that estimated the incidence and prevalence of ESRD as outcomes should not have defined the study population as ESRD population or patients on regular dialysis. Studies where the study population mainly comprised children or pregnant woman were excluded. Main outcome measures The trends of the incidence, prevalence, and mortality rate of ESRD; also, causes of mortality, primary causes and co-morbid conditions associated with ESRD. Results 44 studies included in this review show that the incidence of ESRD has increased while the prevalence and mortality rate of ESRD in the GCC has not been reported sufficiently. The leading primary causes of ESRD recorded in the countries of the GCC is diabetes with the most prevalent co-morbid conditions being Hypertension and Hepatitis C Virus infection; the most common cause of death was cardiovascular disease and sepsis. Conclusions This review highlights that the lack of national renal registries data is a critical issue in the countries of the GCC. The available data also do not provide an accurate and updated estimate for relevant outcomes. Additionally, considering the increasing burden of chronic kidney disease (CKD), these results stressed the needs and the importance of preventative strategies for leading causes of ESRD. Furthermore, more studies are needed to describe the epidemiology of ESRD and for assessing the overall quality of renal care. PMID:22768372

  12. Hospitals in rural or remote areas: An exploratory review of policies in 8 high-income countries.

    PubMed

    Rechel, Bernd; Džakula, Aleksandar; Duran, Antonio; Fattore, Giovanni; Edwards, Nigel; Grignon, Michel; Haas, Marion; Habicht, Triin; Marchildon, Gregory P; Moreno, Antonio; Ricciardi, Walter; Vaughan, Louella; Smith, Tina Anderson

    2016-07-01

    Our study reviewed policies in 8 high-income countries (Australia, Canada, United States, Italy, Spain, United Kingdom, Croatia and Estonia) in Europe, Australasia and North America with regard to hospitals in rural or remote areas. We explored whether any specific policies on hospitals in rural or remote areas are in place, and, if not, how countries made sure that the population in remote or rural areas has access to acute inpatient services. We found that only one of the eight countries (Italy) had drawn up a national policy on hospitals in rural or remote areas. In the United States, although there is no singular comprehensive national plan or vision, federal levers have been used to promote access in rural or remote areas and provide context for state and local policy decisions. In Australia and Canada, intermittent policies have been developed at the sub-national level of states and provinces respectively. In those countries where access to hospital services in rural or remote areas is a concern, common challenges can be identified, including the financial sustainability of services, the importance of medical education and telemedicine and the provision of quick transport to more specialized services. PMID:27312144

  13. Quality of Reporting of Randomised Controlled Trials of Herbal Interventions in ASEAN Plus Six Countries: A Systematic Review

    PubMed Central

    Pratoomsoot, Chayanin; Sruamsiri, Rosarin; Dilokthornsakul, Piyameth; Chaiyakunapruk, Nathorn

    2015-01-01

    Background Many randomised controlled trials (RCTs) of herbal interventions have been conducted in the ASEAN Communities. Good quality reporting of RCTs is essential for assessing clinical significance. Given the importance ASEAN placed on herbal medicines, the reporting quality of RCTs of herbal interventions among the ASEAN Communities deserved a special attention. Objectives To systematically review the quality of reporting of RCTs of herbal interventions conducted in the ASEAN Plus Six Countries. Methods Searches were performed using PubMed, EMBASE, The Cochrane Library, and Allied and Complementary Medicine (AMED), from inception through October 2013. These were limited to studies specific to humans and RCTs. Herbal species search terms were based on those listed in the National List of Essential Medicines [NLEM (Thailand, 2011)]. Studies conducted in the ASEAN Plus Six Countries, published in English were included. Results Seventy-one articles were identified. Thirty (42.25%) RCTs were from ASEAN Countries, whereas 41 RCTs (57.75%) were from Plus Six Group. Adherence to the recommended CONSORT checklist items for reporting of RCTs of herbal interventions among ASEAN Plus Six Countries ranged from 0% to 97.18%. Less than a quarter of the RCTs (18.31%) reported information on standardisation of the herbal products. However, the scope of our interventions of interest was limited to those developed from 20 herbal species listed in the NLEM of Thailand. Conclusions The present study highlights the need to improve reporting quality of RCTs of herbal interventions across ASEAN Plus Six Communities. PMID:25633206

  14. A review of health system infection control measures in developing countries: what can be learned to reduce maternal mortality

    PubMed Central

    2011-01-01

    A functional health system is a necessary part of efforts to achieve maternal mortality reduction in developing countries. Puerperal sepsis is an infection contracted during childbirth and one of the commonest causes of maternal mortality in developing countries, despite the discovery of antibiotics over eighty years ago. Infections can be contracted during childbirth either in the community or in health facilities. Some developing countries have recently experienced increased use of health facilities for labour and delivery care and there is a possibility that this trend could lead to rising rates of puerperal sepsis. Drug and technological developments need to be combined with effective health system interventions to reduce infections, including puerperal sepsis. This article reviews health system infection control measures pertinent to labour and delivery units in developing country health facilities. Organisational improvements, training, surveillance and continuous quality improvement initiatives, used alone or in combination have been shown to decrease infection rates in some clinical settings. There is limited evidence available on effective infection control measures during labour and delivery and from low resource settings. A health systems approach is necessary to reduce maternal mortality and the occurrence of infections resulting from childbirth. Organisational and behavioural change underpins the success of infection control interventions. A global, targeted initiative could raise awareness of the need for improved infection control measures during childbirth. PMID:21595872

  15. Young people of Chinese origin in western countries: a systematic review of their sexual attitudes and behaviour.

    PubMed

    Yu, Juping

    2010-03-01

    People of Chinese origin are a growing population group in western countries. The community is seen to be marginalised, under-researched and neglected, in fact the least understood ethnic minority. This paper reports on a systematic review of sexual attitudes and behaviour among ethnic Chinese young people (mainly aged 13-25 years) living in western countries. An extensive literature search was conducted to cover the period of 1989 and 2009 using Medline, CINAHL, PsycINFO and ScienceDirect databases. There has been a dearth of literature in this area. However, results from existing literature show that ethnic Chinese youth reported poorer sexual health knowledge than white young people in their host countries, while they were found to be more likely to disapprove of uncommitted sex, be virgins, lose their virginity at a later age and have fewer sexual partners. Factors associated with their sexual attitudes and behaviour have also been identified. Countries like the United Kingdom, United States and Canada have become multicultural societies with many diverse ethnic groups. Without doubt educators and sexual health professionals need to provide sex education and services which should be culturally appropriate to people from diverse ethnic backgrounds. An understanding of their sexual values, sexual behaviour and associated factors is the first step towards achieving this goal. PMID:20459527

  16. Underutilization of cervical cancer prevention services in low and middle income countries: a review of contributing factors

    PubMed Central

    Chidyaonga-Maseko, Fresier; Chirwa, Maureen Leah; Muula, Adamson Sinjani

    2015-01-01

    This review aims at identifying barriers to utilization of cervical cancer prevention services in low- and middle-income countries. An electronic search was conducted using the following key words, HPV vaccination, screening, barriers, utilization and low and middle income/developed countries. Using the Garrard (1999) Matrix method approach, a modified matrix was designed and used as a data collection tool and data related to each category listed on the tool were entered into a matrix containing columns reflecting the categories. Constant comparative analysis was used to identify thematic categories. 31 articles published between 2001 and 2014 were yielded from the search. Analysis of the contents of the articles showed that the underutilization of cervical cancer screening services in low and middle-income countries is the result of barriers in accessing and utilizing of the prevention services. Though not mutually exclusive, the barriers were categorized in three categories; individual, community and health system related. Individual barriers include lack of awareness and knowledge about risk factors and prevention of cervical cancer. Age, marital status, diffidence, social economic status, cultural and religious belief of the women also determine the women's' willingness to utilize the services. In some communities there is stigma attached to discussing reproductive health issues and this limits the young women's awareness of cervical cancer and its prevention. Understanding individual, community and health system barriers that hinder women's utilization of cervical cancer prevention services is very crucial in designing effective cervical cancer control programs in low- and middle-income countries. PMID:26523173

  17. Female Genital Mutilation: A Literature Review of the Current Status of Legislation and Policies in 27 African Countries and Yemen.

    PubMed

    Muthumbi, Jane; Svanemyr, Joar; Scolaro, Elisa; Temmerman, Marleen; Say, Lale

    2015-09-01

    This article discusses the results of a literature review that has assessed the impact of Female Genital Mutilation (FGM) legislation in 28 countries (27 in Africa and Yemen) where FGM is concentrated. Evidence on the impact of FGM legislation was available on prevalence of FGM; changes in societal attitudes and perceptions of FGM; knowledge and awareness of FGM legislation and consequences, and the impact on medicalization. While the majority of countries have adopted legal frameworks prohibiting FGM, these measures have been ineffective in preventing and/or in accelerating the abandonment of the practice. Anti-FGM laws have had an impact on prevalence in only two countries where strict enforcement of legal measures has been complemented by robust monitoring, coupled with robust advocacy efforts in communities. Owing to poor enforcement and lax penalties, legal measures have had a limited impact on medicalization. Similarly, legal frameworks have had a limited impact on societal attitudes and perceptions of FGM, with evidence suggesting rigid enforcement of FGM laws has in some instances been counterproductive. Although evidence suggests legislation has not influenced the decline in FGM in the majority of countries, legal frameworks are nevertheless key components of a comprehensive response to the elimination and abandonment of the practice, and need to be complemented by measures that address the underlying socio-cultural norms that are the root of this practice. PMID:26897911

  18. Health information technology in primary health care in developing countries: a literature review.

    PubMed Central

    Tomasi, Elaine; Facchini, Luiz Augusto; Maia, Maria de Fatima Santos

    2004-01-01

    This paper explores the debate and initiatives concerning the use of information technology (IT) in primary health care in developing countries. The literature from 1992-2002 was identified from searches of the MEDLINE, Latin American and Caribbean Health Science Literature Database (LILACS), Cochrane Library and Web of Science databases. The search identified 884 references, 350 of which were classified according to the scheme described by the Pan American Health Organization (PAHO). For the analysis of advantages, problems and perspectives of IT applications and systems, 52 articles were selected according to their potential contribution to the primary health-care processes in non-developed countries. These included: 10 on electronic patient registries (EPR), 22 on process and programmatic action evaluation and management systems (PPAEM) and 20 on clinical decision-support systems (CDS). The main advantages, limitations and perspectives are discussed. PMID:15640923

  19. User charges for health services in developing countries: a review of the economic literature.

    PubMed

    McPake, B

    1993-06-01

    Literature suggests that in theory, the efficiency of user charges for health services is related to the level of externality, the price elasticity of demand, the proportion of total costs which are private access costs, and the level of the government budget constraint. Theoretical models predict that price elasticity of demand for health services is likely to be higher for lower income groups and that user charges are therefore unlikely to promote equity, or reduce the discrepancies between the utilisation rates of the rich and poor, 'ceteris paribus'. Empirical evidence tends to confirm the latter prediction but to suggest that user charges in many countries provide the scope for welfare gains for the majority. Unfortunately, this scope is seldom exploited in practice. It is argued that many countries have little choice but to try to exploit the potential for majority gains, but that more emphasis should be placed on ensuring quality improvements than on superficial financial measures of success. PMID:8511628

  20. Review of household solid waste charges for developing countries--A focus on quantity-based charge methods.

    PubMed

    Welivita, Indunee; Wattage, Premachandra; Gunawardena, Prasanthi

    2015-12-01

    Solid waste management has become a major issue in almost all municipalities especially in developing countries across the world. As more waste needs to be collected and disposed of in urban areas, the increased cost cannot be covered by the available funds in developing countries. Managing the Household Solid Waste (HSW) sector is very important as it is the main contributor of the waste that needs to be collected in residential areas. The reduction of the amount of HSW to be disposed of can be achieved by households themselves practising the "4R" activities: reducing, reusing, recycling and recovering. As a policy instrument, the Waste Management Charge (WMC) for HSW has shown much success in encouraging such activities all over the world. Given the already difficult context in which developing countries operate, it is important to careful consider what kind of charging system is implemented. Using available literature, this paper reviews the applicability of available charging methods, from a flat rate method, through to volume-based (bags, cans or tag/sticker) and weight-based charging methods. These charging methods were evaluated on the basis of overall cost, technology need possible other issues. By considering the conditions in developing countries, a 'pre-paid bag based charging method' could be suggested as the most suitable charging method for a WMC in Sri Lanka or other developing countries. The potential applicability of this method was also examined in the context of social, economic and political characteristics. Whilst the use of economic instruments, including WMC, was widely discussed in the literature, the selection of a charging method in the context of developing countries is rarely discussed. Having said that, this paper gives an insight to the policy makers in developing countries upon using pre-paid bag based charging method for HSW sector. It also provides recommendations regarding possible issues in implementing for developing countries

  1. Adherence to Antiretroviral Medications among Persons who Inject Drugs in Transitional, Low and Middle Income Countries: An International Systematic Review

    PubMed Central

    Feelemyer, Jonathan; Jarlais, Don Des; Arasteh, Kamyar; Uuskula, Anneli

    2014-01-01

    Adherence to antiretroviral (ART) medication is vital to reducing morbidity and mortality among HIV positive persons. People who inject drugs (PWID) are at high risk for HIV infection in transitional/low/middle income countries (TLMIC). We conducted a systematic review of studies reporting adherence to ARTs among persons with active injection drug use and/or histories of injection drug use in TLMIC. Meta-regression was performed to examine relationships between location, adherence measurements, and follow-up period. Fifteen studies were included from seven countries. Adherence levels ranged from 33% to 97%; mean weighted adherence was 72%. ART adherence was associated with different methods of measuring adherence and studies conducted in Eastern Europe and East Asia. The great heterogeneity observed precludes generalization to TLMIC as a whole. Given the critical importance of ART adherence more research is needed on ART adherence among PWID in TLMIC, including the use of standardized methods for reporting adherence to ARTs. PMID:25331268

  2. Schizophrenia in women and children: a selective review of literature from developing countries.

    PubMed

    Chandra, Prabha S; Kommu, John Vijay Sagar; Rudhran, Vidyendran

    2012-10-01

    Women and children with psychotic disorders in developing countries may be vulnerable and have considerable social disadvantages. Gender disadvantage has implications for all health outcomes including mental illnesses. In the more relevant gender-related context we discuss several important issues which affect women with schizophrenia, namely stigma, caregiver burden, functional outcome, marriage, victimization and help-seeking. The findings indicate that there are variations in clinical and functional outcomes and age of onset of illness between different regions. Drug side effects, such as metabolic syndrome appear to be quite common, adding to disease burden in women from developing countries. Victimization and coercion may contribute to poor quality of life and health concerns such as STIs and HIV. Stigma among women with schizophrenia appears to play a major role in help-seeking, caregiver burden and issues such as marriage and parenting. Gender-sensitive care and practices are few and not well documented. Research in the area of psychoses in children and adolescents from LAMI countries is sparse and is mainly restricted to a few clinic-based studies. More research is needed on organic and medical factors contributing to childhood psychoses, pathways to care, help-seeking, and impact of early detection and community care. PMID:23057983

  3. Community Engagement to Enhance Child Survival and Early Development in Low- and Middle-Income Countries: An Evidence Review

    PubMed Central

    Farnsworth, S. Katherine; Böse, Kirsten; Fajobi, Olaoluwa; Souza, Patricia Portela; Peniston, Anne; Davidson, Leslie L.; Griffiths, Marcia; Hodgins, Stephen

    2014-01-01

    As part of a broader evidence summit, USAID and UNICEF convened a literature review of effective means to empower communities to achieve behavioral and social changes to accelerate reductions in under-5 mortality and optimize early child development. The authors conducted a systematic review of the effectiveness of community mobilization and participation that led to behavioral change and one or more of the following: child health, survival, and development. The level and nature of community engagement was categorized using two internationally recognized models and only studies where the methods of community participation could be categorized as collaborative or shared leadership were eligible for analysis. The authors identified 34 documents from 18 countries that met the eligibility criteria. Studies with shared leadership typically used a comprehensive community action cycle, whereas studies characterized as collaborative showed clear emphasis on collective action but did not undergo an initial process of community dialogue. The review concluded that programs working collaboratively or achieving shared leadership with a community can lead to behavior change and cost-effective sustained transformation to improve critical health behaviors and reduce poor health outcomes in low- and middle-income countries. Overall, community engagement is an understudied component of improving child outcomes. PMID:25207448

  4. Tobacco Use and Smoking Cessation Practices among Physicians in Developing Countries: A Literature Review (1987–2010)

    PubMed Central

    Abdullah, Abu S.; Stillman, Frances A.; Yang, Li; Luo, Hongye; Zhang, Zhiyong; Samet, Jonathan M.

    2013-01-01

    Physicians have a key role to play in combating tobacco use and reducing the tobacco induced harm to health. However, there is a paucity of information about tobacco-use and cessation among physicians in developing countries. To assess the need for and nature of smoking cessation services among physicians in developing countries, a detailed literature review of studies published in English, between 1987 and 2010 was carried out. The electronic databases Medline and Pub Med were searched for published studies. The findings show that there are regional variations in the current smoking prevalence, quitting intentions, and cessation services among physicians. Smoking prevalence (median) was highest in Central/Eastern Europe (37%), followed by Africa (29%), Central and South America (25%) and Asia (17.5%). There were significant gender differences in smoking prevalence across studies, with higher prevalence among males than females. Smoking at work or in front of patients was commonly practiced by physicians in some countries. Asking about smoking status or advising patients to quit smoking was not common practice among the physicians, especially among smoker physicians. Organized smoking cessation programs for physicians did not exist in all of these regions. This review suggests that while smoking of physicians varies across different developing regions; prevalence rates tend to be higher than among physicians in developed countries. Quitting rates were low among the physicians, and the delivery of advice on quitting smoking was not common across the studies. To promote tobacco control and increase cessation in populations, there is a need to build physicians’ capacity so that they can engage in tobacco use prevention and cessation activities. PMID:24380976

  5. A review of published literature on emergency medicine training programs in low- and middle-income countries

    PubMed Central

    2013-01-01

    Background The objective of this review is to identify and critically evaluate the published literature on emergency medicine (EM) training programs in resource-limited health-care settings in order to provide insight for developing EM training programs in such health systems. Methods A literature search was conducted up to the end of April 2011 using MEDLINE, EMBASE, The Cochrane Library, EBM Reviews, Healthstar and Web of Science databases, using the following search terms: Emergency Medicine, Emergency Medicine Services, Education Training Residency Programs, Emergency Medical Systems and Medical Education, without limitation to income countries as outlined in the World Bank World Trade Indicators classification 2009-2010 (World Trade Indicators Country Classification by Region and Income, July 2009-July 2010). As the intent of the review was to identify and critically evaluate the literature readily available (published) to LMICs developing EM programs, the gray literature was not searched. Results The search yielded 16 articles that met the final inclusion criteria. As the majority of articles provide a narrative description of the processes and building blocks used in developing the residency programs reported, we present our results in narrative format. By providing a summary of the lessons learned to date, we hope to provide a useful starting point for other resource-limited settings interested in establishing emergency medicine specialty training programs and hope to encourage further information exchange on this matter. Conclusions The results of the review indicate that EM training is in its infancy in resource-constrained health-care systems. There are few detailed reports of these programs successes and limitations, including efforts to optimize graduate retention. Despite the paucity of currently published data on the development of EM residency training programs in these settings, this review demonstrates the need for encouraging further information

  6. Eleven new species of Sugiyamaella and Candida from forest habitats

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Eleven new yeast species from forest habitats are described based on nucleotide sequence analysis of the nearly entire large subunit ribosomal DNA, ITS1-5.8S-ITS2 ribosomal DNA, mitochondrial small subunit ribosomal DNA and the cytochrome oxidase II gene. All are members of the Sugiyamaella clade. ...

  7. Topic 101: Eleven Campuses, One University, Many Strikes

    ERIC Educational Resources Information Center

    Navarro-Rivera, Pablo

    2010-01-01

    Students from the University of Puerto Rico (UPR) went on strike in April, and, soon after, 10 of the 11 campuses of a public system with more than 60,000 students were closed. "Once recintos, una universidad" (eleven campuses, one university) was the maxim students used to emphasize the concept of the UPR as a system unified by similar goals,…

  8. High coverage needle/syringe programs for people who inject drugs in low and middle income countries: a systematic review

    PubMed Central

    2013-01-01

    Background Persons who inject drugs (PWID) are at an elevated risk for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection. In many high-income countries, needle and syringe exchange programs (NSP) have been associated with reductions in blood-borne infections. However, we do not have a good understanding of the effectiveness of NSP in low/middle-income and transitional-economy countries. Methods A systematic literature review based on PRISMA guidelines was utilized to collect primary study data on coverage of NSP programs and changes in HIV and HCV infection over time among PWID in low-and middle-income and transitional countries (LMICs). Included studies reported laboratory measures of either HIV or HCV and at least 50% coverage of the local injecting population (through direct use or through secondary exchange). We also included national reports on newly reported HIV cases for countries that had national level data for PWID in conjunction with NSP scale-up and implementation. Results Studies of 11 NSPs with high-coverage from Bangladesh, Brazil, China, Estonia, Iran, Lithuania, Taiwan, Thailand and Vietnam were included in the review. In five studies HIV prevalence decreased (range −3% to −15%) and in three studies HCV prevalence decreased (range −4.2% to −10.2%). In two studies HIV prevalence increased (range +5.6% to +14.8%). HCV incidence remained stable in one study. Of the four national reports of newly reported HIV cases, three reported decreases during NSP expansion, ranging from −30% to −93.3%, while one national report documented an increase in cases (+37.6%). Estimated incidence among new injectors decreased in three studies, with reductions ranging from −11/100 person years at risk to −16/100 person years at risk. Conclusions While not fully consistent, the data generally support the effectiveness of NSP in reducing HIV and HCV infection in low/middle-income and transitional-economy countries. If high coverage is

  9. What makes Health Demand-Side Financing Schemes Work in Low-and Middle-Income Countries? A Realist Review

    PubMed Central

    Gopalan, Saji S.; Das, Ashis; Mutasa, Ronald

    2014-01-01

    This realist review explored causal pathways of the possible consumer effects of health sector demand-side financial (DSF) incentives, their contextual factors and mechanisms in low-and-middle-income countries. We searched six electronic data bases and identified 659 abstracts with different evaluation designs. Based on methodological rigor and content relevance, only 24 studies published up to April 2013 were selected for the final review. A conceptual framework consisting of various program theories on potential context-mechanism-outcome (C-M-O) configuration of DSF initiative was designed, tested and adapted during the review. Synthesized results were presented as a C-M-O configuration for each of the consumer –side effect. DSF was effective to improve health seeking behaviour considerably and health status to some extent. The causal pathway of DSF’s functioning and effectiveness was not linear. Key demand-side contextual factors which affected DSF’s consumer-side effects were background characteristics of the beneficiaries including their socio-cultural beliefs, motivations, and level of health awareness. At the supply-side, service availability status and provider incentives were contextual determinants. The mechanisms which enabled the interaction of contextual influence were consumer and provider accountability and consumer trust on providers. In order to enhance DSF programs’ effectiveness, their design and implementation should carefully consider the potential contextual elements that may influence the causal pathways. Significance for public health This article focuses on a rare topic i.e. Realist Review, which is an emerging concept to explore causal factors behind every intervention that make it effective or ineffective. This manuscript is a first attempt on a Realist Review of health sector demand-side financing (DSF) in a number of low-and middle-income countries. DSF is a widely employed health promotion strategy in many countries to improve

  10. What makes Health Demand-Side Financing Schemes Work in Low-and Middle-Income Countries? A Realist Review.

    PubMed

    Gopalan, Saji S; Das, Ashis; Mutasa, Ronald

    2014-12-01

    This realist review explored causal pathways of the possible consumer effects of health sector demand-side financial (DSF) incentives, their contextual factors and mechanisms in low-and-middle-income countries. We searched six electronic data bases and identified 659 abstracts with different evaluation designs. Based on methodological rigor and content relevance, only 24 studies published up to April 2013 were selected for the final review. A conceptual framework consisting of various program theories on potential context-mechanism-outcome (C-M-O) configuration of DSF initiative was designed, tested and adapted during the review. Synthesized results were presented as a C-M-O configuration for each of the consumer -side effect. DSF was effective to improve health seeking behaviour considerably and health status to some extent. The causal pathway of DSF's functioning and effectiveness was not linear. Key demand-side contextual factors which affected DSF's consumer-side effects were background characteristics of the beneficiaries including their socio-cultural beliefs, motivations, and level of health awareness. At the supply-side, service availability status and provider incentives were contextual determinants. The mechanisms which enabled the interaction of contextual influence were consumer and provider accountability and consumer trust on providers. In order to enhance DSF programs' effectiveness, their design and implementation should carefully consider the potential contextual elements that may influence the causal pathways. Significance for public healthThis article focuses on a rare topic i.e. Realist Review, which is an emerging concept to explore causal factors behind every intervention that make it effective or ineffective. This manuscript is a first attempt on a Realist Review of health sector demand-side financing (DSF) in a number of low-and middle-income countries. DSF is a widely employed health promotion strategy in many countries to improve health

  11. The Impact of Clinical Social Franchising on Health Services in Low- and Middle-Income Countries: A Systematic Review

    PubMed Central

    Beyeler, Naomi; York De La Cruz, Anna; Montagu, Dominic

    2013-01-01

    Background The private sector plays a large role in health services delivery in low- and middle-income countries; yet significant gaps remain in the quality and accessibility of private sector services. Clinical social franchising, which applies the commercial franchising model to achieve social goals and improve health care, is increasingly used in developing countries to respond to these limitations. Despite the growth of this approach, limited evidence documents the effect of social franchising on improving health care quality and access. Objectives and Methods We examined peer-reviewed and grey literature to evaluate the effect of social franchising on health care quality, equity, cost-effectiveness, and health outcomes. We included all studies of clinical social franchise programs located in low- and middle-income countries. We assessed study bias using the WHO-Johns Hopkins Rigour Scale and used narrative synthesis to evaluate the findings. Results Of 113 identified articles, 23 were included in this review; these evaluated a small sample of franchises globally and focused on reproductive health franchises. Results varied widely across outcomes and programs. Social franchising was positively associated with increased client volume and client satisfaction. The findings on health care utilization and health impact were mixed; some studies find that franchises significantly outperform other models of health care, while others show franchises are equivalent to or worse than other private or public clinics. In two areas, cost-effectiveness and equity, social franchises were generally found to have poorer outcomes. Conclusions Our review indicates that social franchising may strengthen some elements of private sector health care. However, gaps in the evidence remain. Additional research should include: further documentation of the effect of social franchising, evaluating the equity and cost-effectiveness of this intervention, and assessing the role of franchising

  12. mHealth adoption in low-resource environments: a review of the use of mobile healthcare in developing countries.

    PubMed

    Chib, Arul; van Velthoven, Michelle Helena; Car, Josip

    2015-01-01

    The acknowledged potential of using mobile phones for improving healthcare in low-resource environments of developing countries has yet to translate into significant mHealth policy investment. The low uptake of mHealth in policy agendas may stem from a lack of evidence of the scalable, sustainable impact on health indicators. The mHealth literature in low- and middle-income countries reveals a burgeoning body of knowledge; yet, existing reviews suggest that the projects yield mixed results. This article adopts a stage-based approach to understand the varied contributions to mHealth research. The heuristic of inputs-mechanism-outputs is proposed as a tool to categorize mHealth studies. This review (63 articles comprising 53 studies) reveals that mHealth studies in developing countries tend to concentrate on specific stages, principally on pilot projects that adopt a deterministic approach to technological inputs (n = 32), namely introduction and implementation. Somewhat less studied were research designs that demonstrate evidence of outputs (n = 15), such as improvements in healthcare processes and public health indicators. The review finds a lack of emphasis on studies that provide theoretical understanding (n = 6) of adoption and appropriation of technological introduction that produces measurable health outcomes. As a result, there is a lack of dominant theory, or measures of outputs relevant to making policy decisions. Future work needs to aim for establishing theoretical and measurement standards, particularly from social scientific perspectives, in collaboration with researchers from the domains of information technology and public health. Priorities should be set for investments and guidance in evaluation disseminated by the scientific community to practitioners and policymakers. PMID:24673171

  13. The terrain of health policy analysis in low and middle income countries: a review of published literature 1994–2007

    PubMed Central

    Gilson, Lucy; Raphaely, Nika

    2008-01-01

    This article provides the first ever review of literature analysing the health policy processes of low and middle income countries (LMICs). Based on a systematic search of published literature using two leading international databases, the article maps the terrain of work published between 1994 and 2007, in terms of policy topics, lines of inquiry and geographical base, as well as critically evaluating its strengths and weaknesses. The overall objective of the review is to provide a platform for the further development of this field of work. From an initial set of several thousand articles, only 391 were identified as relevant to the focus of inquiry. Of these, 164 were selected for detailed review because they present empirical analyses of health policy change processes within LMIC settings. Examination of these articles clearly shows that LMIC health policy analysis is still in its infancy. There are only small numbers of such analyses, whilst the diversity of policy areas, topics and analytical issues that have been addressed across a large number of country settings results in a limited depth of coverage within this body of work. In addition, the majority of articles are largely descriptive in nature, limiting understanding of policy change processes within or across countries. Nonetheless, the broad features of experience that can be identified from these articles clearly confirm the importance of integrating concern for politics, process and power into the study of health policy. By generating understanding of the factors influencing the experience and results of policy change, such analysis can inform action to strengthen future policy development and implementation. This article, finally, outlines five key actions needed to strengthen the field of health policy analysis within LMICs, including capacity development and efforts to generate systematic and coherent bodies of work underpinned by both the intent to undertake rigorous analytical work and concern

  14. 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

  15. Assistive technologies for ageing populations in six low-income and middle-income countries: a systematic review

    PubMed Central

    Marasinghe, Keshini Madara; Lapitan, Jostacio Moreno; Ross, Alex

    2015-01-01

    Despite the benefits derived from the use of assistive technologies (AT), some parts of the world have minimal or no access to AT. In many low-income and middle-income countries (LMIC), only 5–15% of people who require AT have access to them. Rapid demographic changes will exacerbate this situation as populations over 60 years of age, as well as functional limitations among older populations, in LMIC are expected to be higher than in high-income countries in the coming years. Given both these trends, AT are likely to be in high demand and provide many benefits to respond to challenges related to healthy and productive ageing. Multiple databases were searched for English literature. Three groups of keywords were combined: those relating to AT, ageing population and LMIC selected for this study, namely Brazil, Cambodia, Egypt, India, Turkey and Zimbabwe. These countries are expected to see the most rapid growth in the 65 and above population in the coming years. Results indicate that all countries had AT designed for older adults with existing impairment and disability, but had limited AT that are designed to prevent impairment and disability among older adults who do not currently have any disabilities. All countries have ratified the UN Convention on the Rights of Persons with Disabilities. The findings conclude that AT for ageing populations have received some attention in LMIC as attested by the limited literature results. Analysis of review findings indicate the need for a comprehensive, integrated health and social system approach to increase the current availability of AT for ageing populations in LMIC. These would entail, yet not be limited to, work on: (1) promoting initiatives for low-cost AT; (2) awareness raising and capacity building on AT; (3) bridging the gap between AT policy and practice; and (4) fostering targeted research on AT. PMID:26688747

  16. A Review of Drowning Prevention Interventions for Children and Young People in High, Low and Middle Income Countries.

    PubMed

    Leavy, Justine E; Crawford, Gemma; Leaversuch, Francene; Nimmo, Lauren; McCausland, Kahlia; Jancey, Jonine

    2016-04-01

    Globally, drowning is one of the ten leading causes of child mortality. Children aged <5 years are particularly at risk, and children and young people continue to be overrepresented in drowning statistics. Accordingly, evidence informed interventions to prevent children drowning are of global importance. This review aimed to identify, assess and analyse public health interventions to reduce child drowning and investigate the use of behavioural theories and evaluation frameworks to guide child drowning prevention. Thirteen databases were searched for relevant peer reviewed articles. The systematic review was guided by the PRISMA criteria and registered with PROSPERO. Fifteen articles were included in the final review. Studies were delivered in high, middle and low income countries. Intervention designs varied, one-third of studies targeted children under five. Almost half of the studies relied on education and information to reduce drowning deaths, only three studies used a multi-strategy approach. Minimal use of behavioural theories and/or frameworks was found and just one-third of the studies described formative evaluation. This review reveals an over reliance on education and information as a strategy to prevent drowning, despite evidence for comprehensive multi-strategy approaches. Accordingly, interventions must be supported that use a range of strategies, are shaped by theory and planning and evaluation frameworks, and are robust in intervention design, delivery and evaluation methodology. This approach will provide sound evidence that can be disseminated to inform future practice and policy for drowning prevention. PMID:26499822

  17. A review of the natural history of adult Cetoniinae (Coleoptera: Scarabaeidae) from Argentina and adjacent countries.

    PubMed

    Di Iorio, Osvaldo

    2014-01-01

    A compilation of the known natural history of adult Cetoniinae (Coleoptera: Scarabaeidae) from Argentina and adjacent countries is provided. Food items of adult Cetoniinae include pollen and/or nectar (flower visitors), sap and/or slime flux, ripened fruits on plants, green tissues and leaves, and honey. Of the 36 species of Cetoniinae from Argentina, food items are known only for 11 species (30.5%). Attraction to light and bait-traps, adult activity periods, vertebrate predators, and the occurrence in bird nests are presented and discussed. Other insects that share the same food sources and bait-traps with Cetoniinae are mentioned. PMID:24869870

  18. The Epidemiology of Suicide Behaviors among the Countries of the Eastern Mediterranean Region of WHO: a Systematic Review.

    PubMed

    Malakouti, Seyed Kazem; Davoudi, Farnoush; Khalid, Saeed; Ahmadzad Asl, Masoud; Moosa Khan, Murad; Alirezaei, Narges; Mirabzadeh, Arash; DeLeo, Diego

    2015-01-01

    This systematic review aimed to help better to understand the epidemiology of suicidal behaviors among Eastern Mediterranean Region (EMR) countries. The PubMed, EMR medex, Scopus, PsychInfo, ISI, and IMEMR were searched with no language limitation for papers on the epidemiology of suicidal behaviors in the general population, published up to August 2013. A total of 13 articles were reviewed. The incidence (per 100.000) of committed suicide ranged from 0.55 to 5.4. The lifelong prevalence of attempted suicide, suicidal plan and thoughts were 0.72-4.2%, 6.2-6.7%, and 2.9-14.1%, respectively. The figures for suicide are higher than those officially reported. Suicide behaviors' statistics is susceptible to underestimation presumably due to the socio-cultural, religious and legal barriers, not to mention the lack of well-organized registries and methodologically sound community-based surveys. PMID:26024698

  19. Narrative review: tetanus-a health threat after natural disasters in developing countries.

    PubMed

    Afshar, Majid; Raju, Mahesh; Ansell, David; Bleck, Thomas P

    2011-03-01

    Tetanus is an expected complication when disasters strike in developing countries, where tetanus immunization coverage is often low or nonexistent. Collapsing structures and swirling debris inflict numerous crush injuries, fractures, and serious wounds. Clostridium tetani infects wounds contaminated with dirt, feces, or saliva and releases neurotoxins that may cause fatal disease. Clusters of infections have recently occurred after tsunamis and earthquakes in Indonesia, Kashmir, and Haiti. The emergency response to clusters of tetanus infections in developing countries after a natural disaster requires a multidisciplinary approach in the absence of an intensive care unit, readily available resources, and a functioning cold-chain system. It is essential that injured people receive immediate surgical and medical care of contaminated, open wounds with immunization and immunoglobulin therapy. Successful treatment of tetanus depends on prompt diagnosis of clinical tetanus, treatment to ensure neutralization of circulating toxin and elimination of C. tetani infection, control of spasms and convulsions, maintenance of the airway, and management of respiratory failure and autonomic dysfunction. PMID:21357910

  20. Postpartum Depression among Rural Women from Developed and Developing Countries: A Systematic Review

    ERIC Educational Resources Information Center

    Villegas, Laura; McKay, Katherine; Dennis, Cindy-Lee; Ross, Lori E.

    2011-01-01

    Purpose: Postpartum depression (PPD) is a significant public health problem, with significant consequences for the mother, infant, and family. Available research has not adequately examined the potential impact of sociodemographic characteristics, such as place of residence, on risk for PPD. Therefore, this systematic review and meta-analysis…

  1. Who uses sunbeds? A systematic literature review of risk groups in developed countries.

    PubMed

    Schneider, S; Krämer, H

    2010-06-01

    Skin cancer is caused by ultraviolet radiation (UVR). Indoor tanning is a totally avoidable risk behaviour. This review addresses the specific characteristics of sunbed users and the differences in motivation and risk perception compared with non-users. This review is based solely on empirical original articles. Based on literature searches with widely used reference databases ('PubMed', 'OVID', 'Social Citation Index', 'ERIC--Educational Resources Information Center', 'Web of Science' and the 'International Bibliography of the Social Sciences'), we included studies from developed nations with a publication date between 1 January 2000 and 12 August 2008. All studies were selected, classified and coded simultaneously by both authors on a blinded basis. All searches were performed on 13 and 14 August 2008. In accordance with the QUOROM and the MOOSE Statements, we identified 16 original studies. The typical sunbed user is female, between 17 and 30 years old, and tends to live a comparatively unhealthy lifestyle: Users smoke cigarettes and drink alcohol more frequently and eat less healthy food than non-users. Users are characterized by a lack of knowledge about health risks of UVR, and prompted by the frequent use of sunbeds by friends or family members and the experience of positive emotions and relaxation by indoor tanning. This review is the first systematic review on risk groups among sunbed users that has been published in a scientific journal. There is still a lack of information among users, particularly among young people regarding the safety of solariums. PMID:20015180

  2. 76 FR 38747 - Review of New Sources and Modifications in Indian Country

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-07-01

    ... provisions and consideration of the public comments. On August 21, 2006 (71 FR 48696), EPA proposed the... New Source Review (NSR): Aggregation and Project Netting; 74 FR 2376.) Regarding the proposed list of... with higher applicability thresholds (75 FR 31514). For existing major sources, major NSR applies to...

  3. Country tobacco laws and article 11 of the WHO Framework Convention on Tobacco Control: a review of tobacco packaging and labeling regulations of 25 countries

    PubMed Central

    2013-01-01

    Background Urgent, evidence-based tobacco control efforts have been advocated by the WHO through the Framework Convention on Tobacco Control (FCTC) articles and guidelines. The level of implementation of these guidelines varies by country and region. This paper identifies areas of alignment and non-alignment of country tobacco laws with respect to the FCTC’s article 11 requirements, which lists guidelines for regulating tobacco packaging and labeling. Methods Countries from each of the six WHO regions were ranked by number of smokers and 25 countries were selected, representing countries from all WHO regions with the highest number of smokers. A scoring guide based on the FCTC article 11 requirements was created and used to rank country tobacco laws and assess levels of alignment as well as identify common areas of weakness and strength. Results Across the countries examined, laws were generally strong in mandating the display of health warning messages on the front and back of cigarette packs and cartons. However, they were deficient in prohibiting the display of emission yields, and placing warnings at the top of the principal display area, as well as requiring health messages on tobacco’s negative social and economic outcomes. Conclusion Country tobacco packaging and labeling laws can be strengthened by greater compliance with the FCTC article 11 guidelines. PMID:24195752

  4. The Identification of Children with, or at Significant Risk of, Intellectual Disabilities in Low- and Middle-Income Countries: A Review

    ERIC Educational Resources Information Center

    Robertson, Janet; Hatton, Chris; Emerson, Eric; Yasamy, M. Taghi

    2012-01-01

    Background: Developmental monitoring of children is an important strategy for the early detection and management of intellectual disabilities (ID) in high-income countries. This review summarizes the literature on identifying children with ID in low- and middle-income (LAMI) countries. Materials and methods: Electronic literature database searches…

  5. Mobile health use in low- and high-income countries: an overview of the peer-reviewed literature.

    PubMed

    Bastawrous, Andrew; Armstrong, Matthew J

    2013-04-01

    The evolution of mobile phone technology has introduced new possibilities to the field of medicine. Combining technological advances with medical expertise has led to the use of mobile phones in all healthcare areas including diagnostics, telemedicine, research, reference libraries and interventions. This article provides an overview of the peer-reviewed literature, published between 1 August 2006 and 1 August 2011, for the application of mobile/cell phones (from basic text-messaging systems to smartphones) in healthcare in both resource-poor and high-income countries. Smartphone use is paving the way in high-income countries, while basic text-messaging systems of standard mobile phones are proving to be of value in low- and middle-income countries. Ranging from infection outbreak reporting, anti-HIV therapy adherence to gait analysis, resuscitation training and radiological imaging, the current uses and future possibilities of mobile phone technology in healthcare are endless. Multiple mobile phone based applications are available for healthcare workers and healthcare consumers; however, the absolute majority lack an evidence base. Therefore, more rigorous research is required to ensure that healthcare is not flooded with non-evidence based applications and is maximized for patient benefit. PMID:23564897

  6. Mobile health use in low- and high-income countries: an overview of the peer-reviewed literature

    PubMed Central

    Bastawrous, Andrew; Armstrong, Matthew J

    2013-01-01

    The evolution of mobile phone technology has introduced new possibilities to the field of medicine. Combining technological advances with medical expertise has led to the use of mobile phones in all healthcare areas including diagnostics, telemedicine, research, reference libraries and interventions. This article provides an overview of the peer-reviewed literature, published between 1 August 2006 and 1 August 2011, for the application of mobile/cell phones (from basic text-messaging systems to smartphones) in healthcare in both resource-poor and high-income countries. Smartphone use is paving the way in high-income countries, while basic text-messaging systems of standard mobile phones are proving to be of value in low- and middle-income countries. Ranging from infection outbreak reporting, anti-HIV therapy adherence to gait analysis, resuscitation training and radiological imaging, the current uses and future possibilities of mobile phone technology in healthcare are endless. Multiple mobile phone based applications are available for healthcare workers and healthcare consumers; however, the absolute majority lack an evidence base. Therefore, more rigorous research is required to ensure that healthcare is not flooded with non-evidence based applications and is maximized for patient benefit. PMID:23564897

  7. Effectiveness of Peer Education Interventions for HIV Prevention in Developing Countries: A Systematic Review and Meta-Analysis

    PubMed Central

    Medley, Amy; Kennedy, Caitlin; O’Reilly, Kevin; Sweat, Michael

    2014-01-01

    Background Peer education for HIV prevention has been widely implemented in developing countries, yet the effectiveness of this intervention has not been systematically evaluated. Methods We conducted a systematic review and meta-analysis of peer education interventions in developing countries published between January 1990 and November 2006. Standardized methods of searching and data abstraction were utilized. Merged effect sizes were calculated using random effects models. Results Thirty studies were identified. In meta-analysis, peer education interventions were significantly associated with increased HIV knowledge (OR:2.28; 95% CI:1.88, 2.75), reduced equipment sharing among injection drug users (OR:0.37; 95% CI:0.20, 0.67), and increased condom use (OR:1.92; 95% CI:1.59, 2.33). Peer education programs had a non-significant effect on STI infection (OR: 1.22; 95% CI:0.88, 1.71). Conclusions Meta-analysis indicates that peer education programs in developing countries are moderately effective at improving behavioral outcomes, but show no significant impact on biological outcomes. Further research is needed to determine factors that maximize the likelihood of program success. PMID:19519235

  8. 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

  9. Staffing remote rural areas in middle- and low-income countries: A literature review of attraction and retention

    PubMed Central

    Lehmann, Uta; Dieleman, Marjolein; Martineau, Tim

    2008-01-01

    Background Many countries in middle- and low-income countries today suffer from severe staff shortages and/or maldistribution of health personnel which has been aggravated more recently by the disintegration of health systems in low-income countries and by the global policy environment. One of the most damaging effects of severely weakened and under-resourced health systems is the difficulty they face in producing, recruiting, and retaining health professionals, particularly in remote areas. Low wages, poor working conditions, lack of supervision, lack of equipment and infrastructure as well as HIV and AIDS, all contribute to the flight of health care personnel from remote areas. In this global context of accelerating inequities health service policy makers and managers are searching for ways to improve the attraction and retention of staff in remote areas. But the development of appropriate strategies first requires an understanding of the factors which influence decisions to accept and/or stay in a remote post, particularly in the context of mid and low income countries (MLICS), and which strategies to improve attraction and retention are therefore likely to be successful. It is the aim of this review article to explore the links between attraction and retention factors and strategies, with a particular focus on the organisational diversity and location of decision-making. Methods This is a narrative literature review which took an iterative approach to finding relevant literature. It focused on English-language material published between 1997 and 2007. The authors conducted Pubmed searches using a range of different search terms relating to attraction and retention of staff in remote areas. Furthermore, a number of relevant journals as well as unpublished literature were systematically searched. While the initial search included articles from high- middle- and low-income countries, the review focuses on middle- and low-income countries. About 600 papers were

  10. Application of constructed wetlands for wastewater treatment in developing countries--a review of recent developments (2000-2013).

    PubMed

    Zhang, Dong Qing; Jinadasa, K B S N; Gersberg, Richard M; Liu, Yu; Ng, Wun Jern; Tan, Soon Keat

    2014-08-01

    Inadequate access to clean water and sanitation has become one of the most pervasive problems afflicting people throughout the developing world. Replication of centralized water-, energy- and cost-intensive technologies has proved ineffective in resolving the complex water-related problems resulting from rapid urbanization in the developing countries. Instead constructed wetlands (CWs) have emerged and become a viable option for wastewater treatment, and are currently being recognized as attractive alternatives to conventional wastewater treatment methods. The primary objective of this review is to present a comprehensive overview of the diverse range of practice, applications and researches of CW systems for removing various contaminants from wastewater in developing countries, placing them in the overall context of the need for low-cost and sustainable wastewater treatment systems. Emphasis of this review is placed on the treatment performance of various types of CWs including: (i) free water surface flow CW; (ii) subsurface flow CW; (iii) hybrid systems; and, (iv) floating treatment wetland. The impacts of different wetland design and pertinent operational variables (e.g., hydraulic loading rate, vegetation species, physical configurations, and seasonal variation) on contaminant removal in CW systems are also summarized and highlighted. Finally, the cost and land requirements for CW systems are critically evaluated. PMID:24784754

  11. Policies for the Sustainable Development of Biofuels in the Pan American Region: A Review and Synthesis of Five Countries

    NASA Astrophysics Data System (ADS)

    Solomon, Barry D.; Banerjee, Aparajita; Acevedo, Alberto; Halvorsen, Kathleen E.; Eastmond, Amarella

    2015-12-01

    Rapid growth of biofuel production in the United States and Brazil over the past decade has increased interest in replicating this success in other nations of the Pan American region. However, the continued use of food-based feedstock such as maize is widely seen as unsustainable and is in some cases linked to deforestation and increased greenhouse gas emissions, raising further doubts about long-term sustainability. As a result, many nations are exploring the production and use of cellulosic feedstock, though progress has been extremely slow. In this paper, we will review the North-South axis of biofuel production in the Pan American region and its linkage with the agricultural sectors in five countries. Focus will be given to biofuel policy goals, their results to date, and consideration of sustainability criteria and certification of producers. Policy goals, results, and sustainability will be highlighted for the main biofuel policies that have been enacted at the national level. Geographic focus will be given to the two largest producers—the United States and Brazil; two smaller emerging producers—Argentina and Canada; and one stalled program—Mexico. However, several additional countries in the region are either producing or planning to produce biofuels. We will also review alternative international governance schemes for biofuel sustainability that have been recently developed, and whether the biofuel programs are being managed to achieve improved environmental quality and sustainable development.

  12. When do newborns die? A systematic review of timing of overall and cause-specific neonatal deaths in developing countries

    PubMed Central

    Sankar, M J; Natarajan, C K; Das, R R; Agarwal, R; Chandrasekaran, A; Paul, V K

    2016-01-01

    About 99% of neonatal deaths occur in low- and middle-income countries. There is a paucity of information on the exact timing of neonatal deaths in these settings. The objective of this review was to determine the timing of overall and cause-specific neonatal deaths in developing country settings. We searched MEDLINE via PubMed, Cochrane CENTRAL, WHOLIS and CABI using sensitive search strategies. Searches were limited to studies involving humans published in the last 10 years. A total of 22 studies were included in the review. Pooled results indicate that about 62% of the total neonatal deaths occurred during the first 3 days of life; the first day alone accounted for two-thirds. Almost all asphyxia-related and the majority of prematurity- and malformation-related deaths occurred in the first week of life (98%, 83% and 78%, respectively). Only one-half of sepsis-related deaths occurred in the first week while one-quarter occurred in each of the second and third to fourth weeks of life. The distribution of both overall and cause-specific mortality did not differ greatly between Asia and Africa. The first 3 days after birth account for about 30% of under-five child deaths. The first week of life accounts for most of asphyxia-, prematurity- and malformation-related mortality and one-half of sepsis-related deaths. PMID:27109087

  13. Information needs of health care workers in developing countries: a literature review with a focus on Africa

    PubMed Central

    Pakenham-Walsh, Neil; Bukachi, Frederick

    2009-01-01

    Health care workers in developing countries continue to lack access to basic, practical information to enable them to deliver safe, effective care. This paper provides the first phase of a broader literature review of the information and learning needs of health care providers in developing countries. A Medline search revealed 1762 papers, of which 149 were identified as potentially relevant to the review. Thirty-five of these were found to be highly relevant. Eight of the 35 studies looked at information needs as perceived by health workers, patients and family/community members; 14 studies assessed the knowledge of health workers; and 8 looked at health care practice. The studies suggest a gross lack of knowledge about the basics on how to diagnose and manage common diseases, going right across the health workforce and often associated with suboptimal, ineffective and dangerous health care practices. If this level of knowledge and practice is representative, as it appears to be, it indicates that modern medicine, even at a basic level, has largely failed the majority of the world's population. The information and learning needs of family caregivers and primary and district health workers have been ignored for too long. Improving the availability and use of relevant, reliable health care information has enormous potential to radically improve health care worldwide. PMID:19356239

  14. Policies for the Sustainable Development of Biofuels in the Pan American Region: A Review and Synthesis of Five Countries.

    PubMed

    Solomon, Barry D; Banerjee, Aparajita; Acevedo, Alberto; Halvorsen, Kathleen E; Eastmond, Amarella

    2015-12-01

    Rapid growth of biofuel production in the United States and Brazil over the past decade has increased interest in replicating this success in other nations of the Pan American region. However, the continued use of food-based feedstock such as maize is widely seen as unsustainable and is in some cases linked to deforestation and increased greenhouse gas emissions, raising further doubts about long-term sustainability. As a result, many nations are exploring the production and use of cellulosic feedstock, though progress has been extremely slow. In this paper, we will review the North-South axis of biofuel production in the Pan American region and its linkage with the agricultural sectors in five countries. Focus will be given to biofuel policy goals, their results to date, and consideration of sustainability criteria and certification of producers. Policy goals, results, and sustainability will be highlighted for the main biofuel policies that have been enacted at the national level. Geographic focus will be given to the two largest producers-the United States and Brazil; two smaller emerging producers-Argentina and Canada; and one stalled program-Mexico. However, several additional countries in the region are either producing or planning to produce biofuels. We will also review alternative international governance schemes for biofuel sustainability that have been recently developed, and whether the biofuel programs are being managed to achieve improved environmental quality and sustainable development. PMID:25526849

  15. A critical review of control strategies against meningococcal meningitis epidemics in sub-Saharan African countries.

    PubMed

    Chippaux, J P; Debois, H; Saliou, P

    2002-08-01

    The control strategy of meningitis epidemics in sub-Saharan countries, although reexamined regularly, is based on epidemiological, immunological and logistical considerations put forward at the end of the 1970s. It comprises organizing large-scale vaccinations in the event of a declared epidemic. The obvious failure of this strategy recommended by the World Health Organization (WHO) necessitates evaluation of the emergency vaccination criteria. Despite current controversy on the immunogenicity of the polysaccharide vaccine, its safety, effectiveness in the field and low cost could justify the reopening of a debate on its use in routine vaccination. Routine--or preventive--vaccination could significantly reduce the incidence of meningococcal meningitis and its severity. The conjugate vaccine, when available, will constitute an additional advantage in the prevention of meningococcal meningitis. A strategy combining both polysaccharide and conjugate vaccines according to the population targets and possibilities for funding remain to be defined. PMID:12236565

  16. Dynamic Transmission Economic Evaluation of Infectious Disease Interventions in Low- and Middle-Income Countries: A Systematic Literature Review.

    PubMed

    Drake, Tom L; Devine, Angela; Yeung, Shunmay; Day, Nicholas P J; White, Lisa J; Lubell, Yoel

    2016-02-01

    Economic evaluation using dynamic transmission models is important for capturing the indirect effects of infectious disease interventions. We examine the use of these methods in low- and middle-income countries, where infectious diseases constitute a major burden. This review is comprised of two parts: (1) a summary of dynamic transmission economic evaluations across all disease areas published between 2011 and mid-2014 and (2) an in-depth review of mosquito-borne disease studies focusing on health economic methods and reporting. Studies were identified through a systematic search of the MEDLINE database and supplemented by reference list screening. Fifty-seven studies were eligible for inclusion in the all-disease review. The most common subject disease was HIV/AIDS, followed by malaria. A diverse range of modelling methods, outcome metrics and sensitivity analyses were used, indicating little standardisation. Seventeen studies were included in the mosquito-borne disease review. With notable exceptions, most studies did not employ economic evaluation methods beyond calculating a cost-effectiveness ratio or net benefit. Many did not adhere to health care economic evaluations reporting guidelines, particularly with respect to full model reporting and uncertainty analysis. We present a summary of the state-of-the-art and offer recommendations for improved implementation and reporting of health economic methods in this crossover discipline. PMID:26778620

  17. Mental health issues among migrant workers in Gulf Cooperation Council countries: literature review and case illustrations.

    PubMed

    Kronfol, Ziad; Saleh, Marwa; Al-Ghafry, Maha

    2014-08-01

    More than 15 million non-nationals are currently living and working in Gulf Cooperation Council (GCC) states. The majority are blue-collar or domestic workers coming from the Indian Subcontinent or South East Asia. They often work under very harsh conditions. There are reports of a high rate of psychosis and suicide among these people but no reliable data are available. To address this issue we conducted a literature search both in English and in Arabic to review the available articles on the psychological well-being of this population. Very few articles were found. We hereby review the available literature and contribute by presenting several brief vignettes to illustrate the various clinical aspects of this at risk population. We also discuss possible reasons for underreporting and underscore the need for more research in this area. PMID:25042963

  18. Young, male, road traffic victims: a systematic review of the published trauma registry literature from low and middle income countries

    PubMed Central

    Boughton, Oliver; Jones, Gareth G.; Lavy, Christopher B.D.; Grimes, Caris E.

    2015-01-01

    Background: Trauma contributes significantly to the global burden of disease. We analysed published trauma registries to assess the demographics of those most affected in low and middle-income countries (LMICs). Methods: We performed a systematic review of published trauma registry studies according to PRISMA guidelines. We included published full-text articles from trauma registries in low and middle-income countries describing the demographics of trauma registry patients. Articles from military trauma registries, articles using data not principally derived from trauma registry data, articles describing patients of only one demographic (e.g. only paediatric patients), or only one mechanism of injury, trauma registry implementation papers without demographic data, review papers and conference proceedings were excluded. Results: The initial search retrieved 1868 abstracts of which 1324 remained after duplicate removal. After screening the abstracts, 78 full-text articles were scrutinised for their suitability for inclusion. Twenty three papers from 14 countries, including 103,327 patients, were deemed eligible and included for analysis. The median age of trauma victims in these articles was 27 years (IQR 25–29). The median percentage of trauma victims who were male was 75 (IQR 66–84). The median percentage of road traffic injuries (RTIs) as a percentage of total injuries caused by trauma was 46 (IQR 21–71). Conclusions: Young, male, road traffic victims represent a large proportion of the LMIC trauma burden. This information can inform and be used by local and national governments to implement road safety measures and other strategies aimed at reducing the injury rate in young males. PMID:27163066

  19. Economic impacts of health shocks on households in low and middle income countries: a review of the literature.

    PubMed

    Alam, Khurshid; Mahal, Ajay

    2014-01-01

    Poor health is a source of impoverishment among households in low -and middle- income countries (LMICs) and a subject of voluminous literature in recent years. This paper reviews recent empirical literature on measuring the economic impacts of health shocks on households. Key inclusion criteria were studies that explored household level economic outcomes (burden of out-of-pocket (OOP) health spending, labour supply responses and non-medical consumption) of health shocks and sought to correct for the likely endogeneity of health shocks, in addition to studies that measured catastrophic and impoverishment effects of ill health. The review only considered literature in the English language and excluded studies published before 2000 since these have been included in previous reviews. We identified 105 relevant articles, reports, and books. Our review confirmed the major conclusion of earlier reviews based on the pre-2000 literature--that households in LMICs bear a high but variable burden of OOP health expenditure. Households use a range of sources such as income, savings, borrowing, using loans or mortgages, and selling assets and livestock to meet OOP health spending. Health shocks also cause significant reductions in labour supply among households in LMICs, and households (particularly low-income ones) are unable to fully smooth income losses from moderate and severe health shocks. Available evidence rejects the hypothesis of full consumption insurance in the face of major health shocks. Our review suggests additional research on measuring and harmonizing indicators of health shocks and economic outcomes, measuring economic implications of non-communicable diseases for households and analyses based on longitudinal data. Policymakers need to include non-health system interventions, including access to credit and disability insurance in addition to support formal insurance programs to ameliorate the economic impacts of health shocks. PMID:24708831

  20. Economic impacts of health shocks on households in low and middle income countries: a review of the literature

    PubMed Central

    2014-01-01

    Poor health is a source of impoverishment among households in low -and middle- income countries (LMICs) and a subject of voluminous literature in recent years. This paper reviews recent empirical literature on measuring the economic impacts of health shocks on households. Key inclusion criteria were studies that explored household level economic outcomes (burden of out-of-pocket (OOP) health spending, labour supply responses and non-medical consumption) of health shocks and sought to correct for the likely endogeneity of health shocks, in addition to studies that measured catastrophic and impoverishment effects of ill health. The review only considered literature in the English language and excluded studies published before 2000 since these have been included in previous reviews. We identified 105 relevant articles, reports, and books. Our review confirmed the major conclusion of earlier reviews based on the pre-2000 literature - that households in LMICs bear a high but variable burden of OOP health expenditure. Households use a range of sources such as income, savings, borrowing, using loans or mortgages, and selling assets and livestock to meet OOP health spending. Health shocks also cause significant reductions in labour supply among households in LMICs, and households (particularly low-income ones) are unable to fully smooth income losses from moderate and severe health shocks. Available evidence rejects the hypothesis of full consumption insurance in the face of major health shocks. Our review suggests additional research on measuring and harmonizing indicators of health shocks and economic outcomes, measuring economic implications of non-communicable diseases for households and analyses based on longitudinal data. Policymakers need to include non-health system interventions, including access to credit and disability insurance in addition to support formal insurance programs to ameliorate the economic impacts of health shocks. PMID:24708831

  1. The burden of diabetes mellitus during pregnancy in low- and middle-income countries: a systematic review

    PubMed Central

    Kanguru, Lovney; Bezawada, Navya; Hussein, Julia; Bell, Jacqueline

    2014-01-01

    Background Little is known about the burden of diabetes mellitus (DM) in pregnancy in low- and middle-income countries despite high prevalence and mortality rates being observed in these countries. Objective To investigate the prevalence and geographical patterns of DM in pregnancy up to 1 year post-delivery in low- and middle-income countries. Search strategy Medline, Embase, Cochrane (Central), Cinahl and CAB databases were searched with no date restrictions. Selection criteria Articles assessing the prevalence of gestational diabetes mellitus (GDM), and types 1 and 2 DM were sought. Data collection and analysis Articles were independently screened by at least two reviewers. Forest plots were used to present prevalence rates and linear trends calculated by linear regression where appropriate. Main results A total of 45 articles were included. The prevalence of GDM varied. Diagnosis was made by the American Diabetes Association criteria (1.50–15.5%), the Australian Diabetes in Pregnancy Society criteria (20.8%), the Diabetes in Pregnancy Study Group India criteria (13.4%), the European Association for the Study of Diabetes criteria (1.6%), the International Association of Diabetes and Pregnancy Study Groups criteria (8.9–20.4%), the National Diabetes Data Group criteria (0.56–6.30%) and the World Health Organization criteria (0.4–24.3%). Vietnam, India and Cuba had the highest prevalence rates. Types 1 and 2 DM were less often reported. Reports of maternal mortality due to DM were not found. No geographical patterns of the prevalence of GDM could be confirmed but data from Africa is particularly limited. Conclusion Existing published data are insufficient to build a clear picture of the burden and distribution of DM in pregnancy in low- and middle-income countries. Consensus on a common diagnostic criterion for GDM is needed. Type 1 and 2 DM in pregnancy and postpartum DM are other neglected areas. PMID:24990684

  2. Impact of Pneumococcal Conjugate Vaccine Administration in Pediatric Older Age Groups in Low and Middle Income Countries: A Systematic Review

    PubMed Central

    Bonner, Kimberly; Welch, Emily; Elder, Kate; Cohn, Jennifer

    2015-01-01

    Introduction Pneumococcal conjugate vaccine (PCV) is included in the World Health Organization’s routine immunization schedule and is recommended by WHO for vaccination in high-risk children up to 60 months. However, many countries do not recommend vaccination in older age groups, nor have donors committed to supporting extended age group vaccination. To better inform decision-making, this systematic review examines the direct impact of extended age group vaccination in children over 12 months in low and middle income countries. Methods An a priori protocol was used. Using pre-specified terms, a search was conducted using PubMed, LILACS, Cochrane Infectious Diseases Group Specialized Register, Cochrane Central Register of Controlled Trials, CAB Abstracts, clinicaltrials.gov and the International Symposium on Pneumococci and Pneumococcal Diseases abstracts. The primary outcome was disease incidence, with antibody titers and nasopharyngeal carriage included as secondary outcomes. Results Eighteen studies reported on disease incidence, immune response, and nasopharyngeal carriage. PCV administered after 12 months of age led to significant declines in invasive pneumococcal disease. Immune response to vaccine type serotypes was significantly higher for those vaccinated at older ages than the unimmunized at the established 0.2ug/ml and 0.35ug/ml thresholds. Vaccination administered after one year of age significantly reduced VT carriage with odds ratios ranging from 0.213 to 0.69 over four years. A GRADE analysis indicated that the studies were of high quality. Discussion PCV administration in children over 12 months leads to significant protection. The direct impact of PCV administration, coupled with the large cohort of children missed in first year vaccination, indicates that countries should initiate or expand PCV immunization for extended age group vaccinations. Donors should support implementation of PCV as part of delayed or interrupted immunization for older

  3. Breastfeeding patterns and exposure to suboptimal breastfeeding among children in developing countries: review and analysis of nationally representative surveys

    PubMed Central

    Lauer, Jeremy A; Betrán, Ana Pilar; Victora, Cesar G; de Onís, Mercedes; Barros, Aluísio JD

    2004-01-01

    Background Suboptimal breastfeeding is associated with higher mortality among infants and young children in the developing world. We describe patterns in 'exclusive breastfeeding' and 'any breastfeeding' rates and quantify exposure to suboptimal breastfeeding among children aged two years or younger in developing countries. Methods We reviewed nationally representative surveys that collected data on breastfeeding rates in 94 developing countries. Surveys were categorized by completeness and comprehensiveness of data. Complete and comprehensive data were analysed with minimum chi-square regression. With a fitting procedure, estimated parameters were used to impute missing observations for incomplete or non-comprehensive surveys. Breastfeeding indicators were calculated and are reported for 135 developing countries by UN region. Results Amongst infants aged six months or younger in the developing world, the prevalence of exclusive breastfeeding is 39% and the prevalence of no breastfeeding is 5.6%. The prevalence of continued breastfeeding is 86% and 68% for infants and children aged 6–11 and 12–23 months, respectively, in the developing world. Imputation expands population coverage of indicators, especially for infants. Breastfeeding trends are highly linear and estimated parameters defining the age-specific attrition hazard are robust. Survey-reported rates, particularly for exclusive breastfeeding, appear to have systematic upward bias, and exposure estimates must be considered conservative. Conclusions Compliance with breastfeeding recommendations in developing countries is low, and more attention should be given to increasing breastfeeding – especially exclusive breastfeeding – and to monitoring trends. Although the introduction of more standardized and better validated survey instruments is desirable, since data coverage, completeness and comprehensiveness are extensive, global exposure assessment is relatively robust. Moreover, the regularity of

  4. Comparative Performance of Private and Public Healthcare Systems in Low- and Middle-Income Countries: A Systematic Review

    PubMed Central

    Basu, Sanjay; Andrews, Jason; Kishore, Sandeep; Panjabi, Rajesh; Stuckler, David

    2012-01-01

    Introduction Private sector healthcare delivery in low- and middle-income countries is sometimes argued to be more efficient, accountable, and sustainable than public sector delivery. Conversely, the public sector is often regarded as providing more equitable and evidence-based care. We performed a systematic review of research studies investigating the performance of private and public sector delivery in low- and middle-income countries. Methods and Findings Peer-reviewed studies including case studies, meta-analyses, reviews, and case-control analyses, as well as reports published by non-governmental organizations and international agencies, were systematically collected through large database searches, filtered through methodological inclusion criteria, and organized into six World Health Organization health system themes: accessibility and responsiveness; quality; outcomes; accountability, transparency, and regulation; fairness and equity; and efficiency. Of 1,178 potentially relevant unique citations, data were obtained from 102 articles describing studies conducted in low- and middle-income countries. Comparative cohort and cross-sectional studies suggested that providers in the private sector more frequently violated medical standards of practice and had poorer patient outcomes, but had greater reported timeliness and hospitality to patients. Reported efficiency tended to be lower in the private than in the public sector, resulting in part from perverse incentives for unnecessary testing and treatment. Public sector services experienced more limited availability of equipment, medications, and trained healthcare workers. When the definition of “private sector” included unlicensed and uncertified providers such as drug shop owners, most patients appeared to access care in the private sector; however, when unlicensed healthcare providers were excluded from the analysis, the majority of people accessed public sector care. “Competitive dynamics” for

  5. Review of Electronic Decision-Support Tools for Diabetes Care: A Viable Option for Low- and Middle-Income Countries?

    PubMed Central

    Ali, Mohammed K; Shah, Seema; Tandon, Nikhil

    2011-01-01

    Context: Diabetes care is complex, requiring motivated patients, providers, and systems that enable guideline-based preventative care processes, intensive risk-factor control, and positive lifestyle choices. However, care delivery in low- and middle-income countries (LMIC) is hindered by a compendium of systemic and personal factors. While electronic medical records (EMR) and computerized clinical decision-support systems (CDSS) have held great promise as interventions that will overcome system-level challenges to improving evidence-based health care delivery, evaluation of these quality improvement interventions for diabetes care in LMICs is lacking. Objective and Data Sources: We reviewed the published medical literature (systematic search of MEDLINE database supplemented by manual searches) to assess the quantifiable and qualitative impacts of combined EMR–CDSS tools on physician performance and patient outcomes and their applicability in LMICs. Study Selection and Data Extraction: Inclusion criteria prespecified the population (type 1 or 2 diabetes patients), intervention (clinical EMR–CDSS tools with enhanced functionalities), and outcomes (any process, self-care, or patient-level data) of interest. Case, review, or methods reports and studies focused on nondiabetes, nonclinical, or in-patient uses of EMR–CDSS were excluded. Quantitative and qualitative data were extracted from studies by separate single reviewers, respectively, and relevant data were synthesized. Results: Thirty-three studies met inclusion criteria, originating exclusively from high-income country settings. Among predominantly experimental study designs, process improvements were consistently observed along with small, variable improvements in risk-factor control, compared with baseline and/or control groups (where applicable). Intervention benefits varied by baseline patient characteristics, features of the EMR–CDSS interventions, motivation and access to technology among patients

  6. Dietary management of childhood diarrhea in low- and middle-income countries: a systematic review

    PubMed Central

    2013-01-01

    Background Current WHO guidelines on the management and treatment of diarrhea in children strongly recommend continued feeding alongside the administration of oral rehydration solution and zinc therapy, but there remains some debate regarding the optimal diet or dietary ingredients for feeding children with diarrhea. Methods We conducted a systematic search for all published randomized controlled trials evaluating food-based interventions among children under five years old with diarrhea in low- and middle-income countries. We classified 29 eligible studies into one or more comparisons: reduced versus regular lactose liquid feeds, lactose-free versus lactose-containing liquid feeds, lactose-free liquid feeds versus lactose-containing mixed diets, and commercial/specialized ingredients versus home-available ingredients. We used all available outcome data to conduct random-effects meta-analyses to estimate the average effect of each intervention on diarrhea duration, stool output, weight gain and treatment failure risk for studies on acute and persistent diarrhea separately. Results Evidence of low-to-moderate quality suggests that among children with acute diarrhea, diluting or fermenting lactose-containing liquid feeds does not affect any outcome when compared with an ordinary lactose-containing liquid feeds. In contrast, moderate quality evidence suggests that lactose-free liquid feeds reduce duration and the risk of treatment failure compared to lactose-containing liquid feeds in acute diarrhea. Only limited evidence of low quality was available to assess either of these two approaches in persistent diarrhea, or to assess lactose-free liquid feeds compared to lactose-containing mixed diets in either acute or persistent diarrhea. For commercially prepared or specialized ingredients compared to home-available ingredients, we found low-to-moderate quality evidence of no effect on any outcome in either acute or persistent diarrhea, though when we restricted these

  7. Impact of high ambient temperature on unintentional injuries in high-income countries: a narrative systematic literature review

    PubMed Central

    Otte im Kampe, Eveline; Kovats, Sari; Hajat, Shakoor

    2016-01-01

    Objectives Given the likelihood of increased hot weather due to climate change, it is crucial to have prevention measures in place to reduce the health burden of high temperatures and heat waves. The aim of this review is to summarise and evaluate the evidence on the effects of summertime weather on unintentional injuries in high-income countries. Design 3 databases (Global Public Health, EMBASE and MEDLINE) were searched by using related keywords and their truncations in the title and abstract, and reference lists of key studies were scanned. Studies reporting heatstroke and intentional injuries were excluded. Results 13 studies met our inclusion criteria. 11 out of 13 studies showed that the risk of unintentional injuries increases with increasing ambient temperatures. On days with moderate temperatures, the increased risk varied between 0.4% and 5.3% for each 1°C increase in ambient temperature. On extreme temperature days, the risk of injuries decreased. 2 out of 3 studies on occupational accidents found an increase in work-related accidents during high temperatures. For trauma hospital admissions, 6 studies reported an increase during hot weather, whereas 1 study found no association. The evidence for impacts on injuries by subgroups such as children, the elderly and drug users was limited and inconsistent. Conclusions The present review describes a broader range of types of unintentional fatal and non-fatal injuries (occupational, trauma hospital admissions, traffic, fire entrapments, poisoning and drug overdose) than has previously been reported. Our review confirms that hot weather can increase the risk of unintentional injuries and accidents in high-income countries. The results are useful for injury prevention strategies. PMID:26868947

  8. A Political Review of International Literacy Meetings in Industrialized Countries, 1981-1994

    NASA Astrophysics Data System (ADS)

    Hautecoeur, Jean-Paul

    1997-03-01

    The author presents a historical survey of the official discourse on functional literacy in the industrialized countries on the basis of the reports of 20 seminars and international conferences linked to UNESCO. The article has two objectives: (1) to document and interpret globally the political evolution of the literacy movement in the north - in fact limited to western Europe and north America; (2) within the context of the Fifth International Conference on Adult Education, to pose the question: to what extent are the same issues involved throughout the world under the rubric of literacy? The author goes on to underline the broad geopolitical tendencies of the literacy movement, sketching its symbolic features and the tensions and areas of consensus within it. He traces the evolution of its dominant symbology and the ideological positions of its key figures. He concludes with a typology of the principal political tendencies of this movement, while making it clear that the real objectives of fighting poverty and exclusion are pursued outside the literacy movement and within the "minor literacies" of everyday life.

  9. Comparison of Eleven Heavy Metals in Moringa Oleifera Lam. Products.

    PubMed

    Limmatvapirat, C; Limmatvapirat, S; Charoenteeraboon, J; Wessapan, C; Kumsum, A; Jenwithayaamornwech, S; Luangthuwapranit, P

    2015-01-01

    Eleven heavy metals in various products of Moringa oleifera were analyzed to determine eleven heavy metals (Al, As, Cd, Cr, Cu, Fe, Pb, Mn, Hg, Ni, and Zn) using Inductively Coupled Plasma-Mass Spectrometry. The products of M. oleifera were purchased in Nakhon Pathom, Thailand. All products were digested with nitric acid solution before determining the concentrations of heavy metals. The recoveries of all heavy metals were found to be in the range of 99.89-103.05%. Several criteria such as linearity, limits of detection, limits of quantification, specificity, precision under repeatability conditions and intermediate precision reproducibility were evaluated. Results indicate that this method could be used in the laboratory for determination of eleven heavy metals in M. oleifera products with acceptable analytical performance. The results of analysis showed that the highest concentrations of As, Cr, Hg, and Mn were found in tea leaves while the highest concentrations of Al, Cd, Cu, Fe, Ni, Pb, and Zn were found in leaf capsules. Continuous monitoring of heavy metals in M. oleifera products is crucial for consumer health. PMID:26664066

  10. Comparison of Eleven Heavy Metals in Moringa Oleifera Lam. Products

    PubMed Central

    Limmatvapirat, C.; Limmatvapirat, S.; Charoenteeraboon, J.; Wessapan, C.; Kumsum, A.; Jenwithayaamornwech, S.; Luangthuwapranit, P.

    2015-01-01

    Eleven heavy metals in various products of Moringa oleifera were analyzed to determine eleven heavy metals (Al, As, Cd, Cr, Cu, Fe, Pb, Mn, Hg, Ni, and Zn) using Inductively Coupled Plasma-Mass Spectrometry. The products of M. oleifera were purchased in Nakhon Pathom, Thailand. All products were digested with nitric acid solution before determining the concentrations of heavy metals. The recoveries of all heavy metals were found to be in the range of 99.89-103.05%. Several criteria such as linearity, limits of detection, limits of quantification, specificity, precision under repeatability conditions and intermediate precision reproducibility were evaluated. Results indicate that this method could be used in the laboratory for determination of eleven heavy metals in M. oleifera products with acceptable analytical performance. The results of analysis showed that the highest concentrations of As, Cr, Hg, and Mn were found in tea leaves while the highest concentrations of Al, Cd, Cu, Fe, Ni, Pb, and Zn were found in leaf capsules. Continuous monitoring of heavy metals in M. oleifera products is crucial for consumer health. PMID:26664066